Three-dimensional sonography in the exploration of voiding dysfunction in retroverted impacted adenomyosis: A case report

Pu Tsui Wang, Jenn Ming Yang

Research output: Contribution to journalArticle

Abstract

Objective: Retroverted impacted adenomyosis may cause progressive lower urinary bladder compression, resulting in bladder outflow obstruction and lower urinary tract symptoms. We report a case of a huge impacted adenomyosis in which the pathogenesis of bladder outflow obstruction was explored using three-dimensional sonography and was clearly shown to be different from that of pelvic-organ prolapse. The pathogenesis of urinary retention is described and discussed. Case Report: A 43-year-old patient was admitted for acute urinary retention and a huge impacted retroverted uterus with adenomyosis. Sonographic study revealed that the lower urinary bladder was compressed by the cervix, which was upwardly and forwardly displaced. Three-dimensional sonography more clearly identified the bladder neck and adjacent tissue. Conclusion: Sonography is helpful in exploring the anatomic nature of bladder outflow obstruction resulting from retroverted impacted adenomyosis. In this case, the urethra was neither distorted nor compressed, quite different from cases with pelvic organ prolapse. These two types of bladder outflow obstruction are not distinguishable using traditional urodynamic study. Three-dimensional sonography is more helpful in identification of the compressed reshaped lower urinary bladder and its adjacent anatomic structures, even without urine in the low bladder cavity as contrast.

Original languageEnglish
Pages (from-to)69-71
Number of pages3
JournalTaiwanese Journal of Obstetrics and Gynecology
Volume44
Issue number1
Publication statusPublished - Mar 2005
Externally publishedYes

Keywords

  • Adenomyosis
  • Outflow obstruction
  • Three-dimensional sonography

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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