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Practice exam 6: Answers
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
This patient should be treated with kindness and sympathy and in a non-judgemental way (1). I would explain that FGM may cause problems at delivery and offer to gently inspect and assess the extent of her FGM (1). If the urinary meatus is visible and if two fingers can be inserted into the vagina without discomfort, the mutilation is unlikely to cause major problems at delivery. Digital assessment is not always needed, as physical appearance may provide the reassurance required (1). I would advise the patient about the importance of good nutrition, as some women with FGM try to limit the size of the baby by cutting down on food, hoping that a smaller baby will result in an easier birth (1). I would explain that she is more likely to develop urinary tract and vaginal infections and arrange regular urine testing (1). I would offer defibulation before 20 weeks’ gestation (1). [This ensures the scar is fully healed before labour, and the introitus is adequate for vaginal examination and prevents excessive blood loss at delivery. It also permits application of a fetal scalp electrode and fetal blood sampling in labour if necessary.] She should be offered psychosexual counselling in conjunction with her partner (1).
Fluid balance and continence care
Published in Barbara Smith, Linda Field, Nursing Care, 2019
The urethra extends from the bladder to the urinary meatus (opening). The urethra is shorter in females (3.7 cm), due to the anatomical position in which it lies. In males, it is 20 cm in length. The urethra serves as a passageway for the elimination of urine (micturition) and is comprised of smooth muscle.
Tropical genital and sexually acquired infections
Published in Shiv Shanker Pareek, The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
Males. – preputial opening.– penis shaft.– mucous membranes.– pubic area.– external urinary meatus (urethral opening).– perianal area.– scrotum.– extragenital – due to autoinoculation.
Molecular study and genotype–phenotype in Chinese female patients with 46, XY disorders of sex development
Published in Gynecological Endocrinology, 2021
Junke Xia, Jing Wu, Chen Chen, Zhenhua Zhao, Yanchuan Xie, Zhouxian Bai, Xiangdong Kong
P.5 complained of primary amenorrhea. Testicles were detected around her right iliac fossa by US. The serum testosterone was 11.37 ng/mL. Her mother’s sister suffered from the same symptoms (Supplement Figure 1). P.6 complained of primary amenorrhea. Normal female genitals were observed. US showed no uterus, and two ovarian-like masses around her bilateral iliac vessels. Needle biopsy was performed, and pathology results confirmed that the two masses were actually testicles. P.7 visited the hospital because of genital abnormality. Her clitoridauxe resembled a micropenis, behind which the urinary meatus was observed. The vaginal orifice could not be observed. Labia majora and labia minora were normal. P.8 complained of genital abnormality. Her clitoridauxe resembled a micropenis. Both labia majora and labia minora were over-hypertrophic and resembled a scrotum, which appeared to fuse together with the micropenis. The urinary meatus was at the bottom of the micropenis, and the vaginal orifice could not be observed. P.9 was 1-year old and was admitted to the hospital because of genital abnormality. She had been diagnosed with hernia from an unknown origin. Her clitoridauxe resembled a micropenis, behind which the urinary meatus was observed. The vaginal orifice could not be observed. Labia majora and labia minora were normal.
Association Between Stability and Urologic Lesions in Pelvic Ring Fractures. A Case Series Report
Published in Journal of Investigative Surgery, 2021
Sebastián Corró, Andrea Sallent, Aleix Pons, MD, Óscar Ares, David Barastegui, Roberto Seijas
In addition, the urethra lies in close relation to the anterior arch of the pelvic ring. Lesions involving this structure are divided into injuries of the anterior and posterior urethra, however pelvic fracture urethral injuries usually affect its posterior portion [5]. The findings in the initial evaluation that should raise suspicion of urethral injury are perineal/scrotal/vulvar hematoma or ecchymosis, inability to urinate and presence of blood in the urinary meatus, the latter being the finding of most value [4].