Using laparoscope to remove an ectopic intrauterine device in the anterior wall of urinary bladder:A case report

BACKGROUND An intrauterine device(IUD)is a contraceptive device placed in the uterine cavity and is a common contraceptive method for Chinese women.However,an IUD may cause complications due to placement time,intrauterine pressure and other factors.Ectopic IUDs are among the most serious complications.Ectopic IUDs are common in the myometrium and periuterine organs,and there are few reports of ectopic IUDs in the urinary bladder,especially in the anterior wall.CASE SUMMARY A 52-year-old woman was hospitalized due to a urinary bladder foreign body found via abdominal ultrasound and computed tomography(CT)examination.The patient had a 2-year history of recurrent abdominal distension and lower abdominal pain,accompanied by frequent urination,urgency,dysuria and other discomfort.Ultrasound examination revealed foreign bodies in the bladder cavity,with calculus on the surface of the foreign bodies.CT revealed a circular foreign body on the anterior wall of the urinary bladder,suggesting the possibility of an ectopic IUD.After laparoscopic exploration,an annular IUD was found in the anterior wall of urinary bladder,and an oval calculus with a diameter of approximately 2 cm was attached to the surface of the bladder cavity.The IUD and calculus were successfully and completely removed.The patient recovered well after surgery.CONCLUSION Abdominal ultrasound and CT are effective methods for detecting ectopic IUDs.The IUD is located in the urinary bladder and requires early surgical treatment.The choice of surgical method is determined by comprehensively considering the depth of the IUD in the bladder muscle layer,the situation of complicated calculus,the situation of intravesical inflammation and medical technology and equipment.

Both Juxtacrine and Paracrine Signaling Indispensable in Spermatogonial Stem Cell Cultures

Objective To prove that juxtacrine and paracrine signaling are essential in the culture of spermatogonial stem cells （SSCs） with Sertoli cell feeder layer in vitro. Methods Mice aged 7 d were chosen to harvest testes. A two-step enzyme digestion method was applied in testis suspension. The SSCs and Sertoli cells were separated by adherence distinguishing methods and biologically identified by immunofluorescence and Oil Red 0 staining methods. Flow cytometry was used to analyze purity of SSCs. Three groups were constructed according to different culture conditions. SSC and Sertoli cell co-culture group, SSC conditional culture group and SSC routine culture group. The conditional medium was collected from supernate of culture Sertoli cell in vitro and double-concentrated with DMEM/F12 and fetal bovine serum in a proportion of 4.5 ： 4.5 ： 1. The routine medium was DMEM/F12 containing 10% fetal bovine serum. Adherence rates were measured by Trypan blue staining. Absorbance of SSCs of each group was measured by MTT assay and proliferation curves shown to demonstrate proliferative features of SSCs. Proliferative features and colony formation were observed by inverted microscope. With 24 h difference in adherence rates, proliferations were compared and analyzed.Results The adherence rate of co-culture group was greater than that in the others（P〈0.05）, with insignificant difference in conditional culture group and routine group （P〉0. 05）. SSCs of co-culture group showed stable proliferation immediately following inoculation..4 stable colony formed within 7-10 d and maintained for 30 d. SSCs in conditional culture group and routine group decreased rapidly following transient proliferation. Conclusion The actions of SSCs in Sertoli cell cultures in vitro depended on both juxtacrine and paracrine signaling, Sertoli cell paraerine signaling was unable to promote SSC adherence and proliferation alone.