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At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

[Usefulness of posterior capsulectomy in the treatment of bladder neck disease].

RATIONALE: Presentation of 12-year experience accrued in the surgical treatment of the acquired bladder neck disease. Based on Riches' experience (1961), posterior capsulotomy, although exceptional in terms of indication, was effective in the treatment of 26 patients with early failure of standard endoscopic techniques. MATERIALS AND METHOD: Over a 12-year period, 945 prostatectomies were entered in a protocol, 305 (32.2%) open surgery and 640 (67.8%) transurethral resections. Incidence of sclerosis was 5.03% (48 patients). Treatment of second group with TUR and/or cervicotomy failed in 26 (45-58%) patients. Posterior capsulotomy was effective in 100% patients. RESULTS: Mean follow-up has been productive, and exceeds 4 years based on clinical, radiologic, endoscopic and urodynamic parameters.

Aged↗
PubMed1998

Colour Doppler-guided spectral analysis of gall-bladder wall flow.

For the purpose of the present study to diagnose gall-bladder cancers, which cannot be detected or are only partly visible by conventional ultrasonography (US), we attempted differential diagnoses of 69 patients with gall-bladder diseases (12 with gall-bladder cancer, five with acute cholecystitis, 11 with chronic cholecystitis, 27 with cholesterol polyp and 14 with adenomyomatosis) using the evaluation of gall-bladder wall blood flow (GWBF). GWBF was evaluated by colour Doppler-guided spectral analysis (CDSA). Thirty-three healthy volunteers were selected as controls at random. Two parameters of GWBF, namely flow velocity and resistive index (RI), were compared between patients with gall-bladder diseases and healthy volunteers. GWBF could be ultrasonically evaluated in 92 (90%) of 102 subjects. All 12 patients with gall-bladder cancer had a significantly rapid blood flow value compared with other patients and healthy volunteers. There was no significant difference in RI among patients and healthy volunteers. When cut-off level of the flow velocity was set at 30 cm/s, gall-bladder cancer could be diagnosed by flow velocity with 100% sensitivity (12/12) and 96% specificity (50/52). Using the same cut-off level of the flow velocity, 17 patients were analysed prospectively. In four asymptomatic gall-bladder cancers and two acute cholecystitis cases with some symptoms, the flow velocity was over 30 cm/s. In two of four patients with gall-bladder cancer, only a part of the tumour was visualized on conventional abdominal US. In conclusion, CDSA was more useful for diagnosing gall-bladder lesions than the conventional abdominal US due to estimation of arterial flow velocity in the gall-bladder wall.

Blood Flow Velocity↗
PubMed1991

Genital and urinary tract diseases and bladder cancer.

The relationship between selected urinary tract and genital diseases and the risk of bladder cancer was analyzed using data from a case-control study of 364 cases of bladder cancer and 447 controls hospitalized for acute, nonneoplastic, nongenital tract conditions, unrelated to known or suspected risk factors for bladder cancer. Cystitis was reported by 20% of the cases and 8% of the controls, corresponding to a multivariate relative risk (RR) of 3.8 (95% confidence interval, 2.4 to 5.9). No association was observed with urinary tract stones (RR = 1.2). With reference to genital diseases, the RR was elevated for gonorrhea (RR = 2.8, 95% confidence interval, 1.0 to 4.5) and condylomata acuminata (RR = 5.9, 95% confidence interval 1.0 to 3.6) but not for syphilis. The risk increased with the number of episodes of cystitis (RR = 5.0 for greater than or equal to 4 episodes, chi 2 for trend = 33.04, P less than 0.001), was higher during the last 15 years after the first episode (RR = 5.1 versus 2.3 for over 15 years), and was not heterogeneous across strata of age and sex. The interaction between urinary tract infections and tobacco appeared multiplicative, with RR = 2.4 for ever smoking, 3.2 for cystitis alone, and 10.3 for both exposures. The present study, besides providing further quantitative evidence of a relationship between urinary tract infections (and, possibly, some genital infections, too) and bladder cancer, indicates that the role of infections is probably in one of the latter (promoting) stages of the process of carcinogenesis and suggests a multiplicative interaction with smoking. In terms of prevention and public health, therefore, it is thus important to avoid at least one exposure for subjects with a history of urinary tract infections who smoke tobacco.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Cytokeratins as serum markers in egyptian bladder cancer. A comparison of CYFRA 21-1, TPA and TPS.

Cytokeratins (CKs) have been shown to be overexpressed in bladder cancer and to be valuable as tumor markers. The present study was designed to evaluate the single and combined use of three cytokeratin fragments, CYFRA 21-1, TPA, and TPS, in serum of Egyptian bladder cancer patients. The study subjects comprised 40 healthy controls, 30 patients with benign bladder diseases, and 60 patients with histologically confirmed primary bladder cancer. The cutoff was set at 95% specificity versus benign bladder diseases, resulting in cutoff values of 2.93 ng/mL for CYFRA 21-1, 158 U/L for TPA and 143.7 ng/mL for TPS. With 41% true positive results CYFRA 21-1 had a higher sensitivity than TPA (32%) and TPS (27%). Evaluation by histological findings revealed a highest sensitivity of CYFRA 21-1 (46%) in transitional cell carcinoma (TCC) followed by TPA (27%) and TPS (21%). Also in adenocarcinoma CYFRA 21-1 showed the highest sensitivity (38%) followed by TPA (32%) and TPS (28%). A high percentage (41.6%) of Egyptian bladder cancers is represented by squamous cell carcinoma (SCC). In this population TPS showed the highest sensitivity (69%), followed by CYFRA 21-1 (54%) and TPA (41 %). The sensitivity of each of the three markers increased with advancing tumor stage and increasing tumor grade. Combined use of two of the three markers did not raise the sensitivities obtained by single determination of CYFRA 21-1. The present study suggests that serum CYFRA 21-1 could be a marker of choice in bladder cancer.

Adenocarcinoma↗
PubMed1976

Cystometric, sphincter and electromyelographic abnormalities in Parkinson's disease.

Bladder function was studied in 24 patients with a diagnosis of parkinsonism using cystometry, sphincter electromyography, flowmetry and electromyelography. A high incidence of disturbances in detrusor function and sphincter control was documented and the signal tracing studies showed prolonged conduction times, giving evidence of peripheral neuropathy. The abnormalities of detrusor function were ascribed to the lesion of the basal ganglia, whereas the sphincter disturbances indicate impairment of the corticospinal tract as a result of Parkinson's disease.

Adult↗
PubMed1978

Air cystometry at different flow rates.

Air cystometry was performed with 3 different flow rates in patients suffering from different bladder diseases. To demonstrate neurogenic bladder disorder a flow rate of 75 ml/min was recommended.

Humans↗
PubMed1992

Postoperative radiotherapy of carcinoma in bilharzial bladder: improved disease free survival through improving local control.

Two hundred thirty-six patients with T3 bladder cancer who survived radical surgery and proved to have P3a, P3b, or P4a tumors were randomized in two phases into three groups: (a) no further treatment (83 patients); (b) postoperative radiotherapy multiple daily fractionation (MDF), using 3 daily fractions of 1.25 Gy each, with 3 hr between fractions, up to a total dose of 37.5 Gy in 12 days (75 patients); and (c) postoperative radiotherapy conventional fractionation (CF), for a total dose of 50 Gy/5 weeks (78 patients). The tolerance of the patients to postoperative radiotherapy was quite acceptable, with equal acute reactions in MDF and CF groups. The 5-year disease-free survival (DFS) rates amounted to 49 and 44% in MDF and CF postoperative radiotherapy groups, respectively, compared to 25% in the cystectomy-alone group. The 5-year local control rates were 87% and 93% for those treated with multiple daily fractionation and conventional fractionation while it was 50% in the surgery-alone group. The therapeutic benefit of postoperative irradiation was consistent for all tumor types, histological grades, and pathological stages for both the disease-free survival and local control. Patients with nodal metastases demonstrated lower recurrence rates in the postoperative radiotherapy groups, but this was not associated with improved disease-free survival. Multivariate analysis using the Cox Model confirmed these results. The independent prognostic factors affecting both disease-free survival and local control were the addition of postoperative radiotherapy, the nodal status, the pathological stage, and the tumor grade. Late complications of radiotherapy in the skin, small intestine, rectum, and the anastomotic site of the urinary division were lower with MDF than with conventional fractionation.

Adult↗