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PubMed1994

[Urothelial diseases as an occupational disease].

The number of urothelial tumors of the lower urinary tract caused by occupational exposure is expected to markedly exceed the number of diseases which are actually compensated. The German compensation system for diseases is explained using the example of disease number 1301 which applies to bladder diseases due to aromatic amines. A standard procedure for the evaluation of the percentage of disability ("MdE") caused by tumors of the urinary bladder is presented. Important working areas which are associated with an elevated tumor risk of the lower urinary tract are mentioned. Cancerogenic aromatic amines can also be liberated in the human organism from soluble, i. e. bioavailable, azo dyes by reductive cleavage. Therefore, as a first step, a detailed work history (starting from the beginning of apprenticeship) must be obtained in all cases of urothelial tumors because of the very long latency time of tumors of the urothelium which can be up to fourty years and higher.

Carcinoma, Transitional Cell↗

PubMed1977

The non-neurogenic neurogenic bladder.

The records of 21 children with neuropathic bladder disease are reviewed. The natural history in these cases has been consistent with that of an acquired disorder and the results of urodynamic testing have supported Hinman's contention that the disease is basically a functional one, caused by a discoordination between detrusor contraction and sphincter relaxation. Bladder retraining and specific medication have yielded far better results than were obtained previously by surgical measures alone.

Behavior Therapy↗

PubMed1998

[Spontaneous rupture of the bladder. Apropos of 2 cases with an unusual presentation].

Spontaneous bladder ruptures is the accepted term of bladder rupture not associated with trauma. This rare condition occurs when an obstacle to urinary outflow is associated with a diseased bladder wall. The diagnosis is usually made on the retrograde cystogram. We report two cases of atypical spontaneous bladder rupture with intravesical herniation of the small bowel. The diagnosis was not suspected clinically but was made on CT and MRI.

Ascites↗

PubMed2004

Sonography of the bladder.

Ultrasonography (US) is the method of choice for the diagnosis of bladder disease. It is superior to other imaging techniques, such as urography and cystography, in depicting certain structures and abnormalities. US examination of the bladder should include a study of the ureterovesical junction and the structures round the vesical neck. The examination technique may be transabdominal, transrectal or transvaginal, or transurethral. The bladder pathology that can be studied by US includes cystitis, calculi, clots, diverticula, trauma and tumors. The sensitivity and the specificity of the method are very high and sometimes superior to cystoscopy. Sonography can be used to explore patients with stress incontinence and those with abdominal trauma. The ureterovesical junction may be clearly examined by US and the pathology of the papilla clearly defined.

Humans↗

PubMed1999

Selective estrogen receptor modulators and phytoestrogens: new therapies for the postmenopausal women.

Estrogen deficiency in the postmenopausal woman results in numerous symptomatic and asymptomatic manifestations, including vasomotor symptoms, osteoporosis, heart disease, bladder and vaginal symptoms, and cardiovascular disease. Estrogen replacement therapy is associated with amelioration of these problems but has attendant risks. A newer class of drugs, the selective estrogen receptor modulators, provides both estrogen agonist and antagonist properties, depending on the target tissue. This article discusses the mechanism by which selective estrogen receptor modulators may vary in their end-organ effects and reviews the clinical studies associated with these compounds. Phytoestrogens are widely used in the United States, but little information is available regarding their potential long-term effects.

Aged↗

PubMedDate not supplied

[New variants of intestinal plastic repair of the urinary bladder in experiment].

Two operative techniques of urinary reservoir creation are described. The techniques preserves urethral urination and urinary reservoir for supravesical urine passage with establishment of "dry" enterostoma. Ureteral implantation is made with establishment of invagination-valvular ureterocystoanastomosis. The above operations were tried on 13 mongrel dogs. The experiments have shown that urinary reservoir, serous-muscular constrictor, invagination valve of the urinary reservoir and invagination-valvular ureterocystoanastomosis retain their shape, structure and functional capacity in different postoperative terms and can be practiced in inpatients after radical cystectomy for muscular-invasive cancer of the bladder or in urinary bladder diseases urging greater capacity of the bladder.

Animals↗

PubMed2004

Estimation of CA 125 concentration in patients with congestive heart failure.

Tumour marker CA 125 is used in the monitoring results of treatment woman with ovarian cancer. Its diagnostic effectiveness in selected groups of patients is defined by sensitivity estimated at approximately 75% and specifity at 95%. In practice diagnostic specificity of CA 125 concentration is lower as it is limited by the increase of concentration different tumour diseases (bladder cancer) and non-tumour diseases (pericardial inflammation). The aim of the paper was to estimate CA 125 concentration in patients with congestive heart failure as well as to define the range of changes taking place according to the advancement of the disease. The research included 39 patients: 20 women and 19 men aged 45-75 with diagnosed congestive heart failure graded II-IV in the NYHA classification. It has been found that CA 125 concentration in blood serum of the patiens with congestive heart failure was on average approximately 35.4 +/- 24.8 U/ml and was included in the range from 5.6 to 874 U/ml (limit value 21 U/ml). The concentration increase above the limit value was observed in 34% of patients. Significant statistic differences in CA 125 concentration rates were dependent on the disease advancement. The highest concentration rates were observed in patients classified in group IV NYHA. The results that have been obtained allow us to draw a conclusion that right interpretation of CA 125 concentration in clinical practice (screening examinations, establishment of the level of advancement, prognostication as well as monitoring the ovarian cancer treatment) brings the necessity of taking into consideration the degree of congestive heart failure.

Aged↗

PubMed1991

Extent of bladder and ureteric involvement and urologic management in patients with enterovesical fistulas.

A retrospective review of hospital charts from 1978-1989 identified 21 patients with acquired enterovesical fistulas. Nine patients with fistulas secondary to benign inflammatory processes required extensive bladder resection; 2 of these had ureteric involvement. Of the 9 patients requiring extensive bladder resection, necrotic and severely inflamed bladder was excised and the bladder was closed in a multilayered fashion with absorbable sutures. An omental flap was used when possible. Postoperative bladder drainage was maintained for seven to fourteen days. Ureteral involvement was managed by stenting in 1 case and ureteroureterostomy in another. No postoperative bladder leaks or recurrent fistulas were reported. Extensive inflammatory involvement of the bladder wall may necessitate a large vesical resection. Excision of diseased bladder tissue, multilayered closure, and the use of omental interposition may help reduce postoperative complications and the risk of recurrence. Associated ureteral involvement may be present in these patients and requires urologic management.

Female↗

PubMed1991

Case report: systemic lupus erythematosus (SLE) serositis mimicking acute cholecystitis.

Systemic lupus erythematosus (SLE) is a well recognized cause of an acute abdomen. What is less well recognized is that the underlying pathology can be varied. The computed tomography (CT) and ultrasound appearances of the gall-bladder in a case of SLE serositis are shown. The imaging findings were strongly suggestive of primary gall-bladder disease although at laparotomy the gall-bladder showed serosal inflammation only.

Acute Disease↗

PubMed2005

Long-term followup of augmentation enterocystoplasty and continent diversion in patients with benign disease.

PURPOSE: We evaluated long-term outcomes in patients undergoing augmentation enterocystoplasty (AC) (with or without an abdominal stoma) or continent urinary diversion in patients with benign urological disorders. MATERIALS AND METHODS: This was a retrospective study of 76 consecutive adults who underwent AC (with or without an abdominal stoma) or continent urinary diversion because of benign urological conditions. The outcomes assessed were a patient satisfaction questionnaire, continence status, catheterization status, bladder capacity, bladder compliance, detrusor instability, maximum detrusor pressure, upper tract status, significant postoperative morbidity, need for reoperation, persistent diarrhea and vitamin B12 deficiency. RESULTS: The 76 patients (18 men and 58 women) were 19 to 80 years old (mean age 49). Followup was 1 to 19 years (mean 8.9). Preoperative diagnoses were neurogenic bladder in 41 patients, refractory detrusor overactivity in 9, interstitial cystitis in 7, end stage bladder disease in 7, radiation cystitis in 3, exstrophy in 3, postoperative urethral obstruction in 3 and low bladder compliance in 3. A total of 50 patients underwent simple AC, 15 underwent AC with an abdominal stoma and 11 underwent continent supravesical diversion. Of the 71 evaluable patients 49 (69%) considered themselves cured, 14 (20%) considered themselves improved and 8 (11%) considered treatment to have failed. All 7 patients with interstitial cystitis had failed treatment. Mean bladder capacity increased from 166 to 572 ml and mean maximum detrusor pressure decreased from 53 to 14 cm H2O. Serum creatinine improved or remained normal in all patients. Five patients experienced persistent diarrhea requiring intermittent antispasmodics but none had vitamin B12 deficiency, pernicious anemia or malabsorption syndrome. Long-term complications were stomal stenosis or incontinence in 11 of 26 patients (42%) with stomas, de novo bladder and renal stones in 2 of 71 (3%) and 1 of 71 (1%), respectively, and recurrent bladder stones in 6%. Small bowel obstruction occurred in 5 of 71 patients (7%), requiring surgical exploration in 4 (6%). CONCLUSIONS: AC and urinary diversion provide a safe and effective long-term therapy in patients with refractory neurogenic bladder but stomal problems in patients with continent diversion continue to be a source of complications.

Adult↗

PubMed1998

Role of prostaglandins in the urinary bladder: an update.

Our knowledge of prostanoids is rapidly increasing. In this review we survey the factors governing the synthesis of prostanoids by the urinary bladder, their role in the maintenance of normal bladder function, the pattern of their secretion in bladder disease and the possible use of prostanoids in the treatment of bladder pathology.

Aging↗

PubMed2002

[A case of Menkes disease with urinary bladder hemorrhage].

We report a case of Menkes disease with urinary bladder hemorrhage. Diverticulums were found at 1 year and 3 months of age. He had repetitive urinary tract infections at 2 years old and died of urinary hemorrhage at 2 years and 9 months. Large hematoma and diverticulum were found at necropsy. In patients with Menkes disease, attention should paid to urinary complications.

Child, Preschool↗

PubMed2006

Tissue-engineered autologous bladders for patients needing cystoplasty.

BACKGROUND: Patients with end-stage bladder disease can be treated with cystoplasty using gastrointestinal segments. The presence of such segments in the urinary tract has been associated with many complications. We explored an alternative approach using autologous engineered bladder tissues for reconstruction. METHODS: Seven patients with myelomeningocele, aged 4-19 years, with high-pressure or poorly compliant bladders, were identified as candidates for cystoplasty. A bladder biopsy was obtained from each patient. Urothelial and muscle cells were grown in culture, and seeded on a biodegradable bladder-shaped scaffold made of collagen, or a composite of collagen and polyglycolic acid. About 7 weeks after the biopsy, the autologous engineered bladder constructs were used for reconstruction and implanted either with or without an omental wrap. Serial urodynamics, cystograms, ultrasounds, bladder biopsies, and serum analyses were done. RESULTS: Follow-up range was 22-61 months (mean 46 months). Post-operatively, the mean bladder leak point pressure decrease at capacity, and the volume and compliance increase was greatest in the composite engineered bladders with an omental wrap (56%, 1.58-fold, and 2.79-fold, respectively). Bowel function returned promptly after surgery. No metabolic consequences were noted, urinary calculi did not form, mucus production was normal, and renal function was preserved. The engineered bladder biopsies showed an adequate structural architecture and phenotype. CONCLUSIONS: Engineered bladder tissues, created with autologous cells seeded on collagen-polyglycolic acid scaffolds, and wrapped in omentum after implantation, can be used in patients who need cystoplasty.

Adolescent↗

PubMed2005

Late benefits 10-18 years after drug therapy for infection with Schistosoma haematobium in Kwale District, Coast Province, Kenya.

Late benefits of remote antischistosomal therapy were estimated among long-term residents of an area with high transmission of Schistosoma haematobium (Msambweni, Kenya) by comparing infection and disease prevalence in two local adult cohorts. We compared 132 formerly treated adults (given treatment in childhood or adolescence > or = 10 years previously) compared with 132 age- and sex-matched adults from the same villages who had not received prior treatment. The prevalence of current infection, hematuria, and ultrasound bladder abnormalities were significantly lower among the previously treated group, who were found to be free of severe bladder disease. Nevertheless, heavy infection was equally prevalent (2-3%) in both study groups, and present rates of hydronephrosis were not significantly different. Therapy given in childhood or adolescence appears to improve risk for some but not all manifestations of S. haematobium infection in later adult life. Future prospective studies of continued treatment into adulthood will better define means to obtain optimal, community-based control of S. haematobium-related disease in high-risk locations.

Adult↗

PubMed1982

Nongynecologic bladder and perivesical ultrasound.

Ultrasound is effective in evaluating pathologic entities in and around the urinary bladder. Abnormalities may be classified into 2 groups: lesions primarily affecting the bladder, including the bladder wall; and perivesical lesions, which secondarily affect the urinary tract. Intrinsic bladder diseases include inflammatory lesions, stones, and tumors, both primary and metastatic. Extrinsic perivesical abnormalities include lesions of the prostate, seminal vesicles, urethra, rectum, and perivesical soft tissues. Since the bladder is routinely visualized on pelvic ultrasonography, awareness and recognition of the ultrasonic appearance of disease in and around the urinary bladder can lead to more accurate diagnosis and detection of unsuspected disease.

Carcinoma, Transitional Cell↗

PubMed1992

Balloon cystoscopy with neodymium:YAG laser.

We performed balloon cystoscopy for the diagnosis of gross hematuria as well as for the treatment of bladder tumor using the neodymium:YAG laser. Animal experiments were done to evaluate the efficacy of laser irradiation through the balloon, which proved to have the same effect as conventional laser irradiation. A total of 40 patients with bladder diseases was observed and treated by balloon cystoscopy, and the results were examined comparatively. Even with gross hematuria the structure of the mucosa and the tumor could be observed in detail without irrigating the inside of the bladder. Most bladder tumors were successfully treated with laser irradiation through the balloon through the optic lens system. Therefore, balloon cystoscopy appears to be a useful endoscopic modality in neodymium:YAG laser surgery for the treatment of bladder tumor.

Animals↗

PubMed1978

Experiences with colocystoplasties, cecocystoplasties and ileocystoplasties in urologic surgery: 40 patients.

During the last 16 years (1960 to 1976) we have treated 78 patients with a contracted bladder syndrome, 40 of whom have been treated surgically by replacing part or all of the bladder with an isolated segment of rectosigmoid, cecum or ileum. The series is a combination of 30 patients treated by Shirley in the United States and 10 patients by Mirelman in South America. Chronic interstitial cystitis (26 cases) and chronic radiation cystitis (4 cases) have been the primary causes for surgical treatment of the contracted bladder in the United States, whereas tuberculosis of the urinary tract was the primary etiologic factor for those treated in South America. The results have been gratifying, with 50 per cent excellent and 30 per cent good. Only 3 patients have had to be diverted to and outside colon or ileal conduit. Generally, our results with each type segment of large and small bowel have been satisfactory by the choice of segment must depend on the degree of bladder disease, and the medical and urologic condition of the patient.

Cecum↗

PubMed2004

Sustained intravesical drug delivery using thermosensitive hydrogel.

PURPOSE: Direct instillation of drug solutions into the bladder through a urethral catheter (i.e., intravesical therapy) evades systemic adverse effects of drugs used for bladder diseases. However, conventional vehicles for these drugs fail to extend duration of drug exposure in the bladder beyond the first voiding of urine postinstillation. The current study seeks to overcome the aforementioned inherent limitation of intravesical drug administration by using thermosensitive hydrogel as a matrix for sustained intravesical drug delivery. METHODS: Under halothane anesthesia, normal adult female Sprague-Dawley rats were catheterized with PE-50 tubing to instill either 0.02% w/v solution of fluorescein isothiocyanate (FITC) or the same amount of FITC in a 30% w/v dispersion of thermosensitive [Poly(ethylene glycol)-Poly[lactic acid-co-glycolic acid]-Poly(ethylene glycol)) (PEG-PLGA-PEG) polymer in a 0.1 M phosphate buffer. After instillations, rats were kept in metabolic cages for urine collection. Fluorescence emanating from FITC was measured in the urine at various time points up to 24 h after instillation. A rat model of cyclophosphamide-induced cystitis was chosen for the efficacy study using misoprostol as a model drug entrapped in the thermosensitive hydrogel in place of FITC. Efficacy of hydrogel containing misoprostol was compared against rat groups instilled with saline, hydrogel, and misoprostol independently. RESULTS: Prolonged drug exposure to the bladder afforded by hydrogel was evident from the time course of FITC elimination in the urine and by the green fluorescence of FITC seen at the bladder surface when isolated 24 h after instillation. Rats instilled with free FITC voided almost all of the fluorescence in the urine within the first 8 h, whereas rats instilled with hydrogel encapsulated FITC showed sustained release up to 24 h after instillation. Using a cyclophosphamide-induced cystitis model, rats instilled with misoprostol, a synthetic PGE1 analog, showed significantly reduced frequency of urine voiding (p < 0.05) as compared to the rats instilled with saline. Histological examination of the urothelium showed near normal morphology in rats instilled with misoprostol in hydrogel, whereas extensive tissue damage was observed in rats instilled with saline. CONCLUSION: Our study showed that PEG-PLGA-PEG polymer could be used as a viable sustained drug delivery system for intravesical therapy of diseases of the bladder such as cystitis using misoprostol.

Animals↗