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At least 361 records · Page 20Linked to original sources
PubMed2002

Massive hematuria after cystoscopy in a patient with an internal iliac artery aneurysm.

An unusual case is reported here of a patient with internal iliac artery aneurysm who developed massive hematuria after cystoscopic examination. A 75-year-old man presented with asymptomatic gross hematuria. Cystoscopic examination revealed that the bladder neck was congested and that the right-side wall was being pressed on by an extrinsic mass. Computed tomography showed a right internal iliac artery aneurysm and tortuous perivesical vessels. Three days after the cystoscopic examination the patient suffered massive hematuria. Hemorrhage due to an arteriovesical or arterio-ureteral fistula secondary to rupture of the internal iliac artery aneurysm was suspected, and an emergency operation was performed. At operation the aneurysm had not ruptured but overswelling perivesical vessels were found to have developed, and these fed a high blood flow to the bladder neck. In the present case cystoscopic examination injured the mucosa and led to massive hemorrhage from the bladder neck.

Aged↗
PubMed1999

Photodynamic cystoscopy for detection of bladder tumors.

The use of a photodynamic fluorescence marker for diagnosis of tumors is an intriguing concept to improve thoroughness of surgical tumor resection. Complete surgical resection of multifocal bladder tumors and flat lesions as carcinoma in situ is known to be difficult, and thus a source of recurrencies. We report on the recent experience with the intravesical application of the photosensitizer prodrug 5-aminolevulinic acid (5-ALA), which is a nontoxic physiological heme substrate. Initial results from fluorescence diagnosis using krypton laser light and recent results with a modified incoherent light source constantly showed a 25% increase in urothelial tumor detection compared with white light endoscopy. Because of the high sensitivity, the number of biopsies could be decreased constantly compared with routine random biopsies taken under white light endoscopy. The results show about 25% to 30% of cases with fluorescent lesions, which are histologically benign. 5-ALA is a promising tool for diagnosis of bladder cancer. The outcome of the initial study of 5-ALA in urology in Germany is positive and is continued by prospective multicenter clinical studies to prove the hypothesis of reduction of tumor recurrence with this method. 5-ALA-based fluorescence endoscopy is strongly recommended for further clinical testing.

Adenocarcinoma, Papillary↗
PubMed1995

Video-assisted percutaneous cystoscopy of the bladder and prostatic urethra in the dog: new approach for visual laser ablation of the prostate.

A new minimally invasive approach for video laparoscopy was developed to access the bladder and prostatic urethra of the dog in order to perform laser ablation of the prostate without using either an open laparotomy or urethrostomy. During general anesthesia, a 10-mm laparoscope was introduced into the peritoneal cavity. Under direct vision, the bladder was distended, and trocars were placed percutaneously by two different methods. A 22F cystoscope was introduced through the transcystic trocar into the prostatic urethra for visual laser ablation of the prostate (VLAP). In all eight dogs, the video-assisted technique for percutaneous access to the prostatic urethra was successful. No complications were associated with placement of the Veress needle, creation of the pneumoperitoneum, or accessing of the bladder lumen and proximal urethra. The visibility in the peritoneal cavity was excellent, and hemorrhage was minimal in all cases. In two dogs, a laparotomy was performed after displacement of the cystoscope from the urinary bladder. Irrigation fluid for the cystoscope drained primarily around the trocar cuff surrounding the instrument. In one case, the irrigation fluid drained around the trocar in the bladder and filled the peritoneal cavity.

Animals↗