PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Cystoscopes”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 829 records · Page 46Linked to original sources
PubMed1989

Identification of transitional cell carcinoma of the prostate in bladder cancer patients: a prospective study.

Transitional cell carcinoma involving the prostate in patients with bladder carcinoma impacts on the judicious use of intravesical chemotherapy, partial cystectomy and internal urinary reservoirs anastomosed to the urethra. We compared the accuracy of prostate needle biopsy, fine needle prostatic aspiration and transurethral resection biopsies of the prostate to detect the presence or absence of transitional cell carcinoma involving the prostate in 25 men undergoing radical cystectomy, of whom 40 per cent had transitional cell carcinoma of the prostate. The accuracy of the 3 detection methods was 20, 40 and 90 per cent, respectively. If any 1 of the 3 tests was positive all patients with transitional cell prostatic cancer were correctly identified. These tests should be performed in high risk patients, including those with transitional cell carcinoma in situ of the bladder, or with a positive urine cytology study and a cystoscopically as well as biopsy proved normal bladder urothelium.

Biopsy↗
PubMed1989

High failure rate of indwelling ureteral stents in patients with extrinsic obstruction: experience at 2 institutions.

The indwelling ureteral stent commonly is used to bypass 2 types of obstruction: 1) intrinsic obstruction usually due to stones or ureteropelvic junction abnormalities or 2) extrinsic compression, for example by retroperitoneal tumor. To determine the success of this intervention at 2 institutions the medical records of all patients undergoing cystoscopic placement of a stent for ureteral obstruction were reviewed. Procedures were classified by several parameters, including the type and location of the ureteral obstruction, indications for stent placement and success of the procedure. Stent failure was defined arbitrarily as clinical occlusion of the stent within 30 days of placement. X-rays were reviewed as available to measure stricture length and location in patients with extrinsic obstruction. Of the procedures at Brigham and Women's Hospital in Boston, where silicone stents are used almost exclusively, 23 perforated indwelling stents placed for intrinsic obstruction were uniformly successful. In contrast, of 24 stents placed for extrinsic obstruction 11 failed (p less than 0.0005). At Beth Israel Hospital, where polyurethane stents are used most commonly, all 21 perforated indwelling stents placed for intrinsic obstruction were successful, while 9 of 22 stents placed for extrinsic obstruction failed (5 within the first 24 hours of placement, p less than 0.0005). The only parameter that seemed to be a predictor of stent failure was luminal size, and this only in silicone catheters. The reasons for this surprising failure rate of internal stents in the face of extrinsic obstruction are not known but may be related to previous studies that describe a relationship among ureteral peristalsis, venting side holes and flow rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

Treatment system for whole bladder wall photodynamic therapy with in vivo monitoring and control of light dose rate and dose.

A system is described for in vivo monitoring and control of light dose rate and dose during whole bladder photodynamic therapy (PDT). A modified cystoscope admits an isotropic light source (fiber with diffusing tip, connected to a dye laser) and three translucent nylon catheters that are unfolded in three directions along the bladder wall. An isotropic light detector (0.8 mm. diameter probe on 200 microns. fiber) is inserted into each catheter and connected to an amplifier displaying light dose rate (in mW/cm.2) and integrated light dose (in J/cm.2) for each probe. Before treatment a low light level is used to optimize the position of the light source, requiring equal readings by each of the three dosimetry probes. Uniformity of irradiation is checked by moving the probes through their respective catheters along the bladder wall. With red light (wavelength 630 nm.) a dose rate uniformity of +/- 20% could be achieved in vivo in dog bladder. With green light (514.5 nm.) uniform irradiation was difficult, most likely due to a much smaller contribution of scattered light. Measurements during clinical PDT show that optimizing the light source position by suprapubic transvesical ultrasound may not secure uniform irradiation. Half-way into the treatment a difference of 100% between the readings of two probes was noted. Adjusting the position of the light source resulted in integrated light dose variations of less than 20% among the three probes at the end of treatment.

Animals↗
PubMed1990

Endoscopic balloon dilation of the prostate: early experience.

Coaxial balloon dilation catheters recently have been introduced for transurethral dilation of the prostate. We applied endoscopically a specially designed high pressure, large diameter balloon catheter to patients with benign prostatic hyperplasia or primary bladder neck hyperplasia who presented with symptomatic, cystoscopic and urodynamic evidence of obstruction. We report our preliminary experience with 42 patients: 28 with benign prostatic hyperplasia and 14 with bladder neck hyperplasia. Six months after dilation 46% of the patients demonstrated at least a 25% improvement in subjective (symptom score) and objective (corrected peak flow rate) parameters, while 6 (21%) experienced excellent (greater than 50%) symptomatic improvement despite unchanged corrected peak flow rates and 3 (11%) showed significant (greater than 50%) improvement in corrected flow rate alone. At 1, 3, 6 and 12 months the symptom scores decreased by 70, 67, 61 and 59% (median) from pre-treatment levels. Men with benign prostatic hyperplasia fared better than those with primary bladder neck hyperplasia (74 versus 58% decrease at 6 months). Objective evaluation by corrected peak flow rates demonstrated 25, 24, 28 and 2% median improvement at 1, 3, 6 and 12 months, respectively. Patients with primary bladder neck hyperplasia had substantially greater increases than those with benign prostatic hyperplasia (47 versus 27% at 6 months). Immediately after dilation the serum prostate specific antigen level increased by at least 1.5 ng. per ml. in 16 of 22 patients, indicating significant tissue trauma. Complications included mild bleeding and pain for the initial 24 hours and transient urinary retention in 2 patients. Our experience demonstrates the safety of an endoscopic approach to balloon dilation of the prostate that allows the urologist to maintain a central role in the assessment of a new approach to the treatment of obstructed voiding dysfunction.

Aged↗
PubMed1990

Eosinophilic cystitis presenting as invasive bladder cancer: comments on pathogenesis and management.

Eosinophilic cystitis is a rare bladder lesion that usually presents with hematuria and has the cystoscopic appearance of a bladder tumor. Ten cases (only 4 adults) have been reported in which this disease has presented with a palpable mass. We report a case in which the lesion presented as an invasive bladder tumor with a palpable mass in an adult and comment on the possible etiology.

Cystitis↗
PubMed1990

Preliminary results in invasive bladder cancer with transurethral resection, neoadjuvant chemotherapy and combined pelvic irradiation plus cisplatin chemotherapy.

Preliminary data are presented of a clinically feasible pilot study to select a significant subgroup of patients among those with muscle-invading bladder tumors for local cure and bladder preservation, while also to offer all patients the possibility of preventing the development of distant metastases. Transurethral debulking surgical resection was combined with neoadjuvant methotrexate, cisplatin and vinblastine chemotherapy plus 2 additional courses of cisplatin and 4,000 cGy. If tumor was found on cystoscopic re-evaluation by biopsy and for cytology after cisplatin and partial irradiation (4,000 cGy.) immediate cystectomy was advised. If tumor was not found consolidation by a radiotherapy boost to a total of 6,480 cGy. plus 1 additional course of cisplatin was given. Of 53 consecutive patients the planned treatment was completed in 42 (79%). With a median followup of 26 months (range 15 to 42 months), 72% of all entered patients were alive, 70% have not required cystectomy and 74% have not had distant metastases. Among the 42 patients who completed the planned protocol chemotherapy dose reductions were required in 39% for stomatitis, bone marrow depression and/or renal dysfunction. There were 2 serious complications but no treatment-related sepsis, deaths or significant renal dysfunction. Eight patients underwent immediate radical cystectomy because of positive biopsy and/or cytology results after 4,000 cGy., while 34 completed full chemotherapy and radiotherapy without any significant bladder or bowel injury. Of 42 patients 22 (52%) have maintained the bladder without any recurrence, and of those selected for full chemotherapy and radiotherapy this number increased to 65%. To date 12 patients have persistent or recurrent bladder tumors: 5 (15%) had invasive tumors treated by cystectomy and 7 (21%) had carcinoma in situ treated by intravesical therapy. The true success of this or other selective bladder-preserving treatments will require 3 to 5 years of followup to be confident that such treatment has sterilized the bladder of cancer. This feasibility study has been clinically practical, modestly well tolerated and encouraging for the significant proportion of patients with a sustained complete response and for the 70% over-all survival rate at 2 years. To evaluate critically the efficacy of methotrexate, cisplatin and vinblastine chemotherapy in the prevention of occult distant micrometastases and in increasing the rate of successful bladder preservation, in May 1988 we began a randomized phase 3 trial with and without neoadjuvant methotrexate, cisplatin and vinblastine chemotherapy.

Aged↗
PubMed1990

Laser treatment of bladder hemangioma.

Bladder hemangiomas may occur singly or in association with systemic arteriovenous malformations. A total of 13 patients with bladder hemangiomas underwent treatment at this university. All patients had recurrent bleeding and neodymium:YAG laser energy was delivered endoscopically to the hemangioma. No treatment-related bleeding occurred in any patient, and all had a significant decrease in the frequency and intensity of bleeding episodes. Followup cystoscopic examinations have shown either complete eradication of the hemangioma or a marked decrease in size. Neodymium:YAG laser irradiation provides results superior to alternative therapy and is the preferred treatment for most patients with bladder hemangioma.

Child↗
PubMed1990

Expanding the role of the ureteroscope.

Although the rigid ureteroscope was designed exclusively for the diagnosis and treatment of pathological conditions of the ureter, its smaller diameter and extended length allow for its increased use in endoscopic procedures that cannot be performed successfully with a cystoscope. The indications can be divided into 3 categories: 1) difficult ureteral catheterizations, 2) augmented bladders and diverticula, and 3) narrow, strictured urethras and bladder necks. Several cases from each category are presented to illustrate the expanded role of the rigid ureteroscope in daily urological practice.

Adult↗
PubMed1989

Prevention of urethral stricture formation after transurethral resection of the prostate: a controlled randomized study of Otis urethrotomy versus urethral dilation and the use of the polytetrafluoroethylene coated versus the uninsulated metal sheath.

Stricture formation after transurethral prostatectomy was studied in a randomized clinical trial including 185 patients. The patients were allocated to either a 2-day urethral catheter-dilation or internal Otis urethrotomy and to an operation with either a polytetrafluoroethylene coated or an uninsulated metal resectoscope. Urethral stricture was defined as an obstruction resulting in a maximum urine flow rate of less than 15 ml. per second and not permitting the passage of a 21F cystoscope. The frequency of urethral strictures was significantly lower after Otis internal urethrotomy (4 per cent) than after a 2-day urethral catheter dilation (16 per cent). The incidence of stricture formation was similar in patients operated on with a polytetrafluoroethylene coated (8 per cent) and with an uninsulated metal (12 per cent) resectoscope sheath. The incidence of stricture formation was unrelated to age, duration of preoperative and postoperative catheterization, operating time and presence of urinary tract infection.

Aged↗
PubMed1989

A case of vesical varices as a complication of portal hypertension and manifested gross hematuria.

We report a unique case of vesical varices in a patient who presented with an episode of serious gross hematuria. He also had cirrhosis of the liver and portal hypertension, and had undergone transection of the esophagus 10 years ago. A hemangiomatous mass was discovered on cystoscopic examination, and sonographic examination, computerized tomography and abdominal angiography revealed vesical varices. The genesis of vesical varices and possible treatment in this case are discussed.

Hematuria↗
PubMed1988

Exchange/retrograde ureteral stent set.

Once in position, ureteral stents are relatively inaccessible. A ureteral stent set was developed that allows for retrograde study of the collecting system or exchange of the stent with or without the assistance of a cystoscope. This has proved to be useful for opacification of the collecting system during extracorporeal shock wave lithotripsy or percutaneous nephrolithotomy, or after ureteroscopy.

Catheters, Indwelling↗
PubMed1988

Sonographic urethrogram: comparison to roentgenographic techniques in 22 patients.

A sonographic technique was devised to examine the anterior urethra in 22 men suspected of having stricture disease. All patients underwent sonographic and roentgenographic urethrograms. Cystoscopic examination was done in 17 patients. The sonographic urethrogram findings were as diagnostic as the roentgen findings in 19 patients. In 1 patient the sonographic urethrogram identified a bulbar urethral stricture not seen on a retrograde urethrogram. In 2 patients a bulbar urethral sinus tract was found by the retrograde urethrogram but not by the sonographic urethrogram, although the remaining 2 sonographic urethrograms correctly identified the urethral pathological condition. Structures outside the lumen of the urethra including the urethral wall, corpus spongiosum, corpus cavernosum, bulb and external urinary sphincter were seen clearly by the sonographic urethrogram. The fossa navicularis can be visualized as well. Foreign bodies in the urethra, straddle injury and stricture disease were correctly diagnosed by the sonographic urethrogram. No patient reported discomfort during the examination. The sonographic urethrogram provided valuable information about the luminal and extraluminal anatomy of the anterior urethra. Further long-term studies will be necessary to assess its ultimate diagnostic potential.

Adult↗
PubMed1988

ND: YAG nomogram dosimetry scale for the bladder.

Bowel perforation and damage to surrounding organs is probably the most significant risk with the use of Nd-YAG laser in the bladder. To prevent this unwanted damage, a nomogram dosimetry scale was developed by delivering different settings of laser energy via a cystoscope to 25 female pigs. One week following treatment, exploratory laparotomy and cystectomy were performed. Microscopic analysis of the depth of laser irradiation was accomplished. From this study it was learned that, although the greater the energy delivered, the deeper the tissue damage, this is not uniform. Pulsed energy produced a deeper effect than continuous energy. The use of 30 watts of either pulsed or continuous energy for no longer than 15 seconds (450 joules) or 10 watts of either form of energy for less than 30 seconds (300 joules) did not produce bowel perforation. Other different combinations of high number of watts or pulses translated into transmural necrosis of the bladder with or without perforation and with or without bowel injury. Other factors such as density, thickness, color and temperature of tissue, type and wave length of laser and optimal focusing played a significant role in the final outcome. Useful information for human clinical use may be extrapolated from this experimental model.

Animals↗
PubMed1988

Erosion of an inflatable penile prosthesis reservoir into the bladder, presenting as bladder calculi.

We report a case of erosion of an inflatable penile prosthesis reservoir int the bladder 4 years after implantation for organic impotence. In contrast to previously reported cases this complication was not associated with incontinence, urinary tract infection or a revision procedure. Microscopic hematuria was present but there was no pyuria. Diagnosis evaded radiographic and cystoscopic confirmation. Bladder erosion of the reservoir was discovered incidentally during treatment of bladder calculi.

Erectile Dysfunction↗
PubMed1988

Effects of botulinum A toxin on detrusor-sphincter dyssynergia in spinal cord injury patients.

We evaluated the ability of low doses of botulinum A toxin, an inhibitor of acetylcholine release at the neuromuscular junction, to denervate and relax the spastic rhabdosphincter in 11 men with spinal cord injury and detrusor-sphincter dyssynergia. Toxin concentration, injection volume, percutaneous versus cystoscopic injection of the sphincter and number of injections were evaluated in 3 treatment protocols. All 10 patients evaluated by electromyography after injection showed signs of sphincter denervation. Bulbosphincteric reflexes in the 10 patients evaluated after injection were more difficult to obtain, and they showed a decreased amplitude and normal latency. The urethral pressure profile in the 7 patients in whom it was measured before and after treatment decreased an average of 27 cm. water after toxin injections. Post-void residual urine volume decreased by an average of 146 cc after the toxin injections in 8 patients. In the 8 patients for whom it could be determined toxin effects lasted an average of 50 days. The toxin also decreased autonomic dysreflexia in 5 patients.

Adult↗
PubMed1987

Secondary amyloidosis of the bladder: a cause of massive hematuria.

Secondary amyloidosis of the bladder is a rare cause of hematuria, with only 10 previous reports. Findings and treatment in 5 patients with histologically verified bladder amyloidosis secondary to long-standing rheumatoid arthritis are presented. All patients were hospitalized for massive hematuria. One patient died before cystoscopy. Clot evacuation and fulguration through a cystoscope stopped the bleeding in 1 patient. In the other 3 patients hemostasis was achieved by cystotomy, bilateral percutaneous nephrostomy and continuous alum irrigation of the bladder, respectively.

Aged↗