SEARCH · PubMed Health

Results for “Transurethral Resection of Bladder”

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 1,009 records · Page 56Linked to original sources

PubMed2003

Hypermethylation of an E-cadherin (CDH1) promoter region in high grade transitional cell carcinoma of the bladder comprising carcinoma in situ.

PURPOSE: We elucidated the role of methylation in the promoter region of the 1 gene in bladder carcinogenesis, particularly in those comprising carcinoma in situ. MATERIALS AND METHODS: A total of 49 cases of transitional cell carcinoma of the bladder obtained from transurethral resection were examined. Methylation status of the 1 promoter region was analyzed by methylation specific polymerase chain reaction from chemically modified DNA after Na-bisulfite treatment. Loss of heterozygosity on 16q was examined by blunt end single strand DNA conformation polymorphism using 4 tetranucleotide repeat microsatellite markers assigned on 16q13 to 22.1. E-cadherin expression was evaluated by immunostaining on formalin fixed, paraffin embedded tissue sections using anti E-cadherin murine monoclonal antibody, HECD1 and standard avidin-biotin immunoperoxidase complex technique. RESULTS: Analysis of the 49 bladder transitional cell carcinoma samples showed 1 promoter methylation in 23 (47%). Methylation of the 1 gene did not correlate with tumor stage (p = 0.2097) but with high grade transitional cell carcinoma (p = 0.0416). 1 promoter methylation was observed at a significantly higher frequency in the carcinoma in situ positive group than in the carcinoma in situ negative group (16 of 18 cases or 89% versus 7 of 31 or 23%, p <0.0001) and it strongly correlated with abnormal E-cadherin expression (p <0.0001). We found 16q loss of heterozygosity in 16 of 47 cases (34%), which correlated with higher histological grade (p = 0.0069) but not with the presence of the carcinoma in situ component (p = 0.1235). CONCLUSIONS: This study showed that 1 gene promoter methylation is strongly associated with bladder transitional cell carcinoma comprising carcinoma in situ.

Alleles↗

PubMed2005

Eosinophilic cystitis and its management.

Eosinophilic cystitis (EC) is a rare clinicopathological condition characterized by transmural inflammation of the bladder predominantly with eosinophils, associated with fibrosis with or without muscle necrosis. The cause of EC remains unclear, although it has been associated with various aetiological factors, such as allergy, bladder tumour, bladder trauma, parasitic infections and chemotherapeutic agents. EC is, probably, caused by the antigen-antibody reaction. This leads to the production of various immunoglobulins, which, in turn, cause the activation of eosinophils and initiates the inflammatory process. The most common symptom complex consists of frequency, haematuria, dysuria and suprapubic pain. Cystoscopy and biopsy are the gold standard for diagnosis. Additional laboratory evidence supporting the diagnosis includes proteinuria, microscopic haematuria and peripheral eosinophilia, the last one occurring in few patients. There is no curative treatment for this condition. Current treatment modalities include transurethral resection of the bladder lesion along with non-specific medical therapy, such as non-steroidal anti-inflammatory agents or steroids. Because the lesion tends to recur in spite of the above therapy, long-term follow-up is mandatory.

Algorithms↗

PubMed1998

The role of laser-induced autofluorescence spectroscopy in bladder tumor detection. Dependence on the excitation wavelength.

We assessed the ability of laser-induced autofluorescence spectroscopy to distinguish neoplastic urothelial bladder lesions from normal or nonspecific inflammatory mucosa. Three different pulsed laser excitation wavelengths were used successively: 308 nm (xenium chloride excimer laser), 337 nm (nitrogen laser) and 480 nm (coumarin dye laser). The excitation light was delivered by a specially devised multifiber catheter connected to a 1-mm core diameter silica monofiber introduced through the working channel of a standard cystoscope with saline irrigation. The captured fluorescence light was focused onto an optical multichannel analyzer detection system. Performance of this device was evaluated in 25 patients after obtaining consent and immediately before transurethral resection of a bladder tumor. Spectroscopic results were compared with histological findings. At 337- and 480-nm excitation wavelengths, the overall fluorescence intensity of bladder tumors was clearly decreased compared to normal urothelial mucosa regardless of tumor stage and grade. At the 308-nm excitation wavelength, the shape of the tumor spectra, including carcinoma in situ, was markedly different from that of normal or nonspecific inflammatory mucosa. No absolute intensity determinations were required in this situation, since a definite diagnosis could be established based on the fluorescence intensity ratio at 360 and 440 nm. This spectroscopic study could be particularly useful in designing a simplified autofluorescence imaging device for detection of occult urothelial neoplasms.

Aged↗

PubMed1996

Laser induced autofluorescence diagnosis of bladder tumors: dependence on the excitation wavelength.

PURPOSE: We assessed the ability of laser induced autofluorescence spectroscopy to distinguish neoplastic urothelial bladder lesions from normal or nonspecific inflammatory mucosa. MATERIALS AND METHODS: Three different pulsed laser excitation wavelengths were used successively: 308 nm. (xenium chloride excimer laser), 337 nm. (nitrogen laser) and 480 nm. (coumarin dye laser). The excitation light was delivered by a specially devised multifiber catheter connected to a 1 mm. core diameter silica monofiber introduced through the working channel of a standard cystoscope with saline irrigation. The captured fluorescence light was focused onto an optical multichannel analyzer detection system. Device performance was evaluated in 25 patients after obtaining consent and immediately before transurethral resection of a bladder tumor. Spectroscopic results were compared with histological findings. RESULTS: At 337 and 480 nm. excitation wavelengths the overall fluorescence intensity of bladder tumors was clearly decreased compared to normal urothelial mucosa regardless of tumor stage and grade. At the 308 nm. excitation wavelength the shape of the tumor spectra, including carcinoma in situ, was markedly different from that of normal or nonspecific inflammatory mucosa. No absolute intensity determinations were required in this situation, since a definite diagnosis could be established based on the fluorescence intensity ratio at 360 and 440 nm. CONCLUSIONS: This spectroscopic study could be particularly useful to design a simplified autofluorescence imaging device for detection of occult urothelial neoplasms.

Carcinoma in Situ↗

PubMed1994

The effect of intravesical thiotepa on tumour recurrence after endoscopic treatment of newly diagnosed superficial bladder cancer. A further report with long-term follow-up of a Medical Research Council randomized trial. Medical Research Council Working Party on Urological Cancer, Subgroup on Superficial Bladder Cancer.

OBJECTIVE: To determine the role, if any, of one and five installations of intravesical thiotepa in the treatment of newly diagnosed superficial bladder cancer. PATIENTS AND METHODS: A multicentre randomized clinical trial was carried out involving 417 patients with newly diagnosed superficial bladder cancer. After transurethral resection the patients were randomized into one of three treatment arms: no thiotepa; one instillation of thiotepa at the time of resection; one instillation at time of resection and then at 3-monthly intervals for one year (giving a total of five instillations). In all treatment arms the dosage was 30 mg thiotepa in 50 ml saline. The main outcome measures were time to first superficial recurrence, recurrence rate (defined as the number of possible cystoscopies per annum) and failure-free interval rate (where failure was defined as the development of invasive disease, metastatic disease or death from bladder cancer). RESULTS: After a median follow-up of 8 years and 9 months analysis showed no evidence of a difference between the three groups with respect to time to first recurrence, recurrence rates or the failure-free interval rate. CONCLUSIONS: This analysis confirms that the thiotepa regimens tested cannot be recommended for use outside clinical trials for patients with newly diagnosed superficial bladder cancer.

Administration, Intravesical↗

PubMed2000

The management and outcome of bladder carcinoma in Ontario, 1982-1994.

BACKGROUND: To the authors' knowledge no previous study has described the management and outcome of bladder carcinoma on a population-based level. The objective of the current study was to describe the characteristics, treatment, and outcome of newly diagnosed invasive bladder carcinoma (n = 20,822) reported in Ontario, Canada between 1982-1994. METHODS: Electronic records of invasive bladder carcinoma (International Classification of Diseases code 188) from the Ontario Cancer Registry were linked to surgical and radiotherapy (RT) records. Bivariate and multivariate techniques were used to assess variations in the use of initial cystectomy and pelvic RT. The authors modeled the likelihood of death after diagnosis and the probability of cystectomy free survival. All analyses were controlled for age, gender, histology, and year of diagnosis. RESULTS: The most common histologic type was papillary transitional cell carcinoma. Maximum initial treatment was comprised of total cystectomy (5.1%), partial cystectomy or open excision (3. 5%), pelvic RT (5.9%), transurethral resection of the bladder (66. 7%), or lesser or no procedures (18.7%). The use of total cystectomy and pelvic RT varied among the regions of Ontario. Overall 5-year survival was 58.8%, and was 86.5% for patients with papillary histology. In multivariate analysis, although survival was similar among the regions, the relative risk of cystectomy conditional on survival varied. CONCLUSIONS: Papillary tumors portend a better survival than nonpapillary tumors. Variations in the use of total cystectomy and in the use of pelvic RT among the regions of Ontario did not appear to be associated with variations in survival. However, cystectomy free survival appeared to vary among the regions. These results suggest that patients can be managed safely using a bladder-preserving approach.

Adult↗

PubMed1993

Ki-67 scores and AgNor counts in transitional cell carcinoma of the bladder: apparent lack of prognostic value.

The cellular proliferative state of 18 incident cases of transitional cell carcinomas of the bladder treated with transurethral resection was blindly determined by two independent observers using Ki-67 monoclonal antibody and silver stain for nucleolar organizer regions (AgNORs). Ki-67 scores were significantly related to histological grade (WHO) (rs = 0.65, p < 0.01) and clinical stage (UICC) (rs = 0.46, p < 0.05). However, the follow-up analysis over a six year period did not demonstrate significant relationship between Ki-67 values and survival. AgNOR counting did not show significant association with any of the variables under study. The results of this investigation and the review of the pertinent literature suggest that the assessment of cell proliferation of bladder carcinoma by means of Ki-67 and AgNOR techniques is far from having immediate direct influence on patient management.

Adult↗

PubMed2003

Centrosome hyperamplification and chromosomal instability in bladder cancer.

OBJECTIVE: Chromosomal instability (CIN) is a common feature of malignant tumors. Centrosome hyperamplification (CH) occurs frequently in human cancers, and may be a contributing factor in CIN. In this study, we investigated the relationship between CH and CIN in bladder cancer. METHODS: Clinical samples obtained by transurethral resection from 22 patients with bladder cancer were examined (histological grade G1, 5 cases; G2, 6 cases; G3, 11 cases). CH was evaluated by immunohistochemistry using anti-pericentrin antibody. CIN was evaluated by fluorescence in situ hybridization (FISH). FISH probes for pericentromeric regions of chromosomes 3, 7, and 17 were hybridized to touch preparations of nuclei from frozen tissues. We also analyzed the centrosome replication cycle of bladder cancer by laser scanning cytometry (LSC). RESULTS: Of the 22 cases examined, 18 (81.8%) had centrosome hyperamplification: CH 0, 4 cases (18.1%); CH I, 5 cases (22.7%); CH II, 5 cases (22.7%); CH III, 8 cases (36.4%). The grade of CH was directly proportional to the histological grade (p=0.03, chi(2) test). LSC analysis showed that the centrosome replication cycle was well regulated in pathologically low-grade bladder cancer, which did not have chromosomal instability. In contrast, we found marked variability of centrosomes in pathologically high-grade bladder cancer, which had chromosomal instability. CH and CIN were both detected in pathologically high-grade tumors. The grade of CH was directly proportional to the CIN grade (p=0.0079, chi(2) test). CONCLUSION: The results of the present study suggest that CH may be involved in CIN in bladder cancer.

Aged↗

PubMed1990

Mast cell activation in sterile bladder and prostate inflammation.

Sterile inflammation of the bladder has often been associated with interstitial cystitis (IC), a urologic condition of unknown etiology, predominantly affecting young and middle-aged females, for which no effective therapy is known. Recent reports have indicated that IC is associated with an increased number of bladder mast cells. Here we report the case of a middle-aged man with chronic sterile hematuria, dysuria and lower abdominal pain associated with a high number of bladder and prostate mast cells. Following therapeutic transurethral resection of the trigone area, bladder neck and prostate, samples of bladder and prostate were examined with light and electron microscopy and contained many mast cells (about 150 cells/mm2) which were not degranulated. Nevertheless, mast cells contained many altered granules and urinary levels of histamine were elevated, implying secretion without exocytosis. These findings are discussed in the context of the pathophysiology of IC and possible therapeutic interventions.

Cystitis↗

PubMed1994

[Intraarterial chemotherapy for patients with invasive bladder cancer--clinical effects and preliminary results in bladder preservation].

Preoperative intraarterial chemotherapy including cisplatin, etoposide and adriamycin was performed for 16 patients with invasive bladder cancer between April, 1989 and September, 1993. Of 16 patients, radical cystectomy was done in 12 patients and the bladder was preserved by a transurethral resection in 4. Of 12 patients treated with cystectomy, complete response was achieved in 2 cases and partial response in 4 (response rate: 50%). Pathological evaluation of resected specimens revealed significant downstage of the tumors in 8 of 12 patients (67%). At follow-up 4 patients had recurrent and/or distant metastasis. Three of these four patients died of cancer progression and one survived with cancer. Of 4 patients with preserved bladder, complete response was achieved in one case and partial response in 3. Pathological specimens evaluated by transurethral resection showed significant downstage of tumors in all cases. One patient had an invasive, recurrent tumor in the preserved bladder and was treated with radical cystectomy 6 months after initiation of the therapy. All patients tolerated the treatment well. Intraarterial chemotherapy seems to be effective for invasive bladder cancer, but the true success of bladder-preserving treatment by a transurethral resection, chemotherapy and other therapy will require further study.

Aged↗

PubMed1992

Effects of intravesical Corynebacterium parvum on recurrences of superficial tumors of the urinary bladder.

We studied 96 patients with superficial tumors of the urinary bladder treated by transurethral resection in order to investigate the value of intravesical Corynebacterium parvum (CP) to prevent recurrences. In 52 cases, two vials (2 ml, 4 mg CP) diluted in 60 ml buffer saline were intravesically administered weekly 12 times and then monthly for a period of 2 years. All patients were studied in a 3 year follow-up by cytology, histology and endoscopy. Recurrences were observed in 21.1% of cases in the CP treated group and in 54.5% of cases in the untreated group. CP immunostimulation is less effective in preventing recurrences in patients with malignant cells as indicated by urine smears in the post-operative period. Morphological changes of the bladder wall due to CP administration in patients without recurrences are described. Chronic lymphocyte infiltrate appears to be an essential event for the action of CP as an adjuvant therapy in urinary bladder cancer.

Administration, Intravesical↗

PubMed1994

[Postoperative intravesical installation of tetrahydropyranyl-adriamycin (THP) and cytosine arabinoside (CA) for superficial bladder cancer: clinical results of prophylactic effects on recurrence].

Intravesical instillation of tetrahydropyranyl-adriamycin (THP) and cytosine arabinoside (CA) was performed on 42 patients with superficial bladder cancer after transurethral resection (TUR) for the purpose of prophylaxis of recurrence. The instillation was carried out with 30 mg of THP dissolved in 30 ml of distilled water and 200 mg of CA (total 40 ml). These drugs were instilled 7 times for the initial 2 weeks after TUR, and then 7 times every two weeks, 8 times every month, and 4 times every three months. Cases eligible for evaluation of efficacy were 38 out of 42 patients. The cumulative non-recurrence rate at one, two and three years were 94%, 84% and 75%, respectively. These high non-recurrence rates were demonstrated regardless of the size, number and pathological grade of the tumors. Severe bladder irritability was demonstrated in 8 (19%) of 42 patients, but generalized side effects were not seen in any case. The reformed regimen with 20 mg of THP in 30 ml of physiological saline solution was then performed on trial in several patients and there were no severe symptoms. THP combined with CA seems to be remarkably effective for the prophylaxis of recurrence, while a high concentration of THP in distilled water may lead to severe bladder irritability.

Administration, Intravesical↗

PubMed2005

Loss of blood group A antigen expression in bladder cancer caused by allelic loss and/or methylation of the ABO gene.

Loss of ABO blood group antigen expression has been reported in transitional cell carcinoma (TCC) of the bladder. Synthesis of the ABO blood group antigen was genetically determined by allelic variants of the ABO gene assigned on 9q34.1. We analyzed loss of heterozygosity (LOH) and promoter hypermethylation of the ABO gene in TCC and compared them with alterations of A antigen expression in TCC, dysplasia and normal urothelium. A total of 81 samples of TCC of the bladder obtained from transurethral resection (TUR) (n=44) and radical cystectomy (n=37) were examined. Expression of the A antigen was evaluated by immunohistochemical staining (IHC) using anti-A antigen monoclonal antibody. LOH of the ABO gene locus was examined by blunt-end single-strand DNA conformational polymorphism (SSCP) analysis using flouresence-based auto sequencer. Promoter hypermethylation of the ABO gene were examined by bisulfite PCR-SSCP (BiPS) analysis and/or methylation-specific PCR (MSP). Loss of A allele and/or hypermethylation were significantly associated with abnormal expression of the A antigen in cases undergoing TUR (P=0.02) and radical cystectomy (P=0.0005). For the analysis of the concomitant dysplasia in 23 cases with TCC of the bladder, the expression of the A antigen was maintained, regardless of the A allelic loss or methylation status in the tumor. In conclusion, A allelic loss and hypermethylation in the promoter region of the ABO gene showed significant correlation with reduction of A antigen expression in TCC, while the expression of the A antigen is maintained in concomitant dysplasia or normal urothelium, suggesting that loss of the ABO gene and/or its promoter hypermethylation is a specific marker for TCC.

ABO Blood-Group System↗

PubMed1995

[Intravesical instillation of epirubicin hydrochloride in superficial bladder tumor--prophylactic and therapeutic instillation for carcinoma in situ].

Between May 1990 and May 1993 we performed intravesical instillation of epirubicin hydrochloride (EPI) to 52 patients with superficial bladder tumor after transurethral resection. Indications of these instillations were classified into 3 groups. Group 1 was for carcinoma in situ (CIS) or the CIS other than the original tumor, group 2 was for multiple tumors, and group 3 was for pT1G3 tumor. Intravesical instillations of the drug were given weekly for 10 weeks and close follow-up examinations were performed routinely. Group 1 was treated for CIS, whereas group 2 and group 3 were prophylactic instillations. The disease-free rate in group 1 was 67%, and that in group 2 and group 3 was 77% at 12 months, and 42% at 24 months according to the Kaplan-Meier method. The major side effects of the instillations were bladder irritation, hematuria and pyuria. However, we experienced 5 patients with severe side effects; 2 of atrophic bladder and 3 of hemorrhagic cystitis. Although this study was conducted retrospectively, these findings suggest that intravesical instillations of EPI can be as effective as other drugs, such as mitomycin C, and doxorubicin, by adding the maintenance instillation or by elevating the drug density and shortening the instillation time.

Administration, Intravesical↗

PubMed1999

[Postoperative prophylactic intravesical instillation of tetrahydropyranyl-adriamycin (THP) for superficial bladder cancer].

Intravesical instillation of tetrahydropyranyl-adriamycin (THP) was performed on 51 patients with superficial bladder cancer after transurethral resection (TUR) for prophylaxis of recurrence. The instillation was carried out with 20 mg of THP dissolved in 40 ml of distilled normal saline. Instillation was performed once 24 hours postoperatively, 9 times every 2 weeks, and 8 times every 4 weeks. These drugs were instilled for 30 to 60 minutes. The recurrence-free survival at 1, 2 and 3 years was 74.5%, 64.6% and 58.0%, respectively. Side effects of THP instillation were observed in only 4 cases (7.8%) as slight urinary frequency or micturition pain. Cases involving 5 or more tumors, or tumors measuring 3 cm or larger, more frequently demonstrated recurrence. The cases that did not respond to preoperative intravesical instillation of THP demonstrated a high frequency of recurrence. Intravesical instillation of THP as a prophylaxis against recurrence of superficial bladder cancer was effective in selected patients.

Administration, Intravesical↗

PubMed2005

Significance of stromal reaction patterns in invasive urothelial carcinoma.

We evaluated the types, frequency, and significance of stromal reaction patterns in urothelial carcinoma (UC) of the bladder in 60 transurethrally resected pT1 specimens (low-grade UC, 12; high-grade UC, 48). We observed 5 reaction patterns with 1 pattern in 37 cases (62%) and 2 or more patterns in the remainder. Dominant and secondary patterns, respectively, were as follows: stromal retraction, 30 (50%) and 4 (7%); edema, 18 (30%) and 1 (2%); inflammation, 8 (13%) and 14 (23%); fibroblastic proliferation, 3 (5%) and 5 (8%); fibrosis, 1 (2%) and 4 (7%). Progression occurred in 21 cases, including 9 (30%) of 30 with stromal retraction, 8 (45%) of 18 with edema, 2 (25%) of 8 with inflammation, 1 (33%) of 3 with fibroblastic proliferation, and 1 (100%) of 1 with fibrosis. Differences in progression rates and mean progression-free survival times were not statistically significant. We found that the most common stromal reaction in UC of the bladder is stromal retraction. Stromal reaction patterns seem to have some prognostic usefulness. Cases with stromal edema might benefit from closer follow-up. Awareness of the different types of stromal reactions also is useful for diagnosing invasion.

Adult↗

PubMed2005

Composite paraganglioma-ganglioneuroma of the urinary bladder.

Presented herein is the case of a 73-year-old man, complaining of dysuria, who had a composite paraganglioma-ganglioneuroma of the urinary bladder (CPGUB). At cystoscopy a submucosal tumor was found in the urinary bladder and resected after transurethral biopsy. The levels of serum catecholamine and 24 h urinary excretion of catecholamine and vanillylmandelic acid were elevated. Grossly, the resected tumor, measuring 4 x 3 x 2.5 cm, had a brownish cut surface with no necrosis and hemorrhage. Histologically, the tumor had alternating cellular and fibrous areas. The cellular areas consisted of polygonal cells, arranged in well-defined nests (Zellballen) and positive for Grimelius staining, with abundant amphophilic to acidophilic cytoplasm, occasionally containing eosinophilic hyaline globules and brown pigments. Although the nuclei of several polygonal cells were bizarre, mitoses and vascular invasion were not found. Fibrous areas consisted of spindle cells, resembling Schwann cell, admixed with ganglionic cells. To the authors' knowledge, only four cases of CPGUB have been reported in the English-language literature. Detailed reported cases and the present case showed no malignant features, such as extra-bladder infiltration and metastasis, and no recurrence in the short length of follow up. Accumulation of long-term follow-up cases may provide valuable prognostic information on this composite tumor.

Aged↗

PubMed1996

Role of proliferative activity estimated by bromodeoxyuridine labeling index in determining predictive factors of recurrence in superficial intermediately malignant bladder tumors.

PURPOSE: Previous studies have shown that factors predictive of tumor recurrence include a history of the disease, multiple tumors at diagnosis, and high tumor grade and stage. Additional biological marker for predicting tumor recurrence could potentially be used in the decision making process and could alter the frequency of clinical cystoscopy. We attempted to clarify whether the tumor proliferative activity estimated by bromodeoxyuridine, which is believed to be a thymidine analogue, and deoxyribonucleic acid (DNA) ploidy status correlates well with tumor recurrence as an objective parameter. MATERIALS AND METHODS: We evaluated 103 patients with superficial grade 2 transitional cell carcinoma of the bladder treated with transurethral resection. Mean followup plus or minus standard deviation was 49.5 +/- 11.3 months (minimum 36). Tumor specimens were obtained by transurethral cold-cup biopsy, with bromodeoxyuridine in vitro pulse labeling then performed under hyperbaric oxygen. The flow cytometric determination of the bromodeoxyuridine labeled cell index and DNA ploidy were estimated. RESULTS: When the tumor was classified according to the bromodeoxyuridine labeled cell index the 5-year no recurrence rates were 82.0 and 27.1% for an index of less than 5.3 and more than 5.3%, respectively. Furthermore, the 5-year no recurrence rates were 75.1% for DNA diploid compared to 29.3% for DNA aneuploid tumors, respectively. Multivariate analysis using Cox's proportional hazards model showed that the most important risk factor for tumor recurrence was a bromodeoxyuridine labeled cell index of more than 5.3% (risk ratio 5.31, p < 0.001), followed by DNA ploidy (risk ratio 2.61, p < 0.05). Tumor stage, initial lesion versus recurrence and single versus multiple tumors did not influence the risk factor for tumor recurrence. CONCLUSIONS: These data indicate that bromodeoxyuridine labeling status can be used as an objective risk factor for bladder cancer recurrence.

Actuarial Analysis↗