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PubMedDate not supplied

[Experience in the clinical application of semirigid mini-urethral endoscopes in the diagnosis and treatment of urinary bladder diseases].

We compared efficacy and safety of clinical application of modern semirigid miniureterorenoscopes (MURS) and standard hard-lens ureterorenoscopes (URS). The results of 335 transurethral endoscopic operations on the ureter have been analysed. Positive results of ureteroliths elimination by lithotripsy and lithoextraction were observed in 100 (77.5%) patients of group 1 (hard-lens URS) and in 175 (94.6%) patients of group 2 (semirigid MURS). Ureteral perforation occurred 3 times more often in group 1 patients than in group 2 (3.1 and 1.08%, respectively). A total number of complications observed in group 1 and 2 in the course of transurethral ureterolithotropsy and lithoextraction reached 6.3 and 1.08%, respectively. Ureterolithotomy was performed in group 2 eight times less frequently than in group 1 patients (2.1 and 17.9%, respectively). Ureteropyeloscopy made by semirigid MURS is a valuable therapeutic and diagnostic aid which raises efficacy of transurethral endoscopic manipulations, significantly lowers traumaticity of the upper urinary tracts and reduces to minimum the number of intra- and postoperative complications.

Equipment Design↗
PubMed1987

A critical reappraisal of cystometry in neurogenic bladder diseases.

Repeated cystometry was performed over an eight hour period in 14 patients with detrusor hyperreflexia. Volumes at first contraction, and at bladder capacity and also bladder compliance showed significant differences within individual variances and an increase in standard deviation in relation to increase in mean value. Amplitude of contractions showed equal variances in all patients. After a logarithmic transformation of the measurements the volume at first bladder contraction showed a significant increase (p less than 0.02) from the first to the second investigation performed an hour later. Determination of sample size in clinical trials using the pooled estimate of the standard deviations is discussed.

Adolescent↗
PubMed2002

In vivo optical coherence tomography feasibility for bladder disease.

PURPOSE: Optical coherence tomography is a new imaging modality capable of imaging luminal surface of biological tissue in the near infrared range with a spatial resolution close to the cellular level. We identified characteristic optical coherence tomography patterns for nonproliferative and proliferative inflammation, and malignant alterations of the bladder. MATERIALS AND METHODS: Optical coherence tomography was performed to image the bladder of 66 patients. The probe passed through the operating channel of a cystoscope and was pressed onto the mucosal site of interest. A mucosal biopsy of the image site was obtained. Optical coherence tomography was used to construct 680 images of the bladder and the images were compared with histology slides. RESULTS: Optical coherence tomography images of normal bladder showed 3 layers, namely the mucosa or transitional epithelium, submucosa and smooth muscle. In exudative processes there were poor light scattering areas in the connective tissue layer. Images of bladders with proliferative cystitis revealed nonuniform thickening of the epithelium or hyperplasia. Squamous metaplasia appeared as thicker and less transparent epithelium with a jagged boundary. Images of transitional cell carcinoma were characterized by the complete loss of a regular layered structure of the bladder wall and the penetration depth of optical imaging was slight. CONCLUSIONS: This study provides the characteristic optical coherence tomography pattern of nonproliferative and proliferative inflammation, and the characteristic appearance of severe dysplasia and transitional cell carcinoma. This technique may be useful as a guide for biopsy and for assisting in establishing resection margins.

Carcinoma, Squamous Cell↗
PubMed1978

Re-evaluation of differential sacral rhizotomy for neurological bladder disease.

The authors describe long-term follow-up results (4 to 6 years) in 13 patients who underwent differential sacral rhizotomy for urgency incontinence. Six patients were originally presented in a preliminary report in 1973. In the last seven patients, a highly selective rhizotomy of sacral fascicles innervating only the urinary bladder was performed. Results in the original six patients appear to be superior to those in patients who underwent a more refined rhizotomy. Possible explanations for this as well as alternative approaches to the treatment of urgency incontinence are briefly discussed.

Animals↗
PubMed1986

Sphincterotomy failure in neurogenic bladder disease.

Among 60 spinal cord injury patients who underwent external urethral sphincterotomy 45 experienced success and 15 failed. Failure was established when symptomatic urinary tract infections and high vesical residuals persisted. Urodynamic findings demonstrated detrusor areflexia in 10 patients (66 per cent), detrusor-sphincter dyssynergia in 2 (13.2 per cent), detrusor hyperreflexia with unsustained bladder contractions in 1 (6.6 per cent), and detrusor hyperreflexia and bladder neck obstruction in 2 (13.2 per cent). Among these failures poor detrusor contractility predominated. Detrusor-sphincter dyssynergia may indicate an inadequate surgical relief of obstruction. Bladder neck obstruction may indicate that a bladder neck incision should be considered when an external sphincterotomy is performed.

Adult↗