PubMed Health⌕ Search

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 1,081 records · Page 60Linked to original sources
PubMed1990

[Incidence of vesico-ureteral reflux after endoscopic surgery of superficial tumors of the bladder. A prospective study].

The present retrospective study was undertaken to determine the true incidence of vesicoureteric reflux after transurethral resection (TUR) of superficial bladder tumors. The possible role of tumor size, number, site, etc., relative to the appearance of reflux were analyzed, and the principal pathogenic factors involved in iatrogenic vesicoureteric reflux were determined. The incidence of reflux was studied using pre and postoperative ureterocystograms. The study revealed the presence of vesicoureteric reflux long after TUR in 20.6% of the patients.

Adult↗
PubMed1990

Prophylactic bladder neck incision in the treatment of small benign prostatic hyperplasia.

From May 1986 to January 1989, a total of 178 patients with small prostate (less than 20 grams) received transurethral resection for benign prostatic hyperplasia. Twenty-two patients (12.4%) developed bladder neck contracture with an average interval of 247 days. The prophylactic bladder neck incision was performed concomitantly with transurethral resection of the prostate on 72 patients. Although smaller adenoma (average weight: 11.4 grams) was resected in this group, the bladder neck contracture occurred in 4 patients (5.6%), compared to 18 contractures in 106 patients (16.9%) who underwent transurethral resection of the prostate alone for larger adenoma (14 grams), P value less than 0.05. The operation time, peri-operative morbidity and hospital stay were similar in these two groups. It appeared that prophylactic bladder neck incision could protect against the formation of bladder neck contracture in patients with small obstructing prostatic adenoma.

Chi-Square Distribution↗
PubMed2001

[Two cases of successful treatments with steroid for local and systemic hypersensitivity reaction following intravesical instillation of Bacillus Calmette-Guerin].

We have found steroid pulse therapy to be effective and safe for local and systemic adverse reactions of BCG therapy. Two cases are reported. Case 1: A 57-year-old woman with initial recurrence of urinary bladder carcinoma was treated with transurethral resection. The histopathological findings were transitional cell carcinoma (TCC), G2 > G1, pT1a. To prevent a second recurrence, she was administered Bacillus Calmette-Guerin (BCG) instillation therapy: 80 mg of BCG, (Tokyo strain) suspended in 40 ml of normal saline, instilled into her bladder weekly. After the fifth week of instillation, she was found to have a cough, sputum, edema of the eyelids, congestion of palpebral conjunctive, severe pain on micturition and pollakisuria. Although she was administered antituberculus, antibiotics and antiallergic drugs, all sign and symptoms were aggravated. Blood, urine and sputum cultures remained negative for mycobacterium. She was later diagnosed as having hypersensitive reactions against BCG and treated with steroid pulse therapy. The signs and symptoms mentioned above were decreased immediately and disappeared after a week. Case 2: A 76-year-old man with initial recurrence of urinary bladder carcinoma was treated with transurethral resection. To prevent a second recurrence, he was instilled the BCG six (6) times. Although no adverse reaction was observed, urinary cytology remained positive (class V) and small papillary tumor was detected at the dome of the bladder. Transurethral biopsy was then performed. The histopathological findings showed TCC, G3, CIS on the dome of bladder. Then he was again administered the same BCG instillation therapy. After the fifth instillation, he complained of severe pain of micturition, pollakisuria and dysuria. Although he was administered antibiotics and antiinflammatory drugs, all signs and symptoms were aggravated. Urine culture remained negative for mycobacterium. He was diagnosed as having hypersensitive reactions against BCG and was treated with two times of steroid pulse therapy. The signs and symptoms mentioned above were decreased immediately and disappeared after the second steroid pulse therapy.

Adjuvants, Immunologic↗
PubMed2004

Expression and regulation of tumor suppressor gene maspin in human bladder cancer.

Maspin is a member of serine protease inhibitor family with tumor suppressing activity for breast and prostate cancers, acting at the level of tumor invasion and metastasis. However, there have been no published data regarding the role of maspin in human bladder cancer. We evaluated maspin expression in 65 series of bladder cancer samples (22 transurethral resection (TUR) and 43 radical cystectomy) and studied the regulatory mechanism of maspin gene activation in bladder cancer cells. Maspin expression was immunohistochemically detected in four (18.2%) patients with TUR and 22 (51.2%) patients with radical cystectomy whereas no expression was observed in normal transitional cells located at tumor-free area in bladder. The maspin expression was significantly correlated with the development of muscle invasive bladder cancer (P=0.00008). Using a luciferase reporter system, maspin promoter activity was induced in the maspin-positive bladder cancer cell lines as well as maspin-negative RT4 cells. Furthermore, treatment with the DNA methyltransferase inhibitor, 5-aza-2' deoxycytidine, and histone deacetylase inhibitor, trichostatin A, led to re-expression of maspin in RT4 cells. Our results indicate that maspin may contribute to bladder cancer development and that DNA methylation and histone deacetylation may be important for regulating maspin gene activation in bladder cancer cells.

Adult↗
PubMed1992

Chemoimmunotherapy for prophylaxis of recurrence in superficial bladder cancer: interferon-alpha 2b versus interferon-alpha 2b with epirubicin.

Eighty-five patients who had undergone transurethral resection (TUR) of superficial bladder cancer were randomized to one of two treatments. Patients in Group 1 received a 10-month course of intravesical therapy with interferon (IFN)-alpha 2b (50 MU dose), commencing 21 days after TUR once a week for 8 weeks, then once every 15 days for 4 months and then finally once a month for 4 months. Patients in Group 2 received epirubicin (80 mg) intravesically 0, 24 and 48 h after TUR, and then 21 days after TUR received IFN-alpha 2b as for Group 1. The results confirmed the efficacy of immunoprophylaxis with IFN-alpha 2b, and early treatment with epirubicin tended to further reduce the percentage of relapses and extended the disease-free interval.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Urological complications following abdominoperineal excision of the rectum for carcinoma.

A retrospective study was made of 122 patients who had an abdominoperineal excision (APE) of the rectum for carcinoma at Concord Hospital between 1971 and 1979. Fifty-two percent of patients suffered one or more significant urological complications. These included urinary tract infection (32%), operative trauma to the urinary tract (8.5%) and temporary or permanent bladder dysfunction in 35% of patients. Acute urinary retention, when temporary, was managed by simple measures. Chronic retention, incontinence and some episodes of acute retention were due to a neurogenic bladder. These patients were difficult to treat. It is recommended that urodynamic studies be used to assess these patients who develop a neurogenic bladder before any treatment is instituted. This is relevant especially in those patients in whom a transurethral resection of either the bladder neck or prostate is contemplated.

Abdomen↗
PubMedDate not supplied

Early results of the value of p53 in predicting survival in a homogeneous cohort of patients with invasive bladder cancer treated with a neoadjuvant carboplatin-based regimen (M-CAVI).

AIMS AND BACKGROUND: Several reports on prognostic factors for infiltrating-bladder cancer have given controversial results. We assessed the prognostic value of p53 nuclear overexpression together with known prognostic factors for survival in patients with invasive T2-4 N0 M0 bladder cancer treated with neoadjuvant chemotherapy. STUDY DESIGN: Thirty-five paraffinized tumor samples from initial transurethral resection of patients with bladder cancer were analyzed immunohistochemically to detect overexpression of p53 protein. Patients were treated with 3 to 4 cycles of neoadjuvant methotrexate, carboplatin, and vinblastine (M-CAVI) and then underwent radical cystectomy. Prechemotherapy, treatment, and postchemotherapy factors were analyzed for correlation with survival by univariate and multivariate analysis. Fifty-seven percent of tumors were positive for p53 protein, 71.5% had grade III-IV tumors, and 72% had organ-confined disease. The median follow-up was 20 months (range 5-71+). RESULTS: By univariate analysis, the significant pretreatment factors were initial tumor (T) stage (P < 0.0001) and the male sex (P = 0.03). Five postchemotherapy variables were found significant: surgery performed according to protocol (P = 0.003), overall clinical (P = 0.004), and overall pathologic (P = 0.02) response to therapy, postchemotherapy pathologic stage (P = 0.0002), and tumor status after surgery (P = 0.0006). By multivariate analysis, the initial prechemotherapy T stage was the only factor that demonstrated independent significance. CONCLUSIONS: Although the median follow-up of the study is still too short, in this group of patients treated with a neoadjuvant carboplatin-based regimen, a classical variable (prechemotherapy T stage) rather than p53 nuclear overexpression was an independent prognostic factor for survival. Further follow-up will be required to assess the value of p53 overexpression as a prognostic factor in invasive bladder cancer patients treated with neoadjuvant carboplatin-based chemotherapy.

Aged↗
PubMedDate not supplied

[The role of preserving therapy of invasive cancer of the urinary bladder].

Cystectomy in the treatment of invasive cancer of the urinary bladder is not the only therapeutic modality in this pathology. In selected patients an alternative exists--transurethral resection of the urinary bladder followed by adjuvant concurrent chemotherapy and radiotherapy. The preserving therapy can be recommended to patients over 60 years of age in the presence of a low-grade solitary tumor of a mobile wall of the urinary bladder respectable with preservation of the organ capacity.

Adult↗
PubMed1977

[A bladder-prostate model on which to practice using transurethral resection instruments (author's transl)].

A metal container, open on the top, with a rubber collar on the front and a place inside for mounting an apple, can be used for practicing the TUR of the prostate with all types of resection instruments. The device can be strapped to the resection table, and all technical aspects of the TUR with the exception of blood stanching, can be simulated. The removal of the prostate as far as the capsule can be accomplished with the apple, which is resected from the core to the peel. In addition, a learning method for actual resection is described.

Male↗
PubMed1995

[Radiologic evaluation of parietal infiltration of bladder cancer (integrated imaging: US, TC, RM) and comparison with transurethral resection (TUR)].

In this work we checked the reliability of Ultrasounds (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in the staging of parietal infiltration of bladder carcinoma. We studied 49 patients with documented bladder carcinoma. All patients underwent CT examination, 43 patients to MR examination and 40 patients to US examination. Between the patients who underwent US examination, 35 out of them had a sovra-pubic Ecography, 27 patients a trans-rectal Ecography and in 30 patients a trans-uretral Ecography was performed. After radiologic examination, all patients underwent a deep fractionated trans-uretral resection of the neoplastic mass (TUR) for the tumor staging. The results of the computed images and US examinations were then compared with the TUR staging. Among the group of patients studied with US, the agreement between imaging and TUR staging was respectively of 51% for the sovra-pubic study, 44.5% for the trans-rectal study and 56.7% for the trans-uretral study. The agreement was of 55% with the CT studies and 45.7% with the MRI. The sovra-pubic US studies showed a good correlation in the evaluation of superficial lesions (Tis-T1 stadied on TUR), if compared to the CT and MRI studies; moreover US is certainly more suitable because of its lower price and discomfort for the patient. On the contrary patients with a documented stage > T1 need a CT and MRI study for the correct staging. MRI has shown to be more sensitive in selected cases with localization of tumor on the top of the bladder roof, on its floor or in the follow-up after TUR. CT scan showed a better reliability in the staging of superficial lesions (Tis-T1 stages). On the contrary MRI has shown to be more sensitive in distinguishing superficial lesions (T1-T2 stages) from deeper lesions with muscles infiltration (T3a stage) on the basis of the loss of the parietal hypointense line on the T2 weighted images. Tumors with a grade T3b or more are well studied in both CT scan and MRI, which allow to get more useful information than US about the lynphoglandular involvement.

Adult↗
PubMed1984

Urethral stricture after transurethral resection.

After 101 transurethral resections, iatrogenic postoperative urethral strictures have occurred in 10 cases due to pathologic changes in the bladder and bladder neck. Urethral stricture after transurethral resection (TUR) thus has represented the most common postoperative complication. No morbidity increase of urethral strictures after TUR could be demonstrated in one of the analysed groups. Fifty per cent of the incidence rate of strictures was localized in the pars pendulans urethrae. Factors causing the stricture have been demonstrated, and the incidence rate of strictures was reduced when these factors were taken into consideration. Preference is given either to conservative or surgical therapy depending on the localization of the stricture, even though endoscopic methods are used more frequently now in the treatment of stenoses of the urethra.

Adult↗
PubMed2002

DNA profiles and numeric histogram classifiers in nephrogenic adenoma.

BACKGROUND: The malignant potential of nephrogenic adenoma is still a matter of controversy and therapeutic regimens of this morphologic entity range from partial, even total cystectomy to watchful waiting. The objective of the current study was to evaluate several robust image cytometry-DNA histogram classifiers and to search among those for factors that separate a biologically nonaggressive metaplastic lesion from lesions with increased malignant potential. METHODS: The study included bladder irrigation specimens, 23 preceding transurethral resection of nephrogenic adenoma and 24 preceding resection of papillary bladder carcinoma. Feulgen-stained nuclei were imported to a static image analysis system, and densitometric data were interpreted by two different software programs. Histograms were described numerically by DNA index, 2c deviation index, and by 5c/9c-exceeding and euploid polyploidy rates. In addition, an interpretation algorithm based on a dual parameter analysis with an integrated automatic threshold was used. RESULTS: The numeric classification of DNA histograms of patients suffering from nephrogenic adenoma resulted in DNA indices between 0.91 and 1.15. The 2c deviation indices ranged from 0.03 to 0.43, and the 5c exceeding rates ranged from 0.0 to 1.58. None of the measurements showed nuclei exceeding 9c. The p25-75 ranges of 2c deviation indices in nephrogenic adenoma and papillary urothelial carcinoma did not overlap. These findings might be explained by minor proliferative activity in nephrogenic adenoma. Euploid polyploidy rates less than 5% confirm this explanation. Risk analysis documented high risk only for those patients with nephrogenic adenomas who had proven transitional cell carcinoma in their history. CONCLUSIONS: DNA estimation by image cytometry of urinary bladder irrigation specimens appears able to separate papillary bladder lesions. The method detects those lesions with higher malignant potential but is limited in separating entities with low malignant potential. Comparison of the discriminative power of robust numeric DNA classifiers reveals the 2c deviation index superior to the widely used DNA index and the 5c exceeding rate in this material.

Adenoma↗
PubMed2003

Performance characteristics of multiple urinary tumor markers and sample collection techniques in the detection of transitional cell carcinoma of the bladder.

BACKGROUND: The optimal management of bladder cancer requires early detection of both primary tumor as well as recurrences. This study compared the methodologies of the following tumor markers and diagnostic tools: telomerase, bladder tumor-associated analytes (BTA stat), nuclear matrix protein 22 (NMP22), the hemoglobin (Hb) dipstick and chemiluminometric red cell assays, and determined their respective sensitivity and specificity in detection of bladder cancer along with urine cytology. METHODS: Different sample collection techniques were used including bladder tissue from radical cystectomy or transurethral resection, voided and cystoscopically collected urine and bladder washes. Results of these techniques were compared for some of these markers. RESULTS: The first study utilizing cystoscopically collected urine and bladder washes, the sensitivity of telomerase in detecting bladder cancer was 92% and 87%, respectively, whereas for bladder tissue it was 93%. The sensitivities of cytology, NMP22 and original BTA, however, were 62%, 54% and 49%, respectively. In the second study using first single voided urine from patients with bladder cancer and non-bladder cancer controls, the greatest sensitivity (overall 77%) and specificity (overall 98%) was exhibited with telomerase. The combined sensitivity of telomerase with that of either the hemoglobin dipstick or chemiluminometric red cell assays, showed that the overall sensitivity was increased to 89% and specificity to 98%. CONCLUSIONS: The sensitivity and specificity of telomerase activity in conjunction with chemiluminometric red cell or hemoglobin dipstick assay may be considered as an alternative to urinary cytology. It can also supplement cystoscopy for monitoring recurrence of bladder cancer.

Antigens, Neoplasm↗
PubMed1990

[Transurethral incision of the prostate and bladder neck for the treatment of outflow obstruction caused by a small benign prostate].

Transurethral incision of the prostate and bladder neck (TIPBn) was compared with transurethral resection of the prostate (TURP) followed by bladder neck incision in the treatment of 22 patients with outflow obstruction caused by a small prostate adenoma (below 15 gm). Eleven patients underwent TIPBn and another 11 TURP. An evaluation of the urodynamic findings and subjective symptoms was undertaken before the operation and 3 months afterwards. Urodynamic findings were evaluated, based upon uroflowmetry, i.e., in terms of maximum flow rate, average flow rate, voiding time, initiation time and residual rate. All patients in the TIPBn group revealed an improvement in every urodynamic parameter (MFR: from 6.1 to 10.8 ml/sec, AFR: from 3.1 to 5.8 ml/sec, Voiding time: from 95.5 to 24.2 sec/100 ml, Initiation time: 34.3 to 10.2 sec, Residual rate: 31.6 to 17.8%, in mean value). Ten out of the 11 in the TIPBn group subjectively considered the result to be good. The improvements in the urodynamic parameters in the TIPBn group were statistically comparable to those in the TURP. The improvements in voiding time and initiation time, however, tended to be much better in the TIPBn group. We conclude that TIPBn can be the operation of choice in the treatment of outflow obstruction caused by a small prostate.

Aged↗
PubMedDate not supplied

[Diagnosis and surgical treatment of tumors of the upper urinary tract].

The author believes that in diagnosis of tumors of the upper urinary tracts more information can be obtained at ureteropyeloscopy with retrograde contrasting of the urinary tracts and, if necessary, biopsy of abnormal urothelium regions. 19 patients with pelvic and 4 patients with ureteral tumor were operated on. 2(8.7%) patients with tumor in the lower third of the ureter underwent resection with Boari operation, classic nephroureterectomy with bladder resection was made in 15(65.2%) patients, transurethral resection of the wall of the bladder, ostium and distal ureter followed by nephroureterectomy was performed in 6(26.1%) patients. The latter operative procedure is radical but less traumatic. Five-year survival made up 73.9%.

Aged↗
PubMed2006

Recent improvements in the detection and treatment of nonmuscle-invasive bladder cancer.

In total, 70-80% of newly diagnosed bladder cancers are confined to the mucosa and staged as Ta, T1 or carcinoma in situ according to the 2002 tumor, lymph nodes and metastasis classification. The standard treatment for these nonmuscle-invasive bladder cancers is transurethral tumor resection with or without adjuvant intravesical chemotherapy or intravesical immunotherapy and subsequent follow-up. Diagnosis and follow-up of nonmuscle-invasive bladder cancer offers two main problems. First, approximately 10-20% of all tumors are not seen in standard cystoscopy. Additionally, frequently repeated follow-up cystoscopies are bothersome for the patient. As an adjunct to standard cystoscopy, fluorescence-guided cystoscopy has demonstrated significantly higher tumor detection rates and optimized patient treatment in recent Phase III studies. Second, routinely performed urine cytology is characterized by high specificity but low sensitivity. Today, several urine tests are available that may increase diagnostic accuracy and potentially prolong intervals of follow-up cystocopy. Owing to rather high recurrence rates after transurethral tumor resection in most tumors and high progression rates in poorly differentiated tumors, adjuvant intravesical chemotherapy or intravesical immunotherapy has gained widespread use in patients with nonmuscle-invasive bladder cancer. Only a few further immunomodulatory drugs, such as recombinant cytokines, have shown significant clinical effectiveness. Additional approaches, such as photodynamic therapy with different photosensitizers and thermotherapy in combination with intravesical chemotherapy, have been evaluated in Phase III studies.

Biomarkers, Tumor↗