SEARCH · PubMed Health

Results for “CYSTOSCOPY”

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 1,243 records · Page 69Linked to original sources

PubMed1999

Outpatient flexible cystoscope-assisted insertion of ureteric catheters and ureteric stents.

OBJECTIVE: To examine the feasibility of inserting ureteric catheters (before retrograde ureterography) and JJ ureteric stents (both traditionally performed under general anaesthesia on inpatients) using local anaesthesia in an outpatient setting and with no patient selection bias, thus providing procedures to ease the demand on inpatient lists. PATIENTS AND METHODS: All patients presenting with an appropriate clinical indication for either of the procedures underwent insertion during a scheduled flexible cystoscopy session in the outpatient department; information was collected on a standard proforma. Antibiotic prophylaxis and a nonsteroidal analgesic were administered 30 min before the procedure. RESULTS: To date, 20 patients (seven men, age range 32-74 years, and 13 women, age range 23-86 years) have undergone one of the two procedures. Fourteen patients had attempted retrograde catheter insertion, with success in 12, and six other patients underwent attempted JJ ureteric stent insertion, with success in five. The three failures were caused by an inability to see the relevant ureteric orifice. The mean duration of each procedure was 11 min; 14 of the 17 patients who had a successful procedure had no significant pain or discomfort, while the remaining three experienced significant pain and discomfort. There were no infective complications. CONCLUSION: These two procedures are suitable for the outpatient/day-case situation, and are well tolerated and accepted by most patients.

Adult↗

PubMed2003

A prospective evaluation of detrusor ultrastructural changes in bladder outlet obstruction.

OBJECTIVES: To characterize the ultrastructure of detrusor smooth muscle from the bladders of symptomatic men with bladder outlet obstruction (BOO) caused by benign prostatic enlargement (BPE) and compare this with a matched control group; to determine how detrusor morphology relates to urodynamic findings and to develop a better understanding of the natural development of bladder dysfunction related to BOO. PATIENTS AND METHODS: Twelve men (mean age 66 years, range 52-77) with urodynamically confirmed BOO caused by BPE and 12 age-matched asymptomatic normally voiding controls (mean age 67.8 years, undergoing cystoscopy for other conditions) had detrusor biopsies taken endoscopically. The biopsies were processed for electron microscopy using standard methods. The specimens were randomized and examined at medium power (x 4000) by an examiner unaware of the urodynamic findings. Any ultrastructural patterns identified subjectively were noted. RESULTS: In the BOO group eight of the 12 men had a myohypertrophic pattern, half of which were associated with a degenerative pattern of hypocontractility. Of the remaining four patients, two had the degenerative pattern alone and two were normal. The six men whose biopsies had a degenerative pattern had consistent postvoid residual volumes of > 150 mL; the remainder all had volumes of < 150 mL. There were no ultrastructural abnormalities in the control patients. CONCLUSIONS: There are interesting qualitative ultrastructural changes in the obstructed detrusor, but they are not consistent enough to provide a reliable diagnostic tool. However, there may be an important relationship between the degenerative pattern and postvoid residual volume in BOO.

Adult↗

PubMed2003

Detection of bladder dysplasia using 5-aminolaevulinic acid-induced porphyrin fluorescence.

OBJECTIVE: To report results of a clinical investigation on the detection of bladder dysplasia and in situ carcinoma by using fluorescence induced by 5-aminolaevulinic acid (ALA). PATIENTS AND METHODS: The study included 50 patients with a primary bladder lesion, who had a bladder instillation of 50 mL of 3% ALA solution >or= 1 h before transurethral resection of the tumour. Random biopsies were taken using white-light cystoscopy, then using blue light to induce fluorescence; positive zones were noted and biopsied. The primary lesion was then resected. The frequency of dysplasia detected by ALA-induced fluorescence was evaluated, as was the risk of recurrence with a follow-up of >or= 2 years. RESULTS: In all patients the tumours were positive; in 21 fluorescence distant from the tumour was detected. The pathological report of the biopsies showed 11 cases of dysplasia, six of carcinoma in situ and four of inflammatory lesions. In 29 patients there was no fluorescence and quadrant biopsies were normal in all but three with moderate dysplasia. Within the minimum follow-up patients with bladder dysplasia detected by ALA-induced fluorescence had a higher risk of recurrence. CONCLUSION: ALA-induced fluorescence of the bladder significantly enhanced the detection of dysplasia and in situ carcinoma. However, this technique requires further investigation using well-characterized instrumentation and study protocols to determine any effect on treatment choice.

Aminolevulinic Acid↗

PubMed1996

Penetration of the bladder by a perforating intrauterine contraceptive device: a sonographic diagnosis.

We describe a case of penetration of the urinary bladder by an intrauterine contraceptive device with perforation of the uterine wall. This finding was discovered incidentally during an ultrasound examination for an earlier nonspecific mild abdominal pain of short duration. No abnormality had been noted on pelvic examination, during which the device's strings were found to protrude through the patient's cervix; a short laboratory workup including urinalysis, urine culture, blood count and blood sedimentation rate was also negative. The sonographic diagnosis was confirmed by cystoscopy. The device was retrieved transcervically. No complications were observed on follow-up. Bladder perforation by an intrauterine contraceptive device is very rare, and only a handful of such cases have been described. In all previous cases, the diagnosis followed a rather prominent clinical presentation, whereas, in this case, the patient complained of intermittent low abdominal pain of short duration. We therefore suggest that pelvic ultrasound examination be performed in every patient with unexplained low abdominal pain who is known to carry an intrauterine contraceptive device.

Adult↗

PubMedDate not supplied

Bladder cancer: epidemiology, diagnosis, and management.

PURPOSE: The purpose of this article is to present an overview of the epidemiology diagnosis, and management of bladder cancer, with a focus on the early stage of this disease. OVERVIEW: English-language articles published between 1990 and 2000, as well as selected abstracts published in non-English languages before 1990, were reviewed. Epidemiologic data clearly indicate that bladder cancer is much more common in men, White persons, and the elderly. Cigarette smoking appears to be the most significant environmental risk factor. Screening for the disease is currently not standard in the United States or Canada. Potential tests include urine cytology, hematuria dipstick, and the urinary biomarkers. Diagnosis is made most often on the basis of the findings of cystoscopy, tumor biopsy, and urine cytology. Transurethral resection (TUR) of the tumor is generally the first-line treatment for superficial disease. Cystectomy is the "gold standard" treatment for invasive disease in many countries, although trimodality therapy (TUR, radiation, systemic chemotherapy) has shown promise as a bladder-preserving strategy. Intravesical therapy is effective for preventing disease recurrence, although its role in slowing disease progression is uncertain. Chemotherapy and radiation also can be used with cystectomy to treat or prevent pelvic recurrence of invasive disease or to prolong life in patients with metastatic disease. CLINICAL IMPLICATIONS: Bladder cancer is a commonly occurring disease. Prevention efforts must focus on the avoidance or cessation of cigarette smoking and on public education relating to known environmental risk factors. Patient and disease factors must be considered in making treatment decisions and determining prognosis. Careful follow-up after treatment is essential. It is hoped that ongoing research on potential tumor markers and tumor-specific therapies ultimately will result in improved clinical outcomes for patients with this malignancy.

Adult↗

PubMed1979

Endoscopic procedures in the treatment of urologic disorders in children.

Cystoscopy has been a well established procedure in adult urology for years and more recently for the endoscopic evaluation of the lower urinary tract of infants and children. Utilizing small caliber cold light endoscopes and resectoscopes, therapeutic manipulations are readily possible. Among these are extraction of ureteral stones, lithotripsy of bladder calculi, transurethral resection of bladder tumors, as well as transurethral incision and resection of bladder-neck obstructions, urethral valves and urethral stenoses. The excellent results obtained in the treatment of infravesical urinary obstruction have contributed to the importance of transurethral surgery in pediatric urology.

Child↗

PubMed2000

Fetal hydrolaparoscopy and endoscopic cystotomy in complicated cases of lower urinary tract obstruction.

OBJECTIVE: Vesicoamniotic shunting may be difficult or impossible in selected cases of fetal lower obstructive uropathy. The purpose of this article is to describe the performance of fetal hydrolaparoscopy and endoscopic fetal cystotomy in two fetuses with complicated lower obstructive uropathy. STUDY DESIGN: Fetal hydrolaparoscopy-endoscopic fetal cystotomy was performed in a patient with a markedly thickened bladder that could not be entered percutaneously. A peritoneoamniotic (bridge) shunt was also placed. Fetal hydrolaparoscopy-endoscopic fetal cystotomy was performed in a second patient with a collapsed bladder from a previous vesicocentesis, because vesicoinfusion resulted in further ascites. Fetal cystoscopy was performed after endoscopic fetal cystotomy, and posterior urethral valves were ablated with neodymium:yttrium-aluminum-garnet laser energy. A vesicoamniotic shunt was left in place. RESULTS: Adequate bladder drainage was obtained in both cases. The first baby required bilateral nephrotomy and a permanent cystotomy at birth and is scheduled for a bladder expansion procedure at the age of year. The second patient had premature rupture of membranes and fetal death from treatment of this complication 5 days after the original procedure. CONCLUSION: Fetal hydrolaparoscopy-endoscopic fetal cystotomy can be performed in complicated cases of lower obstructive uropathy. The procedure involves the creation of a defect in the bladder dome under direct endoscopic visualization within a spontaneous or intentional hydroperitoneum. Peritoneoamniotic shunting, vesicoamniotic shunting, or ablation of posterior urethral valves may then be performed. Fetal hydrolaparoscopy-endoscopic fetal cystotomy should be reserved only for complicated cases of lower obstructive uropathy in which conventional vesicoamniotic shunting is not safely possible. Further experience with fetal hydrolaparoscopy-endoscopic fetal cystotomy is necessary to establish its risks and benefits.

Adult↗

PubMed2002

Hormonal manipulation in women with chronic, cyclic irritable bladder symptoms and pelvic pain.

OBJECTIVE: Chronic, painful bladder symptoms are diagnostic and therapeutic challenges for urologists and gynecologists. The aims of this study were to evaluate women with menstrual cycle-related changes in their interstitial cystitis symptoms, to treat them with hormonal manipulation, and to follow them long term. STUDY DESIGN: The cases of women who were referred to a tertiary care center with interstitial cystitis and menstrual cycle exacerbation of symptoms were evaluated in a retrospective study. Fifteen women had undergone laparoscopy that was followed immediately by cystoscopy and bladder hydrodistension. Patients were then treated with leuprolide acetate or oral contraceptive pills. RESULTS: Patient age ranged from 23 to 48 years. The duration of symptoms ranged from 1 to 26 years. Ten patients (67%) had findings of both interstitial cystitis and peritoneal endometriosis. Five of 15 patients (33%) had interstitial cystitis, but no endometriosis was found. Symptoms improved for 8 of 9 women who were treated with leuprolide acetate and for 5 of 6 women who were treated with oral contraceptive pills. Patients were followed up for an average of 55 months. CONCLUSION: Diagnostic laparoscopy should be considered together with hydrodistension of the bladder for women with pelvic pain and irritative bladder symptoms that are exacerbated premenstrually. Endometriosis is often present in patients with these complex symptoms. This is the first report of hormonal treatment for chronic, cyclic irritative bladder symptoms; improvement appears to occur even when endometriosis is not identified by laparoscopy.

Adult↗

PubMed2003

A comparison of anticipated pain before and pain rating after the procedure in patients who undergo cystourethroscopy.

OBJECTIVE: The purpose of this study was to compare anticipated pain before the procedure and actual pain rating after the procedure in female patients who undergo cystourethroscopy. STUDY DESIGN: Eighty-seven consecutive female patients completed a 10-cm visual analog pain scale before and after cystourethroscopy. A 24F urethroscope was used initially to inspect the urethra and was followed by a systematic survey of the bladder with a 17F cystoscope that was lubricated with 2% lidocaine gel. The visual analog pain scale scores were evaluated for significance with the use of the Student t test and the Pearson correlation coefficient. RESULTS: Visual analog pain scale analysis demonstrated a mean anticipated pain score of 3.75 cm before the procedure versus a mean pain rating score of 2.83 cm after the procedure (P <.05). Neither a history of previous cystoscopy (visual analog pain scale score, 3.03 vs 2.30 cm; P =.18) nor talking with someone about the procedure beforehand (visual analog pain scale score, 2.74 vs 2.89 cm; P =.76) influenced the lower pain rating after the procedure. There was no significant correlation between age, parity, body mass index, or presence of pelvic organ prolapse and anticipated or realized pain perception. CONCLUSION: Patients who undergo cystourethroscopy consistently anticipate higher degrees of discomfort than they actually perceive during the procedure.

Analgesics↗

PubMed1988

Bladder carcinoma presenting as exercise-induced hematuria.

Exercise-induced hematuria is becoming a common diagnosis for postexercise hematuria. However, a number of genitourinary tract diseases also may cause gross or microscopic hematuria in some physically active patients. Four cases of postexercise hematuria in patients with transitional cell carcinoma of the bladder are presented. The authors recommend urologic evaluation with excretory urography and cystoscopy for all patients with postexercise hematuria.

Adult↗

PubMed2004

The role of abnormal congenitally displaced ureteral orifices in causing reflux following spinal cord injury.

OBJECTIVE: To determine the role of congenitally displaced ureteral orifices in causing vesicoureteral reflux (VUR) in individuals with spinal cord injury (SCI). DESIGN: Retrospective chart review. PARTICIPANTS: Men and women with (UMN) neurogenic bladders secondary to SCI. MAIN OUTCOME MEASURES: Position of the ureteral orifice and urodynamic parameters in association with VUR. METHODS: A retrospective chart review was performed to identify SCI participants with and without reflux who had evaluation with cystoscopy, cystogram, and urodynamics. The position of ureteral orifice was compared in individuals with SCI who did and did not have ureteral reflex. All cystogram studies were interpreted by board-certified radiologists. The International Classification system was used to grade the severity of the reflux. Fisher exact test was used to evaluate the association of the posterior ureteral orifice and reflux. Analysis also was performed to evaluate the association of reflux with posterior-placed ureteral orifices and urodynamic parameters in the reflux group and nonreflux group. RESULTS: Fifteen participants were found to have reflux--11 had posterior-placed ureteral orifices, whereas 4 had normally positioned orifices. The 11 individuals with posterior-placed ureteral orifices had no bladder wall trabeculation. However, all 4 individuals with normally positioned ureteral orifices had severe trabeculation. Seventeen participants did not exhibit reflux--2 had posteriorly placed ureteral orifices and 15 had normally positioned orifices. Association of posterior position and reflux (P = 0.004). No differences were found with regard to bladder capacity, bladder wall compliance, or voiding pressures between the reflux group and nonreflux group. CONCLUSION: Congenitally displaced ureteral orifices are an important cause of VUR in individuals with SCI. Participants with normally positioned ureteral orifices only had reflux in the presence of severe trabeculation. This study suggests that annual screening with cystograms may not be necessary in individuals with normally positioned ureteral orifices and no significant trabeculation.

Cystoscopy↗

PubMed1976

Roentgenologic aspects of haematuria.

In the roentgenologic investigation of haematuria, urography is the main diagnostic tool, other examinations being only of supplementary value. The main importance of other roentgen examinations is the possibility of excluding certain types of suspected disease as the cause of haematuria, and to demonstrate certain vascular malformations in the kidneys with renal angiography. Urography and cystoscopy should be performed in all patients with haematuria, and the possibility of pathologic conditions in both upper and lower urinary tract must be kept in mind. A large number of overlooked calculi and the finding of unsuspected malignant renal tumors in cases where the urography was performed on an emergency basis, underlines the important fact that "emergency" in these cases only indicates that the patient is an acute distress, not that the examination should be hasty and incomplete, or if so, should be supplemented by a repeat examination under normal conditions.

Aged↗

PubMed2001

Management of ureteral stricture disease during laparoscopic ureteroneocystostomy.

BACKGROUND AND PURPOSE: Laparoscopic surgery has many applications in urology. The surgical management of obliterative ureteral stricture disease using laparoscopy has not been widely reported. We recently implemented this technique in an adult patient with an obliterative ureteral stricture. METHODS: A transperitoneal refluxing right ureteral reimplantation was performed using the Endostitch device. Placement of the new ureteral orifice in the bladder was monitored by simultaneous cystoscopy and laparoscopy. The anastomosis was performed without tension, torsion, or angulation and was stented for 4 weeks. RESULTS: The operative time was 233 minutes. The blood loss was minimal. There were no intraoperative complications, and the postoperative hospital course was uneventful. CONCLUSION: Laparoscopic ureteral reimplantation is a safe and feasible technique. Cystoscopic determination of the neoureteral orifice is helpful. The Endostitch device is a useful adjunct in this procedure.

Adult↗

PubMed2001

Endoscopic extraction of an ejaculatory duct calculus to treat obstructive azoospermia.

Calculous obstruction of an ejaculatory duct is an uncommon cause of azoospermia or low-volume oligospermia in the infertile man. We report the case of a 32-year-old man with azoospermia, low ejaculate volume, and transrectal ultrosonography (TRUS) findings of bilateral seminal vesicle distention. On cystoscopy for planned transurethral resection of the ejaculatory ducts, a calculus obstructing the right ejaculatory duct at the verumontanum was discovered and removed. Three months later, semen analysis showed improvements in volume, sperm concentration, and sperm motility. An ejaculatory duct calculus should be included in the differential diagnosis of obstructive azoospermia or low-volume oligospermia. Magnetic resonance imaging or TRUS may be advisable to identify ductal calculi.

Adult↗

PubMed2003

Retrograde vaginal methylene blue injection for localization of complex urinary fistulas.

BACKGROUND: Ureterovesical and vesicovaginal fistulae usually are easily diagnosed with standard techniques, including radiology, double-dye test, cystoscopy, and vaginal examination. In a few complex cases, however, the localization of the fistulous orifice may be extremely difficult. METHOD: We describe a novel technique of retrograde vaginal methylene blue testing that may assist in the proper localization of the fistulous opening. RESULTS: Our experience with one case each of ureterovesical and vesicovaginal fistula easily diagnosed with this method proves its efficacy, simplicity, and safety. CONCLUSION: This technique should be reserved for cases of urinary fistulae when all standard diagnostic methods have failed.

Adult↗

PubMed1997

Holmium: YAG laser damage to ureteral guidewire.

The holmium:yttrium-aluminum-garnet (holmium:YAG) laser effectively fragments urinary calculi of all compositions. Complications have been minimal and mostly attributable to the ureteroscopy as opposed to the laser. We report a case in which the polytetrafluoroethylene (PTFE) coating of a ureteral guidewire was broken with the holmium:YAG laser and remained in the collecting system after the guidewire was removed postoperatively. The patient required cystoscopy to remove the guidewire coating.

Adult↗

PubMed2004

The pediatric caliceal diverticulum: diagnosis and laparoscopic management.

PURPOSE: To describe the laparoscopic management of anterior caliceal diverticula in pediatric patients and to emphasize the importance of intraoperative retrograde pyelography for the diagnosis of symptomatic lesions when preoperative radiologic evaluation is inconclusive. PATIENTS AND METHODS: We performed laparoscopic transperitoneal excision of a large symptomatic caliceal diverticulum in three patients. Ultrasonography was consistent with a cyst, and a CT scan did not show layering on delayed images. Prior to surgical intervention, we localized the diverticulum by cystoscopy and fluoroscopic retrograde ureteropyelography. RESULTS: Complete ablation of the caliceal diverticulum cavity was achieved in all cases without open conversion. The mean operative time was 134 minutes. Blood loss was minimal in all cases. The mean hospital stay was 37 hours. There were no intraoperative or postoperative complications. Because the preoperative studies were consistent with large anterior cysts, we found retrograde ureteropyelography as an adjunct to laparoscopic surgery invaluable to identify the patent diverticular neck. CONCLUSION: Patients with a large, symptomatic Type 2 caliceal diverticulum with thin overlying parenchyma are ideal candidates for laparoscopic intervention. The laparoscopic technique of caliceal diverticulum ablation in the pediatric population is feasible in appropriate patients.

Adolescent↗

PubMed2005

Three-dimensional CT virtual endoscopy in the detection of simulated tumors in a novel phantom bladder and ureter model.

BACKGROUND AND PURPOSE: Cystoscopy and ureteroscopy have limitations in the evaluation for urothelial tumors, and both are invasive. We studied the utility of three-dimensional (3D) CT virtual endoscopy in phantom models. MATERIALS AND METHODS: A phantom pelvis was constructed of Plexiglas, porcine pelvic bones, and processed animal fat and scanned at various table speeds in a four detector-row CT machine for ability to detect "tumors" of Solidwater plastic polymer. Images were reconstructed at slice thicknesses of 2.5 to 5.0 mm and reconstructed in 3D for evaluation by two radiologists with no knowledge of the scanning parameters or tumor location. Similar studies were performed with a ureter model. RESULTS: With 5-mm slices, the sensitivity for bladder tumors ranged from 67% for 2-mm tumors to 100% for 4-mm tumors, with 12 false-positive findings. The overall sensitivity was 86% with 3.75-mm slices with one false positive, and with 2.5-mm slices, the sensitivity was 93%, again with one false positive. For the ureteral tumors, the overall sensitivities and numbers of false positives were 88.9% and eight with 5.0-mm collimation, 88.9% and four with 3.75-mm collimation, and 100% and three with 2.5-mm collimation. The effective radiation dose for all studies was equivalent to that of a standard abdomen/pelvis scan. CONCLUSIONS: Although virtual endoscopy traditionally has had difficulty detecting tumors <5 mm, the multidetector-row CT protocols used in this study could detect most lesions smaller than this. The scan also depicts the other tissues of the pelvis, which is valuable for staging. The 3D images were produced using data from the CT urogram parameters standard at our institution.

Animals↗