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PubMedDate not supplied

[Bladder tumors. Diagnosis and therapeutic indications].

These originate from the vesical mucosa in 90p. 100 of cases. Hematuria was the first symptom in 3 cases out of 4. Intravenous urography and urinary cytology examined by Papanicolaou's method, are routine examinations for detection, but cystoscopy alone permits precise inventory of the lesions. Endoscopic resection and pathological examination of the fragments, will show the degree of malignancy of the tumour, its penetration in depth within the wall of the bladder, its degree of dedifferentation, all factors which with the site, the size, effects on the upper urinary apparatus and the existence of lymph node involvement on lymphography, may modify the indications for treatment. Benign or border line tumours which do not infiltrate the muscularis mucosae will be treated mainly by resection or endoscopic coagulation. Frankly malignant tumours should be treated by the association of cobalt and surgery. Partial cystectomy is sufficient for tumours of the mobile parts; total cystectomy is necessary for tumours of the trigone of the bladder with pass-by of the urine into the skin, by direct or transileal means, into the sigmoid or into an intestinal substitution bladder anastomosed to the membranous urethra. Treatment with radiotherapy alone should be reserved for patients in poor general condition and strongly dedifferentiated tumours.

Aged↗
PubMed1961

Kidney function tests in children.

Total renal function is best determined by urinalysis and serum creatinine determination. This may be supplemented, under controlled conditions, by fractional urinary phenosulfonphthalein clearance. The excretory urogram, while invaluable as a diagnostic test, lacks quantitative value as a function test. Until recently, individual renal function determinations depended upon the difficult and tedious cystoscopy and bilateral ureteral catheterization and skilled laboratory techniques. Frequently the necessity of anesthesia artificially depressed kidney function. Since 1956, the radioisotope kidney function test has offered an external, innocuous means of assessing individual renal blood flow, function and drainage plus evaluation of vesico-ureteral reflux. The method has distinct advantages for evaluation of pediatric urological problems.

Child↗
PubMed2003

[Diagnostic and therapeutic procedures for hemospermia].

In general, hemospermia represents a trivial condition: nevertheless, it is often alarming for the patient and his partner. Although differential diagnosis is comprehensive, the most frequent underlying causes are infection and inflammatory processes in the lower seminal passages. Cases of primary and solitary hemospermia can be adequately assessed by urinalysis, blood pressure measurement, and reassurance of the patient. Persistent and recurrent cases of hemospermia are best clarified by transrectal ultrasound examination, cystoscopy, and magnetic resonance imaging. Treatment is based on the examination results.

Cystoscopy↗
PubMed2003

[Leiomyoma of the urinary bladder: report of three cases].

We report 3 cases of leiomyoma of the urinary bladder. One patient was a 57-year-old female. Magnetic resonance imaging (MRI) revealed a small tumor, and cystoscopy revealed a submucosal tumor on the left wall. Partial cystectomy was performed, and she has had no recurrence for 10 months. Two females who were aged 68 years and 52 years, were referred to our hospital with the complaint of pain of meatus of urethra, and pollakisuria, respectively. Transurethral resection of bladder tumor (TURBT) was performed, and they have had no recurrence for more than 3 and 4 years, respectively. Histological examination in the three cases showed a leiomyoma of the urinary bladder. To our knowledge, there are 151 cases of leiomyoma of the urinary bladder reported in the literature in Japan.

Aged↗
PubMed1992

[Recurrent transitional cell carcinoma of the bladder in a young woman: report of a case].

A rare case of transitional cell carcinoma of the bladder in an 18-year-old female is presented. The chief complaint was gross hematuria and pain on urination. Transurethral resection was performed and pathological findings were low grade transitional cell carcinoma without invasion. During a 5-year follow up, she had relapse of the bladder tumor twice. Transitional cell carcinoma of the bladder in children and adolescents may be low grade, low stage and rarely recurrent, but the possibility of recurrence does exist. We emphasize the necessity of periodic cystoscopy for following up young adolescents with transitional cell carcinoma of the bladder.

Adolescent↗
PubMed1992

[Pseudosarcomatous fibromyxoid tumor of the urinary bladder: a case report].

A 41-year-old man was referred to our clinic for gross hematuria. Cystoscopy revealed a 6 x 5 x 5 cm wide-based tumor located at the dome of the bladder. Pathological diagnosis of the biopsy was pseudosarcomatous fibromyxoid tumor. Microscopically this tumor was composed of spindle cells and myxoid stroma, and immunohistochemical and ultrastructural studies showed benign characteristics of this tumor. Therefore partial cystectomy was performed. It is important to recognize the histological characteristics of this essentially benign condition so that total cystectomy can be avoided.

Adult↗
PubMed2003

[Clinical significance of macroscopic 5-aminolevulinic acid (ALA)-inducer fluorescence in transurethral resection of non-invasive bladder cancer].

Macroscopic fluorescence which is induced with aminolevulinic acid (ALA) allows visualizing of small flat tumors, carcinoma in situ, true neoplasm margins and dysplasias of the bladder. Following ALA instillation, cystoscopy was performed under both standard and blue light illumination. In a prospective randomized multicenter study, 102 patients underwent TUR of bladder tumor(s) either with white light or ALA-fluorescence. Significant reduction in the number of residual tumours was detected in 59% (p = 0.005) after 8 weeks, 3 months--in 58% (p = 0.002) and 6 months in 38% (p = 0.01) respectively.

Aminolevulinic Acid↗
PubMedDate not supplied

[Bladder mucormycosis. Report of one case].

OBJECTIVES: To report one case of an opportunistic bladder infection by fungus of the Mucorales order. METHODS: An old patient with permanent bladder catheter due to cerebral vascular accident presented with hematuria associated with change in his general health status, and a bladder mass on ultrasound Cystoscopy and cold biopsy were performed RESULTS: Pathology reported bladder mucormycosis. CONCLUSIONS: Mucormycosis is an opportunistic infection by fungus of the Mucorales order, which disseminate hematogenously from an entrance. Diagnosis is usually histological, seeing characteristic hyphae and ischemic or hemorrhagic necrosis. Bladder involvement is very uncommon. Treatment is based on the combination of debridement of the necrotic areas and intravenous antifungal drugs (amphotericin B).

Aged↗
PubMed2004

[A case of idiopathic retroperitoneal fibrosis with a marked thickening of the urinary bladder wall].

The patient was a 49-year-old male with the chief complaint of right lower extremity edema. Ultrasonography showed a right hydronephrosis and a thickening of the right side of bladder wall. No bladder tumor was found by cystoscopy. The right renal pelvis and ureter were not visualized by drip infusion pyelography (DIP). Computed tomography (CT) demonstrated a soft tissue mass surrounding the bilateral common iliac artery and extending to thickened bladder wall. After the echo-guided needle biopsy, steroid therapy was performed under the diagnosis of the idiopathic retroperitoneal fibrosis. Prednisolone was administered for 10 weeks, resulting in the complete disappearance of thickening of the bladder wall.

Cystoscopy↗
PubMed2004

[Squamous cell carcinoma of the urinary bladder after intravesical bacillus Calmette-Guerin therapy for carcinoma in situ: a case report].

A 88-year-old woman presented with bladder tamponade caused by gross hematuria. She had received 2 courses of bacillus-Calmette-Guerin (BCG) intravesical instillation therapy 4 months previously because of the bladder tumor with carcinoma in situ (CIS). Imaging studies and cystoscopy showed a bladder tumor invading into perivesical fat. She underwent total cystectomy and bilateral ureterocutaneostomy on May 27, 2002. Histopathologically, the tumor consisted of squamous cell carcinoma and transitional cell carcinoma.

Administration, Intravesical↗
PubMed2005

Early diagnosis and monitoring of superficial transitional cell carcinoma by microsatellite analysis on urine sediment.

It has recently been shown that allelic abnormalities, detected by microsatellite analysis of the DNA extracted from urine sediment, can be successfully used for the detection of transitional cell carcinoma (TCC) of the bladder. The diagnostic accuracy of urinary cytology, urinary bladder cancer (UBC) marker, bladder tumor antigen (BTA) and microsatellite sequence alterations was compared in 42 patients who were recruited for the study. Of them, 30 had been diagnosed with TCC at cystoscopy plus biopsy (group A). Seven patients without any apparent lesions after trans-urethral resection (TUR) and 6 subsequent weeks of endovesical administration of bacillus Calmette-Guerin (BCG), had irritative symptoms. None of them had positive cytology or TCC bladder mucosa biopsies (group B). In the control group were 5 other subjects who were affected by benign prostatic hypertrophy and candidates for prostatectomy (group C). Urine and blood samples were obtained from all of the patients before surgery. Tumor tissue and normal mucosa samples were taken from groups A and C during surgery. Different urinary sediment analyses were performed by using both nuclear medicine and molecular tests. UBC and BTA-t analyses were carried out using monoclonal antibody tests while microsatellite analyses were performed using extracted DNA and electrophoresis of polymerase chain reaction (PCR) products on 13 different primers. Urinary cytological examinations were carried out using the Autocyte Preparation System(R). Urinary cytology confirmed the presence of TCC in 13.3% of patients. The BTA-t marker allowed the identification of 73.3% of cancers with 50% specificity; the UBC marker identified 63.3% of the cases with 41.6% specificity. Microsatellite analysis permitted the identification of 83.3% of the tumors with 100% specificity. DNA analysis demonstrated high sensitivity in patients affected by superficial (81.4%) or G1 (80%) tumors, even when cytological studies demonstrated little or no sensitivity. Microsatellite analysis is a highly-sensitive and specific marker for TCC diagnosis and its monitoring, especially in patients with low-stage and low-grade tumors. Other testing procedures failed to increase urinary cytological diagnostic significance.

Antigens, Neoplasm↗
PubMed2004

The transobturator sling: newest tension-free suburethral sling for treatment of stress urinary incontinence.

T his innovative sling system places the sling between the obturator foramens using a perineal approach while preserving an intact retropubic space. Potential complications associated with tension-free sling systems that use needle-carrier placement through the retropubic space, such as the tension-free vaginal tape (TVT, Gynecare, Ethicon, Somerville, NJ, USA), are eliminated and routine cystoscopy is not required. The procedure is effective and safe for the primary treatment of stress urinary incontinence in patients with urethral hypermobility, intrinsic sphincter deficiency, or both. It is equally efficient in treatment of recurrent and mixed urinary incontinence. Short-term results are similar to those of the retropubic tension-free slings.

Aged↗
PubMed2005

[Primary signet ring cell carcinoma of the bladder: a case report].

A 71-year-old man complained of dyspnea and general fatigue. His blood tests showed severe renal dysfunction. Computed tomographic scan, bone scintigram, and cystoscopy revealed primary signet ring cell carcinoma of the urinary bladder with multiple bone metastases (cT2N0M1). As the general condition of the patient was poor, nephrostomy was performed. He died one month after the diagnosis due to cancer progression. The prognosis of signet ring cell carcinoma of the bladder is poor because many cases presented at an advanced stage. Fifty cases of signet ring cell carcinoma in the urinary bladder reported in Japan are reviewed.

Aged↗
PubMed2005

Acute kidney transplant failure following transurethral bladder polyp fulguration.

Ureteral obstruction and anastomotic leak represent the most common urologic complications of kidney transplantation. Delay in diagnosis or treatment can lead to allograft loss. Obstruction of the ureter occurs in 2% of kidney transplant recipients. Although the majority of cases are immediate technical complications of the operation, subsequent manipulation of the genitourinary system can result in iatrogenic ureteral injury. We report the case of a long-term kidney transplant recipient who developed obstructive uropathy and acute renal failure requiring dialysis after undergoing cystoscopy and bladder polyp fulguration. The etiology was inadvertent thermal injury of the ureteroneocystostomy incurred during the procedure. After attempted percutaneous management, definitive open repair resulted in a return of allograft function to baseline.

Acute Kidney Injury↗
PubMed1992

Diagnosis and treatment of enterovesical fistulae.

Presenting symptoms, diagnostic progression, etiology, therapy, and complications of 44 patients with enterovesical fistulae who came to three Yale teaching hospitals over a 9-year period were reviewed. Patients with diverticulitis as the cause of their fistula were older and came to the hospital with pneumaturia/fecaluria. Patients with pelvic cancer were more likely to have fecaluria, gastrointestinal symptoms, or hematuria. Patients with Crohn's disease were an average of 20 years younger than the patients with cancer or diverticulitis and they came to the hospital with pneumaturia, abdominal pain, abdominal mass, and tenderness. Computerized axial tomography scanning, cystoscopy, charcoaluria, and barium enema were useful in making the diagnosis; intravenous pyelography and colonoscopy were not. One-tenth of the patients were not candidates for operation, and one-quarter of the patients did not undergo complete operative resolution with restoration of enteric and urinary continuity. Nine patients underwent a two-stage repair consisting of resection/repair of the fistula with proximal fecal diversion and subsequent re-establishment of bowel continuity. These patients had a higher morbidity than the 19 patients who underwent one-stage repair. Enterovesical fistula is a challenging entity, the etiology of which may be suspected upon taking the patient's history or performing the physical assessment; however, the definitive diagnosis of enterovesical fistula can remain elusive. Single-stage repair can be achieved with low morbidity and mortality in many candidates.

Adolescent↗
PubMed2005

[Hemospermia].

Hemospermia refers to the presence of blood in the seminal fluid and is not very common urologic symptom. Its prevalence remains unknown. Historically, hemospermia was linked to excessive sexual overindulgence, prolonged sexual abstinence, interrupted coitus. Newer imaging modalities have altered the diagnosis and etiological factors of hemospermia are now more frequently identified. Hemospermia can result from many causes. Infections or inflammatory disorders account from 39% to 55% of cases, malignancies and trauma account just 4-13%. The remaining 11% of cases were caused by a variety of other pathologic conditions. Predisposing diseases are prostatitis, epididymitis, urinary stones, tuberculosis, cirrhosis of the liver, arterial hypertension, hematologic diseases. In 30-70% of the cases there is no association with any significant pathology. Cases of primary and solitary hemospermia can be adequately assessed by urinanalysis, blood pressure measurement, genital and rectal examination, PSA-test, and reassurance of the patient. Persistent and recurrent cases of hemospermia are best clarified by transrectal ultrasound examination, cystoscopy, computer tomography and magnetic resonance imaging. Treatment depends on the diagnostic findings but often simply involves reassurance.

Adult↗
PubMed2005

[A young patient with invasive small cell carcinoma of the urinary bladder: a case report].

A 29-year-old woman with gross hematuria was referred to our hospital. Cystoscopy revealed a nonpapillary broad-based tumor on the right lateral wall of the urinary bladder, which a transurethral biopsy identified as transitional cell carcinoma (G2). CT and MRI suggested that the carcinoma invaded beyond the bladder wall. We performed a radical cystectomy with hysterectomy and the construction of an ileal neobladder. Pathological examination of the specimen indicated that it was small-cell undifferentiated carcinoma at the stage of pT2bpN0. For adjuvant chemotherapy, four cycles of CPT-11 and CDDP chemotherapy were performed, which is currently the usual chemotherapy for small-cell lung carcinoma in Japan. The patient is alive without any evidence of tumor recurrence at 12 months after surgery.

Adult↗