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At least 1,441 records · Page 80Linked to original sources
PubMed1991

Diagnosis and management of vesicoenteric fistulas.

Vesicoenteric fistulas represent challenging clinical problems and may be characterized by difficulty in diagnosis as well as controversy in management. We present our experience with 56 patients with vesicoenteric fistulas. The results of our series were compared with a report of 1,100 in the literature during the past 20 years. Fecaluria (48 per cent), abdominal pain (43 per cent) and pneumaturia (41 per cent) were the most common presenting symptoms among the patients we studied. Fistulas were most frequently attributable to diverticulitis (52 per cent), Crohn's disease (18 per cent), carcinoma of the colon (11 per cent) or other pelvic malignant conditions (9 per cent). The most accurate diagnostic modalities in our series were cystoscopy (88 per cent), cystography (56 per cent) and barium enema (32 per cent). The combined findings of these studies led to the diagnosis of a fistula in all patients. Intravenous urography, intestinal endoscopy and computed tomography were less useful, providing a diagnosis in only 5, 6 and 11 per cent, respectively. Surgical treatment was single staged in 57 per cent and multistaged in 35 per cent, while 8 per cent of the patients underwent intestinal diversion only. Comparison of the single versus multistaged approaches revealed that the total complication rate, frequency of additional procedures, rate of infectious complications and length of hospitalization were no higher for the single stage group. Based on these findings, we advocate single stage repair, except in those patients who have unusual complications.

Barium Sulfate↗
PubMed1990

[A case of cystitis glandularis suspected of malignant tumor of urinary bladder].

A case of cystitis glandularis is reported. A 70-year-old male was admitted to our hospital with the complaint of urinary frequency and gross hematuria. A bladder tumor was suspected by ultrasonography. Cystoscopy revealed multiple cystic lesions arising from the bladder neck and trigone. Transurethral biopsy of the bladder wall lesion revealed cystitis glandularis. Transurethral resection was performed. His postoperative course was uneventful.

Aged↗
PubMed1990

[A case of primary localized amyloidosis of the urinary bladder].

A case of primary localized amyloidosis is reported. The patient was a 73-year-old female who suffered from miction pain and consulted our department. There was a 1.5 x 1.5 cm slightly red, nonpapillary tumor around the right ureteral orifice in cystoscopy. The diagnosis was amyloidosis with cystitis hemorrhagica histopathologically. After the treatment with antibiotics for about one month there were no symptoms and no tumors in the urinary bladder cystoscopically. The clinical course was relatively good. The treatment varies from transurethral resection to total cystectomy with urinary diversion. This case was cured by non-operative treatment, but close follow-up of the patient is necessary because of the frequency of multiple recurrence.

Aged↗
PubMed1990

[Leiomyoma of urinary bladder: report of a case].

A case of leiomyoma of the urinary bladder in a 46-year-old woman is reported. The patient was referred to us because of incidental finding of a mass in the bladder. Cystoscopy revealed a protruding tumor covered with normal-appearing urothelium on the right posterior wall of the bladder. The tumor was well-demarcated from adjacent organs on echography and computed tomographic scan. Transurethral biopsy revealed a bladder leiomyoma. Partial cystectomy was performed. The patient is now apparently free of disease 7 months after the operation.

Biopsy↗
PubMed1990

[A case of emphysematous cystitis].

Emphysematous cystitis is a rare but interesting disease. A case is reported of cystitis emphysema with acute pyelonephritis and uncontrolled diabetes. The patient was a 54-year-old woman complaining of gross hematuria and fever. A submucosa emphysema in bladder was found by cystoscopy . Radiography showed the gas around the bladder. The patient was administered antibiotics, then symptoms was improved. We reviewed 12 cases of emphysematous cystitis reported in Japan and summarized the pathophysiologic features of this entity.

Acute Disease↗
PubMedDate not supplied

[The preclinical diagnosis of bladder neoplasms].

On the basis of 3,000 questionnaires used in the population survey, the authors distinguished 430 persons who were at risk. This group comprised from 5.3 to 20.9 per cent with regard to certain professional characteristics. The rest 2570 persons served as controls. Urologic investigation (microscopic and cytologic study of the urinary sediment and detection of the urologic symptoms) performed in 307 (71.4 per cent) persons from the risk group and 1540 (59.9 per cent) controls were shown to require 46 (15 per cent) cystoscopies for those enrolled in the risk group and 18 for the controls (1.2 per cent). The study resulted in the diagnosis of papillary carcinoma, papilloma, the inflammation of the Lieutaud's triangle and the neck of the urinary bladder in 2, 2 and 33 examinees, respectively. The same inflammation was diagnosed in 11 persons enrolled in the control group. Histological study (biopsy) employed in 22 (7.2 per cent) risk-group persons and in 7 (0.5 per cent) controls revealed 11 oncological cases in the risk-group patients; 2 transitional carcinomas, 3 papillomas, 4 leukoplakias and 2 epithelial dysplasias. In general, cancer or precancer diseases of the urinary bladder were diagnosed in 22 (7.2 per cent) persons from the risk group and precancer conditions (inflammation with reactive epithelial proliferation) in 7 (0.5 per cent) controls. The results obtained permitted the used questionnaires to be assessed with the concentration index as 15.7, sensitivity index as 75.8 and specificity index as 84.3 per cent.

Cystoscopy↗
PubMed1990

[Diagnosis in hematuria].

In investigation of hematuria the aim is as much to exclude serious illness as to establish the diagnosis. Hematuria which is demonstrated by a test strip should always be verified by examination of sediment. The further investigation comprises depiction of the kidneys with ultrasound examination together with cytological inspection of the urine and cystoscopy. The investigation is supplemented at need with computer tomography or angiography. Hematuria and simultaneous proteinuria or the incidence of pathological cylinders indicate parenchymatous kidney disease where the diagnosis is verified by renal biopsy. Hematuria in young individuals is usually due to infection, concrement or parenchymatous kidney disease. Already at age 40, however, cancer must be considered.

Adult↗
PubMed1990

Assessment of urinary dysfunction in the elderly.

This article discusses the significance of specific signs and symptoms in the history and physical examination as they apply to the lower urinary tract in the geriatric population. The relevant use of urodynamics, cystoscopy, and other innovative techniques that aid in the assessment of urinary dysfunction will be covered.

Aged↗
PubMed1988

Noninvasive evaluation of the enlarged prostate preliminary results.

The choice between a conventional endoscopic examination of the prostate and a noninvasive technique with ultrasound raises a basic question: Which method is most reliable and informative yet has an acceptable costbenefit ratio? One hundred patients selected on the basis of fixed criteria were examined by ultrasonography and so far 50 have been operated on. Pathologic conditions were observed in the upper urinary tract at ultrasonography in 18% of the cases. The method was found reliable as a basis for the choice between open prostatectomy and transurethral resection. Noninvasive examination of patients with an enlarged prostate is a reliable method in the preoperative evaluation. The method is convenient to the patient and no more time-consuming than cystoscopy. The capital investment in ultrasound is high, but the cost per examination low.

Aged↗
PubMedDate not supplied

[Bladder bilharziasis. Presentation of a clinical case].

We present a case of vesical Bilharziosis in a young black man. We briefly discuss the pathogeny, the diagnosis, based fundamentally on the microscopic study of urine and cystoscopy, as well as the treatment with Praziquantel as the preferential medication in Schistosomiasis due to S. haematobium.

Adult↗
PubMed1989

Endoscopy in the diagnosis of genital tuberculosis.

From 1977 to 1986, endoscopy (laparoscopy, cystoscopy and hysteroscopy) was used in the evaluation of women for pelvic tuberculosis. Among 687 cases of diagnostic laparoscopy, pelvic tuberculosis was suspected in 101 (14.7%) from the appearance alone. The appearance was correlated with other criteria for the diagnosis. Definitive evidence was found in 70 cases. All 101 patients were placed on an antibiotic. Seventy-three patients reported for follow-up for more than two years. Of them, six (8.2%) were judged to be cured. Thirty-eight (52.05%) improved as determined by second-look laparoscopy and/or negative histopathology or hysterosalpingographic evidence. Eleven women (15.06%) had an intrauterine pregnancy; nine delivered normally, and two underwent termination of pregnancy for medical reasons. There were three tubal pregnancies (4.1%). In 15 cases (20.5%) the disease remained stationary.

Cystoscopy↗
PubMedDate not supplied

Cytohistologic correlation of urothelial lesions secondary to photodynamic therapy.

Qualitative cytologic evaluations of urinary bladder washings were performed on a selected population following photodynamic therapy for recurrent transitional cell carcinoma of the bladder. The seven patients were monitored trimonthly by cystoscopy, multiple biopsies and cytopreparations. Cancers reappeared in two of the five patients who initially responded to therapy. In the remaining two patients, the recurrent neoplasms were therapeutically refractory. Cytology detected recurrent cancer prior to biopsy confirmation and/or cytoscopic identification. Exfoliative cytology was correlated with the histopathology of the concurrent biopsies; a possible source for a false-positive cytodiagnosis was the cellular atypia of reepithelialized bladder mucosa. Dysplasia was not identified cytologically or histologically.

Biopsy↗
PubMedDate not supplied

[Urinary cytodiagnosis in urothelial neoplasms. A study of 678 cases].

Reliability of urinary cytology was studied in 678 cases in the pathology department of the A.C. Camargo Hospital from 1966 to 1988. Cytologic diagnosis was compared to the final diagnosis of the patients (histopathologic diagnoses, cystoscopy, and clinical data). The rate of sensitivity, specificity, predictive value (positive and negative), and efficiency was obtained. Patients ranged from 2 months to 88 years, mean age being 59.9, among 446 men and 180 women. Cytologic diagnoses produced 139 positive cases (20.5%), 459 negative (67.7%), 21 "suspected" (3.0%), and 59 unsatisfactory cases (8.8%). There were 306 true negative cases (58.4%), 88 false-negative (16.8%), 126 true-positive (24.0%), and only 4 false-positive (.76%). The authors did not prepare a statistical correlation for the "suspected" and unsatisfactory cases; in 74 cases there was not information enough to perform the necessary comparison. The rate of sensitivity was 59.0%, specificity 98.7%, predictive positive value 96.9%, predictive negative value 77.6%, and efficiency 82.4%.

Adolescent↗
PubMedDate not supplied

[Ultrasonic diagnosis of ureterocele].

Diagnostic ultrasonic investigation has found many applications in routine urologic practices. The use of ultrasound for the investigation of 19 patients with ureterocele is reported. High diagnostic value, simplicity and noninvasiveness of echographic diagnosis of this congenital malformation of distal ureteral portions and related complications are pointed out. Its advantages over conventional means of ureterocele diagnosis, such as excretory urography and cystoscopy, are demonstrated, while their shortcomings are avoided. Echography is particularly effective in cases of impaired renal activity, doubled upper urinary tract and segmentary ureterohydronephrosis. Ultrasound makes it possible to choose the type of surgical intervention, and exclude angiography from the diagnostic complex in some cases. Follow-up echographic examination after surgery for ureterocele provides adequate information on treatment results.

Adult↗
PubMed1989

Evaluating hematuria in adults.

Although most causes of hematuria are benign, urinary tract bleeding may signal the existence of a life-threatening disease. Gross and microscopic hematuria share a common differential diagnosis, including urinary tract infection, urolithiasis and bladder cancer. Clinical evaluation may be guided by the patient's age, sex, medical history and physical examination. Intravenous pyelography or sonography is usually the first procedure performed, although cystoscopy is indicated in the face of active bleeding. Those patients who remain undiagnosed after a complete evaluation should be followed with routine urinalysis and cytology to allow early detection of malignancy.

Adult↗
PubMed1989

[Endoscopic studies of the bladder in breeding sows--diagnosis of cystitis].

With a flexible scope the examination of the bladder is possible at the standing sow without anaesthesia. When using a non-flexible scope general anaesthesia with a supplementary spinal anaesthesia is necessary in order to avoid lesions of the urinary tract and damage of the instrument. For a systematic inspection the bladder must be emptied and filled with air. The state of the bladder can be estimated by the colour of mucosa, the condition of visible blood vessels and of the mucosal surface. To prevent infections careful disinfection of the scope as well as antibiotic treatment of the bladder is important. There were good correlations between endoscopic findings in sows with cystitis and parameters of urinalysis especially for sensory parameters, proteinuria, leukocyturia and significant bacteriuria. An advantage of cystoscopy is the possibility to survey beginning or chronic symptoms of cystitis, even when urine is nearly unchanged.

Anesthesia, General↗
PubMed1988

MRI of periprostatic venous plexus in staging of early prostatic carcinoma.

The periprostatic venous plexus can be observed as a bright rim in coronal magnetic resonance (MR) images obtained by spin-echo (SE) 2060/60 technique. A carcinoma of the prostate which penetrates through the capsule into the periprostatic tissues interrupts or obliterates this rim, whereas an intact rim indicates that the tumor is confined within the prostatic capsule. One hundred patients with proven prostatic carcinoma were prospectively imaged by MR to detect periprostatic involvement. The results were compared with those obtained by cystoscopy and digital rectal examination under general anesthesia. The imaging and clinical methods agreed with each other in 76% of the patients.

Adult↗