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PubMed1988

Sarcomatoid carcinoma of the urinary bladder. A clinicopathologic analysis of 12 cases and review of the literature.

Twelve carcinomas of the urinary bladder with a prominent component of spindle-shaped cells (sarcomatoid carcinomas) that arose in patients from 60 to 83 (average, 71.5 years) years of age are reported. The seven male and five female patients typically complained of hematuria. Seven tumors were sessile and five were polypoid. On microscopic examination, the malignant spindle cells merged with in situ transitional cell carcinoma or various forms of invasive carcinoma, including transitional cell carcinoma (11 cases), adenocarcinoma (2 cases), squamous cell carcinoma (2 cases), and small cell undifferentiated carcinoma (2 cases). Immunocytochemical stains were performed in 11 cases; the spindle cells stained for cytokeratin, epithelial membrane antigen, and vimentin. Limited follow-up in this series does not allow for conclusions concerning differences in behavior between sarcomatoid carcinoma and conventional transitional cell carcinoma of similar grade and stage. However, the typically deep invasion of the former tumors and their histologic features indicate that they are highly aggressive neoplasms.

Aged↗

PubMed2006

Significance of muscularis mucosae in metastasis involvement of urinary bladder transitional cell carcinoma.

OBJECTIVE: To assess the significance of muscularis mucosae involvement in metastasis of urinary bladder transitional cell carcinoma. MATERIAL AND METHOD: This was a retrospective cohort study of superficial urothelial carcinoma (transitional cell carcinoma). Histopathology and patient records of 192 patients were collected from 1990 to 2004. There were 115 males and 77 females, their age ranged from 43 to 83 years old with an average of 60 +/- 5 years. One hundred cases did not invade muscularis mucosae layer (group A) and 92 cases invaded the muscularis mucosae layer (group B). The histopathology of biopsy or cystectomy specimens for recurrence, progression of the disease and the number of vessels above and below the muscularis mucosae layer of bladder cancer specimens were compared by light microscopic examination with Hematoxylin and Eosin (H&E) and followed by immunoperoxidase desmin stain. RESULTS: The amount per high power field of the blood and lymphatic vessels below muscularis mucosae layer, 9 (6-12), was significantly higher than that above muscularis mucosae layer, 7 (5-10) (p < 0.05). The cancer high grade (grade 3) in group B had also significantly higher percentage than that in group A, 30.4:5.0 (p < 0.05). Moreover, the recurrent rate (recurrent > 2) in group B had also a significantly higher percentage than that in group A, 21.4:4.0 (p < 0.05). CONCLUSION: The present study has confirmed previous findings that not all muscularis mucosae layers (about 50%) were found in the biopsy specimens. The findings of superficial urothelial cancer (no invasion to muscularis propria) invading the muscularis mucosae are a warning sign for invasive tumor that needs more aggressive treatment.

Adult↗

PubMed1983

Cellular changes in rat urinary bladder carcinomas induced by FANFT: a quantitative electron microscopic analysis.

Morphometric data of normal and neoplastic urinary bladder epithelia have been collected from the Fischer rat FANFT model. Sequential measurements of volumes, surface areas, and numerical densities of organelles, and where pertinent, cellular compartments have been made during FANFT carcinogenesis, utilizing standard point and intersection counting methods. The data show that neoplastic transformation of rat bladder epithelium, and progression of FANFT tumors are associated with increasing volume densities of cells, nuclei, microvilli, rough endoplasmic reticulum, and mitochondria, as well as with decreasing volume densities of the cytoplasmic matrix, fusiform vesicles, Golgi complex, and lysosomes. Surface densities of the plasma membrane (microvillar), nuclei, rough endoplasmic reticulum, as well as mitochondrial outer and inner membranes progressively increase while surface densities of non-microvillar plasma membrane, fusiform vesicles, and Golgi complex decrease with time. Smooth endoplasmic reticulum reaches its maximum volume and surface densities in tumors present 26 weeks after the initiation of FANFT feedings (26-F tumors). This may reflect the function of smooth endoplasmic reticulum as the site of detoxification of the carcinogen, noting that FANFT is metabolized by microsomal enzymes, and in this experiment is fed only for 26 weeks. The nuclear/cytoplasmic ratio is 1:4 in normal Fischer rat urothelium, 1:3 in 26-F and 43-F tumors, which are noninvasive, and 1:2 in 61-F, which are invasive tumors. The quantitative data correlate well with the changes in degree of differentiation of the tumors and with their biological behavior.

Animals↗

PubMed1983

Primary adenocarcinoma of urinary bladder.

We reviewed the clinical course and pathologic findings of 17 patients with adenocarcinoma of the urinary bladder at Massachusetts General Hospital between 1962 and 1978. The 12 men and 5 women were between thirty-eight and eighty-six years old (mean, sixty years). Five patients had urachal adenocarcinoma, 8 had pure adenocarcinoma, and 4 had mixed adenocarcinoma and transitional cell carcinoma. Twelve of 17 patients (71 per cent) had muscle invasion (T2-T3), and none had evidence of regional or distant metastases at initial presentation. The mean follow-up was four years. The treatment modalities included transurethral resection alone in 3 patients, radical cystectomy in 4, simple cystectomy in 2, salvage radical cystectomy in 1, and partial cystectomy in 7, 3 of whom also received radiation therapy. Over-all crude three and five-year survival rates were 60 per cent and 27 per cent, respectively; patients with invasive disease did poorly regardless of treatment modality. Five of 8 patients who died had evidence of metastatic disease, and only 1 patient with invasive disease was alive more than five years. However, 2 of 3 patients with invasive urachal adenocarcinoma who had preoperative radiotherapy plus partial cystectomy are free of disease at thirty-eight and sixty months.

Adenocarcinoma↗

PubMed1999

Extramedullary myeloid cell tumor of the urinary bladder in a patient with myelodysplastic syndrome.

We report a case of extramedullary myeloid cell tumor of the urinary bladder in an elderly male with a three year history of myelodysplastic syndrome (refractory anemia with excess blasts), noninvasive papillary transitional cell carcinoma of the urinary bladder, and in situ transitional cell carcinoma of the left ureter. Light microscopy demonstrated a poorly differentiated neoplasm composed of medium to large cells with eosinophilic cytoplasm. The tumor cells showed immunohistochemical expression of myeloperoxidase, lysozyme, CD15, CD68 and CD43. Bone marrow examination following cystectomy demonstrated refractory anemia with excess blasts (6-10%) and a normal karyotype. Cytogenetics, approximately 1 year after cystectomy, demonstrated a deletion of the short arm of chromosome number 12. Four years after presentation, the patient succumbed to pulmonary aspergillosis.

Aged↗

PubMed1992

Diagnosis of ruptured urinary bladder in a foal by the identification of calcium carbonate crystals in the peritoneal fluid.

A 3-day-old Quarter Horse colt was examined because of signs of severe depression, discomfort, and abdominal straining. The foal seemed disoriented, and the abdomen was tense and distended ventrally. The differential diagnoses included ruptured urinary bladder, retained meconium, septicemia/bacteremia, and neonatal maladjustment syndrome. Serum biochemical analysis revealed marked hyponatremia, hypochloremia, and moderate hyperkalemia, as well as mildly high urea, creatinine, and phosphorus concentrations. The primary differential diagnosis at this time was ruptured urinary bladder. Abdominocentesis was performed to confirm this diagnosis. Microscopic examination of abdominal fluid revealed calcium carbonate crystals, which originated from the urine of the foal. Biochemical analysis also confirmed the diagnosis of ruptured urinary bladder, because the ratio of peritoneal fluid creatinine to serum creatinine was 2.8:1. The foal died before surgical correction could be attempted.

Animals↗

PubMed1977

[Suprapubic drainage of the urinary bladder].

The author describes the method of the suprapubic drainage of the urinary bladder by using the Snaider Urevac of the firm "Zimmer". In 20 patients all urinocultures sampled one and five days after the surgery were negative. The method involves no danger, it is simple and comfortable for the patient in comparison with the transurethral drainage. According to the initial experience of the author, the method of suprapubic drainage could be recommended for a more frequent use in the continuous drainage of the urine in the postoperative period of gynecological patients.

Female↗

PubMed1999

Paraganglioma of the urinary bladder: A case report and review of the Japanese literature.

We describe a patient with primary paraganglioma of the urinary bladder associated with typical clinical symptoms. Systolic blood pressure frequently increased to 300 mm Hg immediately after micturition. Levels of urinary vanillylmandelic acid excretion and serum norepinephrine were significantly elevated. The tumor was removed by partial cystectomy. Histological examination of the tumor revealed paraganglioma of the urinary bladder. Compared with a review of 53 similar cases reported in Japan, the distribution of age, sex and tumor location in the bladder differed from those described worldwide.

Cystectomy↗

PubMedDate not supplied

[Pseudosarcomatous lesions of the urinary bladder. Report of a case].

OBJECTIVE: The present study describes a case of pseudosarcomatous lesion of the urinary bladder, a rare disease entity that may occasionally be clinically mistaken for malignant neoplasms. METHODS/RESULTS: A 79-year-old male with hematuria who had previously undergone surgery is described. Cystoscopic examination revealed a tumor which was resected by TUR. The histological analysis disclosed a benign proliferative mesenchymal lesion comprised of spindle cells. CONCLUSIONS: Pseudosarcomatous lesions of the urinary bladder are benign lesions of fibroblastic or myofibroblastic origin that are more frequent in young adults and prevalent in females. Clinically they present with hematuria and treatment is by surgical excision (partial cystectomy or TUR). The prognosis is excellent.

Aged↗

PubMed2003

Ca2+ sparks and K(Ca) channels: novel mechanisms to relax urinary bladder smooth muscle.

Negative feedback pathways that relax and stabilize UBSM are critical to the proper functioning of the urinary bladder. The complex interactions between K(Ca) channels and RyRs are just beginning to be unraveled. The consequences of SK, BK, and RyR dysfunction would increase cell excitability and lead to urinary bladder instability. Although each of these channels is a potential target for the development of therapeutics to treat urinary incontinence, SK is of special interest, since this SK isoform does not appear to be present in vascular smooth muscle.

Animals↗

PubMed1997

Expression of neuropeptides and nitric oxide synthase in neurones innervating the inflamed rat urinary bladder.

Micturition reflexes become hyperexcitable with the development of a cystitis. In the present study the question is addressed, whether alterations in the expression of neuropeptides and nitric oxide synthase (NOS) in the neuronal pathways to the bladder may be involved in the hyperexcitability. Primary sensory neurones in the dorsal root ganglia (DRG) L1, L2, L6 and S1 as well as postganglionic efferent neurones in the major pelvic ganglia (MPG) that innervate the rat urinary bladder were labeled with retrogradely transported Fast Blue (FB). Immunocytochemical techniques were used to determine alterations in the expression of calcitonin gene-related peptide (CGRP), substance P (SP), galanin (GAL) and NOS in these neurones following mustard oil-induced inflammation of the urinary bladder. Instillation of 2.5% mustard oil into the bladder led to a massive leukocyte infiltration of the vesical tissues, partial damage of the mucosal layer and a marked hyperreflexia of the detrusor muscle. 48 h after induction of the cystitis the proportion of FB-labeled bladder afferent neurones that expressed CGRP and SP were significantly increased in both the rostral lumbar DRGs (L1, L2) and the lumbosacral DRGs (L6, S1) (CGRP, +15-38%; SP, +47-158%) as compared to control animals. However, there was a differential effect of the inflammation on the expression of GAL and NOS in bladder afferents at the two segmental levels examined. Significant alterations in the number of FB-labeled afferents exhibiting GAL immunoreactivity were mainly restricted to the lumbosacral DRGs L6 (+169%) and S1 (+60%). On the contrary, the proportion of NOS-immunoreactive bladder afferents significantly increased only in the rostral lumbar DRGs L1 (+144%) and L2 (+193%), while the level of NOS-expression was unaffected at the lumbosacral levels. Inflammation furthermore induced a significant increase (+275%) in the number of FB-labeled neurones in the MPGs that exhibited NOS immunoreactivity. These results indicate that an upregulation of CGRP-, SP-, GAL- and NOS-synthesis in sensory and efferent neurones is involved in the response to an acute cystitis. Because of the differences in the segmental pattern and degree of upregulation of these substances in bladder afferents that project to the rostral lumbar and lumbosacral spinal cord a different regulation of the sympathetic and parasympathetic efferent outflow to the urinary bladder is suggested. The involvement of CGRP, SP, GAL and NOS in the modulation of both excitatory and inhibitory mechanisms that control the cystitis-induced detrusor hyperreflexia is discussed.

Animals↗

PubMed1981

The effects of nucleotides on the response of the isolated guinea pig urinary bladder to nonadrenergic, noncholinergic nerve stimulation.

The ability of adenosine 5'-triphosphate (ATP) to suppress the contractile response of guinea pig urinary bladder to nonadrenergic, noncholinergic nerve stimulation was investigated. Strips of guinea pig urinary bladder were incubated for 1 h at 37 degrees C in a modified Krebs solution containing atropine (2 X 10(-7) M), guanethidine (1 X 10(-6) M), and indomethacin (5.5 X 10(-6) M). Four successive administrations of ATP, guanosine, 5'-triphosphate (GTP), and cytidine 5'-triphosphate (CTP), each at 5 X 10(-4) M, in the absence of washout resulted in complete desensitization of the tissue to the contractile effect of the nucleotide. Strips desensitized to GTP or CTP were also nonresponsive to ATP. The response of the strips to electrical stimulation (100 V, 0.1-ms pulse, 5-s train at 3 Hz) was markedly reduced following desensitization with ATP but only slightly with GTP or CTP. Under similar conditions, adenosine 5'-monophosphatase (AMP) or diphosphate (ADP) or adenosine (A) also reduced the response of the strips to intramural nerve stimulation, but guanosine 5'-monophosphate (GMP) or diphosphate (GDP), guanosine (G), cytidine 5'-monophosphate (CMP) or diphosphate (CDP), or cytidine (C) did not. The present data suggest that desensitization of smooth muscle to exogenous ATP may be predominantly the result of its conversion to metabolic products rather than inactivation of "purinergic" receptor per se.

Adenosine Triphosphate↗

PubMed1989

[A case of small cell carcinoma of the urinary bladder].

A case of small cell carcinoma with a high serum alpha-fetoprotein level of the urinary bladder is reported. Histologically, in addition to the small cell carcinoma, there were small areas of atypical carcinoids and larger epithelial cells. Immunohistochemically, the small cell carcinoma and the atypical carcinoids showed positivity for neuron-specific enolase, chromogranin, and vimentin. On the other hand, the larger epithelial cells showed positivity for alpha-fetoprotein, keratin, and carcinoembryonic antigen. Electron microscopically, a few neurosecretory granules were noted in the cytoplasm of the small cell carcinoma. After a total cystectomy, the serum alpha-fetoprotein level decreased to within a normal range. Postmortem examination of recurrent tumorous masses revealed only features of the small cell carcinoma. This case supports a theory that a small cell carcinoma of the urinary bladder develops from multipotential epithelial cells.

Aged↗

PubMed1990

[Ifosfamide-induced urinary bladder lesion and its inhibition by mesna].

This study examined the characteristics of urinary bladder lesions (cystitis) induced by ifosfamide (IF), an antitumor agent, and their inhibition by mesna in rats. Single i.v. doses of 50 mg/kg or more of IF induced cystitis characterized by increased bladder weight with mucosal hemorrhage and edema within 3 hr, with a plateau being reached 1 to 3 days after the injection. This change occurred earlier than myelotoxicity. Injection of IF to ureter-ligated rats did not induce the cystitis. Also, when IF was infused to one of a pair of rats in which the ureters had been crossed, the cystitis occurred only in the non-injected member of the pair whose bladder received urine flow from the IF-injected rat. Cystitis did not occur with direct injection of 10 mg of IF into the urinary bladder, but did with injection of the metabolite, 14 micrograms of acrolein. These findings show that IF-induced cystitis is not a systemic effect like myelotoxicity or an antitumor effect but a local effect. The cystitis could be completely inhibited by mesna, and this effect, which was dose-dependent, occurred from one-tenth of the IF dose. The effect was strongest when mesna was administrated within 1 hr of the IF injection. There was little difference in the effect between single and divided doses. The combined administration of IF with mesna did not lower the antitumor effect of IF.

Animals↗

PubMed2003

Spinal neuronal responses to urinary bladder stimulation in rats with corticosterone or aldosterone onto the amygdala.

Elevating glucocorticoids in the amygdala produces colorectal hypersensitivity through activation of lumbosacral spinal neurons. The aim of this study was to determine if descending modulation from the amygdala affects spinal processing of input from urinary bladder afferents. Fischer-344 rats received cholesterol (inactive control)-, corticosterone-, or aldosterone-containing micropellets placed stereotaxically on the dorsal margin of the left and right amygdala (n = 10 for each group). Seven days after amygdaloid implantation, extracellular potentials of single L6-S1 spinal neurons were examined for the responses to graded (0.5-2.0 ml, 20 s) urinary bladder distension (UBD). Spontaneous activity of neurons with excitatory responses to UBD in aldosterone-implanted rats [11.0 +/- 1.7 (SE) imp/s], but not in corticosterone-implanted rats, was higher than in the cholesterol-implanted group (6.6 +/- 1.1 imp/s, P < 0.05). Noxious UBD (1.5 ml) produced a greater excitatory response (21.6 +/- 2.6 imp/s) in aldosterone-implanted rats compared with cholesterol- or corticosterone-implanted rats (15.1 +/- 1.5 and 13.6 +/- 1.4 imp/s; P < 0.05). In contrast, the duration of excitatory responses to UBD in corticosterone-implanted rats (38.5 +/- 3.4 imp/s) was significantly longer than those in the aldosterone or control groups (26.8 +/- 1.8 and 24.7 +/- 1.5 imp/s). Neurons with low thresholds for excitatory responses to UBD were seen more frequently in aldosterone-implanted rats than in corticosterone or cholesterol treated rats (74 vs. 44% and 39%, P < 0.05). No difference in somatic field properties of spinal neurons responsive or nonresponsive to UBD was found among the three groups. These findings suggest that both mineralocorticoid- and glucocorticoid-mediated mechanisms in the amygdala are involved in descending modulation to lumbosacral spinal neurons receiving inputs from the urinary bladder; and this mechanism may play a role in the activation and maintenance of primary central sensitization to noxious visceral stimuli.

Action Potentials↗

PubMed1989

Spontaneous extraperitoneal rupture of the urinary bladder in children.

The authors describe two children who had spontaneous extraperitoneal rupture of the urinary bladder into the retropubic space secondary to acute urinary retention following lower urinary tract surgery. One also had urinary ascites. In one, the urinoma was initially mistaken for the bladder during ultrasonography. In both cases, the diagnosis of bladder rupture was not considered initially because of a lack of familiarity with the occurrence of this entity in children.

Child, Preschool↗

PubMedDate not supplied

[Non-conventional fractionation in the irradiation of transitional cell tumors of the urinary bladder].

OBJECTIVE: To analyze the potentials of non-conventional fractionated radiotherapy regimens for transitional cell tumors of the urinary bladder. METHODS: The biological principles and clinical aspects taken into account in the design of non-conventional fractionated radiotherapy and the possibility of incorporating the foregoing to enhance the efficacy of the treatment protocols that are widely utilized are briefly analyzed. RESULTS: Non-conventional fractionation enhances the results achieved with conventional radiotherapeutic regimens and should be included together with chemotherapy and cystectomy in the treatment of bladder cancer. CONCLUSIONS: Preservation of the bladder while maintaining or improving the cure rate continues to be the principal aim of treatment in cancer of the urinary bladder. The foregoing can be achieved with chemoradiotherapeutic regimens that include non-conventional fractionation of the radiation dose. A better understanding and knowledge of the factors that may have an influence on the therapeutic response and outcome can enhance patient selection for cystectomy.

Carcinoma, Transitional Cell↗

PubMed1980

Ion transport by the urinary bladder of the gobiid teleost, Gillichthys mirabilis.

Transport characteristics of the two epithelial cell types lining the urinary bladder of the goby can be studied in Ussing-type chambers. Cuboidal cell regions from seawater- and 5% seawater-acclimated fish exhibit little mucosal-to-serosal Na or Cl transport. In contrast, columnar cell regions from both seawater- and 5% seawater-acclimated fish transport substantial amounts of Na and Cl. Whereas all electrolyte transport in 5% seawater-acclimated fish is electrically silent (neutral), columnar cell regions from seawater-acclimated fish possess an electrogenic Na transport component in addition to the neutral transport. Columnar cell regions also possess a Cl/Cl exchange diffusion mechanism. Neutral Na and Cl transport are not altered in response to external salinity; electrogenic transport varies both with acclimation to salinity and season. Reabsorption of Na and Cl from urine reduces excretory losses of these ions from 5% seawater-acclimated fish and drives urinary bladder water reabsorption in seawater-acclimated fish.

Animals↗