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At least 19 recordsLinked to original sources

PubMed1978

A correlative study on urinary cytology and FDP with cystoscopy and pathology in the urinary bladder cancers.

In view of comparatively-high incidence of papillary, well or moderately-well differentiated, transitional cell carcinomas in urology, and of frequent recurrence of carcinomas after appropriate procedures, we have undertaken the correlative study on urinary cytology with cystoscopy, pathology and the amount of fibrinogen and degradation products of fibrinogen and fibrin (FDP). Cytopathologically, 191 cases were confirmed histologically for cancers out of 442 cases studied cytologically; among these 442 classes IV and V were found in 136 cases, and 99 of 136 cases (72.8%) had cancers. Admittedly, we were unable to suspect tumors cytologically in 24.5% of the cases. As to histological gradings and cytology, 48.7% of classes I and II in well differentiated were found against 52.9% and 57.1% of classes IV and V in moderately-well and poorly differentiated carcinomas, respectively. Urinary FDP assay was quite promising; out of 19 cases with both positive cytology and FDP, 18 (94.7% had carcinomas histologically, whereas 12 of 56 cases (21.4%) with both negative cytology and FDP bore cancers. Subsequently, several proposals for improving the diagnostic accuracy were discussed. We concluded the importance of accumulating more cases by combining several diagnostic procedures, especially among well and moderately-well differentiated carcinomas.

Carcinoma, Transitional Cell↗

PubMed2026

Clinical Validation of a Multiplex Urine Biomarker Assay for Surveillance of Recurrent Bladder Cancer.

PURPOSE: More than 50% of patients with non-muscle-invasive bladder cancer experience recurrence, requiring lifelong surveillance with repeated cystoscopy. Given the invasive nature and cost of cystoscopy, accurate noninvasive tools are needed to support risk-adapted monitoring. We evaluated the ability of Oncuria-Monitor, a multiplex urine biomarker assay, to detect recurrent bladder cancer during surveillance. PATIENTS AND METHODS: Between February 2017 and August 2020, six medical centers in the United States and Japan prospectively enrolled 300 patients with a history of bladder cancer, generating 1,248 serial urine samples. Participants were divided into training and validation cohorts. At each surveillance visit over 2 years, urine samples were analyzed in a blinded manner using Oncuria-Monitor and BladderChek, alongside urine cytology. Test performance was compared with cystoscopy and histopathology-confirmed recurrence. RESULTS: Recurrent bladder cancer was identified in 31% (93/300) of participants, with 143 total recurrences during follow-up, including 90 tumors in the validation cohort. In the validation cohort, Oncuria-Monitor achieved a sensitivity of 85.6% [95% confidence interval (CI), 78.1%-92.2%] and a negative predictive value (NPV) of 93% (95% CI, 89.2%-96.4%). In comparison, BladderChek demonstrated a sensitivity of 20.0% and an NPV of 88%, whereas urine cytology showed a sensitivity of 36.9% and an NPV of 91.6%. The number needed to evaluate to detect one recurrence was 3 for both cystoscopy and Oncuria-Monitor, compared with 15 for BladderChek and 8 for cytology. CONCLUSIONS: In this large prospective longitudinal study, Oncuria-Monitor demonstrated clinically actionable performance, enabling a rule-out strategy that could safely reduce cystoscopy in approximately 25% of surveillance visits. These findings support a paradigm shift toward biomarker-guided, risk-adapted surveillance in bladder cancer that reduces unnecessary invasive procedures while maintaining oncologic safety.

Humans↗

PubMed2026

A stratified urine-based molecular diagnostic and prognostic model for non-muscle-invasive bladder cancer management.

BACKGROUND: Non-muscle-invasive bladder cancer (NMIBC) is characterized by a high recurrence rate requiring lifelong cystoscopic surveillance. Existing urine-based molecular assays mainly rely on mutations or methylation, which fail to capture large-scale genomic instability. Copy number variation (CNV) profiling offers complementary information on tumor evolution and aggressiveness, but its application in urinary diagnosis remains limited. We aimed to integrate CNV and DNA methylation signals from urinary DNA to establish a noninvasive and biologically informed stratified diagnostic model for NMIBC recurrence surveillance and risk stratification. METHODS: Urine samples were prospectively collected from 91 patients (75 evaluable) between June 2021 and August 2023. Shallow whole-genome sequencing (sWGS) was used to detect CNVs at chromosomal arm and focal gene levels, while ONECUT2 promoter methylation was quantified by qPCR. Diagnostic and prognostic performance was evaluated by ROC analysis, Kaplan-Meier survival, and stratified recurrence assessment. RESULTS: We evaluated a stratified diagnostic model combining CNV and ONECUT2 methylation testing in a cohort of 79 patients. CNV analysis alone showed high specificity (0.923) for NMIBC diagnosis. A combined model, using CNV as an initial screen followed by ONECUT2 methylation testing in CNV-positive cases, achieved a sensitivity of 0.783, specificity of 0.981, and a negative predictive value (NPV) of 0.911. This approach reduced the number of required ONECUT2 tests by 35% and identified a high proportion of true-negative patients (98.1%), which may help reduce unnecessary cystoscopy procedures. The model also demonstrated significant prognostic value, with the molecularly defined high-risk group showing significantly shorter recurrence-free survival (RFS) than the low-risk group (median RFS: 4.33 months vs. not reached; p < 0.001). Additional, in patients with initially negative cystoscopy after urine sample collection, the model demonstrated a predictive accuracy of 0.922 for recurrence, with molecular positivity observed a median of 9.6 months prior to clinical diagnosis. CONCLUSIONS: Integrating CNV and DNA methylation profiling from urinary DNA provides a powerful and noninvasive molecular framework for NMIBC surveillance. By combining early epigenetic changes with genomic instability signals, this approach enhances recurrence risk assessment and enables earlier detection compared with conventional cystoscopy. It offers a practical route toward personalized and adaptive post-treatment monitoring of NMIBC. TRIAL REGISTRATION: NCT04994197.

Humans↗

PubMed1977

[Bladder carcinoma: therapeutic concept of the Urology Department of the University Hospital, Mainz].

A therapeutic concept based on tumor staging and grading is presented: T0N0M0 - urine cytology positive - cystoscopy every 3 months. Transitional cell carcinoma (90%): T(iS)N0M0 - carcinoma in situ - cystoscopic biopsy every 3 months. Cystectomy with commencing tumor infiltration. T1N0M0 (80% of all bladder tumors): T1N0M0G0 - TUR; cystoscopy every 3 months. T1N0M0G1-3 - TUR; control-TUR 6 weeks later with systematic biopsy. G3 with tumor recurrence - cystectomy. T2N0/N1M0; G1-2 - TUR; local chemotherapy (adriamycin). G3 - cystectomy; high voltage treatment in inoperable patients. T4NxMx - symptomatic-palliative therapy: TUR, urinary diversion. Squamous cell carcinoma (2-5%): as transitional cell carcinoma; with high voltage therapy adjuvant chemotherapy using bleomycine. Adenocarcinoma (2-3%): as transitional cell carcinoma; cystectomy including part of the anterior abdominal wall and umbilicus. Immunostaging (assessment of the immunocompetence) should be part of the diagnostic procedures and follow-up examination.

Adenocarcinoma↗

PubMed2026

Induction and characterization of neoplastic bladder tumors in a transgenic porcine model.

BACKGROUND: Large animal models of bladder cancer are lacking. OBJECTIVE: This study aimed to develop and characterize a transgenic porcine model of bladder cancer (BC) using Oncopigs expressing Cre-inducible KRASG12D and TP53R167H mutations. METHODS: Eleven female Oncopigs underwent tumor induction via three cystoscopic inoculation procedures: Procedure I (N = 3, 1 inoculation/pig), chemical dissolution of the glycosaminoglycan layer with N-Dodecyl-β-d-Maltoside DDM followed by adenoviral Cre-recombinase (AdCre) instillation; Procedure II (N = 4, 3 inoculation/pig), mechanical mucosal denudation followed by AdCre instillation; and Procedure III (N = 4, 3 inoculation/pig), cystoscopy-guided submucosal injection of AdCre. Animals were clinically monitored throughout follow-up (14-28 days). Tumor development was assessed on cystoscopy and ultrasonography, and pathologically, immunohistochemically (IHC), and genomically characterized. RESULTS: All pigs remained clinically healthy. Tumors developed at 59% (16/27) of inoculation sites: nine (33%) were neoplastic and seven (26%) were inflammatory. Procedure I achieved 100% neoplastic tumors and produced both non-muscle invasive (71%) and muscle-invasive (29%) tumors. Procedure II achieved 50% neoplastic tumors, all of which were muscle invasive (100%). Procedure III generated only inflammatory tumors. Histologically, neoplastic tumors were pathologically interpreted as urothelial cell carcinomas with sarcomatoid differentiation, with IHC confirming the presence of both epithelioid and sarcomatoid features with abundant mixed leukocytic infiltrates. Genomic analyses verified Cre-induced alterations alongside other mutations seen in human BC. CONCLUSIONS: We herein demonstrate an efficient and reproducible method for developing autochthonous neoplastic bladder tumors in Oncopigs that resemble human bladder cancer of varying stages. This large animal model facilitates the evaluation of novel surgical and intravesical therapies in BC.

bladder cancer↗

PubMed1977

[Criteria of identification of schistosomiasis caused by Schistosoma hamatobium and S. mansoni (486 patients: 275 case of schistosomiasis)].

Out of a total of 486 patients who originated from French Equatorial Africa, from the West Indies or from the Indian Ocean, the authors identified 275 cases of schistosomiasis of which 230 were due to S. Hematobium and 45 to S. Mansoni. The diagnostic methods were biopsy of the rectal mucosa, immunofluorescence, in the West Indians, examination of the stools, in the Africans examination of the urine, intravenous urography and less often cystoscopy. The value of these investigations was studied in each case, then by comparison with one another and with data in the literature. The most valuable investigation was biopsy of the rectum, better in Africans than examination of the urine, immunofluorescence and better than cystoscopy when this was possible.

Adolescent↗

PubMed1978

Interstitial cystitis: early diagnosis, pathology, and treatment.

In a retrospective review, 52 patients with interstitial cystitis have been studied. Patients with persistent lower tract irritative symptoms, repeatedly sterile urine, and negative urine cytology must be suspected of having interstitial cystitis, and a diagnosis of urethral syndrome in such patients is highly questionable until cystoscopy under anesthesia has been performed. We believe that the finding of multiple petechia-like hemorrhages (glomerulations) on the second distention of the bladder is the hallmark of interstitial cystitis, and that a reduced bladder capacity and a Hunner's ulcer represent a different (classic) stage of this disease. In all stages, the characteristic histologic finidng is submucosal edema and vasodilation. The presence of eosinophils and mast cells is variable, and even in the classic disease the muscularis often appears to be normal. Immuno fluorescent studies and laboratory tests, including the fluorescent antinuclear antibody test (FANA), have not helped us to diagnose (or investigate) interstitial cystitis. Bladder instillations with a 0.4 per cent solution of oxychlorosene sodium (Clorpactin WCS-90) have provided remarkable relief for many patients with this disease, particulary those with the classic form.

Adult↗

PubMed2026

Hot vs cold knife for endoscopic ablation of posterior urethral valves: a systematic review by the EAU-YAU paediatric urology working group.

INTRODUCTION: Posterior urethral valves (PUV) are the most frequent cause of congenital lower urinary tract obstruction in males. Despite early surgical ablation, up to 22% of patients develop chronic kidney disease and 11% progress to end-stage renal disease. Multiple endoscopic modalities have been described for valve ablation but the optimal technique remains uncertain. This systematic review aims to determine whether cold or hot knife ablation provides superior effectiveness for primary endoscopic treatment of PUV in a single surgical session. MATERIAL AND METHODS: A systematic search of PubMed and Embase databases was conducted to identify studies comparing cold and hot knife techniques for endoscopic ablation of PUV in children, covering all publications up to December 2025. The review was performed in accordance with PRISMA 2020 guidelines and was prospectively registered in PROSPERO (ID CRD420251180556). Original studies including patients <18 years who underwent primary valve ablation with postoperative cystoscopy or VCUG and ≥6 months of follow-up were included. Quality assessment was done using RoB 2.0 for randomized trials and MINORS for observational studies. RESULTS: A total of 1581 studies were identified, of which 26 met the inclusion criteria, comprising one randomized controlled trial, five prospective, and 20 retrospective studies constituting a sum of 1725 paediatric patients. The overall methodological quality of included studies was moderate, with marked heterogeneity in design, follow-up duration, and outcome reporting, limiting direct comparisons across series. Thus statistical analysis was not possible. Of these, 829 (48.1%) underwent cold valve ablation and 896 (51.9%) underwent hot ablation techniques. Within the cold group, most patients were treated with a cold knife (80.2%), followed by balloon dilatation (7%), the Mohan valvotome (6.5%), cold hook (5%), and, rarely, a modified venous valvulotome (1.3%). Among hot techniques, 32.8% of procedures were performed by electro-fulguration with a resectoscope, 29.4% using a Bugbee electrode, 23.8% with a hook electrode and 14% with laser-based systems. Follow-up ranged from 6 months to 22 years across studies. Single-session success rates for valve ablation ranged from 22% to 100% in the cold resection group and from 71.4% to 100% in the hot resection group. Reintervention for residual valves was reported in 0%-78% of cold cases and in 0%-28.6% of hot resections. Urethral stricture rates ranged from 0% to 11.1% after cold incision and from 0% to 23.8% after hot techniques. Reporting of postoperative outcomes such as urinary tract infection, incontinence, bladder dysfunction, vesicoureteral reflux (VUR) resolution, hydronephrosis improvement, and renal function varied widely among studies and was assessed using different methodologies. CONCLUSIONS: Both cold and hot ablation techniques for PUV achieved high single-session success rates and low complication rates. Cold resection appeared slightly safer, although this finding should be interpreted cautiously given the heterogeneity and observational nature of the available data.

Humans↗

PubMed1978

XXY Klinefelter's syndrome with bilateral cryptochidism, obesity, multiple capillary hemangiomas and telangiectasia.

A case of XXY Klinefelter's syndrome associated with bilateral cryptochidism, -ultiple capillary hemangiomas and vesical telangiectasia is reported. Testicular biopsy revealed Leydig cell hyperplasia with hyalinization of the seminiferous tubular membrane. The patient presented with recurrent hematuria. Excretory urography, urethroscopy and renal angiography were normal. Cystoscopy revealed multiple telangiectasia, which was responsible for the hematuria. To our knowledge this is the first report of multiple capillary hemangiomas and vesical telangiectasia associated with calssical Klinefelter's syndrome.

Adult↗

PubMed1977

Modified Makari skin test in follow-up of bladder-cancer patients.

123 patients who had been treated for carcinoma of the bladder and who were clinically recurrence-free at the time of their initial Makari skin test are being followed-up; 77 were negative and 46 positive. 48 of these patients have been followed-up so far, for 3-9 months, with cystoscopic review and repeat Makari testing; 75 have still to be followed-up. The high initial positive rate of 37% has been largely explained by the discovery of a recurrent tumour at the first cystoscopy after the test. The concordance between tumour status and repeat Makari testing indicates its ability to detect early recurrence.

Cystoscopy↗

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↗

PubMed1977

Interstitial cystitis. Observations on diagnosis and on treatment with anti-inflammatory drugs, particularly benzydamine.

Interstitial cystitis is often missed on "routine" cystoscopy. If the disease is suspected, the bladder must be observed twice during complete filling. An anti-inflammatory drug, Benzydamine, has given mixed results but in view of its low toxicity it is worth trying in any patient with severe symptoms.

Anti-Inflammatory Agents↗

PubMed1978

Tumours of the urinary bladder accidentally diagnosed during prostatectomy.

By analysing 1472 prostatectomies, the authors have stated a coexistence of tumour of the bladder in 31 cases (2.11%). In 11 patients (0.75%) the tumours were accidentally diagnosed, as late as during the operation itself. Eight patients were operated transvesically. The tumour was diagnosed immediately after opening the bladder. The tumour was removed first and then the adenoma. Three patients were operated on according to Millin's method, their tumours having been detected only after enucleation of adenoma of the prostate. In five cases cancer of the bladder was diagnosed and in six papillary tumour of the bladder was found. The bladder cancers were treated by partial excision of the bladder or by deep electrocoagulation. The authors maintain that the small percentage of accidentally diagnosed tumours is no indication for a routine performance of cystoscopy in every case of adenoma of the prostate before intended prostatectomy.

Humans↗

PubMed1977

Microscopic foci of cancer in prostatectomy for benign disease: diagnostic and surgical considerations.

A study of 66 patients in whom microscopic foci of prostatic cancer was found in prostatectomies done for benign prostatic hyperplasia revealed in 32 of the 66 cases (48%) that there were in retrospect abnormal rectal findings that should have suggested the possibility of neoplasia. Other abnormalities were elevated serum acid phosphatase (5 patients), asymmetrical enlargement of one lateral prostatic lobe at cystoscopy (7 patients), and unilateral hydroureteronephrosis (7 patients). Urinary retention was the presenting symptoms in 56% of the patients. Difficult enucleation was noted in 41% of the open prostatectomies. The importance of performing careful prostatic biopsy in any suspicious prostatic enlargement is again stressed.

Adenocarcinoma↗

PubMed2026

Long-term outcomes of surgical correction of ventral penile curvature in children: Patient-reported measures, surgical results, and decisional regret.

INTRODUCTION: There is a dearth of data on long-term outcomes, including patient-reported outcomes (PROMs), decisional regret, and complication rates for surgical correction of isolated ventral penile curvature in childhood. PATIENTS AND METHODS: Twenty-six children treated for ventral curvature between 1993 and 2008 were identified; 24 met inclusion criteria (isolated ventral curvature without hypospadias or need for urethral reconstruction). Surgical correction consisted of degloving alone or degloving with Nesbit-like dorsal plication when residual curvature >20° persisted after degloving. PROMs were collected via pre-mailed validated questionnaires after puberty: Danish Prostatic Symptom Score (DAN-PSS) for LUTS, Erection Hardness Score (EHS) for erectile function, Penile Perception Score (PPS) for cosmetic perception, and items assessing decisional regret and perceived appropriateness of surgical timing. RESULTS: Curvature was corrected intraoperatively in all 24 patients. Twelve underwent degloving alone and 12 required additional dorsal plication. During long-term follow-up (median 14.2 years), one patient (4%) underwent re-operation for residual curvature, and three (13%) underwent cosmetic revisions; two (8%) underwent cystoscopy for flow concerns. 71% returned PROMs at a median age of 16.2 years. LUTS were uncommon, with low bother scores. Erectile function was favorable: 87% (13/15) reported EHS 4 and 93% (14/15) reported ejaculation. Cosmetic outcomes were favorable, with PPS dissatisfaction rates comparable to controls. Two patients reported dissatisfaction with overall appearance, and one with residual subjective curvature. No patient expressed decisional regret, and 88% felt timing of surgery was appropriate. CONCLUSION: Early surgical correction of isolated ventral penile curvature using degloving with or without dorsal plication provided durable anatomical correction and favorable long-term functional and cosmetic outcomes. These findings support early intervention as an effective approach with sustained patient-perceived benefits.

Humans↗

PubMed2026

Persistent cloaca without vaginal-common channel fistula: A Case series characterizing a rare phenotype.

INTRODUCTION: Persistent cloaca occurs in approximately 1 in 25,000 live births. Among patients with cloaca, the absence of a vaginal connection to the common channel represents a rare phenotype with distinct anatomic and management considerations. We describe the urologic, gynecologic, and surgical characteristics of this patient subset. METHODS: We performed a retrospective analysis of a single-institution cohort of patients with persistent cloaca managed at a quaternary-care children's hospital between 2019 and 2025. Patients were eligible if they underwent primary cloacal repair by our multidisciplinary team and met all three diagnostic criteria for absent vaginal-common channel fistula: no hydrocolpos on imaging, no identified vaginal opening on cystoscopy or cloacagram, and no visible lumen between müllerian and cloacal structures identified intraoperatively. RESULTS: Of 51 patients who underwent primary repair, 6 (12%) met criteria for absent vaginal-common channel fistula. All met criteria for VACTEGRLS association. Common channel length ranged from 1.1 to 7.0 cm and urethral length from 0.5 to 2.2 cm. Urologic anomalies were nearly universal: five patients (83%) had a solitary functional kidney and four (67%) had vesicoureteral reflux. All underwent posterior sagittal anorectoplasty (PSARP) for rectal repair with the common channel repurposed as the neourethra. Five (83%) underwent diagnostic laparoscopy during which the müllerian structures were examined but left in situ. At last follow-up (median 17.5 months, range 4-35 months), three patients (50%) had volitional voiding and three (50%) required assisted bladder emptying via vesicostomy or Mitrofanoff. CONCLUSION: Persistent cloaca without a vaginal-common channel fistula represents a rare but clinically distinct phenotype characterized by severe urologic anomalies. Recognition of this phenotype is essential for surgical planning and long-term urologic and gynecologic surveillance. Because there was no connection between the vagina and the urinary tract, delaying management of the müllerian structures did not adversely affect the urinary tract.

Humans↗

PubMed1975

Bladder outlet obstruction caused by vaginal fibromyoma: the female prostate.

Three patients with urinary difficulty were cured by surgical removal of a viaginal fibromyoma. The appearance of this benign tumor on an intravenous cystogram and cystoscopy as well as the clinical response to surgical removal bears similarity to the hypertrophied prostate in men. The best surgical technique for its removal is enucleation via a vaginal incision.

Adult↗

PubMed1977

Serum alphafetoprotein in bladder carcinoma.

112 cases, of varying ages, which were diagnosed as having carcinoma of the bladder by cystoscopy and biopsy from the tumor, were investigated for the presence of alphafetoprotein (AFP) in the sera. 59 (52.6%) out of the total, showed positive results, and no false positive results occured. Radioimmunoassay was capable of increasing the positivity rate still further. All of the cases were proved by liver scan and laparotomy to be free of metastasis, but all had bilharziasis during childhood, in which there is no factor affecting the liver that is responsible for the release of AFP, as the only species of bilharziasis present in Iraq is that of hematobium.

Aged↗