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The objective of the present study was to globally characterize the changes in the gene expression profile in the ileum after long-term urine exposure in a rat ileal augmented bladder model using cDNA microarrays.Bladder augmentation using the ileum was performed in female 8-week-old rats. The ileal epithelia used for bladder augmentation were harvested 1 and 3 months postoperatively and changes in the gene expression in these tissues were compared with that of intact ileal epithelia from sham-operated rats using cDNA microarrays consisting of 1176 rat genes.Marked changes in gene expression in the ileum used for bladder augmentation were observed for 30 genes (16 up-regulated and 14 down-regulated genes). The differentially expressed genes include those associated with signal transduction, cell adhesion and stress response. Subsequent evaluation of changes in two randomly selected genes from the 30 differentially expressed genes by semiquantitative reverse transcription-polymerase chain reaction demonstrated the reliability of the present cDNA microarray analyses.The present experiments identified an extensive list of genes differentially expressed in the ileum after bladder augmentation, providing valuable information for the pathophysiological assessment of patients who undergo urinary reconstruction and representing a source of novel targets for treating complications after urinary diversion. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine whether renal function influences the acid–base metabolism in patients undergoing orthotopic bladder replacement using intestinal segment. Acid–base balance, serum electrolytes and renal function were studied in 30 patients with colon neobladder and 18 patients with ileal neobladder. Mean follow up was 51 months. Effects of renal function on acid–base metabolism in both types of bladder replacement were compared. Therapeutic efficacy of the sodium bicarbonate administration was also evaluated in cases with hyperchloremic acidosis. No significant differences were observed in any of the variables examined between the colon and ileal neobladder groups, except for potassium concentration. Although metabolic acidosis was detected using the Siggard–Anderson acid–base nomogram in eight (26.7%) and seven (38.9%) patients in the colon and ileal neobladder groups, respectively, this difference was not significant. In both the colon and ileal neobladder groups, the serum creatinine concentrations in patients diagnosed with metabolic acidosis were significantly higher than in those diagnosed with a normal metabolic status. Furthermore, as a result of severe metabolic acidosis, three (10.0%) and three (16.7%) patients in the colon and ileal neobladder groups, respectively, were administered sodium bicarbonate and their metabolic status was fully normalized. Despite there being no statistical difference, patients with ileal neobladder may more easily develop metabolic acidosis compared with those with colon neobladder. In addition, a close association between the serum creatinine level and the degree of metabolic acidosis was observed in both groups. However, even if severe metabolic acidosis occurs, it is relatively easy to correct using sodium bicarbonate. These findings suggest that it might be safe to use a colon segment for orthotopic bladder reconstruction in patients with higher serum creatinine levels, despite no significant difference in acid–base metabolism and detection rates of metabolic acidosis between the colon and ileal neobladder groups. [ABSTRACT FROM AUTHOR]

We report MR imaging characteristics of a prostatic urethral polyp in a 35-year-old man. Traditionally, the methods of diagnosis include computed tomography, transrectal sonography, voiding cysto-urethrography, intravenous pyelography, urethroscopy, and cystoscopy. To our knowledge, MR findings have not been previously described. In this case, MR imaging clearly demonstrated a polypoid tumor located in the prostatic urethra with a stalk connected to the bladder neck. A pathological study revealed the polyp consisted of a fibrovascular core covered with a double layered, prostatic-type epithelium. [ABSTRACT FROM AUTHOR]

Examines the complications of radical retropubic prostatectomy. Evaluation of precise anastomosis using a Foley catheter; Application of vesicourethral anastomosis; Examination of the prolonged urinary extravasation and temporary urinary retention; Significance of using Foley catheter in precise anastomotic.

The article discusses acanthosis nigricans (AN) which is a paraneoplastic process usually associated with adenocarcinomas. The underlying tumors originate primarily in the gastrointestinal tract, ovary, lungs. Other types of malignant tumor associated with acanthosis nigricans are squamous cell carcinoma, lymphoma, and malignant pinealoma. Acanthosis nigricans can be divided into two categories, namely, "benign" and "malignant." The skin lesions of AN do not in themselves show any evidence of malignancy, but they are associated with either benign or malignant tumors. In patients with AN, a careful examination must be carried out, not only of the gastrointestinal tract and lungs, but also of the urinary bladder.

A case of a solitary fibrous tumor (SFT) of the pelvic space in a 64-year-old man is reported herein. Computed tomography (CT) of the pelvis showed a large mass enhanced heterogeneously left paracentral and posterior to the bladder and intimately associated with prostate. The site of origin of the mass could not be defined on CT because margins blended with the bladder, prostate, and rectum. A tumorectomy was performed and has remained well with no evidence of recurrence during the last 3 months. The tumor was 12.5×9.5×8.3 cm in size, solid with a fibromuscular capsule, and gray-tan in color. Histologically, the neoplasms were well circumscribed and composed of short spindle cells arranged without an obvious pattern. Immunohistochemically, these cells were strongly positive for CD 34 and negative for S-100, alpha SMA, and AE1/AE3. [ABSTRACT FROM AUTHOR]

: ObjectivesTo present the results of a new technique for construction of a sigmoid neobladder after radical cystectomy.: MethodsForty-two men, 43 to 74 years of age (mean age 62 ± 8), underwent radical cystectomy for invasive bladder cancer and had a sigmoid neobladder created using a modification of the standard ureterointestinal anastomosis with rotation of the reservoir. The mean follow-up of this retrospective study was 35 ± 20 months (range 6 to 90). The blood chemistry was analyzed routinely during follow-up, and complications, continence, and voiding pattern were assessed at regular intervals.: ResultsThere were 21 early complications in 14 patients: persistent urinary leakage in 2; wound infection in 9; prolonged ileus in 4; leakage from the colonic anastomosis in 2; and pulmonary embolus in 2. One patient each had venous thrombus of the lower extremities and methicillin-resistant Staphylococcus aureus colitis. One patient died in the perioperative period of massive pulmonary embolus, yielding a mortality rate of 2.4%. Eleven late complications occurred in 9 patients. Stenosis of the ureterointestinal anastomosis developed in 2 of 82 anastomoses, stenosis of urethral anastomosis in 4, and neobladder-ureteral reflux in 1. A reservoir stone was found in 1 patient, and adenoma and adenocarcinoma of the reservoir occurred in 1 patient each. One patient developed symptomatic hyperchloremic metabolic acidosis, and routine electrolyte evaluation revealed a slight metabolic acidosis in 6 patients. Hypovitaminosis B12 did not occur in any patients. Of the 42 patients, 40 could void volitionally without catheterization. Patient satisfaction on continence, by day and night, was 77.3% and 72.7%, respectively. The mean neobladder capacity and the mean residual urine volume was 375 ± 116 mL (range 234 to 624) and 68 ± 86 mL (range 4 to 365), respectively.: ConclusionsThe modified sigmoid neobladder provides satisfactory results after radical cystectomy. [Copyright &y& Elsevier]

Objectives. To observe the expression of beta-3-adrenoceptor in the detrusor muscle in female rats and investigate the relaxant effect of beta-adrenoceptor agonists on detrusor muscle in ovariectomized rats with or without estrogen replacement therapy.Methods. We first performed reverse transcriptase-polymerase chain reaction to demonstrate mRNA encoding the beta-3-adrenoceptor in the detrusor muscle from female rats. We then performed pharmacologic and physiologic studies to determine the effect of estrogen replacement therapy on the beta-adrenoceptor-mediated relaxation of the detrusor muscle of the ovariectomized rats.Results. Beta-3-adrenoceptor was expressed in the detrusor muscle in female rats with or without ovariectomy. A nonselective beta-adrenoceptor agonist relaxed precontracted detrusor muscle irrespective of ovariectomy or estrogen replacement in a dose-dependent manner; and a selective beta-3-adrenoceptor agonist relaxed the detrusor muscle more in ovariectomized rats than in ovariectomized rats with estrogen replacement or in control rats.Conclusions. Selective beta-3-adrenoceptor agonists relaxed the detrusor muscle of female rats with low estrogen levels. This result may give a clue to the treatment of frequent urination or incontinence in postmenopausal women who are not receiving hormonal replacement therapy. [Copyright &y& Elsevier]