58 results on '"Small bladder"'
Search Results
2. A prospective study comparing side-firing KTP laser enucleation vs bipolar transurethral resection of bladder tumor for small bladder tumors in an outpatient setting
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Pirzada Faisal Masood, Nikhil Khattar, T Manasa, Rajeev Sood, Rajpal Singh, Anurag Singla, and Mahesh Chandra Tripathi
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medicine.medical_specialty ,Original Paper ,Bladder cancer ,business.industry ,Enucleation ,General Medicine ,Perioperative ,Small bladder ,medicine.disease ,Lower risk ,Surgery ,transurethral resection of bladder tumor ,KTP enucleation ,medicine ,Ktp laser ,Reflex ,bladder cancer ,Prospective cohort study ,business - Abstract
Introduction Laser therapy provides an alternative option for treating non-muscle-invasive bladder cancer. The clinical evidence for potassium-titanyl-phosphate (KTP) laser en bloc resection is still limited. Here, we evaluated the efficacy, safety profile, and outcomes of side-firing KTP laser enucleation with bipolar transurethral resection of bladder tumor (TURBT) in carefully selected patients with small bladder tumors in an office setting. Material and methods A total of 83 patients with small bladder tumors were treated with either side-firing KTP laser enucleation (Group A; n = 40) or bipolar TURBT (Group B; n = 43). Intraoperative and postoperative parameters of interest were recorded and analyzed as per the study so as to evaluate the efficacy, safety profile, and outcome of KTP laser enucleation. Results The mean enucleation time was 23 ±5.24 min in Group A and the mean operative time was 21.98 ±4.77 min in Group B (p = 0.207). Group A had a lower risk of obturator reflex (0 vs 8; p = 0.005) and lesser amount of irrigation used intraoperatively as compared to Group B (6.2 ±0.61 L vs 7.65 ±0.75 L; p
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- 2021
3. Loop ureterocystoplasty for multiple reimplantation failures of refluxing megaureter to atrophic bladder: A novel technique and its long term outcome
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Shina Kawai, Satoru Inoguchi, Taro Kubo, Kazuya Tanabe, Taiju Hyuga, Shigeru Nakamura, and Hideo Nakai
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Novel technique ,medicine.medical_specialty ,Urinary bladder ,business.industry ,Augmentation cystoplasty, ureterocystoplasty, ureteroneocystostomy ,Pediatrics, Pediatric Surgery, Pediatric Urology ,Small bladder ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,Surgery ,Ureter ,medicine.anatomical_structure ,augmentation cystoplasty, ureterocystoplasty, ureteroneocystostomy ,medicine ,business ,Refluxing Megaureter - Abstract
We encountered a 9-year-old boy with a small bladder who had previously undergone multiple ureteroneocystostomies for unilateral refluxing megaureter. He underwent excision of the affected non-functioning kidney and ureterocystoplasty used the dilated regional ureter, in which the loop shaped urinary bladder was reconstructed without detubularization of the dilated ureter. The long-term postoperative course has been satisfactory. There have been no reports of ureterocystoplasty used a dilated ureter after multiple ureteroneocystostomies and none describing ureterocystoplasty in which the ureter was looped. This case is presented herein.
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- 2019
4. Robot-Assisted Buccal Mucosa Graft Ureteroplasty for Bilateral Long Segment Mid-Ureteral Strictures
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Jeni Mathew, Girdhar S. Bora, and R.S. Mavuduru
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endocrine system ,medicine.medical_specialty ,business.industry ,Small bladder ,urologic and male genital diseases ,Long segment ,Buccal mucosa ,female genital diseases and pregnancy complications ,Surgery ,Materials Chemistry ,medicine ,Chronic renal insufficiency ,Ureteral Stricture ,business - Abstract
Background/Objective: Managing long-segment bilateral ureteral strictures in the mid/upper ureters with chronic renal insufficiency (CRI) and small bladder capacity is challenging. A Boari...
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- 2021
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5. The reasons and countermeasures of Bladder Rupture caused by Transurethral Clot Evacuation
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Kai-Long Liu, Chang-Bao Qu, Xin Wang, and Jin-Chun Qi
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medicine.medical_specialty ,Bladder rupture ,030232 urology & nephrology ,Transurethral clot evacuation ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Posterior wall ,medicine ,Paracentesis ,medicine.diagnostic_test ,Urinary retention ,business.industry ,Open surgery ,030208 emergency & critical care medicine ,General Medicine ,Small bladder ,Creative commons ,female genital diseases and pregnancy complications ,Surgery ,Bladder tamponade ,Original Article ,Tamponade ,medicine.symptom ,business - Abstract
Objective: Bladder rupture caused by transurethral clot evacuation is rare in clinic, but an emergency operation is indeed needed in the patient with bladder rupture. We analyzed the reasons of bladder rupture caused by transurethral clot evacuation and provided the countermeasures to guide clinical surgeon to prevent the iatrogenic damage of bladder. Method: We retrospectively reviewed the records of 287 patients in our hospital, who had bladder tamponade resulting from clots of blood for various reasons and underwent transurethral clot evacuation from January 2007 to January 2019. Six male cases, aged from 28 to 76 years (mean 56.67±17.76) had bladder rupture. Four patients whose bladder ruptured intraperitoneally were changed to open surgery to repair bladder and clear the remanent blood clots. Two patients with extraperitoneal bladder rupture and a small bladder crevasse underwent a conservative therapy. Results: We observed that the incidence rate of bladder rupture was not associated with bladder tamponade and the age, but may be associated with gender, bladder paracentesis preoperative and urinary retention preoperative. All six cases were male.. They had different period of urinary retention before operation. No supra-pubis bladder paracentesis was made before operation. The bladder crevasses located in the triangle zone and posterior wall of bladder entirely, and the length of the bladder crevasses ranged from 3 to 7cm (mean 4.83cm). The bladder crevasses were all lengthways, and four cases were of’ bladders ruptured intraperitoneally while another two presented an extraperitoneal bladder rupture. Conclusions: The reasons of bladder rupture caused by transurethral clot evacuation may be related to gender, bladder paracentesis preoperative and urinary retention preoperative. We should decide to use expectant treatment or open surgery immediately according to the extent of the rupture when bladder rupture occurs. doi: https://doi.org/10.12669/pjms.37.3.3911 How to cite this:Liu KL, Wang X, Qu CB, Qi JC. The reasons and countermeasures of Bladder Rupture caused by Transurethral Clot Evacuation. Pak J Med Sci. 2021;37(3):903-907. doi: https://doi.org/10.12669/pjms.37.3.3911 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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- 2021
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6. Treatment of Nonmuscle Invasive Bladder Cancer Using a Novel Zedd Scissors
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Milap Shah, Kanthilatha Pai, Bhaskar K. Somani, Belthangady Monu Zeeshan Hameed, Nithesh Naik, and Padmaraj Hegde
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Detrusor muscle ,medicine.medical_specialty ,Bladder cancer ,business.industry ,Urology ,En bloc resection ,Small bladder ,urologic and male genital diseases ,medicine.disease ,female genital diseases and pregnancy complications ,Resection ,medicine.anatomical_structure ,Bladder tumor ,medicine ,business - Abstract
Introduction: Treatment of nonmuscle invasive bladder cancer (NMIBC) usually requires piecemeal resection of the tumor. En bloc resection emerges as a promising technique for small bladder tumors
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- 2020
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7. Associations between nighttime and daytime maximum voided volumes: Relevance for nocturia?
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Jason Lazar, Jeffrey P. Weiss, Lori A. Birder, Roger R. Dmochowski, Thomas F. Monaghan, Karel Everaert, and Donald L. Bliwise
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Male ,medicine.medical_specialty ,Urology ,Urinary Bladder ,030232 urology & nephrology ,Urination ,Nocturnal ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Nocturia ,Humans ,In patient ,Aged ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,business.industry ,Polyuria ,Functional bladder capacity ,Small bladder ,Middle Aged ,Etiology ,Urology clinic ,Female ,Neurology (clinical) ,medicine.symptom ,Prostatic obstruction ,business - Abstract
Aim The relationship between maximum voided volumes (MVV) during the night and day is poorly understood. Such measurements are important because they are often used to indicate functional bladder capacity (FBC), a relevant parameter for nocturia. This study examined the association of such nighttime and daytime measurements in men with nocturia. Methods We retrospectively analyzed 356 24-hour voiding diaries showing ≥2 nocturnal voids from 220 men at an outpatient urology clinic. We defined small FBC as MVV ≤ 200 mL. Results A total of 131 entries demonstrated a nocturnal MVV ≤ 200 mL, of which a majority (98 [74.8%]) also showed a 24-hour MVV ≤ 200 mL (ie, global small FBC), and 33 (25.2%) exceeded the 200 mL threshold during the day (ie, nocturnal-specific small FBC). Correspondingly, among voiding diaries without global small FBC (n = 258), most (225/258 [87.2%]) showed a nocturnal MVV > 200 mL. Data were similar when analyzing only the first complete voiding diary per case, when limiting analyses to those without benign prostatic obstruction, and when limiting analyses to cases with nocturnal polyuria. Conclusion Nocturia may be attributable to nocturnal-specific small FBC or global small FBC. Although the etiology of nocturnal-specific small FBC remains unclear, it was present in a significant minority of patients with small FBC, thus necessitating more directed research. Conversely, diminished nocturnal MVV was nevertheless relatively uncommon in the absence of global small FBC, such that nocturnal-only voiding diaries may provide a rational alternative for follow-up evaluation in patients with nocturia due to global small bladder capacity.
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- 2020
8. Does Variant Histology Change Management of Non-muscle-invasive Bladder Cancer?
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Maximilian Burger, David J. McConkey, and Ashish M. Kamat
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Urinary Bladder ,030232 urology & nephrology ,Change Management ,urologic and male genital diseases ,Cystectomy ,Bladder preservation ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Patient summary ,Bladder cancer ,business.industry ,Small bladder ,medicine.disease ,female genital diseases and pregnancy complications ,Oncology ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Treatment strategy ,Surgery ,Radiology ,Neoplasm Recurrence, Local ,business ,Non muscle invasive ,Variant histology - Abstract
A 52-yr-old man, 35 pack-year smoker, is diagnosed with two non-muscle-invasive urothelial tumors, pTa and pT1, the former upstaged to pT1 by a reference pathologist. Two possible treatment strategies include intravesical bacillus Calmette-Guerin (BCG) and/or primary or rescue cystectomy. The importance or even accurate existence of "variant histology" is put into perspective, and whether the reference pathologist's diagnosis of a micropapillary variant requires a real change in treatment strategy is considered. PATIENT SUMMARY: The reference urologist diagnosed two small bladder tumors as two different depths of infiltration: one as pTa and the other (slightly more severe) as pT1. Suspecting a variant, the reference urologist referred to a second pathologist, who upstaged the less severe tumor to T1, with both defined as micropapillary cancer. This presentation discusses removal of the bladder versus a trial of treatment with bladder preservation.
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- 2019
9. Residual urinary Incontinence after Successful Repair of Obstetric Fistula
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Sayeba Akhter, Fahmida Zabin, and Musarrat Sultana
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medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,business.industry ,Fistula ,030232 urology & nephrology ,Obstetrics and Gynecology ,Urinary incontinence ,Small bladder ,medicine.disease ,Surgery ,03 medical and health sciences ,Genitourinary Fistula ,0302 clinical medicine ,medicine ,Bladder size ,Sex organ ,Observational study ,medicine.symptom ,Fistula repair ,business - Abstract
Objective(s): Aim of the study was to identify the risk factors in those women who remain with incontinence after successful fistula repair.Materials & method: The women admitted in Dhaka Medical College Hospital with obstetrical genitourinary fistula were the study population.A observational study was done with all women having successful repair. They were asked to return for a follow-up appointment, 3 months after discharge . Women were examined and questioned at discharge and at follow up appointment. A structured questionnaire were used and information entered into a database.Results: Women who returned for follow-up 3 month postsurgery were included in predictors of closure analyses. Small bladder size (ARR 3.7; 95% CI 1.211.8), severe scarring (ARR 1.2; 95% CI 1.12.7), urethral involvement (ARR 7.3; 95% CI 3.31.46), were predicted failed fistula closure. Women with a closed fistula at 3 month follow-up were included in predictors of residual incontinence analyses .Conclusion:The prognosis for genital fistula closure is related to preoperative bladder size, previous repair, vaginal scarring, and urethral involvement.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 86-91
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- 2016
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10. Bladder augmentation in children: current problems and experimental strategies for reconstruction
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Sophie Langer, Martin L. Metzelder, Eva Györi, Alexander Springer, and Christine Radtke
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medicine.medical_specialty ,Neurogenic bladder ,Spinal dysraphism ,Urinary Bladder ,030209 endocrinology & metabolism ,Harnblasendysfunktion ,Review ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,Biomaterials ,03 medical and health sciences ,0302 clinical medicine ,Urinary bladder dysfunction ,medicine ,Humans ,Bladder augmentation ,Neurogene Harnblase ,Urothelium ,Adverse effect ,Child ,Neurogenic bladder dysfunction ,Biomaterialien ,business.industry ,Anastomosis, Surgical ,Congenital malformations ,General Medicine ,Small bladder ,Plastic Surgery Procedures ,medicine.disease ,Ileozystoplastie ,female genital diseases and pregnancy complications ,Surgery ,Bladder exstrophy ,Urodynamics ,Urologic Surgical Procedures ,business ,Blasenaugmentation ,Ileocystoplasty - Abstract
Summary Bladder augmentation is a demanding surgical procedure and exclusively offered for selected children and has only a small spectrum of indications. Paediatric bladder voiding dysfunction occurs either on a basis of neurological dysfunction caused by congenital neural tube defects or on a basis of rare congenital anatomic malformations. Neurogenic bladder dysfunction often responds well to a combination of specific drugs and/or intermittent self-catheterization. However, selected patients with spinal dysraphism and children with congenital malformations like bladder exstrophy and resulting small bladder capacity might require bladder augmentation. Ileocystoplasty is the preferred method of bladder augmentation to date. Because of the substantial long-and short-term morbidity of augmentation cystoplasty, recent studies have tried to incorporate new techniques and technologies, such as the use of biomaterials to overcome or reduce the adverse effects. In this regard, homografts and allografts have been implemented in bladder augmentation with varying results, but recent studies have shown promising data in terms of proliferation of urothelium and muscle cells by using biological silk grafts.
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- 2018
11. Bladder Re-augmentation in Classic Bladder Exstrophy: Risk Factors and Prevention
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John Jayman, John P. Gearhart, Karl Benz, Mahir Maruf, Timothy Baumgartner, Karen M. Doersch, and Matthew Kasprenski
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Male ,Reoperation ,medicine.medical_specialty ,Adolescent ,Colon ,Urology ,Urinary Bladder ,030232 urology & nephrology ,Bladder capacity ,Ileum ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Risk Factors ,Medicine ,Humans ,In patient ,Child ,business.industry ,Bladder Exstrophy ,Sigmoid colon ,Small bladder ,Organ Size ,Plastic Surgery Procedures ,medicine.disease ,Surgery ,Bladder exstrophy ,Urethrocutaneous fistula ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Child, Preschool ,Cohort ,Female ,business - Abstract
Objective To characterize the causes of re-augmentation in patients with classic bladder exstrophy (CBE). Methods A prospectively maintained institutional database of 1327 exstrophy-epispadias complex patients was reviewed for patients with CBE who underwent more than 1 augmentation cystoplasty (AC) procedure. Data regarding bladder capacities, complications following AC, and reasons for re-augmentation were evaluated. Results A total of 166 patients with CBE underwent AC. Of these, 67 (40.4%) were included in the control group and 17 (10%) patients underwent a re-augmentation. There were several indications for re-augmentation including continued small bladder capacity (17 of 17), inadequate bladder necks (8 of 17), failed rattail augmentation (2 of 17), stomal incontinence (1 of 17), a urethrocutaneous fistula (1 of 17), and an hourglass augmentation (1 of 17). Of note, 5 of the 17 patients (29%) had a re-augmentation procedure with a ureteral reimplantation. The sigmoid colon was the most commonly used bowel segment in the failed initial AC (8 patients), whereas the ileum was the most commonly used segment during re-augmentation (12 patients). In the re-augmentation cohort, the mean amount of bowel used during the first AC procedure was 12 cm (standard deviation [SD] 3.6) compared with 19 cm (SD 5.0) during re-augmentation. The mean amount of bowel used for control group augmentations was 20.8 cm (SD 4). The mean re-augmentation preoperative bladder capacity of 100 mL (SD 60) immediately increased after re-augmentation to 180.8 mL (SD 56.4) (P = .0001). Conclusion Bladder re-augmentation is most commonly required in the setting of a small bladder capacity after an initial AC, when an insufficient amount of bowel is used during the first AC procedure.
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- 2017
12. Multiple failed closure of bladder in children with vesical exstrophy: Safety and efficacy of temporary ileal patch augmentation in assisting bladder closure
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Abraham Mammen, Karthikeya K. Varma, and Kolar Venkatesh Satish Kumar
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medicine.medical_specialty ,medicine.medical_treatment ,lcsh:Surgery ,urologic and male genital diseases ,Ureterosigmoidostomy ,Bladder exstrophy ,Bladder closure ,medicine ,Surgical approach ,business.industry ,lcsh:RJ1-570 ,Mean age ,lcsh:Pediatrics ,Small bladder ,lcsh:RD1-811 ,medicine.disease ,female genital diseases and pregnancy complications ,Surgery ,medicine.anatomical_structure ,Early results ,Pediatrics, Perinatology and Child Health ,failed primary bladder closure ,Sphincter ,Original Article ,business ,temporary ileal patch augmentation ,radical soft-tissue mobilization ,delayed primary bladder closure - Abstract
Objective: The surgical approach to small bladder template in exstrophy bladder is difficult. Previously, many of these children underwent ureterosigmoidostomy and in recent times, the trend is to do a delayed primary closure. We have used ileal patch as a temporary cover for these small bladders with a view to encourage bladder growth and early results are encouraging. Materials and Methods: In five of the 45 children with bladder exstrophy managed by radical soft-tissue mobilization over 10 years, primary bladder closure was not possible due to repeated failed closures. A detubularized ileum was used to patch the bladder initially and after 4 months the patch was excised and bladder closure with sphincter repair was done in second stage. Results: In five children (three girls and two boys) the mean age at initial bladder closure was 14 months and mean age at ileal patch was 22 months. In four patients, the bladder grew facilitating closure and in one patient it failed. There were no complications with the use of gut in patch. Conclusion: A temporary ileal patch seems promising in managing failed bladder closure in exstrophy patients. Long-term studies are needed before such a technique can be used in all patients with failed primary bladder closures.
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- 2014
13. Promising Long-Term Outcome of Bladder Autoaugmentation in Children with Neurogenic Bladder Dysfunction
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Eva Lund Hansen, L. Henning Olsen, Yazan F. Rawashdeh, and Gitte M Hvistendahl
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medicine.medical_specialty ,Time Factors ,Adolescent ,Bladder compliance ,Urology ,Urinary Bladder ,Bladder capacity ,urologic and male genital diseases ,medicine ,Humans ,Postoperative Period ,Urinary Bladder, Neurogenic ,Detrusor myotomy ,Child ,Neurogenic bladder dysfunction ,Urinary bladder ,business.industry ,Infant ,Recovery of Function ,Small bladder ,Leak point pressure ,Clean Intermittent Catheterization ,medicine.disease ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Child, Preschool ,Urologic Surgical Procedures ,business - Abstract
We evaluated the long-term outcome of bladder autoaugmentation in children with neurogenic bladder dysfunction.Data were compiled from the records of 25 children with a median age of 9.3 years (range 0.9 to 14.2) who underwent detrusor myotomy between 1992 and 2008. All patients were diagnosed with small bladder capacity, low compliance and high end filling pressures, and were unresponsive to clean intermittent catheterization and anticholinergics.Median followup was 6.8 years (range 0.1 to 15.6). Median postoperative bladder capacity was unchanged or decreased to 95 ml (range 25 to 274) during the first 3 months compared to a median preoperative capacity of 103 ml (14 to 250). At 5 months postoperatively median bladder capacity increased significantly to 176 ml (range 70 to 420, p0.01). This increase remained significant during the rest of followup. Median bladder compliance doubled after 1 year to 10 ml/cm H2O (range 1 to 31, p0.05) compared to the preoperative level, and further increased to 17 ml/cm H2O (5 to 55) at 5 years (p0.05). Median maximal detrusor pressure was 43 cm H2O (range 8 to 140) preoperatively. This value decreased significantly postoperatively (p0.01) and at final followup it was 26 cm H2O (range 6 to 97). Kidney function developed normally in all patients except 1 with persistent uremia. Reflux was alleviated in 7 of 9 cases. Of the patients 18 became continent on clean intermittent catheterization.Bladder autoaugmentation in children with neurogenic bladder dysfunction offers, after a transient decrease in bladder capacity, a long lasting increase in capacity and compliance, while the end filling pressure decreases.
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- 2013
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14. Murine bladder wall biomechanics following partial bladder obstruction
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W. David Merryman, Beth A. Drzewiecki, John C. Pope, and Joseph Chen
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medicine.medical_specialty ,Time Factors ,Urinary Bladder ,Biomedical Engineering ,Biophysics ,Urology ,Mice ,Bladder outlet obstruction ,Axial strain ,medicine ,Animals ,Orthopedics and Sports Medicine ,Bladder Obstruction ,medicine.diagnostic_test ,business.industry ,Rehabilitation ,Biomechanics ,Cystometry ,Anatomy ,Small bladder ,Fibrosis ,Biomechanical Phenomena ,Urinary Bladder Neck Obstruction ,Disease Models, Animal ,Ovariectomized rat ,Female ,Ureter ,business ,Ligation - Abstract
Evaluation of bladder wall mechanical behavior is important in understanding the functional changes that occur in response to pathologic processes such as partial bladder outlet obstruction (pBOO). In the murine model, the traditional approach of cystometry to describe bladder com pliance can prove difficult secondary to small bladder capacity and surgical exposure of the bladder. Here, we explore an alternative technique to characterize murine mechanical properties by applying biaxial mechanical stretch to murine bladders that had undergone pBOO. 5–6 week old female C57/Bl6 mice were ovariectomized and subjected to pBOO via an open surgical urethral ligation and sacrificed after 4 weeks (n¼12). Age matched controls (n¼6) were also analyzed. Bladders were separated based on phenotype of fibrotic (n¼6) or distended (n¼6) at the time of harvest. Biaxial testing was performed in modified Kreb' ss olution at 371C. Tissue was preconditioned to 10 cycles and mechanical response was evaluated by comparing axial strain at 50 kPa. The normal murine bladders exhibited anisotropy and were stiffer in the longitudinal direction. All mice showed a loss of anisotropy after 4 weeks of pBOO. The two phenotypes observed after pBOO, fibrotic and distended, exhibited less and more extensibility, respectively. These proof-of-principle data demonstrate that pBOO creates quantifiable changes in the mechanics of the murine bladder that can be effectively quantified with biaxial testing. & 2013 Published by Elsevier Ltd.
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- 2013
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15. Traditional Japanese medicine,Yokukansan, for the treatment of nocturnal enuresis in children
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Toshiaki Shimizu, Shuichiro Fujinaga, Shinichi Niijima, Yoshiyuki Ohtomo, Masaru Takada, and Daisuke Umino
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Night Terrors ,Pediatrics ,medicine.medical_specialty ,Nocturnal polyuria ,business.industry ,Yokukansan ,Small bladder ,Nocturnal ,Temper tantrums ,Enuresis ,Pediatrics, Perinatology and Child Health ,medicine ,medicine.symptom ,Desmopressin ,business ,Psychiatry ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug - Abstract
Background The major pathogenic factors involved in nocturnal enuresis are nocturnal polyuria, small bladder capacity and/or detrusor overactivity, and a high arousal threshold. Desmopressin is the first-line therapy for the patients with diuresis-dependent nocturnal enuresis. Yokukansan, a traditional Japanese medicine, has been used in Japan to treat patients with nervousness, insomnia, and children with night terrors and temper tantrums. We experienced the positive effect of Yokukansan in some of the patients who did not respond well to desmopressin therapy. Methods In total, 32 children with monosymptomatic nocturnal enuresis with nocturnal polyuria were treated with oral desmopressin melt tablets, which were approved for clinical use in Japan on 29 May 2012. This treatment was effective for 14 of them. For the rest (n = 18), Yokukansan was introduced in combination with desmopressin. Results Yokukansan was effective for 12 out of the 18 cases. Conclusions: Yokukansan should be a candidate for the medication of nocturnal enuresis.
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- 2013
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16. Neglected Pessary Perforating Small Bowel: A Case Report
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Thuraya Al-Badr, Ahmed Al-Badr, and Lubna Al-Badr
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Pessary ,medicine.medical_specialty ,Pelvic organ ,business.industry ,Fistula ,Perforation (oil well) ,medicine ,Small bladder ,medicine.disease ,business ,Complication ,Surgery - Abstract
Pessaries are commonly used to treat pelvic organ prolapse. Although the success rate is usually high, complications may arise if neglected for a long time. There is a general lack of literature regarding pessary use, and specifically related to pessary complications. This is the first case report of a pessary-related complication in Saudi Arabia, as well as the first report of a pessary perforating the small bowel. In our patient, the pessary had been neglected for 20 years, leading to the perforation of the small bladder and the formation of a fistula. Pessary was successfully removed and fistula corrected. Recommendations to avoid such complications include maintenance of pessary and routine follow-up with a physician. Although such complications have been declining in recent years due to increased awareness, it is important that practitioners are reminded that complications still may occur.
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- 2016
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17. Pediatric overactive bladder and lower urinary tract dysfunctions: diagnosis and treatment
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Israel Franco
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Pediatrics ,medicine.medical_specialty ,business.industry ,Urinary system ,Urology ,Small bladder ,urologic and male genital diseases ,medicine.disease ,Overactive bladder syndrome ,female genital diseases and pregnancy complications ,Overactive bladder ,Pediatrics, Perinatology and Child Health ,medicine ,Nocturia ,Hypertonia ,medicine.symptom ,Urgency frequency syndrome ,Hyperactive bladder ,business - Abstract
The most common lower urinary tract (LUT) dysfunction in children is overactive bladder syndrome (OAB). This has been known by numerous other names such as urge syndrome, urgency frequency syndrome, hyperactive bladder syndrome, persistent infantile bladder and detrusor hypertonia. Recently, the International Children’s Continence Society has been attempting to standardize the nomenclature; OAB is the accepted terminology today. OAB is defined by the presence of one or all the following symptoms: urgency, frequency, urge incontinence and nocturia, which is less common in children than in the adults. This constellation of symptoms in general represents what the International Children’s Continence Society defines as storage symptoms. Until recently, the concepts that had been used to dictate the management of this problem in children were based on the foundation that this was primarily a bladder problem (small bladder capacity) and/or a delay in maturation in the nervous system of children. The expectation that children would outgrow their problems led many pediatric urologists and other practitioners to tell parents that “they would not be wetting themselves on their wedding day”. However, recent studies in adult patients with OAB have shown that they had symptoms as children. Recent findings of associations between LUT symptoms and sexual dysfunction, as well as between LUT dysfunction and neuropsychiatric problems, have opened up a new frontier into the possible mechanisms of OAB in children. These findings point to OAB as a symptom of a more centrally located dysfunction that affects multiple systems. This review presents a brief review of the neurophysiology of voiding as well as a how to evaluate and treat the child with OAB symptoms. In conclusion, the movement away from a vesicocentric way of thinking to a more corticocentric mode of thinking, along with new imaging modalities that can examine the brain as it works, will be of great value in determining future treatments of OAB. Medications generated from these evidence-based studies will hopefully treat the underlying disease process and not just the symptoms.
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- 2008
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18. Evaluation and Management of Primary Nocturnal Enuresis
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Kim E. Riley and Lorna Schumann
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Male ,medicine.medical_specialty ,Holistic Nursing ,Primary nocturnal enuresis ,business.industry ,Nurse practitioners ,Urinary Bladder ,Cognitive reframing ,Small bladder ,Enuresis ,Combined Modality Therapy ,Pharmacological treatment ,medicine ,Humans ,Female ,medicine.symptom ,Child ,Desmopressin ,Intensive care medicine ,business ,Competence (human resources) ,Nursing Assessment ,General Nursing ,medicine.drug - Abstract
Enuresis can be a source of family crisis, and can contribute to a lack of self-esteem in the affected child. It must be stressed to both parent and child that improvement is gradual and largely a function of maturation in cases where no organic problem is identified. Research shows that many enuretic children seem to have small bladder capacities (Long, 1991), and that the majority have a polyuric factor such as a decreased level of AVP that is amenable to replacement therapy with desmopressin (Bloom, 1993; Hamburger, 1993; Hjalmas & Bengtsson, 1993; Norgaard & Djurhuus, 1993). Utilizing pharmacologic treatment can accelerate spontaneous cure or act as a substitute until time provides nocturnal continence (Norgaard & Djurhuus, 1993). Nurse practitioners can use multiple modalities in a holistic approach to reframe this problem and to involve children in solving their own problem. The child who is given a basic understanding of the physiology involved in the healing process will be able to identify inner healing resources and utilize external resources available to him or her. This approach begins with children's imaging the desired outcome of urinary control and ends with achieving increased self-esreem and the sense of competence they deserve.
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- 1997
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19. Endoscopic partial cystectomy for bladder leiomyoma using retroperitoneoscopic and transurethral procedures
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Tadashi Matsuda, Yoshihiro Komai, Ichiro Fujita, Mutsushi Kawakita, Takashi Murota, and Shozo Danno
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Cystectomy ,urologic and male genital diseases ,Resection ,Humans ,Medicine ,Leiomyoma ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Cystoscopy ,Small bladder ,Bladder Leiomyoma ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,female genital diseases and pregnancy complications ,Surgery ,Urinary Bladder Neoplasms ,business - Abstract
Retroperitoneoscopic partial cystectomy was performed to remove a leiomyoma in the right wall of the bladder in a 58-year-old man. The tumor was initially circumscribed with a mucosal incision using a transurethral resectoscope, and once the bladder wall had been penetrated with the resectoscope, the remaining procedures were performed retroperitoneoscopically. The bladder wall was closed using a retroperitoneoscopic suturing technique. Endoscopic partial cystectomy using both a transurethral incision and a retroperitoneoscopic resection is technically feasible in the treatment of small bladder tumors.
- Published
- 2002
- Full Text
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20. Clean intermittent self-catheterization
- Author
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A. S. Robertson, A. L. Lawson, David E. Neal, and R. J. Webb
- Subjects
medicine.medical_specialty ,Clean intermittent self-catheterization ,Bladder reconstruction ,business.industry ,Urology ,Obstetrics and Gynecology ,Small bladder ,Detrusor hyperreflexia ,urologic and male genital diseases ,medicine.disease ,female genital diseases and pregnancy complications ,medicine.anatomical_structure ,medicine ,Physical therapy ,Sphincter ,Major complication ,Intensive care medicine ,business ,Low bladder compliance ,Neurogenic bladder dysfunction - Abstract
The introduction of clean intermittent self-catheterization (CISC) as a method of management for patients with impaired bladder emptying has been a major advance in clinical urology. It requires commitment and enthusiasm from the staff involved and motivation from the patient to be successful, but has assumed increasing importance because of the advent of bladder reconstruction procedures. Selection of patients by the urologist, based on motivation, dexterity and urodynamic factors, is an important determinant in the final symptomatic outcome, but in view of the low morbidity of CISC, patients should be given the benefit of the doubt. Most patients can be taught the technique, but it can be difficult for the wheelchair-bound female with poor dexterity. A high proportion of patients with impaired bladder emptying will do well, but adverse urodynamic factors include a relatively small residual urine, a small bladder capacity, low bladder compliance, detrusor hyperreflexia and a weak sphincter mechanism. Major complications directly caused by the technique are rare, particularly in women. Minor problems include hematuria and discomfort on catheterization, but these can be diminished by careful technique. CISC is an easily learned technique that is safe and acceptable to patients and one which places few extra burdens on hospital or community resources.
- Published
- 1993
- Full Text
- View/download PDF
21. The feasibility of real-time bladder mapping using a stereotactic navigational system
- Author
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Ronald O.P. Draga, M. T. W. Tycho Lock, Herke Jan Noordmans, Matthijs C. M. Grimbergen, J.L.H. Ruud Bosch, and Radiology and nuclear medicine
- Subjects
medicine.medical_specialty ,Bladder cancer ,business.industry ,Navigational system ,Small bladder ,medicine.disease ,urologic and male genital diseases ,Video image ,female genital diseases and pregnancy complications ,Surgery ,Low contrast ,Image-guided surgery ,Operating time ,medicine ,Radiology ,business - Abstract
Stereotactic navigational devices have been implemented in neurosurgery, orthopedics and ear-nose-throat to improve surgical accuracy. However, the feasibility of navigating inside the bladder has not yet been investigated. Occasionally, transurethral resections of bladder tumors (TURBTs) are impeded by bleeding and cloudiness inside the bladder and, consequently, the bladder lesions are not found back easily. In addition, small bladder lesions are often concealed when viewed with the camera some distance away from the bladder wall due to low contrast differences. The aim of the study is to investigate the feasibility of real-time bladder mapping using the Medtronic Stealthstation system, without the use of pre-operative images. Seven patients scheduled for a TURBT were included in the study. During the TURBT procedure, the spatial coordinates of the bladder lesions were recorded two times independently, after filling the bladder with a fixed volume of 390 ml. The distance between the spatial coordinates of two consecutive measurements, in millimeters, was calculated. We found that bladder lesions can be found back using the navigational system with an accuracy of less than 12 mm. Real-time bladder navigation is feasible without the necessity of pre-operative images or calibration. If the coordinates are directly superimposed on the video image this could facilitate the retrieval of bladder lesions during TURBT. This system could reduce the stress for the surgeon and decrease the operating time.
- Published
- 2010
- Full Text
- View/download PDF
22. Surgical management of intractable interstitial cystitis
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D. Kappor, G. Zhang, and A. A. Sidi
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,Obstetrics and Gynecology ,Interstitial cystitis ,Small bladder ,Treatment results ,medicine.disease ,Surgery ,Cystectomy ,medicine ,In patient ,Augmentation cystoplasty ,business ,Surgical treatment - Abstract
Interstitial cystitis represents a diagnostic and therapeutic challenge. Most patients can be managed conservatively, but a small number of patients do not respond to conservative therapy and for them surgical treatment is indicated. This article reviews the historical and currently used surgical modalities. Enterocystoplasty is the surgical treatment of choice for intractable interstitial cystitis. The results of enterocystoplasty are satisfactory in approximately 80% of patients. However, no histological findings, such as mast cell density or degree of inflammation, can be used as a preoperative predictor of treatment results. The best results of cystoplasty seem to be achieved in patients who have a small bladder capacity, determined preoperatively under anesthesia. Approximately 10%–20% of patients may not be able to void spontaneously after surgery and require self-catheterization. Because of the unpredictable results, cystoplasty must be recommended with caution for certain patients. There is no evidence to indicate that a supratrigonal cystectomy and substitution cystoplasty offer a therapeutic advantage over augmentation cystoplasty alone. The choice of bowel segment does not affect the final outcome provided that it is tubularized and made spherical in configuration.
- Published
- 1992
- Full Text
- View/download PDF
23. Voiding dysfunction due to chronic viral encephalitis in a young woman
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D. Rohrmann, Alaa Abdel R Abdel Hafez, E Ali Salah, and G. Jakse
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Adult ,medicine.medical_specialty ,business.industry ,Urology ,Viral encephalitis ,Residual urine ,Urinary incontinence ,Small bladder ,medicine.disease ,Acute viral encephalitis ,Chronic viral encephalitis ,Urinary Incontinence ,Internal medicine ,Anesthesia ,Medicine ,Humans ,Female ,Encephalitis, Viral ,medicine.symptom ,business ,Urgency incontinence ,Video urodynamics - Abstract
We record a case of a 37-year-old female with acute viral encephalitis, frequency and urgency incontinence. Video urodynamics showed small bladder capacity, sensory urgency, high residual urine and a Christmas tree appearance of the bladder. MRI showed inflammation and edema in the area of the thalamus and internal capsule in the early stage, then cavitation and gliosis in the same regions in the late stage.
- Published
- 2009
24. Clam ileoplasty bladder augmentation and renal transplantation
- Author
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Cedomir Topuzovic, D. Milutinovic, and Jovan Hadzi-Djokic
- Subjects
Adult ,medicine.medical_specialty ,Clam ileocystoplasty ,business.industry ,Urinary Bladder ,Urology ,General Medicine ,Small bladder ,urologic and male genital diseases ,medicine.disease ,Kidney Transplantation ,female genital diseases and pregnancy complications ,Transplantation ,Radiography ,Bladder augmentation ,Ileum ,End stage renal failure ,medicine ,Humans ,Kidney Failure, Chronic ,Female ,Bladder function ,business ,Kidney transplantation - Abstract
In our patient, with a small contacted bladder and end stage renal failure, bladder augmentation (clam ileocystoplasty) was done in conjunction with renal transplantation. Our patient has stable renal and bladder function 46 months after kidney transplantation.
- Published
- 2008
25. Voided stain on paper method for analysis of mouse urination
- Author
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Hironori Haga, Naoki Yoshimura, Yoshio Sugino, Yukio Hayashi, Osamu Ogawa, K. Yoshimura, and Akihiro Kanematsu
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Male ,Paper ,medicine.medical_specialty ,Pathology ,Time Factors ,Urology ,media_common.quotation_subject ,Urinary Bladder ,Urination ,Urine ,urologic and male genital diseases ,Body weight ,Stain ,Mice ,Cystitis ,medicine ,Animals ,Cyclophosphamide ,media_common ,Filter paper ,business.industry ,Body Weight ,Reproducibility of Results ,Histology ,Small bladder ,Disease Models, Animal ,Urodynamics ,Female ,Neurology (clinical) ,Linear correlation ,business - Abstract
Aims To evaluate the usefulness of a quantification method using filter paper for analyzing minute voided urine of the mouse. Methods Voided stain on paper (VSOP) method; the correlation between area of stained spot on a filter paper and amount of applied liquid was calculated. Voiding behavior of the mice was analyzed by placing the animal above the same filter paper and recording voided time and area over 2 hr. The usefulness of the VSOP method was tested in analysis of the voiding behavior of five female 7-week-old ddY mice treated with cyclophosphamide (CPM, 150 mg/kg, intraperitoneally) and five control ones, in comparison with the histology of CPM-induced cystitis. Further, the voided volume of male and female ddY mouse ranging from 2 to 13 weeks was assessed. Results There was a linear correlation between liquid volume and stained area on the filter paper (y = 16.472x − 22.411, R2 = 0.9981). Between control mice and those with histologically proven CPM cystitis, there was a significant difference in voided volume (362.7 ± 51.9 and 127.8 ± 100.0 µl
- Published
- 2008
26. Chronic subdural hematoma associated with voiding dysfunction
- Author
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G. Jakse, D. Rohrmann, A.A. Badawi, and A. Abdel Hafez
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Male ,Urology ,Urinary Bladder ,urologic and male genital diseases ,Hematoma ,Chronic subdural hematoma ,medicine ,Humans ,Urgency incontinence ,Paresis ,Aged ,business.industry ,Electromyography ,Brain ,Small bladder ,medicine.disease ,Urination Disorders ,female genital diseases and pregnancy complications ,Urodynamics ,Hemiparesis ,Frontal lobe ,Anesthesia ,Fluoroscopy ,Hematoma, Subdural, Chronic ,Intracranial lesions ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
We report the case of a 73-year-old male who presented with a chronic subdural hematoma that compressed the frontal lobe, an area known to be active in detrusor control, and caused contralateral hemiparesis and urgency incontinence. Urodynamically, he had a small bladder capacity and high amplitude overactive detrusor contractions with an intact sphincteric response. We concluded that the effect of intracranial lesions on voiding depends upon the site rather than the type of the pathology. Further in-depth studies are needed to clarify the effect of intracranial lesions, and accordingly the function of different brain regions and their influence on voiding.
- Published
- 2008
27. Extended partial cystectomy with augmentation cystoplasty in urachal adenocarcinoma: An oncologically favorable but underutilized alternative to radical cystectomy
- Author
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Niraj K Goyal, Syed Jamal Rizvi, and Rohan Satish Valsangkar
- Subjects
medicine.medical_specialty ,business.industry ,urachal adenocarcinoma ,Urology ,medicine.medical_treatment ,Case Report ,Small bladder ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,urologic and male genital diseases ,Capacity bladder ,extended partial cystectomy ,female genital diseases and pregnancy complications ,Urachal adenocarcinoma ,Surgery ,Cystectomy ,Bladder augmentation ,Augmentation cystoplasty ,medicine ,business ,radical cystectomy - Abstract
Partial/extended partial cystectomy (EPC) is the most common surgery done for localized urachal malignancies. However, sometimes, after EPC, patients may be left with small bladder remnant, reconstruction of which will result in very small capacity bladder with resultant severe storage voiding symptoms. We report a case of urachal adenocarcinoma, in which when a small bladder remnant was left post-EPC, instead of proceeding with radical cystectomy (RC) and neobladder (the standard alternative), bladder augmentation was done with good oncological and voiding outcome. Augmentation cystoplasty has many advantages over neobladder and we suggest it as an oncologically comparable alternative to RC with neobladder, which has been underutilized in urachal malignancies as we found on literature review.
- Published
- 2016
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28. Bilateral single ectopic ureters with hypoplastic bladder: how should we treat these challenging entities?
- Author
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Yoshihiko Wakabayashi, Mitsuhiro Narita, Yusaku Okada, Chul Jang Kim, Kazuyoshi Johnin, and Tatsuhiro Yoshiki
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,Urinary diversion ,Small bladder ,urologic and male genital diseases ,female genital diseases and pregnancy complications ,Surgery ,Ureter ,medicine.anatomical_structure ,Staged operation ,Bladder augmentation ,Hypoplastic bladder ,Pediatrics, Perinatology and Child Health ,medicine ,business ,human activities - Abstract
Bilateral single ectopic ureters with hypoplastic bladder are rare and difficult to treat. Urinary diversion (e.g. by ileal conduit) is usually performed because of small bladder capacity. We report a case treated by staged operation without urinary diversion or bladder augmentation. The outcome shows that ureterovesicostomy between the dilated ureter and the bladder is a feasible method to increase capacity for bilateral single ectopic ureters with hypoplastic bladder.
- Published
- 2005
29. Bladder function in infants
- Author
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Ulla Sillén
- Subjects
medicine.medical_specialty ,Pediatrics ,Urology ,Urinary Bladder ,urologic and male genital diseases ,Reference Values ,Medicine ,Humans ,Urinary bladder ,Pelvic floor ,business.industry ,Infant, Newborn ,Urinary Bladder Diseases ,Infant ,Small bladder ,medicine.disease ,Early infancy ,Infant newborn ,female genital diseases and pregnancy complications ,Surgery ,Urodynamics ,medicine.anatomical_structure ,Nephrology ,Reference values ,business ,Bladder function ,Urinary bladder disease - Abstract
The purpose with the present review was to describe what could be considered as normal urodynamic findings in neonates and infants. During the first months of life, urodynamics were characterised by small bladder capacity and high voiding pressure levels, the latter especially marked in male infants. Also dyscoordination at voiding was a common finding. However, detrusor overactivity (unstable contractions) during filling was uncommon in infants. Towards the end of infancy, findings became more in accordance with what is seen in older children. Concluding these findings concerning urodynamic pattern in early infancy high voiding pressure levels must be looked upon as normal and the same is true for intermittent increase in activity in the pelvic floor during voiding. However, instability during filling is rarely seen.
- Published
- 2004
30. Micturitional disturbance in pure autonomic failure
- Author
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M. Asahina, Takamichi Hattori, T. Yamanishi, Ryuji Sakakibara, and Tomoyuki Uchiyama
- Subjects
Male ,medicine.medical_specialty ,Disturbance (geology) ,Urinary Bladder ,Urology ,Detrusor hyperreflexia ,urologic and male genital diseases ,Dyssynergia ,medicine ,Humans ,Pure autonomic failure ,Aged ,Urinary symptoms ,Reflex, Abnormal ,business.industry ,Electromyography ,Urinary Bladder Diseases ,Small bladder ,Middle Aged ,medicine.disease ,Denervation supersensitivity ,female genital diseases and pregnancy complications ,Surgery ,Urodynamics ,medicine.anatomical_structure ,Urinary Incontinence ,Autonomic Nervous System Diseases ,Sphincter ,Female ,Neurology (clinical) ,business - Abstract
We obtained micturitional histories and performed urodynamic studies in six patients with pure autonomic failure. All patients had urinary symptoms. Urodynamic studies showed postmicturition residuals in two, small bladder capacities in two, detrusor hyperreflexia in four, low bladder compliance in two, detrusor-external sphincter dyssynergia in one, neurogenic sphincter electromyography in three, and denervation supersensitivity of the bladder in two. Micturitional disturbance is a common feature in pure autonomic failure because of peripheral and central types of abnormalities.
- Published
- 2000
31. Bladder Exstrophy Combined with a Small Bladder Plate: Indication for Cystectomy or Primary Closure?
- Author
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Yuriy Rudin, Diamid Marukhnenko, and Yuriy Chekeridi
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,Small bladder ,Urine ,urologic and male genital diseases ,medicine.disease ,female genital diseases and pregnancy complications ,Surgery ,Bladder exstrophy ,Cystectomy ,Neck of urinary bladder ,Pediatrics, Perinatology and Child Health ,medicine ,Bladder volume ,In patient ,Bladder function ,business - Abstract
Purpose Specialists debate whether it is reasonable or not to preserve a bladder exstrophy plate with a minimum size of less than 25 – 30 mm. Many urologists recommend that cystectomy be performed and the ureters be diverted from the bladder to an isolated segment of bowel. Is it possible to preserve bladder function in patients with minimum bladder sizes? Material and Methods Over a period of 1996-2008, 60 children from two days to eight months of age underwent surgical repair of bladder exstrophy. Group 1 included 42 (60%) children with a satisfactory size (>30 mm) of bladder plate, and group 2 included 18 (30%) with a small size ( Results The outcomes of primary closure were analyzed with regard to detrusor volume and dry periods. In the children under one year of age, the volume of the bladder was 30-70 ml in group 1 and 20-40 mm in group 2. However, 12 children from group 2 voided small portions of urine with dry periods of up to 10-15 min. At the age 1-3 years old, the children from group 2, with small bladder plates, underwent Cantwell-Ransley repair combined with grafting dorsal surface of corporeal bodies with endoscopic VUR correction (STING) as the second step of treatment. Finally, the bladder volume in the children from group 2 increased up to 50-60 ml, with dry periods of up to 30-40 min. At the next step of treatment, six patients from group 2 underwent uretrocystoneoctomy and bladder neck plasty. As a result, in the children of 1-3 years old, with small bladder plates, the bladder volume was 70-120 ml and dry periods were 40-70 min. Conclusions Our findings evidence that, even with small bladder plates, it is possible to achieve satisfactory outcomes of treatment of bladder exstrophy
- Published
- 2009
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32. The Use of Sub-Mucosal Collagen in the Small Bladder Associated with Bladder Exstrophy
- Author
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A. Lais and Paolo Caione
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Urinary incontinence ,Small bladder ,urologic and male genital diseases ,Cloacal exstrophy ,medicine.disease ,humanities ,female genital diseases and pregnancy complications ,Bladder exstrophy ,Neck of urinary bladder ,Medicine ,medicine.symptom ,business - Abstract
A small bladder plate is a common finding in the exstrophic complex. However, today it is usual practice to attempt closing at birth each exstrophic bladder encountered, even the very small ones. This principle was first emphazised by the John Hopkins’ Pediatric Urologists and later accepted by most worldwide.1
- Published
- 1999
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33. MP-19.16: Resection of small bladder tumors using a flexible cystoscopy on an out patient basis
- Author
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Fumiyasu Endo, T. Oguchi, Osamu Muraishi, M. Ikeda, Yoshiyuki Shiga, and M. Yashi
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,medicine ,Small bladder ,Radiology ,Flexible cystoscopy ,business ,Resection - Published
- 2007
- Full Text
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34. The accuracy of Bladderscan in intrapartum care
- Author
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M. Abdel Fattah, J. W. Barrington, and A. S. Arunkalaivanan
- Subjects
Adult ,medicine.medical_specialty ,Labor, Obstetric ,Amniotic fluid ,Ruptured membranes ,business.industry ,Obstetrics ,Urology ,Urinary system ,Urinary Bladder ,Intrapartum care ,Obstetrics and Gynecology ,Small bladder ,Urine ,Catheter ,Pregnancy ,Bladder volume ,Humans ,Medicine ,Female ,Urinary Catheterization ,business ,Ultrasonography - Abstract
This study was carried out to ascertain whether the Bladderscan machine is accurate in the measurement of bladder volume of women in labor. This would help avoid unnecessary intervention for a significant number of women who have small bladder volumes. Fifty women had a Bladderscan measurement during labor which was compared with an immediately obtained catheter volume. The overall correlation was weak (r = 0.593) but was influenced by the absence or presence of amniotic fluid. In women with ruptured membranes the relationship between Bladderscan volume and catheter-obtained volume was good (r = 0.851), but poor if the membranes were intact (r = 0.128). The Bladderscan may have a role in measuring bladder volume in women in labor and may therefore reduce the frequency of unnecessary catheterization, with the inherent increased incidence of urinary tract infection.
- Published
- 2003
- Full Text
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35. Radiographer-performed abdominal and pelvic ultrasound: its value in a urology out-patient clinic
- Author
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G. M. Flannigan, V. H. Nargund, P. A. Hamilton Stewart, K. Lomas, and D. A. Sapherson
- Subjects
Adult ,Male ,Urologic Diseases ,medicine.medical_specialty ,Outpatient Clinics, Hospital ,Adolescent ,Urology ,Urinary system ,Out patient clinic ,Bladder outlet obstruction ,Medicine ,Humans ,General hospital ,Urinary Tract ,False Negative Reactions ,Aged ,Ultrasonography ,Aged, 80 and over ,Urinary symptoms ,business.industry ,Ultrasound ,Small bladder ,Kidney Diseases, Cystic ,Middle Aged ,Urinary Retention ,Surgery ,England ,Urinary Bladder Neoplasms ,Urology clinic ,Female ,Urinary Calculi ,Radiology ,business - Abstract
Objective To assess the efficacy of radiographer performed ultrasound examination as a routine investigative procedure in a urological out-patient clinic. Patients and methods A total of 151 patients attending a District General Hospital Urological Out-patient Department underwent an ultrasound examination in the clinic. Results Diagnosis by ultrasound was achieved in 93% of patients. The remaining patients underwent further investigations. Two (1%) patients with normal scans had small bladder tumours. Subsequent intravenousurography in these individuals showed normal upper tracts. Conclusion Abdominal and pelvic ultrasound examination performed in the urological out-patient clinic on unprepared patients was the only investigation necessary for evaluation of common problems such as non-specilk urinary symptoms, recurrent urinary tract infections and bladder outlet obstruction.
- Published
- 1994
36. Novel bladder augmentation in a bilateral single system vaginal ectopia
- Author
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Subir K Chatterjee and Uday Sankar Chatterjee
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Urinary Bladder ,Choristoma ,Ureterostomy ,Ureteroscopy ,Humans ,Medicine ,Total urinary incontinence ,medicine.diagnostic_test ,business.industry ,Infant ,Urography ,Cystoscopy ,Small bladder ,Plastic Surgery Procedures ,Bilateral single vaginal ectopia, bladder augmentation, ectopic ureters, incontinence, ureterocystoplasty ,Surgery ,Treatment Outcome ,Urinary Incontinence ,Bladder augmentation ,Urogenital Abnormalities ,Vagina ,Pediatrics, Perinatology and Child Health ,Female ,Blood supply ,Ureter ,business ,Pyelogram - Abstract
A 3-month-old girl presented with total urinary incontinence along with small bladder and bilateral single-system vaginal ectopic ureters [BSSVEU]. Bladder augmentation was done with dilated ureters (ureterocystoplasty) based on proximal blood supply of the ureters.
- Published
- 2011
- Full Text
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37. Does Neonatal Bladder Exstrophy Closure Lead to Better Bladder Growth than Delayed Closure?
- Author
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John P. Gearhart, Rayan Orosco, Nima Baradaran, and Raimondo M. Cervellione
- Subjects
education.field_of_study ,medicine.medical_specialty ,business.industry ,Urology ,Population ,Small bladder ,urologic and male genital diseases ,medicine.disease ,female genital diseases and pregnancy complications ,Group B ,Surgery ,Bladder exstrophy ,Bladder closure ,Pediatrics, Perinatology and Child Health ,medicine ,Closure (psychology) ,Lead (electronics) ,education ,business - Abstract
Purpose Neonatal bladder exstrophy closure is thought to offer the advantage of early bladder cycling leading to better bladder growth in subsequent years compared to delayed bladder closure. This study was designed to verify this assumption. Material and Methods The authors retrospectively reviewed classic bladder exstrophy patients treated at their institution who had repeated cystograms between the age of 1 and 5 years. Patients with previous failed bladder closure were excluded. Two groups were identified according to the timing of bladder closure: neonatal (group A) and delayed (group B). Patients in group B had small bladder templates which did not allow neonatal bladder closure. A bladder growth trend line was fit for patients in group A and B. Student t-test was used to compare age of closure, cystographic capacity at 1 and 5 years and the rate of bladder growth in group A and B. Results Seventy-three patients were identified: 46 in group A (33 male and 13 females) and 27 in group B (21 males and 6 females). Table 1 shows the main results for both groups. Patients in group A had larger cystographic capacity at the age of 1 and 5 years compared to those in group B, however the rate of bladder growth (ml/year) was not statistically significantly different between the 2 groups. Group A Group B P value Mean (SD) age at closure (days) 3 (2) 375 (218) Mean (SD) capacity at 1 year (ml) 62 (38) 36 (24) 0.04 Mean (SD) capacity at 5 years (ml) 114 (48) 82 (37) 0.01 Bladder growth rate (ml/year) 12.2 12.5 NS Conclusions Patients with small bladder templates, who underwent delayed bladder closure, showed smaller cystographic capacities compared to those with bigger bladder templates, who underwent neonatal bladder closure. However, timing of closure did not modify the rate of bladder growth in our exstrophy population.
- Published
- 2010
- Full Text
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38. POS-02.40: Local anesthesia (LA) with N-Do injector (PHYSION) for TUR of small bladder tumors (BT) and bladder mapping (BM): preliminary results and cost-effectiveness analysis
- Author
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G. Simonini, G. Verrini, G.L. Giliberto, G. DeLuca, Maurizio Brausi, M. Gavioli, G. Peracchia, and M. Viola
- Subjects
medicine.medical_specialty ,law ,business.industry ,Urology ,medicine ,Local anesthesia ,Small bladder ,Injector ,Cost-effectiveness analysis ,business ,Surgery ,law.invention - Published
- 2007
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39. THE USE OF LOCAL ANAESTHESIA WITH N-DO™ INJECTOR (THYSION™) FOR TUR OF SMALL BLADDER TUMOURS (BT) AND BLADDER MAPPING: PRELIMINARY RESULTS AND COSTEFFECTIVENESS ANALYSIS
- Author
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Manuela Viola, G. Verrini, Maurizio Brausi, G. De Luca, M. Gavioli, G. Peracchia, and G. Simonini
- Subjects
medicine.medical_specialty ,law ,business.industry ,Urology ,medicine ,Small bladder ,Injector ,Radiology ,business ,law.invention - Published
- 2006
- Full Text
- View/download PDF
40. The Urodynamic Characteristics of Multiple Sclerosis
- Author
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T. Philp, D. J. Read, and R. H. Higson
- Subjects
Adult ,Male ,medicine.medical_specialty ,Multiple Sclerosis ,Urology ,urologic and male genital diseases ,Bladder instability ,Filling cystometry ,medicine ,Humans ,Aged ,Urinary symptoms ,Electromyography ,business.industry ,Multiple sclerosis ,Urethral sphincter ,Small bladder ,Middle Aged ,Urination Disorders ,medicine.disease ,Bladder pressure ,female genital diseases and pregnancy complications ,Urodynamics ,Female ,Detrusor sphincter dyssynergia ,business - Abstract
Summary— Urodynamic assessment was performed in 52 patients with urinary symptoms positively diagnosed as suffering from multiple sclerosis. Fifty-one patients had unequivocal bladder instability on filling cystometry the exception had inappropriate relaxation of the urethral sphincter at a small bladder capacity and low bladder pressure. Results of sphincter electromyography and synchronous cineradiography of voiding in a number of our patients led to the conclusion that many of these patients also suffer detrusor sphincter dyssynergia. There was no correlation between any measurable urodynamic parameter and the severity of the physical disability.
- Published
- 1981
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41. Controlled Bipolar High-Frequency Coagulation for Transurethral Application: A New Method for the Destruction of Urinary Bladder Tumors
- Author
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Pensel J, K. Fastenmeier, E. Keiditsch, Alfons Hofstetter, and K. Rothenberger
- Subjects
Adult ,medicine.medical_specialty ,Skin Neoplasms ,Necrosis ,Swine ,Urology ,Biological effect ,Resection ,Dogs ,In vivo ,Electrocoagulation ,medicine ,Animals ,Humans ,Coagulation (water treatment) ,Electrodes ,Papilloma ,business.industry ,Small bladder ,Urinary Bladder Tumors ,Surgery ,Liver ,Urinary Bladder Neoplasms ,Homogeneous ,Female ,medicine.symptom ,business ,Biomedical engineering - Abstract
The coagulation of small bladder papillomas or of the resection base after transurethral resection by unipolar high-frequency current has turned out not to be sufficiently radical so far. There is no definite and reproducible correlation between the achieved biological effect. Bipolar high-frequency current produces the desired necrosis in the deeper layers of tissue. When providing the high-frequency generator with a new experimental automatic control equipment, reproducible deep and homogeneous necrosis of the tissue can be achieved without taking a great deal of time. Moreover, adherence of the probe and carbonization are prevented. First, the experiments had been carried out in vitro on livers of cattle and secondly, in vivo on canine livers. By the conventional unipolar high-frequency coagulation a reproducible and homogeneous necrosis cannot be achieved. With the regulated high-frequency coagulation, however, we are able to produce homogeneous tissue necroses up to a depth of 7 mm, the extension of which can definitely be assigned to the adjusted technical parameters. The electrodes do not adhere, since carbonization does not occur because of the automatic control. Premature interruption of the coagulation process, even if the generator is adjusted too high by mistake, can be considered a further advantage of this protective switch. A first clinical experience is reported.
- Published
- 1983
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42. Recurrent Urinary Infections in Girls: Effects of Urethral Dilatation1
- Author
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S. L. Stanton, D. Innes Williams, and W. F. Hendry
- Subjects
medicine.medical_specialty ,Urinary infection ,medicine.diagnostic_test ,business.industry ,Urology ,Reflux ,Small bladder ,Cystoscopy ,Irritability ,Surgery ,Pharmacotherapy ,Urethral pressure profile ,Medicine ,medicine.symptom ,business ,RECURRENT URINARY INFECTIONS - Abstract
Summary The effects of urethral dilatation have been investigated in girls with recurrent urinary infection. About 65 per cent of girls showed some improvement when this procedure was combined with long-term antibiotic therapy, provided that there was no serious vesico-ureteric reflux. However, the results were unpredictable, and in a controlled prospective trial the preliminary results of dilatation did not differ significantly from those obtained with cystoscopy alone. Nevertheless, improvement after dilatation did seem to be associated with a high urethral pressure profile, high bladder pressure, small bladder capacity and marked detrusor irritability; it is suggested that this “dysfunctional bladder syndrome” may be the cause of recurrent infections in these cases, and that improvement may be anticipated after urethral dilatation, which should be combined with anti-cholinergic drug therapy if day wetting is a co-existing problem.
- Published
- 1973
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43. ASSOCIATION OF CONGENITALLY SMALL PELVIC OUTLET WITH HYPOPLASIA OF BLADDER AND URETHRA, AND ABSENT KIDNEYS
- Author
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Guido Currarino
- Subjects
Male ,Urinary system ,Urinary Bladder ,Kidney ,Absent kidneys ,broadcast ,Pelvis ,Urethra ,broadcast.radio_station ,Humans ,Medicine ,Abnormalities, Multiple ,Radiology, Nuclear Medicine and imaging ,business.industry ,Infant, Newborn ,Pneumothorax ,General Medicine ,Small bladder ,Anatomy ,medicine.disease ,Hypoplasia ,medicine.anatomical_structure ,Urogenital Abnormalities ,Bony pelvis ,Pelvic outlet ,Radiography, Thoracic ,business - Abstract
Two newborn male infants are reported in whom a contracted pelvic outlet was found to be associated with a very small bladder and urethra and absent kidneys.It is suggested that this roentgen finding in the bony pelvis of a newborn may represent another possible clue as to the likelihood of a coexisting severe malformation (underdevelopment) of the urinary tract.
- Published
- 1970
- Full Text
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44. Bladder Capacity (Ounces) Equals Age (years) Plus 2 Predicts Normal Bladder Capacity and Aids in Diagnosis of Abnormal Voiding Patterns
- Author
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James J. Conway, George Moran, Robert M. Berger, Casimir F. Firlit, and Max Maizels
- Subjects
medicine.medical_specialty ,Adolescent ,Urology ,media_common.quotation_subject ,Urinary Bladder ,Urination ,Bladder capacity ,urologic and male genital diseases ,Enuresis ,medicine ,Humans ,Child ,media_common ,business.industry ,Age Factors ,Large bladder ,Infant ,Small bladder ,Urination Disorders ,female genital diseases and pregnancy complications ,Surgery ,Primary enuresis ,Urodynamics ,Linear relationship ,Child, Preschool ,Normal bladder ,medicine.symptom ,business - Abstract
Standardization of the bladder capacities of children will improve the precision of urodynamic evaluation. In an attempt to develop a practical guide to predict the normal bladder capacity during childhood the bladder capacities of 132 children without a clinically abnormal pattern of voiding were measured. When the bladder capacities are correlated by age the following linear relationship exists: normal bladder capacity (ounces) equals age (years) plus 2.The bladder capacities of 68 children with primary enuresis, frequency or infrequent voiding were then measured. Children with clinically infrequent voiding demonstrated large bladder capacities and those with frequency or enuresis demonstrated small bladder capacities compared to normal children.The formula appears to be a useful guide to predict normal bladder capacity by age and also to aid in the diagnosis of abnormal voiding patterns.
- Published
- 1983
- Full Text
- View/download PDF
45. The hidden vesicostomy
- Author
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J. H. Naude
- Subjects
Male ,medicine.medical_specialty ,Urology ,Labia ,Urinary Bladder ,Vesicovaginal fistula ,Intermittent catheterisation ,medicine ,Methods ,Humans ,In patient ,Urinary Bladder, Neurogenic ,Augmentation cystoplasty ,Child ,Pubic Bone ,Vesicovaginal Fistula ,business.industry ,Small bladder ,medicine.disease ,Pubic hair ,Surgery ,medicine.anatomical_structure ,Urinary Incontinence ,Female ,business ,Urinary Catheterization ,Penis - Abstract
Summary— A continent vesicostomy has been developed by the use of a tubed bladder flap brought to the skin superficial to the pubic bone and with the stoma sited in the labio-clitoral fold, usually on the right, in right-handed patients. This technique has found application, initially in cases of vesicovaginal fistula, where the continence mechanism has been completely destroyed, and later has been applied to cases of neurogenic bladder due to meningomyelocoele. This operation has been performed on 20 patients. With the exception of our first patient, a technical failure, all patients have been fully continent, the majority on intermittent self-catheterisation. The situation of the stoma facilitates self-catheterisation and the stoma is not visible unless the thighs are abducted and the labia deliberately separated. In patients with a small bladder capacity, augmentation cystoplasty has been done. In males the stoma cannot be so well hidden, although it is not very obvious at the root of the penis in the pubic hair. This operation offers full continence of urine on intermittent catheterisation and the hope of an acceptable body image.
- Published
- 1982
46. Bladder exstrophy: increase in capacity following epispadias repair
- Author
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John P. Gearhart and Robert D. Jeffs
- Subjects
Male ,medicine.medical_specialty ,Epispadias ,Time Factors ,Urology ,Urethroplasty ,medicine.medical_treatment ,Urinary Bladder ,Bladder capacity ,urologic and male genital diseases ,Urethra ,medicine ,Humans ,Hydronephrosis ,business.industry ,Bladder Exstrophy ,Small bladder ,medicine.disease ,female genital diseases and pregnancy complications ,Surgery ,Bladder exstrophy ,Neck of urinary bladder ,Urinary Incontinence ,Child, Preschool ,business ,Follow-Up Studies - Abstract
The achievement of satisfactory continence in the management of classical bladder exstrophy remains a surgical challenge. This may be particularly difficult in the patient with a small bladder capacity after initial closure. The 12-year experience at our institution with bladder exstrophy is reviewed and attention is focused on the approach to those patients with a small bladder capacity. A total of 155 children with bladder exstrophy were treated. Of these 155 patients 28 boys were believed to have a bladder capacity inadequate for satisfactory bladder neck reconstruction (less than 60 cc). All patients have undergone staged reconstruction with a urethroplasty for epispadias and they are available for evaluation. After a median interval of 22 months bladder capacity increased by a median 54.5 cc. No child had hydronephrosis after the epispadias repair or bladder neck reconstruction. Of the 28 patients 25 have undergone bladder neck reconstruction with a median followup of 4.5 years and 88 per cent (22 of 25) demonstrate continence with a dry interval greater than 3 hours. Another 2 patients have been rendered continent following bladder augmentation. These results demonstrate that satisfactory continence is an achievable goal in the exstrophy patient with a small bladder capacity when bladder neck reconstruction is preceded by epispadias repair.
- Published
- 1989
47. Enuresis--its background and management
- Author
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Pranesh Nigam, V. K. Tandon, V. R. Thacore, and Narottam Lal
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Imipramine ,Bladder capacity ,Placebos ,Sex Factors ,Recovery rate ,Enuresis ,medicine ,Humans ,Imipramine Hydrochloride ,Child ,business.industry ,Age Factors ,Small bladder ,Psychotherapy ,Socioeconomic Factors ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Combined therapy ,Female ,medicine.symptom ,Birth Order ,business ,medicine.drug - Abstract
Enuresis was more frequent in boys (64.3%) as compared to girls (35.7%) and the incidence decreases as the age advances. The highest incidence (47.6%) was in the 4–6 years age group. Enuresis was more commonly seen in children of middle (46.4%) and lower (33.3%) socio-economic groups. The children of parents with an educational status up to class V (57.1% were more commonly affected. Regular bedwetters (60.7%) were more in number as compared to occasional bed wetters (39.3%). There was a greater prevalence of bedwetting among later born children (72.8%) of large families. 11.6% of sibs had the history of bedwetting. Enuretic children were apt to have a small bladder (bladder capacity 190–250 ml./sq.m.) and to void frequently during the day. A slightly higher percentage of recovery rate was noticed in regular bed wetters when put on both psychotherapy and imipramine hydrochloride (80.9% or 17 out of 21) as compared to those receiving imipramine only (72.8% or 16 out of 22). The response to combined therapy in occasional bedwetters was better (100%) as compared to imipramine only (90%).
- Published
- 1973
48. Family size and age of menarche
- Author
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H.D. Singh
- Subjects
medicine.medical_specialty ,Adolescent ,Genetics, Medical ,India ,Growth ,Constriction ,Internal os ,medicine ,Humans ,Nutritional Physiological Phenomena ,Trachelotomy ,Cervical canal ,Menarche ,Family Characteristics ,business.industry ,Age Factors ,Obstetrics and Gynecology ,Small bladder ,Surgery ,body regions ,Suction curettage ,Laminaria Tents ,medicine.anatomical_structure ,Socioeconomic Factors ,Internal cervical os ,Female ,Birth Order ,business - Abstract
direction. Variations in the degree of cervical funneling might account for the variable degrees of migration. In 3 patients in whom the medium-sized Type r\ tent was used, the tents migrated sufficiently far into the uterine cavities so that the tents were not visible and coulcl be palpated at various depths in the cervical canal. Traction on the suture resulted in splitting of the tents and loss of the traction suture. Fig. 2 indicates the varying degrees of migration by noting the markedly different locations of the constriction rings produced by the internal cervical OS. Repeated attempts at instrumental removal resulted only in crumbling of the tents. A dissection of a small bladder flap with anterior cervical trachelotomy about half way to the internal OS was required for removal of the tents. The abortions were completed with suction curettage without subsequent difficulty. This complication was not seen with the Type B laminaria tents. It is our opinion that the medium-sized Type A laminaria tents probably should not be used for therapeutic abortions. The addition of a collar device to aid retention of the suture and thereby prevent laceration of the device might possibly improve the Type B tent.
- Published
- 1972
49. SUBACUTE TOXICITY OF TWO CHRYSANTHEMUMIC ACID ESTERS: BARTHRIN AND DIMETHRIN
- Author
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M.S. Masri, A.P. Hendrickson, Floyd DeEds, and A.J. Cox
- Subjects
Pathology ,medicine.medical_specialty ,Insecticides ,Cytoplasmic inclusion ,Urinary Bladder ,Subacute toxicity ,Physiology ,Autopsy ,Dermatitis ,Biology ,Body weight ,medicine.disease_cause ,Dermatitis, Contact ,Kidney ,Toxicology ,Pyrethrins ,medicine ,Pharmacology ,Low toxicity ,Research ,Body Weight ,Esters ,Small bladder ,Rats ,medicine.anatomical_structure ,Liver ,Organ Specificity ,Irritation - Abstract
The subacute toxicity of barthrin and dimethrin was investigated in albino rats. Each compound was studied at 4 dietary levels: 0.1, 0.3, 1, and 2% for barthrin; and 0.2, 0.6, 1.5, and 3% for dimethrin. Weekly food consumption and body weight were recorded. Toxicologic data obtained included: hematologic measurements, organ weights, and histopathologic examination. Skin irritation tests were obtained with rabbits. In general, both compounds appear to have low toxicity in the rat. The toxicologic findings were: 1. 1. Significant decrease in body weight at sacrifice (16 weeks on test substances) was observed in the following groups: males on 2% barthrin (16% reduction in body weight); all female groups on barthrin (average 9% reduction); males on 0.6 and 3% dimethrin (11 and 36% reduction); and female groups on 1.5 and 3% dimethrin (14 and 27% reduction). 2. 2. One control female, 1 male on 1% barthrin, and 1 female on 3% dimethrin died before the end of the experiment. 3. 3. The following scattered gross pathologic changes were noted at autopsy: small bladder stones in 2 males on 2% barthrin, 1 male on 1% barthrin, 1 male on 0.6% dimethrin, and 1 male on 0.2% dimethrin; spotted lungs in 1 female on 2% barthrin, 1 female on 0.3% barthrin, 3 females on 0.6% dimethrin, and 1 male on 0.6% dimethrin. 4. 4. The hematologic data did not show differences between the control groups and the experimental groups tested (1 and 2% barthrin and 1.5 and 3% dimethrin). 5. 5. Significantly higher organ to body weight ratios were obtained for the kidney and liver in the groups on 1 and 2% barthrin and 1.5 and 3% dimethrin. The liver enlargement encountered with both compounds was accompanied by the appearance of unusual cytoplasmic inclusions in hepatic cells, suggesting cytoplasmic storage or alteration in cytoplasmic fine structure. The effect of increased liver and kidney weight to body weight ratios as well as the histopathologic changes in the liver were shown to be reversible after withdrawal of barthrin or dimethrin. 6. 6. Test for local (skin) irritation in rabbits indicated mild scaliness with dimethrin which disappeared after cessation of application.
- Published
- 1964
50. Indications for endoscopic surgery
- Author
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R. Theodore Bergman, Roger W. Barnes, and Henry L. Hadley
- Subjects
medicine.medical_specialty ,Neck of urinary bladder ,business.industry ,Open surgery ,Prostatic Adenomas ,medicine ,Bladder tumor ,Endoscopic surgery ,Small bladder ,business ,Contraindication ,Resection ,Surgery - Abstract
The indications for endoscopic surgery vary within wide limits, depending chiefly upon the surgeon who is to perform the operation. If he has had adequate training and extensive experience in endoscopic surgery, the indications for him will include the removal of prostates weighing up to 150 to 200 grams, the resection of bladder tumors as large as 4 to 5 cm. in diameter, the crushing of stones up to 3 to 4 cm. in diameter and other procedures which are technically difficult. Surgeons who have not had this extensive training and experience, or who are unequipped in other ways to perform the more difficult endoscopic procedures, will limit the use of this approach to the small sized lesions. If a surgeon has had no training or experience in endoscopic surgery, there is no indication for its use by him; it is better for him not to attempt it. For the average urologist, endoscopic surgery is indicated for relief of bladder neck obstruction due to prostatic carcinoma which does not respond to hormone therapy and for removal of bladder neck contractures, median bars and the smaller prostatic adenomas. Small bladder tumors, small stones and sometimes Hunner ulcers and other intravesical lesions can usually be removed more successfully by the average urologist through the endoscopic approach than by open surgery. The ultimate factor determining the approach best suited to a given case is the operator himself. If he has established proficiency at removing large prostates and other lesions endoscopically, there is no contraindication to continuance of this method in his hands.
- Published
- 1959
- Full Text
- View/download PDF
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