The changes in excitability and autorhthmicity of bladder detrusor in experimental non-insulin dependent diabetes mellitus (NIDDM) rats were observed. Sixty-nine NIDDM rats as NIDDM group and 69 normal rats as control group were enrolled into this experimental study. At 6th, 10th, 14th, 18th, 22nd and 26th week after the rats were injected last time, the changes in the excitability and autorhthmicity of detrusor strips in vitro were observed. The results showed that the threshold of the tension which made the detrusor strips contract was significantly higher in NIDDM group (0.716 +/- 0.325 g) than in control group (0.323 +/- 0.177 g) (F = 59.63, P < 0.001). At different stages, the threshold of the tension resulting the contract of the detrusor strips in NIDDM group was also higher than in control group. At 18th week after STZ injection, the frequency of spontaneous contract of the detrusor strips in NIDDM was significantly higher than in control group (P < 0.05), whereas at 22nd week, that in NIDDM group was significantly lower than in control group (P < 0.05). It was concluded that the decreased excitability of the bladder detrusor was the earliest and most obvious changes in bladder function in diabetes rats and the autorhthmicity had also changed at the early stage of diabetic bladder.
Diabetes Mellitus, Experimental/*physiopathology ; Diabetes Mellitus, Type 2/physiopathology ; Muscle Contraction/physiology ; Muscle Relaxation/physiology ; Rats, Wistar ; Urinary Bladder/*physiopathology ; Urinary Bladder Diseases/etiology ; Urinary Bladder Diseases/*physiopathology

In order to study the pathogenesis, clinical and pathological characteristics of proliferative lesions of the bladder, 50 cases of proliferative lesions of the bladder from 150 patients with complaints of frequency, urgency, hematuria and dysuria were subjected to cystoscopic biopsy of the suspicious foci in the bladder. In combination with the symptoms, urine and urodynamics, the relationship of proliferative lesions of the bladder to the inflammation and obstruction of the lower urinary tract was analyzed. Of the 50 cases of proliferative bladder lesions, 44 cases (88%) had lower urinary tract infection and 29 (58%) lower urinary tract obstruction. The patients with lower urinary tract obstruction were all complicated with infection. Three cases were associated with transitional cell carcinoma. Malignant cells were detected in 1 case by urinary cytologic examination. Proliferative lesions of the bladder, especially those without other obvious mucosa changes under cystoscopy, are common histological variants of urothelium in the patients with chronic inflammation and obstruction of the lower urinary tract. Chronic inflammation and obstruction of the lower urinary tract might be the causes for proliferative lesions of the bladder. It is suggested that different treatments should be applied according to the scope and histological type of the proliferative lesions.
Cystitis/*complications ; Hyperplasia ; Mucous Membrane/pathology ; Precancerous Conditions/*pathology ; Urinary Bladder/*pathology ; Urinary Bladder Diseases/*etiology ; Urinary Bladder Diseases/pathology ; Urinary Bladder Neck Obstruction/*complications ; Urination Disorders/complications ; Urodynamics/physiology

Dystrophic calcification can be defined as a calcification that occurs in degenerated or necrotic tissue. It is associated with multiple clinical conditions, such as collagen vascular diseases. It involves the deposition of calcium in soft tissues despite no generalized disturbance in the calcium or phosphorus metabolism, and this is often seen at sites of previous inflammation or damage. Potassium-titanyl phosphate (KTP) laser vaporization of the prostate is safe and relatively bloodless procedure that results in a shorter catheterization, immediate symptomatic improvement, and less severe postoperative irritative symptoms. However, longer follow-up studies or reports about complications are lacking. Here in we report a case of dystrophic calcification and stone formation on the entire bladder neck after performing KTP laser vaporization of benign prostate hyperplasia. That was treated by lithotripsy and transurethral resection.
Aged ; Calcinosis/*diagnosis/pathology ; Humans ; Lasers, Solid-State/*adverse effects ; Lithotripsy ; Male ; Prostatic Hyperplasia/*surgery ; Urinary Bladder Calculi/*diagnosis/etiology/ultrasonography ; Urinary Bladder Diseases/*diagnosis/etiology/ultrasonography

In order to study the pathogenesis, clinical and pathological characteristics of proliferative lesions of the bladder, 50 cases of proliferative lesions of the bladder from 150 patients with complaints of frequency, urgency, hematuria and dysuria were subjected to cystoscopic biopsy of the suspicious foci in the bladder. In combination with the symptoms, urine and urodynamics, the relationship of proliferative lesions of the bladder to the inflammation and obstruction of the lower urinary tract was analyzed. Of the 50 cases of proliferative bladder lesions, 44 cases (88%) had lower urinary tract infection and 29 (58%) lower urinary tract obstruction. The patients with lower urinary tract obstruction were all complicated with infection. Three cases were associated with transitional cell carcinoma. Malignant cells were detected in 1 case by urinary cytologic examination. Proliferative lesions of the bladder, especially those without other obvious mucosa changes under cystoscopy, are common histological variants of urothelium in the patients with chronic inflammation and obstruction of the lower urinary tract. Chronic inflammation and obstruction of the lower urinary tract might be the causes for proliferative lesions of the bladder. It is suggested that different treatments should be applied according to the scope and histological type of the proliferative lesions.
Adult ; Aged ; Cystitis ; complications ; Female ; Humans ; Hyperplasia ; Male ; Middle Aged ; Mucous Membrane ; pathology ; Precancerous Conditions ; pathology ; Urinary Bladder ; pathology ; Urinary Bladder Diseases ; etiology ; pathology ; Urinary Bladder Neck Obstruction ; complications ; Urination Disorders ; complications ; Urodynamics ; physiology

Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas.
Bladder Fistula/diagnosis/etiology ; Female ; Fistula/*diagnosis/*etiology ; Human ; Intestinal Fistula/diagnosis/etiology ; *Pelvis ; Ureteral Diseases/diagnosis/etiology ; Urinary Fistula/diagnosis/etiology ; Uterine Diseases/diagnosis/etiology ; Vaginal Fistula/diagnosis/etiology

Vesicoenteric fistula is a rare complication of bladder squamous cell carcinoma. We report the case of a 70-year-old male who complained of painless, total gross hematuria. Abdominopelvic computed tomography (CT) revealed an approximately 2.7-cm lobulated and contoured enhancing mass in the bladder dome. We performed partial cystectomy of the bladder dome after transurethral resection of the bladder. The biopsy result was bladder squamous cell carcinoma, with infiltrating serosa histopathologically, but the resection margin was free. Postoperatively, follow-up CT was done after 3 months. Follow-up CT revealed an approximately 4.7-cmx4.0-cm lobulated, contoured, and heterogeneous mass in the bladder dome. A vesicoenteric fistula was visible by cystography. Here we report this case of a vesicoenteric fistula due to bladder squamous cell carcinoma.
Aged ; Carcinoma, Squamous Cell/*complications/pathology/radiography ; Fatal Outcome ; Humans ; Intestinal Fistula/*etiology/radiography ; Male ; Sigmoid Diseases/*etiology/radiography ; Tomography, X-Ray Computed ; Urinary Bladder Fistula/*etiology/radiography ; Urinary Bladder Neoplasms/*complications/pathology/radiography

Adenocarcinoma ; complications ; Aged ; Colonic Diseases ; etiology ; surgery ; Humans ; Intestinal Fistula ; etiology ; surgery ; Male ; Sigmoid Neoplasms ; complications ; Urinary Bladder Fistula ; etiology ; surgery

OBJECTIVETo investigate the etiology and treatment of bladder spasm associated with benign prostatic hyperplasia (BPH).

METHODSUrodynamic tests were performed in 102 cases of BPH before operation. The correlation of bladder spasm with aging, international prostate symptom score (IPSS), quality of life, prostatic volume, operation methods and urodynamic indexes was studied by t and chi2 tests.

RESULTSThe incidences of bladder spasm in the lower compliant bladder and unstable bladder were 32.1% (9/28) and 42.5% (13/20), and those after suprapubic prostatectomy and transurethral resection of the prostate (TURP) were 50.9% (26/51) and 23.3% (12/51). There was significant difference between operation methods (P < 0.05).

CONCLUSIONBladder spasm easily develops in the lower compliant bladder and unstable bladder, especially after suprapubic prostatectomy. TURP might decrease the incidence of bladder spasm after BPH operation.

Aged ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prostatic Hyperplasia ; surgery ; Spasm ; etiology ; prevention & control ; Transurethral Resection of Prostate ; Urinary Bladder Diseases ; etiology ; prevention & control ; Urodynamics

OBJECTIVETo reveal the roles of Rho kinase (ROCK) in the mechanisms of complications in diabetes by reviewing the correlations between ROCK and related complications in diabetes.

DATA SOURCESThe data used in the present article were mainly from PubMed with relevant English articles published from 1998 to 2010. The search terms were "ROCK" and "diabetes".

STUDY SELECTIONOriginal articles including the roles of ROCK or its inhibitors in diabetic complications and review articles about the biological character of ROCK were selected.

RESULTSThe activity and expression of ROCK were up-regulated in the models of type 1 or type 2 diabetes animals and the cultured cells with concentrations of high glucose, ROCK activation was associated with the development or progression of complications in diabetes. Inhibition of RhoA/ROCK pathway prevented or ameliorated the pathologic changes of diabetic complications, and ROCK has been regarded as a key target for treatment of these complications.

CONCLUSIONRhoA/ROCK signaling plays important roles in the pathogenesis of long-term complications in diabetes and ROCK inhibitors are becoming a promising solution to treatments of complications in diabetes.

Animals ; Cardiomyopathies ; etiology ; Diabetes Complications ; etiology ; therapy ; Humans ; Sexual Dysfunction, Physiological ; etiology ; Signal Transduction ; Urinary Bladder Diseases ; etiology ; rho-Associated Kinases ; antagonists & inhibitors ; chemistry ; physiology ; rhoA GTP-Binding Protein ; antagonists & inhibitors ; chemistry ; physiology

The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort (CRBD) after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale: (1) no pain, (2) mild pain (revealed only by interviewing the patient), (3) moderate (a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation) and (4) severe discomfort (agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra). Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD (mild CRBD: 40.5%; moderate or severe CRBD: 44.0%) at day 1, while 31.9% developed CRBD (mild CRBD: 29.3%; moderate or severe CRBD: 2.6%) at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI (1.1-5.6), P<0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI (0.1-0.6), P<0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI (1.2-8.9), P<0.05] and history of catheterization [OR=0.5, 95%CI (0.2-0.9), P<0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP(B)=3.074, 95%CI (1.3-7.4), P<0.05] and the history of catheterization [EXP(B)=2.458, 95%CI (1.1-5.9), P<0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surgery and the history of catheterization might be predictive factors of moderate and severe CRBD after urological surgery.
Adult ; Aged ; Catheters ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Pain ; etiology ; pathology ; physiopathology ; Postoperative Complications ; pathology ; physiopathology ; Prospective Studies ; Urinary Bladder Diseases ; etiology ; pathology ; physiopathology ; Urologic Surgical Procedures ; adverse effects