An ultrasonic scanner in the field of urology is described that can be used for transurethral as well as for transrectal scanning of the bladder and prostate. The bladder was visualized best by transurethral scanning, while the rectal approach was preferable for examination of the prostate. Transurethral ultrasonography was performed in 7 patients with bladder cancer. Transrectal ultrasonography was performed in 21 controls and 41 patients with prostatic disease. The following results were obtained: 1. Diagnostic accuracy of the staging of transurethral ultrasonography was 85.7% in bladder cancer. 2. The average values of maximum anterioposterior, superio-inferior and transverse diameter. obtained from ultrasonogram were 2.43+/-0.29cm, 3.27+/-0.41cm, 4.07+/-0.91cm in control group ;3.11+/-0.6lcm, 4.16+/-0.66 cm, 4.71+/-0.76cm in B.P.H.; 3.65+/-0.46cm, 4.88+/-0.23cm, 5.98+/-0.18cm in prostatic cancer. 3. Diagnostic accuracy of transrectal ultrasonography was 93% in B.P.H. and 80% in prostatic cancer. 4. Transurethral ultrasonography enabled us to determine the degree of tumor invasion of the bladder wall and was useful to help select appropriate therapy. Transrectal ultrasonography has proved especially in estimating prostatic size and in detecting pathology.
Humans ; Pathology ; Prostate ; Prostatic Diseases ; Prostatic Neoplasms ; Ultrasonics ; Ultrasonography* ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urology

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

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

Neurogenic bladder in systemic lupus erythematosus (SLE) has been considered to occur rarely. Myelopathy, cyclophosphamide treatment, vasculitis have been implicated as the causes of the bladder pathology in patients with SLE. In this report, we describe a 46-year- old female with SLE who simultaneously combined with the neurogenic bladder. The diagnosis of neurogenic bladder, attributed to peripheral neuropathy, was made on the basis of cystometrography and clinical symptom. Steroid therapy couldn't improve the clinical manifestation of neurogenic bladder despite the amelioration of the other lupus symptom.
Cyclophosphamide ; Diagnosis ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Pathology ; Peripheral Nervous System Diseases ; Spinal Cord Diseases ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Vasculitis

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

Urge incontinence with uninhibited detrusor contraction has been known to be a typical findings observed in the supraspinal neurologic disorders such as cerebrovascular accident(CVA). However, voiding difficulty with significant amounts of residual urine are frequently noted in the patients with organic brain diseases. Also, little is known about the exact causes of voiding difficulty in aged people without obstruction. Herein, Resnik at all have identified a specific physiological abnormality-detrusor hyperreflexia with impaired contractility (DHIC)- a distinct physiological subset of detrusor hyperreflexia. DHIC presents with a seemingly paradoxical set of findings: the bladder is overactive but empties ineffectively. We evaluated the symptoms and urodynamic findings for the 50 patients with supraspinal neuropathies and, also for the 28 elderly peoples complaining voiding dysfunction without evidence of bladder outlet obstruction or, pathologies in the brain. Of the 50 patients with parenchymal brain disease, 41 had CVA, 6 had Parkinson's disease and, 3 had senile dementia. Age of patients ranged from 52 to 89 years and 63 patients of them was man. As a results of urodynamic study; DHIC was noted in 36, DH (detrusor hyperreflexia) in 24, DH with obstructive pattern in 8, ID (impaired detrusor contractility) in 5, normal findings in 5 patients. Of the 36 patients with DHIC, CVA were noted in 19, senile dementia in 1, and, normal aged peoples in 16 cases. In 24 patients with DH, CVA were noted in 9, senile dementia in 1, Parkinson's disease in 6 and, normal aged peoples in 8 cases. Of the 8 patients showed DH with obstruction, CVA was present in 7 and, senile dementia in 1 cases. Of the 5 patients with IDC, CVA was present in 2 and, normal aged peoples in 3 cases. Patients showed DHIC, DH with obstruction and IDC complained obstructive symptoms more frequently than irritative symptoms. On the contrary, DH patients complained irritative symptoms more frequently than obstructive symptoms. Mean fraction of volume voided was 48% in DHIC and 23% in DH with obstruction, which were significantly less than 77% in DH. With this study, hyperreflexic contraction of detrusor was observed in 68(87%), and decreased contractility in 41 patients(53%). The fact that the patients showed DHIC was substantially older than those with DH may imply the decreased contractile function of the detrusor muscle by the aging process. It is also interesting that more than 90% (27/28) of the aged peoples without any pathologies exhibited abnormal findings in urodynamic study explain that the aging process itself may induce the changes of the bladder contractility. Urge incontinence due to DH has been known to be the most common findings in supraspinal lesion. However, these results showed that the impairment of detrusor contractility was also commonly found in the patients with supraspinal lesions and, in aged peoples. Treatment for the DHIC seem to be a dilemma for both the patients and physicians, and it may need emptying of residual urine in addition to the administration of anticholinergics or smooth muscle relaxants.
Aged ; Aging ; Alzheimer Disease ; Brain ; Brain Diseases ; Cholinergic Antagonists ; Humans ; Muscle, Smooth ; Nervous System Diseases ; Parkinson Disease ; Pathology ; Reflex, Abnormal* ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Incontinence, Urge ; Urodynamics

Primary vesical actinomycosis is an extremely rare disease. In most cases it is misdiagnosed as vesical or urachal tumor and usually diagnosed through post-operative pathologic confirmation. Here we report a case of primary vesical actinomycosis confirmed by preoperative repeated multiple transabdominal biopsies. The patient was a 49-yr-old woman who presented with frequency, dysuria, and intermittent gross hematuria for 2 months. Computed tomography and cystoscopic examination showed broad-based, edematous, and protruding mass at the dome and anterior portion of the bladder. The clinical and imaging findings of the patient initially suggested vesical malignancy. Transurethral resection and multiple biopsies of the mass were performed. Pathologic examination demonstrated fibrosis with chronic inflammation. We performed repeated transabdominal multiple needle biopsies for further pathologic confirmation. Histopathologic examination demonstrated typical sulfur granules, which were consistent with actinomycosis.
Abdomen ; Actinomycosis/drug therapy/*pathology/surgery/ultrasonography ; Biopsy, Needle/methods ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Penicillins/therapeutic use ; Treatment Outcome ; Urinary Bladder/*pathology/surgery/ultrasonography ; Urinary Bladder Diseases/drug therapy/*pathology/surgery/ultrasonography

PURPOSE: The main goal of this retrospective study is to explore the predictors of success in learning clean intermittent self-catheterization (CISC) in patients over 65 years of age. The secondary goal is to assess whether in this population, the risk of failure to perform CISC is greater, compared with patients under 65 with similar pathologies. METHODS: All patients older than 65 consulting between January 2011 and January 2016 for learning CISC were included. A control population younger than 65 matching with sex, body mass index, and pathology was selected. RESULTS: One hundred sixty-nine of the 202 patients (83.7%) over 65 succeeded in learning CISC. Obesity (P < 0.05), low pencil and paper test (PP test) (P < 0.01) and low functional independence measure (FIM) (P < 0.01) scores were risk factors of failure. No significant differences were found with sex or pathology. In multivariate analysis, low PP test perineum access (odds ratio [95% confidence interval], 2.30 [1.32–4.42]), low FIM motor (1.04 [1.01–1.08]), and FIM cognition (1.18 [1.03–1.37]) scores were independent factors of learning failure. Compared to control group, age over 65 was not predictive of failure (P=0.15). CONCLUSIONS: Our study shows that success in learning CISC does not depend on age but on difficulties in mobility, access to perineum and probably cognitive disorders.
Adult* ; Body Mass Index ; Cognition ; Humans ; Intermittent Urethral Catheterization ; Learning* ; Multivariate Analysis ; Obesity ; Pathology ; Perineum ; Retrospective Studies ; Risk Factors ; Urinary Bladder Diseases ; Urinary Retention

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

Adenoma ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; Cystadenocarcinoma ; pathology ; Cystitis ; metabolism ; pathology ; Endometriosis ; immunology ; pathology ; Fallopian Tube Neoplasms ; pathology ; Female ; Humans ; Intestines ; pathology ; Keratin-7 ; metabolism ; Male ; Metaplasia ; pathology ; Racemases and Epimerases ; metabolism ; Urinary Bladder Neoplasms ; metabolism ; pathology ; Uterine Diseases ; immunology ; pathology