MedWorm: Cystoscopy

Cystodistension: No Standards And No Benefits-Survey Of UK Practice - When Data Is Limited, The Place Of Hydrodistention And Hunner's Lesion Ablation

Health News from Medical News Today — Sat, 20 Mar 2010 08:00:00 +0100

UroToday.com - Cystoscopy with hydrodistention is not practiced in any standardized fashion despite proposals by the National Institute of Diabetes Digestive and Kidney Disorders (NIDDK) 2 decades ago and more recently the European Society for the Study of Interstitial Cystitis (ESSIC) to establish such standards. Mahendru and Al-Taher from Colchester and Kings Lynn UK posted questionnaires to 486 Consultant gynecologists, and urologists in the UK to assess current practices... (Source: Health News from Medical News Today)

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Cystodistension: No Standards And No Benefits-Survey Of UK Practice - When Data Is Limited, The Place Of Hydrodistention And Hunner's Lesion Ablation

Urology / Nephrology News From Medical News Today — Sat, 20 Mar 2010 08:00:00 +0100

UroToday.com - Cystoscopy with hydrodistention is not practiced in any standardized fashion despite proposals by the National Institute of Diabetes Digestive and Kidney Disorders (NIDDK) 2 decades ago and more recently the European Society for the Study of Interstitial Cystitis (ESSIC) to establish such standards... (Source: Urology / Nephrology News From Medical News Today)

Bladder lithiasis on tension-free polypropylene tape after TVT technique.

Urological Research — Fri, 12 Mar 2010 00:00:00 +0100

We describe a case of a 74-year-old woman with a history of hysterectomy and subsequent placement of tension-free tape, according to TVT procedure, who presented with bladder lithiasis secondary to bladder perforation after placement of the aforementioned tape. The treatment included endoscopic lithotripsy for lithiasis removal and resection of distal and proximal ends of intra-bladder tape with the aid of endoscopic scissors, and photocoagulation of the resulting carved lesions with Holmium:Yag laser. The composition of lithiasis was magnesium ammonium phosphate with some calcium phosphate 1 month later, the patient feels asymptomatic; cystoscopy reveals complete restitution of bladder mucosa and absence of intra-bladder protrusion of the aforementioned material. PMID: 20221826 [PubMe...

Bladder lithiasis on tension-free polypropylene tape after TVT technique

Urological Research — Thu, 11 Mar 2010 07:57:15 +0100

Cystoscopy alone most cost-effective method to detect bladder cancer recurrence

HemOncToday.com — Fri, 05 Mar 2010 09:59:00 +0100

(Source: HemOncToday.com)

Costly Tests May Not Help Detect Bladder Cancer Recurrence

Health News from Medical News Today — Fri, 05 Mar 2010 08:00:00 +0100

In a new study from The University of Texas M. D. Anderson Cancer Center, researchers found that cystoscopy, the standard for screening for recurrence of early-stage bladder cancer, is a cost-effective method of detecting tumors. Adding other tests to cystoscopy increases the cost, as well as the number of false positives that may result in emotional distress and unnecessary procedures, the investigators include. The study was presented today in advance of the American Society of Clinical Oncology (ASCO) Genitourinary Cancer Symposium. Jose Karam, M.D., a fellow in M. D... (Source: Health News from Medical News Today)

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Costly Tests May Not Help Detect Bladder Cancer Recurrence

Cancer / Oncology News From Medical News Today — Fri, 05 Mar 2010 08:00:00 +0100

Cystoscopy suffices for bladder cancer

Health News - UPI.com — Fri, 05 Mar 2010 04:54:11 +0100

HOUSTON, March 4 (UPI) -- U.S. researchers suggest cystoscopy alone suffices as a test for recurrent bladder cancer. (Source: Health News - UPI.com)

ASCO: Cystoscopy Alone More Cost-Effective in Surveillance

Modern Medicine — Thu, 04 Mar 2010 00:00:00 +0100

Follow up screening for non-muscle-invasive bladder cancer recurrence with only cystoscopy is more cost-effective than combined cystoscopy with urinary biomarker detection, and is associated with a lower incidence of false-positive results, according to research presented at the 2010 Genitourinary Cancers Symposium, held from March 5 to 7 in San Francisco. (Source: Modern Medicine)

Costly tests may not help detect bladder cancer recurrence, M. D. Anderson study finds

EurekAlert! - Medicine and Health — Wed, 03 Mar 2010 05:00:00 +0100

(University of Texas M. D. Anderson Cancer Center) In a new study from the University of Texas M. D. Anderson Cancer Center, researchers found that cystoscopy, the standard for screening for recurrence of early-stage bladder cancer, is a cost-effective method of detecting tumors. (Source: EurekAlert! - Medicine and Health)

Costly Tests May Not Help Detect Bladder Cancer Recurrence, M. D. Anderson Study Finds

M. D. Anderson Cancer Center - News Releases — Wed, 03 Mar 2010 00:00:00 +0100

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A Coupled Level Set Framework for Bladder Wall Segmentation With Application to MR Cystography

IEE Transactions on Medical Imaging — Mon, 01 Mar 2010 00:00:00 +0100

In this paper, we propose a coupled level set (LS) framework for segmentation of bladder wall using ${rm T}_{1}$-weighted magnetic resonance (MR) images with clinical applications to virtual cystoscopy (i.e., MR cystography). The framework uses two collaborative LS functions and a regional adaptive clustering algorithm to delineate the bladder wall for the wall thickness measurement on a voxel-by-voxel basis. It is significantly different from most of the pre-existing bladder segmentation work in four aspects. First of all, while most previous work only segments the inner border of the wall or at most manually segments the outer border, our framework extracts both the inner and outer borders automatically except that the initial seed point is given by manual selection. Secondly, it is adap...

Editorial Comment

Urology — Mon, 01 Mar 2010 00:00:00 +0100

This study by Shen and Shao from Shanghai suggests that 4 weekly intravesical instillations followed by 2 monthly intravesical instillations of 40 mg hyaluronic acid in 40 mL of normal saline can, when combined with initial hydrodistention of the bladder, result in significant improvement in pain, frequency, and functional bladder capacity extending over 6 months. The study is small and open-label, and does not include the 2 hyaluronic acid dropouts and 1 heparin/lidocaine dropout as failures, as would be consistent with an intent-to-treat study. Nevertheless, the findings are compelling and deserve follow-up in a larger, double-blind placebo-controlled trial that would ideally include a group without hydrodistention, but only cystoscopy. (Source: Urology)

Unilateral Hydroureteronephrosis After a Mesh Procedure

The Journal of Minimally Invasive Gynecology — Mon, 01 Mar 2010 00:00:00 +0100

We describe the case of a woman with unilateral hydroureteronephrosis after a mesh procedure (Gynecare Prolift; Ethicon Women's Health & Urology, Ethicon, Inc., Somerville, New Jersey) successfully treated by neoureterocystostomy. A 39-year-old woman with pelvic organ prolapse underwent the mesh procedure. Two months later, she had left flank pain, and hydroureteronephrosis was diagnosed on the same side despite cystoscopic confirmation of ureteral passage at the first operation. The arm of the mesh was removed surgically, and neoureterocystostomy was performed successfully. Mesh surgery is not without serious complications, and surgeons should bear in mind the possible complications associated with this surgical procedure. (Source: The Journal of Minimally Invasive Gynecology)

Massive Hematuria from the Bilateral Upper Urinary Tract in a Patient Treated for Advanced Lung Cancer with Gefitinib

Japanese Journal of Clinical Oncology — Fri, 26 Feb 2010 16:57:32 +0100

We report a case of gefitinib-induced bilateral upper urinary tract bleeding in an 82-year-old woman administered the drug daily for advanced non-small cell adenocarcinoma of the lung (T4N3M0). Hematuria is an uncommon adverse effect of gefitinib, and in most cases, the bleeding site is unknown. On the 44th day of oral gefitinib administration, the patient noted asymptomatic macroscopic bloody urine. Cystoscopy revealed bleeding from the bilateral ureteric orifices without hemorrhagic inflammation of the bladder. One week later, she was admitted complaining of severe abdominal pain, and her condition was found to be complicated by liver damage and renal dysfunction. We stopped gefitinib administration and started hydration and diuresis. Renal function and urine output soon recovered, and a...

Bladder metastases of appendiceal mucinous adenocarcinoma: a case presentation

BMC Cancer — Tue, 23 Feb 2010 00:00:00 +0100

Conclusions: The rarity of the appendiceal carcinoma invading the urinary bladder and its usual involvement of nearest organs and the posterior bladder wall, led us to describe this case which demonstrates the ability of the appendiceal cancer to metastasize different regions of urinary bladder. (Source: BMC Cancer)

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Can Advance Transobturator Sling Suspension Cure Male Urinary Postoperative Stress Incontinence?

The Journal of Urology — Mon, 22 Feb 2010 00:00:00 +0100

Conclusions: The transobturator sling suspension operation is a minimally invasive, safe procedure for male postoperative stress incontinence. Significantly improved continence was not observed on pad test but significant improvement in continence and bother was seen on the visual analog scale at 3 months. (Source: The Journal of Urology)

Fatal cytomegalovirus infection with CD4+ T-lymphocytopenia during corticosteroid therapy for bronchial asthma

Journal of Infection and Chemotherapy — Mon, 15 Feb 2010 18:00:35 +0100

Abstract An 80-year-old woman was admitted with dyspnea. She had been treated with oral prednisolone for bronchial asthma. She was intravenously treated with dexamethasone. On the 9th day, she presented oliguria and thrombocytopenia. She was diagnosed as dehydration and disseminated intravascular coagulation, and was treated with hydration and heparin infusion. On the 12th day, she presented macroscopic hematuria and melena. Cystoscopy revealed hemorrhagic cystitis. Bone marrow aspiration showed hemophagocytosis. Serum antigen of cytomegalovirus (CMV) was positive. CD4+ T cell count was very low (40/μL). She was diagnosed as disseminated CMV infection, and was treated with gancyclovir and immunoglobulin infusion. On the 14th day, she died of pneumonia. This is the first r...

Cystoscopy and Ureteroscopy

MedicineNet Cancer General — Fri, 12 Feb 2010 07:00:00 +0100

Title: Cystoscopy and UreteroscopyCategory: Procedures and TestsCreated: 9/17/2007Last Editorial Review: 2/12/2010 (Source: MedicineNet Cancer General)

Cystoscopy and Ureteroscopy

MedicineNet Womens Health General — Fri, 12 Feb 2010 07:00:00 +0100

Title: Cystoscopy and UreteroscopyCategory: Procedures and TestsCreated: 9/17/2007Last Editorial Review: 2/12/2010 (Source: MedicineNet Womens Health General)

Cystoscopy and Ureteroscopy

MedicineNet Mens Health General — Fri, 12 Feb 2010 07:00:00 +0100

Title: Cystoscopy and UreteroscopyCategory: Procedures and TestsCreated: 9/17/2007Last Editorial Review: 2/12/2010 (Source: MedicineNet Mens Health General)

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Transvesicoscopic Repair of Vesicovaginal Fistula

Diagnostic and Therapeutic Endoscopy — Wed, 10 Feb 2010 15:45:43 +0100

Conclusions. Transvesicoscopic repair of VVF is feasible, safe, and results in lower morbidity and quicker recovery time. (Source: Diagnostic and Therapeutic Endoscopy)

The effect of changes in Medicare reimbursement on the practice of office and hospital-based endoscopic surgery for bladder cancer

Cancer — Mon, 08 Feb 2010 00:00:00 +0100

Procedures performed in the office offer potential cost savings. Recent analyses suggest, however, that a fee-for-service system may incentivize subscale operations and, thus, contribute to excessive spending. The authors of this report sought to characterize changes in the practice of office-based and hospital-based endoscopic bladder surgery after 2005 increases in Medicare reimbursement.All office and hospital-based endoscopic surgeries that were performed in a faculty practice from 2002 through 2007 were identified using billing codes for procedures, diagnoses, and procedure locations and then analyzed using the chi-square test and logistic regression. Costs were estimated based on published Medicare reimbursements for office and hospital-based surgeries.In total, 1341 endoscopic bladd...

Editorial Comment

Urology — Mon, 01 Feb 2010 00:00:00 +0100

Proper selection and accurate evaluation of response to induction chemoradiation therapy is a prerequisite to successful bladder-sparing strategies. In this pilot study, the authors propose that diffusion-weighted magnetic resonance imaging (DWI) assessed the therapeutic response to initial therapy better than conventional magnetic resonance imaging. To their credit, they correlated their imaging assessments with the pathologic findings after patients had undergone either radical or partial cystectomy. They studied 20 patients and 7 (35%) had residual cancer. A 30% understaging rate after initial chemotherapy for muscle-invasive bladder cancer is what we expect from bladder-preservation series. The challenge lies in identifying those patients clinically. Of the 20 patients, 4 had macroscop...

Intraoperative endoscopy during choledochal cyst excision: extended long-term follow-up compared with recent cases

Journal of Pediatric Surgery — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: We attribute our lower incidence of stones directly to IOE and recommend that it be performed routinely during cyst excision. It is simple, is effective, and improves outcome. (Source: Journal of Pediatric Surgery)

Intraoperative measurement of rectourethral fistula: prevention of incomplete excision in male patients with high-/intermediate-type imperforate anus

Journal of Pediatric Surgery — Mon, 01 Feb 2010 00:00:00 +0100

Conclusion: Knowing the exact length of the RUF facilitates safe and complete excision in an otherwise blind situation. (Source: Journal of Pediatric Surgery)

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Double-J stenting: initial management of injured ureters recognized late after gynecological surgery

International Urogynecology Journal — Sat, 30 Jan 2010 18:11:28 +0100

Conclusions Ureteral double-J stenting, as first-line treatment, could avoid invasive urological surgery in damaged ureter detected after gynecological surgery. More cases are needed for accurate conclusions. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00192-009-1092-6Authors Jae Sik Kim, The Catholic University of Korea Department of Urology, Incheon St. Mary’s Hospital, College of Medicine #665, Bupyeong 6-dong, Bupyeong-gu Incheon KoreaDong Hwan Lee, The Catholic University of Korea Department of Urology, Incheon St. Mary’s Hospital, College of Medicine #665, Bupyeong 6-dong, Bupyeong-gu Incheon KoreaHong Jin Suh, The Catholic University of Korea Department of Urology, Incheon St. Mary’s Hospital, College of Medicine #665, Bupyeong 6-dong...

Cystoscopic and video-urodynamic features of a ketamine abuser

Surgical Practice — Tue, 26 Jan 2010 00:00:00 +0100

(Source: Surgical Practice)

Massive Rectus Sheath Hematoma with Spontaneous Bladder Perforation - A Cases Series

Journal of Surgical Research — Mon, 25 Jan 2010 16:42:37 +0100

Conclusions: Spontaneous bladder perforation is a potential complication of massive rectus sheath hematoma. All patients in our series were elderly females on therapeutic anticoagulation. The etiology for the RSH was unclear in all cases and but might be due to needle injury during subcutaneous injection. Management is mostly the same as that for RSH in addition to CBI. Antibiotics are not routinely indicated. In hospital care in these patients is complex and requires a group of closely working specialists including surgeons, physicians and intensivists. (Source: Journal of Surgical Research)

Urovysion™ testing can lead to early identification of intravesical therapy failure in patients with high risk non-muscle invasive bladder cancer

International Braz J Urol — Sat, 23 Jan 2010 15:25:40 +0100

Conclusions: The use of UroVysion™ following intravesical therapy for high-risk superficial bladder tumors helps to identify patients at high risk of refractory or recurrent disease who should undergo immediate biopsy under anesthesia. (Source: International Braz J Urol)

Editorial Comment

The Journal of Urology — Fri, 22 Jan 2010 00:00:00 +0100

The authors report that infants born with high grade vesicoureteral reflux and 3 findings have a less than 10% chance of having the reflux resolve before age 3 years. These findings are scintigraphic renal abnormality, poor bladder emptying and breakthrough infection. Conversely in the absence of all 3 findings 90% of cases will resolve or improve to a low grade (I to II) by age 3 years. This observation confirms what many may know intuitively, which is that infants with high grade reflux who are least likely to have the condition resolve spontaneously are those with the most abnormal vesicoureteral junctions and associated congenital renal dysplasia. The poor bladder emptying described is consistent with megacystis-megaureter syndrome, which often accompanies high grade reflux. Finally br...

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[Can inverted papilloma in urinary bladder be considered as a benign tumor?]

Orvosi Hetilap — Wed, 13 Jan 2010 21:26:15 +0100

Conclusions: Based on authors' experience, inverted papilloma of the urinary bladder is a benign lesion, but malignant changes or concomitant transitiocellular tumor may occur, thus follow-up is needed. Although references are not standardized, authors suggest following patients with inverted papilloma as a primary (pTa G1) bladder cancer. PMID: 20061266 [PubMed - in process] (Source: Orvosi Hetilap)

A 1-year maintenance after early adjuvant intravesical chemotherapy has a limited efficacy in preventing recurrence of intermediate risk non-muscle-invasive bladder cancer

BJU International — Tue, 12 Jan 2010 00:00:00 +0100

Study Type [ndash] Therapy (RCT)Level of Evidence 1b To evaluate the efficacy of 1-year maintenance after a 6-week cycle of early intravesical chemotherapy, as the role of maintenance in intravesical chemotherapy is debated. Between May 2002 and August 2003, 577 patients with non-muscle-invasive bladder cancer (NMI-BC) underwent transurethral resection (TUR) and early intravesical chemotherapy (epirubicin, 80 mg/50 mL). They were randomized between a 6-week induction cycle and the induction cycle plus maintenance with 10 monthly instillations. In all, 95 patients with T1G3, Tis or single and primary Ta[ndash]T1 G1[ndash]G2 tumours were excluded; 482 patients at intermediate risk of recurrence continued the study. All patients had cytology and cystoscopy at 3-monthly intervals for the first...

Photocure Received Positive Response From FDA On The New Drug Application (NDA) For Hexvix(R) For Detection Of Bladder Cancer

Health News from Medical News Today — Mon, 04 Jan 2010 11:00:00 +0100

The Food and Drug Administration (FDA) has informed Photocure that the new drug application (NDA) for Hexvix for detection of non-invasive papillary bladder cancer may be approved pending approval of the PMA for the Karl Storz photodynamic diagnosis system and final agreements between Photocure and FDA on labeling, and post-marketing commitments. The photodynamic diagnosis system is the blue light cystoscopy system that will be used with Hexvix on the US market. Photocure expects the pending issues to be agreed with FDA within the first half year of 2010... (Source: Health News from Medical News Today)

Urodynamic Testing And Interstitial Cystitis/painful Bladder Syndrome

Health News from Medical News Today — Mon, 04 Jan 2010 08:00:00 +0100

UroToday.com - The current paradigm for BPS diagnosis is heavily reliant on history and physical examination with the diagnosis relying primarily on the exclusion of confusable disorders. Dr. Deeptha Sastry and colleagues from Philadelphia report on a retrospective chart review of 128 patients to evaluate the relationship between symptom severity, urodynamic testing, and cystoscopic findings at the time of hydrodistention under anesthesia. The authors point out that studies thus far have been inconclusive in finding a role for urodynamic testing in the routine diagnosis of the condition... (Source: Health News from Medical News Today)

Double trouble: The blind duplex ureter

British Journal of Medical and Surgical Urology — Fri, 01 Jan 2010 00:00:00 +0100

A 19-year-old female presented with recurrent urinary tract infections despite prophylactic and culture sensitive antibiotics. As her infections persisted, an ultrasound and intravenous urogram were carried out demonstrating a duplex left collecting system and a normal single right sided system (). Rigid cystoscopy and retrograde pyelography were then performed to further clarify the aetiology of her persistent re-infection. Both left ureteric orifices were visualised with the duplex ureters in continuity with the renal pelvis obeying the Weigert–Meyer law. Unexpectedly, two right sided ureteric orifices were identified. The medial ureter was in continuity with the right renal pelvis. The lateral ureteric orifice was cannulated revealing a completely independent blind-ending ureter (). C...

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Surgical Treatment of Endometriosis in Private Practice: Cohort Study with Mean Follow-up of 3 Years

The Journal of Minimally Invasive Gynecology — Fri, 01 Jan 2010 00:00:00 +0100

Abstract: Study Objective: To describe our experience with surgical treatment of endometriosis.Design: Observational cohort study (Canadian Task Force classification II-2).Setting: Private hospital.Patients: One hundred sixty-three patients with histologically confirmed endometriosis who had completed a preoperative questionnaire, had available intraoperative findings and photographic documentation, and had been followed up to 6 years.Intervention: Laparoscopic electrosurgical excision of endometriotic implants.Measurements and Main Results: Patients completed a visual analogue scale (VAS) for 6 components of endometriosis-related symptoms. The EuroQol Group EQ-5D questionnaire was used for evaluation of quality of life. Long-term follow up was performed using a questionnaire and review of...

Bias in Detecting Bladder Cancer Recurrence Assessed

Modern Medicine — Mon, 28 Dec 2009 00:00:00 +0100

Patients with bladder cancer and a positive urine test result are more likely to have a recurrence detected by cystoscopy if the urologist is aware of the positive result, according to a study in the January issue of The Journal of Urology. (Source: Modern Medicine)

Repeated Injections of Botulinum Toxin-A for Idiopathic Detrusor Overactivity

Urology — Fri, 25 Dec 2009 00:00:00 +0100

Conclusions: BTX-A appears to be effective and safe after repeated administration in patients with idiopathic detrusor overactivity. Certain patients will benefit from dose optimization to improve efficacy or prevent voiding dysfunction. (Source: Urology)

Preliminary Results of Prostate Vaporization in the Treatment of Benign Prostatic Hyperplasia by Using a 200-W High-intensity Diode Laser

Urology — Fri, 25 Dec 2009 00:00:00 +0100

Conclusions: From our preliminary data, it was evident that diode laser prostatectomy can achieve excellent hemostasis, and provide immediate relief from obstructive voiding symptoms. However, the postoperative irritative symptoms and sloughing of necrotic tissues remained to be an important issue that needed to be resolved. (Source: Urology)

Reply

Urology — Thu, 24 Dec 2009 15:25:54 +0100

In this study, it was clear that the patients who underwent urethroplasty for the first time showed good results. However, there has been evidence of poor results in patients undergoing urethroplasty after realignment or urethroplasty. In case of realignment, this could be either because of adverse effect of the procedure itself or severe primary urethral injury, which may explain the failure of realignment as well as subsequent urethroplasty. Realignment can worsen the injury in many ways. First, it may physically exaggerate the urethral injury. This may be especially true when realignment is done in suboptimal conditions (without flexible cystoscopy and expertise, overzealous multiple attempts) or in an early phase when traumatized urethral margins are edematous, friable, and ischemic. S...

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Stille AB - Sonesta 6202 - Class 2 Recall

Medical Device Recalls since July 07, 2006 — Thu, 24 Dec 2009 02:00:10 +0100

Stille Sonesta Urodynamic Table 6202 Gynecology/Urology Procedure Chair; an electric cystometric table; Stille AB, Solna, Sweden. Used to position the subject/patient in a desired position during urodynamic, general examinations, cystoscopy, ultrasound, biofeedback, vasectomy and OBGYN procedures. (Source: Medical Device Recalls since July 07, 2006)

Stille AB - Sonesta 6302 and 6302U - Class 2 Recall

Medical Device Recalls since July 07, 2006 — Thu, 24 Dec 2009 02:00:10 +0100

Stille Sonesta Gynecology and Urology Table 6302 and 6302U; an electric cystometric table; Stille AB, Solna, Sweden. Used to position the subject/patient in a desired position during urodynamic, general examinations, cystoscopy, ultrasound, biofeedback, vasectomy and OBGYN procedures. (Source: Medical Device Recalls since July 07, 2006)

Stille AB - Sonesta 6303 - Class 2 Recall

Medical Device Recalls since July 07, 2006 — Thu, 24 Dec 2009 02:00:10 +0100

Stille Sonesta Gynecology and Urology Table 6303 ; an electric cystometric table; Stille AB, Solna, Sweden. Used to position the subject/patient in a desired position during urodynamic, general examinations, cystoscopy, ultrasound, biofeedback, vasectomy and OBGYN procedures. (Source: Medical Device Recalls since July 07, 2006)

Laparoscopic management of urachal remnants in women affected of pelvic pain

Gynecological Surgery — Fri, 18 Dec 2009 07:08:37 +0100

In conclusion, complete excision of urachal remnants in women affected of pelvic pain is advisable in order to treat the symptoms and can be safely performed by a laparoscopic approach. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s10397-009-0544-9Authors Juan Gilabert-Estelles, Hospital Casa de Salud Unit of Gynecological Endoscopy Av. Manuel Candela 41 46010, 46009 Valencia SpainJuan Gilabert-Aguilar, Hospital Casa de Salud Unit of Gynecological Endoscopy Av. Manuel Candela 41 46010, 46009 Valencia Spain Journal Gynecological SurgeryOnline ISSN 1613-2084Print ISSN 1613-2076 (Source: Gynecological Surgery)

Dipstick Pseudohematuria: Unnecessary Consultation and Evaluation

The Journal of Urology — Wed, 16 Dec 2009 00:00:00 +0100

Conclusions: Positive dipstick heme tests should always be confirmed by microscopic urinalysis before urological referral or evaluation. Education of referring physicians regarding the American Urological Association guidelines could possibly help limit costly and potentially harmful, unnecessary evaluation of patients without true microhematuria. (Source: The Journal of Urology)

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Diagnostic value of fibronectin and mutant p53 in the urine of patients with bladder cancer: impact on clinicopathological features and disease recurrence

Medical Oncology — Fri, 11 Dec 2009 06:54:54 +0100

This study included 100 patients diagnosed with bladder cancer, 93 patients with benign urological disorders and 47 healthy volunteers. The urine supernatant was used for determination of fibronectin by ELISA, while urine sediment was used for cytology and detection of mutant p53 by PCR-SSCP followed by DNA sequencing. The sensitivity and specificity were 59% and 91.4% for VUC, 82% and 84.3% for fibronectin, and 37% and 100% for mutant p53; combination of the three parameters increased sensitivity to 95% but specificity was only 78.6%. A significant association was observed between disease recurrence and mutant p53, stage and lymph node involvement. Our results indicate that fibronectin had the highest sensitivity compared to VUC and mutant p53 in bladder cancer detection; however, m...

Narrow-band imaging cystoscopy to evaluate bladder tumours – individual surgeon variability

BJU International — Fri, 11 Dec 2009 00:00:00 +0100

Study Type [ndash] Diagnosis (exploratory cohort)Level of Evidence 2b To assess individual urologist variability using narrow-band imaging (NBI) cystoscopy to evaluate bladder tumours. In all, 50 patients underwent white-light and NBI cystoscopy to evaluate for recurrent bladder tumours. Endoscopic images in each patient were independently viewed by four urologists assessing presence or absence of tumour. Their findings were correlated with biopsy results. In all, 26 patients had recurrent tumour and 24 had benign histology. There were no significant differences among urologists detecting recurrent tumour or in determining final pathology. There does not appear to be a 'learning curve' for adapting to NBI-surveillance cystoscopy in patients with bladder cancer. (Source: BJU International)

Analysis Of Symptoms, Endoscopy And Urothelial Morphology In Bladder Pain Syndrome/interstitial Cystitis Shows Treatment Results Unpredictable

Health News from Medical News Today — Sun, 06 Dec 2009 08:00:00 +0100

UroToday.com - In a study designed to assess the course of bladder pain syndrome and whether the treatment algorithm can be modified according to baseline data, no dramatic findings were identified to aid the clinician. Dr. Libor Zamecnik and colleagues from Prague characterized and followed 58 patients with interstitial cystitis who had subjective, cystoscopic, and histopathologic findings of the disorder for a mean of 6 years. Out of this well-categorized group, 31 patients were treated with oral pharmacotherapy and 27 patients were treated by intravesical application of heparin... (Source: Health News from Medical News Today)

Fetal cystoscopy for severe lower urinary tract obstruction - initial experience of a single center

Prenatal Diagnosis — Sat, 05 Dec 2009 00:00:00 +0100

To report the experience with fetal cystoscopy and laser fulguration of posterior urethral values (PUV) for severe lower urinary tract obstruction (LUTO).Between July 2006 and December 2008, fetal cystoscopy was offered to 23 patients whose fetuses presented with severe LUTO, favorable urinary analysis and gestational age (Source: Prenatal Diagnosis)

Testing for urinary hyaluronate improves detection and grading of transitional cell carcinoma.

Urologic Oncology — Thu, 03 Dec 2009 00:00:00 +0100

CONCLUSIONS: Our results support the postulate that urinary HA may be used as a tumor marker to aid in the diagnosis and grading of TCC. Additionally, more invasive tumors produce and release more HA in urine than superficial tumors, thus higher HA levels indicate more aggressive disease. PMID: 19962919 [PubMed - as supplied by publisher] (Source: Urologic Oncology)

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Abstract C35: Rapid assessment of aneuploidy using 5 minute oligo-FISH probes

Cancer Research — Wed, 02 Dec 2009 04:15:34 +0100

More than 15 years ago, development of non-radioactive FISH probes revolutionized clinical cytogenetics and FISH is now routinely used for mapping genes, detecting pathogenic DNA, and diagnosing cancers and genetic diseases. However, most FISH applications rely on probes generated from large genomic fragments (BAC, YAC or plasmids), cDNA, or PCR generated fragments. The large probe size (200–600bp) results in poor cell penetration necessitating long, 8 to 16 hours hybridization. Furthermore, large BAC probes require high probe concentration and stringent wash conditions.We recently developed short (30mer), synthetic Oligo-FISH probes targeting highly repetitive sequences which offer several advantages for assessing aneuploidy, including performance in < 10 min compared to 8–...

Reply

Urology — Tue, 01 Dec 2009 00:00:00 +0100

We greatly appreciate the editorial comment which is constructive and well thought out. It indeed points out the remaining clinical problems in current TUR procedures. On the basis of 200 operating-room cases we have performed so far, we find that conventional white-light cystoscopy can provide sufficient diagnosis for papillary TCC. The benefits of deploying cystoscopic optical coherence tomography (COCT) are to provide accurate tumor margins to guide TUR and to enhance re-TUR cases where the scar or necrosis induced by previous resections may complicate surface imaging (cystoscopy) to identify residual or recurrent tumors. It has been found in our study that the major benefit of COCT is to enhance the diagnosis of small nonpapillary tumors (eg, early low-grade TCC and CIS) that surface i...

The utility of fluorescence in situ hybridization for detection of bladder urothelial carcinoma in routine clinical practice.

J Korean Med Sci — Tue, 01 Dec 2009 00:00:00 +0100

Authors: Kwak KW, Kim SH, Lee HM To evaluate the ability of fluorescence in situ hybridization (FISH) in detecting bladder urothelial carcinoma (BUC), FISH and cytology were compared for the evaluation of 308 consecutive urine samples from patients suspected of having BUC. All patients underwent cystoscopy for identification of bladder lesions. The FISH results were compared with the cytology assessment. In all, 122 patients had confirmed BUC. Among them, 68 (55.7%) were FISH-positive, while only 33 (27%) were positive on cytology. According to disease stage (superficial vs. invasive) and grade (low vs. high), the sensitivities of FISH were also significantly higher than those of cytology in all categories. Moreover, in 36 patients who had no visible tumor with flat, erythematous mucos...

Endoscopic ablation of Hunner's lesions in interstitial cystitis patients.

Canadian Urological Association Journal — Tue, 01 Dec 2009 00:00:00 +0100

CONCLUSION: Endoscopic ablation of Hunner's lesions improves symptoms in IC patients. Recurrence of symptoms should prompt repeat cystoscopy to identify recurrent lesions, as repeat ablation offers symptomatic improvement. PMID: 20019976 [PubMed - in process] (Source: Canadian Urological Association Journal)

Critical review of biomarkers for the early detection and surveillance of bladder cancer

Journal of Men's Health — Tue, 01 Dec 2009 00:00:00 +0100

Abstract: Increasing interest in the early diagnosis of urothelial carcinoma of the bladder (UCB) has led to a better understanding of bladder carcinogenesis and an explosion of new biomarkers for this disease. Current surveillance protocols after initial diagnosis include serial cystoscopy, which is invasive and expensive, and cytology, which has a low sensitivity and suffers from high variability. To date, the US Food and Drug Administration (FDA) has approved six urine-based biomarkers to complement cystoscopy in the monitoring of UCB patients. In addition, various promising tests are under investigation.In this review, we describe the rationale and address the most recent and relevant findings for the FDA-approved biomarkers (bladder tumor antigen (BTA) test, BTA stat, BTA TRAK, Immuno...

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Fibered confocal microscopy: A novel adjunct to improvise cystoscopy

Indian Journal of Urology — Mon, 30 Nov 2009 15:59:44 +0100

Gupta Ankush, Goel Apul, Singh Bhupendra PIndian Journal of Urology 2009 25(4):560-561 (Source: Indian Journal of Urology)

The orthotopic Fischer/AY-27 rat bladder urothelial cell carcinoma model to test the efficacy of different apaziquone formulations.

Urologic Oncology — Thu, 26 Nov 2009 00:00:00 +0100

CONCLUSIONS: Apaziquone showed an excellent antitumor activity. The effectiveness of apaziquone in this orthotopic rat bladder tumor model corroborates the clinical observations and implies the validity of this model. PMID: 19945311 [PubMed - as supplied by publisher] (Source: Urologic Oncology)

Intravesical lignocaine in the diagnosis of bladder pain syndrome

International Urogynecology Journal — Sat, 21 Nov 2009 08:29:20 +0100

Conclusions Intravesical lignocaine appears to be useful in excluding patients with pelvic pain originating from organs other than the urinary bladder. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00192-009-1045-0Authors Rajesh Taneja, Pushpawati Singhania Research Institute Press Enclave Road, Sheikh Sarai, Phase II New Delhi 17 India Journal International Urogynecology JournalOnline ISSN 1433-3023Print ISSN 0937-3462 (Source: International Urogynecology Journal)

Prospective Validation of the Clinical Usefulness of Reflex Fluorescence In Situ Hybridization Assay in Patients With Atypical Cytology for the Detection of Urothelial Carcinoma of the Bladder

The Journal of Urology — Fri, 13 Nov 2009 00:00:00 +0100

Conclusions: This prospective study of a reflex fluorescence in situ hybridization assay in patients with atypical cytology validates our previous findings. In patients with atypical cytology and obvious tumor on cystoscopy the assay was unnecessary but it was beneficial in those with equivocal or negative cystoscopy results. The fluorescence in situ hybridization assay identified all urothelial carcinoma tumors in patients with equivocal or negative cystoscopy. In patients with equivocal or negative cystoscopy and atypical cytology, a reflex fluorescence in situ hybridization assay may help avoid unnecessary evaluation while identifying those who would need further evaluation. (Source: The Journal of Urology)

Cystoscopy Revisited as the Gold Standard for Detecting Bladder Cancer Recurrence: Diagnostic Review Bias in the Randomized, Prospective CEFUB Trial

The Journal of Urology — Fri, 13 Nov 2009 00:00:00 +0100

Purpose: We evaluated the influence of knowledge of urine test outcome on the accuracy of cystoscopy (diagnostic review bias) during surveillance in patients with low grade, nonmuscle invasive urothelial carcinoma.Materials and Methods: We performed a prospective, single-blind, randomized, multicenter clinical trial of surveillance by microsatellite analysis urine test in 448 patients with nonmuscle invasive (pTa, pT1, G1, G2) urothelial carcinoma. Positive or negative urine test results were only communicated to the urologist in the intervention arm of 226 patients, in which cystoscopy was done if the test was positive, and at 3, 12 and 24 months. Urine test results were not communicated in the control arm of 222 patients who underwent standard 3-month cystoscopy. The primary outcome meas...

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Long-term Outcome of Patients With a Negative Work-up for Asymptomatic Microhematuria

Urology — Fri, 13 Nov 2009 00:00:00 +0100

Conclusions: Patients who have negative complete evaluations for asymptomatic MH have little chance of subsequently developing BC. The recommended “appropriate” follow-up for these patients may require reconsideration in light of these data. (Source: Urology)

Long-term Clinical Outcomes of a Phase I Trial of Intravesical Docetaxel in the Management of Non–muscle-invasive Bladder Cancer Refractory to Standard Intravesical Therapy

Urology — Fri, 13 Nov 2009 00:00:00 +0100

Conclusions: After 4 years of follow-up without maintenance therapy, intravesical docetaxel has demonstrated the ability to prevent recurrence in a select number of patients with refractory NMI bladder cancer and warrants further investigation. (Source: Urology)

Fluoroscopic Placement of Double-Pigtail Ureteral Stents

Diagnostic and Therapeutic Endoscopy — Tue, 03 Nov 2009 15:26:12 +0100

Purpose: Double-pigtail ureteral stent is placed cystoscopically after ureteroscopy. We describe a technique for fluoroscopic placement of ureteral stents and demonstrate its use in a non-randomized prospective study. (Source: Diagnostic and Therapeutic Endoscopy)

Treatment of Bladder Diverticula, Impaired Detrusor Contractility, and Low Bladder Compliance

Urologic Clinics of North America — Sun, 01 Nov 2009 00:00:00 +0100

Bladder diverticula are common enough to be encountered by most urologists in practice but are reported less frequently in the literature than they were 50 years ago. Some patients can be managed nonoperatively, whereas others will need surgical intervention consisting of bladder outlet reduction and possibly removal of the diverticulum itself. In addition to the decision to operate, the timing of each intervention deserves careful consideration. Cystoscopy, computed tomography with contrast, urodynamic studies, cytology, and voiding cystourethrography play important roles in informing the clinician. Many new techniques for treatment of the bladder outlet and the diverticulum are available, such as laparoscopy and robotic surgery. (Source: Urologic Clinics of North America)

A Round Table Discussion: Case Studies of Patients with Lower Urinary Tract Symptoms

Urologic Clinics of North America — Sun, 01 Nov 2009 00:00:00 +0100

This article examines real-life case histories of men with routine and not so routine conditions underlying lower urinary tract symptoms (LUTS), and demonstrates the utility of what has become our standard evaluation: repeated bladder diaries, urinary flow rate postvoid residual urine flow, cystoscopy, and videourodynamics, as well as the routinely used LUTS questionnaire. Each case history was sent to each of the other authors of this monograph who, on a case by case basis, answered queries and made relevant comments. The patient evaluations and case histories are discussed by top experts who have authored articles in this issue. (Source: Urologic Clinics of North America)

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A Round Table Discussion: Case Studies of Patients with Lower Urinary Tract Symptoms.

The Urologic Clinics of North America — Sun, 01 Nov 2009 00:00:00 +0100

Treatment of Bladder Diverticula, Impaired Detrusor Contractility, and Low Bladder Compliance.

The Urologic Clinics of North America — Sun, 01 Nov 2009 00:00:00 +0100

Authors: Powell CR, Kreder KJ Bladder diverticula are common enough to be encountered by most urologists in practice but are reported less frequently in the literature than they were 50 years ago. Some patients can be managed nonoperatively, whereas others will need surgical intervention consisting of bladder outlet reduction and possibly removal of the diverticulum itself. In addition to the decision to operate, the timing of each intervention deserves careful consideration. Cystoscopy, computed tomography with contrast, urodynamic studies, cytology, and voiding cystourethrography play important roles in informing the clinician. Many new techniques for treatment of the bladder outlet and the diverticulum are available, such as laparoscopy and robotic surgery. PMID: 19942049 [PubMe...

Placenta percreta: urologic complication after successful conservative management by uterine arterial embolization: a case report

American Journal of Obstetrics and Gynecology — Sat, 31 Oct 2009 14:41:46 +0100

We report a case of placenta accreta that was managed conservatively by uterine arterial embolization and subsequently was complicated by hematuria. Ultrasound revealed a calcified mass at the posterior bladder wall. A careful resection under cystoscopy was carried out without hemorrhagic complication. Pathologic examination showed placental tissue that confirmed placenta percreta. (Source: American Journal of Obstetrics and Gynecology)

Presenting manifestations of eosinophilic cystitis in two Filipino children

International Urology and Nephrology — Thu, 29 Oct 2009 07:15:19 +0100

We report two cases of Filipino children with eosinophilic cystitis who presented with irritative voiding symptoms, gross hematuria, peripheral eosinophilia, and hydroureteronephrosis and urinary bladder wall thickening visualized on ultrasonography and CT urography. Cystoscopy and transurethral biopsy confirmed the diagnosis. Both patients were started with corticosteroid with or without an antihistamine. Resolution from the signs and symptoms were observed in both patients as documented by disappearance of peripheral eosinophilia, normal urinalysis results, and resolution of the hydroureteronephrosis and urinary bladder wall thickening on ultrasonography on follow-up. Content Type Journal ArticleCategory Urology - Case ReportDOI 10.1007/s11255-009-9665-3Authors Paul Joseph T. ...

Two-Year Efficacy and Safety of Botulinum a Toxin Intravesical Injections in Patients Affected by Refractory Painful Bladder Syndrome.

Current Drug Delivery — Thu, 29 Oct 2009 00:00:00 +0100

Conclusions: Intravesically injected BoNT/A is effective and safe in the medium-term management of patients with PBS. As the beneficial effect decreased progressively within a few months after treatment, repeat injections of the neurotoxin were needed over time. PMID: 19863481 [PubMed - as supplied by publisher] (Source: Current Drug Delivery)

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Flexible And Rigid Cystoscopy In Women

Health News from Medical News Today — Mon, 26 Oct 2009 11:00:00 +0100

UroToday.com - In this single blinded, prospective study, 36 women requiring cystoscopy were randomized to either rigid or flexible cystoscopy; all patients were placed in the dorsal lithotomy position and were given 2% local lidocaine urethral jelly. Questionnaires were completed prior, just after, and one week after the cystoscopy. (Source: Health News from Medical News Today)

Rupture of the male membranous urethra

Irish Journal of Medical Science — Fri, 23 Oct 2009 22:28:43 +0100

Conclusions If the patient is stable and requires emergency laparotomy for other abdominal injuries, he should have immediate realignment of the urethra. Early realignment of the urethra at taparotomy at 1–2 weeks can be combined with orthopaedic fixation of pelvic fractures. Patients who remain unstable due to associated injuries should have delayed urethroplasty at three months. Content Type Journal ArticleCategory Original PaperDOI 10.1007/BF03167698Authors M. S. Khan, The Adelaide & Meath Hospital, Incorporating The National Children’s Hospital Urology Department Tallaght, Dublin IrelandJ. A. Thornhill, The Adelaide & Meath Hospital, Incorporating The National Children’s Hospital Urology Department Tallaght, Dublin IrelandR. Grainger, The Adelaide & Meath Ho...

A 31-year-old woman with urethral duplication, stress urinary incontinence, uterovaginal prolapse, and rectal prolapse

International Urogynecology Journal — Fri, 23 Oct 2009 22:27:12 +0100

We report a case of urethral duplication in a woman with uterovaginal and rectal prolapse but without other associated congenital anomalies. On urodynamic and cystoscopic evaluation, an accessory urethra was noted to emerge from beneath the clitoral hood. The patient underwent exploratory laparotomy and transabdominal excision of the rudimentary urethral orifice with concurrent transvaginal prolapse repair and rectopexy. At 5-year follow-up, the patient continued to be continent and without prolapse. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00192-009-1022-7Authors John A. Occhino, Mayo Clinic Division of Gynecologic Surgery 200 First Street SW Rochester MN 55905 USAAndrew J. Croak, Northwest Ohio Center for Urogynecology and Women’s Health 625 Gibbs Street Ma...

Sexually transmitted papillomavirus infections: epidemiology pathogenesis, clinic, morphology, important differential diagnostic aspects, current diagnostic and treatment options

Anais Brasileiros de Dermatologia — Fri, 23 Oct 2009 12:59:34 +0100

The family of human papilloma viruses (HPV) comprises more than 100 genotypes. Approximately 30 of the genotypes are responsible for infections in the human anogenital area. A precisely defined algorithm with the goal of diagnosing and removing HPV for a prolonged or indefinite length of time, as well as to protect the patient from any malignant ransformation, does not currently exist. The identification of HPV strains by PCR or DNA hybridization in lesional tissue provides higher security for the patients. In high-risk patients additional colposcopy, rectoscopy, and rethroscopy/cystoscopy increase the probability of proper diagnosis and the application of a reliable therapeutic strategy. Removal of lesions by means of invasive methods, such as electrodessication, cryosurgery, and/or laser...

AUA NY 2009 - Fluorescence cystoscopy for detection of initial and recurrent bladder cancer - ...

UroToday — Thu, 22 Oct 2009 23:05:00 +0100

SEWARD, AK, USA - Presented by Ihor S. Sawczuk, MD (http://www.urotoday.com/5/meet_the_expert/meet_the_experts/meet_the_expert__ihor_s_sawczuk.html?s_cid=invite_2009_auany_expertpg_t) at the 107th Annual Meeting of the AUA -... (Source: UroToday)

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Urinary biomarkers in bladder cancer

British Journal of Medical and Surgical Urology — Thu, 22 Oct 2009 14:38:14 +0100

Introduction: Single urinary biomarkers have not achieved the sensitivity and specificity required to replace cystoscopy for diagnosis and follow-up for patients with bladder cancer. Combinations of biomarkers may increase diagnostic accuracy. (Source: British Journal of Medical and Surgical Urology)

Ventral vesical cyst causing outflow obstruction

British Journal of Medical and Surgical Urology — Thu, 22 Oct 2009 14:38:13 +0100

A 36-year-old gentleman presented with a 2-month history of frequency, hesitancy and poor stream. Abdominal and genital examination were normal. Urinalysis revealed red blood cells. Urinary tract ultrasound revealed a thin walled 1.1cm×0.9cm×1.7cm cystic structure arising from the bladder, immediately adjacent to the midline and ventral to the urethral opening [a and b]. It contained a single septation and demonstrated no Doppler colour flow. Cystoscopy revealed the ventral bladder neck cyst, demonstrating outlet obstruction and a ‘ball-valve effect’ with irrigation turned off [a and b]. Transurethral resection was performed, histology showing urinary mucosa, thin smooth muscle bundles, von Brunn's nests and cystitis cystica. The patient reported complete resolution of symptoms. (Sou...

Differential Diagnosis of Overactive Bladder in Men

The Journal of Urology — Mon, 19 Oct 2009 00:00:00 +0100

Conclusions: Overactive bladder is a complex diagnosis with many underlying, contributing urological pathologies. It should be considered a symptom complex and not a syndrome. Knowledge of the differential diagnosis in men with overactive bladder symptoms would hopefully provide clinicians with a diagnostic rubric to more specifically treat such patients with improved success. (Source: The Journal of Urology)

Urethral and bladder injuries with mid-urethral sling procedures - do we always need to cystoscope? Authors' Reply.

BJOG : An International Journal of Obstetrics and Gynaecology — Sun, 18 Oct 2009 23:10:56 +0100

Authors: Hilton P, Morton H PMID: 19832758 [PubMed - in process] (Source: BJOG : An International Journal of Obstetrics and Gynaecology)

Urethral and bladder injuries after mid-urethral sling procedures - do we always need to cystoscope?

BJOG : An International Journal of Obstetrics and Gynaecology — Sun, 18 Oct 2009 23:10:53 +0100

Authors: Smith P PMID: 19832759 [PubMed - in process] (Source: BJOG : An International Journal of Obstetrics and Gynaecology)

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Urodynamic testing and interstitial cystitis/painful bladder syndrome

International Urogynecology Journal — Thu, 15 Oct 2009 17:21:46 +0100

Conclusion UDT may be a useful adjunctive test in the evaluation of patients with irritative voiding symptoms. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00192-009-1015-6Authors Deeptha N. Sastry, University of Medicine and Dentistry of New Jersey Robert-Wood Johnson Medical School, Cooper University Hospital Camden NJ USAKrystal M. Hunter, University of Medicine and Dentistry of New Jersey Robert-Wood Johnson Medical School, Cooper University Hospital Camden NJ USAKristene E. Whitmore, Drexel University College of Medicine Philadelphia PA USA Journal International Urogynecology JournalOnline ISSN 1433-3023Print ISSN 0937-3462 (Source: International Urogynecology Journal)

AUA MA 2009 - Hexaminolevulinate fluorescence cystoscopy improves detection and resection of ...

UroToday — Tue, 13 Oct 2009 23:05:00 +0100

WILLIAMSBURG, VA, USA (UroToday.com) - Hexaminolevulinate (HAL) enhanced cystoscopy has the potential to identify bladder tumors not apparent on white... (Source: UroToday)

Cellvizio Helps Urologists Differentiate Cells in the Bladder in Real Time

Medical News (via PRIMEZONE) — Tue, 13 Oct 2009 13:00:00 +0100

PARIS, Oct. 13, 2009 (GLOBE NEWSWIRE) -- Urologic surgeons from Stanford University reported that Cellvizio(R) has been used to differentiate benign inflammation in bladder tissue from cancerous tissue in real time. Cellvizio(R), the world's smallest flexible microscope, was used during routine cystoscopy examinations to produce the findings, according to a study published and featured on the October cover issue of The Journal of Urology. (Source: Medical News (via PRIMEZONE))

Hexylaminolaevulinate fluorescence cystoscopy in patients previously treated with intravesical bacille Calmette-Guérin

BJU International — Mon, 12 Oct 2009 23:00:00 +0100

To determine if hexylaminolaevulinate fluorescence cystoscopy (HAL-FC) has the potential to improve the diagnosis of bladder cancer in patients who have been treated with bacille Calmette-Guérin (BCG). Patients scheduled for rigid cystoscopy after BCG therapy were recruited prospectively between April 2005 and February 2006. Patients received HAL (HexvixTM, PhotoCure ASA, Oslo, Norway) and the D-light system (Storz, Tuttlingen, Germany) was used to detect fluorescence. The bladder was mapped and biopsies taken under white light and then using HAL-FC. The main outcome was the frequency and nature of additional pathology detected by HAL-FC. Twenty-seven patients (21 men and six women; median age 70 years, range 49[ndash]82) underwent 32 HAL-FC. Recurrent bladder cancer was detected in 11 of...

Hydrodistension under local anesthesia for patients with suspected painful bladder syndrome/interstitial cystitis: Safety, diagnostic potential and therapeutic efficacy

International Journal of Urology — Sat, 10 Oct 2009 23:00:00 +0100

Objectives: To evaluate the safety, diagnostic potential and therapeutic efficacy of cystoscopy with hydrodistension under local anesthesia in patients with suspected painful bladder syndrome/interstitial cystitis (PBS/IC).Methods: Thirty-six patients with frequency, urgency or bladder pain for [ge]6 months and an average voided volume of (Source: International Journal of Urology)

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Lipiodol injection for target volume delineation and image guidance during radiotherapy for bladder cancer

Radiotherapy and Oncology — Mon, 05 Oct 2009 00:00:00 +0100

Abstract: A technique was developed for bladder tumour demarcation with lipiodol injection through a flexible cystoscope. The technique proved to be simple and useful for image-guided radiotherapy in bladder cancer as well as a helpful aid in the tumour delineation process. (Source: Radiotherapy and Oncology)

Straddle injuries to the bulbar urethra: management and outcome in 53 patients

International Braz J Urol — Fri, 02 Oct 2009 17:57:53 +0100

Conclusions: Suprapubic cystostomy is better than urethral realignment and catheterization as primary management after straddle injury to the bulbar urethra. Stricture excision and re-anastomosis is better than VIU as delayed management for strictures that develop after straddle injury to the bulbar urethra. (Source: International Braz J Urol)

Botulinum toxin: An emerging therapy in female bladder outlet obstruction

Indian Journal of Urology — Thu, 01 Oct 2009 17:55:07 +0100

Conclusions:</b> Botulinum toxin proved successful in improving the voiding characteristics. It possibly acts at the zone of hypertonicity at the bladder neck or midurethra. The only disadvantage is the high cost of the drug. (Source: Indian Journal of Urology)

Antegrade urethrogram: A technique to visualize the proximal bulbous urethral segment in anterior urethral stricture

Indian Journal of Urology — Thu, 01 Oct 2009 17:55:07 +0100

Goel Apul, Gupta Ankush, Dalela DivakarIndian Journal of Urology 2009 25(3):415-416In patients of stricture urethra that are on suprapubic catheter if the proximal bulbous urethral segment is not visualized at the time of voiding cystourethrography, antegrade urethrogram can be done. Through the suprapubic tract ureteric catheter is passed cystoscopically into the proximal urethra and contrast instilled to visualize the proximal urethra. (Source: Indian Journal of Urology)

Photodynamic diagnosis (PDD) in non-muscle invasive bladder cancer. Literature review.

Actas Urologicas Espanolas — Thu, 01 Oct 2009 00:00:00 +0100

Authors: Oliva Encina J, Rioja Sanz C Non-muscle invasive bladder cancer is one of the most prevalent and incident neoplastic conditions in the Western world. Its clinical management involves significant costs for health systems. Diagnosis and treatment are based on direct visualization of the disease and on detection of flat forms having no specific morphology and which are sometimes overlooked. Prognosis of NMIBC often depends on quality of transurethral resection and on early detection of undifferentiated flat forms. Cystoscopy using photosensitive substances such as 5-aminolevulinic acid (5-ALA) or hexyl aminolevulinic acid (HAL) achieves overdetection rates of 29 % for bladder neogrowths and 59% for carcinoma in situ. This overdetection ability results in an increased disease-free...

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Flexible cystoscopy: a revolution in urological practice.

British Journal of Hospital Medicine — Thu, 01 Oct 2009 00:00:00 +0100

Authors: Pillai PL, Sooriakumaran P Flexible cystoscopy has revolutionized the field of diagnostic urology. It can be done under local anaesthesia in the outpatient setting and is thus a highly useful tool. Its role in therapeutic urology is more limited but it still has a place in the management of certain conditions. PMID: 19966704 [PubMed - in process] (Source: British Journal of Hospital Medicine)

Editorial Comment

Urology — Wed, 30 Sep 2009 23:00:00 +0100

Bladder cancer is usually detected by cystoscopy. However, this highly sensitive test can miss both carcinoma in situ and papillary disease. The 2008 EAU guidelines on non-muscle-invasive urothelial carcinoma state that fluorescence cystoscopy is more sensitive than conventional white-light cystoscopy for detecting bladder cancer. Obvious limitations to this exciting new technology are the added expenses for equipment and drug and the increased potential for false-positive results. The authors report their large experience with 5-aminolevulinic acid (ALA)-induced fluorescence cystoscopy focusing on potential causes of false-positive findings. As indicated by the authors, intravesical therapy and previous transurethral resection have been identified as causes for this phenomenon. (Source: U...

Reply

Urology — Wed, 30 Sep 2009 23:00:00 +0100

Fluorescence cystoscopy improves the detection of occult bladder tumors and carcinoma in situ (CIS). In our series, about 60% of the CIS lesions, which are associated with poor prognosis, were detected by fluorescence cystoscopy only. (Source: Urology)

Transitional cell carcinoma in a remnant ureter after retroperitoneoscopic simple nephrectomy for benign renal disease.

J Korean Med Sci — Wed, 30 Sep 2009 23:00:00 +0100

Authors: Park JY, Park J, Ku JH, Kim HH A 70-yr-old man presented with painless gross hematuria. He underwent right nephrectomy for benign disease 9 yr ago. Computed tomography and cystoscopy showed a mass in the distal region of the right ureteral stump. He underwent right ureterectomy and bladder cuff resection. Pathological examination showed T1 and WHO grade 2 transitional cell carcinoma. At 6 months postoperatively, the patient is alive without any evidence of recurrence. PMID: 19795009 [PubMed - in process] (Source: J Korean Med Sci)

Lipiodol injection for target volume delineation and image guidance during radiotherapy for bladder cancer.

Wed, 30 Sep 2009 23:00:00 +0100

Authors: Pos F, Bex A, Dees-Ribbers HM, Betgen A, van Herk M, Remeijer P A technique was developed for bladder tumour demarcation with lipiodol injection through a flexible cystoscope. The technique proved to be simple and useful for image-guided radiotherapy in bladder cancer as well as a helpful aid in the tumour delineation process. PMID: 19800703 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

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Intermittent self-catheterization and the risk of squamous cell cancer of the bladder: An emerging clinical entity?

Canadian Urological Association Journal — Wed, 30 Sep 2009 23:00:00 +0100

We report on an eighth case, and the first case described in a patient with a Mitrofanoff continent appendicovesicostomy. A description of the case and review of the literature are presented. Risk factors for squamous cell cancer include recurrent urinary tract infections, keratinising squamous metaplasia (leukoplakia) and local mucosal trauma from intermittent self-catheterization. There is no recognized or validated monitoring program for patients performing ISC who may also have these risk factors. Reasonable protocols may include regular urinary cytology and cystoscopy with random or targeted bladder biopsies. Squamous cell cancer may present late in this cohort of patients and is associated with a dismal prognosis. PMID: 19829719 [PubMed - as supplied by publisher] (Source: Canadi...

Composite paraganglioma-ganglioneuroma of the urinary bladder: a rare neoplasm causing hemodynamic crisis at tumour resection.

Canadian Urological Association Journal — Wed, 30 Sep 2009 23:00:00 +0100

Authors: Chen CH, Boag AH, Beiko DT, Siemens DR, Froese A, Isotalo PA A 64-year-old man presented with gross painless hematuria. Cystoscopy revealed a submucosal bladder neck mass covered by normal urothelium. During transurethral resection, the patient developed hemodynamic crisis including sinus bradycardia. Histopathologic examination revealed a primary bladder composite paraganglioma-ganglioneuroma (CPG). The patient underwent partial cystectomy and is symptom-free after one year. Bladder CPGs are extremely rare neoplasms that may result in life-threatening catecholamine secretion, especially during tumour manipulation. These tumours require complete surgical excision and should be included in the differential diagnosis of any solitary bladder mass covered by normal urothelium, esp...

Narrow-band imaging cystoscopy to evaluate the response to bacille Calmette-Guérin therapy: preliminary results

BJU International — Mon, 28 Sep 2009 23:00:00 +0100

To evaluate whether narrow-band imaging cystoscopy (NBIC) can identify bladder tumour suspected on follow-up white-light cystoscopy (WLC) after intravesical bacille Calmette-Guérin (BCG) therapy, as BCG causes an intense reaction in the bladder, appearing as red lesions on WLC, which might be residual tumour or BCG-induced inflammation. Sixty-one patients with high-risk non-muscle-invasive bladder tumours were evaluated 3 months after starting induction BCG therapy. All patients had abnormal erythematous lesions on WLC, suspected to be residual carcinoma in situ. After WLC, they were evaluated by NBIC, urine cytology and biopsy, followed by transurethral resection of all visible lesions. Of the 61 patients, 22 (36%) had residual tumour. NBIC correctly identified tumour in 21 patients, but...

Oral analgesia by non-steroidal anti-inflammatory drug zaltoprofen to manage cystoscopy-related pain: A prospective study

International Journal of Urology — Thu, 24 Sep 2009 23:00:00 +0100

Conclusions: Pre-emptive zaltoprofen is able to control cystoscopy-associated pain, which translates into better quality of life for patients. Thus, its use is recommended in the management of these patients. (Source: International Journal of Urology)

Cystoscopy and bladder biopsies in patients with bladder pain syndrome carried out following ...

UroToday — Wed, 23 Sep 2009 23:00:00 +0100

Department of Urology, Faculty of Medicine, University Antwerp and University Hospital, Antwerp, Belgium. (Source: UroToday)

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Editorial - Flexible and rigid cystoscopy in women

UroToday — Tue, 22 Sep 2009 23:05:00 +0100

BERKELEY, CA (UroToday.com) - In this single blinded, prospective study, 36 women requiring cystoscopy were randomized to either rigid or... (Source: UroToday)

Transurethral Cystolithotripsy With Holmium Laser Under Local Anesthesia in Selected Patients

Urology — Tue, 22 Sep 2009 00:00:00 +0100

Conclusions: Transurethral holmium:YAG laser lithotripsy under local anesthesia appears to be a safe and effective technique for the large bladder calculi. Thus, it may be used as an alternative treatment option in selected patients. (Source: Urology)

Flexible and rigid cystoscopy in women - Abstract

UroToday — Sun, 20 Sep 2009 23:05:00 +0100

Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA (Source: UroToday)

Successful Treatment with Hydrodistension in a Boy with Refractory Overactive Bladder with Glomerulation

The Journal of Pediatrics — Fri, 18 Sep 2009 17:01:54 +0100

A 9-year-old boy was referred because of daytime incontinence, urgency, urinary frequency, nocturnal enuresis, and intermittent bladder pain for 5 years. Although he had been prescribed several medications, the symptoms had not improved. Ultrasonography and voiding cystourethrography showed no abnormality in the kidney, bladder, and urethra. Uroflow measurements showed that the maximum flow rate was 16.9 mL/s with a voided volume of 69 mL. No postvoid residual urine was found. Cystometry and pressure flow study revealed normal bladder compliance, no detrusor overactivity, and no detrusor-sphincter dyssynergia. Cystoscopy showed the banding of smooth muscle fiber, devascularization, and diffuse petechial hemorrhages at 80 cm H2O in the distended state. After hydrodistension, diffuse glomeru...

A girl of Klippel-Trenaunay Weber syndrome coexistence of recurrent bloody vaginal discharge

International Urology and Nephrology — Fri, 18 Sep 2009 16:27:20 +0100

In conclusion, we have emphasized that the girls with recurrent vaginal discharge might be KTWS. Angiokeratoma may be considered as a dermatological finding of KTWS. KTWS may also have enlarged kidney and enlargement in venous structures of the kidney in hypertrophied side. Content Type Journal ArticleCategory Urology - Case ReportDOI 10.1007/s11255-009-9640-zAuthors Mehmet Turkmen, Dokuz Eylul University Hospital Department of Pediatrics Mithatpasa cad 665/4 Kucukyali 35280 Izmir TurkeySalih Kavukçu, Dokuz Eylul University Hospital Department of Pediatrics Mithatpasa cad 665/4 Kucukyali 35280 Izmir TurkeyHandan Çakmakci, Dokuz Eylul University Hospital Department of Radyology Izmir TurkeyAlper Soylu, Dokuz Eylul University Hospital Department of Pediatrics Mithatpasa cad 665/4 Ku...

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Robotic ureteroureterostomy in children with a duplex collecting system

Journal of Robotic Surgery — Thu, 17 Sep 2009 23:28:39 +0100

Abstract Duplex collecting system pathology can be handled using an ablative procedure or reconstructive procedure even in the light of a poorly functioning moiety. We propose that, when a reconstructive procedure is an option, a robotic ureteroureterostomy is safe and feasible. Fifteen children between the ages of 6 months and 10 years (mean 31.26 months) underwent transperitoneal robotic ureteroureterostomy for duplex collecting system pathology. The surgical procedure included transperitoneal robotic approach. Outcome measures included operative time, length of hospital stay, and resolution of symptoms. Mean operative time was 1.2 h (range 0.75–2.2 h) for the entire procedure, including the cystoscopic evaluation. Length of stay averaged 20.8&n...

Decreased nanobacteria levels and symptoms of nanobacteria-associated interstitial cystitis/painful bladder syndrome after tetracycline treatment

International Urogynecology Journal — Thu, 17 Sep 2009 12:44:22 +0100

Conclusions A high prevalence of NB was observed in female IC/PBS, and anti-NB treatment effectively improved the symptoms, which suggest that NB may cause some cases of IC/PBS. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00192-009-0994-7Authors Qing-hua Zhang, Third Military Medical University Urological Research Institute of PLA, Southwest Hospital Chongqing 400038 People’s Republic of ChinaXue-cheng Shen, Third Military Medical University Urological Research Institute of PLA, Southwest Hospital Chongqing 400038 People’s Republic of ChinaZhan-song Zhou, Third Military Medical University Urological Research Institute of PLA, Southwest Hospital Chongqing 400038 People’s Republic of ChinaZhi-wen Chen, Third Military Medical University Urologi...

Pure Natural Orifice Translumenal Endoscopic Surgery Partial Cystectomy: Intravesical Transurethral and Extravesical Transgastric Techniques in a Porcine Model

Urology — Wed, 16 Sep 2009 00:00:00 +0100

Conclusions: NOTES partial cystectomy could potentially reduce morbidity of conventional methods of partial cystectomy. Transurethral NOTES may be the least invasive method possible for partial cystectomy. Potential advantages of a transgastric NOTES approach include visualization of adjacent structures, access to sites difficult to reach transurethrally, and lymph node sampling. However, a gastrotomy could be a source of morbidity. Further investigation is required to assess safety, efficacy, and adequate bladder healing. (Source: Urology)

Urology — Wed, 16 Sep 2009 00:00:00 +0100

The Atlas of Urogynecological Endoscopy serves as a welcome practice manual for cystoscopy and laparoscopy. This text presents the integral components of endoscopy in urogynecology. The author has drawn upon his own archive of visual images, which surely demonstrates impressive depth, to fill the pages with astute observations and high-yield information. As proof of the author's long experience in the field and its leaders, he has utilized the expertise of many internationally renowned specialists to construct this thorough, yet succinct atlas. Although some overlap occurs, all chapters are informative and stand on their own by nature of the obvious extensive effort given to a thorough review of each subject. A seamless transition is made from the basics of anatomy, standard instrumentatio...

A Novel Approach to Using Matrix Metalloproteinases for Bladder Cancer

The Journal of Urology — Tue, 15 Sep 2009 23:00:00 +0100

Conclusions: A noninvasive urine diagnostic assay that uses metalloproteinases with the Clinical Intervention Determining Diagnostic could lead to more efficient treatment in bladder cancer survivors by decreasing the number of negative cystoscopies (42%), allowing physicians to more selectively monitor those at high risk. (Source: The Journal of Urology)

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Editorial Comment

The Journal of Urology — Tue, 15 Sep 2009 23:00:00 +0100

The ultimate goal of novel tests for bladder carcinoma is to replace cystoscopy. Unfortunately while there are many interesting candidates, none is accurate enough. To ensure that a tumor is not missed 100% NPV is needed and to our knowledge no test comes close to date. These authors report 98% NPV for MMP-9 using a novel analysis called CIDD. Patients with high MMP-9 have cancer and patients with low MMP-9 do not. Only patients with middle values require cystoscopy. This seems like the perfect test, catches all cancers and saves many patients the cost and inconvenience of cystoscopy. (Source: The Journal of Urology)

Reply by Authors

The Journal of Urology — Tue, 15 Sep 2009 23:00:00 +0100

While cystoscopy, cytology and upper urinary tract imaging remain the standard of care for patients with bladder cancer, our novel approach of using urinary markers of bladder cancer with high positive and negative predictive values is more consistent with the way physicians practice diagnostics. CIDD is based on multiple MMP biomarkers with 98% NPR to identify patients who do not have primary or recurrent bladder cancer. We agree that 100% NPV is clearly the preferred result. However, even current standard of care procedures do not achieve such performance characteristics. (Source: The Journal of Urology)

Increased frequency and nocturia in a middle aged male may not always be due to benign prostatic hypertrophy: a case report

Cases Journal — Mon, 14 Sep 2009 23:00:00 +0100

We report a case of 58 year old Caucasian male who presented with a 5 month history of increased frequency of urination, nocturia and weight loss without any fever or hematuria. He was found to have an increased creatinine of 2.8mg/dl and a prostate specific antigen level of 0.18 ng/ml. His azotemia was thought to be secondary to BPH. A Foley catheter was initially placed with a plan for outpatient follow up. On removal of the catheter his problems persisted and he returned to the hospital. Diagnostic work up including abdominal ultrasonography, computed tomography scan, retrograde pyelogram, cystography and cystoscopic biopsies revealed the diagnosis of primary signet ring cell carcinoma of urinary bladder. Although cystectomy was planned, our patient passed away before this could be done...

Bladder recurrence after surgery for upper urinary tract urothelial cell carcinoma: Frequency, risk factors, and surveillance.

Urologic Oncology — Mon, 14 Sep 2009 23:00:00 +0100

CONCLUSION: Prior histories of bladder cancer and upper tract tumor multifocality are the most frequently reported risk factors for bladder tumors following UUT-UCCs. Surveillance regimen is based on cystoscopy and on urinary cytology for at least 5 years. PMID: 19762256 [PubMed - as supplied by publisher] (Source: Urologic Oncology)

Office Cystoscopy And Transrectal Ultrasound-guided Prostate Biopsies Pose Minimal Risk: Prospective Evaluation Of 921 Procedures

Health News from Medical News Today — Thu, 10 Sep 2009 10:00:00 +0100

UroToday.com - The Institute of Medicine has drawn professional and public attention to the safety of patients in our health care system through two prominent publications. The Joint Commission has responded by developing a series of National Patient Safety Goals that must be followed to achieve accreditation. (Source: Health News from Medical News Today)

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Commentary: the role of cytologic analysis of voided urine in the work-up of asymptomatic microhematuria

BMC Urology - Latest articles — Wed, 09 Sep 2009 23:00:00 +0100

Microscopic hematuria is a common finding in patients presenting to both primary care doctors as well as urologists. Sources of microscopic hematuria include infection, stones, inflammatory disorders as well as cancer of the genitourinary tract, particularly urothelial cancer. A primary focus in the urologic workup of hematuria is to rule out cancer. This is done using radiographic studies as well as procedures such as cystoscopy and bladder biopsy. As the authors state in their article titled "The utility of serial urinary cytology in the initial evaluation of the patient with microscopic hematuria", cytologic analysis of voided urine, though attractive due to its noninvasive nature, has been found to have the neither the sensitivity, cost-effectiveness, nor the ease of administration nec...

Posttraumatic ventral urethral fistula: case report and review of literature

Cases Journal — Tue, 08 Sep 2009 23:00:00 +0100

Conclusion: Self retraction of the urethral catheter with balloon may result with clinically important urethral fistula. A wide range of possible options such as complete excision of the fistula tract and primary closure may be considered for individual cases. (Source: Cases Journal)

Lower urinary tract obstruction secondary to congenital bladder diverticula in infants

Pediatric Surgery International — Thu, 03 Sep 2009 06:24:49 +0100

Conclusion Primary bladder diverticulum in infants may present with lower urinary obstructive symptoms indistinguishable from posterior urethral valves. A carefully done VCUG can help in diagnosis. Primary definitive repair can be undertaken even in first few months of life with good results. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-009-2470-3Authors Arbinder Kumar Singal, RH-5, O-26, Sector-7, Vashi Navi Mumbai 400703 Maharashtra IndiaV. V. S. S. Chandrasekharam, Rainbow Children’s Hospital and Mahavir Hospital & Research Centre Hyderabad AP India Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358 (Source: Pediatric Surgery International)

Percutaneous Nephrostomy: Native and Transplanted Kidneys

Techniques in Vascular and Interventional Radiology — Tue, 01 Sep 2009 00:00:00 +0100

This article discusses the indications, techniques, imaging guidance modalities, and outcomes related to percutaneous nephrostomy. Extensions of the nephrostomy procedures, such as ureteric stent placement and nephro–ureteral stent placement are discussed in subsequent articles in this issue. (Source: Techniques in Vascular and Interventional Radiology)

Combined retropubic balloon vaginoplasty and laparoscopic canalization: A novel blend of techniques provides a minimally invasive treatment for cervicovaginal aplasia

American Journal of Obstetrics and Gynecology — Mon, 31 Aug 2009 23:00:00 +0100

We studied the operative and functional outcomes of combined retropubic balloon vaginoplasty and laparoscopic canalization (RBV-LC) for treatment of cervicovaginal aplasia. The RBV-LC procedure was performed successfully in 4 cases of cervicovaginal aplasia within 35-40 minutes primary operative time. Cystoscopy was performed to ensure bladder and urethral integrity. Endoscopically monitored canalization with laparoscopic canalization is a feasible, effective, less invasive way for management of cervicovaginal aplasia. (Source: American Journal of Obstetrics and Gynecology)

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Displacement of ureteral orifices following anterior colporrhaphy

International Urogynecology Journal — Fri, 28 Aug 2009 14:56:26 +0100

Conclusions Anterior colporrhaphy is associated with significant caudal and lateral displacement of both ureteral orifices. These findings are of potential importance for pelvic reconstructive surgeons and may facilitate faster cystoscopic evaluation of ureteral patency postoperatively. They may also have implications on the angle of the preferred optical equipment to be used. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00192-009-0979-6Authors Lena Dain, Division of Urogynecology and Reconstructive Pelvic surgery Haifa IsraelRon Auslander, Division of Urogynecology and Reconstructive Pelvic surgery Haifa IsraelArie Lissak, Division of Urogynecology and Reconstructive Pelvic surgery Haifa IsraelOfer Lavie, Division of Urogynecology and Reconstruct...

URS 2009 - Metabonomics in bladder cancer detection - Abstract

UroToday — Thu, 27 Aug 2009 23:05:00 +0100

PORT DOUGLAS, AUSTRALIA (UroToday.com) - Cystoscopy is considered as the current gold standard for diagnosis of bladder carcinoma. (Source: UroToday)

Beyond the Abstract - Office cystoscopy and transrectal ultrasound-guided prostate biopsies ...

UroToday — Tue, 25 Aug 2009 23:05:00 +0100

BERKELEY, CA (UroToday.com) - The Institute of Medicine has drawn professional and public attention to the safety of patients in... (Source: UroToday)

[Confocal laser scanning microscopy of the urothelium.]

Der Urologe. Ausg. A — Tue, 25 Aug 2009 23:00:00 +0100

Authors: Nohr-Westphal C, Stachs O, Kröger M, Kram W, Guthoff R, Hakenberg OW In order to improve the detection of flat urothelial neoplasia an improvement in optical methods might be helpful. We investigated the use of confocal laser scanning microscopy in a pilot study of specimens with bladder cancer.A total of 35 fresh ex vivo specimens of 20 human bladders of patients who underwent radical cystectomy were examined with a modified confocal laser scanning microscope (670 nm). The field size was 200x200 microm and tissue was investigated up to depths of 120 microm. Resulting data sets were reconstructed three-dimensionally by computer software. Results were compared with conventional histology. Microscopically diseased bladder mucosa showed cytological and histological criteria ...

[The value of urinary cytology in the diagnostic of high grade urothelial tumors.]

Der Urologe. Ausg. A — Fri, 21 Aug 2009 23:00:00 +0100

Authors: Niedworok C, Rembrink V, Hakenberg OW, Börgermann C, Rossi R, Schneider T, Becker M, Szarvas T, von Ostau C, Swoboda A, Rübben H, Vom Dorp F Urinary cytology is a non-invasive adjunct to cystoscopy in the diagnosis of bladder cancer. In order to assess the diagnostic accuracy of urinary cytology as an office-based method for clinically relevant high grade (G3) bladder cancer, three nationwide cytology survey tests were performed. Urine specimens from seven patients, three patients with high grade (G3) bladder cancer and four patients with urinary tract infections, were collected. A total of 1,000 cytology slides were produced from each urine specimen. Each set contained five slides (two malignant, three benign) which were sent to all participating German urologists.T...

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Follow-up at 24 Months after Treatment of Overactive Bladder with 0.2 % Sodium Chondroitin Sulfate.

Aktuelle Urologie — Tue, 18 Aug 2009 23:00:00 +0100

CONCLUSION: Our findings suggest that instillation treatment with 0.2 % sodium chondroitin sulfate results in a more sustained improvement or cure of the symptoms of overactive bladder due to development of a glycosaminoglycan layer. Long-term results are needed for confirmation. PMID: 19693752 [PubMed - as supplied by publisher] (Source: Aktuelle Urologie)

Diagnostic Rigid Endoscopy: Otoscopy, Rhinoscopy, and Cystoscopy

Veterinary Clinics of North America: Small Animal Practice — Tue, 18 Aug 2009 11:48:19 +0100

This article presents the procedure, equipment, indications, and examples of abnormalities of rigid endoscopy in these areas. Textbooks, “hands-on” courses, and in-hospital training are methods for learning about these techniques and their applications. In addition to improving diagnostics, endoscopy can also be used for therapy in these three body areas. (Source: Veterinary Clinics of North America: Small Animal Practice)

Botulinum Toxin A for Overactive Bladder and Detrusor Muscle Overactivity in Patients With Parkinson's Disease and Multiple System Atrophy

The Journal of Urology — Sun, 16 Aug 2009 23:00:00 +0100

Conclusions: The new beneficial effect that we report in a small study sample encourages larger trials to confirm botulinum toxin type A injection into the detrusor muscle as an effective and safe treatment for refractory overactive bladder symptoms and detrusor overactivity related to Parkinson's disease and multiple system atrophy. (Source: The Journal of Urology)

Predictors of False Positives in 5-Aminolevulinic Acid-induced Photodynamic Diagnosis of Bladder Carcinoma: Identification of Patient Groups That May Benefit Most From Highly Specific Optical Diagnostics

Urology — Sun, 16 Aug 2009 23:00:00 +0100

Conclusions: Recent TURBTs and female gender are significant independent predictors of false positives in fluorescence cystoscopy. (Source: Urology)

Asymptomatic emphysematous cystitis presenting at a flexible cystoscopy clinic—Admit?

British Journal of Medical and Surgical Urology — Fri, 14 Aug 2009 11:16:58 +0100

A 77-year-old female was referred to the haematology department with asymptomatic anaemia (Hb 8g/dL). An initial diagnosis of warm antibody autoimmune haemolytic anaemia (WA-AIHA) was made. The patient started oral prednisolone 60mg while investigations were carried out to exclude an underlying cause—in particular lymphoma. Three weeks after commencing steroids the patient underwent a contrast enhanced computerised tomogram (CT). The CT () showed extensive gas within the wall of the bladder consistent with emphysematous cystitis (EC), with normal ureters and kidneys. The patient was referred to the urological outpatient and seen 7 days later. (Source: British Journal of Medical and Surgical Urology)

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Spontaneous intra-peritoneal perforation of the bladder secondary to peritoneal tuberculosis

British Journal of Medical and Surgical Urology — Fri, 14 Aug 2009 11:16:58 +0100

A 28-year-old Indian female presented to the Urology department with acute urinary retention, having being diagnosed 4 weeks previously with peritoneal tuberculosis. Prior to this episode of retention, she had complained of urinary frequency and poor stream for 3 days. Her post-catheterisation residual volume was 1500ml. She failed a subsequent trial without catheter due to large post-micturition residual volumes, and therefore commenced intermittent self-catheterisation. After 2 weeks of self-catheterisation her residuals became insignificant, and this was discontinued. Spinal magnetic resonance imaging (MRI) to investigate her symptoms revealed no abnormality. Cystoscopy revealed a diverticulum at the dome of the bladder, but otherwise normal bladder mucosa. (Source: British Journal of M...

Cement burn causing a vesicoarticular fistula

British Journal of Medical and Surgical Urology — Fri, 14 Aug 2009 11:16:58 +0100

An 85-year-old man presented with pain in the thigh and break down of the wound with some serous discharge 9 months after revision of a right total hip replacement. The patient underwent washout of the joint and a sinus between the scar and the joint was demonstrated. MC&S of the aspirated fluid demonstrated infection with S. aureus and the patient was given 6 weeks of antibiotics. The wound healed and the pain improved. 11 months following surgery the patient was readmitted for treatment with IV antibiotics after the symptoms recurred. At that time the patient reported some painless frank haematuria. He was referred to the Urology team and underwent an ultrasound scan that demonstrated normal upper tracts and a solid mass at the right lateral wall of the bladder. A solid tumour was resect...

Optical Biopsy of Human Bladder Neoplasia With In Vivo Confocal Laser Endomicroscopy

The Journal of Urology — Thu, 13 Aug 2009 23:00:00 +0100

Conclusions: We report the first study to our knowledge of in vivo confocal laser endomicroscopy in the urinary tract. Marked differences among normal urothelium, low grade tumors and high grade tumors were visualized. Pending further clinical investigation and technological improvement, confocal laser endomicroscopy may become a useful adjunct to conventional cystoscopy. (Source: The Journal of Urology)

Combined Thermo-Chemotherapy for Recurrent Bladder Cancer After Bacillus Calmette-Guerin

The Journal of Urology — Thu, 13 Aug 2009 23:00:00 +0100

Conclusions: Thermo-chemotherapy may be effective for papillary nonmuscle invasive urothelial cell carcinoma of the bladder that recurs after BCG treatment without increasing the risk of tumor progression. Maintenance therapy is important and improves the outcome. (Source: The Journal of Urology)

Marked hydronephrosis and hydroureter after distigmine therapy in an adult male patient with paraplegia due to spinal cord injury: a case report

Cases Journal — Wed, 05 Aug 2009 23:00:00 +0100

Conclusion: Distigmine therapy resulted in marked bilateral hydronephrosis and hydroureter. Persistence of hydronephrosis after omitting distigmine, and presence of residual urine in bladder over many years probably predisposed to formation of polypoid cystitis and follicular cystitis, and contributed to prolonged haematuria, which occurred after an episode of urine infection. This case illustrates the dangers of prescribing distigmine to promote spontaneous voiding in spinal cord injury patients. Instead of using distigmine, spinal cord injury patients should be advised to consider intermittent catheterisation together with oxybutynin or propiverine to achieve complete, low-pressure emptying of urinary bladder. (Source: Cases Journal)

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[Urology and National Socialism illustrated by the example of Leopold Casper (1859-1959).]

Der Urologe. Ausg. A — Wed, 05 Aug 2009 23:00:00 +0100

Authors: Moll FH, Rathert P, Fangerau H Leopold Casper (1859-1959) was one of the founders of the German Urological Society (DGfU) in 1906. He introduced functional kidney testing and a special cystoscope for ureteral catheterization. In 1913 he was president of the 4th congress held in the German capital Berlin. His textbook on genito-urinary diseases was translated by Charles W. Bonney in 1910 and proved the high quality of his scientific work. As a Jew he was forced to leave Nazi Germany later on in 1933 and from 1941 onwards he lived in New York. The anniversary of his 150th birthday should be remembered with special focus on the exodus of Jewish German scientists during the Nazi period. PMID: 19655122 [PubMed - as supplied by publisher] (Source: Der Urologe. Ausg. A)

Mesh erosion into the urinary bladder following laparoscopic inguinal hernia repair; is this the tip of the iceberg?

Hernia — Wed, 05 Aug 2009 18:10:34 +0100

Abstract A 67-year-old man presented with recurrent sepsis, groin swelling, and lower urinary tract symptoms 12 years after bilateral TEP inguinal hernia repair. Diagnosis of mesh migration and erosion into the urinary bladder was made by cystoscopy. Exploration of the groin confirmed Prolene mesh erosion into the lateral wall of the urinary bladder. This is the second reported case following TEP repair. A review of the literature reveals eight reported cases following laparoscopic repair since 1994. The factors contributing to mesh migration and erosion are discussed. With large case series of mesh non-fixation being reported in world literature, it may be that the incidence of this complication will increase in the future. A lower diagnostic threshold and reporting ...

Diagnosis of Bladder Cancer With Microelectromechanical Systems-based Cystoscopic Optical Coherence Tomography

Urology — Wed, 05 Aug 2009 00:00:00 +0100

Objectives: To examine the utility and potential limitations of microelectromechanical systems-based spectral-domain cystoscopic optical coherence tomography (COCT) so as to improve the diagnosis of early bladder cancer.Methods: An optical coherence tomography catheter was integrated into the single instrument channel of a 22F cystoscope to permit white-light-guided COCT over a large field of view (4.6 mm wide and 2.1 mm deep per scan at 8 frames/s) and 10-μm resolution. Intraoperative COCT diagnosis was performed in 56 patients, with a total of 110 lesions examined and compared with biopsied histology.Results: The overall sensitivity of COCT (94%) was significantly higher than cystoscopy (75%, P = .02) and voided cytology (59%, P = .005); the major enhancement over cystoscopy was for low...

Randomized Controlled Multisite Trial of Injected Bulking Agents for Women With Intrinsic Sphincter Deficiency: Mid-urethral Injection of Zuidex Via the Implacer Versus Proximal Urethral Injection of Contigen Cystoscopically

Urology — Tue, 04 Aug 2009 23:00:00 +0100

Conclusions: Confounding multiple variables inherent in the study design make a detailed analysis of study outcomes difficult. (Source: Urology)

Evidence-based prescription of antibiotics in urology: a 5-year review of microbiology

BJU International — Fri, 31 Jul 2009 23:00:00 +0100

To analyse the results of positive urine cultures over a 5-year period in a large hospital and urology department (amongst both inpatients and outpatients), assess the prevalence of different organisms and the resistance profiles of a range of antibiotics, and thus provide information on which organisms are likely to cause urosepsis. The use of antibiotics should be based on knowledge of which pathogens are present and what resistance patterns are emerging, particularly relevant in surgical disciplines like urology, as antibiotics are now routinely administered peri-operatively, whereby evidence-based prescription is preferable to generic guidelines. We therefore examined almost 25 000 positive urine cultures in our hospital over a 5-year period, and focused on the infections encountered a...

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Small bowel perforation in a hernia sac after TVT placement at the time of colpocleisis

International Urogynecology Journal — Thu, 30 Jul 2009 08:19:33 +0100

Abstract Tension-free vaginal tape (TVT) is commonly considered as the first line of treatment for stress urinary incontinence (SUI) with demonstrated efficacy and limited complications. An 82-year-old woman with complete uterine procidentia and SUI underwent a Le Forte colpocleisis, TVT, posterior repair, and cystoscopy. A 4-cm bulge was noted over the site of the left TVT incision on postoperative day 1. On postoperative day 3, she developed bilious vomiting with slight abdominal distention. Computed tomography scan showed a strangulated left inguinal hernia. An immediate exploratory laparotomy noted an inguinal hernia displaced medially with loops of small bowel in the hernia sac. Although properly positioned, one loop of bowel was perforated by the sling mesh. A small ...

The Contribution of Irish Urology to Clinical Practice

Urology — Thu, 30 Jul 2009 00:00:00 +0100

Conclusion: Irish urologists have made considerable contributions to urology throughout modern history, particularly in the areas of endoscopy and prostate surgery. (Source: Urology)

Vaginal Stones in a 5-Year-Old Girl: A Novel Approach of Removal

Journal of Pediatric and Adolescent Gynecology — Thu, 30 Jul 2009 00:00:00 +0100

Conclusion: We recommend the use of a nephroscope in visualizing the vagina and cervix and facilitating instrumentation in prepubertal girls. (Source: Journal of Pediatric and Adolescent Gynecology)

Urine cytology is an unnecessary expense in the evaluation of adult haematuria

International Journal of Urological Nursing — Wed, 29 Jul 2009 23:00:00 +0100

This study has shown that urine cytology offers no unique information to adult patients being investigated for haematuria. It remains an expensive test and delays the haematuria pathway. (Source: International Journal of Urological Nursing)

Placenta Percreta With Urinary Tract Involvement: The Case for a Multidisciplinary Approach

Urology — Wed, 29 Jul 2009 23:00:00 +0100

Conclusions: PP remains a technically challenging and high-risk obstetric condition. In the setting of urinary tract involvement, adequate imaging, surgical planning, and preoperative urologic assessment with placement of temporary ureteral catheters were associated with a lower incidence of urologic complications in our series. Adequate preoperative planning with a multidisciplinary team is recommended to reduce the complications associated with PP. (Source: Urology)

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Assay plus cystoscopy sharpens bladder cancer diagnosis

Modern Medicine — Wed, 29 Jul 2009 11:09:43 +0100

Combination of an immunofluorescence test and cytology may improve quality of bladder cancer diagnostics. (Source: Modern Medicine)

Adult presentation of congenital ectopic vas deferens insertion into ureter with unilateral renal agenesis

Surgical and Radiologic Anatomy — Sat, 25 Jul 2009 04:24:39 +0100

This report describes a rare adult presentation in a 20-year-old man where evaluation with ultrasonograms, isotope renogram, magnetic resonance imaging scans and cystoscopy with retrograde instillation of contrast into the right ureter confirmed aberrant insertion of vas deferens into the ureter associated with ureterocele and ipsilateral renal agenesis. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00276-009-0532-9Authors Sudhir Sukumar, Amrita Institute of Medical Sciences and Research Centre Department of Urology Kochi 682 026 Kerala IndiaVinodh Khanna, Amrita Institute of Medical Sciences and Research Centre Department of Urology Kochi 682 026 Kerala IndiaBalagopal Nair, Amrita Institute of Medical Sciences and Research Centre Department of Urology Kochi 682...

[Chyluria presenting as milky urine and nephrotic-range proteinuria and milky urine: Chyluria or glomerulopathy? Case report and literature review.]

Nephrologie & Therapeutique — Tue, 21 Jul 2009 23:00:00 +0100

Authors: Poitou C, Kheder-Elfekih R, Djebbar M, Perreira P, Deray G, Izzedine H A patient is admitted in hospital to explore a nephrotic proteinuria associated with milky urine. This is explained by a chyluria (presence of lymphatic fluid in the urines), which is due to a pyelolymphatic fistula probably linked to a lymphatic filariasis. Usually, the diagnosis of chyluria can be confirmed by the presence of urinary chylomicrons. The presence of an urinary-lymphatic fistula can be proved by different techniques (cystoscopy, retrograde pyelography, uroscanner, lymphoscintigraphy). The main cause of chyluria is parasitic infections (filarial infection, echinococcus, cysticercosis), but other causes can be found, such as granulomatosis, neoplasia, lymphatic malformations, or sequela of surg...

Bladder Tumor in Women with Microscopic Hematuria: An Iranian Experience and a Review of the Literature

Advances in Urology — Tue, 21 Jul 2009 11:49:28 +0100

Conclusion. Female microscopic hematuria is relevant and deserves evaluations, especially in elderly patients. Patients whose reason for microhematuria would not be diagnosed at the initial evaluations should be followed. (Source: Advances in Urology)