Search

In studies performed until now it was proved that about 80% of bladder tumors discovered as first diagnostic are in a non-infiltrative stage (pTa, pT1, CIS). White light cystoscopy (WLC) is a cornerstone in the diagnosis of bladder diseases in general and especially of tumor pathology. Narrow-band imaging (NBI) cystoscopy represents a complementary endoscopic method based on the principle of visualization in narrow band due to the white light filtration. Thus, is generated an ameliorated contrast between the normal urothelium and tumor hypervascularized tisssue, increasing the rate of detection of urothelial tumors. Comparatively with standard cystoscopy, NBI provides a clearer view of papillary tumors on the one hand, and especially of specific capillary architecture, better defining the edges of plate lession of in situ carcinoma. Studies published until now evidenced a significantly ameliorated tumor detection rate, specific to NBI visualization mode, thus confirming a substantial rate of additional tumors detected exclusively from this method. The specialty literature confirmed a certain category of patients diagnosed with non-invasive bladder cancer only using the NBI endoscopic evaluation. On the other side, this alternative was marked by a reduced specificity compared with conventional cystoscopy, manifested by an increased rate of false-positive outcomes. In conclusion, the changing of the anatomic endoscopic architecture of urinary bladder in tumor pathology was marked by a further quality after the introduction of NBI as additional routinely investigation, without suplementary costs. [ABSTRACT FROM AUTHOR]

Introduction: Secondary bladder neck sclerosis (BNS) represents a common late complication of prostate surgery, however so far insufficiently assessed in the available literature. More over, the previously attempted and analyzed therapeutic modalities failed to achieve acknowledgement as standard treatment for this particular pathology. Methods: The bipolar plasma vaponzation (BPV) was introduced as a viable mean of removing the obstructing scar formation in a gradual fashion. Several tips and tricks" were described as particularly useful in optimizing the plasma corona vaporization effect. The proper BPV technique is simple and safe while closely relying on certain surgical steps, the simultaneous vaporization and coagLlation processes and a superior endoscopic vision. Recent technological advances created the premises for further improvements. Results: The plasma-button vaporization is characterized by a satisfactory surgical speed, remote intraoperative bleeding risks, high-quality endoscopic visibility as well as the achievement of a complete sclerotic tissue removal. Within a short learning curve, a superior final aspect of the prostatic fossa and bladder neck is obtained at the end of surgery. The continuous plasma vaporization mode provides additional technical advantages. The previously described drawbacks of transurethral incision or resection seem to have been overcome by the practical features of the plasma vaporization process. Conclusions: The BPV technique outlines a promising modality of efficiently ablating the obstructing fibrous tissue in secondary BNS patients. The simplicity and safety of the bipolar vaporization approach, together with the thorough obstructing scar removal in a radical fashion, create the premises for a favorable long term BPV clinical outcome. [ABSTRACT FROM AUTHOR]