30,459 results on '"Bladder"'
Search Results
52. Op weg naar een 'animictielijst'?: Geanimeerde instructie verbetert het begrip van hoe een plasdagboek moet worden ingevuld.
- Author
-
Schlatmann, Florine W. M., Smeenk, Stella C., and van Balken, Michael R.
- Subjects
- *
URINARY urge incontinence , *BLADDER , *URINATION , *HEALTH literacy , *ADULTS - Abstract
Introduction: The bladder diary (BD) is a widely used diagnostic instrument. Its correct completion is essential for obtaining a reliable clinical impression. Previous studies reported problems with correctly completing the BD. This qualitative study investigated whether an animated fill-in instruction improves comprehension compared with a textual fill-in instruction. Material and methods: Adults assessed either a BD with the regular textual fill-in instruction (TBD) or a BD with an animated fill-in instruction (ABD). The thinking-aloud method and interviews were used. Predefined items were scored. Results: ABD participants had a better understanding of the BD than the TBD participants, especially participants with low levels of education. They scored better in naming micturition, fluid intake, incontinence and urge. Non-native speakers appreciated the visual support. Conclusion: Textual fill-in instructions for bladder diaries are difficult to understand for participants of all education levels because of terminology and layout. Animated fill-in instructions improve comprehension and completion quality and provide more reliable information. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
53. Management of Extraperitoneal Bladder Injuries in Patients With Pelvic Fractures.
- Author
-
Byars, Virginia H., Byerly, Saskya E., Dong, Caroline T., Lenart, Emily K., Evans, Cory R., Kerwin, Andrew J., and Filiberto, Dina M.
- Subjects
- *
PELVIC fractures , *TRAUMA centers , *BLADDER , *RETROSPECTIVE studies , *WOUNDS & injuries - Abstract
Background: The management of extraperitoneal bladder injuries (EBIs) when present with concomitant pelvic fractures is controversial. Current evidence is divided between supporting non-operative management with catheter drainage compared to operative management of bladder injury. The purpose of this study was to evaluate current management of EBI in the setting of pelvic fractures at our institution. We hypothesize there is no difference between operative and non-operative groups. Methods: Retrospective review of patients with concomitant bladder injuries and pelvic fractures at a level 1 trauma center from 2017 to 2022 was performed. Demographics, injury characteristics, management strategies, and complications were collected. Patients were stratified by management (cystorrhaphy vs non-operative) and compared. Results: Of 90 patients with bladder injuries and pelvic fractures, 50 patients (56%) presented with EBI, 26 patients (29%) presented with only intraperitoneal injuries, and 14 patients (16%) presented with a combined injury. Of patients with EBI, 18 (36%) underwent cystorrhaphy and 32 (64%) underwent non-operative management. There was no difference in demographics, orthopedic pelvic operative intervention, length of stay, or mortality between groups. Patients in the operative cohort had more bladder leaks [7 (39%) vs 4 (13%), P =.0406], compared to those in the non-operative cohort. Composite complications [7 (39%) vs 7 (22%), P =.1984] were similar between groups. Conclusions: Patients with EBI and pelvic fractures who underwent cystorrhaphy had more bladder leaks on follow-up imaging, although there was no difference in composite complications, when compared to those who underwent non-operative management. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
54. Morphological and Molecular Characterization of Three Myxosporean Species of the Genera Myxobolus , Henneguya , and Myxidium (Cnidaria: Myxozoa) Infecting Freshwater Fish, Isolated for the First Time in Japan.
- Author
-
Sekiya, Mariko, Sakai, Haruya, Li, Ying-Chun, Rosyadi, Imron, Yunus, Muchammad, and Sato, Hiroshi
- Subjects
- *
DNA data banks , *FISH morphology , *FRESHWATER fishes , *RIBOSOMAL RNA , *BLADDER - Abstract
The majority of myxosporean species (Cnidaria: Myxozoa) of the genera Myxobolus (35 species), Henneguya (8 species), and Myxidium (9 species) from freshwater or brackish fish in Japan were recorded more than 30 years ago (accumulatively 81.1% [43/53]). The re-discovery and molecular–genetic characterization of these species is a current research priority. During our myxosporean survey in Japanese freshwater fish, we detected three species that had never been recorded in Japan, but in the Russian Far East (Sakhalin Island, and Maritime Province): Myxobolus tribolodonus sp. n., forming cysts in the gills of Tribolodon sachalinensis (syn. M. marinus sensu Aseeva, 2000; M. marinus sensu Sokolov et Frolova, 2015, recorded from the gills of Pseudaspius (syn. Tribolodon) spp.); Henneguya pungitii Achmerov, 1953, forming cysts in the subcutis of external skin and buccal submucosa of Pungitius sinensis; and Myxidium salvelini Konovalov et Shulman, 1966, in the urinary bladder of Oncorhynchus masou ishikawae. These new isolates were characterized by integrated taxonomic approaches, i.e., myxospore morphology and molecular–genetic characterization of the small subunit ribosomal RNA gene (SSU rDNA). These new isolates were phylogenetically differentiated from any species whose SSU rDNA sequences were deposited in the DNA databases, and concurrently compared with recorded species based on classical morphological criteria. All three species were differentiated from myxosporeans previously recorded in Japan, indicating new distribution records out of the Russian Far East. For reliable species identification, accumulation of at least SSU rDNA sequences of known species worldwide is critically important. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
55. Standardizing male pelvic anatomy teaching using a clinical enrichment video.
- Author
-
MacDonald, Landan, Ory, Jesse, Pulakunta, Thejodhar, and MacLellan, Dawn L.
- Subjects
- *
PELVIC anatomy , *COMPUTER simulation , *SURGICAL robots , *UROLOGY , *MEDICAL education , *HUMAN anatomical models , *MALE reproductive organs , *MEDICAL specialties & specialists , *ANATOMY , *EDUCATIONAL outcomes , *MEDICAL cadavers , *CLINICAL trials , *RADICAL prostatectomy , *HEALTH occupations students , *TEACHING methods , *DESCRIPTIVE statistics , *MEDICAL students , *AUTODIDACTICISM , *PRE-tests & post-tests , *PERINEUM , *SURVEYS , *BLADDER , *LEARNING strategies , *COMPARATIVE studies , *GENITOURINARY organs , *VIDEO recording , *UROLOGICAL surgery - Abstract
INTRODUCTION: Evolving trends in medical education and modern curricular changes have reduced the amount of time and resources allocated for anatomy education. As the amount of dedicated anatomy education time decreases, more self-directed learning is required. Cadaveric dissection and didactic teaching have been supplemented with multimedia, clinical anatomy, and imaging for over 20 years, with mixed results. Specifically, the use of videobased anatomy teaching increases medical learning, if done methodically. METHODS: A 20-minute video was produced highlighting surgical anatomy using the following operative cases: perineal anatomy (artificial urinary sphincter case), inguinal and testicular anatomy (scrotal orchidopexy for acute testicular torsion), prostate anatomy (robotic radical prostatectomy), and bladder anatomy (endoscopy). The annotated video was shown to first-year medical students. Pre- and post-video multiple choice question quizzes were given to the students. Once submitted, the students completed a survey. RESULTS: Overall, 191 first-year medical students participated in our study. Average scores were similar between each quiz (50±16% vs. 49±17%) and there was no statistically significant change. Seventy-seven percent of participants felt the video improved their knowledge of urologic anatomy and 83% agreed the video should be shown to future classes. Sixty percent of participants felt the video solidified their anatomy knowledge, 78% felt the video was stimulating and entertaining, and 43% of the students felt the video increased their interest in pursuing urology as a career choice. CONCLUSIONS: Anatomy teaching can be supplemented using surgical videos, especially in a time when in-person anatomy teaching is limited. Further study is required to determine whether this teaching modality improves long-term anatomy knowledge retention. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
56. Long term outcomes and impact on renal function following radical cystectomy.
- Author
-
Tilala, Yash Manharla, Panda, Sabyasachi, Tripathi, Abhilekh, Sharma, Sachin, Paul, Amiya Shankar, Choudhuri, Sanjay, and Swain, Samir
- Subjects
- *
TRANSITIONAL cell carcinoma , *SURGICAL margin , *BLADDER , *LYMPHATIC metastasis , *OVERALL survival , *LYMPHADENECTOMY - Abstract
Introduction: To assess clinical, oncological outcomes and impact on renal function in patients who underwent the radical cystectomy with pelvic lymphadenectomy for muscle invasive and high risk non-muscle invasive transitional cell carcinoma of urinary bladder without evidence of non-regional lymph nodes and distant metastasis. Materials and methods: With curative intent total 156 patients underwent radical cystectomy with pelvic lymphadenectomy from January 2015 to December 2022. Total 132/156 patients had primary transitional cell carcinoma of bladder. Thirty patients, presented with obstructive nephropathy, operated after stabilization of renal function. Pre-operatively and post-operatively eGFR calculated using modified diet in renal disease formula. Results: In present study 114 (86.36%) patients had high grade TCC, 70 (53.02%) patients had organ confined disease. Nodal extension seen in 74 (56.06%) patients. Perioperative mortality noted in 36 (27.2%) patients. The overall survival and recurrence free survival (RFS) over 5 years was 66.67 and 45.45%. RFS was significantly related to pathological stage, nodal status, histological-grade, positivity of surgical margin and time of surgery from diagnosis. Total 92/132 (69.7%) patients had recurrence. Pelvic recurrence in 10/92 (10.87%) whereas 82/92 (89.13%) patients had distant recurrence. Pre-operatively mean creatinine was 2.6 mg/dl and mean eGFR was 38.9 ml/h in patients who presented with obstructive nephropathy after stabilization of renal function. Post-operatively in 46/132 (34.8%) patients had improvement in eGFR while 86/132 (65.2%) patients had deterioration of eGFR over 62 months of median follow up. Conclusion: Radical cystectomy provides good overall survival outcomes. Pre-operative eGFR has significant impact on post-operative renal function in long term. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
57. Location‐specific diagnostic efficiency of photodynamic diagnosis‐guided biopsy in bladder mapping biopsies.
- Author
-
Nakamura, Yuki, Ishikawa, Yudai, Kobayashi, Masaki, Fujiwara, Motohiro, Fan, Bo, Fukuda, Shohei, Waseda, Yuma, Tanaka, Hajime, Yoshida, Soichiro, and Fujii, Yasuhisa
- Subjects
- *
TRANSURETHRAL resection of bladder , *CANCER diagnosis , *EARLY detection of cancer , *URETHRA , *BLADDER - Abstract
Background Methods Results Conclusions Photodynamic diagnosis (PDD)‐assisted transurethral resection of bladder tumors (TURBT) has emerged as a promising complementary tool to white light (WL) cystoscopy, potentially improving cancer detection and replacing conventional mapping biopsies. This study aimed to investigate the diagnostic accuracy of PDD by anatomical locations in mapping biopsies through lesion‐based analysis.PDD and WL findings were prospectively recorded in 102 patients undergoing mapping biopsies and PDD‐assisted TURBT using oral 5‐aminolevulinic acid. We evaluated 673 specimens collected from flat tumor or normal‐looking lesions on WL cystoscopy, after excluding 98 specimens collected from papillary or nodular tumors.Among the 673 lesions, cancer was detected in 110 (16%) by lesion‐based analysis. PDD demonstrated significantly higher sensitivity (65.5% vs. 46.4%, p < 0.001) and negative predictive value (92.5% vs. 89.5%, p < 0.001) compared to WL. The sensitivity of PDD findings varied by location: posterior (100%), right (78.6%), dome (73.3%), left (70.6%), trigone (58.8%), bladder neck (41.7%), anterior (40.0%), and prostatic urethra (25.0%). Incorporating targeted biopsies of specific locations (bladder neck, anterior, and prostatic urethra) into the PDD‐guided biopsies, regardless of PDD findings, significantly increased the overall sensitivity from 65.5% to 82.7% (p = 0.001).This study first demonstrated the detection rate of location‐specific mapping biopsies using PDD, revealing difficulties in accuracy assessment in areas susceptible to tangential fluorescence. While PDD‐guided biopsy improves cancer detection compared to WL cystoscopy even for flat tumors or normal‐looking lesions, more careful decisions, including mapping biopsies, may be beneficial for an assessment in these tangential areas. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
58. Intraluminal administration of a carboxymethyl‐starch powder for bladder haemorrhage treatment in two adult horses.
- Author
-
Memoli, Giulia, Fontana, Lucia, Basano, Ilaria, Pallante, Marcello, Bertuglia, Andrea, and Bullone, Michela
- Subjects
- *
TOPICAL drug administration , *BLADDER , *URINARY catheters , *HEMORRHAGE , *VETERINARY hospitals - Abstract
Summary: Internal bleeding and mucosal bleeding in hollow organs are uncommon conditions in equine medicine and endoscopy. Most of the time, they respond to treatment of the underlying primary condition. However, there are cases in which a rapid and effective control of blood loss is required and the animal is not suited for surgery or general anaesthesia. We report two cases referred to our Veterinary Teaching Hospital with signs of urinary disease and bladder haemorrhage identified by cystoscopy which were successfully managed with topical application of a haemostatic carboxymethyl‐starch powder. The product was applied directly on the bleeding mucosa after bladder emptying either under endoscopic guidance or blindly, through a urinary catheter. The application of the haemostatic powder appears to be easy to perform, safe and helpful in controlling mucosal bleeding in hollow organs in a short time, with no adverse reactions noticed. This approach should be considered in cases where mucosal bleeding can be identified by endoscopy and a prompt control of blood loss is required, also in the field. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
59. Indirect inguinal herniation of the urinary bladder in a Shetland pony foal.
- Author
-
Buyck, Camille, Robert, Mickaël, Tricaud, Cyril, and Cousty, Matthieu
- Subjects
- *
FOALS , *HERNIA , *PONIES , *INGUINAL hernia , *GROIN , *CASTRATION , *BLADDER - Abstract
Summary: A 6‐week‐old male Shetland pony was presented with pollakiuria and a scrotal mass. The diagnostic procedures conducted included a thorough clinical examination, external palpation, a scrotal ultrasonographic examination and urinary catheterisation. These revealed an indirect herniation of the urinary bladder into the tunica vaginalis. Subsequently, the case was managed surgically with a partial cystectomy through an inguinal approach. Bilateral castration was performed with an additional closure of the superficial inguinal ring. Five months post‐surgery, a routine telephone questionnaire highlighted no postoperative concerns. Gross examination of the inguinal region revealed no abnormalities and the foal was maturing as expected. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
60. Pictorial review of multiparametric MRI in bladder urothelial carcinoma with variant histology: pearls and pitfalls.
- Author
-
Arita, Yuki, Woo, Sungmin, Kwee, Thomas C., Shigeta, Keisuke, Ueda, Ryo, Nalavenkata, Sunny, Edo, Hiromi, Miyai, Kosuke, Das, Jeeban, Andrieu, Pamela I. Causa, and Vargas, Hebert Alberto
- Subjects
- *
DIFFUSION magnetic resonance imaging , *NON-muscle invasive bladder cancer , *TRANSURETHRAL resection of bladder , *MAGNETIC resonance imaging , *BLADDER - Abstract
Bladder cancer (BC), predominantly comprising urothelial carcinomas (UCs), ranks as the tenth most common cancer worldwide. UCs with variant histology (variant UC), including squamous differentiation, glandular differentiation, plasmacytoid variant, micropapillary variant, sarcomatoid variant, and nested variant, accounting for 5–10% of cases, exhibit more aggressive and advanced tumor characteristics compared to pure UC. The Vesical Imaging-Reporting and Data System (VI-RADS), established in 2018, provides guidelines for the preoperative evaluation of muscle-invasive bladder cancer (MIBC) using multiparametric magnetic resonance imaging (mpMRI). This technique integrates T2-weighted imaging (T2WI), dynamic contrast-enhanced (DCE)-MRI, and diffusion-weighted imaging (DWI) to distinguish MIBC from non-muscle-invasive bladder cancer (NMIBC). VI-RADS has demonstrated high diagnostic performance in differentiating these two categories for pure UC. However, its accuracy in detecting muscle invasion in variant UCs is currently under investigation. These variant UCs are associated with a higher likelihood of disease recurrence and require precise preoperative assessment and immediate surgical intervention. This review highlights the potential value of mpMRI for different variant UCs and explores the clinical implications and prospects of VI-RADS in managing these patients, emphasizing the need for careful interpretation of mpMRI examinations including DCE-MRI, particularly given the heterogeneity and aggressive nature of variant UCs. Additionally, the review addresses the fundamental MRI reading procedures, discusses potential causes of diagnostic errors, and considers future directions in the use of artificial intelligence and radiomics to further optimize the bladder MRI protocol. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
61. Comparison of urethral parameters in females presenting cystoceles with and without stress urinary incontinence based on dynamic magnetic resonance imaging: are they different?
- Author
-
Tang, Lian, Liang, Shiqi, Chen, Chunlin, Feng, Jie, Chen, Lan, Peng, Cheng, and Liu, Ping
- Subjects
- *
URINARY stress incontinence , *MAGNETIC resonance imaging , *PELVIC organ prolapse , *CHI-squared test , *BLADDER , *URETHRA - Abstract
Purpose: To compare urethral parameters between cystocele patients with and without stress urinary incontinence (SUI) and explore factors influencing SUI in cystocele patients via dynamic MRI. Methods: The two-dimensional parameters evaluated included the paravaginal defects, levator ani muscle defects, urethral length, urethral funnel shape, bladder neck funnel width, bladder neck funnel depth, urethral angle, posterior vesicourethral angle, and anterior bladder protrusion. The three-dimensional parameters included the proximal urethra rotation angle, the distal urethra rotation angle, bladder neck mobility, urethral midpoint mobility, and external urethral meatus mobility. The independent samples t test was used for continuous variables, and the chi-square test was used for categorical variables. Binary logistic regression was used to identify factors independently associated with SUI in cystocele patients. Results: The baseline parameters were similar between the 2 groups. Cystocele patients with SUI had a significantly higher point Aa (1.63 ± 1.06 cm vs. 0.81 ± 1.51 cm, p = 0.008); more anterior bladder protrusion (33.3% vs. 11.4%, p = 0.017); greater bladder neck mobility (36.38 ± 11.46 mm vs. 28.81 ± 11.72 mm, p = 0.005); mid-urethral mobility (22.94 ± 6.50 mm vs. 19.23 ± 6.65 mm, p = 0.014); and external urethral meatus mobility (22.42 ± 8.16 mm vs. 18.03 ± 8.51 mm, p = 0.022) than did cystocele patients without SUI. The other urethral parameters were similar in the groups (p > 0.05). Binary logistic regression showed that bladder neck mobility was independently associated with SUI in females with cystoceles (odds ratio, 1.06; 95% CI 1.015–1.107; p = 0.009). Conclusion: Cystocele patients with SUI have a higher point Aa, more anterior bladder protrusion, and greater urethral mobility than those without SUI. Bladder neck mobility is independently associated with SUI in females with cystoceles. Registration number: NCT03146195. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
62. Urological cancer statistics on incidence from 1975 to 2019 and mortality from 1958 to 2022 in Japan.
- Author
-
Sasaki, Takeshi, Higashi, Takahiro, and Inoue, Takahiro
- Subjects
- *
BLADDER , *URINARY organs , *RENAL cancer , *BLADDER cancer , *DEATH rate , *AGE groups , *PROSTATE cancer - Abstract
Background: In Japan, comprehensive cancer statistics are collected through cancer registries. However, data on urological cancers are rarely summarized or published in research papers. Methods: This retrospective study was performed using publicly available statistical data on urological cancers (prostate cancer [PCa], bladder cancer [BCa], and cancers of kidney and urinary tract [except urinary bladder]) in Japan, including a summary of the Ministry's mortality statistics, cancer incidence statistics from the Regional Cancer Registries through 2015, and the National Cancer Registry statistics from 2016. We examined the incidence and mortality rates of urological cancers stratified by age groups. Results: The number of new cases of PCa, BCa, and cancers of kidney and urinary tract (except urinary bladder) in 2019 was 94,748, 23,383, and 30,458, respectively, and the number of deaths in 2022 was 13,439, 9,598, and 9,795, respectively. The incidence and mortality rates of urological cancers have consistently increased. Since 2000, there has been a noteworthy increase in the mortality rate of urological cancers among individuals aged > 85 years. The incidence and mortality rates of BCa and cancers of kidney and urinary tract (except urinary bladder) were significantly higher in males than in females. Conclusions: Urological cancers in very elderly patients (> 85 years) will become increasingly important in the future. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
63. Detection of bladder cancer cells using quantitative interferometric label‐free imaging flow cytometry.
- Author
-
Dudaie, Matan, Dotan, Eden, Barnea, Itay, Haifler, Miki, and Shaked, Natan T.
- Abstract
Bladder cancer is one of the most common cancers with a high recurrence rate. Patients undergo mandatory yearly scrutinies, including cystoscopies, which makes bladder cancer highly distressing and costly. Here, we aim to develop a non‐invasive, label‐free method for the detection of bladder cancer cells in urine samples, which is based on interferometric imaging flow cytometry. Eight urothelial carcinoma and one normal urothelial cell lines, along with red and white blood cells, imaged quantitatively without staining by an interferometric phase microscopy module while flowing in a microfluidic chip, and classified by two machine‐learning algorithms, based on deep‐learning semantic segmentation convolutional neural network and extreme gradient boosting. Furthermore, urine samples obtained from bladder‐cancer patients and healthy volunteers were imaged, and classified by the system. We achieved accuracy and area under the curve (AUC) of 99% and 97% for the cell lines on both machine‐learning algorithms. For the real urine samples, the accuracy and AUC were 96% and 96% for the deep‐learning algorithm and 95% and 93% for the gradient‐boosting algorithm, respectively. By combining label‐free interferometric imaging flow cytometry with high‐end classification algorithms, we achieved high‐performance differentiation between healthy and malignant cells. The proposed technique has the potential to supplant cystoscopy in the bladder cancer surveillance and diagnosis space. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
64. Nitric oxide signaling pathways in the normal and pathological bladder: Do they provide new pharmacological pathways?—ICI‐RS 2023.
- Author
-
Chakrabarty, Basu, Winder, Michael, Kanai, Anthony J., Hashitani, Hikaru, Drake, Marcus, Abrams, Paul, and Fry, Christopher H.
- Subjects
NITRIC oxide ,CELLULAR signal transduction ,URINARY organs ,BLADDER ,GUANYLATE cyclase - Abstract
Aims: The nitric oxide (NO•)/soluble guanylate cyclase/cyclic‐GMP (cGMP) signaling pathway is ubiquitous and regulates several functions in physiological systems as diverse as the vascular, nervous, and renal systems. However, its roles in determining normal and abnormal lower urinary tract functions are unclear. The aim was to identify potential therapeutic targets associated with this pathway to manage lower urinary tract functional disorders. Methods: This review summarizes a workshop held under the auspices of ICI‐RS with a view to address these questions. Results: Four areas were addressed: NO• signaling to regulate neurotransmitter release to detrusor smooth muscle; its potential dual roles in alleviating and exacerbating inflammatory pathways; its ability to act as an antifibrotic mediator; and the control by nitrergic nerves of lower urinary tract vascular dynamics and the contractile performance of muscular regions of the bladder wall. Central to much of the discussion was the role of the NO• receptor, soluble guanylate cyclase (sGC) in regulating the generation of the enzyme product, the second messenger cGMP. The redox state of sGC is crucial in determining its enzymic activity and the role of a class of novel agents, sGC activators, to optimize activity and to potentially alleviate the consequences of lower urinary tract disorders was highlighted. In addition, the consequences of a functional relationship between nitrergic and sympathetic nerves to regulate vascular dynamics was discussed. Conclusions: Several potential NO•‐dependent drug targets in the lower urinary tract were identified that provide the basis for future research and translation to clinical trials. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
65. Can we predict and manage persistent storage and voiding LUTS following bladder outflow resistance reduction surgery in men? ICI‐RS 2023.
- Author
-
Tarcan, Tufan, Hashim, Hashim, Malde, Sachin, Sinha, Sanjay, Sahai, Arun, Acar, Omer, Selai, Caroline, Agro, Enrico Finazzi, Abrams, Paul, and Wein, Alan
- Subjects
BLADDER ,OVERACTIVE bladder ,CYSTOMETRY ,URINARY organs ,PATIENT selection ,BENIGN prostatic hyperplasia ,RESEARCH institutes - Abstract
Aims: Lower urinary tract symptoms (LUTS) persist in up to 50% of patients after bladder outflow resistance reduction surgery (BORRS) in men. Our think tank aims to address the predictive factors for persistent LUTS after BORRS and to propose the recommendations for future research to enable improved better patient counseling and selection by more accurate prediction of treatment outcome. Methods: A think tank of ICI‐RS gathered in 2023, Bristol, UK, to discuss the pre and postsurgical clinical and urodynamic evaluation of men undergoing BORRS and whether it is possible to predict which men will have persistent LUTS after BORRS. Results: Our think tank agrees that due to the multifactorial, and still not fully understood, etiology of male LUTS it is not possible to precisely predict in many men who will have persistent LUTS after BORRS. However, severe storage symptoms (overactive bladder, OAB) in association with low volume and high amplitude detrusor overactivity and low bladder capacity in preoperative urodynamics, increase the likelihood of persistent OAB/storage symptoms after BORRS. Furthermore, patients who are clearly obstructed and have good bladder contractility on preoperative pressure flow studies do better postoperatively compared to their counterparts. However, the benefit of pressure flow studies is decreased in patients who do not acceptably void during the study. Poor voiding after BORRS may occur due to persistent obstruction or detrusor underactivity. Conclusion: Future research is needed to increase our understanding of why male LUTS persist after surgery, and to enable better patient selection and more precise patient counseling before BORRS. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
66. Can we predict whether a man with acute or chronic urinary retention will void after bladder outflow resistance reduction surgery? ICI‐RS 2023.
- Author
-
Tarcan, Tufan, Acar, Ömer, Malde, Sachin, Sinha, Sanjay, Sahai, Arun, Perrouin‐Verbe, Marie‐Aimee, Hashim, Hashim, Agro, Enrico Finazzi, Wein, Alan, and Abrams, Paul
- Subjects
BLADDER ,ENUCLEATION of the eye ,SURGERY ,RESEARCH institutes - Abstract
Aims: To address the predictive factors of a successful voiding after bladder outflow resistance reduction surgery (BORRS) in men presenting with acute or chronic urinary retention (UR). Methods: A think tank (TT) of ICI‐RS was gathered in 2023, Bristol, UK, to discuss several aspects of the problem, such as the pathophysiology of UR, the clinical and urodynamic evaluation of men with UR and whether it is possible to predict which men will be able to successfully void after treatment with contemporary surgical options. Results: The TT agreed that successful voiding after BORRS depends on several factors but that a strong recommendation cannot be made regarding preoperative evaluation and whether there are predictive factors of success because of the heterogeneity of patients and methodology in published trials. The diagnosis of obstruction in men with UR may be challenging when there is apparent reduced detrusor contraction during urodynamic studies. Even in the absence of bladder contractility there is documentation of such cases that have voided adequately after BORRS. Still, detrusor underactivity and inadequate relief of prostatic obstruction are the main causes of an unsuccessful voiding after BORRS. Conventional resection and enucleation methods remain the most successful surgeries in relieving UR in men, whereas the efficacy of minimally invasive surgical treatments needs to be assessed further. Conclusion: Research is needed to understand the pathophysiology of UR and the predictors of successful voiding after different types of BORRS in men with UR. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
67. Can we increase the value of data from bladder diaries? International Consultation on Incontinence—Research Society 2023.
- Author
-
Liapis, Ilias, Gammie, Andrew, Mohamed‐Ahmed, Rayan, Yates, Derick, Selai, Caroline, Cotterill, Nicky, Rantell, Angela, and Toozs‐Hobson, Philip
- Subjects
BLADDER ,SCIENTIFIC literature ,RESOURCE-limited settings ,URINARY organs ,PATIENT compliance - Abstract
Background: Bladder diaries represent a fundamental component in the assessment of patients presenting with lower urinary tract symptoms. Nevertheless, their importance often remains underappreciated and undervalued within clinical practice. This paper aims to conduct a comprehensive review of the existing literature concerning the utility of bladder diaries, underscore the criticality of their precision, elucidate the factors contributing to noncompliance with bladder diary completion, and investigate potential strategies for enhancing patient compliance. Materials and Methods: A review of the English‐language scientific literature available in the domains of Medline, Embase, Emcare, Midirs, and Cinahl was conducted. This was supplemented by discussion at the International Consultation on Incontinence Research Society Proposal session to define knowledge and identify gaps in knowledge surrounding the utility of bladder diaries. The existing evidence and outcome of the relevant discussion held in the meeting are presented. Results: Bladder diaries (BD) serve to characterize the nature and severity of storage lower urinary tract symptoms (LUTS) and provide an objective record of an individual's urination patterns. They aid in the refinement and customization of treatment strategies based on the clinical responses documented in the diary, optimizing treatment outcomes. Notably, both BD and urodynamic studies (UDS) play complementary yet distinct roles in LUTS evaluation. BD offers a more comprehensive and accessible approach to assessing specific storage LUTS, particularly due to their affordability and widespread availability, especially in resource‐limited settings. Nevertheless, the absence of a standardized BD format across global healthcare systems presents a significant challenge. Despite being recognized as reliable, noninvasive, validated, and cost‐effective tools for evaluating patients with LUTS, the implementation and completion of BD have proven to be complex. The introduction of automated bladder diaries heralds an era of precise, real‐time data collection, potentially enhancing the patient–clinician relationship. Completion of bladder diaries depends on an array of individual, social, and healthcare‐specific factors. Compliance with bladder diary completion could be enhanced with clear instructions, patient education, regular follow‐ups and positive re‐enforcement. This study has identified four critical areas for future research: Addressing healthcare disparities between affluent and developing nations, enhancing the current functionality and effectiveness of bladder diaries, exploring the feasibility of incorporating bladder diaries into the treatment and education process and improving the quality and functionality of existing bladder diaries. Conclusion: Bladder diaries play a pivotal role in the evaluation and management of patients with LUTS, providing a holistic perspective. When their complete potential is harnessed, they have the capacity to revolutionize the paradigm of LUTS management, ushering in a patient‐centered era of care. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
68. Is the time right for a new initiative in mathematical modeling of the lower urinary tract? ICI‐RS 2023.
- Author
-
Damaser, Margot S., Valentini, Françoise A., Clavica, Francesco, and Giarenis, Ilias
- Subjects
URINARY organs ,LITERATURE reviews ,MATHEMATICAL models ,RESEARCH questions ,QUANTUM computing - Abstract
Introduction: A session at the 2023 International Consultation on Incontinence – Research Society (ICI‐RS) held in Bristol, UK, focused on the question: Is the time right for a new initiative in mathematical modeling of the lower urinary tract (LUT)? The LUT is a complex system, comprising various synergetic components (i.e., bladder, urethra, neural control), each with its own dynamic functioning and high interindividual variability. This has led to a variety of different types of models for different purposes, each with advantages and disadvantages. Methods: When addressing the LUT, the modeling approach should be selected and sized according to the specific purpose, the targeted level of detail, and the available computational resources. Four areas were selected as examples to discuss: utility of nomograms in clinical use, value of fluid mechanical modeling, applications of models to simplify urodynamics, and utility of statistical models. Results: A brief literature review is provided along with discussion of the merits of different types of models for different applications. Remaining research questions are provided. Conclusions: Inadequacies in current (outdated) models of the LUT as well as recent advances in computing power (e.g., quantum computing) and methods (e.g., artificial intelligence/machine learning), would dictate that the answer is an emphatic "Yes, the time is right for a new initiative in mathematical modeling of the LUT." [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
69. Could a better understanding of the underlying pathophysiologies lead to more informed treatment choices in patients with lower urinary tract dysfunction due to an acontractile or underactive detrusor? ICI‐RS 2023.
- Author
-
Sinha, Sanjay, Everaert, Karel, Kheir, George Bou, Roberts, Neil, Solomon, Eskinder, Belal, Mohammed, Selai, Caroline, Perrouin‐Verbe, Marie‐Aimée, Spicchiale, Claudia Fede, Wein, Alan, and Abrams, Paul
- Subjects
URINARY organs ,BIOMARKERS ,URODYNAMICS ,URINATION disorders ,BLADDER - Abstract
Introduction: The underlying pathophysiology behind a diagnosis of acontractile or underactive detrusor at invasive urodynamics is very heterogeneous. Lack of etiological classification currently limits the possibility of stratifying therapy. Methods: This subject was discussed at a think‐tank on the subject at the International Consultation on Incontinence‐Research Society held in Bristol, June 2023. This manuscript is a result of those deliberations and the subsequent discussions of the think‐tank. Results: There are challenges in defining abnormalities of detrusor contraction with resultant implications for available evidence. Pathology at any level of the neuromuscular pathway can impair or prevent a detrusor voiding contraction. Attempts have been made to identify clinical markers that might predict an underactive detrusor but strong supporting evidence is lacking. Hence, a holistic approach to phenotyping requires specialized neuro‐imaging as well as physiological investigations. Several general measures can help individuals with an abnormal detrusor contraction. The search for a molecule to enhance the detrusor voiding contraction remains elusive but there are promising new candidates. Neuromodulation can help select individuals but data is not well stratified by underlying etiology. Manipulation of central neurotransmitters might offer an alternate therapeutic option. Conclusions: A better understanding of the underlying pathophysiologies behind an abnormality of the detrusor voiding contraction is needed for improving management. Towards this goal, the think‐tank proposes a classification of the underactive detrusor that might help in selecting and reporting more well‐defined patient cohorts. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
70. How does the lower urinary tract contribute to bladder sensation? ICI‐RS 2023.
- Author
-
Grundy, Luke, Wyndaele, Jean J., Hashitani, Hikaru, Vahabi, Bahareh, Wein, Alan, Abrams, Paul, Chakrabarty, Basu, and Fry, Christopher H.
- Subjects
OVERACTIVE bladder ,URINARY organs ,BLADDER ,INTERSTITIAL cystitis ,SENSES - Abstract
Aim: Bladder sensation is critical for coordinating voluntary micturition to maintain healthy bladder function. Sensations are initiated by the activation of sensory afferents that innervate throughout the bladder wall. However, the physiological complexity that underlies the initiation of bladder sensory signaling in health and disease remains poorly understood. This review summarises the latest knowledge of the mechanisms underlying the generation of bladder sensation and identifies key areas for future research. Methods: Experts in bladder sensory signaling reviewed the literature on how the lower urinary tract contributes to bladder sensation and identified key research areas for discussion at the 10th International Consultation on Incontinence—Research Society. Results: The importance of bladder sensory signals in maintaining healthy bladder function is well established. However, better therapeutic management of bladder disorders with exaggerated bladder sensation, including overactive bladder syndrome (OAB) and interstitial cystitis/bladder pain syndrome (IC/BPS) is limited by a lack of knowledge in a number of key research areas including; the contribution of different nerves (pudendal, pelvic, hypogastric) to filling sensations in health and disease; the relative contribution of stretch sensitive (muscular) and stretch‐insensitive (mucosal) afferents to bladder sensation in health and disease; the direct and indirect contributions of the muscularis mucosae to bladder contraction and sensation; and the impact of manipulating urothelial release factors on bladder sensation. Conclusion: Disturbances in bladder sensory signaling can have severe consequences for bladder sensation and function including the development of OAB and IC/BPS. Advancing therapeutic treatments for OAB and IC/BPS requires a deeper understanding of the mechanisms underlying the generation of bladder sensation, and key areas for future research have been identified. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
71. Beyond the urothelium: Interplay between autonomic nervous system and bladder inflammation in urinary tract infection, bladder pain syndrome with interstitial cystitis and neurogenic lower urinary tract dysfunction in spinal cord injury—ICI‐RS 2023
- Author
-
Wyndaele, Michel, Charrua, Ana, Hervé, François, Aronsson, Patrik, Grundy, Luke, Khullar, Vik, Wein, Alan, Abrams, Paul, Cruz, Francisco, and Cruz, Célia Duarte
- Subjects
INTERSTITIAL cystitis ,CYSTITIS ,URINARY tract infections ,AUTONOMIC nervous system ,BLADDER ,SPINAL cord injuries - Abstract
Introduction: Inflammation and neuronal hypersensitivity are reactive protective mechanisms after urothelial injury. In lower urinary tract dysfunctions (LUTD), such as urinary tract infection (UTI), bladder pain syndrome with interstitial cystitis (BPS/IC) and neurogenic LUTD after spinal cord injury (SCI), chronic inflammation can develop. It is unclear how the protective reactionary inflammation escalates into chronic disease in some patients. Methods: During its 2023 meeting in Bristol, the International Consultation on Incontinence‐Research Society (ICI‐RS) reviewed the urothelial and inflammatory changes after UTI, BPS/IC and SCI. Potential factors contributing to the evolution into chronic disease were explored in a think‐tank. Results: Five topics were discussed. (1) Visceral fat metabolism participates in the systemic pro‐inflammatory effect of noradrenalin in BPS/IC and SCI. Sympathetic nervous system‐adipocyte‐bladder crosstalk needs further investigation. (2) Sympathetic hyperactivity also potentiates immune depression in SCI and needs to be investigated in BPS/IC. Gabapentin and tumor necrosis factor‐α are promising research targets. (3) The exact peripheral neurons involved in the integrative protective unit formed by nervous and immune systems need to be further identified. (4) Neurotransmitter changes in SCI and BPS/IC: Neurotransmitter crosstalk needs to be considered in identifying new therapeutic targets. (5) The change from eubiosis to dysbiosis in SCI can contribute to UTI susceptibility and needs to be unraveled. Conclusions: The think‐tank discussed whether visceral fat metabolism, immune depression through sympathetic hyperactivity, peripheral nerves and neurotransmitter crosstalk, and the change in microbiome could provide explanations in the heterogenic development of chronic inflammation in LUTD. High‐priority research questions were identified. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
72. Emerging cancer disease burden in a rural sub-Saharan African population: northeast Nigeria in focus.
- Author
-
Ezenkwa, Uchenna S., Lawan, Aliyu Ibrahim, Garbati, Musa Abubakar, Suleiman, Dauda E., Katagum, Dauda A., Kabir, Abba, Adamu, Adamu Isa, Modu, Abubakar Kolomi, Olanrewaju, Olaniyi David, Dachi, Rufai Abdu, Abdullahi, Yusuf Mohammed, Alkali, Muhammed, Bojude, Danladi Adamu, Usman, Hadiza Abdullahi, Omotoso, Ayodele, Schlumbrecht, Matthew, George, Sophia H. L., and Audu, Bala Mohammed
- Subjects
SUB-Saharan Africans ,BLADDER ,SKIN cancer ,BURDEN of care ,AGE groups ,NON-communicable diseases - Abstract
Introduction: Sub-Saharan Africa (SSA) is plagued by myriads of diseases, mostly infectious; but cancer disease burden is rising among non-communicable diseases. Nigeria has a high burden of cancer, however its remote underserved culturally-conserved populations have been understudied, a gap this study sought to fill. Methods: This was a cross-sectional multi-institutional descriptive study of histologically diagnosed cancers over a four-year period (January 2019-December 2022) archived in the Departments of Pathology and Cancer Registries of six tertiary hospitals in the northeast of Nigeria. Data obtained included age at diagnosis, gender, tumor site and available cancer care infrastructure. Population data of the study region and its demographics was obtained from the National Population Commission and used to calculate incident rates for the population studied. Results: A total of 4,681 incident cancer cases from 2,770 females and 1,911 males were identified. The median age at diagnosis for females was 45 years (range 1-95yrs), and 56 years (range 1-99yrs) for males. Observed age-specific incidence rates (ASR) increased steadily for both genders reaching peaks in the age group 80 years and above with the highest ASR seen among males (321/100,000 persons) compared to females (215.5/100,000 persons). Breast, cervical, prostatic, colorectal and skin cancers were the five most common incident cancers. In females, breast, cervical, skin, ovarian and colorectal cancers were the top five malignancies; while prostate, haematolymphoid, skin, colorectal and urinary bladder cancers predominated in men. Conclusion: Remote SSA communities are witnessing rising cancer disease burden. Proactive control programs inclusive of advocacy, vaccination, screening, and improved diagnostics are needed. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
73. An In‐Situ‐Tag‐Generation Proximity Labeling Technology for Recording Cellular Interactions.
- Author
-
Yao, Yunyan, Jia, Ru, Liu, Chuanming, Wang, Haiqi, Li, Ting, Zheng, Xiaocui, Zhong, Tong, Feng, Nan, Sun, Jiahui, Li, Ke, Xie, Ran, Ding, Lijun, Yan, Chao, Ding, Lin, and Ju, Huangxian
- Subjects
- *
GALACTOSE , *RADIO frequency identification systems , *BLADDER , *ALDEHYDES - Abstract
Obtaining information about cellular interactions is fundamental to the elucidation of physiological and pathological processes. Proximity labeling technologies have been widely used to report cellular interactions in situ; however, the reliance on addition of tag molecules typically restricts their application to regions where tags can readily diffuse, while the application in, for example, solid tissues, is susceptible. Here, we propose an "in‐situ‐tag‐generation mechanism" and develop the GalTag technology based on galactose oxidase (GAO) for recording cellular interactions within three‐dimensional biological solid regions. GAO mounted on bait cells can in situ generate bio‐orthogonal aldehyde tags as interaction reporters on prey cells. Using GalTag, we monitored the dynamics of cellular interactions and assessed the targeting ability of engineered cells. In particular, we recorded, for the first time, the footprints of Bacillus Calmette‐Guérin (BCG) invasion into the bladder tissue of living mice, providing a valuable perspective to elucidate the anti‐tumor mechanism of BCG. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
74. Ultrasonographic features of female urethral caruncle: a retrospective study of 20 patients.
- Author
-
Liu, Zhiran, Wang, Xia, Shui, Wen, Yan, Yulin, Zhou, Minzhi, Chen, Bin, Zhang, Rui, and Ying, Tao
- Subjects
- *
ULTRASONIC imaging , *BLOOD flow , *POSTMENOPAUSE , *BLADDER , *DIAGNOSTIC imaging , *URETHRA , *ENDORECTAL ultrasonography - Abstract
Female urethral caruncle is the most common urethral mass in postmenopausal women, yet there is a lack of studies on its imaging. The aim of this study was to provide a summary of the clinical and ultrasound features as well as the precise location of female urethral caruncle. This study reviewed the clinical and ultrasonographic records of 20 consecutive women with pathologically confirmed urethral caruncle. Data on patient demographics, symptoms, and transperineal and transrectal ultrasound imaging features, including location, shape, margin, size, blood flow, and inner echo of the caruncle, were extracted. Each patient presented with only one mass at the urethral meatus. Most caruncles were located on the posterior lip (75%) of the urethra, presenting as oval (80%), mixed-echoic (50%), or hypo-echoic (40%) nodules with abundant linear (40%) or dendritic (60%) blood flow. The average distance between the bladder neck and the cranial end of the masses was 28 mm. Hyper-echogenic spots, cystic echo areas, and macrocalcifications were detected in thirteen caruncles (70%). This study shows that transperineal combined with transrectal ultrasound can be used to assess female urethral caruncle, and its relative location to the urethra can be accurately described, which is helpful for surgeons making preoperative localization and conversations. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
75. A review of urinary bladder microbiome in patients with bladder cancer and its implications in bladder pathogenesis.
- Author
-
Stamatakos, Panagiotis Velissarios, Fragkoulis, Charalampos, Zoidakis, Ieronymos, Ntoumas, Konstantinos, Kratiras, Zisis, Mitsogiannis, Iraklis, and Dellis, Athanasios
- Subjects
- *
LITERATURE reviews , *BLADDER , *URINARY organs , *SEARCH algorithms , *ENGLISH language writing , *BLADDER cancer - Abstract
Purpose: The recent discovery of the urinary microbiome has led to an emerging field of investigation about the potential role of microorganisms in the pathogenesis of urinary bladder cancer. Few preliminary data have been reported so far implicating urobiome as causative and prognostic factor of bladder tumorigenesis. In the present study, a review of the current evidence is presented about microbiome composition among patients with bladder cancer and healthy individuals as well as possible implications of microbiome on urothelial carcinoma of the bladder. Methods: A literature review was conducted using PubMed/MEDLINE, Scopus, and the Cochrane library until December 2023. Search algorithm was constructed using the following terms and their associated Mesh terms and Boolean operators: "urinary microbiome" and "urinary microbiota". Studies written in English language, identifying, and comparing urinary microbiome among bladder cancer patients and healthy control group were included in the review. Results: A total of 2,356 reports were identified. From this total 16 articles complied with the inclusion criteria were selected for analysis. These articles represent a total of about 486 bladder cancer patients. Conclusion: Recent studies revealed the colonization of the urinary tract and the bladder by micro-organisms using both enhanced culture- and molecular-based techniques for microbial characterization. However, several limitations exist in the literature decreasing the reliability of the current reports. As a result, urinary microbiome consist an ambitious era in bladder cancer research with an increasing number of evidence about its potential pathogenetic, prognostic and therapeutic role. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
76. Simultaneous primary posterior urethral valves ablation and bladder neck incision may decrease kidney and bladder failure in long-term follow-up in patients with bladder neck hypertrophy and poor bladder function at presentation: report of 301 cases.
- Author
-
Sobhani, Soheila, Foroushani, Abbas Rahimi, Arshadi, Hamid, Hekmati, Pooya, and Kajbafzadeh, Abdol-Mohammad
- Subjects
BLADDER obstruction ,KIDNEY failure ,BLADDER ,URETHRAL obstruction ,VALVES ,GASTRIC outlet obstruction ,HYPERTROPHY - Abstract
Objectives: To investigate the effects of bladder neck incision (BNI) and primary valves ablation on long-term kidney and bladder function in children with posterior urethral valves (PUV) and bladder neck hypertrophy (BNH). Patients and methods: From 1997 to 2016, a total of 1381 children with PUV were referred to our tertiary hospital. Of these patients, 301 PUV patients with bladder neck hypertrophy need concurrent BNI and valve ablation. All patients were followed up every 3–6 months on regular basis in first 2 post-surgical years and annually then after. The paired t-test and chi-square test were used to perform statistical analysis with p value < 0.05 defined as the level of significance. Results: Mean age at diagnosis was 7.22 ± 2.45 months (ranging from 7 days to 15 months) with a mean follow-up of 5.12 ± 2.80 years. The incidence of hydronephrosis was decreased from 266 (88.3%) at the baseline to 73 (24.3%) patients in long-term follow-up. At baseline, 188 (62.5%) patients were diagnosed with VUR, which decreased to 20 (6.6%) individuals at the end of follow-up. Bladder and renal function were improved in follow-ups following concomitant PUV ablation and BNI. No Myogenic failure was depicted in all patients with BNH. No ureteric reimplantation was needed during the two decades follow-up. Conclusion: Simultaneous valve ablation with BNI may present further profits in children with PUV and BNH particularly cases of BNH with poor bladder function at the time of presentation. This method can improve the results of urodynamic and imaging studies after the surgery. We hypothesize every child with PUV presentation who has concurrent vesicoureteral reflux, CKD or persistent hydrourethronephrosis may suffer from secondary bladder neck obstruction. This secondary bladder outlet obstruction must be managed through BNI as the surgical relief. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
77. Case report: Treatment response of NF-1-associated bladder ganglioneuroma to trametinib.
- Author
-
Chan, Marcus C. Y., Fung, Kevin K. F., Wai-Fu Ng, Ho-Ming Luk, Ku, Dennis T. L., and Liu, Anthony P. Y.
- Subjects
BLADDER ,MITOGEN-activated protein kinases ,NEUROFIBROMATOSIS ,RAPAMYCIN - Abstract
We present the clinical course of a 4-year-old girl with neurofibromatosis type 1-associated, unresectable, symptomatic urinary bladder ganglioneuroma. She was initially trialed on sirolimus without response and subsequently responded to MEK inhibitor trametinib, with improvement clinically and radiographically over 10 months. This report broadens the repertoire of therapeutic strategies for MEK inhibition in diseases related to the MAPK pathway. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
78. Giant Urinary Bladder in a Woman with Down Syndrome: A Case Report.
- Author
-
Padzel, Syameme, Ariffin, Farnaza, Mohd Yusuf, Salma Yasmin, and Mohamad Ali, Norliana Dalila
- Subjects
- *
BLADDER , *BEHAVIOR modification , *INTERMITTENT urinary catheterization , *OVARIAN tumors , *NEUROGENIC bladder ,PEOPLE with Down syndrome - Abstract
Objective: Unusual clinical course Background: Non-neurogenic neurogenic bladder involves fluctuating flow rates due to involuntary muscle contractions during voiding in those with normal neurological function. The diagnostic challenge lies in distinguishing between massive urinary bladder distension and ovarian tumors. While various pathologies mimicking ovarian tumors are documented, cases of a massively distended urinary bladder, known as giant urinary bladder, posing as such are notably scarce. Case Report: This case report presents the unique clinical scenario of a 31-year-old woman with Down syndrome who was initially misdiagnosed with an ovarian tumor due to progressive abdominal distention, reduced appetite, and weight loss. On presentation, she appeared dehydrated, with an abnormal renal profile. Despite hydration, the renal profile worsened. Initial ultrasound showed a large, uniloculated cystic lesion measuring 11×15 cm in the pelvis. Due to the size of the cyst, which appeared to be ovarian in origin, ovarian tumor was suspected. However, tumor markers were normal. A computed tomography scan subsequently showed a massively distended urinary bladder measuring 11.6×13.6×17.6 cm causing bilateral obstructive uropathy, with moderate hydronephrosis and hydroureter. Needing intermittent catheterization at first, the patient subsequently passed urine on her own following behavioral modification. Conclusions: This rare case of non-neurogenic neurogenic bladder causing a giant urinary bladder in a patient with Down syndrome highlights the importance of an awareness of this condition for effective assessment and patient treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
79. Effects of an exercise intervention in primary care after robot-assisted radical cystectomy for urinary bladder cancer: a randomised controlled trial.
- Author
-
Porserud, Andrea, Karlsson, Patrik, Aly, Markus, Rydwik, Elisabeth, Torikka, Simon, Henningsohn, Lars, Nygren-Bonnier, Malin, and Hagströmer, Maria
- Subjects
- *
EXERCISE physiology , *BLADDER , *PEDOMETERS , *RANDOMIZED controlled trials , *EXERCISE therapy , *BLADDER cancer - Abstract
Introduction: After radical cystectomy physical activity is important to reduce risk of complications, but patients with urinary bladder cancer have difficulties in achieving general recommendations on physical activity and exercise. The aim of this randomised controlled trial was therefore to evaluate the effects of a physical exercise programme in primary care, following discharge from hospital after robot-assisted radical cystectomy for urinary bladder cancer. Materials and Methods: Patients with urinary bladder cancer scheduled for robot-assisted radical cystectomy at Karolinska University Hospital, Sweden between September 2019 and October 2022 were invited to join the study. At discharge, they were randomised to intervention or active control group. The intervention group was planned to start exercise with physiotherapist in primary care during the third week; the programme included aerobic and strengthening exercises, twice a week for 12 weeks, and daily walks. The control group received unsupervised home-based exercise with daily walks and a sit-to-stand exercise. Assessments were conducted before surgery, at discharge and after four months regarding the primary outcome physical function (Six-minute walk test), and secondary outcomes physical activity, pain, health-related quality of life, fatigue, and psychological wellbeing. Results: Ninety patients were included, mean (sd) age 71.5 (8.5) years. An intention-to-treat analysis showed no intervention effect on the primary outcome physical function, or on pain or psychological wellbeing, but effect on physical activity with a difference from discharge to four months with a median (IQR) of 4790 (3000) and 2670 (4340) daily steps in the intervention and control group, respectively (p = 0.046), and for fatigue, and health-related quality of life, in favour of the intervention group. Conclusion: Both the intervention and control groups improved physical function, but the patients who exercised in primary care experienced additional positive effects on physical activity, fatigue, and health-related quality of life. Hence, exercise in primary care after discharge from hospital could be a promising method after radical cystectomy for urinary bladder cancer. Trial registration: The study was registered in Clinical Trials with registration number NCT03998579, 20,190,607. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
80. Early life‐history stages of the olive barb, Systomus sarana (Hamilton), and a key ontogenetic systematic character of Smiliogastrinae.
- Author
-
Lal, Melbin and Anvar Ali, P. H.
- Subjects
- *
LIFE history theory , *YOLK sac , *FISH breeding , *SPAWNING , *OLIVE , *LARVAE , *BLADDER - Abstract
The current study aims to uncover the early life‐history stages of Systomus sarana, a medium‐sized smiliogastrin cyprinid important for aquaculture in South Asia. The fish were effectively bred in captivity by administering 0.25 mL of breeding hormone per kilogram of fish. The spawning occurred 8.54 ± 0.55 h after the injection, and the eggs were phyto‐lithophilic with a pale yellow color and a diameter of 1.49 ± 0.04 mm. Hatching occurred 17 h after fertilization, and the yolk‐sac larvae of 3.43 ± 0.08 mm total length (TL) were adhering to the plant parts and other substrata with the cement glands on the forehead. On the third day, with complete absorption of the yolk sac and the disappearance of the attachment organ, the pre‐flexion larvae measured 5.3 ± 0.11 mm TL. On the eighth day, the flexion larvae measured 6 ± 0.4 mm TL with a well‐inflated posterior swim bladder, and the post‐flexion larvae, at 11 days post‐hatching (dph), developed a two‐chambered gas bladder. The juvenile stage, on day 21 post‐hatching, was marked by the loss of the median finfolds and the appearance of black blotches on the caudal, subdorsal, and supra‐anal regions. The commencement of squamation and the appearance of the rudiments of maxillary barbels distinguished the juvenile stage. The subadults measuring 4.6 ± 0.36 cm TL had finished squamation and completely lost the subdorsal and supra‐anal blotches. We propose that the presence of subdorsal blotches is a distinctive ontogenetic and systematic feature of larval and juvenile forms of smiliogastrin barbs. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
81. Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols.
- Author
-
Guel, Diana Nohemi Briceño, Laverick, Nicola, MacLaren, Linda, MacLeod, Nicholas, Glegg, Martin, Lamb, Gillian, Houston, Peter, Carruthers, Ross, Grocutt, Laura, and Valentine, Ronan M.
- Subjects
- *
BLADDER cancer , *BLADDER , *CANCER invasiveness , *DRUG dosage , *RADIOTHERAPY - Abstract
Background: Radical radiotherapy for muscle-invasive bladder cancer (MIBC) is challenging due to large variations in bladder shape, size and volume during treatment, with drinking protocols often employed to mitigate geometric uncertainties. Utilising adaptive radiotherapy together with CBCT imaging to select a treatment plan that best fits the bladder target and reduce normal tissue irradiation is an attractive option to compensate for anatomical changes. The aim of this retrospective study was to compare a bladder empty (BE) protocol to a bladder filling (BF) protocol with regards to variations in target volumes, plan of the day (PoD) selection and plan dosimetry throughout treatment. Methods: Forty patients were included in the study; twenty were treated with a BE protocol and twenty with a BF protocol to a total prescribed dose of 55 Gy in 20 fractions. Small, medium and large bladder plans were generated using three different CTV to PTV margins. Bladder (CTV) volumes were delineated on planning CTs and online pre-treatment CBCTs. Differences in CTV volumes throughout treatment, plan selection, PTV volumes and resulting dose metrics were compared for both protocols. Results: Mean bladder volume differed significantly on both the planning CTs and online pre-treatment CBCTs between the protocols (p < 0.05). Significant differences in bladder volumes were observed between the planning CT and pre-treatment CBCTs for BF (p < 0.05) but not for BE (p = 0.11). Both protocols saw a significant decrease in bladder volume between first and final treatment fractions (p < 0.05). Medium plans were preferentially selected for BE whilst when using the BF protocol the small plan was chosen most frequently. With no significant change to PTV coverage between the protocols, the volume of body receiving 25.0–45.8 Gy was found to be significantly smaller for BE patients (p < 0.05). Conclusions: This work provides evidence in favour of a BE protocol compared to a BF protocol for radical radiotherapy for MIBC. The smaller treatment volumes observed in the BE protocol led to reduced OAR and total body doses and were also observed to be more consistent throughout the treatment course. These results highlight improvements in dosimetry for patients who undergo a BE protocol for MIBC. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
82. Optimizing hemostasis in HoLEP surgery: retrospective review of selective bipolar plasmakinetic technology guided by bladder irrigation fluid color.
- Author
-
Hu, Hengda, Chen, Wenpu, Ma, Weixiong, Yu, Chengshuai, He, Qirui, Tang, Jinrong, and Yu, Guofeng
- Subjects
- *
IRRIGATION (Medicine) , *HEMOSTASIS , *BLADDER , *RETROSPECTIVE studies , *URINARY catheters - Abstract
Object: To evaluate the effectiveness of selective bipolar plasmakinetic technology based on bladder irrigation fluid color on hemostasis in HoLEP surgwery Methods: A total of 209 patients who underwent HoLEP surgery from October 2021 to July 2023 were included and divided into Hemostasis Management Group and control group. the color of the irrigation fluid was categorized into 5 levels and the bipolar plasmakinetic technology was applied when the color came to level 4 or up. The following was analyzed: postoperative use of balloon compression, blood loss, irrigation time, length of hospital stay, and the number of a second operation. Results: Only 4 patients in Hemostasis Management Group required postoperative urinary catheter balloon compression, while there are 15 in the control group(p=0.03). The average irrigation time for patients in the HM Group with bipolar plasmakinetic hemostasis was 21.88±13.76 hours, compared to that in patients with catheter balloon compression(p=0.007). Conclusion: Based on the bladder irrigation color chart, the selective application of bipolar plasmakinetic hemostasis led to a significant reduction in the number of patients requiring postoperative bladder catheter balloon compression. Secondly, the irrigation time of patients who underwent bipolar plasmakinetic hemostasis also decreased. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
83. Comparison of Wireless Continuous Axillary and Core Temperature Measurement after Major Surgery.
- Author
-
Nathansen, Anders Blom, Mølgaard, Jesper, Meyhoff, Christian Sylvest, and Aasvang, Eske Kvanner
- Subjects
- *
TEMPERATURE measurements , *SKIN temperature , *ABDUCTION (Kinesiology) , *AXILLA , *BLADDER , *BODY temperature , *LOW temperatures , *VITAL signs - Abstract
Background: Temperature is considered one of the primary vital signs for detection of complications such as infections. Continuous wireless real-time axillary temperature monitoring is technologically feasible at the general ward, but no clinical validation studies exist. Methods: This study compared axillary temperature with a urinary bladder thermometer in 40 major abdominal postoperative patients. The primary outcome was changes in axillary temperature registrations. Secondary outcomes were mean bias between the urinary bladder and the axillary temperatures. Intermittent frontal and tympanic temperature recordings were also collected. Results: Forty patients were monitored for 50 min with an average core temperature of 36.8 °C. The mean bias was −1.0 °C (LoA −1.9 to −0) after 5 min, and −0.8 °C (LoA −1.6 to −0.1) after 10 min when comparing the axillary temperature with the urinary bladder temperature. After 20 min, the mean bias was −0.6 °C (LoA −1.3–0.1). During upper arm abduction, the axilla temperature was reduced to −1.6 °C (LoA −2.9 to −0.3) within 1 min. Temporal skin temperature measurement had a resulted in a mean bias of −0.1 °C (LOA −1.1 to −1.0) compared with central temperature. Compared with the mean tympanic temperature, it was −0.1 °C (LoA −0.9 to −1.0) lower than the urinay bladder temperature. Conclusions: Axillary temperature increased with time, reaching a mean bias of 1 °C between axillary and core temperature within 5 min. Opening the axillary resulted in rapidly lower temperature recordings. These findings may aid in use and designing corrections for continuous axillary temperature monitoring. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
84. Intrauterine Contraceptive Device Migrated in the Urinary Tract: Case Report and Extensive Literature Review.
- Author
-
Varlas, Valentin Nicolae, Meianu, Andreea Ioana, Rădoi, Andra Ioana, Balescu, Irina, Bacalbasa, Nicolae, and Varlas, Roxana Georgiana
- Subjects
- *
URINARY organs , *INTRAUTERINE contraceptives , *BLADDER , *LITERATURE reviews , *SIGMOID colon , *PELVIC pain - Abstract
The migration or translocation of an intrauterine device (IUD) in the urinary tract is a rare event. Here, we present the case of a 55-year-old woman who accidentally discovered the ectopic presence of an IUD following a radiological examination for pelvic pain caused by a lumbar discopathy. Over the years, the patient had several IUDs inserted without being able to specify which one had migrated. The removal of the IUD was performed laparoscopically with the minimum resection of the bladder wall and the subsequent cystorrhaphy. The evolution of the patient was favorable. To better analyze these events, we conducted an all-time extensive electronic search of the PubMed database and identified 94 eligible articles, with a total of 115 cases. The literature analysis on the IUD migrations shows either the simultaneous existence of the second IUD or of a maximum number of up to two IUD insertions during the life of patients. Thus, in the presented case, we identified five IUD insertions over time, which explained the chronic inflammatory process by forming an important mass of adherents that included the urinary bladder, uterus, omentum, sigmoid colon, and abdominal wall. Therapeutic management must be adapted to each case depending on the intra/extravesical location of the migrated IUD evaluated by imaging. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
85. Different Neurogenic Bladders in Patients with Cervical and Thoracic Myelopathy: Direct Comparison from a Prospective Case Series.
- Author
-
Kim, Hyoungmin, Chang, Bong-Soon, Park, Sanghyun, Nam, Yunjin, and Chang, Sam Yeol
- Subjects
- *
URINARY organs , *SPINAL cord diseases , *BLADDER , *PROSTATE , *SYMPTOMS , *UROLOGICAL surgery , *CERVICAL spondylotic myelopathy - Abstract
Background/Objectives: This study aimed to identify the unique characteristics of neurogenic bladders and associated symptoms in patients with cervical or thoracic myelopathy using clinical surveys and urodynamic studies (UDSs). Methods: Patients with degenerative cervical (DCM) or thoracic (DTM) myelopathy and lower urinary tract symptoms (LUTSs) scheduled for decompressive surgery were prospectively enrolled. A UDS was performed one day preceding surgery to evaluate the preoperative urological function. Subjective symptoms were evaluated using the International Prostate Symptom Score (IPSS) and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire before surgery and one year postoperatively. Results: Sixty-two patients (DCM: 50, DTM: 12) with a mean age of 63.2 years (men: 30, women: 32) were enrolled. The UDS revealed that 5 (8.1%) patients, all with DCM, exhibited completely normal UDS results, and the remaining 57 had at least one abnormal finding. Based on the International Continence Society classification, an underactive bladder was significantly more common in patients with DTM compared to patients with DCM (75.0% vs. 18.0%, p < 0.001). The results of the questionnaire showed that the voiding symptom IPSS were significantly worse, preoperatively, in patients with DTM (5.0 ± 4.4 [DCM] vs. 8.7 ± 4.5 [DTM]; p = 0.013). One year postoperatively, the IPSS grade of 24.0% of patients with DCM improved, whereas only one (8.3%) patient with DTM showed improvement. Conclusions: Patients with DTM reported worse voiding symptoms and exhibited more underactive bladders on UDS than patients with DCM before decompression. One year postoperatively, more patients with DCM showed subjective improvements in urinary function than those with DTM. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
86. Dual-Energy Computed Tomography in Urological Diseases: A Narrative Review.
- Author
-
Coppola, Andrea, Tessitore, Luigi, Fontana, Federico, Piacentino, Filippo, Recaldini, Chiara, Minenna, Manuela, Capogrosso, Paolo, Minici, Roberto, Laganà, Domenico, Ierardi, Anna Maria, Carrafiello, Gianpaolo, D'Angelo, Fabio, Carcano, Giulio, Cacioppa, Laura Maria, Dehò, Federico, and Venturini, Massimo
- Subjects
- *
POLYCYSTIC kidney disease , *COMPUTED tomography , *BLADDER , *URINARY organ diseases , *URINARY calculi - Abstract
Dual-Energy computed tomography (DECT) with its various advanced techniques, including Virtual Non-Contrast (VNC), effective atomic number (Z-eff) calculation, Z-maps, Iodine Density Index (IDI), and so on, holds great promise in the diagnosis and management of urogenital tumours. In this narrative review, we analyze the current status of knowledge of this technology to provide better lesion characterization, improve the staging accuracy, and give more precise treatment response assessments in relation to urological tumours. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
87. Outcomes and prognostic factors in patients with synchronous and metachronous oligometastatic urothelial carcinoma with visceral metastases.
- Author
-
Yoshida, Soichiro, Maezawa, Yuya, Ishihara, Kensaku, Inoue, Naoki, Tanabe, Kenji, Izumi, Keita, Fujiwara, Motohiro, Toide, Masahiro, Yamamoto, Takanobu, Uehara, Sho, Araki, Saori, Inoue, Masaharu, Takazawa, Ryoji, Numao, Noboru, Ohtsuka, Yukihiro, Tanaka, Hajime, and Fujii, Yasuhisa
- Subjects
- *
TRANSITIONAL cell carcinoma , *PROGNOSIS , *METASTASIS , *OVERALL survival , *BLADDER - Abstract
Objectives Methods Results Conclusions To evaluate the clinical characteristics of oligometastatic disease (OMD) in metastatic urothelial carcinoma (mUC) with visceral metastases when classified into synchronous and metachronous metastases.Of 957 cases of de novo mUC treated between 2008 and 2023, 374 with visceral metastases were analyzed. Cases were classified into OMD with up to three metastatic lesions and polymetastatic disease (PMD), and into synchronous and metachronous metastases. The clinical characteristics and overall survival (OS) for each group were analyzed.Overall, 196 (52.4%) had synchronous metastasis and 178 (47.6%) had metachronous metastasis. Median OS for synchronous metastases was significantly shorter than for metachronous metastases (12.1 months vs. 15.3 months, p = 0.011). Among the synchronous metastases, 48 (24.5%) were OMD and 148 (75.6%) were PMD. There was no significant difference in OS between the OMDs and PMDs (median 14.9 months vs. 11.7 months, p = 0.32), and only decreased albumin level was identified as a significant predictor of poor OS. Among the metachronous metastases, 64 (36.0%) were OMD and 114 (64.0%) were PMD. There was no significant difference in OS between the OMD and PMD (median 21.2 months vs. 15.0 months, p = 0.35), and no significant predictors of poor OS were identified.For mUC with visceral metastases, the timing of metastasis appearance was associated with prognosis, with synchronous metastases being a poorer prognostic factor compared to metachronous metastases. There was no prognostic difference between OMD and PMD with visceral metastases when classified into synchronous or metachronous metastases. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
88. Computational fluid dynamics of bladder voiding using 3D dynamic MRI.
- Author
-
Shahid, Labib, Gonzalez‐Pereira, Juan Pablo, Johnson, Cody, Bushman, Wade, and Roldán‐Alzate, Alejandro
- Subjects
- *
COMPUTATIONAL fluid dynamics , *BLADDER , *MAGNETIC resonance imaging , *URINATION disorders , *BLADDER diseases - Abstract
Over the last couple of decades, image‐based computational fluid dynamics (CFD) has revolutionized cardiovascular research by uncovering hidden features of wall strain, impact of vortices, and its use in treatment planning, as examples, that were simply not evident in the gold‐standard catheterization studies done previously. In the work presented here, we have applied magnetic resonance imaging (MRI)‐based CFD to study bladder voiding and to demonstrate the feasibility and potential of this approach. We used 3D dynamic MRI to image the bladder and urethra during voiding. A surface mesh processing tool was developed to process the bladder wall prior to executing a wall‐motion driven CFD simulation of the bladder and urethra. The obtained flow rate and pressure were used to calculate urodynamic nomograms, which are currently used in the clinical setting to assess bladder voiding dysfunction. These nomograms concluded that our healthy volunteer has an unobstructed bladder and normal contractility. We calculated the work done to void the bladder and propose this as an additional quantitative metric to comprehensively assess bladder function. Further, we discuss the areas that would improve this relatively new methodology of image‐based CFD in urodynamics. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
89. Diagnostic performance of photodynamic diagnosis with oral 5-aminolevulinic acid for upper tract- and bladder urothelial carcinoma: a single-centre, retrospective analysis.
- Author
-
Sano, Takeshi, Yoshida, Takashi, Nakamoto, Takahiro, Ohe, Chisato, Taniguchi, Hisanori, Yanishi, Masaaki, and Kinoshita, Hidefumi
- Subjects
- *
TRANSITIONAL cell carcinoma , *TRANSURETHRAL resection of bladder , *RECEIVER operating characteristic curves , *BLADDER , *DIAGNOSIS - Abstract
Purpose: To compare the diagnostic performance of photodynamic diagnosis (PDD) enhanced with oral 5-aminolaevulinic acid between the suspected upper tract urothelial carcinoma (UTUC) and bladder urothelial carcinoma (BUC) cases. Methods: This retrospective study included 18 patients with suspected UTUC who underwent ureteroscopy (URS) with oral 5-ALA in the PDD-URS cohort between June 2018 and January 2019; and 110 patients with suspected BUC who underwent transurethral resection of bladder tumour (TURBT) in the PDD-TURBT cohort between January 2019 and March 2023. Sixty-three and 708 biopsy samples were collected during diagnostic URS and TURBT, respectively. The diagnostic accuracy of white light (WL) and PDD in the two cohorts was evaluated, and false PDD-positive samples were pathologically re-evaluated. Results: The area under the receiver operating characteristic curve (AUC) of PDD was significantly superior to that of WL in both cohorts. The per biopsy sensitivity, specificity, and positive and negative predictive values of PDD in patients in the PDD-URS and PDD-TURBT cohorts were 91.2 vs. 71.4, 75.9 vs. 75.3, 81.6 vs. 66.3, and 88.0 vs. 79.4%, respectively. The PDD-URS cohort exhibited a higher AUC than did the PDD-TURBT cohort (0.84 vs. 0.73). Seven of four false PDD-positive samples (57.1%) in the PDD-URS cohort showed potential precancerous findings compared with eight of 101 (7.9%) in the PDD-TURBT cohort. Conclusion: The diagnostic performance of PDD in the PDD-URS cohort was at least equivalent to that in the PDD-TURBT cohort. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
90. Human HPSE2 gene transfer ameliorates bladder pathophysiology in a mutant mouse model of urofacial syndrome.
- Author
-
Lopes, Filipa M., Grenier, Celine, Jarvis, Benjamin W., Al Mahdy, Sara, Lène-McKay, Adrian, Gurney, Alison M., Newman, William G., Waddington, Simon N., Woolf, Adrian S., and Roberts, Neil A.
- Subjects
- *
GENETIC transformation , *BLADDER , *HUMAN genes , *LABORATORY mice , *ANIMAL disease models , *CONTRACTILITY (Biology) , *AUTOPSY - Abstract
Rare early-onset lower urinary tract disorders include defects of functional maturation of the bladder. Current treatments do not target the primary pathobiology of these diseases. Some have a monogenic basis, such as urofacial, or Ochoa, syndrome (UFS). Here, the bladder does not empty fully because of incomplete relaxation of its outflow tract, and subsequent urosepsis can cause kidney failure. UFS is associated with biallelic variants of HPSE2, encoding heparanase-2. This protein is detected in pelvic ganglia, autonomic relay stations that innervate the bladder and control voiding. Bladder outflow tracts of Hpse2 mutant mice display impaired neurogenic relaxation. We hypothesized that HPSE2 gene transfer soon after birth would ameliorate this defect and explored an adeno-associated viral (AAV) vector-based approach. AAV9/HPSE2, carrying human HPSE2 driven by CAG, was administered intravenously into neonatal mice. In the third postnatal week, transgene transduction and expression were sought, and ex vivo myography was undertaken to measure bladder function. In mice administered AAV9/HPSE2, the viral genome was detected in pelvic ganglia. Human HPSE2 was expressed and heparanase-2 became detectable in pelvic ganglia of treated mutant mice. On autopsy, wild-type mice had empty bladders, whereas bladders were uniformly distended in mutant mice, a defect ameliorated by AAV9/HPSE2 treatment. Therapeutically, AAV9/HPSE2 significantly ameliorated impaired neurogenic relaxation of Hpse2 mutant bladder outflow tracts. Impaired neurogenic contractility of mutant detrusor smooth muscle was also significantly improved. These results constitute first steps towards curing UFS, a clinically devastating genetic disease featuring a bladder autonomic neuropathy. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
91. The osmoregulated metabolism of trehalose contributes to production of type 1 fimbriae and bladder colonization by extraintestinal Escherichia coli strain BEN2908.
- Author
-
Souza Klemberg, Vivian, Brisotto Pavanelo, Daniel, Houle, Sébastien, Dhakal, Sabin, Pokharel, Pravil, Iahnig-Jacques, Simone, Dozois, Charles M., and Horn, Fabiana
- Subjects
TREHALOSE ,BACTERIAL colonies ,ESCHERICHIA coli ,URINARY tract infections ,BLADDER ,URINARY organs - Abstract
In Escherichia coli, the disaccharide trehalose can be metabolized as a carbon source or be accumulated as an osmoprotectant under osmotic stress. In hypertonic environments, E. coli accumulates trehalose in the cell by synthesis from glucose mediated by the cytosolic enzymes OtsA and OtsB. Trehalose in the periplasm can be hydrolyzed into glucose by the periplasmic trehalase TreA. We have previously shown that a treA mutant of extraintestinal E. coli strain BEN2908 displayed increased resistance to osmotic stress by 0.6 M urea, and reduced production of type 1 fimbriae, reduced invasion of avian fibroblasts, and decreased bladder colonization in a murine model of urinary tract infection. Since loss of TreA likely results in higher periplasmic trehalose concentrations, we wondered if deletion of otsA and otsB genes, which would lead to decreased internal trehalose concentrations, would reduce resistance to stress by 0.6 M urea and promote type 1 fimbriae production. The BEN2908DotsBA mutant was sensitive to osmotic stress by urea, but displayed an even more pronounced reduction in production of type 1 fimbriae, with the consequent reduction in adhesion/invasion of avian fibroblasts and reduced bladder colonization in the murine urinary tract. The BEN2908DtreAotsBA mutant also showed a reduction in production of type 1 fimbriae, but in contrast to the DotsBA mutant, resisted better than the wild type in the presence of urea. We hypothesize that, in BEN2908, resistance to stress by urea would depend on the levels of periplasmic trehalose, but type 1 fimbriae production would be influenced by the levels of cytosolic trehalose. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
92. Evaluation of Flattening Filter-Free RapidArc and Intensity-Modulated Radiation Therapy Techniques for Postoperative Cervical Cancer Treatment.
- Author
-
MANNA, Sumanta, SINGH, Sharad, GUPTA, Pramod Kumar, and T., Ragul
- Subjects
- *
RADIOTHERAPY , *FEMUR head , *RADIATION dosimetry , *CANCER patients , *OPERATIVE surgery , *COMPUTERS in medicine , *BLADDER , *RADIATION doses , *RECTUM ,CERVIX uteri tumors ,PLANNING techniques - Abstract
OBJECTIVE To study the dosimetric characteristics and treatment plan complexity of Intensity-Modulated Radiotherapy (IMRT) and RapidArc (RA) techniques for Flattening Filter (FF) and Flattening Filter-Free (FFF) beams in the treatment of cervical cancer. METHODS A cohort comprising twenty post-operative cervical cancer patients was selected for this study. Four distinct sets of treatment plans were generated utilizing both RA and IMRT techniques employing FFF and FF beams. The dosimetric parameters were subjected to a comprehensive comparison, encompassing considerations such as the coverage of the Planning Target Volume (PTV), Conformity Index, Homogeneity Index, Heterogeneity Index, Gradient Index, Organ at Risk doses, and Peripheral doses. RESULTS The dose-volume parameters exhibited a significant difference in V95 between RA_FF and FFF plans. However, V98 demonstrated a higher percentage of coverage with FF beams for both IMRT and RA planning techniques (p<0.01). IMRT and RA plans resulted in a percentage reduction in V45 for the bladder and rectum with the FFF beam. Furthermore, the FFF beam showed a significant increase in MUs and a significant reduction in V30% for the femoral head for both IMRT and RA plans. No difference was observed in normal tissue sparing with the FFF beam for both techniques. CONCLUSION Dosimetrically, FF and FFF beam plans exhibit comparable target coverage and OAR sparing for postoperative cervical carcinoma using both IMRT and RA techniques. However, in terms of plan quality, RA_FFF plans demonstrate a superior coverage index, conformity, and better sparing of normal tissue compared to IMRT_FFF, except for homogeneity. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
93. Pattern of Expression of MicroRNA in Patients with Radiation-Induced Bladder Injury.
- Author
-
Nakamura, Ko, Ohno, Takaya, Inamoto, Teruo, Takai, Tomoaki, Uchimoto, Taizo, Fukushima, Tatsuo, Nishimura, Kazuki, Yano, Yusuke, Nishio, Kyosuke, Kinoshita, Shoko, Matsunaga, Tomohisa, Nakamori, Keita, Tsutsumi, Takeshi, Tsujino, Takuya, Uehara, Hirofumi, Komura, Kazumasa, Takahara, Kiyoshi, and Azuma, Haruhito
- Subjects
- *
DATA analysis , *MICRORNA , *RADIATION injuries , *RADIATION , *RETROSPECTIVE studies , *TUMOR suppressor genes , *LOG-rank test , *BLADDER , *STATISTICS , *SURVIVAL analysis (Biometry) , *PROPORTIONAL hazards models - Abstract
Introduction: Bladder cancer (BC) is sensitive to radiation treatment and a subset of patients experience radiation-induced injuries including shrinkage of bladder due to bladder fibrosis. Methods: This study is a retrospective cohort study. Three Japanese BC patients were randomly selected. Using a microRNA (miRNA) array, comparing their samples with or without radiation-induced injuries, we have checked the clustering of miRNA expression. Results: Hsa-miR-130a, hsa-miR-200c, hsa-miR-141, and hsa-miR-96 were found to be highly expressed (>50 times) in patients with fibrotic bladder shrinkage (FBS) compared to those with intact bladder (IB) function. In patients with FBS, hsa-miR-6835, hsa-miR-4675, hsa-miR-371a, and hsa-miR-6885 were detected to have lesser than half expression to IB patients. We have analyzed the significance of these genes in relation to overall survival of 409 BC patients retrieved from the Cancer Genome Atlas data set. All available cutoff values between the lower and upper quartiles of expression are used for the selected genes, and false discovery rate using the Benjamini-Hochberg method is computed to correct for multiple hypothesis testing. We have run combined survival analysis of the mean expression of these four miRNAs highly expressed in FBS patients. 175 patients with high expression had a longer median survival of 98.47 months than 23.73 months in 233 patients with low expression (hazard ratio [HR]: 0.53; 0.39–0.72, log-rank p value: 7.3e−0.5). Combination analysis of all 8 genes including hsa-miR-6835, hsa-miR-4675, hsa-miR-371a, and hsa-miR-6885 showed the same HR for OS. Target scanning for these miRNAs matched specific cytokines known as an early biomarker to develop radiation-induced fibrosis. Conclusions: BC patients with fibrotic radiation injury have specific miRNA expression profile targeting profibrotic cytokines and these miRNAs possibly render to favorable survival. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
94. Learning curve for intracorporeal robotic Padua ileal bladder: 10‐year functional assessment from a high‐volume single‐centre series.
- Author
-
Tuderti, Gabriele, Mastroianni, Riccardo, Anceschi, Umberto, Bove, Alfredo Maria, Brassetti, Aldo, Ferriero, Mariaconsiglia, Misuraca, Leonardo, Flammia, Rocco Simone, Proietti, Flavia, D'Annunzio, Simone, Leonardo, Costantino, Guaglianone, Salvatore, Anselmi, Marianna, Zampa, Ashanti, Torregiani, Giulia, Gallucci, Michele, and Simone, Giuseppe
- Subjects
- *
URINARY diversion , *ILEAL conduit surgery , *FUNCTIONAL assessment , *LENGTH of stay in hospitals , *BLADDER , *SURGICAL complications , *REGRESSION analysis - Abstract
Objectives: To assess the impact of the learning curve (LC) on perioperative and long‐term functional outcomes of a consecutive single‐centre series of robot‐assisted radical cystectomy with Padua intracorporeal orthotopic neobladder. Patients and Methods: Patients treated between 2013 and 2022 were included, with ≥1 year of follow‐up. The entire cohort was divided in tertiles. Categorical and continuous variables were compared. Joinpoint regression analysis was used to identify significant changes over the decade in linear slope of the 1‐year day‐ and night‐time continence. Uni‐ and multivariable Cox regression analyses identified predictors of day‐ and night‐time continence recovery. Day‐time continence was defined as 'totally dry' (no pads), night‐time continence as pad wetness ≤50 mL (one safety pad). Results: Overall, 200 patients were included. The mean hospital stay (P = 0.002) and 30‐day complications (P = 0.04) significantly reduced over time; the LC significantly impacted on Trifecta achievement (P < 0.001). The 1‐year day‐ and night‐time continence probabilities displayed a significant improving trend (day‐time continence annual average percentage change [AAPC] 11.45%, P < 0.001; night‐time continence AAPC 10.05%, P = 0.009). The LC was an independent predictor of day‐ (hazard ratio [HR] 1.008; P < 0.001) and night‐time continence (HR 1.004; P = 0.03) over time. Conclusion: Patients at the beginning of the LC had significantly longer hospitalisations, more postoperative complications, and lower Trifecta rates. At the 10‐year analyses, we observed a significant improving trend for both the 1‐year day‐ and night‐time continence probabilities, highlighting the crucial role of the LC. However, we are unable to assess the case volume needed to achieve a plateau in terms of day‐ and night‐time continence rates. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
95. Laparoscopic totally extraperitoneal repair for recurrent inguinal bladder hernia: A case report.
- Author
-
Kitano, Yuto, Okamoto, Koji, Aoki, Tatsuya, Watanabe, Kazuhide, Takehara, Akira, and Shibahara, Kazushige
- Subjects
- *
INGUINAL hernia , *HERNIA surgery , *COMPUTED tomography , *LAPAROSCOPIC surgery , *HERNIA , *BLADDER , *CYSTOTOMY - Abstract
We present a case of a recurrent inguinal bladder hernia that was previously unsuccessfully operated on three times and was repaired using totally extraperitoneal repair (TEP). A 79‐year‐old man presented with a right inguinal swelling that had been treated three times on the same side with anterior approaches. Computed tomography confirmed a recurrent inguinal bladder hernia. TEP was performed after identifying the bladder hernia preoperatively, with previous surgeries that used a plug‐and‐patch technique through an anterior approach. The extraperitoneal approach allowed the bladder to be reduced without injury and the hernia to be safely repaired using a 3D Max® Light Mesh. The postoperative recovery was uneventful, with no recurrence after 1 year. TEP facilitates the diagnosis and repair of bladder hernias, emphasizing the importance of preoperative diagnosis and the efficacy of endoscopic procedures in bladder hernia repair, even in recurrent cases. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
96. Transvesical bladder diverticulectomy via bladder neck opening during robot‐assisted radical prostatectomy.
- Author
-
Hattori, Yuto, Kambe, Takanari, Mine, Yuta, Hagimoto, Hiroki, Kokubun, Hidetoshi, Abe, Yohei, Tsutsumi, Naofumi, Kawakita, Mutsushi, and Yamasaki, Toshinari
- Subjects
- *
RADICAL prostatectomy , *RETROPUBIC prostatectomy , *BLADDER , *SURGICAL robots , *NECK dissection , *BLADDER obstruction , *DIVERTICULUM - Abstract
Introduction: As bladder diverticula in older adults are often secondary to bladder outlet obstruction, bladder diverticulectomy is often performed with prostate treatment. Cases of sequentially performed robot‐assisted bladder diverticulectomy and prostatectomy have been reported; however, performing cystotomy for each procedure may increase the risk of complications and prolong operative time. Materials and Surgical Technique: We reported the cases of three patients who underwent diverticulectomy without additional cystotomy via the bladder opening during robot‐assisted laparoscopic radical prostatectomy in our hospital. Discussion: This technique corresponds to a transvesical approach through the bladder neck opening. Hence, it is especially useful for well‐visualized diverticula close to the ureteral orifice or on the posterior wall. Although other approaches may be better depending on the location of the diverticulum, it is considered a reasonable approach that does not require an additional cystotomy. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
97. Totally retroperitoneal approach for robot‐assisted nephroureterectomy with bladder cuff without repositioning.
- Author
-
Hattori, Yuto, Yamamoto, Akihiro, Nagoshi, Akihiko, Fujiwara, Tasuku, Kambe, Takanari, Igarashi, Atsushi, Akagi, Naoki, Shibasaki, Noboru, Kawakita, Mutsushi, and Yamasaki, Toshinari
- Subjects
- *
SURGICAL robots , *ABDOMINAL surgery , *BLADDER , *LYMPHADENECTOMY , *RETROPERITONEUM , *RETROPUBIC prostatectomy - Abstract
Introduction: Robot‐assisted nephroureterectomy (RANU) for upper urinary tract urothelial carcinoma is typically performed via the transperitoneal approach because of limited surgical space. However, a retroperitoneal approach may be preferable in patients with a history of abdominal surgery or in those in whom pelvic lymph node dissection is unnecessary. Materials and Surgical Techniques: RANU via the retroperitoneal approach was selected for two patients diagnosed with high‐grade upper urothelial carcinoma with a history of abdominal surgery. Nephrectomy was performed in the 90° flank position, and the bed was tilted at 20°. The retroperitoneal space was extended, and the robot trocar was subsequently repositioned in the left lower quadrant. After redocking the robot, the distal ureter was dissected, and the bladder cuff was resected en bloc along with the kidney and the ureter. Neither patient had any complications within 3 months postoperatively. Discussion: By devising a new technique for trocar placement, total retroperitoneal RANU without repositioning was possible, even in a small patient. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
98. Intraoperative bladder visualization by indocyanine green filling and subsequent washout in endoscopic hysterectomy: ICG‐Washout method.
- Author
-
Yoshida Ueno, Akiko, Sato, Takayuki, Namba, Takaomi, Kawase, Fumie, Komatsu, Junko, and Hayashi, Kazutoshi
- Subjects
- *
INDOCYANINE green , *BLADDER , *HYSTERECTOMY , *CYSTOMETRY , *ABDOMINAL surgery , *SALINE solutions - Abstract
Introduction: Despite a potential risk of bladder injury in laparoscopic hysterectomy (LH) and robot‐assisted LH (RaLH), an intraoperative method for delineating the entire bladder with indocyanine green (ICG) has not been established. Methods: We conducted a preliminary experiment using porcine bladders to verify the appropriate amount of ICG for intraoperative bladder visualization. Afterward, intraoperative bladder visualization was tried in LH and RaLH in two patients suspected of having adhesions around the bladder after previous abdominal surgery. Results: Although near‐infrared (NIR) fluorescence was well observed through the wall of the porcine bladder filled with ICG solution at a concentration of 0.024 mg/mL, the subsequent replacement of the ICG solution with saline made the NIR fluorescence brighter. In both patients, the bladder was successfully delineated by NIR fluorescence after filling the bladder with ICG solution and the subsequent washout with saline. Conclusion: The ICG‐Washout method for locating the bladder by NIR fluorescence could be useful in LH and RaLH. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
99. Urinary bladder involvement in IgG4-related disease: A case-based review.
- Author
-
Vijayvergia, Parag, Mukherjee, Sayan, Singh, Lily, and Dhakad, Urmila
- Subjects
- *
GENITOURINARY diseases , *ASPARTATE aminotransferase , *CYTOTOXIC T cells , *BLADDER , *T helper cells , *URINARY tract infections , *PHLEBITIS - Abstract
This article discusses the rare occurrence of urinary bladder involvement in IgG4-related disease (IgG4-RD). It presents a case study of a 39-year-old male who initially presented with urinary symptoms and was suspected to have bladder carcinoma. However, further investigations confirmed the diagnosis of IgG4-RD. The patient was treated with glucocorticoids and showed improvement after one year of follow-up. The article emphasizes the importance of considering IgG4-RD in the differential diagnosis of urinary bladder masses and the need for prompt treatment to minimize damage. [Extracted from the article]
- Published
- 2024
- Full Text
- View/download PDF
100. Kidney, ureter, and urinary bladder segmentation based on non-contrast enhanced computed tomography images using modified U-Net.
- Author
-
Jang, Dong-Hyun, Lee, Juncheol, Jeon, Young-Jin, Yoon, Young Eun, Ahn, Hyungwoo, Kang, Bo-Kyeong, Choi, Won Seok, Oh, Jaehoon, and Lee, Dong Keon
- Subjects
- *
BLADDER , *COMPUTED tomography , *URETERS , *URINARY calculi , *KIDNEYS , *MACHINE learning - Abstract
This study was performed to segment the urinary system as the basis for diagnosing urinary system diseases on non-contrast computed tomography (CT). This study was conducted with images obtained between January 2016 and December 2020. During the study period, non-contrast abdominopelvic CT scans of patients and diagnosed and treated with urinary stones at the emergency departments of two institutions were collected. Region of interest extraction was first performed, and urinary system segmentation was performed using a modified U-Net. Thereafter, fivefold cross-validation was performed to evaluate the robustness of the model performance. In fivefold cross-validation results of the segmentation of the urinary system, the average dice coefficient was 0.8673, and the dice coefficients for each class (kidney, ureter, and urinary bladder) were 0.9651, 0.7172, and 0.9196, respectively. In the test dataset, the average dice coefficient of best performing model in fivefold cross validation for whole urinary system was 0.8623, and the dice coefficients for each class (kidney, ureter, and urinary bladder) were 0.9613, 0.7225, and 0.9032, respectively. The segmentation of the urinary system using the modified U-Net proposed in this study could be the basis for the detection of kidney, ureter, and urinary bladder lesions, such as stones and tumours, through machine learning. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.