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Background. Although both nonfunctional paraganglioma of the bladder (NPB) and urothelial carcinoma of the bladder (UCB) are subtypes of bladder tumors, they are entirely different entities with distinct tissue origins and anatomical locations. However, NPB is frequently misdiagnosed as UCB chiefly due to the similarities in their clinical characteristics and cystoscopic features. This study aimed to compare the differences in their clinical characteristics and cystoscopic features. Patients and Methods. Between April 2007 and September 2017, 14 patients with NPB (NPB group) were retrieved from 2 centers, and 42 patients with new-onset UCB (UCB group) were randomly retrieved. Demographic, symptomatic, imaging, and cystoscopic data of patients in both groups were collected and compared. Results. NPB group comprised 7 males and 7 females, with a mean age of 43.1 ± 13.6 years. Compared with the UCB group, patients in the NPB group were significantly younger (p<0.001), less likely to be male (p<0.05), and to present with hematuria (p<0.01). However, no significant difference in maximum tumor diameter was observed between the 2 groups (p=0.609). Compared with the UCB group, cystoscopically, patients in the NPB group were significantly more likely to present with hypervascularization but less likely to present with hemorrhage, necrosis, calcification, pedunculation, and multilesion (p<0.05). No patients with NPB were clinically diagnosed correctly before cystoscopy. Of the 5 patients who underwent both cystoscopy and biopsy, 4 were diagnosed with NPB, while 1 remained undiagnosed. Of the remaining 9 patients who underwent cystoscopy only, 5 were diagnosed with nonepithelial tumor, and 4 were misdiagnosed with UCB. Conclusions. Age, sex, and hematuria may provide clues to differentiating NPB from UCB. Differences in cystoscopic features between NPB and UCB are of high diagnostic value. Cystoscopic biopsy should be considered in the preoperative diagnosis of NPB. [ABSTRACT FROM AUTHOR]

Objectives: Paragangliomas of the urinary bladder (PUBs) are challenging catecholamine-producing neuroendocrine tumors. We aimed to facilitate their diagnosis and treatment by functional and anatomical classifications.Materials and Methods: Between April 2007 and September 2017, 31 cases from 2 centers were retrieved, in which the patients were pathologically diagnosed with PUB. Besides classifying them into functional and nonfunctional PUBs, functional PUBs were further subclassified into typical functional PUB (with typical symptoms and elevated catecholamines/metabolites levels) and atypical functional PUB. Anatomically, they were classified into submucosal, intramural, and subserosal PUBs.Results: Functionally, these cases comprised 17 (54.8%) functional and 14 (45.2%) nonfunctional PUBs. Functional PUBs had significantly larger diameters than nonfunctional PUBs (P < 0.01). Of the 17 functional PUB cases, 8 were further subclassified into typical functional PUB, of which 4 were diagnosed without cystoscopy. Anatomically, these cases comprised 14 (45.2%) submucosal, 13 (41.9%) intramural, and 4 (12.9%) subserosal PUBs. Intramural and subserosal PUBs had significantly larger diameters and were more likely to be functional than submucosal PUBs (P < 0.05). Cystoscopy failed to detect the tumor in all patients with subserosal PUB. Besides all patients with intramural or subserosal PUB, 1 patient with submucosal PUB underwent partial cystectomy. The remaining 13 patients with submucosal PUB underwent transurethral resection of bladder tumor, 5 of whom required extra surgical intervention.Conclusions: By functional classification, omitting cystoscopy is feasible in the diagnosis of typical functional PUBs. By anatomical classification, intramural, and subserosal PUBs tend to be large and functional. Moreover, negative cystoscopic findings are not sufficient to exclude subserosal PUBs. Finally, not all submucosal PUBs are amenable to transurethral resection of bladder tumor. [ABSTRACT FROM AUTHOR]

Background: Cutis laxa is a connective tissue disease characterized by loose, wrinkled, and redundant skin. It is either inherited or acquired. In most cases, acquired cutis laxa is associated with neoplasms, drugs, and autoimmune diseases. We present a rare case of acquired cutis laxa following a recurrent urticaria-like eruption in the absence of an autoimmune disease, neoplasm, drugs and or syndrome. Case presentation: We report a case of a 45-year-old Chinese lady with a 1-year history of widespread pruritic urticarial eruption and a 6-month history of progressive skin wrinkling. On examination, the patient appeared older than her actual age, with apparent wrinkling on the mid-torso with generalized smooth, erythematous macules and wheals. A family history of similar conditions was absent. Biopsy revealed hypersensitivity and atrophy. Following the Food and Drug Administration (FDA) guidelines, we administered antihistamines, which relieved the itching, but her hyperpigmentation and cutis laxa never improved. Conclusion: Our case shows that the decrease of elastic fibers may be associated with the infiltration of inflammatory cells in the dermis. This supports the hypothesis that chemical mediators may play a major role in the destruction of elastic fibers, thus causing cutis laxa. In addition, we advise practitioners to take a complete clinical and family history to determine if the condition is inherited or acquired. [ABSTRACT FROM AUTHOR]

Purpose: NTrap® stone entrapment and extraction device (NTrap®) is a device used to extract and remove stones from the urinary tract and to minimize retrograde stone migration during ureterolithotripsy (URS). This study aimed to evaluate the efficacy and safety of NTrap® in URS.Methods: From Jan 2014 to June 2017, 148 patients underwent URS with the aid of NTrap® (Group A), and 209 patients underwent standard URS without any anti-retropulsion device (Group B). Their demographics, operation time, complications, stone migration rate, and stone-free rate (SFR) were recorded for comparison.Results: Compared with group B, Group A had a significantly shorter operative and lasering time (P = 0.003, P<0.001, respectively). There was no significant difference between the 2 groups in overall complications, a decrease in mean hemoglobin, and length of stay (LOS) (P = 0.426, P = 0.097, P = 0.058, respectively). The incidence of stone migration was significantly lower in Group A than Group B (P = 0.035). The postoperative auxiliary procedure rate (in patients with stones retropulsion during the operation) was significantly lower in Group A compared to Group B (P = 0.024). The SFR was considerably higher in Group A than Group B (P = 0.009).Conclusion: URS, with the aid of NTrap®, is an effective and safe method for treating ureteric stones. It may prevent stones from retropulsion and shorten the operative time. [ABSTRACT FROM AUTHOR]

Metatropic dysplasia (MD), is a rare skeletal dysplasia occurring predominantly in infants characterized by a distinctive long torso and short limbs; it is as a result of mutations in the TRPV4 gene. However, a clear distinction between various forms of skeletal dysplasias caused by the transient receptor potential vanilloid 4 (TRPV4) gene is difficult but could be achieved by a combination of gene sequencing, medical and radiological criteria. We hereby report a case of a 14‐month old girl who presented with an abnormal stature. The diagnosis of nonlethal MD was confirmed by X‐ray with dumbbell‐shaped long bones, platyspondyly, and delayed carpal ossification, as well as broadened pelvis with marginally widened ilia, epiphyseal plates, and slightly flattened acetabula. Furthermore, gene sequencing confirmed gene mutation on exon 15 of the TRPV4 gene with a heterozygous missense mutation (c.2396C > T), but no mutation was present in her parents. Our findings recorded metatropic dysplasia with the c.2396C > T mutation in the TRPV4 gene in China. This mutation caused changes in amino acid of TRPV4, which can induce growth retardation in children. [ABSTRACT FROM AUTHOR]

The transurethral resection of bladder tumor (TURBT) remains the most widely used method in the surgical treatment of the non-muscle invasive bladder tumor (NMIBT). Despite its popularity, the laser technique has been widely used in urology as an alternative, via the application of transurethral laser enucleation of bladder tumor. The aim of the present study was to compare the efficacy and feasibility between transurethral laser enucleation and transurethral resection of bladder tumor. A systematic search of the following databases was conducted: PubMed, Wed of Science, Cochrane Library, EMBASE, Google scholar, and Medline. The search included studies up to the 1st of January 2017. The outcomes of interest that were used in order to assess the two techniques included operation time, catheterization time, hospitalization time, obturator nerve reflex, bladder perforation, bladder irritation, 24-month-recurrence rate, and the postoperative adjuvant intravesical chemotherapy. A total of 13 trials with 2012 participants were included, of which 975 and 1037 underwent transurethral laser enucleation and transurethral resection of bladder tumor, respectively. No significant difference was noted in the operation time between the two groups, although significant differences were reported for the variables catheterization time, hospitalization time, obturator nerve reflex, bladder perforation, bladder irritation, and 24-month-recurrence rate. In the mitomycin and epirubicin subgroups, no significant differences were observed in the laser enucleation and TURBT methods with regard to the 24-month-recurrence rate. The laser enucleation was superior to TURBT with regard to the parameters obturator nerve reflex, bladder perforation, catheterization time, hospitalization time, and 24-month-recurrence rate. Moreover, laser enucleation can offer a more accurate result of the tumor's pathological stage and grade. [ABSTRACT FROM AUTHOR]