RESUMEN
A 76-year-old man was seen at this hospital for the treatment of asymptomatic gross hematuria. Retrograde pyelography revealed a filling defect in the left lower calyx. The diagnosis was left renal pelvic carcinoma by urinary cytology. The patient underwent left nephrouretectomy with partial cystectomy. Hemosiderin accumulation on histological examination demonstrated an arteriovenous malformation in the left lower calyx. Transitional cell carcinoma was confirmed apart from the arteriovenous malformation, and no relation between the two was seen. These findings suggest the coexistence of a renal arteriovenous malformation with a renal pelvic and ureteral carcinoma. Hematuria was due probably to rupture of the renal arteriovenous malformation.
Asunto(s)
Malformaciones Arteriovenosas/complicaciones , Carcinoma de Células Transicionales/complicaciones , Neoplasias Renales/complicaciones , Pelvis Renal , Neoplasias Primarias Múltiples , Arteria Renal/anomalías , Venas Renales/anomalías , Neoplasias Ureterales/complicaciones , Anciano , Carcinoma de Células Transicionales/cirugía , Hematuria/etiología , Humanos , Neoplasias Renales/cirugía , Masculino , Rotura Espontánea , Neoplasias Ureterales/cirugíaRESUMEN
It has been considered that the urethral obstruction influence the function and the nerve innervation of the bladder. In this study, the changes in the bladder function and the nerve growth factor (NGF) synthesized in the bladder were systematically analyzed both during partial urethral obstruction and after its relief in the rat. The maximum contraction pressure was temporally decreased and then increased 1.5 times of the normal level 6 week after the obstruction. NGF in the bladder, measured by ELISA method, was rapidly increased 5 times of the normal level 1 day after the obstruction. It gradually decreased 2 weeks after the obstruction but did not recover to the normal level. The maximum contraction pressure and the bladder NGF recovered to the normal level after the removal of 1 to 6 weeks obstruction. These results suggest that partial urethral obstruction reversibly increases the contractility and the NGF synthesis of the bladder.