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2.
J Ayub Med Coll Abbottabad ; 34(3): 563-565, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36377176

RESUMO

Megalourethra is an infrequent malformation of the anterior urethra that is caused by the lack of corpus sponigosum and in severe cases is accompanied by the lack of corpora cavernosa as well. We report a five-year-old boy presented to us with scaphoid variety of megalourethra having complaints of ballooning of urethra during voiding. He was investigated with urethrogram and cystoscopy and subsequently repaired with Nesbitt Longitudinal Reduction Urethroplasty. He had smooth recovery postoperatively with normal voiding stream on follow up.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Uretra , Humanos , Masculino , Pré-Escolar , Uretra/diagnóstico por imagem , Uretra/cirurgia , Pênis/anormalidades , Procedimentos Cirúrgicos Urológicos , Cistoscopia
3.
J Med Syst ; 46(11): 73, 2022 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-36190581

RESUMO

Processing full-length cystoscopy videos is challenging for documentation and research purposes. We therefore designed a surgeon-guided framework to extract short video clips with bladder lesions for more efficient content navigation and extraction. Screenshots of bladder lesions were captured during transurethral resection of bladder tumor, then manually labeled according to case identification, date, lesion location, imaging modality, and pathology. The framework used the screenshot to search for and extract a corresponding 10-seconds video clip. Each video clip included a one-second space holder with a QR barcode informing the video content. The success of the framework was measured by the secondary use of these short clips and the reduction of storage volume required for video materials. From 86 cases, the framework successfully generated 249 video clips from 230 screenshots, with 14 erroneous video clips from 8 screenshots excluded. The HIPPA-compliant barcodes provided information of video contents with a 100% data completeness. A web-based educational gallery was curated with various diagnostic categories and annotated frame sequences. Compared with the unedited videos, the informative short video clips reduced the storage volume by 99.5%. In conclusion, our framework expedites the generation of visual contents with surgeon's instruction for cystoscopy and potential incorporation of video data towards applications including clinical documentation, education, and research.


Assuntos
Cistoscopia , Neoplasias da Bexiga Urinária , Cistoscopia/métodos , Diagnóstico por Imagem , Documentação , Humanos , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/cirurgia
5.
Biosensors (Basel) ; 12(10)2022 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-36290934

RESUMO

Bladder cancer is a common malignant tumor of the urinary system. Cystoscopy, urine cytology, and CT are the routine diagnostic methods. However, there are some problems such as low sensitivity and difficulty in staging, which must be urgently supplemented by novel diagnostic methods. Surgery, intravesical instillation, systemic chemotherapy, and radiotherapy are the main clinical treatments for bladder cancer. It is difficult for conventional treatment to deal with tumor recurrence, progression and drug resistance. In addition, the treatment agents usually have the defects of poor specific distribution ability to target tumor tissues and side effects. The rapid development of nanomedicine has brought hope for the treatment of bladder cancer in reducing side effects, enhancing tumor inhibition effects, and anti-drug resistance. Overall, we review the new progression of nano-platforms in the diagnosis and treatment of bladder cancer.


Assuntos
Neoplasias da Bexiga Urinária , Humanos , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/terapia , Nanomedicina , Recidiva Local de Neoplasia/diagnóstico , Administração Intravesical , Cistoscopia
6.
World J Urol ; 40(10): 2575-2581, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36048232

RESUMO

PURPOSE: To evaluate the effectiveness of immersive VR distraction technology in alleviating anxiety and pain during flexible cystoscopy. METHODS: We prospectively recruited 270 study participants who qualified for flexible cystoscopy and randomly assigned them to experimental and control groups. The experimental group consisted of 135 patients who employed a VR set during flexible cystoscopy, and the control group consisted of 135 patients who underwent the procedure without a VR set. Patient anxiety was determined quantitatively according to the State-Trait Anxiety Inventory. A visual analog scale for assessing pain intensity, satisfaction, and willingness to repeat the procedure was evaluated. In addition, difference in the hemodynamic parameter was also examined. RESULTS: The study findings demonstrated that the use of a VR set during flexible cystoscopy significantly improved the anxiety level over that of the control group (p = 0.001). Furthermore, this intervention led to a significantly increased level of satisfaction and willingness to repeat the procedure and a decrease in hemodynamic variables, specifically, systolic pressure, diastolic pressure, and heart rate (p = 0.001 in each case). Nonetheless, there were no significant differences between the groups with respect to the basic characteristic data, pain intensity, or oxygen saturation. CONCLUSIONS: Based on the present study, immersive VR can measurably decrease anxiety and increase satisfaction and willingness to repeat the procedure during flexible cystoscopy. TRIAL REGISTRATION DATE: 14 September 2019; number: TCTR20190914002.


Assuntos
Cistoscopia , Realidade Virtual , Ansiedade/etiologia , Ansiedade/prevenção & controle , Cistoscopia/efeitos adversos , Cistoscopia/métodos , Humanos , Medição da Dor , Estudos Prospectivos
7.
Eur J Med Res ; 27(1): 170, 2022 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-36068585

RESUMO

BACKGROUND: Schwannomas can occur in the body where nerve sheaths are present. Genitourinary schwannomas are very rare, especially primary bladder schwannomas. They account for only 0.1% of bladder tumours. The literature reports that simple surgical resection has a good effect and prognosis. CASE PRESENTATION: A 39-year-old man had no significant improvement in symptoms due to frequent urination and urgency for 1 month following the treatment of prostatitis for 2 weeks. Ultrasound and computed tomography (CT) showed a mass in the left side wall of the bladder (size approximately 2.0 × 1.9 cm) that had clear boundaries and protruded outward from the bladder. After the extraperitoneal space was dilated with a balloon, a minimally invasive laparoscopic partial cystectomy was performed in this space to remove the tumour. The pathological diagnosis was bladder schwannoma. Immunohistochemical staining showed that it was strongly S100 protein positive. There was no recurrence after 2 years follow-up by cystoscopy and CT. CONCLUSIONS: Bladder schwannomas are clinically rare benign bladder lesions and no specific clinical manifestations. Laparoscopic partial cystectomy through the extraperitoneal space is a safe and feasible treatment option.


Assuntos
Laparoscopia , Neurilemoma , Neoplasias da Bexiga Urinária , Adulto , Cistectomia/métodos , Cistoscopia , Humanos , Laparoscopia/métodos , Masculino , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Bexiga Urinária/patologia , Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/cirurgia
8.
Urology ; 169: 65-69, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35944653

RESUMO

OBJECTIVES: To evaluate office flexible cystoscopy findings in the evaluation and management of postmenopausal women with recurrent urinary tract infections (RUTIs). METHODS: An IRB-approved, prospectively maintained database of women evaluated for RUTIs at a tertiary care center was retrospectively reviewed by an independent investigator for flexible cystoscopy (FC) findings and related treatment decisions over three consecutive years. Data reviewed in the electronic medical record (EMR) included demographics, UTI history, history of diabetes, hormone replacement therapy (HRT), prior urological surgeries, sexual activity, coital antibiotic prophylaxis use, urine culture findings, antibiotic resistance/allergies, cystoscopy, and treatment plan. RESULTS: Between 2017 and 2019, 113 consecutive postmenopausal women, mostly Caucasian, underwent flexible office cystoscopy to complete their RUTI evaluation. Eighty-four women (74%) had abnormal cystoscopy findings. The rate of overall abnormal findings on cystoscopy increased yearly, including findings of trigonitis (p = 0.022). Other abnormal cystoscopy findings, as well as post-evaluation treatment plans, did not significantly differ over time. Trigonitis was the most common (67%) finding on cystoscopy. RUTI management included exposed urethral/bladder mesh removal and/or electrofulguration of chronic cystitis areas. CONCLUSIONS: Flexible cystoscopy, as an office diagnostic procedure, can provide valuable information of underlying etiology of RUTIs and allow directed management.


Assuntos
Cistite , Infecções Urinárias , Feminino , Humanos , Cistoscopia/efeitos adversos , Cistoscopia/métodos , Estudos Retrospectivos , Pós-Menopausa , Infecções Urinárias/diagnóstico , Infecções Urinárias/terapia , Antibioticoprofilaxia
9.
Medicine (Baltimore) ; 101(34): e30314, 2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36042663

RESUMO

RATIONALE: Bladder calcification is a rare presentation that was first interpreted to be related to a urea-splitting bacterial infection. Aside from infection, other hypotheses such as schistosomiasis, tuberculosis, cancer, and cytokine-induced inflammatory processes have also been reported. Severe coronavirus disease 2019 (COVID-19) is known for its provoking cytokine storm and uninhibited systematic inflammation, and calcification over the coronary artery or lung has been reported as a long-term complication. PATIENT CONCERNS: We presented a 68 years old man who had persistent lower urinary tract symptoms after recovery from severe COVID-19. No urea-splitting bacteria were identified from urine culture. DIAGNOSIS: Cystoscopy examination revealed diffuse bladder mucosal and submucosa calcification. INTERVENTIONS: Transurethral removal of the mucosal calcification with lithotripsy. OUTCOMES: The patient's lower urinary tract symptoms improved, and stone analysis showed 98% calcium phosphate and 2% calcium oxalate. No newly formed calcifications were found at serial follow-up. CONCLUSION: Diffuse bladder calcification may be a urinary tract sequela of COVID-19 infection. Patients with de novo lower urinary tract symptoms after severe COVID-19 should be further investigated.


Assuntos
COVID-19 , Calcinose , Sintomas do Trato Urinário Inferior , Doenças da Bexiga Urinária , Idoso , COVID-19/complicações , Calcinose/complicações , Cistoscopia , Humanos , Sintomas do Trato Urinário Inferior/complicações , Masculino , Sobreviventes , Bexiga Urinária , Doenças da Bexiga Urinária/etiologia
10.
Cytopathology ; 33(6): 716-724, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36004492

RESUMO

BACKGROUND: The ThinPrep® Imaging System (TIS) is a Food and Drug Administration-approved review system for cervical cytopathology, where it has been shown to increase performance over manually reviewed slides. Application of the TIS to urinary cytology has only been reported in a single study, in 2013. METHODS: We aimed to compare the agreement of two cytotechnologists' and a pathologist's manual screening (dots) with the fields of view (FOVs) selected by the TIS. We also aimed to track cases in which the TIS could identify missed abnormals and reduce the false-negative fraction. Electronically marked TIS fields (EMTFs) suspicious for high-grade urothelial carcinoma (SHGUC) were controlled by follow-up cystoscopy and histology, where available. RESULTS: A total of 826 consecutive specimens were studied. Of those, 94 (11.4%) were unreadable by the TIS. There were 710 possible comparisons, of which 380 (53.5%) received no dot after manual screening. Of the 330 remaining slides, 149 (45.1%) had at least one dot matching with the TIS FOVs. After TIS reading, EMTFs were noted in 13 of 636 (2.0%) negative cytology cases. Surveillance showed that 3/13 (23.1%, 0.4% of the 710 possible comparisons) of those cases matched with high grade urothelial carcinoma (HGUC), whereas 6/13 (46.1%, 0.8% of the 710 possible comparisons) had negative follow-up at 24 months, and 4/13 (30.8%) were lost for follow-up. CONCLUSION: The TIS increases the detection rate of SHGUC cells, potentially leading to a slight decrease in the false-negative fraction, but at the expense of a slight but larger increase in the number of false-positive cases. These findings stress the importance of a careful approach to the evaluation of the FOVs.


Assuntos
Carcinoma de Células de Transição , Neoplasias da Bexiga Urinária , Neoplasias Urológicas , Carcinoma de Células de Transição/diagnóstico , Carcinoma de Células de Transição/patologia , Cistoscopia , Citodiagnóstico/métodos , Humanos , Hiperplasia/patologia , Programas de Rastreamento , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/patologia , Neoplasias Urológicas/patologia , Urotélio/patologia
11.
J Vet Intern Med ; 36(5): 1700-1707, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35986564

RESUMO

BACKGROUND: Cystourethroscopy and vaginoscopy (uroendoscopy) is often used in the diagnostic evaluation of dogs with lower urinary tract disorders (LUTD). OBJECTIVE/HYPOTHESIS: To evaluate if uroendoscopy is warranted in dogs with various LUTD, the agreement between uroendoscopic and ultrasonographic diagnoses were compared. Dogs with recurrent urinary tract infections (rUTI) will have the highest diagnostic agreement between uroendoscopy and ultrasonography (US) compared to dogs presenting for other LUTD. ANIMALS: Two hundred thirty-seven dogs presenting between 2014 and 2019 with lower urinary tract signs (LUTS) that had US within 60 days preceding uroendoscopy. METHODS: Retrospective study. Dogs were categorized by primary indication for ultrasound. Pertinent uroendoscopic findings were recorded and agreements (κ analysis) between the final uroendoscopic diagnosis were compared with the final ultrasonographic diagnosis. RESULTS: Pertinent uroendoscopic findings were recorded for 69/237 (29%) cases. For dogs presenting primarily for urinary incontinence (UI), agreement between uroendoscopy and US was 71% (46/65; κ = 0.47, 95% CI 0.28-0.66), for dogs with stranguria, 58% (29/50; κ = 0.47, 95% CI 0.31-0.62) and for dogs with rUTI the agreement was substantial at 87% (26/30; κ = 0.70, 95% CI 0.43-0.98). Urethral strictures were the majority (14/21; 67%) of pertinent uroendoscopic findings for dogs with stranguria, of which 12 were male dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: Agreement between uroendoscopy and US was moderate for all dogs. Based on these data, recommendation for uroendoscopy should be tailored to individual clinical presentation and signalment; transabdominal US is not the preferred modality for urethral lesions.


Assuntos
Doenças do Cão , Incontinência Urinária , Infecções Urinárias , Animais , Cistoscopia/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/patologia , Cães , Feminino , Masculino , Estudos Retrospectivos , Ultrassonografia/veterinária , Bexiga Urinária/patologia , Incontinência Urinária/veterinária , Infecções Urinárias/diagnóstico por imagem , Infecções Urinárias/veterinária
12.
Artigo em Inglês | MEDLINE | ID: mdl-35955004

RESUMO

The aim of this review is to analyze and describe the current landscape of bladder cancer diagnostic and surveillance biomarkers. We researched the literature from 2016 to November 2021 to find the most promising new molecules and divided them into seven different subgroups based on their function and location in the cell. Although cystoscopy and cytology are still the gold standard for diagnosis and surveillance when it comes to bladder cancer (BCa), their cost is quite a burden for national health systems worldwide. Currently, the research is focused on finding a biomarker that has high negative predictive value (NPV) and can exclude with a certainty the presence of the tumor, considering missing it could be disastrous for the patient. Every subgroup has its own advantages and disadvantages; for example, protein biomarkers cost less than genomic ones, but on the other hand, they seem to be less precise. We tried to simplify this complicated topic as much as possible in order to make it comprehensible to doctors and urologists that are not as familiar with it, as well as encourage them to actively participate in ongoing research.


Assuntos
Neoplasias da Bexiga Urinária , Biomarcadores Tumorais/análise , Cistoscopia , Humanos , Valor Preditivo dos Testes , Neoplasias da Bexiga Urinária/diagnóstico , Urologistas
13.
Prog Urol ; 32(12): 813-829, 2022 Oct.
Artigo em Francês | MEDLINE | ID: mdl-36041956

RESUMO

INTRODUCTION: The impact of simulation on the acquisition of surgical skills as well as their transfer to the operating room is still debated. The objective was to assess these two specific points, focusing on the field of endourology. METHODS: A systematic review of the literature, following the PRIMA statement, was performed using Medline database through September 2021 without time limit. Studies focusing on the impact of simulators on the acquisition of surgical technical skills as well as their transfer to the operating room in the field of endourology were included. The endourological procedures were: cystoscopy, ureteroscopy, percutaneous nephrolithotomy, endoscopic treatment of benign prostatic hyperplasia, endoscopic bladder resection. RESULTS: Among the 11,442 publications identified, fifty-two studies were included in the analysis. The majority reported an improvement in procedure time of the requested tasks and dexterity of participants, regardless of the type of simulator and procedure. The level of evidence of included studies was often low. Few studies evaluated the transfer of acquired skills from the simulator to the operating room. CONCLUSION: This review showed the positive impact of simulation on the acquisition of technical skills in endourology. However, in order to include proficiency-based progression in the curriculum of trainees, some parameters such as the choice of reference simulators, choice of tasks, and method of validation of acquired skills must be validated in a consensual manner to offer a quality training.


Assuntos
Competência Clínica , Treinamento por Simulação , Simulação por Computador , Cistoscopia , Humanos , Ureteroscopia
14.
Biosensors (Basel) ; 12(8)2022 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-36005027

RESUMO

Bladder cancer is commonly diagnosed by evaluating the tissue morphology through cystoscopy, and tumor resection is used as the primary treatment approach. However, these methods are limited by lesion site specificity and resection margin, and can thereby fail to detect cancer lesions at early stages. Nevertheless, rapid diagnosis without biopsy may be possible through fluorescence sensing. Herein, we describe a minimally invasive imaging system capable of sensing even small tumors through a 1.2 mm diameter flexible fiber bundle microprobe. We demonstrate that this new device can be used for the early diagnosis of bladder cancer in rats. Bladder cancer was induced in rats using the carcinogen N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN), and a togglable filter capable of PpIX fluorescence sensing was installed in the microendoscopic system. Following 5-aminolevulinic acid administration, tissue in the early stages of bladder cancer was successfully identified with fluorescence detection and confirmed with hematoxylin/eosin and ferrochelatase staining. Although the time required for BBN to induce bladder cancer varied between 3 and 4 weeks among the rats, the microendoscopic system allowed the minimally invasive follow-up on cancer development.


Assuntos
Neoplasias da Bexiga Urinária , Ácido Aminolevulínico , Animais , Carcinógenos , Cistoscopia/métodos , Microscopia de Fluorescência/métodos , Ratos , Neoplasias da Bexiga Urinária/diagnóstico
15.
Int J Mol Sci ; 23(15)2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35955727

RESUMO

The non-muscle invasive bladder cancer tends to recur and progress. Therefore, it requires frequent follow-ups, generating costs and making it one of the most expensive neoplasms. Considering the expensive and invasive character of the current gold-standard diagnostic procedure, white-light cystoscopy, efforts to find an alternative method are ongoing. Although the last decade has seen significant advancements in urinary biomarker tests (UBTs) for bladder cancer, international guidelines have not recommended them. Currently, the paramount urgency is to find and validate the test with the best specificity and sensitivity, which would allow for the optimizing of diagnosis, prognosis, and a treatment plan. This review aims to summarise the up-to-date state of knowledge relating to UBTs and new developments in the detection, prognosis, and surveillance of bladder cancer and their potential applications in clinical practice.


Assuntos
Neoplasias da Bexiga Urinária , Biomarcadores Tumorais , Cistoscopia , Humanos , Biópsia Líquida , Recidiva Local de Neoplasia/patologia , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/patologia
16.
Beijing Da Xue Xue Bao Yi Xue Ban ; 54(4): 669-673, 2022 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-35950390

RESUMO

OBJECTIVE: To determine the optimal cystoscopic frequency for intermediate-risk non-muscle invasive bladder cancer. METHODS: Patients with intermediate-risk non-muscle invasive bladder cancer, who underwent transurethral resection of bladder tumor in Peking University People's Hospital from January 2001 to October 2019, were retrospectively analyzed. Their clinical, pathological and follow-up data were collected. In postoperative 2-year period, the patients were underwent cystoscopy every 3 to 6 months. Depending on recurrence and progression of the patients, we hypothesized three strategies of surveillance intensity in the first 2 years after surgery: model 1: 3-month intervals, model 2: 6-month intervals, and model 3: 12-month intervals. The differences in the numbers and time of delayed detection of recurrence and progression were compared among the three models. RESULTS: A total of 185 patients were enrolled, including 144 males (77.8%) and 41 females (22.2%). The median age was 68 (59-76) years. There were 118 cases (63.8%) with single tumor and 67 cases (36.2%) with multiple tumor. Of the patients 179 (96.8%) had stage Ta and 6 (3.2%) had stage T1. There were 108 cases (58.4%) with high-grade disease and 77 cases (41.6%) with low-grade disease. During the follow-up period of the first 2 years, 52 patients (28.1%) had recurrence, 133 cases (71.9%) had no recurrence, 11 cases (5.9%) had progression and 174 cases (94.1%) had no progression. Compared with model 1, 29 (55.8%) delayed detection of recurrence in model 2 vs. 41 (78.8%) delayed detection of recurrence in model 3, and the difference was statistically significant (P=0.012). The median delayed time of detecting recurrence was 1.00 months in model 1, 1.99 months in model 2 and 4.19 months in model 3, respectively. There were statistically significant differences between mode 1 and model 3 (P=0.001), and between model 2 and model 3 (P=0.013). Compared with model 1, 5 (45.4%) delayed detection of progression in model 2 vs. 8 (72.7%) delayed detection of progression in model 3, and the difference was not statistically significant. The median delayed time of detecting progression was 1.00 month in model 1, 2.00 months in model 2 and 3.00 months in model 3, respectively. There was no statistically significant difference among them. CONCLUSION: Although providing slightly slower detection of tumor recurrence and progression, compared with 3-month intervals of cystoscopy, 6-month intervals do not result in serious adverse outcomes and reduce cost and pain of the patients, which is feasible in intermediate-risk non-muscle invasive bladder cancer.


Assuntos
Cistoscopia , Neoplasias da Bexiga Urinária , Idoso , Progressão da Doença , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia/diagnóstico , Estudos Retrospectivos , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia
17.
J Am Anim Hosp Assoc ; 58(4): 176-179, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35793482

RESUMO

A recessed vulva is a conformational abnormality that predisposes affected dogs to urinary tract infections. An episioplasty can be recommended for correction of this abnormality when medical management of recurrent urinary tract infection fails. The objective of this study was to investigate the type and incidence of urogenital abnormalities visualized by cystoscopy in dogs presenting for episioplasty. Medical records of 29 dogs that presented for an episioplasty and had a concurrent or prior cystoscopy were reviewed. Eleven of the 29 dogs had urogenital abnormalities diagnosed on cystoscopic evaluation, and 1 dog was diagnosed with a urogenital abnormality during vaginal examination while under general anesthesia. Ten of the dogs with urogenital abnormalities had a corrective procedure performed, 8 of which were cystoscopically assisted. Cystoscopy provides the ability to directly visualize the urinary tract and obtain samples for biopsy and culture and facilitates correction of some anatomic abnormalities that may predispose the patient to developing recurrent urinary tract infections. Cystoscopy should be considered as a routine part of a thorough evaluation of the urinary tract in cases presenting for episioplasty.


Assuntos
Doenças do Cão , Anestesia Geral/veterinária , Animais , Biópsia/veterinária , Cistoscopia/veterinária , Doenças do Cão/cirurgia , Cães , Feminino , Procedimentos Neurocirúrgicos/veterinária
18.
Pathol Res Pract ; 237: 153998, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35843032

RESUMO

CONTEXT: In contrast to urothelial cancers, non-urothelial neoplasms involving the bladder are uncommon and often diagnostically challenging. These lesions include a variety of benign and malignant tumors often presenting with a combination of hematuria and the presence of a polypoid lesion at cystoscopy that may lead to an erroneous diagnosis of urothelial cancer. OBJECTIVE: We set out to quantify and classify the spectrum of non-urothelial lesions diagnosed in our institution, and briefly review the relevant literature on each lesion, with a focus on differential diagnosis and potential pitfalls. DESIGN: We performed a retrospective review (Jan 2008 - Jun 2022) of the cases diagnosed on TURB material at our institution. RESULTS: Out of 4071 TURB specimens, a total of 66 (1.62 %) non-urothelial lesions were identified. Most of these lesions were malignant (n = 51, 77 %), with metastases being the most common (n = 40, 60.6 %), followed by non-Hodgkin lymphoma (n = 8, 12 %). The remaining cases were benign lesions (n = 15, 22.7 %), with the most common being inflammatory myofibroblastic tumor (n = 4, 6.1 %) and endometriosis (n = 3, 4.5 %). CONCLUSIONS: In this retrospective case series, we identified various malignant and benign entities, some of which have been rarely reported in the bladder, such as paragangliomas, inflammatory myofibroblastic tumor, and leiomyosarcoma. These lesions may macroscopically and histologically mimic urothelial carcinoma. Because of their relative rarity and diagnostic overlap with conventional urothelial tumors, the pathologist should always keep in the mind the possibility of non-urothelial lesions.


Assuntos
Carcinoma de Células de Transição , Granuloma de Células Plasmáticas , Neoplasias da Bexiga Urinária , Neoplasias Urológicas , Feminino , Humanos , Bexiga Urinária/patologia , Carcinoma de Células de Transição/patologia , Neoplasias da Bexiga Urinária/patologia , Estudos Retrospectivos , Cistoscopia , Neoplasias Urológicas/patologia , Granuloma de Células Plasmáticas/patologia
20.
BMC Urol ; 22(1): 98, 2022 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-35794598

RESUMO

BACKGROUND: Lower urinary tract symptoms are very common in elderly women, and transvaginal delivery and multiple deliveries have been confirmed to be risk factors. Transvaginal delivery and multiple deliveries may lead to an increase in pubic symphysis degeneration. CASE PRESENTATION: A 79-year-old woman consulted a urologist because of worsening lower urinary tract symptoms such as frequent urination and urodynia. Color ultrasound and cystoscopy suggested the possibility of a bladder mass. A lump on the anterior wall of the bladder was observed although the surface mucosa was normal. Physical examination showed obvious tenderness in the posterior area of the pubic symphysis. Further urological computed tomography (CT) and pelvic magnetic resonance imaging (MRI) showed a nodular bony protuberance in the posterior part of the pubic symphysis, which was more obvious than before, with compression changes near the anterior wall of bladder. Open pelvic surgery showed that nodular bone tissue originating from the pubic symphysis significantly oppressed the anterior wall of the bladder behind the pubic symphysis. After resection of the nodule, the lower urinary tract symptoms were relieved significantly. CONCLUSIONS: Pubic symphysis degeneration caused by transvaginal delivery may be an important cause of lower urinary tract symptoms in women. Pelvic CT or MRI is necessary to diagnosis this condition.


Assuntos
Sintomas do Trato Urinário Inferior , Sínfise Pubiana , Idoso , Cistoscopia , Feminino , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Imageamento por Ressonância Magnética/métodos , Sínfise Pubiana/diagnóstico por imagem , Tomografia Computadorizada por Raios X
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