Changing pattern of epidimiology and histopathology of bfadder cancer in Egypt

To estimate the changes in the epidimiology and histopathology of bladder cancer in rural and urban areas and their impact on the treatment prognosis. Seventy cases of bladder cancer at different stages from a rural area [El Minoufiya] were tabulated according to the age, the sex and the histopatho/ogic types. Of the.seventy pateints included 57 pateints [81.4%] were invasive [T2T3T4] and subjected to radical cystectomy at Tala Central Hospital and Shebin El Kom Teaching Hospital, group I [the rural group]. Those [57] pateints were compared with [58] pateints with invasive bladder cancer [T2, T3, T4] from a mixed area who underwent radical cystectomy in the urology department, Kasr El Ainy Hospital, group II [the mixed group]. The age of the patients included ranged between 30-83 [57.82 +/- 11.8] years and 25-82 [56.68 +/- 11.2] years in group l andll respectively with a significant increase in the age incidence than in the past. The male to female ratio was [4.6:1] in group I and [4.2:1] in group II which is higher than the known ratio of about [2.7 : 1]. The percentage of pateints according to the histopathology was as follows: Transitional Cell Carcinoma was 57.9% and 50% in group I and II, while Squamous Cell Carcinoma was 31.6% and 46.55% in group I and II respectively. The lymph node invasion was 26.3% in group I and 15.5% in group II. The bladder cancer epidemilogy and histopathology in Egypt, both in rural and urban areas has changed in the last decades not only due to decreased incidence of bilharzial infection and increased age incidence but also due to the wide exposure to different types of enviromental carcinogens

Transvaginal ureterolithotomy experience with five cases

To find out a short and safe way to the lower ureters through the anterior vaginal wall especially in the multiparous women. Five multiparous women with lower ureteric stones [2] left-sided and [3] right-sided. In four cases the stones were single, but one of the right cases was multiple. The size of the stones ranged between 12 mm to 20 mm. in the long diameter. In the lithotomy position and through the anterior vaginal wall, the stones has been reached, extracted and the ureters were closed with indwelling stents. The anterior vaginal wall was closed without drain. In four patients the procedure was generally without troubles but in one patient -at the beginning of the operation- and during vaginal examination, the stone dislodged up and the procedure was aborted. The operative time was reasonable and the postoperative course was as a rule without complications. The immediate and long-term results of the operation are satisfactory. Transvaginal ureterolithotomy is an easy and safe operation for extraction of fixed stones from the lower ureter in multiparous women. The operation is very beneficial in recurrent and/or obese women. The post operative period was very smooth without complications. The operation is very economic and can be done on an outpatient basis