The influence of distal colon irritation on the changes of cystometry parameters to esophagus and colon distentions

ABSTRACT The co-occurrence of multiple pathologies in the pelvic viscera in the same patient, such as, irritable bowel syndrome and interstitial cystitis, indicates the complexity of viscero-visceral interactions and the necessity to study these interactions under multiple pathological conditions. In the present study, the effect of distal colon irritation (DCI) on the urinary bladder interaction with distal esophagus distention (DED), distal colon distention (DCD), and electrical stimulation of the abdominal branches of vagus nerve (abd-vagus) were investigated using cystometry parameters. The DCI significantly decreased the intercontraction time (ICT) by decreasing the storage time (ST); nonetheless, DED and Abd-vagus were still able to significantly decrease the ICT and ST following DCI. However, DCD had no effect on ICT following the DCI. The DCI, also, significantly decreased the Intravesical pressure amplitude (P-amplitude) by increasing the resting pressure (RP). Although DED has no effect on the P-amplitude, both in the intact and the irritated animals, the abd-vagus significantly increased the P-amplitude following DCI by increasing the maximum pressure (MP). In the contrary, 3mL DCD significantly increased the P-amplitude by increasing the MP and lost that effect following the DCI. Concerning the pressure threshold (PT), none of the stimuli had any significant changes in the intact animals. However, DCI significantly decreased the PT, also, the abd-vagus and 3mL DCD significantly decreased the PT. The results of this study indicate that chemical irritation of colon complicates the effects of mechanical irritation of esophagus and colon on urinary bladder function.

Cistectomia com reconstrução de neobexiga ortotópica ileal para tratamento de bexiga contraída após aplicação de bacilo de Calmette-Guérin intravesical / Cystectomy with orthotopic ileal neobladder reconstruction for treatment of bladder contracture after intravesical bacillus Calmette-Guerin therapy

O câncer de bexiga é um importante problema de saúde mundial, tanto pelas elevadas taxas de prevalência, quanto pelos custos relacionados ao tratamento. Desde a introdução da imunoterapia intravesical adjuvante com bacilo Calmette-Guérin, vem sendo observada diminuição na taxa de recorrência. As principais complicações são de pequeno porte e simples resolução a partir de medidas locais e orientações. A bexiga contraída, uma complicação local rara e grave, mas incapacitante em alguns casos, é observada principalmente em doentes com um programa de manutenção. Relatamos aqui o caso de um paciente masculino submetido a ressecção transuretral da bexiga por um carcinoma urotelial T1 de alto grau, que desenvolveu tal complicação durante tratamento com bacilo Calmette-Guérin, sendo portanto submetido à cistoprostatectomia com realização de neobexiga ortotópica ileal.

Bladder cancer is an important health problem worldwide due to high prevalence rates and costs related to treatment. A reduction in recurrence rates has been observed since the introduction of adjuvant intravesical immunotherapy with bacillus Calmette-Guerin. There are mild complications that are easily solved by local measures and orientations. Bladder contracture, a rare and severe local complication, in some cases leading to disability, is observed primarily in patients in a maintenance program. In this article we reported the case of a male patient who underwent transurethral resection of the bladder because of a high-grade T1 urothelial carcinoma and developed this complication during treatment with bacillus Calmette-Guerin. For this reason he was submitted to cystoprostatectomy with orthotopic ileal neobladder reconstruction.

A new problem in inflammatory bladder diseases: Use of mobile phones!

Purpose Technological developments provide a lot of conveniences to our lives. This issue is one of the risks that arise along with these conveniences. In our study we tried to understand the impact of electromagnetic waves from mobile phones on bladder tissue. Materials and Methods Twenty-one adult male albino rats were divided into three equal groups. Group 1 was exposed to electromagnetic wave for 8 hours per day for 20 days and then their bladders were taken off immediately. Group 2 was firstly exposed to electromagnetic wave for 8 hours per day for 20 days then secondly another for 20 days without exposition to electromagnetic wave and then their bladders were taken off. Group 3 was the control group and they were not exposed to electromagnetic wave. Results Under microscopic examination of bladder tissue, in the first group severe inflammatory cell infiltration was seen in lamina propria and muscle layer in contrast to intact urothelium. In the second group mild inflammatory cell infiltration was seen in lamina propria and muscle layer. The mean scores for the three groups were 5.5 ± 2.5, 0.8 ± 1.3 and 1.2 ± 1.5 respectively. Mean score of group 1 was statistically higher than others (p = 0.001). Conclusion Intensive use of mobile phones has negative impact on bladder tissue as well as the other organs. Keeping a minimum level of mobile phone use makes it easy to be kept under control of diseases in which inflammation is an etiologic factor. .

Chronic partial urethral obstruction in female rats: description of an experimental model and initial results / Obstrução parcial uretral crônica em ratos: descrição de um modelo experimental e resultados iniciais

PURPOSE: To develop an experimental model of infravesical urinary obstruction in female rats. METHODS: After median caudal laparotomy, the urethra of 14 female rats was delicately separated from the vagina and loosely wrapped with cellophane tape measuring 0.4 x 1.0 cm. The animals were evaluated 4 (n=7) and 8 (n=7) weeks later. Five additional control animals were only subjected to separation of the urethra and vagina and monitored for 12 weeks. RESULTS: After four weeks, three rats presented vesical dilation associated with discrete ureteral ectasis in 2 animals, with the third presenting discrete hydronephrosis in one kidney. After eight weeks, five rats (71.4 percent) presented vesical distension with bilateral ureterohydronephrosis. No significant changes (p>0.05) in serum urea or creatinine occurred in any group compared to preoperative values. CONCLUSION: We present here an inexpensive and simple method for the slow induction of urethral obstruction in adult female rats, with the development of progressive vesical hypertrophy and ureterohydronephrosis, which may be used as an experimental model for the study of different aspects of obstructive nephropathy.

OBJETIVO: Desenvolver modelo experimental de obstrução urinária infravesical em ratas. MÉTODOS: Após laparotomia caudal mediana, as uretras de 14 ratas foram delicadamente separadas da vagina e frouxamente envoltas com fita de celofane medindo 0.4 x 1.0 cm. Os animais foram avaliados 4 (n=7) e 8 (n=7) semanas depois. Cinco animais adicionais (controle) foram submetidos apenas à separação da uretra e da vagina e monitoradas por 12 semanas. RESULTADOS: Após quatro semanas, três ratas apresentaram dilatação vesical associada a discreta ectasia ureteral em 2 animais, com o terceiro apresentando discreta hidronefrose em um rim. Após oito semanas, cinco ratas (71.4 por cento) apresentaram distensão vesical com ureterohidronefrose bilateral. Não ocorreram alterações significativas (p>0.05) nos valores de uréia ou creatinina em qualquer grupo, comparado com valores pré-operatórios. CONCLUSÃO: Apresentamos aqui um método barato e simples para a indução lenta de obstrução uretral em ratas adultas, com desenvolvimento progressivo de hipertrofia vesical e ureterohidronefrose, podendo ser utilizado como modelo experimental para estudo de diferentes aspectos da nefropatia obstrutiva.

Prognostic factors for late urinary toxicity grade 2-3 after conformal radiation therapy on patients with prostate cancer

OBJECTIVE: Identify prognostic factors associated to late urinary toxicity in patients with prostate cancer submitted to radical conformal radiotherapy (3DCRT) MATERIALS AND METHODS: From July 1997 to January 2002, 285 patients with localized prostate cancer were consecutively treated with 3DCRT and retrospectively analyzed. Thirty seven (13 percent) patients were submitted to transurethral prostate resection previously to 3DCRT. The median dose delivered to the prostate was 7920 cGy (7020-8460). Patient and treatment characteristics were analyzed and correlated to late urinary toxicity grade 2-3, especially whether certain radiation doses applied to certain bladder volumes, when visualized through computerized tomography (CT) planning, correlated with the observed actuarial incidences of late urinary complications, using bladder volume as a continuous variable RESULTS: On a median follow-up of 53.6 months (3.6-95.3), the 5-year actuarial free from late urinary toxicity grade 2-3 survival was 91.1 percent. Seven and fifteen patients presented late urinary toxicity grades 2 and 3, respectively. Prior transurethral resection of prostate and radiation dose over 70 Gy on 30 percent of initial bladder volume were independent prognostic factors for late urinary toxicity grade 2-3 CONCLUSIONS: This study suggests that restricting radiation doses to 70 Gy or less on 30 percent of bladder volume, visualized through CT planning, may reduce late urinary complications. It furthermore suggests that patients with prior transurethral resection of prostate may indicate a group of patients with a greater risk for late urinary toxicity grade 2-3 after 3DCRT.

Infantile bladder rupture during voiding cystourethrography

Bladder rupture is rare during infancy and most of reported cases had urethral obstruction or neurogenic bladder. We report two cases of infantile bladder rupture during voiding cystourethrography (VCUG). This report reinforces the criteria for proper VCUG imaging procedure. Consideration of expected bladder volume for body weight, and close monitoring of bladder pressure and injection speed could prevent such complications.

Actualidad en el diagnóstico y manejo del acretismo placentario / Update on the diagnosis and treatment of placenta accreta

El acretismo placentario es una entidad que incrementa considerablemente la morbimortalidad materna y fetal. Gracias al advenimiento de nuevos métodos diagnósticos como la resonancia magnética, la cistoscopia, los marcadores séricos, el ultrasonido doppler, etc., el diagnóstico prenatal es factible. El manejo del acretismo placentario de forma tradicional supone la realización de histerectomía multidisciplinaria, involucrando a cirujanos generales, oncoginecólogos o uroginecólogos. Algunos autores han propuesto al manejo conservador como una solución adecuada en ciertos casos, ya sea con el uso de diversos medicamentos que incluyen quimioterápicos o bien de forma expectante. Sin embargo, aún no existe evidencia sólida que determine si el manejo conservador o tradicional es el mejor.

Placenta accreta supposes a special situation that increases the fetal and maternal mo rb i mortality of considerable form. Thanks all new arrival methods as the image of magnetic resonance, the cystoscopy, serum markers, doppler ultrasound, etc., the prenatal diagnostic is feasible. The management of placenta accreta of traditional form supposes a multidisciplinary approach form hysterectomy execution, involving general surgeons, oncogynecologist or urogynecologist. Some authors have proposed the conservative management as an adequate solution in certain cases, whether with the use of several drugs including chemotherapy or expectant form. Nevertheless, not yet solid evidence exists if the surgical traditional approach or the conservative management is the best option.

Cinta suburetral transobturatriz (TOT) en la incontinencia urinaria de esfuerzo: continencia a mediano plazo y evolución de los síntomas irritativos vesicales / Transobturator tape (TOT) for stress urinary incontinence

Objetivos: Evaluar la continencia urinaria a mediano plazo en las pacientes sometidas a cirugía de incontinencia urinaria con cinta suburetral transobturatriz (TOT) y comparar esta técnica con la técnica de Burch, Marion y puntos de Kelly. Método Evaluación prospectiva de 74 pacientes con incontinencia urinaria de esfuerzo sometidas a alguna de las técnicas señaladas entre Octubre de 2003 y Mayo de 2005 en el Hospital Parroquial de San Bernardo. Se realizó TOT en 52, Burch en 9, Marion en 9 y Kelly en 4 pacientes. Las pacientes fueron evaluadas en el seguimiento post operatorio por un médico diferente al que realizó la cirugía. Resultados: El seguimiento promedio para el TOT fue 10,6, Burch 14,8, Marion 11,3 y Kelly 8,6 meses. La continencia total o parcial fue para TOT 88 por ciento, Burch 77 por ciento, Marion 62 por ciento y Kelly 75 por ciento. La continencia a 18 meses para el TOT fue de 80 por ciento, Burch 71 por ciento y Marion 40 por ciento. Las pacientes que se sometieron sólo a TOT mantienen la continencia urinaria en un 100 por ciento, significativamente mejor al 81,9 por ciento de las que se sometieron a otro procedimiento quirúrgico asociado. La urgencia miccional desapareció en el TOT en 82 por ciento, Burch 66 por ciento, Marion 71 por ciento y Kelly en el 100 por ciento de las pacientes. La urgencia de novo apareció con TOT en 12 por ciento, Burch 33 por ciento y en ninguna paciente del grupo de Marion o Kelly. Conclusiones: La técnica de TOT tiene excelentes resultados sobre la continencia a mediano plazo y esta se logra con más frecuencia cuando se realizó como procedimiento único. Los síntomas irritativos vesicales ceden en un porcentaje importante de pacientes, independiente de la técnica utilizada.

Objectives: Medium term evaluation of urinary incontinence in patients treated with transobturator tape (TOT) compared to Burch. Marion and Kelly technique. Method: Prospective evaluation of 74 patients with stress urinary incontinence, treated with the mentioned techniques between October 2003 and May 2005 at Hospital Parroquial of San Bernardo. There were 52 TOT, 9 Burch, 9 Marion and 4 Kelly surgeries performed. Patients were all evaluated by other physician different from the one who made the procedure. flesu/fs;The patients were followed up for an average of 10.6 months for TOT, 14,8 months for Burch, 11.3 for Marion, and 8,6 for Kelly. Total or partial continence was achieved in 88 percent of TOT, 77 percent of Burch, 62 percent of Marion and 75 percent of Kelly. Continence within 18 months was obtained in 80 percent of TOT, 71 percent of Burch and 40 percent of Marion submitted patients. Patients who underwent TOT only, had 100 percent continence rates, significantly higher than those who underwent another associated surgical procedure. Micturition urgency disappeared in 82 percent of TOT, 66 percent of Burch, 71 percent of Marion and 100 percent of Kelly surgery. De novo urgency appeared in 12 percent for TOT, 33 percent for Burch and in none of either Marion or Kelly group. Conclusions: The TOT surgical technique has excellent rates of urinary continence evaluated at medium term. Continence rates are best when TOT was performed as the only surgical procedure. Urinary irritating symptoms disappear in a good percentage of patients regardless of the surgical technique chosen.

Placenta percreta with bladder invasion. A plea for multidisciplinary approach

Placenta previa percreta with the urinary bladder invasion is a rare but potentially lethal condition. It has an increasing clinical significance due to its association with previous cesarean sections and uterine curettage. Herein, we report on a patient with placenta percreta and bladder invasion, who presented with hematuria and in whom delivery was delayed to almost full term highlighting the potential catastrophic results and the need for a multidisciplinary approach with the need to involve surgeons who are familiar with vascular and urologic surgery. We also present an elegant MRI of placenta percreta invading the urinary bladder, which shows that MRI is potentially an excellent diagnostic modality in this difficult condition

Experimental study of excitability and autorhthmicity in urinary bladder detrusor of diabetes rats / 华中科技大学学报（医学）（英德文版）

The changes in excitability and autorhthmicity of bladder detrusor in experimental non-insulin dependent diabetes mellitus (NIDDM) rats were observed. Sixty-nine NIDDM rats as NIDDM group and 69 normal rats as control group were enrolled into this experimental study. At 6th, 10th, 14th, 18th, 22nd and 26th week after the rats were injected last time, the changes in the excitability and autorhthmicity of detrusor strips in vitro were observed. The results showed that the threshold of the tension which made the detrusor strips contract was significantly higher in NIDDM group (0.716 +/- 0.325 g) than in control group (0.323 +/- 0.177 g) (F = 59.63, P < 0.001). At different stages, the threshold of the tension resulting the contract of the detrusor strips in NIDDM group was also higher than in control group. At 18th week after STZ injection, the frequency of spontaneous contract of the detrusor strips in NIDDM was significantly higher than in control group (P < 0.05), whereas at 22nd week, that in NIDDM group was significantly lower than in control group (P < 0.05). It was concluded that the decreased excitability of the bladder detrusor was the earliest and most obvious changes in bladder function in diabetes rats and the autorhthmicity had also changed at the early stage of diabetic bladder.

Disfunción vesical en cirugía pélvica por cáncer del recto: análisis de 60 pacientes consecutivos / Bladder dysfunction in pelvic surgery by rectal cancer: analysis of 60 consecutive patients

Se revisa en forma retrospectiva la incidencia y magnitud de la disfunción vesical (DV) luego de cirugía pélvica por un cáncer del recto. En un período de 60 meses se intervinieron 60 pacientes en forma consecutiva, 36 hombres y 24 mujeres con un promedio de edad de 65 años, el 55 por ciento de ellos con una o más condiciones co-mórbidas teóricamente relacionadas con la DV. Se efectuaron 53 intervenciones con conservación de esfínter y 7 amputaciones (RAP). En 20 pacientes sometidos a una resección anterior ultrabaja o una RAP la incidencia de DV fue de 45 por ciento comparado con 10 por ciento (4/40) en resecciones más altas (p=0,008). En 17 pacientes (28 por ciento) se registró una complicación mayor que prolonga la estadía hospitalaria, de los cuales 13 presentan una DV y 8 una infección del tracto urinario (ITU). El retiro de la sonda uretrovesical (SUV) se indicó en promedio a los 6,9 días (extremos 2-20) y ocurrió antes de los 5 días en el 27 por ciento sin casos de DV. Fue necesario reinstalar la SUV en 10 pacientes, mayoritariamente en los pacientes que presentan una complicación mayor (p=0,034). El promedio de hospitalización fue de 15 días (extremos 5-56). Dos pacientes se dan de alta con SUV y otros 2 requieren de cateterismo intermitente por período prolongado, lo que eleva la cifra de vejiga neurogénica al 6,7 por ciento. En el análisis multivariado de regresión logística la altura de la resección y la presencia de una complicación mayor mantienen su significación estadística como variables independientes (p=0,019 y 0,003, respectivamente). El género, las enfermedades asociadas y el estadio de la enfermedad no resultaron predictivos de una DV postoperatoria. La ITU, globalmente presente en el 20 por ciento de los casos, es una complicación que se asocia frecuentemente con la DV pero no es obligatoria. La baja adherencia al protocolo de los 7 días utilizado como estándar en el manejo de la SUV en cirugía pélvica implica una revaluación de dicho criterio a la luz de los factores predictivos de DV señalados.

Cirugía en la incontinencia de orina de esfuerzo: cinta suburetral media de prolene(r): experiencia prospectiva del Hospital Dr. Sótero del Río / Surgery in the female urinary stress incontinence: tension-free prolene(r) suburethral slings: prospective experience of Hospital Dr. Sótero del Río

La Incontinencia de Orina de Esfuerzo (IOE) femenina es una patología de alta prevalencia, que deteriora la calidad de vida. Ninguna técnica quirúrgica ha obtenido resultados óptimos al largo plazo en su tratamiento. Por ello han habido muchas modificaciones en la técnica quirúrgica. Desde hace ya 8 años se comenzaron a publicar los primeros reportes sobre las cintas suburetrales (TVT®) sin tensión con resultados muy promisorios. En el último tiempo hemos podido conocer los primeros resultados de seguimiento a 5 años de esta técnica mínimamente invasiva. El propósito de este trabajo es evaluar nuestros resultados de las pacientes operadas de IOE con la cinta suburetral sin tensión con malla de Prolene® construida en nuestro hospital. La técnica consiste en la colocación de una cinta de Prolene® suburetral de 30 x 1,1 cm por vía vaginal anterior, sin tensión, fijándose a los tejidos paravaginales y retropúbicos por fibrosis sin suturas, creando un uroligamento artificial reforzando el piso pélvico, entregando soporte posterior a la uretra. Requiere sólo una incisión vaginal de 1,5 cm y dos incisiones de 5 mm a nivel suprapúbico, bajo anestesia regional. Pacientes: El grupo está formado por 124 mujeres, portadoras de incontinencia de orina de esfuerzo tipo I, II y III, incluyendo pacientes con incontinencia de esfuerzo pura, mixta y/o recidivada. Su edad promedio es de 55,3 (18-78) años, utilizando 5,84 (1-20) paños /día. 21 pacientes tenían IOE recidivada y 23 utilizaban anticolinérgicos preoperatoriamente. En 34 casos se realizó cirugía combinada de IOE más patología ginecológica por vía vaginal o laparoscópica.

Complicaciones en la evacuación vesical de la cirugía correctiva de la incontinencia de orina al esfuerzo / Complications in the bladder emptying caused by corrective surgey of the stress incontinence

Se estudian 52 pacientes operadas de incontinencia de orina con complicaciones obstructivas. La edad va de los 38 a los 65 años, con una media de 52. Fueron operadas con la técnica de Burch o similares 32-61, 53 porciento, Schlomo Raz 15-28, 84 porciento, Sling 4-7, 69 porciento y videolaparoscopía 1-1, 92 porciento. Todas las pacientes consultan por alteración de la evacuación vesical y el 76,92 porciento presentan infección urinaria a repetición. El tiempo desde la operación a la consulta fue de 3 meses a 2 años. Se realizaron, previo descarte de infección urinaria, estudios ecográficos, uretrocistografía, cistofibroscopía y urodinamia. Todos tenían residuo postmiccional elevado, con un mínimo de 40 ml y un máximo de 220 ml, con una media de 75 ml. Podemos dividir en 2 grupos. Uno con 32 pacientes, el 61,53 porciento, con contracciones no inhibidas de alta presión, vejigas hiperactivas, con flujo bajo y curva obstructiva, el 60 porciento de ellas tenían escape de orina en el curso de una contracción involuntaria. Otro, con 20 pacientes, el 38, 46 porciento, con vejigas hipoactivas e hipocontráctiles, con marcada dificultad para orinar. Treinta y siete pacientes fueron tratadas y controladas. A 11 se les realizó tratamiento médico, 6 con vejiga hiperactiva y 5 con vejiga hipotónica, con resultados aceptables en el 50 y 60 porciento, respectivamente. A los 26 restantes, 15 con vejigas hiperactivas y 11 hipocontráctiles, se las operó, realizando una uretrolisis y reimplantación de los tejidos periuretrales en situación más distal, con excepción del sling, que se abordaron por vía vaginal, seccionando simplemente el sling. Se obtuvieron buenos resultados en el 53, 33 y 63, 63 porciento, respectivamente. En los 4 sling reapareció la incontinencia. Es importante realizar una buena valoración preoperatoria antes de indicar la terapéutica en la IOE para evitar complicaciones obstructivas, teniendo en cuenta correlacionar en forma adecuada la alteración anatómica con la funcional. Hay técnicas, como las retropúbicas y el sling, que tienden a producir más obstrucción y su indicación debe ser cuidadosa. En las vejigas hipoactivas, tener en cuenta también, la posibilidad de ejercicios y electro estimulación, previo a la indicación de cirugía.

Analysis on pathogenesis of 50 cases of bladder proliferative lesions / 华中科技大学学报（医学）（英德文版）

In order to study the pathogenesis, clinical and pathological characteristics of proliferative lesions of the bladder, 50 cases of proliferative lesions of the bladder from 150 patients with complaints of frequency, urgency, hematuria and dysuria were subjected to cystoscopic biopsy of the suspicious foci in the bladder. In combination with the symptoms, urine and urodynamics, the relationship of proliferative lesions of the bladder to the inflammation and obstruction of the lower urinary tract was analyzed. Of the 50 cases of proliferative bladder lesions, 44 cases (88%) had lower urinary tract infection and 29 (58%) lower urinary tract obstruction. The patients with lower urinary tract obstruction were all complicated with infection. Three cases were associated with transitional cell carcinoma. Malignant cells were detected in 1 case by urinary cytologic examination. Proliferative lesions of the bladder, especially those without other obvious mucosa changes under cystoscopy, are common histological variants of urothelium in the patients with chronic inflammation and obstruction of the lower urinary tract. Chronic inflammation and obstruction of the lower urinary tract might be the causes for proliferative lesions of the bladder. It is suggested that different treatments should be applied according to the scope and histological type of the proliferative lesions.

Spontaneous bladder rupture secondary to posterior urethral valves in a neonate.

Bladder rupture is a rare cause of ascites in neonates. A review of literature revealed about 32 cases including both iatrogenic and spontaneous rupture. This case report describes a successfully treated case of spontaneous rupture of bladder with ascites in a neonate with posterior urethral valves.

Risk factors in bladder cancer of Iraqi patients

A total of 135 bladder cancer patients diagnosed during eight monthes at the Medical City Hospital, were studied to determine the pathological subtypes, and the possible risk factors. Squamous cell carcinoma formed 41%, transitional cell carcinoma 47%, and adenocarcinoma formed 9%. Bilharzial ova were detected in tissue section of 32% of the cases [43 patients]. The histological analysis of bladder cancer associated with bilhariasis showed significantly different pattern i.e. squamous cell carcinoma forms 72%, papillary transitional cell carcinoma 2.8% non papillary transitional cell 9.3%, and adenocarcinoma forms 16.3%.Regarding the geographical distribution of various histological types; the squamous cell carcinoma predominated in patients coming from the middle and south of the country [44% and 45% respectively], while being rare in the north [8.3%]. This distribution is similar to endemicity pattern of bilhariziasis in Iraqi. The occupational hazard detected was peasantry. Smoking was significantly more common in bladder cancer not associated with bilhariziasis, as well as in bladder patients with papillary transitional cell carcinoma. Past history of recurrent urinary tract infection was common in bladder cancer associated with schistosmiasis [69%], while those associated with past history of urolithiasis were observed in only 29%

Granuloma de vejiga: complicación de la operación de Burch / Granuloma of the bladder: complications of Buch's operation

Se realiza un estudio retrospectivo de las pacientes con incontinencia primaria de esfuerzo operadas en el Servicio de Ginecología mediante la operación suprapúbica de Burch en quienes se diagnosticó, posteriormente, la presencia de granulomas vesicales. Se comprueba que en el 20,0 % de los casos operados sin la ayuda de solución de contraste intravesical se produjo perforación inadvertida de la luz vesical. En todos los casos se etableció el diagnóstico mediante cistoscopia y se efectuó la exéresis por esta misma vía sin complicaciones. Se sugiere la utilización de 100 mL de solución de azul de metileno intravesical en el transoperatorio de todos los casos en quienes se efectúe la colpocistouretropexia de Burch

Denervación vesical por vesicolisis: análisis crítico y seguimiento a largo plazo / Denervation of the bladder by cystolysis: critical analysis and follow-up

En un estudio crítico se analiza la evolución a más de 1 año, de 21 casos con vejiga hiperactiva tratada con vesicolisis. La evaluación urodinámica a los 3 meses y 12 meses muestra curva plana en el 71,4 por ciento y 19 por ciento respectivamente. Inversamente, hubo mala compliance vesical en el 19 por ciento a los 3 meses y el 61,9 por ciento a los 12 meses. Como resultado sólo 2 casos eran continentes al año de evolución post-vesicolisis. Se concluye que los buenos resultados de la vesicolisis observados inicialmente, no son tal en el control más tardío