Circulating soluble Fas and Fas antigen tissue expression in human bladder cancer

This study was performed to determine the role of sFas and Fas expression in human bladder cancer. The percussion of schistosomiasis association and correlations between various parameters and tumor progression were evaluated as well. Fifty patients [24 with chronic cystitis and 26 with bladder cancer [20 with transitional cell carcinoma and 6 with squamous cell carcinoma]] were included in this study and fifteen individuals served as normal controls. SFas level in sera was estimated using enzyme linked immunosorbent assay. Fas expression in bladder tissue was immunohistochemically determined. SFas level and% of Fas expression in chronic cystitis and bladder cancer patients were significantly higher than normal controls. Moreover, a significant increase in sFas level and% of Fas expression was detected in chronic cystitis associated with schistosomiasis compared to chronic nonspecific cystitis. SFas level was significantly increased with tumor progression in the invasive group compared to the noninvasive group; whereas,% of Fas expression was comparable in both groups. Moreover, the number of Fas positive cases was significantly high in invasive than noninvasive

subserosal extramural tunnel for uretral implantation in the Ileal-W bladder: an ideal antireflux Technique for dilated ureters

Anti reflux in ileal pouches could be a real challenge when the ureters are considerably dilated. We adopted in this work the technique of subserosal extra lumenal tunnel 1st presented by Abol-Enein and Ghoneim, which we applied with some modifications to suit the dilated ureters, both in augmentation ileo cystoplasty and after radical cystectomy. The technique was applied in 19 patients in two groups. Group I was 11 patients for bladder substitution after radical cystectomy and group II was 8 patients for augmentation after supra trigonal cystectomy for neurogenic or contracted bladder. Patients were followed for 6 to 36 months by routine lab, ultrasound, intravenous pyelography [renogram for some] ascending and voiding pouchography and urodynamics. In the 38 renal units done by the technique, all with considerably dilated ureters, non was refluxing throughout the follow up period. 2 units in one patient were obstructed and managed primarily endoscopicaly, but later, one ureter needed open surgical correction. We found this technique ideal for dilated ureters even in the Bilharzial thick walled, with no incidence of reflux and assuming the original anatomical appearance of the uretrovesical junction with easy endoscopical manipulation if needed