Effect of Suprapubic Vibration on Urodynamic Study in Patients with Voiding Dysfunction / 대한비뇨기과학회지

PURPOSE: Suprapubic vibrating stimulus may improve the urinary symptom in patients with neurogenic bladder. We attempted to evaluate the suprapubic vibration effect on urodynamic study in patient with voiding dysfunction. MATERIALS AND METHODS: From October 1997 to July 1998, We have performed urodynamic studies(UDS) on 30 patients(13 males, 17 females). They had intact suprapubic sensation without lower urinary tract obstruction, who visited under the chief complaints of voiding dysfunction(frequency, voiding difficulty etc.). All patients were checked UDS before and after using a vibrating device(frequency 120Hz, mechanical output 0.081mm), which was placed on the 2?3cm above the pubic symphysis. Results of detrusor pressure were compared pre- and post-vibration at 150ml bladder filling and at strong desire to void and maximum bladder capacity. The most common underlying disease was peripheral lesions(11 cases). Results of UDS were grouped into three. Group I consisted of 11 patients with hyperactive bladder. Group II consisted of 6 patients with normal bladder, and group III consisted of 13 patients with hypoactive bladder. RESULTS: Changes of detrusor pressure at the 150ml bladder filling in group I couldn`t be measured due to early urine leakage. In group II&III, the average detrusor pressure changes of pre- and post-vibration were from 4.2+/-.6cmH2O to 3.8+/-.2cmH2O(p>0.05) and from 5.7+/-.8cmH2O to 6.7+/-.2cmH2O(p>0.05) respectively. Detrusor pressure at strong desire to void was changed from 39.0+/-8.6cmH2O to 40.0+/-0.0cmH2O in group I(p>0.05), 25.3+/-2.8cmH2O to 19.0+/-2.2cmH2O in group II(p>0.05), and from 15.0+/-.9cmH2O to 19.5+/-2.3cmH2O in group III(p0.05), from the 402.0+/-2.8ml to 399.3+/-4.5ml in group II(p>0.05), and from 547.5+/-9.5ml to 520.1+/-9.6ml in group III(p<0.05). In group III, ten of the 13 patients(77%) showed the increase of detrusor pressure at strong desire to void(mean: 6.6cmH2O) and nine of the 13 patients(69%) showed the decrease in maximum bladder capacity(mean: 46.4ml)(p<0.05). CONCLUSIONS: These results suggest that the use of suprapubic vibrator may be an ancillary therapeutic tool in selected patients of voiding dysfunction with hypoactive bladder.

Sequential Involvement of Carcinosarcoma in the Ureter, Bladder and Kidney: A Case Report / 대한비뇨기과학회지

We report a case of carcinosarcoma involving the ureter, bladder and kidney in a 63-year-old woman. The diagnosis of carcinosarcoma was confirmed by immunohistochemical stain.

Bladder Mucosal Mast Cell Response in Bladder Tumor / 대한비뇨기과학회지

Mast cells are immune-mediators producing cells and involved in neovascularization of some tumors. Such roast cell is divided into two cell types: mucosal mast cell and connective tissue mast cell. There are controversies about the roles of mast cells in suppression and metastasis of some tumors (including bladder tumor). We performed bladder mucosal biopsies in 28 patients (from September 1994 to July 1996) and observed bladder mucosal mast cell responses in bladder tumor (TCC) under toluidine blue stain (x 400). Patients were divided into 2 groups: group A was consisted of bladder tumor patients (21 cases), whereas group B was the control group (7 cases). Mast cell responses, average mucosal mast cell counts in high power field, in group A and B were 1.75+/-0.25 cells/HPF, 0.29+/-0.20 cel1/HPF respectively. We observed more mast cell responses in bladder tumor patients group. But fundamental researches will be needed to elucidate the causes of mast cell activation in bladder tumor.