ABSTRACT
Urinary tract reconstruction by using various gastrointestinal segments is not devoid of complications which may hamper to a great extent the beneficial effects of the procedure. Intestinal mucosa is the primary site responsible for these complications and any procedure aiming at the prevention of untoward effects of intestinal interposition should abolish the absorptive and secretory functions of the mucosa. Augmentation cystoplasties by ileal segments were performed on 24 male albino Wistar rats. In 12 animals de-epithelialization of the mucosa with an enzymatic cock-tail, consisting of type I and type V collagenases and trypsin, preceded the cystoplasty. The functional capacity of the epithelium was determined by a simplified glucose absorption test in the third postoperative week. Morphological examination before the absorption test did not reveal any fibrosis or shrinkage of the ileal segments. Complete elimination of the absorptive capability in enzyme treated mucosa was found during the glucose absorption test, while a rapid and highly effective absorption was observed in the control group (p < 0.05). As a result, it seems possible to obtain intestinal segments covered with a mucosa which acquired similar characteristics to uro-epithelium, therefore closely resembling the original urinary tissues.
Subject(s)
Collagenases/pharmacology , Ileum/drug effects , Ileum/transplantation , Trypsin/pharmacology , Urinary Reservoirs, Continent/methods , Urologic Diseases/surgery , Anastomosis, Surgical , Animals , Blood Glucose/analysis , Collagenases/administration & dosage , Disease Models, Animal , Ileum/pathology , Intestinal Mucosa/drug effects , Intestinal Mucosa/pathology , Male , Rats , Rats, Wistar , Reference Values , Trypsin/administration & dosage , Urinary Bladder/pathology , Urinary Bladder/surgeryABSTRACT
Retroperitoneal fibrosis is idiopathic in two thirds of cases and is found most commonly as an isolated fibrotic plaque centered over the lumbar spine and entrapping one or both ureters. It has been postulated that fibrosis in the idiopathic cases results from a hypersensitivity reaction to antigens leaking into the retroperitoneum from atheromatous plaques in the aorta or common iliac arteries. In the remaining one third of cases, causes include ergot-derivative drugs, retroperitoneal haemorrhage or urine extravasation, and a desmoplastic response to a variety of tumours.
Subject(s)
Genital Neoplasms, Female/complications , Retroperitoneal Fibrosis/etiology , Fatal Outcome , Female , Genital Neoplasms, Female/diagnosis , Humans , Middle Aged , Retroperitoneal Fibrosis/diagnosisABSTRACT
Various alternatives exist for the treatment of bladder outlet obstruction due to benign prostatic hyperplasia (BPH). Incision of the bladder neck and prostate has proved its efficacy in many studies, especially in small prostates. The major drawback of the procedure is inability to obtain tissue specimens to exclude malignancy. We introduced a method to overcome this drawback by incising grooves at 5 and 7 o'clock with standard resection loops which created not only the incisions but also provided enough tissue for pathological examination. Twenty-five patients with BPH underwent transurethral grooving. Pre- and post-operative urodynamic studies revealed significant improvement in both maximum and average flow rates. The re-operation rate in the entire group was 12%. Transitional cell carcinoma of the prostatic urethra was detected in 1 patient, which proved its superiority to standard incision procedures.
