ABSTRACT
Non-traumatic spontaneous rupture of the otherwise normal bladder is a rare occurrence. The literature is reviewed and 4 new cases are reported. Experimental data are presented and a theory is reviewed regarding the frequent intraperitoneal location of the rupture. The frequent paucity of symptoms compared to the high mortality rate is stressed.
Subject(s)
Urinary Bladder Diseases/diagnosis , Adult , Aged , Alcoholism/complications , Ascites/etiology , Coma/complications , Female , Hematuria/diagnosis , Humans , Hydrostatic Pressure , Infant, Newborn , Male , Rupture, Spontaneous/diagnosis , Rupture, Spontaneous/etiology , Rupture, Spontaneous/surgery , Urinary Bladder Diseases/etiology , Urinary Bladder Diseases/surgery , Urinary Bladder Fistula/diagnosis , Urinary Catheterization , Urination Disorders/etiology , Valsalva ManeuverABSTRACT
Patients with high spinal cord injuries frequently will develop a syndrome of autonomic hyperreflexia when stimulated by urological instrumentation. Severe sustained hypertension is the most hazardous component encountered during this reaction. Herein we report a series of patients exhibiting this condition who were managed safely and successfully by the use of the ganglionic blocking agent, pentolinium.
Subject(s)
Autonomic Nervous System , Nervous System Diseases/drug therapy , Pentolinium Tartrate/therapeutic use , Reflex, Abnormal/drug therapy , Adolescent , Adult , Humans , Hypertension/drug therapy , Middle Aged , Pentolinium Tartrate/administration & dosage , Premedication , Spinal Cord Injuries/complications , Urologic Diseases/surgeryABSTRACT
We herein describe 44 new cases of leukoplakia of the renal pelvis, bladder and urethra. Leukoplakia is uncommon. It occurs twice as often in the bladder as in the pelvis and ureter and it is associated with and perhaps caused by chronic infection. Carcinoma is present in 10 to 20 per cent of the cases at diagnosis. We believe that leukoplakia is not simple squamous metaplasia but a step further down the line--a process that evolved through squamous metaplasia and perhaps could result in cancer. We think leukoplakia is potentially pre-malignant and it should be treated as a low grade and low stage tumor since no satisfactory treatment exists.
