Clear cell adenocarcinoma of the urinary bladder: report of a case of probable müllerian origin.

A 35-yr-old woman with a history of endometriosis and several recent episodes of hematuria was found to have an exophytic tumor arising from the mucosa of the posterior bladder wall. Microscopic examination showed a typical clear cell adenocarcinoma with a predominant tubulo-cystic pattern. A radical cystectomy was performed. Pathologic examination showed no residual tumor, but grossly visible intramural cysts at the site of the tumor had features of endometriosis on microscopic examination, strongly suggesting that the clear cell adenocarcinoma arose from endometriosis and was of müllerian derivation. Only one other adenocarcinoma of the bladder, an endometrioid adenocarcinoma, has had a probable müllerian origin. Although rare, these cases indicate that some vesical adenocarcinomas are of müllerian type.

Age related flow rate nomograms in a normal pediatric population.

Uroflow studies in a normal pediatric population were analysed statistically. Single studies for 511 subjects (272 boys and 239 girls) were reviewed. Nomograms relating peak flow to volume voided and age were established. An acceptable lower limit for peak flow was obtained from the data and a volume voided range was calculated so that both criteria could be used with 90% probability to define the normal voiding situation. The mean values of peak flow rate increased with volume voided in both sexes and also with age in the male population. Different sets of nomograms, which are necessary for daily clinical evaluation, are given. They define the normal values in the normal population.

Body surface related flow rate nomograms in a normal pediatric population.

Uroflow studies for 511 normal pediatric subjects (272 boys, 239 girls) were analyzed statistically. Nomograms relating peak flow to volume voided and body surface were established. An acceptable lower limit for peak flow was obtained from the data and a volume voided range was calculated so that both criteria could be used with 90% probability to define the normal voiding situation. Body surface area was found to be a more reliable index than age in the establishment of nomograms. In the male population the 90% probability applied to a significantly greater volume voided reliability. In the female population mean peak flow rate rose with increased body surface. Finally, in both sexes the 10% lower limit was closer to the regression mean, allowing a tighter distribution around this value.

Radiologic investigation of the urinary tract in the neonate with myelomeningocele.

A significant number of neonates with myelomeningocele are born with potentially damaging abnormalities of the urinary tract. Therefore, it is logical to investigate these patients aggressively and initiate therapy as early as possible to preserve renal function and maintain lower tract integrity for future continence management. Results of excretory urograms and voiding cystourethrograms were reviewed in 68 consecutive neonates with myelomeningocele. They indicate clearly that only a third of the patients with normal excretory urograms had a normal voiding cystourethrogram, which implies that both studies be performed for complete evaluation of the urinary tract. In other words, of these 68 patients 55 (80.9 per cent) had a normal excretory urogram but only 17 (30.9 per cent) had a normal voiding cystourethrogram. Of the 13 patients (19.1 per cent) with an abnormal excretory urogram 12 (92.3 per cent) had an abnormal voiding cystourethrogram. Reflux occurred in 16.2 per cent of patients; 6 of 7 patients with grade II reflux and 1 of 3 patients with grade III reflux had a normal excretory urogram.