HISTOPATHOLOGICAL ANALYSIS OF SCHISTOSOMA HAEMATOBIUM METAPLASIA OF THE URINARY BLADDER.

The present cross sectional study was carried out to analyze the histopathological changes in the urinary bladder affected by Schistosoma haematobium among 54 patients (aged between 20-60 years; 40 males, 14 females; 44 from rural, 10 from urban areas) attending Sohag University Hospital, Egypt from. October 2015 to March 2016. 10% formalin fixed biopsy specimens were examined from which sections of 5 jum were prepared and examined microscopically. Mid-stream urine samples were collected from the patients after a slight physical exercise immediately transported to the Parasitological Laboratory to be examined for S. haematobium eggs. Histopathological examination revealed squamous metaplasia of the urinary bladder in 38/54 cases (70.4%); 20/54-(37%) non- keratinizing metaplasia, 18/54 (33.3%) keratinizing metaplasia and invasive squamous carcinoma in 11/54 (20.4%). It was concluded that Schistosonia haematobium is still one of the major risks of developing squamous cell metaplasia of the urinary bladder in Egypt which was found to be of high statistically significance in both males and females in rural areas. In this study, bladder squamous metaplasia was subdivided into non-keratinizing. with less malignant potential, keratinizing with a definite affinity to carcinogenesis and invasive severe forms; but these subdivisions were found to be statistically not significant in relation to gender, age and locality, although they were of importance for the proper and successful management of the encountered cases.

Orthotopic diversion after cystectomy in women: A single-centre experience with a 10-year follow-up.

OBJECTIVE: To evaluate and update the clinical and surgical outcome of orthotopic diversion in an eligible cohort of women with bladder carcinoma. PATIENTS AND METHODS: From 1999 to 2010, 78 women (mean age 42.4 years) had a radical cystectomy (RC) with orthotopic diversion using ileal neobladder reconstruction to treat invasive bladder carcinoma. The mean (SD) follow-up was 62 (25) months. RESULTS: The histopathological pattern was squamous cell carcinoma in 52 (67%) patients, transitional cell carcinoma in 17 (22%), mixed in four (5%) and undifferentiated carcinoma in five (6%). Three patients were completely incontinent day and night. Stress urinary incontinence after this surgery was reported in 11 (14%) patients, with daytime continence reported in 64 (82%); 59 (76%) patients were completely continent day and night. Chronic retention developed in nine (12%) patients. There was pouch prolapse through the vaginal stump in five (6%) patients, and a pouch-vaginal fistula in seven (9%). Sexual dysfunction was reported in 45 (69%) patients of 65 sexually active women. Stones formed in the pouch in five (6%) patients, while there were renal stones in four renal units. Oncological recurrence was reported in 15 (19%) patients, which was local in 11 (14%) and distant in four (5%). CONCLUSION: The long-term results showed that orthotopic neobladder construction after RC in women provides oncological safety and is functionally effective with proper surgical technique. Removal of the gynaecological organs during RC in women might be unnecessary for low-grade, low-stage tumour.