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Prolonged irritative voiding symptoms due to Enterobius vermicularis bladder infestation in an adult patient
Sammour, Zein Mohamed;Gomes, Cristiano Mendes;Tome, Andre Luiz Farinhas;Bruschini, Homero;Srougi, Miguel;
Brazilian Journal of Infectious Diseases , 2008, DOI: 10.1590/S1413-86702008000400020
Abstract: enterobius vermicularis (pinworm) is one of the most prevalent intestinal parasites in the world. the urinary tract is rarely affected and few cases have been reported. we report a case of bladder infestation by mature female worms of e. vermicularis in a woman presenting with irritative voiding symptoms.
Leiomyoma of Bladder  [cached]
Sudhakar P,Malik Neelam,Malik Ashok
Saudi Journal of Kidney Diseases and Transplantation , 2008,
Abstract: A case of leiomyoma of urinary bladder, a rare benign tumor, is presented. The patient was a 45-year-old woman with long duration history of dysuria. Intravenous urography (IVU), ultrasound (US), computed tomography (CT) and biopsy diagnosed this case accurately. The clinical presentation, imaging findings and management of this benign tumor are discussed.
Leiomyoma of the Female Urethra—A Rare Tumor: Case Report and Review of the Literature  [PDF]
Mrinal Pahwa,Yusuf Saifee,Archna R. Pahwa,Manu Gupta
Case Reports in Urology , 2012, DOI: 10.1155/2012/280816
Abstract: Leiomyoma is a benign smooth muscle tumor which is rarely found in urethra. Only a handful of cases have been reported in the literature. We hereby report a case of urethral leiomyoma in a twenty-seven-year-old female who presented with intermittent hematuria. Mass was completely excised with a rim of normal tissue. Patient remained asymptomatic with no evidence of recurrence in followup. 1. Introduction Urethral leiomyomas are rare benign tumors arising from the smooth muscle of urethra. These are more common in women [1]. Approximately 40 odd cases have been reported in world literature [1–9]. 2. Case Report A twenty-seven-year-old woman presented with intermittent hematuria and a mass coming out from the vagina. On examination, she was found to have a fleshy mass at the urethral meatus (Figure 1). She did not have any voiding symptoms or perineal pain. On urethroscopy, the mass was occupying the mid and distal urethra from 10 o′clock to 6 o′clock position. Cystoscopy was normal. The urethra could be calibrated up to 18?Fr. The mass was excised and the proximal urethral mucosa was mobilized and approximated with the distal edge. After excision of the tumor, the urethra could admit a 30?Fr dilator. Patient was catheterized for 48 hours and voided well on catheter removal. Histopathological examination revealed an encapsulated tumor composed of spindle-shaped smooth muscle fibers arranged in a whorling pattern. On immunohistochemical examination tumor was positive for vimentin and smooth muscle actin. A diagnosis of leiomyoma was made (Figure 2). Figure 1: Local examination revealed a 2??×??2?cm growth arising from urethral meatus. Figure 2: Histopathology 40x-bladder mucosa with submucosal encapsulated leiomyoma. 3. Discussion Leiomyoma of urethra is a rare condition affecting women more than men. The tumor is most common in third and fourth decade; the mean age of the appearance is around 41 years [8, 9]. Distal urethra can be affected but proximal segment is the most common site [3]. Common presenting symptoms include urinary tract infection (64.3%), a mass (50%), dyspareunia, urinary retention, and irritative lower urinary tract symptoms. The tumor has been reported to enlarge during pregnancy and shrink after delivery, suggesting a possible hormonal dependence [5]. A differential diagnosis of urethrocele, a urethral diverticulum, caruncle, and malignancy should be considered. A careful clinical examination, urethroscopy, and radiological examination of the lower urinary tract are essential to distinguish it from urethrocele, urethral diverticulum,
Bladder Leiomyoma: Case Report  [PDF]
Hatice ?ztürkmen Akay,Ali Ferruh Akay,Hüseyin Büyükbayram,Hayrettin ?ahin
Dicle Medical Journal , 2004,
Abstract: Leiomyoma of the bladder is a rare benign mesenchymal tumor. Theclinic symptomatology depends on the tumor site, and this type of lesion ismorefrequently found in women. Treatment mainly consist of endoscopicresection, but may involve partial cystectomy.
Bladder leiomyoma: case report
Castillo,Octavio; Foneron,Alejandro; Vitagliano,Gonzalo; Sánchez-Salas,Rafael; Díaz,Manuel; Fajardo,Marcelo; Franco,Carmen;
Archivos Espa?oles de Urología (Ed. impresa) , 2008, DOI: 10.4321/S0004-06142008000100017
Abstract: objective: leiomyoma is a benign lesion which represents 0,04-0,5% of bladder tumors. it is more common in females and its peak incidence is between 4th and 5th decades. surgery is the treatment of choice and adequate results have been previously reported. methods: 38 years old male patient who consulted for chronic pelvic pain syndrome. ct scan showed a 2cm diameter exophitic lesion at the anterior left lateral bladder wall, which protruded into the perivesical fat. we performed a laparoscopic partial cistectomy locating the tumor and resecting it with simultaneous cystoscopic control, obtaining negative margins. the operative time was 70 minutes with an intraoperative blood loss of 50 ml. postoperative period was uneventful. final pathology reported: bladder wall leiomyoma, without mitosis or atypia. immunohistochemistry was positive for actine and vimentine stablishing diagnosis. cd 117 (ckit) was negative and ruled out a gastrointestinal stromal tumor. conclusions: leiomyoma is bladder?s most common benign non epithelial tumor. it represents 35-46% of these lesions with a 2:5 male/female ratio. it origins from the smooth muscle bundles and at the urinary tract the most common localizations are kidney and bladder. clinical presentation depends on tumor size and localization. ultrasound is the most useful diagnostic tool and the pathological diagnosis is mandatory. surgery is the treatment of choice and technique depends on tumor size and localization. the laparoscopic approach seems to be an effective alternative in this group of tumors. prognosis is good and recurrence is rare.
Infantile bladder rupture during voiding cystourethrography
Kajbafzadeh, Abdol M.;Saeedi, Parisa;Sina, Ali R.;Payabvash, Seyedmehdi;Salmasi, Amirali H.;
International braz j urol , 2007, DOI: 10.1590/S1677-55382007000400012
Abstract: bladder rupture is rare during infancy and most of reported cases had urethral obstruction or neurogenic bladder. we report two cases of infantile bladder rupture during voiding cystourethrography (vcug). this report reinforces the criteria for proper vcug imaging procedure. consideration of expected bladder volume for body weight, and close monitoring of bladder pressure and injection speed could prevent such complications.
Voiding by Mandatory Position Changing: Giant Bladder Stone  [cached]
Tufan Cicek,Okan Istanbulluoglu,Murat Gonen,Bulent Ozturk
Cukurova Medical Journal , 2013,
Abstract: Voiding by Mandatory Position Changing: Giant Bladder Stone Bladder Stones frequently develops on the base of neurogenic micturation disorders, infection, bladder outlet disorders, spinal cord injury and foreign bodies. BPH for men and previous incontinans surgery in women are risk factors for bladder Stone development according to gender. In this case report a 49 years old man, who can void by mandatory position changing owing to a giant bladder stone is presented . [Cukurova Med J 2013; 38(1.000): 120-122]
Leiomyoma of the bladder. Case report and literature review
Charles Rosenblatt,Antonio Carlos Lima Pompeo,André Luiz Farinhas Tomé,Alexandre Saad Feres Lima Pompeo
Einstein (S?o Paulo) , 2005,
Abstract: We present a case of leiomyoma of the bladder consideringdiagnosis, treatment and literature review. A leiomyoma of thebladder was diagnosed in a 60-year-old woman based on physicalexamination, urinary tract imaging (ultrasonography, computedtomography and magnetic resonance imaging) andcystourethroscopy with biopsy of the lesion. Cystourethroscopyshowed a bladder tumor covered by normal epithelium.Management included complete transurethral resection with norelapse after a seven-month follow-up.
Near-Infrared Spectroscopy of the Bladder: New Parameters for Evaluating Voiding Dysfunction  [PDF]
Andrew Macnab,Babak Shadgan,Kourosh Afshar,Lynn Stothers
International Journal of Spectroscopy , 2011, DOI: 10.1155/2011/814179
Abstract: We describe innovative methodology for monitoring alterations in bladder oxygenation and haemodynamics in humans using near-infrared spectroscopy (NIRS). Concentrations of the chromophores oxygenated (O2Hb) and deoxygenated (HHb) haemoglobin and their sum (total haemoglobin) differ during bladder contraction in health and disease. A wireless device that incorporates three paired light emitting diodes (wavelengths 760 and 850 nanometers) and silicon photodiode detector collects data transcutaneously (10?Hz) with the emitter/detector over the bladder during spontaneous bladder emptying. Data analysis indicates comparable patterns of change in chromophore concentration in healthy children and adults (positive trend during voiding, predominantly due to elevated O2Hb), but different changes in symptomatic subjects with characteristic chromophore patterns identified for voiding dysfunction due to specific pathophysiologies: bladder outlet obstruction (males), overactive bladder (females), and nonneurogenic dysfunction (children). Comparison with NIRS muscle data suggests altered bladder haemodynamics and/or oxygenation may underlie voiding dysfunction offering new insight into the causal physiology. 1. Introduction Near-infrared spectroscopy (NIRS) is an established noninvasive optical technique, which uses light in the near-infrared (NIR) spectrum (700–1000?nm) to monitor tissue oxygenation and haemodynamics transcutaneously by measuring changes in chromophore concentration in the microcirculation (oxygenated [O2Hb] and deoxygenated [HHb] haemoglobin) [1–4]. These changes (expressed as μmol/100?mL) are measured in real-time as a change relative to baseline. Changes in total haemoglobin concentration [tHb] (the sum of [O2Hb] and [HHb]) indicate change in blood volume [5, 6]. The physics principles underlying this technology, the wide range of research using NIRS [1, 3, 4], and the NIRS-derived parameters with validated methods of measurement [3] have been comprehensively described. However, urological applications are recent, and NIRS monitoring of the bladder (detrusor muscle) is a novel use of NIRS, and a disruptive technology in the context of the evaluation of voiding dysfunction, as a noninvasive measure of changes in oxygenation and haemodynamics during voiding is now feasible. The evolution and technical aspects of NIRS use in urology have been reviewed [4, 7]; evidence is accumulating that the patterns of change in [O2Hb], [HHb], and [tHb] observed in the bladder microcirculation during the voiding cycle differ in health and disease, and algorithms
Percutaneous intervention of large bladder calculi in neuropathic voiding dysfunction
Hubsher, Chad P.;Costa, Joseph;
International braz j urol , 2011, DOI: 10.1590/S1677-55382011000500011
Abstract: purpose: to report our results and rationale for treating large bladder calculi in patients with neuropathic voiding dysfunction (nvd) using percutaneous cystolithalopaxy. materials and methods: ten patients with a previously diagnosed nvd presenting with a large stone burden were identified from our department database and a retrospective review of case notes and imaging was performed. results: percutaneous access to remove bladder stones (range 8x7 to 3x2 cm) had a mean surgery length of 150 min and blood loss of 23 ml. six of the seven patients treated percutaneously were discharged on the day of surgery and suffered no complications, while one patient experienced poor suprapubic tube drainage and required overnight admission with discharge the following day. transurethral removal of stone burden (range 4x4 to 4x3 cm) had a mean surgery length of 111 min and blood loss of 8 ml. each of these three patients were under our care for less than 23 hours, and one patient required a second attempt to remove 1x0.5 cm of stone fragments. there was no statistical difference between mean operative times and estimated blood loss, p = 0.5064 and p = 0.0944 respectively, for the two treatment methods. conclusion: in this small series, percutaneous cystolithalopaxy was a safe, effective, and often preferred minimally invasive option for removal of large calculi in patients with nvd. we suggest possible guidelines for best endoscopic approach in this population, although a larger and prospectively randomized series will be ideal for definitive conclusions.
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