1/65. Test or trauma? The voiding cystourethrogram experience of young children.Many diagnostic procedures, while necessary and appropriate, may be experienced by a child as a trauma. health care professionals often perceive invasive procedures such as surgery and needle biopsies as more painful and threatening to the child than "test" such as voiding cystourethrograms (VCUGs). However, clinical experience indicates that the VCUG is often perceived by children as more highly distressing than other procedures. Success and a sense of competence (or shame and doubt) in mastering challenging life experiences, such as medical procedures, contribute to a child's evolving self-concept (Harter, 1983). These memories and successful behaviors can be applied to future similar situations. health care professionals are challenged to help the child and the parents through the procedure with minimal distress in an effective and efficient manner. A series of vignettes illustrating parents' and children's experiences with a VCUG procedure highlight the impact of the VCUG on children's coping ability and adjustment. Recommendations for developmentally appropriate clinical practice standards of care related to the VCUG procedure in young children also are presented. Preparation as an ongoing partnership process among children, parents, and health care professionals.- - - - - - - - - - ranking = 1keywords = propria (Clic here for more details about this article) |
2/65. endometriosis of the urinary bladder.Although every seventh or eighth case of endometriosis is found to have urinary involvement, this type of endometriosis is still rarely recognized. The symptoms are not specific and are frequently suggestive of a neoplastic process. On the basis of our two cases of histopathologically two types of endometriosis as well as literature review the practical significance of endometriosis in urology is described. In each patient who previously underwent a gynaecological or surgical procedure in the abdominal cavity, endometriosis of the bladder is likely to occur. This possibility should not be ruled out, otherwise it could lead to misdiagnosis and inappropriate treatment.- - - - - - - - - - ranking = 0.5keywords = propria (Clic here for more details about this article) |
3/65. Laparoscopic excision of endocervicosis of the urinary bladder.Endocervicosis is a benign lesion in which endocervical mucosa develops in anatomic locations distant from the endocervical canal. Two cases of infiltrating endocervicosis of the urinary bladder were managed by laparoscopic partial cystectomy. This avoided the morbidity of laparotomy and provided improved visualization of the extent of bladder resection required to remove the lesion completely.- - - - - - - - - - ranking = 0.22514592080278keywords = mucosa (Clic here for more details about this article) |
4/65. prenatal diagnosis of cystic bladder distension secondary to obstructive uropathy.We report the perinatal findings of a huge midline posterior cystic bladder distension secondary to lower urinary tract obstruction and prune-belly syndrome in a male fetus. A 40-year-old woman, gravida 3, para 0, was referred at 21 gestation weeks with sonographic findings of anhydramnios and a fetus with a 9.5 x 6.0 cm intra-abdominal cystic mass containing two chambers. The in utero ultrasound-guided fetal bladder drainage using a single needle aspiration and the ultrasound follow-ups of fetal bladder filling provided a diagnostic aid. This method helped to show the position of the bladder and the cystic bladder mass as well as the status of communication in response to decompression or filling of the fetal bladder. cytogenetic analysis revealed a 46,XY karyotype. autopsy showed agenesis of the posterior urethra, prominent megacystis, a cystically distended mass arising from the lower posterior bladder, hydronephrosis, megaureters, and anorectal agenesis with an intestinal blind end adherent to the posterior wall of the uterus. There were no urogenital duplication, hindgut duplication, or urachal abnormalities. The contracted bladder had a full-thickness muscular wall with a trigone and two ureteral orifices while the cystically distended bladder did not have any opening and was lined by a very thin wall. histology of the cystic bladder wall demonstrated typical urothelium, lamina propria and muscularis propria. The pathogenesis and differential diagnosis of cystic bladder distension are discussed.- - - - - - - - - - ranking = 1keywords = propria (Clic here for more details about this article) |
5/65. Spontaneous regression of inflammatory pseudotumor of the urinary bladder.Inflammatory pseudotumor of the urinary bladder is a benign proliferative lesion of the submucosa and its treatment has not yet been established. Here we present a case of spontaneously regressed inflammatory pseudotumor of the urinary bladder.- - - - - - - - - - ranking = 0.22514592080278keywords = mucosa (Clic here for more details about this article) |
6/65. Combined antegrade and retrograde endoscopic approach for the management of urinary diversion-associated pathology.BACKGROUND: Endourologic management of stones and strictures in patients with a urinary diversion is often cumbersome because of the absence of standard anatomic landmarks. We report on our technique of minimally invasive management of urinary diversion-associated pathology by means of a combined antegrade and retrograde approach. patients AND methods: Five patients with urinary diversion-associated pathology were treated at our institution between May 1997 and October 1998. Their problems were: an obstructing ureteral stone in a man with ureterosigmoidostomy performed for bladder extrophy; two men with a valve stricture in their hemiKock urinary diversions; an anastomotic stricture in a man with an ileal loop diversion; and a long left ureteroenteric stricture in a man with a right colon pouch diversion. After percutaneous placement of an guidewire across the area of interest, the targeted pathology was accessed via a retrograde approach using standard semirigid or flexible fiberoptic endoscopes. Postoperative follow-up with intravenous urography, differential renal scan, or both was performed at 3 to 24 months (mean 12 months). RESULTS: The combined antegrade and retrograde approach allowed successful access to pathologic areas in all patients. holmium laser/Acucise incision of stenotic segments or ballistic fragmentation of stones was achieved in all cases without perioperative complications. None of the strictures with an initially successful outcome has recurred; however, in one patient, the procedure failed as soon as the internal stent was removed. The patient with the ureteral calculus remains stone free, and his ureterosigmoidostomy is patent without evidence of obstruction on his last imaging study, 24 months postoperatively. CONCLUSIONS: Combined antegrade and retrograde endoscopic access to the area of interest is our preferred method of approaching pathologic problems in patients with a urinary diversion. An antegrade nephrostogram provides better delineation of anatomy, while through-and-through access enables rapid and easier identification of stenotic segments that may be hidden by mucosal folds. Furthermore, this approach allows the use of larger semirigid or flexible endoscopes in conjunction with more efficient fragmentation devices, resulting in enhanced vision from better irrigation. Finally, an initial endoscopic approach may be preferred because its failure does not compromise the success of future open surgery.- - - - - - - - - - ranking = 0.22514592080278keywords = mucosa (Clic here for more details about this article) |
7/65. Chronic painless hematuria and urethral bleeding as the presenting manifestations of Osler-Weber-Rendu disease.A case of a young man with profound iron deficiency anemia, chronic painless hematuria and urethral bleeding is presented. He had the typical cutaneous findings of Osler-Weber-Rendu disease (hereditary hemorrhagic telangiectasia). Appropriate urological studies demonstrated bladder and urethral telangiectases, with no other explanation for the bleeding. Osler-Weber-Rendu disease should be considered in the differential diagnosis of chronic painless hematuria.- - - - - - - - - - ranking = 0.5keywords = propria (Clic here for more details about this article) |
8/65. Neonatal hydronephrosis caused by vesical diverticula.Bladder diverticula are uncommon in infants and are an uncommon cause of hydronephrosis in newborns but can cause significant problems. A thorough diagnostic approach must include both excretion urography and cystourethrography. Early appropriate surgical intervention will result in preservation of renal function.- - - - - - - - - - ranking = 0.5keywords = propria (Clic here for more details about this article) |
9/65. Urachal abscess and infected bladder diverticulum.Urachal abscess is an uncommon condition with protean features and often presents a diagnostic challenge to clinicians. This case report describes a 41-year-old woman with severe multiple sclerosis who was referred to a gynaecological oncology service with the presumed diagnosis of advanced ovarian cancer. A diagnosis of urachal abscess and infected bladder diverticulum was made by a combination of imaging modalities and a percutaneous biopsy. It is important to be aware of this entity, as the presentation varies widely and when diagnosed early the condition may be treated appropriately by relatively minor surgical intervention.- - - - - - - - - - ranking = 0.5keywords = propria (Clic here for more details about this article) |
10/65. Inflammatory pseudotumor of the urinary bladder in a child.The inflammatory pseudotumor of the urinary bladder is rare, especially in children. It is a benign proliferative lesion of the submucosal stroma easily mistaken for a sarcoma clinically, so it should be differentiated from a malignant neoplasm. We report the case of bladder inflammatory pseudotumor in a 7-year-old girl.- - - - - - - - - - ranking = 0.22514592080278keywords = mucosa (Clic here for more details about this article) |
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