Cases reported "Urinary Bladder Neoplasms"

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1/13. Advanced adenocarcinoma of the urinary bladder successfully treated by the combination of cisplatinum, mitomycin-C, etoposide and tegafur-uracil chemotherapy.

    Primary adenocarcinoma of the urinary bladder has shown an extremely poor response to radiation or chemotherapy. Therefore, radical surgery is the only therapeutic treatment for it. A case report is presented of a primary advanced adenocarcinoma of the urinary bladder invaded into the uterus with distant metastases which responded completely to systemic combination chemotherapy including tegafur-uracil. The patient was a 53-year-old woman with a history of asymptomatic macrohematuria. She was treated with the combination of cisplatinum, mitomycin-C, etoposide and tegafur-uracil chemotherapy. After four courses of the chemotherapy, computed tomography showed marked regression of the primary tumor of the urinary bladder and the complete disappearance of the distant metastases in the liver, lung and para-aortic lymph node. Subsequently, she underwent radical cystectomy and cutaneous ureterostomy. Pathologically, no viable cancer cells were detected. Three years after the operation, she has no evidence of disease recurrence. Treatment of advanced adenocarcinoma of the urinary bladder by this combination chemotherapy is of benefit.
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ranking = 1
keywords = ureterostomy
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2/13. Reconstruction of urinary tract utilizing transverse colon conduit for a cystectomized patient with post-ureterocutaneostomy complications and sigmoid colon cancer.

    A seventy-four years old man had been suffering from symptomatic and infectious complications associated with conjoined cutaneoureterostomy following the radical cystectomy for advanced transitional cell carcinoma of the bladder 3 years ago. He underwent urinary reconstruction using transverse colon conduit after diagnostic exclusion of recurrent urothelial tumor in the upper urinary tract, evaluation of performance status and endoscopic examination of the colon. Enteroscopy incidentally revealed he had an early stage adenocarcinoma in his sigmoid colon to be resected, and the resection was followed by the urinary diversion. Postoperatively he is satisfied to be free from urinary complications and frequently visits the outpatient clinic for painful and troublesome ureteral catheter exchange.
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ranking = 1
keywords = ureterostomy
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3/13. Distal ureteral replacement with tubularized porcine small intestine submucosa.

    Extensive ureteral injury can result from renal stone disease, iatrogenic injury, or penetrating trauma. A significant ureteral stricture can be repaired using various techniques, including the psoas hitch, Boari flap, transureteroureterostomy, ileal ureter, or renal autotransplantation. We describe a woman with a 5-cm, ischemic uretero-indiana pouch stricture that developed after cystectomy and urinary diversion. Severe pelvic fibrosis prevented adequate mobilization of the ureter and indiana pouch and would not permit any of the above-mentioned procedures. We report the first human use of tubularized small intestine submucosa to successfully replace a 5-cm strictured segment of distal ureter.
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ranking = 1
keywords = ureterostomy
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4/13. Simple correction of ureteral stomal stenosis for cutaneous ureterostomy.

    Cutaneous ureterostomy is a simple procedure to perform, but has some morbidity owing to stomal stenosis. We describe a new and simple technique applied to the stomal stenosis for cutaneous ureterostomy.
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ranking = 6
keywords = ureterostomy
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5/13. A case of quadruple cancer including urinary bladder, oral cavity, stomach and lung.

    A 67-year-old man, who had smoked heavily for many years, was found in 1997 to have bladder tumors, and transurethral resection of the bladder tumor (TUR-Bt) was performed. Histopathological diagnosis was urothelial carcinoma (G2>G3, pTa, N0, M0, ly0, v0). In December, 1998, he noticed an oral cavity tumor. After preoperative radiation therapy (total 40 Gy, 17 times), surgical treatment was undertaken. Histopathological diagnosis was well differentiated squamous cell carcinoma (pT2, pN2b, M0). In February, 2000, gastric tumor was detected by endoscopic examination, and subtotal gastorectomy and Roux en Y operation were performed. Histopathological diagnosis was well differentiated adenocarcinoma (pT2, pN0, M0, P0, CY0). A chest computed tomographic (CT) scan revealed a solitary lung tumor in April, 2000. Partial peumonectomy was performed, and histopathological diagnosis was poorly differentiated adenocarcinoma (pT1, N0, M0, P0). In April, 2000, multiple lesions of bladder cancer in the neck of the urinary bladder and posterior urethra were found and radical cystoprostatourethrectomy combined with lymph node dissection and bilateral cutaneous ureterostomy were performed (urothelial carcinoma, G3, pT4a, pN2, M0, pL2, pV0, pR0). Since then, the patient has been followed carefully.
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ranking = 1
keywords = ureterostomy
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6/13. Unique urinary-fecal calculus after cystectomy and ureterosigmoidostomy.

    A 36-year-old m an had stage B1 bladder cancer-treated by cystectomy and ureterosigmoidostomy. Postoperatively, a urinary leak was managed successfully by transureteroureterostomy and temporary colostomy. In succeeding years a large calculus developed in the region where the bladder had been and it also involved the sigmoid colon. The huge stone was removed successfully. A nonabsorbable suture was found in the center of the stone. This is a unique complication of ureterosigmoidostomy.
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ranking = 1
keywords = ureterostomy
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7/13. Vesicoureteral reflux in complete ureteral duplication: surgical options.

    Vesicoureteral reflux is the most common abnormality seen with complete ureteral duplication. The majority of cases require surgical correction. The techniques used in 62 patients with 71 duplicated systems with reflux are reviewed. Reflux into the lower pole was encountered in 51 duplicated systems, both poles in 19 systems and the upper pole in 1. A total of 42 conjoint ureteral reimplantations was performed but in 8 cases only the lower pole ureter with reflux was reimplanted after it was separated from the nonrefluxing ureter. Ipsilateral ureteroureterostomy was performed in 19 cases of lower pole reflux. Two patients underwent lower pole heminephrectomy. Satisfactory results were obtained by all 3 reconstructive techniques. However, for lower pole reflux we recommend ipsilateral ureteroureterostomy unless a contralateral operation also is necessary. Ureteroureterostomy proved to be a simple and safe operation free of complications, with little morbidity and requiring a shorter hospitalization.
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ranking = 3
keywords = ureterostomy
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8/13. Intravesical adriamycin chemotherapy in bladder cancer.

    In an experimental study undertaken to elucidate the mechanism whereby Adriamycin (ADM) instilled into the bladder produces its side-effects, the time course of ADM concentration in blood, urine, and tissues of various organs, and also histopathological changes in the bladder mucosa were investigated in normal adult dogs that had undergone bilateral ureterostomy and then received intravesically instilled ADM. Clinically, ADM was used in the treatment of superficial bladder tumors in an attempt to facilitate the transurethral operative procedure. A total of 261 patients were included in this trial. ADM was instilled into the bladder at the following dosages: 1,000 micrograms/ml (30 mg ADM per 30 ml physiological saline), 1,600 micrograms/ml (50 mg ADM per 30 ml physiological saline), and 2,000 micrograms/ml (60 mg ADM per 30 ml physiological saline). The rate of effectiveness was 32%, 66%, and 60%, respectively. The incidence of side-effects was 29%, 20%, and 45%, respectively. The systemic uptake of the drug was small and the side-effects were pain an micturition, pollakiuria, and urgency. From the aspects of efficacy and toxicity, 1,600 micrograms/ml was found to be the optimal dosage.
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ranking = 1
keywords = ureterostomy
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9/13. Micturition with headache: phaeochromocytoma of the bladder.

    A patient with a 20-year history of severe frontal headaches when passing urine was found to be severely hypertensive. Investigations confirmed a clinical diagnosis of phaeochromocytoma of the bladder. Treatment by a partial cystectomy and transuretero-ureterostomy resulted in a complete removal of the tumour, control of his hypertension and resolution of the headaches.
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ranking = 1
keywords = ureterostomy
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10/13. Laparoscopic bilateral cutaneous ureterostomy for palliation of ureteral obstruction caused by advanced pelvic cancer.

    In cases of advanced urologic malignancies with impairment of renal function secondary to tumor infiltration in high-risk patients, the possibility of performing a laparoscopic instead of an open cutaneous ureterostomy should be considered. We performed laparoscopic cutaneous ureterostomy in three male patients, two with prostate cancer and one with bladder cancer, and in one female patient with uterine cancer. Five operative ports were used. The ureters were identified, dissected, severed, and passed through two 10-mm ports; and cutaneous ureterostomies were performed in the usual manner. The mean operative time was 96 minutes. patients were discharged after 5 to 7 (mean 6) days. The two patients with prostate cancer are now in treatment with GnRH analogues with a follow-up of 3 and 7 months. The patient with bladder cancer underwent palliative radiotherapy and is well after 6 months. The patient with uterine cancer has stable disease after 3 months. Laparoscopic urinary diversion causes less discomfort and has a low complication rate and may be the first-choice diversion in patients with advanced cancer who have a life expectancy longer than 6 months.
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ranking = 6
keywords = ureterostomy
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