scholarly journals Intraoperative Problems and Solutions in Pneumovesicum Laparoscopic Cross-trigonal Ureteral Reimplantation in Children by a Beginner Surgeon

2021 ◽  
Vol 73 (11) ◽  
pp. 758-762
Author(s):  
Thawatchai Mankongsrisuk ◽  
Jad A. Degheili ◽  
Bansithi Chaiyaprasithi
Keyword(s):  
Anterior Abdominal Wall ◽  
Bladder Wall ◽  
Ureteral Reimplantation ◽  
Air Leakage ◽  
Oral Antibiotics ◽  
Bladder Mucosa ◽  
Problems And Solutions ◽  
Urinary Bladder Wall ◽  
Tract Infections

Objective: Many beginner surgeons feel anxious when first doing the procedure. Some may encounter many intraoperative difficulties or problems, resulting in abandoning the technique. We will demonstrate our methods and the solutions to major intraoperative problems.Materials and Methods: A beginner surgeon performed the operation on 13 children with VUR (20 ureters) who met the indications for surgery between October 2016 and August 2017. Age ranged from 2 to 7 years. Each operation comprised 2 main steps: anchoring the urinary bladder wall to the anterior abdominal wall under cystoscopic vision, followed by a cross-trigonal ureteral reimplantation under pneumovesicum laparoscopy. The intraoperative problems, postoperative care, and follow-up periods were recorded to identify surgical outcomes.Results: Most significant, intraoperative problems were air leakage, bleeding, tear of the bladder mucosa above the tunnel, and inability to insert a tube into the ureter pre- and post-reimplantation. Most problems could be managed. Only one case had to be converted to open reimplantation due to uncontrolled air leakage. Postoperatively, 2 patients had hydroureteronephrosis at 4 weeks, but it eventually spontaneously regressed. One patient had cystitis, treated with oral antibiotics. Between the 1-year and 4-year follow-up, no patients had hydroureteronephrosis or urinary tract infections (UTI).Conclusion: Pneumovesicum laparoscopic ureteral reimplantation is a feasible technique for beginner surgeons. Although many intraoperative problems may be encountered, most can be managed, resulting in the completion of the laparoscopic procedure.

scholarly journals Urachal Tumor: A Case Report of an Extremely Rare Carcinoma

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
José Palla Garcia ◽  
Rita Sampaio ◽  
Carlos Peixoto
Keyword(s):  
Anterior Abdominal Wall ◽  
Bladder Wall ◽  
Disease Recurrence ◽  
Rare Tumor ◽  
Past Medical History ◽  
Third Trimester ◽  
Surgical Specimen ◽  
The Third ◽  
Mucosal Erosion

The urachus is a tubular structure that connects the bladder to the allantois in the embryonic development, involuting after the third trimester. The urachus carcinoma is an extremely rare tumor that accounts for <1% of all bladder cancers. We report a case of a 46-year-old woman, with no past medical history, complaining of hematuria with 6-month duration and a physical exam and an abdominal computed topographic scan revealing an exophytic mass of 6.8 cm longer axis that grew depending on the anterior bladder wall, invading the anterior abdominal wall. Cystoscopy detected mucosal erosion. The biopsy showed structures of adenocarcinoma of enteric type. The surgical specimen showed urachus adenocarcinoma of enteric type with stage IVA in the Sheldon system and stage III in the Mayo system. This case has a 3-year follow-up without disease recurrence.

PHAEOCHROMOCYTOMA OF URINARY BLADDER

1962 ◽  
Vol 39 (1) ◽  
pp. 1-12 ◽  
Author(s):  
R. Mićić ◽  
M. Kičić ◽  
S. Adanja
Keyword(s):  
Blood Pressure ◽  
Urinary Bladder ◽  
Arterial Hypertension ◽  
Bladder Wall ◽  
Short Review ◽  
Uneventful Recovery ◽  
Urinary Bladder Wall ◽  
The Right ◽  
Catecholamines In Urine

ABSTRACT A case of phaeochromocytoma localized in the urinary bladder wall above the right ureter in a 19 years old male is described. The patient had a sustained arterial hypertension between 170/120 and 260/170, without haematuria, with regular headache and palpitations immediately after urination. Catecholamines in urine 409 and 340 micrograms per day. A partial resection of the urinary bladder wall was performed with extirpation of a tumour weighing 40 g. Size of the tumour 80 × 60 × 60 mm. The tumour contained 1.5 mg adrenaline and 0.03 mg noradrenaline per g of tissue. Postoperatively blood pressure 140/90, catecholamines in the urine normal, and the patient made an uneventful recovery. The last follow-up ten months after operation. A short review of previously published cases is given.

scholarly journals Intrauterine contraceptive device migration to the urinary bladder

2021 ◽  
Vol 10 (12) ◽  
pp. 4558
Author(s):  
Urmila G. Gavali ◽  
Mayuri D. Pawar ◽  
Gautam S. Aher ◽  
Suhas S. Shinde
Keyword(s):  
Urinary Bladder ◽  
Intrauterine Device ◽  
Bladder Wall ◽  
Lower Abdominal Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Urinary Symptoms ◽  
Contraceptive Device ◽  
Urinary Bladder Wall

Intravesical migration represent as uncommon complication of intrauterine device insertion. We present a case of an IUD that migrated to the urinary bladder and impacted in urinary bladder wall, causing significant urinary symptoms. A 44 years old woman presented with menorrhagia, lower abdominal pain and urinary symptoms since past 1 year. She reported an IUD insertion 10 years back. Imaging detected the presence of IUD in the urinary bladder wall with large fibroid in uterus. Under anaesthesia, total abdominal hysterectomy with bilateral salphingoophorectomy is performed and IUD was removed out of the bladder without any complications. In her follow-up evaluation after 2 week, she had no urinary symptoms. A regular follow-up of IUD for visible thread would help in earlier detection of misplaced IUD and prevent the complications such as intravesical migration.

scholarly journals Community-Acquired Methicillin-ResistantStaphylococcus aureusProstatic Abscess Presenting as Acute Urinary Retention: A Case Report and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Ali Naboush ◽  
Ali Abou Yassine ◽  
Mohamad Yasmin ◽  
Neville Mobarakai
Keyword(s):  
Urine Analysis ◽  
Bladder Wall ◽  
Lower Abdominal Pain ◽  
Review Of The Literature ◽  
Urinary Frequency ◽  
Prostatic Abscess ◽  
Uncommon Disease ◽  
Urinary Bladder Wall ◽  
Mrsa Strains

Background. Community-associated MRSA (CA-MRSA) strains have emerged as a substantial cause of infection in individuals without exposure to the healthcare system. Prostatic abscess is an uncommon disease. To date, there are only 6 published reports of a prostatic abscess secondary to CA-MRSA.Case Description. A 52-year-old diabetic Caucasian presented to the emergency department with severe lower abdominal pain of few hours duration, urinary frequency, and dribbling over the last 3 weeks. Physical examination was remarkable for an enlarged nontender prostate. A urine analysis showed pyuria while urine cultures grew CA-MRSA. Computed tomography of the abdomen and pelvis showed multiple prostate abscesses and a thickened urinary bladder wall. A TURP was performed by the urology team and pathology showed severe acute and chronic prostatitis with abscess formation and necrotic tissue. Our treatment regimen included IV vancomycin followed by oral trimethoprim/sulfamethoxazole and rifampin. Eradication of CA-MRSA was confirmed by follow-up cultures 2 months following discharge.Conclusion. This case illustrates the successful identification, diagnosis, and prompt treatment of a prostatic abscess secondary to CA-MRSA in a diabetic patient without recent hospitalization. Early treatment with antibiotics and transurethral resection of the prostate abscess led to a shortened hospital stay and decreased morbidity.

scholarly journals Effectiveness of Ultrasound Measured Urinary Bladder Wall Thickness as a = Diagnostic and Follow up Tool in Men With Bladder Outlet Obstruction

2020 ◽  
Vol 22 (2) ◽  
pp. 188-193
Author(s):  
Mohammad Khairuzzaman ◽  
Muhammad Humayun Kabir ◽  
Tanvir Ahmed ◽  
Syed Alfasani ◽  
Md Shariful Islam ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Wall Thickness ◽  
Postoperative Period ◽  
Bladder Wall ◽  
Surgical Correction ◽  
Therapeutic Effects ◽  
Noninvasive Test ◽  
Bladder Wall Thickness ◽  
Urinary Bladder Wall

Aim: The present study was undertaken with the aim to standardize ultrasound measured urinary bladder wall thickness (UMUBWT) as an additional routine noninvasive test to assess the bladder outflow obstruction (BOO) and to monitor the therapeutic effects of BOO in follow-up after surgical correction of obstruction. Methods: This is an interventional study (pretest-posttest type of clinical trial) conducted between December 2012 to May 2015 where sample size was 55 and sampling technique was purposive. In BOO patient transabdominal sonography was performed using a 7.5 MHz. probe. The thickness of the anterior bladder wall at the midline was measured in both preoperative and postoperative period ( three months after operation) at 3 points approximately 1 cm apart and the average value was recorded. Results: In this study age range was 21-73 years with mean±SD of age was 48.76±15.08 years. In BOO patient preoperative UMUBWT was 0.51 ± 0.16 cm and which reduced to 0.26 ± 0.05 cm three months after surgical correction of obstruction. Conclusion: UMUBWT is a noninvasive, cheap and easily available additional diagnostic tool for detecting BOO as well as it can measure the therapeutic effects in postoperative period. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.188-193

scholarly journals Prognosis and treatment of 46 Chinese pediatric cystic fibrosis patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qionghua Chen ◽  
Yuelin Shen ◽  
Hui Xu ◽  
Xiaolei Tang ◽  
Haiming Yang ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Respiratory Tract Infections ◽  
Adverse Reactions ◽  
Clinical Presentation ◽  
Public Awareness ◽  
Sputum Production ◽  
Tract Infections ◽  
Lost To Follow Up

Abstract Background Since public awareness of cystic fibrosis (CF) has increased, more children have been diagnosed with CF in China. This study aimed to investigate medical and other challenges faced by pediatric CF patients in China. Method Treatments and treatment outcomes were retrospectively analyzed for 46 pediatric CF patients diagnosed from August 2009 to June 2019. Pre- and post-treatment results were compared using independent samples t-test. Results Of 46 pediatric CF study patients, four died and five were lost to follow-up. Thirty-seven patients were monitored for 0.03 to 9.21 years; patients exhibited fewer attacks of respiratory tract infections after diagnosis (4.49 ± 2.13 episodes/year before diagnosis vs 1.97 ± 1.87 times/year after 1-year treatment, p < 0.05), significantly reduced sputum production and experienced 1.62 ± 1.71 exacerbations/year. Patient mean body mass index was 16.87 ± 3.53 and pancreatic malfunction persisted in 15 patients. For 17 children, no significant differences in lung function were found at follow-up as compared to lung function at diagnosis (FEV1: 82.45% ± 16.56% vs 75.26% ± 22.34%, FVC: 87.18% ± 13.64% vs 86.99% ± 19.95%, FEF75%: 46.51% ± 28.78% vs 36.63% ± 24.30%, P = 0.27, 0.97, 0.20, respectively). Pseudomonas aeruginosa (17/27) and bronchiectasis (22/22) were found during follow-up evaluation. Twenty-four patients (64.8%) maintained good adherence to therapies. Overall, azithromycin and tobramycin treatments were administered for 0.5–62 months and 0.5–48 months, respectively, and triggered no obvious adverse reactions. Conclusion No obvious declines in clinical presentation or lung function were found in Chinese pediatric CF patients after receiving standard therapeutic and active treatments, although malnutrition and low compliance were persistent challenges.

scholarly journals Microbiome recovery in adult females with uncomplicated urinary tract infections in a randomised phase 2A trial of the novel antibiotic gepotidacin (GSK140944)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea Nuzzo ◽  
Stephanie Van Horn ◽  
Christopher Traini ◽  
Caroline R. Perry ◽  
Etienne F. Dumont ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Human Microbiome ◽  
Time Points ◽  
Pharyngeal Cavity ◽  
Adult Females ◽  
Microbiome Diversity ◽  
Antibiotic Drug ◽  
Tract Infections

Abstract Background With increasing concerns about the impact of frequent antibiotic usage on the human microbiome, it is important to characterize the potential for such effects in early antibiotic drug development clinical trials. In a randomised Phase 2a clinical trial study that evaluated the pharmacokinetics of repeated oral doses of gepotidacin, a first-in-chemical-class triazaacenaphthylene antibiotic with a distinct mechanism of action, in adult females with uncomplicated urinary tract infections for gepotidacin (GSK2140944) we evaluated the potential changes in microbiome composition across multiple time points and body-sites (ClinicalTrials.gov: NCT03568942). Results Samples of gastrointestinal tract (GIT), pharyngeal cavity and vaginal microbiota were collected with consent from 22 patients at three time points relative to the gepotidacin dosing regimen; Day 1 (pre-dose), Day 5 (end of dosing) and Follow-up (Day 28 ± 3 days). Microbiota composition was determined by DNA sequencing of 16S rRNA gene variable region 4 amplicons. By Day 5, significant changes were observed in the microbiome diversity relative to pre-dose across the tested body-sites. However, by the Follow-up visit, microbiome diversity changes were reverted to compositions comparable to Day 1. The greatest range of microbiome changes by body-site were GIT followed by the pharyngeal cavity then vagina. In Follow-up visit samples we found no statistically significant occurrences of pathogenic taxa. Conclusion Our findings suggest that gepotidacin alteration of the human microbiome after 5 days of dosing is temporary and rebound to pre-dosing states is evident within the first month post-treatment. We recommend that future antibiotic drug trials include similar exploratory investigations into the duration and context of microbiome modification and recovery. Trial registration NCT03568942. Registered 26 June 2018.

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