HISTOPATHOLOGICAL EXAMINATIONS PROFILE OF BLADDER DISEASES IN DR. SOETOMO GENERAL ACADEMIC HOSPITAL FROM JANUARY 2015 TO DECEMBER 2019

Objective: This study aimed to analyze the profile of bladder disease in Soetomo General Hospital based on histopathological examination. Material & Methods: This study was using secondary data. Histopathological examination data of patients with bladder disease were evaluated based on age, gender, and histopathological types. Results: There were 419 patients with bladder abnormalities. Non-neoplasm bladder diseases were found in 62 patients consisted of 56 patients (90.32%) with cystitis and 6 patients (9.67%) with glandular cystitis. Neoplastic bladder diseases were found in 357 patients and were divided into benign and malignant neoplasm. Benign neoplasms were found in 11 patients consisted of 5 patients (45.45%) with UP and 6 patients (54.54%) with IUP. Malignant neoplasms were found in 340 patients consisted of 300 patients (88.23%) with urothelial carcinoma, 26 patients (7.64%) with adenocarcinoma, 14 patients (4.12%) with SCC. Moreover, six male patients with PUNLMP were also reported. Conclusion: Histopathological examination in patients with bladder abnormalities shows that neoplastic bladder diseases (357/419, 85.20%) were more common than non-neoplastic bladder disease (62/419, 14.80%).

Voiding cystourethrography in children: spectrum of findings with clinical correlation

Background Voiding cystourethrography (VCUG) is a gold standard diagnostic tool in the detection of lower urinary tract structural abnormalities in children. Objective To study the spectrum of different urinary tract abnormalities that could be detected in pediatric patients who underwent VCUG. Methods A retrospective study was carried at pediatric radiology unit Ain Shams university hospitals, starting from March 2019 till September 2019. Spectrum of findings were quantified in relation to patients’ symptoms. The number of true acquisitions and fluoroscopic frames, as well as the time of examination, were used as an indicator for radiation dose exposure. Results Out of 134 patients who were included in our study and underwent VCUG, the majority was males (n = 85, 63.4%) and patients who had more than 24 months and less than 216 months with median (IQR) 72 (48-108)months being (n = 82, 61.2%). We found that half of the cases had abnormal VCUG findings (n = 67, 50%). The most common abnormality was vesicoureteric reflux (VUR) (n = 38, 28.4%) followed by bladder abnormalities (n = 14, 10.5%).The commonest presented complaint was urinary tract infection symptoms (n = 58, 43.3%). Infants below 24 months of age showed more abnormal findings than older children. Males showed more abnormal findings than females. High-grade VUR (IV-V) was more frequent than low grade. Both recurrent urinary tract infection (UTI) and bladder abnormalities were found to be strong predictors for VUR (p = 0.019 and 0.013, respectively). The median (IQR) of static films within patients who had abnormal VCUG findings was greater than the median (IQR) of static films within patients who had normal VCUG findings being 7.0 (7.0 – 8.0) versus 6.0 (5.0 – 7.0), respectively with a significant statistically difference (F = 6.571, p = 0.011). Conclusion VCUG can detect different lower urinary abnormalities in children. VUR is the commonest encountered finding during VCUG, especially among patients with recurrent UTI.

Safety of augmentation cystoplasty in patients with bladder abnormalities undergoing renal transplantation: a systematic review

BACKGROUND Augmentation cystoplasty (AC) has been recently proposed to improve a bladder condition before or after a renal transplantation for an optimal allograft function. Until now, AC in adults with end-stage renal disease (ESRD) is uncommon and rarely practiced. This study aimed to investigate the safety of AC in patients with bladder abnormalities who required renal transplantation. METHODS Studies of patients with ESRD and abnormal bladder who underwent AC were searched in ProQuest, PubMed, EBSCO, and Cochrane Library online databases. Only studies published in English from January 1985 to May 2020 were included. The keywords used were renal transplantation, bladder dysfunction, cystoplasty, and their synonyms. Data were extracted by two independent authors who selected, screened, and assessed the articles’ eligibility and quality. The outcomes were graft survival rate and complications of AC. RESULTS A total of 19 articles were included. AC improved an intravesical pressure, a bladder capacity, and a compliance in patients with ESRD and bladder abnormalities, allowing patients to undergo the renal transplantation. Even though AC in patients with renal transplantation resulted in a significantly higher urinary tract infection rate than patients who underwent renal transplantation only, performing AC after renal transplantation was considered safe. CONCLUSIONS AC was considered safe for patients with bladder abnormalities who underwent renal transplantation.

An unusual presentation of synchronous bladder metastases from an oesophageal adenocarcinoma

Adenocarcinoma of the bladder is a rare form of malignancy accounting for fewer than 2% of bladder tumours. It is most commonly a result of direct invasion from prostatic, rectal or gynaecological primaries and less commonly presents from distant haematological or lymphatic metastasis. We report a rare case of oesophageal carcinoma metastasising to the bladder. It involves a 71-year-old man with progressive dysphagia and diagnostic computerised tomography findings of thickening in the oesophagus, bladder and common bile duct. Subsequent endoscopic biopsies of the oesophageal and bladder abnormalities showed immunohistochemical features consistent with upper gastrointestinal malignancy. This report aims to add to current clinical evidence of this route of metastasis and also highlight some of the key markers used by pathologists in interpretation of specimens. It also emphasises the essential role of a multidisciplinary approach for the diagnosis of such rare conditions.

Congenital anomalies of the bladder: world and national data

Introduction. Congenital anomalies of the bladder are relatively rare, characterized by a wide variety of possible variants and a frequent combination with other malformations. These anomalies lead to serious consequences and necessitate early adequate medical and diagnostic assistance to such patients. With this in mind, this lecture was devoted to a review of current approaches to the diagnosis, treatment and prevention of potential complications associated with bladder abnormalities. The main part. The following malformations of the bladder were considered as the main options: anomalies of the urachus; agenesis of the bladder; hypoplasia of the bladder; megacystis; bladder duplication; diverticulum of the bladder; bladder exstrophy; bladder neck contracture. At the same time all the variants of bladder anomalies under consideration were illustrated by the data of radiation diagnostic methods or images of the appearance of such observations. Conclusions. The presented material can be recommended for use in the practice of medical specialists of various profiles, in the educational process of medical universities in the preparation of students of various specialties, highly qualified personnel in residency programs and scientific and pedagogical personnel in graduate school, in postgraduate training of doctors in advanced training programs and professional retraining in the specialty "Urology", as well as in research institutions during scientific research.

Nefrectomia e Cistectomia Parcial no Tratamento de Carcinoma em Bexiga de Cão

O carcinoma de células transicionais (CCT) é considerado a neoplasia mais comum da vesícula urinária do cão. Sua etiologia é multifatorial, porém foi sugerido que fêmeas idosas são mais suscetíveis para desenvolvimento da doença. As manifestações clínicas mais comuns que ocorrem com os animais acometidos são consistentes com hematúria, estrangúria e polaquiúria que podem estar presentes por semanas a meses antes do diagnóstico. O diagnóstico definitivo é realizado através de análise histopatológica, entretanto, através do exame de ultrassonografia podemos detectar anormalidades da bexiga, onde as neoplasias são uma suspeita. Várias terapias têm sido propostas para o tratamento do carcinoma de células transicionais, incluindo cirurgia, radioterapia, quimioterapia, cuidados médicos e paliativos. A excisão cirúrgica em canídeos com CCT pode ser indicada para a obtenção de amostras para biopsia, remoção do carcinoma e para manter ou restaurar o fluxo urinário. O tratamento médico é indicado quando não é possível a ressecção cirúrgica do carcinoma e quando existem metástases, consistindo no uso de quimioterápicos, inibidores COX e a combinação destes dois tipos de tratamento. Objetiva-se com este trabalho relatar o caso de um canino, fêmea, da raça Bloodhound, de sete anos, com carcinoma de células transicionais que foi submetido ao tratamento cirúrgico. Neste caso a nefrectomia associada a cistectomia parcial mesmo com envolvimento de região de trígono e ureter apresentou tratamento curativo durante o período de avaliação do animal, que em sua última avaliação demonstrou-se com doze meses de remissão, assim aumentando a longevidade e melhorando a qualidade de vida do mesmo. Palavras-chave: Canino. Células Transicionais. Cirurgia. Rim. Trígono Vesical. Abstract Transitional cell carcinoma (TCC) is the most common neoplasm of the urinary vesicle in dogs. Its etiology is multifactorial; however, it has been suggested that elderly female dogs appear more susceptible to disease development. Clinically, the affected animals frequently demonstrate hematuria, strangury, and polaquiuria. These symptoms may be present for weeks to months prior to diagnosis. Definitive diagnosis is made through histopathological analysis; however, ultrasound examination enables detection of bladder abnormalities, where neoplasms often occur. Several therapies are used to treat, including surgery, radiation therapy, chemotherapy, and medical and palliative care. Surgical excision in dogs with TCC can be indicated to obtain samples for biopsy, carcinoma removal and to maintain or restore urinary flow. Medical treatment is indicated when surgical resection of the carcinoma is not possible and when there are metastasis, consisting of the use of chemotherapy, COX inhibitors and the combination of these two types of treatment. The objective of this study was to report a case of a seven-year-old female Bloodhound dog with TCC who underwent surgical treatment. In this case, nephrectomy associated with partial cystectomy, even with involvement of the trigone and ureter region, presented curative treatment during the evaluation period of the animal, which in its last evaluation was demonstrated with twelve months of remission, thus increasing longevity and improving quality life. Keywords: Canine. Kidney. Surgery. Transitional cell. Vesical trigone.

Indications and Contraindications for Cystography, Diagnostic Value of the Method

Diseases of the urinary system are quite common, both among adults and among children. If, in case of infectious and inflammatory diseases of the urinary organs, an assessment of the clinical picture and general analysis of the urine is sufficient to make a diagnosis, in a number of other situations — trauma and rupture of the bladder, abnormalities of its development, malignant neoplasms — visualization of the organ is needed. One of these diagnostic methods is cystography.

Contemporary Perspective of Comorbidity in Celiac Syndrome: Connection Between Morphological Changes in Duodenum Mucosa and Biliary Dysfunction

Study Objective: to identify the key clinical and diagnostic markers of comorbidity presenting the risk of biliary pathology in celiac syndrome patients. Study Design: screening observation. Materials and Methods. The study included 133 patients with confirmed celiac syndrome and biliary dysfunction. Subjective clinical symptoms were analysed on the basis of reviews and questionnaires, while objective clinical symptoms were assessed following physical examination. When clinical symptoms were characterised, presence of subjective clinical criteria of functional disorders of gall bladder (GB) and Oddi’s sphincter were assessed. Study Results. Specific markers of biliary dysfunction in patients with celiac syndrome were identified. Following IV Rome criteria (2016), it was determined that subjective symptoms in some patients were signs of biliary indigestion syndrome: aches in right hypochondrium (45.1%), bitter taste in mouth (36.1%), nausea (36.1%). Subject had ultrasound signs on GB pathologies: bends in GB body (31.6%), GB neck (35.3%) and both (33.1%). Celiac syndrome patients had significant correlation between duodenitis severity and morphological characteristic of the major duodenal papilla. Major duodenal papilla inflammation is associated with lymphocytoplasmocytic (44.4%) and leucocytal infiltration (22.6%), dystrophic charges in glandular epithelium, gland hyperplasia (62.9%) (χ2(3) = 48.53; р < 0.001; С = 0.75), demonstrating impact on bile passage. A higher risk of biliary sludge in gall bladder in patients with celiac syndrome is due to GB abnormalities and signs of inflammation and atrophy in major duodenal papilla mucosa and its relation to major duodenal papilla. Conclusion. Our analysis demonstrated that comorbidity in patients with celiac syndrome is associated with biliary dysfunction syndrome. Biliary dysfunction markers are congenital abnormalities in GB structure, that are a result of GB deformation and dyscholia; marked chronic inflammation of major duodenal papilla and duodenum mucosa; stage 3 atrophic changes in duodenum mucosa, according M.N. Marsh. Keywords: celiac syndrome, biliary dysfunction, gall bladder abnormalities, comorbid pathology.

Detection of Urinary Tract Pathology in SomeSchistosoma haematobiumInfected Nigerian Adults

Screening forSchistosoma haematobiuminfection and its possible morbidity was carried out in 257 adult participants in Eggua community, Ogun State, Nigeria. Parasitological assessment for the presence of ova ofS. haematobiumin urine and abdominopelvic ultrasonographic examination for bladder and secondary kidney pathology were carried out.S. haematobiumprevalence of 25.68% (66/257) was recorded among the participants. There was a significantly higher prevalence of 69.2% of urinary schistosomiasis in the females than the prevalence of 31.8% in males (P=0.902). The intensity of infections was mostly light (55) (21.8%) compared to heavy (10) (3.9%) with the mean intensity of 16.7 eggs/10 mL urine. Structural bladder pathology prevalence among participants was 33.9%. The bladder and kidney pathologies observed by ultrasound in subjects withS. haematobiuminfections included abnormal bladder wall thickness (59%), abnormal bladder shape (15.2%), bladder wall irregularities (15.2%), bladder masses (1.5%), bladder calcification (1.5%), and hydronephrosis (3%). Infection withS. haematobiumwas associated with bladder pathology. Higher frequencies of bladder abnormalities were observed more in the participants with light intensity ofS. haematobiuminfection than in those with heavy infection. More bladder pathology was also seen in women than in men, although this was not statistically significant. In conclusion, there is evidence that the development of bladder pathology may be associated withS. haematobiuminfection.