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Management of deep infiltrative endometriosis (DIE) causing gynecological morbidity: A urologist's perspective
Published in Seema Chopra, Endometriosis, 2020
Aditya Prakash Sharma, Girdhar Singh Bora
Cystoscopy is to be performed in all patients with BE, which can demonstrate bluish intraluminal mass at the dome or the posterior wall. Cystoscopy is crucial before planning any surgical intervention. The location and size of the tumor, as well as distance from the ureteric orifices, should be assessed [7]. Preoperative stenting can be done if the ureteric orifice is close, and a biopsy can be planned when urothelial malignancy or other bladder tumors are suspected.
Pediatric urology
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Laurel Sofer, Emilie K. Johnson
A systematic pelvic exam should be performed, including palpation of the anterior vaginal wall, bladder neck, urethra, vestibule, cervix, adnexa, posterior vaginal wall, and rectum. Evaluation of myofascial trigger points should also be performed. Performing a pelvic exam may be difficult in a child or adolescent. In young patients, this may need to be deferred until the patient is under anesthesia in the operating room if cystoscopy is planned.37
Interstitial cystitis and chronic pelvic pain
Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019
Cystoscopy under general anesthesia: Traditionally required for a diagnosis of IC23However, recent clinical data have not supported this concept, and the vast majority of patients with IC symptoms will have normal or non-specific cystoscopic findings29,30Therefore, cystoscopy under general anesthesia is not required in the evaluation of suspected IC patients.26
Diagnostic performance of urine and blood microRNAs for bladder cancer: a meta-analysis
Published in Expert Review of Anticancer Therapy, 2022
Qingfeng Ye, Jundan Wang, Da Xu, Yu Liu, Dimei Zhang, Jufeng Ye, Hua Li
Bladder cancer (BCa) is the most frequent urologic malignancy with high incidence and mortality in the world [1]. In the United States alone, approximately 83,730 new cases of BCa were diagnosed in 2021, with an estimate of 17,200 deaths [2]. There were an estimated 73,000 new cases diagnosed in China, 2017, with an incidence of 3.89/100,000, and the total number of new cases increased by 164.49% from 1990 to 2017 [3]. According to the invasive depth, bladder tumor is categorized into two subtypes; non-muscle invasive BCa (NMIBC) and muscle invasive BCa (MIBC). Among the new diagnosed BCa, the proportions for NMIBC and MIBC are 75% and 25%, respectively [4]. It has been reported that the overall 5-year recurrence rate of patients with NMIBC was 50%–90% after tumor resection [5,6]. However, the recurrence rate for MIBC was as high as 90% within the first 2 years [7]. Cystoscopy and urinary cytology are the current standards for BCa detection. However, the two diagnostic methods are not without limitations. Cystoscopy is high in specificity, but low in sensitivity [8]. In addition, cystoscopy is an invasive procedure, and may lead to severe complications, such as bleeding and urinary tract infection. Urine cytology is noninvasive and plays a good role in evaluating eluent from an organ, while low sensitivity for low-grade BCa hampers its application. Therefore, sensitive and noninvasive diagnostic biomarkers are urgently needed for early BCa detection.
Intralesional injection of mitomycin C following internal urethrotomy of de novo bulbar urethral stricture:New experience using a novel adjustable-tip needle
Published in Arab Journal of Urology, 2021
Yasser A. Noureldin, Abdallah Fathy, Shabib Ahmed, Alaa El Shaer, Saad Ali, Zakaria Saki, Ahmed Sebaey
The intervention was performed under spinal anaesthesia. Preoperative antibiotic prophylaxis with a single oral dose of levofloxacin 500 mg was given. Patients were put in lithotomy position, and cysto-urethroscopy was performed using a 17-F rigid cystoscope to allow for a guidewire and ureteric catheter to pass through the stricture into the urinary bladder. Cold-knife incisions, at the 12-, 4-, and 8-o’clock positions, were made through the whole thickness of the fibrosis until healthier tissue appeared (Figure 2). In Group-A, a special depth-adjustable injection needle for rigid cystoscope use (DIS199: injeTAK® adjustable-tip needle, LABORIE, Williston, VT, USA) was used to inject 0.4 mg/mL MMC along the whole length of each incision into healthier-appearing tissue (4 mg dose of MMC) (Figure 3). The needle is 35 cm and 23 G/4.8 F.
Non-surgical treatment for hematocele in the bladder associated with ascites puncture in a patient with ovarian hyperstimulation syndrome: a case report
Published in Postgraduate Medicine, 2021
Xue Ke, Yong-Hong Lin, Fang Wang
For patients with hematocele in the bladder without active bleeding or ureter injury, we use the 22-French three-way Foley catheter. Specifically, the diameter of this catheter can produce a large enough surging force and suction the fragmented small blood clots. It should be noted that 1) after the indwelling catheter is placed, attention should be paid to not completely remove all of the liquid during the irrigation process; suctioning of the bladder wall may cause the patient pain. Furthermore, during the irrigation and suction process, the color, character, and volume of the suctioned liquid should be closely observed. The ureter position, angle, and depth should be continuously adjusted under abdominal B-ultrasound guidance, until ultrasonography reveals that the weak echogenic masses have decreased. The irrigation should be terminated when the suctioned liquid becomes clear. 2) During the irrigation and suction process, special importance should be attached to sterile operation to prevent secondary infection. 3) The irrigation and suction solution should be 0.9% normal saline, and it should be appropriately heated to the temperature close to human body temperature (34–37°C). On the basis of our experience, low temperatures can induce bladder convulsion and subsequent abdominal pain. 4) If conservative treatment is ineffective, preoperative preparation should be meticulous in order to remove the blood clots in the bladder under a cystoscope.