Other diseases (transverse myelitis, tropical spastic paraparesis, progressive multifocal leukoencephalopathy, Lyme’s disease)
Jacques Corcos, David Ginsberg, Gilles Karsenty in Textbook of the Neurogenic Bladder, 2015
Mori et al.34 recommended in patients with HAM/TSP ultrasound (US) and video-urodynamic studies as the usual methods to define the common diagnosis of neurogenic bladder. Many kidney disturbances can occur due to HAM/TSP neurogenic bladder. US evaluation determines the renal size and parenchyma detail, enlargement of the ureters, hydronephrosis, and kidney stones. Neurogenic bladder leads to incomplete emptying and chronic inflammation of the bladder. Stone formation and acquired diverticula are possible complications. The study of urodynamics is useful for establishing the bladder pattern and choosing the best therapeutic approach. This evaluation identifies the storage pressures, the residual volume, and voiding dysfunctions, which are important for the planning of treatment strategies. Cystoscopy is a method that complements bladder evaluation, since it allows a direct view of its contents and mucosa aspect.34
Urinary tract infection
Shiv Shanker Pareek in The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
Most cases do not require further diagnostic tests. If there is excessive blood in the urine, the following tests may be carried out to rule out more serious conditions or complications: ultrasound – this imaging technique can identify obstructions and causes of abnormal bladder emptying.intravenous urogram (IVU) – a dye is injected into the bloodstream so that the blood flow around the urinary tract can be viewed on X-ray.cystoscopy – the inside of the bladder is viewed with an instrument similar to an endoscope.
Endoscopic Evaluation of Neurogenic Bladder
Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg in Essentials of the Adult Neurogenic Bladder, 2020
Patients with chronic indwelling catheters must undergo annual cystoscopic evaluation. Usually, this routine starts after 5 years of continuous indwelling catheterization. Cystoscopy remains the only way (with cytology) to detect suspicious lesions such as bladder carcinoma. Usually, these lesions start at the level of the trigone, where the catheter and the balloon lie down. In these patients, there is almost always a small reddish area, which is difficult to differentiate from an early carcinoma (Figure 21.16). Biopsy of these lesions is a simple way of reassuring the physician and patient. Bladder tumors can be located anywhere in the bladder and have different aspects, but most frequently papillary (Figure 21.17). Much less frequent are urethral tumors (Figure 21.18).
The etiology and management of recurrent urinary tract infections in postmenopausal women
Published in Climacteric, 2019
C. Jung, L. Brubaker
Cystoscopy, simply performed in the office, provides a view of the bladder and urethra. In a study of 118 women with rUTI undergoing cystoscopy, significant abnormalities were seen in 8%49. The upper urinary tract can be imaged by renal ultrasound or computed tomography50–52. There is limited evidence for upper tract imaging in rUTI patients, with one study of 116 mostly postmenopausal women with rUTI undergoing either renal ultrasound, computed tomography scan, or intravenous pyelogram showing significant abnormalities in 0.9%53. Computed tomography scan is more sensitive and specific in most cases; however, ultrasound has the benefit of no radiation and reduced cost54. Pelvic magnetic resonance imaging is the imaging modality of choice when urethral diverticulum is suspected55,56. Due to the overall limited evidence for further diagnostic work-up of women with rUTI with cystoscopy and upper tract imaging, the decision to pursue is often guided by individual clinical judgment and consultation with providers specializing in the management of rUTI.
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.
Related Knowledge Centers
- Bladder
- Endoscopy
- Microscope
- Urinary Tract Infection
- Urine
- Urethra
- Urinary System
- Lidocaine
- Urinary Meatus
- French Catheter Scale