Gross hematuria 10 years after radical cystectomy: adenomatous polyp.

Patients undergoing radical cystectomy with an ileal neobladder need intensive follow-up due to the recent studies concerning the potential neoplastic transformation of the intestinal mucosa. We report a case of a gross hematuria due to a lesion that developed in an ileal orthotopic bladder 10 years after a nerve and seminal sparing radical cystectomy for transitional bladder cancer. We performed a transurethral resection of the lesion and histopathological evaluation revealed an adenomatous polyp.

Patients with bladder outlet obstruction who refuse treatment show no clinical and urodynamic change after long-term follow-up.

Objective: To evaluate in patients with mild bladder outlet obstruction (BOO) who refused the proposed treatment and were on watchful waiting (WW), the symptomatic and urodynamic changes after 1-5 years of follow-up.

Methods: 102 patients with lower urinary tract symptoms (LUTS) and BOO (Schafer class: 2-6, median 3) were clinically and urodinamically re-evaluated after 1-5 years of follow-up. Of these, 82 were submitted to medical (alfuzosin or finasteride) or surgical treatment (prostatectomy or TUIP) and 20, who refused the proposed treatment, were on WW.

Clinical and pressure-flow changes after long-term treatment with alfuzosin SR.

Objectives: The aim of our study was to evaluate the symptomatic and urodynamic changes after 1-5 years of treatment with alfuzosin in patients with benign prostatic hyperplasia.

Methods: Out of 255 patients with lower urinary tract symptoms observed from 1992 to 1997, who completed the International Prostatic Symptom Score (I-PSS) and underwent full urodynamic investigation, 161 were found to be obstructed (Schäfer classes 2-6). One hundred and two subsequently consented to a second clinical and urodynamic evaluation.

Genetic instability in superficial bladder cancer and adjacent mucosa: an interphase cytogenetic study.

A systematic analysis of both tumors and the surrounding urothelium to help identify what lies behind the mechanism of multifocal tumor development has not yet been performed. In this study we investigated chromosome 1, 7, 9, and 17 aneusomy in 25 superficial papillary carcinomas and in 51 tissue samples taken from sites of macroscopically uninvolved urothelium surrounding the tumors, using the fluorescence in situ hybridization method. Our data demonstrated a close genetic relationship between all examined tumors and normal-appearing mucosa.

The evolution of detrusor overactivity after watchful waiting, medical therapy and surgery in patients with bladder outlet obstruction.

Purpose: We analyzed the evolution of detrusor overactivity in patients with bladder outlet obstruction treated with either medical or surgical therapy or watchful waiting.

Materials And Methods: Of 255 patients with symptomatic benign prostatic enlargement who completed the International Prostate Symptom Score and underwent full urodynamic investigation 161 presented with bladder outlet obstruction. Of the 161 men 101 were reevaluated with a second clinical evaluation and urodynamics 1 to 5 years (mean 2) after watchful waiting in 20, medical treatment (alfuzosin 20 and finasteride 16) in 36 and surgery (transurethral incision of the prostate 13 and prostatectomy 32) in 45.

Long-term maintenance bacille Calmette-Guérin therapy in high-grade superficial bladder cancer.

Objectives: To assess the long-term results of intravesical bacille Calmette-Guérin (BCG) induction plus long-term maintenance treatment for high-grade superficial bladder cancer.

Methods: Between 1994 and 2000, 41 patients who presented to our clinic with superficial urothelial carcinoma of the bladder (T1G3, T1G3 plus carcinoma in situ, or recurrent TaG2-3) were treated by transurethral resection of all visible tumor and an induction cycle of BCG plus a long-term maintenance BCG course consisting of 11 monthly instillations followed by 4 quarterly instillations and then by 6 six-monthly instillations. The median follow-up was 40 months.

Technical modification of Mainz pouch II urinary diversion: preliminary experience.

Use of the Mainz pouch II technique leads to a reduction in the complications frequently observed because of the high pressure associated with ureterosigmoidostomy. A technical variation of the procedure is described in which reimplantation of the left ureter in the rectosigmoid is carried out to avoid the risk of stretching and kinking and the need to fix the pouch to the sacrum. Furthermore, this procedure is easier to perform and less time consuming.

Superficial bladder tumors in patients under 40 years of age: clinical, prognostic and cytogenetic aspects.

Bladder carcinoma with transitional cells is the most frequent neoplasia in the urinary system, but it is quite rare in patients under 40 years of age (0.4-2%). An analysis of 21 patients under 40 and a review of other reports show that tumors in patients under 20 years old have little tendency to recur and to progress, while tumors in patients aged between 21 and 40 have a behavior pattern similar to older age groups regarding recurrence and disease progression.

Role of 5-aminolevulinic acid in the diagnosis and treatment of superficial bladder cancer: improvement in diagnostic sensitivity.

Objectives: To use 5-aminolevulinic acid (5-ALA) in diagnostic cystoscopy and during transurethral resection of the bladder (TURB) to treat transitional cell carcinoma. The efficacy of this new technique was compared with standard cystoscopy.

Methods: The 5-ALA, instilled in the bladder 2 hours before cystoscopy, makes the pathologic tissue fluorescent when illuminated with blue light (375 to 400 nm).

Determination of trazodone and its metabolite, m-CPP, in serum and urine by HPLC.

A sensitive and rapid method for the analysis of trazodone (TZD) and its metabolite, 1-(m-chlorophenyl)piperazine (m-CPP), in the serum and urine of rabbits treated with the drug was developed. The assay requires extraction from the biological fluids with adequately buffered organic solvents followed by HPLC. The assay allows good reproducibility, fair recovery, and excellent linearity in the range of 0.

A new method for the determination in blood and urine of a novel triazolobenzodiazepine (estazolam) by HPLC.

In this study the authors report a new method to determine estazolam in blood and urine by high pressure liquid chromatography (HPLC). This compound is a triazolobenzodiazepine and shows an interesting psychopharmacological activity. The extraction from biological fluids was carried out using a mixture of ethylenechloride, methylenechloride, and ethylacetate (1:1:8).