The use of the cystoscope in revision hip arthroplasty.
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PURPOSE: We evaluated the urethrocystoscopic findings and results of urodynamic studies in elderly men with voiding complaints. MATERIALS AND METHODS: A total of 492 consecutive patients with voiding complaints underwent a standardized screening program, including transrectal ultrasonography of the prostate, urodynamic investigations with pressure-flow study analysis and flexible urethrocystoscopy. RESULTS: A significant correlation was found between bladder trabeculation and grade of bladder outlet obstruction. Detrusor instability correlated significantly with grade of trabeculation. Grade of obstruction showed a clear correlation with prostatic occlusion of the urethra and the presence of a middle lobe at cystoscopy. CONCLUSIONS: The findings at urethrocystoscopy correlate well with those of urodynamic investigations.
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The treatment of superficial bladder tumours (Ta, T1) is a time-consuming exercise for urological surgeons and patients. A method of treating the tumours, whether primary or recurrent, by endoscopic suction diathermy has been developed. The technique significantly reduces the amount of tumour debris within the bladder during treatment as well as the amount of diathermy employed. By removing the free tumour cells in the irrigation fluid the risk of tumour cell implantation may be kept to a minimum.
The use of the flexible cytoscope in the follow-up of patients with bladder carcinoma is becoming more widespread. In a series of 17 patients, cystodiathermy of small recurrent tumours using the flexible cytoscope and topical urethral anaesthesia proved to be a safe, effective and well tolerated procedure.
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The occurrence of squamous change in the bladder epithelium was studied in bladder biopsies from patients with recurrent urinary infections or symptoms of cystitis and comparisons were made with sections taken at necropsy from control subjects. Two types of squamous change, termed ;vaginal' and ;cornified', are described. Vaginal change was frequent in females, and seemed to be a normal finding in them, but was not observed in males. It did not seem to be caused by urinary infection. Cornified change was also common in females and was found in one (infected) man. Like vaginal change it was most often found in sections from the trigone. Urinary infection may predispose to its formation but we were unable to prove this. Squamous change did not seem to cause symptoms, and could not usually be recognized at cystoscopy. The varieties described are so common that they are unlikely to be markedly precarcinomatous.
OBJECTIVE: To evaluate the place and value of cystoscopy in paediatric bladder dysfunction. METHODS: A retrospective analysis of files of 100 children who underwent cystoscopy. RESULTS: In 6 patients with neurogenic bladder dysfunction, cystoscopy was done for the diagnosis of secondary uropathy. In patients with uropathy, of the neonatal group of 6 patients 2 were seen for evaluation of disorders of sexual differentiation and 4 were seen for further diagnosis of neonatal hydronephrosis. In 21 children cystoscopy was part of the diagnostic and/or therapeutic workup for severe urinary-tract infection and in 5 patients for other uropathies. Sixty-two patients with non-neurogenic, non-uropathic bladder dysfunction were selected to undergo cystoscopy on the urodynamic findings. In boys, 36 had an obstruction and 12 had normal cystoscopy. In girls, 4 had an obstruction and 10 had a minimal meatal deformity. CONCLUSIONS: In children with neurogenic dysfunction, cystoscopy is only indicated in diagnosis and therapy of secondary uropathies. Cystoscopy is part of the diagnostic and therapeutic strategy in uropathy. In non-neurogenic, non-uropathic dysfunction urodynamic study allows the selection of patients who have minimal anatomic deformities that provoke the bladder dysfunction and for whom cystoscopy is indicated.