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PubMed1986

[A case of leiomyosarcoma of the urinary bladder].

A case of leiomyosarcoma of the urinary bladder in a 33-year-old female is reported. She was admitted with the complaint of gross hematuria. Cystoscopic examination showed a thumb-tip sized mass, located at the dome. CT showed a wide-based tumor at the dome (CT number was 60.2 H.U.). Segmental resection of bladder was performed, followed by radiation and chemotherapy (VCR, ACT-D, CPM and ADM). She is alive without evidence of disease 13 months after surgery. A case report and review of the literature are presented.

Adult↗

PubMedDate not supplied

Expression of c-erbB-2 protein in normal and neoplastic urothelium: lack of adverse prognostic effect in human urinary bladder cancer.

The clinical significance of c-erb B-2 expression in urinary bladder cancer remains controversial. We performed an immunohistochemical study to examine the expression of c-erb B-2 in non-neoplastic urothelium (n = 12) and transitional cell carcinoma of the urinary bladder (n = 82). c-erb B-2 protein was localized in superficial and some intermediate cells of non-neoplastic urothelium. A total of 29 out of 82 (35%) tumors were positive for c-erb B-2 over-expression. There was no significant association of c-erbB-2 expression with tumor grade (p = 0.12), stage (p = 0.93), DNA ploidy status (p = 0.56) and the sex of patients (p = 0.5). Expression of epidermal growth factor receptor and Ki-67 index was available in 33 cases. Both parameters showed no apparent association with c-erbB-2 expression (p = 0.53 and 0.58 respectively). Factors correlated with poor patient survival by univariate analysis were tumor stage (p = 0.0001), tumor grade (p = 0.001), development of second recurrence (p = 0.002) and negative expression of c-erbB-2 (p = 0.017). Important indicators associated with first recurrence were tumor stage (p = 0.028), and c-erbB-2 expression with the risk of second recurrence (p = 0.031). Multivariate survival analysis revealed that tumor stage was among the most important prognostic factors (p = 0.029), followed by tumors without c-erbB-2 expression (p = 0.031) with a median follow-up at 46 months. The age of patients and c-erbB-2 expression were significantly associated with developing second recurrence (p = 0.031 and 0.046 respectively). The results indicate that expression of c-erbB-2 is independent of the stage and grade of bladder cancer. Although c-erbB-2 status can discriminate subpopulations with a high risk of recurrence, evaluation of its expression in paraffin-embedded tumors does not indicate poor prognosis for patients with urinary bladder cancer. To address this discrepancy a better understanding of the regulatory mechanism and physiological properties of c-erbB-2 protein in urothelium is required.

Adult↗

PubMed1996

Management of urinary bladder injuries in laparoscopic assisted vaginal hysterectomy.

BACKGROUND: To illustrate our experience and evolution in management of urinary bladder injury in laparoscopically assisted vaginal hysterectomy. METHODS: Four hundred and twenty-two women underwent laparoscopically assisted vaginal hysterectomy with or without adnexectomy during the period March 1991-September 1994. The indicators for hysterectomy included adenomyosis, myoma uteri, intractable menorrhagia, endometriosis and severe pelvic adhesion. There are six cases of urinary bladder injuries resulting from our 422 cases of laparoscopically assisted vaginal hysterectomy. RESULTS: The first two cases of urinary bladder injuries were repaired through exploratory laparotomy. The third case was repaired through laparoscopic intracorporeal suture. The technique of the automatic linear stapler through laparoscopy was used in case 4. The last two cases were repaired vaginally. All these patients recovered well after primary repair with an indwelling catheter for five to seven days regardless of the method of repair. The operation time for repairing the injuries is shortest in vaginal approach. CONCLUSIONS: The urinary bladder injury is one of the most common complications associated with laparoscopically assisted vaginal hysterectomy. Early detection and treatment enable complications to be overcome easily. As the laparoscopist acquires further experience in dealing with these complications, the urinary bladder injury may be managed laparoscopically. However, vaginal approach may be an easier way in dealing with this complication. Thus, most laparotomy or high technique laparoscopically repair could be avoided.

Female↗

PubMed1998

[10-Hydroxycamptothecin induces apoptosis in human T24 urinary bladder cancer cells].

OBJECTIVE: To study the emechanisms of 10-Hydroxycamptothecine (HPT) inhibiting human urinary bladder cancer. METHODS: Using flow cytometry, electron microscopy and fluorescence microscopy, we studied the effects of HPT on human T24 urinary bladder cancer cells. RESULTS: HPT at 0.005 mg/L inhibited T24 bladder cancer cells by preventing the cells from S phase to G2/M phase and did not induce apoptosis. The apoptotic cells were induced by HPT at the concentration of 0.01-0.10 mg/L. CONCLUSION: HPT can inhibit human T24 urinary bladder cancer cells and induced apoptosis at some concentrations. The induction of apoptosis is a very important mechanism of 10-Hydroxycamptothecine to treat urinary bladder cancer cells.

Antineoplastic Agents, Phytogenic↗

PubMed1999

Expression of cyclooxygenase-2 (COX-2) in human invasive transitional cell carcinoma (TCC) of the urinary bladder.

Cyclooxygenase (COX)-inhibiting drugs have antitumor activity in canine and rodent models of urinary bladder cancer. Two isoenzymes of COX have been identified, COX-1 and COX-2. The purpose of this study was to characterize COX-1 and COX-2 expression in human invasive transitional cell carcinoma of the urinary bladder by immunohistochemistry and Western blot analysis. COX-2 was not expressed in normal urinary bladder samples but was detected in 25 of 29 (86%) invasive transitional cell carcinomas of the urinary bladder and in 6 of 8 (75%) cases of carcinoma in situ. These results indicate that COX-2 may play a role in bladder cancer in humans and support further study of COX-2 inhibitors as potential antitumor agents in human bladder cancer.

Aged↗

PubMed1999

The role of alpha 1L-adrenoceptor in rat urinary bladder: comparison between young adult and aged rats.

We examined the role of the alpha1L-adrenoceptors in the urinary bladder of young adult and aged rats in vitro. In the isolated body of the urinary bladder (corpus vesicae), phenylephrine-induced contractions were significantly facilitated in aged rats. Either prazosin, a non-selective alpha1-adrenoceptor antagonist, or JTH-601, an alpha1L-adrenoceptor antagonist, competitively inhibited the phenylephrine-induced contraction of isolated body of the urinary bladder. The antagonistic effect of JTH-601 was almost equipotent between young adult and aged rats (pA2 values were 9.61+/-0.12 and 9.79+/-0.07, respectively), although a statistically significant difference was noted for that of prazosin (pA2 values were 9.49+/-0.09 and 9.19+/-0.06, respectively). In macroscopic autoradiographic studies, specific binding of [3H]JTH-601 (5nM) was seen widely in the muscle layer of urinary bladder, but no differences were noted between young adult and aged rats. In the present study, there was no evidence to suggest a role of the alpha1L-adrenoceptors in the body of rat urinary bladder. On the other hand, alpha1A-adrenoceptors may play an important role in an age-related increase of alpha1-adrenoceptors response in this tissue. These results suggest that a facilitation of contractile response mediated by alpha1A-adrenoceptors may be a cause of unstable bladder in aged persons.

Adrenergic alpha-Agonists↗

PubMed1997

Impact of aging on rat urinary bladder fatigue.

PURPOSE: Little is known about the fatigability of the urinary bladder. In these experiments, we characterized contractile and bioenergetic changes in bladder fatigue and investigated the impact of aging on these changes. MATERIALS AND METHODS: Whole urinary bladders from 3-month-old (n = 17) and 24-month-old (n = 12) SD rats were isolated and individually mounted in organ baths. The bladders were electrostimulated repeatedly (50 volts, 32 Hz, 1 MS; every 2.5 minutes). The pressure generation, rate of pressure generation and the emptying ability (% volume emptied) of the isolated bladders were measured with each stimulation. After the 20th electrostimulation, the bladders were immediately stimulated with 500 microM bethanechol. Upon completion of their series of stimulations, some of the bladders were quickly frozen in liquid nitrogen. Tissue phosphocreatine and ATP content of the frozen bladders and a group (six 3-month-old and six 24-month-old rats) of fresh bladder tissues was determined using high performance liquid chromatography (HPLC). RESULTS: The results can be summarized as follows: (1) Pressure generation, rate of pressure generation and emptying ability were gradually reduced in both young and aged bladders as repeated stimulation proceeded. (2) The final bethanechol stimulation emptied the same intravesical volume as the 20th electrostimulation emptied (in both groups), indicating that bladder fatigue is due to a post-synaptic mechanism. (3) As compared to their own first responses, aged rats exhibited significantly greater rates of reduction in both pressure generation and emptying ability than did young rats. (4) Analysing fresh bladder tissues, the phosphocreatine and ATP concentration of the aged bladders were significantly less than those of the young bladders-13.2 +/- 2.0 and 1.2 +/- 0.3 nmol/mg. protein respectively in the aged bladders vs. 21.2 +/- 1.8 and 7.5 +/- 1.0 nmol/mg. protein respectively in the young bladders. After repeated stimulation, phosphocreatine and ATP concentration were reduced in both groups (1.4 +/- 0.3 and 0.43 +/- 0.1 nmol./mg. protein in the aged bladders, 7.5 +/- 1.4 and 4.1 +/- 0.5 nmol./mg. protein in the young bladders), with a greater degree of reduction in the aged bladders. CONCLUSION: These observations indicate that, in response to repeated electrostimulation, aged rat bladders became fatigued faster than young bladders. Decreased capability in energy production might be one contributing factor for faster fatiguability of the aged urinary bladders.

Aging↗

PubMedDate not supplied

AVP-independent high osmotic water permeability of frog urinary bladder and autacoids.

In the isolated frog urinary bladder a 20- to 50-fold increase of the osmotic water permeability has been revealed in the absence of arginine vasopressin (AVP) as a result of several successive changes of the serosal Ringer solution. This increase of the osmotic water permeability was of the same magnitude as that of the effect of 1 nM AVP. Similarly to the effect of AVP, the amount of adenosine 3',5'-cyclic monophosphate (cAMP) in the cells rose, and aggregates of intramembraneous particles were formed in the apical plasma membrane of granular cells (as shown by the freeze-fracture method). Immunocytochemical studies using anti-actin monoclonal antibodies indicated depolymerization of F-actin following the AVP-independent change in water permeability. It was possible to decrease the high level of osmotic permeability to the initial level if 10 microl/ml of frog blood serum or a lipid extract of this blood serum, or 1 microM arachidonic acid or 1 nM prostaglandin E2 was added to the serosal Ringer solution. The rapid restoration of the osmotic water impermeability of the epithelium after the AVP- evoked effect was achieved by the addition to the serosal Ringer solution of Ringer solution in which intact frog urinary bladders had been previously incubated for 1 h. The data obtained indicate that the maintenance of the impermeability to water of the osmoregulating epithelium and the restoration of the initial low level of the osmotic permeability after the effect of AVP are due to participation of prostaglandin E2 and other autacoids as well as, probably, some physiologically active substances of a lipid nature that are present in the blood serum.

Animals↗

PubMed2002

Distressful symptoms after radical radiotherapy for urinary bladder cancer.

BACKGROUND: Radical radiotherapy for muscle-invasive urinary bladder cancer can sterilize the tumour with preserved organ function. Here we studied symptoms, symptom distress and trade-off among long-term survivors and compared figures to those of population controls and patients who had undergone cystectomy. MATERIALS AND METHODS: We identified 71 patients who had had urinary bladder cancer treated with radical radiotherapy before 1995. For comparison, 325 patients treated with radical cystectomy and urostomy, continent or non-continent, during the same period and 460 individuals randomly selected from the general population were included. Information was collected by means of an anonymously answered postal questionnaire to avoid investigator-related bias. RESULTS: Answers were obtained from 58 (82%) radiated patients, 251 (85%) cystectomized patients and 310 (71%) population controls. Of the radiated patients, 74% reported little or no distress from symptoms from the urinary tract, 38% had had intercourse the previous month and 57% (men) reported they had ejaculated. Among the cystectomized patients, 13% had had intercourse and 0% (men) had ejaculated. Moderate or much distress from symptoms from the gastrointestinal tract was reported by 32% of the radiated patients, 24% of the cystectomized patients and 9% of the population controls. After radical radiotherapy, 46% of the patients were willing to accept some risk of decreased survival to become symptom-free. CONCLUSIONS: About 3/4 of these long-term survivors after radical radiotherapy for bladder cancer had a functioning urinary bladder with little or no distress from the urinary tract. The prevalence of sexual dysfunction was lower than after cystectomy and the prevalence of distress from the gastrointestinal tract was comparable.

Aged↗

PubMed2003

High incidence of urinary bladder involvement in carcinomas of the sigmoid and rectum: a retrospective review of 580 patients with colorectal carcinoma.

BACKGROUND AND OBJECTIVES: It is not uncommon for colorectal carcinomas to invade the urinary bladder. However, the actual incidence of urinary bladder invasion of colorectal carcinomas and the common sites of the original tumors are still unclear. METHODS: The clinical records of 580 patients diagnosed with colorectal carcinoma were retrospectively reviewed. A further review of patients with urinary bladder invasion was performed. RESULTS: Of the 580 patients, 17 (2.9%) had a diagnosis of urinary bladder invasion intraoperatively. The incidence of bladder involvement was significantly higher in carcinomas of the sigmoid and rectum than in carcinomas of other colon segments (4.1 vs. 0.5%, P = 0.017). Although a combination of computed tomography (CT) and cystoscopy predicted 80% of the bladder involvement, preoperative diagnostic modalities could not provide information for the differentiation between macroscopic and pathological invasion or the necessity for total cystectomy. CONCLUSIONS: The sigmoid colon and rectum were common sites of the original tumors invading the urinary bladder compared with other colon segments. CT and cystoscopy are recommended for preoperative screening of the bladder involvement of sigmoid colon and rectal cancer. However, it appeared to be difficult to predict the pathological invasion of malignant cells and the necessity for total cystectomy preoperatively.

Adult↗

PubMed1987

[Effect of terodiline hydrochloride on the function of urinary bladder in rats].

The effect of terodiline on the function of urinary bladder was investigated in anesthetized rats. When saline was infused continuously into the urinary bladder of rats, terodiline (1-10 mg/kg, i.v.) prolonged the time to micturition in a dose-dependent manner. When enough saline was infused into the urinary bladder to induce the voiding contraction in urethra-ligated rats, terodiline (1-10 mg/kg, i.v.) and verapamil (1 mg/kg, i.v.) abolished the contraction, of which amplitude and frequency were partially inhibited by atropine (1 mg/kg, i.v.). Efferent discharge from the pelvic nerve on the micturition reflex was inhibited by terodiline (3 mg/kg, iv.v.). Both of the bladder contractions evoked by the electrical stimulation of the peripheral or central cut end of the pelvic nerve were dose-dependently inhibited by terodiline (1-10 mg/kg, i.v.). At 3 mg/kg or more, terodiline significantly inhibited the contraction, and the effects were long lasting. The effect of atropine (1 mg/kg, i.v.) was similar to that of terodiline (3 mg/kg, i.v.). Increase in frequency of urination and decrease in total urinary volume per micturition after the bilateral transection of the hypogastric nerve were improved after on oral administration of terodiline (1-10 mg/kg).

Animals↗

PubMed1995

Pseudosarcoma of the urinary bladder.

A case of pseudosarcoma of the urinary bladder is described in a woman aged 23. The tumor presenting with symptoms of cystitis arised in the left wall and invaded vesical cavity and pelvis. Histological, histochemical, immunohistochemical and electron microscope studies revealed a fibroblastic and myofibroblastic proliferation with atypias, accompanied by inflammatory infiltrates and rich vascularity. The tumor was furthermore characterized by extensive necrosis, involving the muscularis propria, and infiltrated the perivesical fat. The favourable outcome four years after partial cystectomy suggests the diagnosis of pseudosarcoma. The differential diagnosis and the pathogenesis of this rare lesion is discussed.

Adult↗

PubMedDate not supplied

Small cell carcinoma of the urinary bladder: CT and MR imaging findings.

OBJECTIVE: Primary small cell carcinoma (SCC) is a rare aggressive malignancy of the urinary bladder, with identical histopathology to that of the lung. The treatment and prognosis of bladder SCC are somewhat different from those of more frequent transitional cell carcinoma. The purpose of this study was to analyze the CT and MR imaging findings of bladder SCC. MATERIALS AND METHODS: Six adult patients (five males and one female) with pathologically proven SCC of the urinary bladder who had undergone pelvic CT and/or MR imaging were included in this study. The radiologic findings were retrospectively evaluated in terms of tumor location, texture, calcification, depth of invasion, perivesical extension, lymph node involvement, and local or distant metastasis, by two radiologists, who established a consensus. RESULTS: CT and MR images depicted all tumors as large, ill-defined, relatively well enhancing, broad-based polypoid intramural masses with (n=3) or without (n=3) cystic portions. Their frequent location was posterior and trigonal (n=3). Calcification was found within one tumor, and lymphadenopathy in four. At T2-weighted MR images, the solid portion of the tumor was relatively hypointense. The stage at the time of diagnosis was C in three patients, and D1 in three. Follow-up imaging showed brain metastasis in one patient and liver metastasis in two. CONCLUSION: On CT and MR images, SCC of the urinary bladder appeared as a large, enhancing, broad-based polypoid mass. It was stage C or higher, and lymph nodes and distant metastasis were frequent. T2-weighted MR images showed that the solid portion of the tumor was relatively hypointense. When radiologic examinations demonstrate a bladder tumor of this kind in adults, SCC of the urinary bladder should be included in the differential diagnosis.

Carcinoma, Small Cell↗

PubMedDate not supplied

Expression of the tumor-associated glycoproteins MCA, CA 125 and BW 495/36-P in epithelial tumors of the kidney and the urinary bladder.

The differential expression of the tumor-associated glycoproteins MCA, CA 125 and BW 495/36-P was investigated in 11 renal cell carcinomas and 11 urinary bladder carcinomas and compared with their expression in non-neoplastic tissue preparations from the kidney (n = 9) and urinary bladder (n = 12). The glycoproteins were demonstrated immunohistologically in frozen sections and additionally, in some cases, in paraffin sections. MCA and BW 495/36-P positive cells were present in all preparations except for a grade I transitional cell carcinoma of the bladder, in which no MCA-expression could be detected. In the non-neoplastic renal tissue mainly the cells of the distal tubuli were stained by the antibodies against these two glycoproteins. Carcinoma cells of the kidney and of the urinary bladder showed an increased expression of both epitopes. CA 125, in comparison, was strongly expressed in 3 of the 11 urinary bladder carcinomas investigated but could only be shown in a few cells of a single renal cell carcinoma. Normal renal tissue showed no and the urinary bladder only very isolated CA 125 positive epithelial cells. Apart from this distribution, strong staining of the connective tissue fibers with CA 125 antibody was seen in all paraffin sections, but not in the frozen sections. This leads to the supposition that in these structures there is a CA 125 cryptantigen.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Tumor-Associated, Carbohydrate↗

PubMedDate not supplied

[Use of gastric segment in urinary bladder replacement after total cystectomy].

Drainage of urine by abnormal way is urinary derivation. Various forms of urinary derivations are available for urinary bladder replacement after radical cystectomy for invasive bladder tumor. Construction of continent urinary reservoir, so called pouch, from different bowel segments is named continent urinary derivations. If such urinary reservoir is connected with urethra, then it is about orthotopic derivation and reservoir is defined as neobladder. Upon satisfactory results of introduction of continent urinary derivations with Mainz pouch I and Orthotopic Mainz pouch, we performed continent orthotopic urine derivation with isolated gastric segment in 74-year old male patient who had previously undergone radical cystoprostatectomy because of the invasive urothelial cancer of the urinary bladder. Even though there were no major surgical complications in the near postoperative course, the patient had to be operated ten months later for ileus; 20 months after the procedure, significant loss of neobladder capacity, bilateral vesicoureteral reflux, persistent urinary infection and incipient renal failure were manifested. In the further course, reoperation was needed and neobladder augmentation by ileal pouch along with both ureteral reimplantations into the pouch wall was carried out. After this reintervention, the patient was alive in the following three years with satisfactory quality of life and preserved renal function. Our conclusion is that gastric neobladder should not be the first method of choice for urinary bladder replacement after radical cystectomy in older patients.

Aged↗

PubMed1988

The absorption of trichloroethylene and its metabolites from the urinary bladder of anesthetized dogs.

In order to examine the absorption of trichloroethylene (TRI) and its metabolites from the urinary bladder of dogs, we injected TRI and its metabolites, i.e., chloral hydrate (CH), free trichloroethanol (F-TCE), trichloroacetic acid (TCA) and conjugated trichloroethanol (Conj-TCE), into the urinary bladder of anesthetized dogs, and measured the agents and their respective metabolites in the blood or serum, urine and bile. The percentage of water absorbed from the urinary bladder was 10-20% 2 h after the administration of all substances. The percentage of agents absorbed was 60-70% for the TRI and TCA groups, and 50-60% for the CH, F-TCE and Conj-TCE groups 2 h after administration. The combined urinary and biliary excretion rates of the absorbed materials from the urinary bladder 2 h after administration were 46% for F-TCE, 30% for CH, 6% for Conj-TCE and 0.5-1.0% for TRI and TCA. Urinary re-excretion rates of the total excreted amounts were 65-70% in TRI, CH and F-TCE groups, about 50% in TCA and 99% in Conj-TCE group. It is possible that all of the substances administered, particularly F-TCE, are metabolized to Conj-TCE in the urinary bladder.

Animals↗

PubMed1993

Magnetic resonance imaging of urinary bladder cancer: an overview and new developments.

The role of magnetic resonance (MR) imaging in the management of carcinoma of the urinary bladder is reviewed and illustrated. In vivo and in vitro MR images of the normal urinary bladder, carcinoma, and surrounding structures are presented. Factors for optimal MR imaging of urinary bladder carcinoma are reviewed. Pulse sequence optimization, (endorectal) surface coils, and other new developments such as fast spin echo, subtraction turbo-fast low angle shot (FLASH), three-dimensional rapid acquisition gradient echo sequences, and the use of contrast agents are discussed. Finally, the value of MR imaging in staging urinary bladder carcinoma is compared with clinical staging, staging based on findings from computed tomography and intravesical sonography.

Humans↗

PubMed2000

Activation of epithelial Na(+) channel activity in the rabbit urinary bladder by cAMP.

The rabbit urinary bladder actively absorbs Na(+) from the urine. The rate-limiting step in this process is the diffusion of Na(+) across the apical membrane of bladder epithelial cells, mediated by amiloride-sensitive epithelial Na(+) channels. We have investigated the effects of cAMP on epithelial Na(+) channel activity in the rabbit bladder by measuring the amiloride-sensitive short-circuit current across bladders mounted in Ussing chambers. Three agents that raise intracellular cAMP levels (forskolin, dibutyryl-cAMP and 3-isobutyl-1-methylxanthine (IBMX)) increased the amiloride-sensitive short-circuit current relative to control preparations. The forskolin-induced increase in amiloride-sensitive short-circuit current was significantly inhibited by the vesicle fusion inhibitor brefeldin A and the protein synthesis inhibitor cycloheximide. These findings, together with the magnitude and protracted time course of the cAMP effects, suggests that cAMP stimulates the insertion of new Na(+) channels into the apical membrane of the rabbit bladder epithelium.

1-Methyl-3-isobutylxanthine↗