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At least 595 records · Page 33Linked to original sources
PubMed1999

[Bilateral hydronephrosis with papillary polypoid cystitis].

OBJECTIVE: A case of papillary polypoid cystitis with bilateral hydronephrosis and an intravesical mass is presented. METHODS/RESULTS: A routine ultrasound evaluation performed in a 64-year-old diabetic female revealed an intravesical mass and bilateral hydronephrosis. There was extensive bladder involvement and the ureteral orifices could not be visualized during endoscopy. Transurethral resection of the lesion was performed. The histological examination showed papillary polypoid cystitis. The urinary cultures were positive, antibiotic therapy was instituted and the hydronephrosis, disappeared. CONCLUSIONS: Papillary polypoid cystitis, although a benign and superficial lesion, can be diffuse, involve both ureteral orifices and cause hydronephrosis.

Abdomen↗
PubMed1999

[Interstitial cystitis: surgical treatment].

Surgical therapy of interstitial cystitis must never be considered a first option but must be reserved for cases, less than 10%, in which conservative therapy has proven ineffectual. Surgical therapy includes a variety that started at the turn of the century. Neurosurgical denervation and perivesical denervation like cysto-cystoplasty and cystolysis, manipulate the innervation to reduce the bladder's hypersensitivity. This surgical approach may be considered in patients in whom bladder capacity is normal. The results are uncertain and the complications like neurogenic bladder relevant. Enterocystoplasty is much more widespread because interstitial cystitis is a benign disease that rarely required radical surgery. Augmentation cystoplasty and substitution cystoplasty are two variants but only the later has a rationale as it involves the resection of the detrusor which is the source of the pain. Detubularization drastically reduced urinary incontinence. The resection of the detrusor can be supratrigonal, subtrigonal or at the proximal urethra like in the orthotopic neobladder. If urinary diversion is chosen, the bladder must be removed. Before recommending surgical therapy each patient should undergo tests for the localization of the pain; moreover psychological and gynaecological evaluations should be made. If the bladder capacity exceeds 400 cc surgical operation is not advisable. If, on the other hand, the bladder capacity is lower than 400 cc substitution cystoplasty is first choice. If the patient suffers from trigonal cystitis or urethral hypersensitivity, urinary diversion is a better therapy. According to the questionnaires send to the Urologic Departments in Lombardy in 1998, the most widespread type of operation seems to be supratrigonal cystectomy + enterocystoplasty and augmentation cystoplasty. Subtrigonal cystectomy or urinary diversion are only occasionally chosen; continent pouch is the least frequent therapy at all.

Adult↗
PubMed2000

[Efficacy of single-dose therapy with levofloxacin for acute cystitis: comparison to three-day therapy].

To investigate the safety, efficacy and recurrence-inhibiting effect of a single dose of levofloxacin (LVFX) for the treatment of acute uncomplicated cystitis in women, 56 females with acute uncomplicated cystitis between 17 and 73 years old were studied, based on the urinary tract infection (UTI) drug efficacy evaluation. The patients were divided into two groups; in Group A a single 200 mg dose of LVFX was administered, while in Group B, 100 mg of LVFX was administered twice a day for three days. The patients were re-examined three days later. The presence or absence of recurrence was surveyed by a questionnaire 3 months after the treatment. The efficacy rate on the third day after the administration in Group A and Group B was 96.9% (32 cases) and 95.8% (24 cases), respectively, and the recurrence rate within three months after administration 17.4% (4 in 23 cases) and 5.6% (1 in 18 cases), respectively. As for adverse drug reaction, abdominal pain was seen in one case, without a clear cause-effect relationship. Although the number of cases studied was small, no significant difference was seen between the single dose group and 3-day dose group in the safety, efficacy and recurrence-inhibiting effect of the new quinolone antibacterial treatment for acute uncomplicated cystitis in women, confirming the usefulness of the single dose treatment.

Acute Disease↗
PubMed2000

[Glandular cystitis. Endovesical steroid treatment].

OBJECTIVE: To report a case of cystitis glandularis, a proliferative disorder of the bladder mucosa whose incidence is estimated to be approximately 1%. METHODS/RESULTS: A case of diffuse cystitis glandularis in a male patient is presented. Intravesical steroid therapy achieved symptomatic resolution, although the proliferative mucosal lesions persist. CONCLUSION: There is currently no non ablative treatment that has been demonstrated to be effective in diffuse cystitis glandularis.

Administration, Intravesical↗
PubMed2000

Pentosanpolysulfate inhibits mast cell histamine secretion and intracellular calcium ion levels: an alternative explanation of its beneficial effect in interstitial cystitis.

PURPOSE: Mast cells are ubiquitous cells derived from the bone marrow and are responsible for allergic reactions as they release numerous vasodilatory, nociceptive and pro-inflammatory molecules in response to immunoglobulin E (IgE) and specific antigen. Mast cell secretion is also triggered by a number of peptides, such as bradykinin and substance P, and may also be involved in the development of inflammatory responses. An example is interstitial cystitis, which is a sterile painful bladder disorder that has been associated with a defective glycosaminoglycan bladder mucosal layer and an increased number of activated mast cells. Pentosanpolysulfate is a synthetic, sulfated polysaccharide that has been approved for the treatment of interstitial cystitis on the premise that it may replenish the defective glycosaminoglycan layer. We hypothesize that pentosanpolysulfate may also have an additional or alternate action on bladder mast cells. We report that pentosanpolysulfate has a powerful dose dependent inhibitory effect on mast cell release of histamine induced by the mast cell secretagogue compound 48/80. MATERIALS AND METHODS: Inhibition of mast cell secretion was documented by light and electron microscopy and extended to stimulation by substance P or IgE and antigen. RESULTS: The inhibition was more potent than that seen with the clinically available mast cell stabilizer disodium cromoglycate (cromolyn). Maximal inhibition by pentosanpolysulfate was apparent within 1 minute, was unaffected by the length of pre-incubation and persisted after the drug was washed off. In contrast, the effect of cromolyn was limited by rapid tachyphylaxis. In addition, while cromolyn has no effect on mucosal or rat basophilic leukemia cells, pentosanpolysulfate inhibited histamine secretion from both. Confocal microscopy using a calcium indicator dye showed that pentosanpolysulfate decreased intracellular calcium ion levels. CONCLUSIONS: Pentosanpolysulfate appears to be a potent inhibitor of allergic and nonimmune mast cell stimulation, which is an alternative explanation of its benefit in interstitial cystitis.

Animals↗
PubMed1975

Epidemiology of interstitial cystitis.

Almost all the patients (95 women and 8 men) with interstitial cystitis, i.e. autoimmune cystitis, in this area with a population of about 970,000 were probably traced. The prevalence of the disease in the female members of this population was 18.1 cases per 100,000 women of all ages. The joint prevalence of both sexes together was 10.6 cases per 100,000. The annual incidence of new female cases was 1.2 per 100,000 women. The disease is not rare when mild and moderately severe cases are also diagnosed. Severe cases account for only a tenth of all cases. Only about a tenth of the patients are men and most of them had the mild form of the disease. It may begin at any age. The incidence has possibly been rising during the last 10 years. Interstitial cystitis does not as a rule progress continuously but reaches its final stage rapidly, then usually remains in the same category. With this prevalence and incidence every urologist in this area can expect to see at least one case a year.

Adolescent↗
PubMed2001

Management of ischemic hemorrhagic cystitis with hyperbaric oxygen therapy.

We report a case of a T8 paraplegic woman who experienced necrosis of the bladder due to inadvertent chronic over distention. After bladder repair, the patient suffered from severe ischemic hemorrhagic cystitis. Despite many attempts to control the bleeding with standard treatments, the hematuria continued. Although hyperbaric oxygen (HBO2) therapy has not been proven to be helpful in patients with hemorrhagic cystitis not related to radiation or chemotherapy, the physiopathologic mechanisms of the cysttis, involving ischemia, led us to believe that outpatient would benefit from HBO2 therapy in analogy to the approved use of HBO2 therapy in radiation cystitis. Since the use of HBO2 therapy has not been previously reported in this situation, we met with some hesitation from the HBO2 therapy department After reviewing the literature and discussing the case, a medical panel reached a consensus to allow us to commence the treatment The patient had a remarkable response, and remains without hematuria 6 mo. after treatment.

Cystitis↗
PubMed2002

The efficacy of chondroitin sulfate 0.2% in treating interstitial cystitis.

OBJECTIVE: An open label study of chondroitin sulfate was undertaken to determine the response of patients with interstitial cystitis and positive potassium test results to this agent. METHOD: Eighteen patients with classic features of interstitial cystitis were enrolled in the study. Patients received 40 mL chondroitin sulfate, 0.2% instilled intravesically once a week for four weeks and then once a month for 12 months. At the same times, Quality of Life Improvement scores, voiding diaries, and pain and voiding indices were reviewed. RESULTS: Thirteen of 18 patients were followed for the entire 13-month study. Twelve of these patients responded to treatment within 3 to 12 weeks, on average. A total of 6/13 (46.2%) showed a good response, 2/13 (15.4%) had a fair response, and 4/13 (30.8%) had a partial response and 1/13 (7.7%) showed no response. CONCLUSION: Intravesical chondroitin sulfate seems to demonstrate some beneficial effects in treatment of interstitial cystitis patients who have positive potassium stimulation test results.

Chondroitin Sulfates↗
PubMed2002

Tumor necrosis factor-alpha and interleukin-1beta mediate the production of nitric oxide involved in the pathogenesis of ifosfamide induced hemorrhagic cystitis in mice.

PURPOSE: We investigated the participation of nitric oxide in ifosfamide induced hemorrhagic cystitis in mice, and the involvement of tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta in the induction of nitric oxide production in this model. MATERIALS AND METHODS: Hemorrhagic cystitis was induced in mice by 100 to 400 mg./kg. ifosfamide and evaluated 6, 12, 24 or 48 hours thereafter by certain parameters, including vesical edema measurements, microscopic analysis and immunohistochemical testing for inducible nitric oxide synthase. Ifosfamide injected mice were pretreated with 10 to 40 mg./kg. of the nitric oxide synthesis inhibitor L-NG-nitroarginine methyl ester, 80 mg./kg. of mesna, a chemical antagonist of acrolein and the urotoxic metabolite of ifosfamide, 50 microl. antiserum against TNF-alpha and IL-1beta per mouse, 45 mg./kg. of the selective TNF-alpha synthesis inhibitor thalidomide or 200 mg./kg. of the TNF-alpha and IL-1beta synthesis inhibitor pentoxifylline. RESULTS: Ifosfamide induced vesical edema, which peaked 12 hours after ifosfamide injection. Microscopic analysis revealed vascular congestion, edema, hemorrhage, fibrin deposition, neutrophil infiltration and epithelial denudation. Inducible nitric oxide synthase immunolocalization demonstrated intense reactivity to inducible nitric oxide synthase in the cytoplasm of bladder epithelial cells, which showed diffuse necrosis. Pretreatment with mesna reduced the increases in vesical edema, while treatment with L-NG-nitroarginine methyl ester, antiserum to TNF-alpha or IL-1beta, thalidomide or pentoxifylline inhibited vesical edema and microscopic alterations. Antiserum treatments also inhibited the expression of inducible nitric oxide synthase in the urothelium. CONCLUSIONS: Nitric oxide produced by inducible nitric oxide synthase is involved in urothelial damage and in the inflammatory events leading to hemorrhagic cystitis after ifosfamide administration in mice. The induction of inducible nitric oxide synthase in the urothelium appears to depend on the synergistic effect of IL-1beta and TNF-alpha.

Animals↗
PubMedDate not supplied

[Postoperative cystitis in children].

Operative intervention on the urinary bladder in children entails postoperative reactive cystitis. Biopsies of urinary bladder mucosa were studied morphologically. Basing on these morphological findings and clinical evidence, three leading variants of the mucosa changes were distinguished: focal squamous cell metaplasia; excess of the lymphoid tissue and lymphangiectasia; hemangiectasia. These morphological changes aggravate the course of postoperative cystitis. UHF-therapy and magnetic-laser radiation beginning postoperative day 4 and 7, respectively, reduce inflammation developing in postoperative cystitis. This indicates effectiveness of the above combined therapy which can be also used for prevention of acute inflammation episodes in postoperative period.

Adolescent↗
PubMed2002

[Hyperbaric oxygen therapy and radiation-induced hemorrhagic cystitis].

Radiotherapy alone or in combination with other modalities is used in the treatment of a large number of pelvic tumours of urological or gynaecological origin. Despite constant progress in this field, medium-term and long-term complications remain frequent and often require difficult long-term management. Radiation cystitis is one of the most frequent complications and directly concerns urologists. Among the various treatment options for haemorrhagic cystitis, hyperbaric oxygen therapy appears to give good short-term and medium-term results. It is currently reserved for cases refractory to the standard treatments for radiation cystitis.

Cystitis↗
PubMed2002

[Interstitial cystitis: update on pathogenesis, diagnosis, and treatment].

OBJECTIVES: Interstitial cystitis is a nosological entity of which many etiological, diagnostic and therapeutic features were unknown until recently, so that we had the objective to review new knowledge acquired during the last decade to offer an update in the disease. METHODS: A bibliographic review on interstitial cystitis is performed with special interest in national and international authors who have experience and large case series. RESULTS: Among the multiple etiopathogenical theories proposed in the past, the hypothesis to be highlighted, that is gaining strength, is the altered bladder urothelium permeability or hemato-urinary barrier alteration, with the aggression of toxic substances contained in urine in high concentrations like potassium. Epidemiologically, some authors think the disease is present in the population in a higher frequency than it is diagnosed, and it may be found in many women with the misdiagnosis of recurrent urinary tract infections. Regarding diagnosis, a new test is proposed to help clinical diagnosis: the potassium test, which consists in the endovesical instillation of this ion at high concentrations reproducing the symptoms. Finally, in the medical treatment it is demonstrated the efficacy of drug associations over monotheraphy (heparinoids, antihistaminic and antidepressant drugs), looking for the correction of the physiopathological abnormalities caused by the disease. Psicologic support and continuous information to the patient about the disease continue to be one of the mainstays of this multimodal therapy. New options like neural stimulation have appeared, although its results are not conclusive so that further studies must be done. CONCLUSIONS: New knowledge about interstitial cystitis allow us to better understand the chain of events happening in it. An early clinical diagnosis, now reinforced with a positive potassium test, is key to start medical treatment (drug combination) targeted to stop the pathogenic process, because it is more effective in the early phases of the disease. For that purpose, the Urologist must have this disease in mind.

Cystitis, Interstitial↗
PubMed2002

[Cystic cystitis in children].

Cystic cystitis is a common urinary bladder disease with a histologic picture of nodular lesions of the bladder mucosa. Intralesional lymphoid proliferation due to recurrent urinary tract infection play a major role in the occurrence of cystic cystitis. It is often found together with vesicoureteral reflux and other urinary tract anomalies and urodynamic disturbances. Examination of 116 children with cystic cystitis revealed it to be associated with urinary tract anomalies, especially vesicoureteral reflux. The average age at diagnosis is 7 years. The disease often needs longterm prophylaxis for urinary tract infections, and has favorable prognosis.

Adolescent↗
PubMed2003

[Treatment of glandular cystitis].

OBJECTIVE: To improve the therapeutic results of patients with glandular cystitis. METHODS: One hundred and twenty-seven patients with glandular cystitis were treated according to their different etiological factors. The therapeutic methods included anti-infection, obstruction relief, bladder irrigation, transurethral resection, partial cystectomy, total cystectomy. RESULTS: The patients who were associated stones and foreign bodies (50%) were cured spontaneously with an effective rate of 94%. The effective rate in patients with low urinary tract obstruction was 84%. Patients with simple urinary tract infection (53%) were cured spontaneously after anti-infection therapy. The effective rate, recurrence rate and malignancy rate in patients without associated diseases were 71%, 46% and 21% respectively. CONCLUSIONS: Cystitis glandularis should be treated according to different etiological factors.

Adolescent↗
PubMed2003

[Eosinophilic cystitis in children:a report of six cases and review of literature].

OBJECTIVE: Eosinophilic cystitis is a very rare tumor-like inflammatory disease especially in children. It can involve any portion of the bladder and interfere with its function. Here we present 6 pediatric cases and review the literature. METHODS: Six children, with mean age of 8.3 years, were referred to our clinic. Their major complaints included voiding urgency, frequency, dysuria, enuresis, intermittent hematuria and abdominal pain. Ultrasound, CT scan and voiding cystourethrogram (VCUG) showed diffuse thickening of bladder wall and a filling-defect lesion. They all suggested the possibility of bladder tumor. The final diagnosis of eosinophilic cystitis was made by cystoscopic tissue biopsy or open surgery. Patients underwent bladder autoaugmentation, mass resection or mere oral administration of corticosteroid and antibiotics respectively. RESULTS: 5 among 6 patients were followed up for 5 - 28 months. Their voiding complaints and image changes gradually disappeared. Up to now, there is no relapse. CONCLUSIONS: The clinical presentation of eosinophilic cystitis includes irritative voiding symptoms, hematuria and abdominal pain. Tumor-like changes could be found in the imagination examinations. A biopsy is mandatory to establish the diagnosis. Treatment in general varies from the removal of the antigenic stimulus, if identifiable, to administration of corticosteroid and antibiotics. When patients fail to respond to the medication treatment, the opening operation could be required.

Adolescent↗
PubMed2004

[Emphysematous cystitis complicating non-conservative total hysterectomy for ovarian cancer].

The authors report a case of emphysematous cystitis in a 50-year-old woman treated by corticosteroids, occurring 1 month after hysterectomy for locally advanced ovarian cancer. Although the patient presented a vesico-vaginal fistula, the presence of air in the bladder wall and only in the bladder lumen, confirmed the diagnosis of emphysematous cystitis. Despite intensive care and surgery with colostomy and Mikulicz drainage associated with urinary diversion (transparietal bladder catheter on one side and cutaneous ureterostomy on the other side), the patient died on day 10 in a context of sepsis. The circumstances of discovery, the various clinical forms and the radiological features of emphysematous cystitis described in the literature are reviewed together with the modalities of management.

Cystitis↗
PubMed2004

[Management of radiation cystitis].

Radiation cystitis is a lesion of the bladder caused by irradiation of a pelvic organ. These lesions can range from a simple inflammatory reaction to almost complete bladder retraction. The frequency of chronic lesions is estimated to be between 5% and 10% of patients receiving pelvic radiotherapy. Radiation cystitis generally presents in the form of macroscopic haematuria associated with frequency and urgency. The diagnosis is often easy due to the patient's history of pelvic irradiation. Cystoscopy demonstrates a pale, frosted bladder mucosa with scattered telangiectasias and sometimes well defined torpid ulcerations. The treatment of radiation cystitis is essentially symptomatic, mainly consisting of controlling the episodes of haematuria by bladder lavage. Several more or less specific treatments have been proposed in order to decrease the episodes of haematuria. The treatments most frequently used are intravesical instillations of formalin, silver nitrate or alum with an efficacy on symptoms of about 70%. Another more recent and very encouraging treatment option is hyperbaric oxygen therapy, which allows better tissue diffusion of oxygen, improving neo-angiogenesis by increasing the vascular density of irradiated tissues. This technique is effective in about 80% to 90% of cases with a lasting effect. It also allows objective improvement of the bladder mucosa. Finally, in severe cases of persistent haematuria, arterial embolization or even cystectomy with urinary diversion may be proposed.

Cystitis↗
PubMedDate not supplied

Emphysematous cystitis: a case report and literature review.

Emphysematous cystitis (EC), a rare form of cystitis, is often an incidental radiological finding but it can be associated with diffuse abdominal or suprapubic pain. The clinical course can vary from asymptomatic infection to fulminant sepsis. We present the case of a 79-year-old woman with diffuse abdominal pain, back pain accompanied with low-grade fevers, urinary frequency, urinary urgency, and emesis who was ultimately found to have emphysematous cystitis. A review of the etiology, pathogenesis, diagnosis and treatment options follows.

Abdominal Pain↗