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PubMed1982

Genitourinary tract injuries due to fracture of the pelvis in females: sequelae and their management.

The pathophysiology of injury to the female genitourinary tract secondary to a fractured pelvis has been studied in 5 patients. Delayed complications were frequent and their management is described. It is concluded that a transpubic approach to the lower urinary tract facilitates the satisfactory reconstruction of the urinary tract. Long-term follow-up of 4 to 5 years is necessary for the satisfactory management of these patients following their initial injury.

Adolescent↗
PubMed1988

Update in cancer chemotherapy: genitourinary tract cancer, Part 3: Cancer of the prostate.

An update of the state of the art of cancer chemotherapeutic treatment of genitourinary tract cancer is described in this multi-part series: included are cancers of the kidney, bladder, prostate, testicle, ovary, uterus, vulva, and gestational trophoblastic neoplasms. Part 3 is a review of treatments for cancer of the prostate.The role of cancer chemotherapeutics as adjuvant therapy and in combination modalities in the treatment of prostatic carcinoma has yet to be determined. No single agent or combination can be considered standard therapy. The role of chemotherapy in prostatic carcinoma needs further definition. Only through randomized trials will better guides to better treatment be established.

Adenocarcinoma↗
PubMed1988

Update in cancer chemotherapy: genitourinary tract cancer, Part 7: Gestational trophoblastic neoplasms.

Part 7 of an update of the state of the art of cancer chemotherapy of the genitourinary tract is directed to the treatment of gestational trophoblastic neoplasms. Chemotherapy is the cornerstone of treatment for gestational trophoblastic neoplasms, as these tumors are generally highly curable with chemotherapy.In early stage disease, 40 percent of cases are cured with hysterectomy. In low-risk cases, single-agent methotrexate or dactinomycin provides cure rates of over 90 percent. In high-risk disease sequential methotrexate/dactinomycin, methotrexate plus dactinomycin plus cyclophosphamide or chlorambucil, or methotrexate plus 6-mercaptopurine, or a combination protocol consisting of cyclophosphamide, hydroxyurea, dactinomycin, methotrexate, vincristine (VCR), folinic acid, and doxorubicin (CHAMOCA) produce complete remission rates in 70 to 80 percent of patients. Newer studies are under way with etoposide (VP16), cisplatin, and investigational agents to determine whether better chemotherapy regimens can be developed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

Tissue engineering applications in the genitourinary tract system.

The concept of cell transplantation using tissue engineering techniques has provided numerous possibilities in the area of urologic tissue reconstruction. Tissue engineering applications in the genitourinary tract system have been investigated in almost every tissue in order to improve, restore and replace existing tissue function. Although most reconstructive efforts still remain in the experimental stage, several technologies have been transferred to the bedside with satisfactory outcome. In this article, we describe tissue engineering approaches attempted in the genitourinary system for reconstruction.

Animals↗
PubMed1985

Plasma concentrations of lidocaine resulting from instillation of lidocaine jelly into genitourinary tract prior to cystoscopy.

Plasma concentrations of lidocaine were measured over a period of three hours following the instillation of lidocaine jelly (Xylocaine 2% Jelly) into the genitourinary tract of 30 patients (15 male, 15 female) scheduled for cystoscopy. The mean quantity of jelly instilled was 21.4 Gm (11-27.5 Gm) and of lidocaine HCl administered thereby 428 mg (218-550 mg). Plasma concentration reached measurable levels in only 5 cases, never exceeding 0.2 microgram/ml.

Adult↗
PubMed1989

[Postoperative pseudosarcomas of the genitourinary tract. A diagnostic trap. Presentation of 4 cases of which 2 were studied immunohistochemically and review of the literature].

Four cases of postoperative pseudosarcomatous nodules of the genitourinary tract are reported. Two occurred in the vagina of 38 and 57 year-old women, 1 and 3 months after vaginal hysterectomy. The third one occurred in the bladder of a 60-year-old man, 1 and 1/2 months after prostatic adenomectomy. The fourth one occurred in the bladder of a 60-year-old woman, 2 months after transurethral cystoscopy with biopsies. On microscopic examination, the lesions were cellular spindle cell proliferations with numerous mitoses and minimal or no cytonuclear atypia. They mimicked sarcoma, with an overall appearance suggestive of leiomyosarcoma. Immunohistochemical studies performed on 2 cases showed strong reactivity of the cells with vimentin. Cytokeratins, desmin, smooth muscle myosin, smooth and striated muscle actins and factor VIII were negative. Despite simple, sometimes partial, local excision of the nodules, there was neither recurrence nor metastasis 8 months to 5 years later.

Adult↗
PubMed1986

Heterogeneity of basement membranes of the human genitourinary tract revealed by sequential immunofluorescence staining with monoclonal antibodies to laminin.

We used monoclonal antibodies specific for human laminin to analyze immunohistochemically the heterogeneity of the basement membranes in various parts of the genitourinary tract. By indirect immunofluorescence microscopy we show that antibody 3H11 reacts with all epithelial basement membranes in the kidneys, testes, epididymis, prostate, uterus, oviduct, and ovary, as well as the smooth muscle cells, blood vessels, and nerves. Antibody 4E10 reacted with most epithelial basement membranes in these organs but was unreactive with the basement membranes of peripheral glomerular capillary loops and the basement membranes of the oviductal mucosa, seminiferous tubules, straight tubules, and rete testis. Hilar seminiferous tubules were reactive with 4E10. In contrast to 3H11, which reacted with all vascular, subendothelial, and muscular basement membranes, 4E10 reacted only with the subendothelial basement membrane of capillaries and veins. The difference in the distribution of epitopes could be demonstrated in tissue sections sequentially reacted with two monoclonal antibodies, but only if the antibody of restricted reactivity (4E10) was used first. These data show that the heterogeneous expression of distinct epitopes of laminin in basement membranes can be demonstrated in the same tissue section by sequential staining. This heterogeneity of basement membranes most likely reflects conformational differences in the expression of epitopes on the laminin molecule in various anatomic structures.

Adult↗
PubMed1996

Operative trauma to the genitourinary tract in the treatment of anorectal malformations: 15 years' experience.

OBJECTIVES: To determine the incidence of urologic trauma during surgical correction of anorectal malformations (ARM). METHODS: The records of 228 children with ARM were retrospectively reviewed. RESULTS: Operative trauma to the genitourinary tract was seen in 12 patients, all male. Of 133 patients with a high ARM, 92 underwent an abdominoperineal pull-through and 41 underwent a posterior sagittal anorectoplasty (PSARP); the incidence of urologic trauma was 12% and 0%, respectively. In the subgroup of male infants with a high ARM (99 patients), the incidence of genitourinary trauma was 11%; in those with a low anomaly, the incidence was 1 of 43 (2%). There were 3 urethral tears, 4 urethral strictures, 5 urethral diverticula, 2 vas deferens injuries, and 1 ureteric injury. Nine of the 12 patients do not have any long-term sequelae resulting from the injuries; however, 2 are now infertile and 1 has urinary incontinence. Four patients are additionally compromised because of an absent or nonfunctioning kidney on one side. CONCLUSIONS: In children with ARM, those undergoing a conventional pull-through repair are more likely to have a genitourinary injury than those undergoing the PSARP, and boys with high ARM are at greatest risk.

Anal Canal↗
PubMed1987

Diagnostic sonography of the fetal genitourinary tract.

Fetal diagnosis has vastly improved over the last decade. Ultrasound has become the imaging modality of choice. As real-time equipment has improved technologically, the ability to deduce subtle abnormalities has greatly increased. The fetal genitourinary tract may be evaluated for renal dysplasias, anomalies, or obstruction. Points of obstruction and, at times, the exact cause of obstruction may be deduced. Abnormalities of the ureter, bladder, urethra, scrotum, or reproductive system can be detected. Early diagnosis allows for proper individual or family counseling for hereditable disorders and chromosomal abnormalities. The perinatology team can be alerted to an abnormality that may require early neonatal surgical or medical intervention. Early treatment can prevent significant deterioration of renal function. The possibilities of prenatal intervention may be considered.

Amniotic Fluid↗
PubMed1989

Genitourinary tract anomalies in Thai children with urinary tract infection.

One hundred and forty-three pediatric patients with initial documented UTI were analysed retrospectively. E. coli was the most common organism found in uncomplicated cases. Forty-six per cent of 110 patients who had radiologic evaluation had genitourinary tract anomaly with higher frequency in boys during the infancy period and girls during the early childhood period. Primary VUR was found in 11 per cent of patients mainly in infancy with an equal number among boys and girls. We conclude and strongly advise that radiologic evaluation should be done in all children with UTI, especially if they are younger than 5 year old.

Adolescent↗
PubMed2007

Perivascular epithelioid cell tumor (PEComa) in the genitourinary tract.

Perivascular epithelioid cell tumors (PEComas) are mesenchymal tumors composed of histologically, immunohistochemically, ultrastructurally, and genetically distinctive cells. PEComas have been described in different organs and are considered ubiquitous tumors. In this review we discuss recent informations related to PEComas in the genitourinary tract.

Angiomyolipoma↗
PubMed2002

Relationship of the fistulas to the rectum and genitourinary tract in mouse fetuses with high anorectal malformations induced by all-trans retinoic acid.

Since high anorectal malformations with fistulae in human embryos and fetuses of successive developmental stages have not been reported, the embryologic relationship between the rectal fistula (RF) and the genitourinary tract (GUT) in high anorectal agenesis (ARA) remains to be elucidated. This study investigates the developmental relationship between the RF and the GUT in male and female fetuses with high ARA using our established model for high ARA with fistula in mice. Pregnant mice received all-trans retinoic acid suspended in corn oil (5 mg/ml) 100 mg/kg i.p. on day 9 of pregnancy. All fetuses were removed from the uterus on a single day from days 12 to 18 of pregnancy. The caudal regions were analyzed histologically with hematoxylin and eosin staining. All fetuses examined had high ARA with fistula. On day 12 of pregnancy, an anomalous communication was seen between the urogenital sinus (UGS) and the rectum. In the affected female fetuses, on day 14 of pregnancy the paramesonephric (müllerian) ducts and müllerian tubercle were located above the rectocloacal fistula (RCF), and on day 18 of pregnancy the uterovaginal canal was located between the cloaca and the RCF. In the male fetuses, on day 14 of pregnancy the junction between the mesonephric (wolffian) duct and the UGS was located away from the junction between the rectum and the UGS. On day 18 of pregnancy the ejaculatory duct was located between the urinary bladder and the rectourethral fistula. The results of our experiment clearly show the embryologic relationship between the RF and the GUT with high ARA. The anomalous communication between the UGS and the rectum may interfere with normal caudal migration along the dorsal wall of the UGS at the junction between the UGS and the mesonephric or paramesonephric duct.

Anal Canal↗
PubMed2005

Tuberculosis of the genitourinary tract: imaging features with pathological correlation.

The prevalence of pulmonary and extrapulmonary tuberculosis (TB) has been increasing over the past decade, due to the rising number of people with acquired immunodeficiency syndrome and the development of drug-resistant strains of Mycobacterium tuberculosis. The genitourinary tract is the most common site of extrapulmonary TB. Diagnosis is often difficult because TB has a variety of clinical and radiological findings. It can mimic numerous other disease entities. A high level of clinical suspicion and familiarity with various radiological manifestations of TB allow early diagnosis and timely initiation of proper management. This pictorial essay illustrates the spectrum of imaging features of TB affecting the kidney, ureter, bladder, and the female and male genital tracts.

Dilatation, Pathologic↗
PubMed1990

Progress in the approach of tuberculosis of the genitourinary tract: remarks on a decade's experience over cases.

Tuberculosis still holds the first position among the spectrum of potentially lethal inflammatory diseases. The present paper presents the progress noted in the approach of the disease and observations recorded from the management of 160 cases of genitourinary tract tuberculosis. All patients had been admitted to the Urology Department of the Evangelismos Hospital during the period 1976-1986. Age at presentation, symptoms, diagnostic methods, staging of the disease at first diagnostic are analysed. With the latest progress in the means of diagnosis and assessment of tuberculous dissemination, and the use of new chemotherapeutic agents, the percentage of the patients medically managed have shown a definite increase. Simultaneously, the number of cases treated with reconstructive surgical operations is also increasing. Radical ablative surgical procedures still hold their position in advanced neglected cases or when chemotherapeutic regimes fail. The combined use of the new endo-urologic methods and chemotherapy is of great value.

Adolescent↗
PubMed1980

Anomalies of the kidneys and genitourinary tract in alcoholic embryopathy.

in addition to the well known major signs of growth retardation, microcephaly, mental retardation and typical craniofacial dysmorphism, malformations of the urinary tract were found in 9 of 110 patients with alcohol embryopathy. Of the 110 patients 21 have been examined adequately. An extensive urologic investigation of children with alcohol embryopathy and symptoms suggesting kidney or genitourinary tract disease is essential for early diagnosis and correction of malformations. Awarness of alcohol embryopathy in a child referred for correction of urinary tract anomalies may help to establish the diagnosis and prevent it in further offspring.

Child, Preschool↗