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PubMed1978

beta-Adrenoceptor stimulation of the human urinary bladder in vivo.

The effect of beta-adrenorecptor stimulation on the volume of the urinary bladder in 16 neurologically normal humans without symptoms of micturition disturbances was investigated. Terbutaline, a selective beta2-adrenoceptor stimulating agent, was tested in 9 persons and isoprenaline, a general beta-adrenoceptor stimulating agent, was tested in 7 persons. After terbutaline the maximum increase in the bladder volume was 10% and on an average aroung 5%. After isoprenaline the maximum increase in the bladder volume was 15% and on an average around 5%. Terbutaline as well as isoprenaline administration resulted in tachycardia and an increased pulse pressure. The tachycardia was somewhat more marked after isoprenaline. In conclusion, only a small increase in the volume of the urinary bladder was noted after beta-adrenoceptor stimulation in neurologically normal humans without symptoms of micturition disturbances, in contrast to effects achieved in some patients with urgency. Terbutaline seems to have less cardiac effects compared to isoprenaline and is therefore to be preferred when beta-adrenoceptor stimulation is required in patients with urgency.

Adolescent↗
PubMed1993

Experimental rectus abdominis myocutaneous and rectus abdominis myoperitoneal flaps as urinary bladder wall substitutes in miniature swine.

An experiment was performed in Yucatan miniature swine to determine the feasibility and characteristics of musculocutaneous or musculoperitoneal flaps as urinary bladder wall substitutes. In five swine, a single-pedicle skin island flap (rectus abdominis myocutaneous, RAM/C) was sutured into the bladder. In five other swine the flap was a peritoneum island (rectus abdominis myoperitoneal, RAM/P). Three swine were sham-operated controls. The patches were in place for 20 weeks, remaining viable and elastic. Inflammation, maceration, and infection were absent. Skin patch histology was unchanged. The peritoneal patches became resurfaced with uroepithelium. The sham bladder volume (ml/kg body weight) did not differ significantly from RAM/P bladder volume (p = 0.54). RAM/C bladders were slightly smaller than shams (p = 0.11) and significantly smaller than RAM/P bladders (p = 0.03). Substitution of the bladder wall with RAM patch flaps is feasible. This is an important preliminary step toward our goal of nonenteral urinary bladder wall substitution.

Abdominal Muscles↗
PubMed1978

Brunnian adenoma (inverted papilloma) of the urinary bladder: report of a case.

An additional case of a benign polypoid tumor of the urinary bladder is reported, the first one observed at autopsy and the first in which photographic documentation of the gross appearance is presented. The lesion was first described as an adenomatoid polyp in 1927. We consider the subsequent (1963) designation of inverted papilloma misleading. Because its histologic morphology bears a striking resemblance to Brunn's nests and because the term papilloma of the urinary bladder connotes potential malignant change, we propose the designation brunnian adenoma. All cases previously reported have been benign.

Adenoma↗
PubMedDate not supplied

[Spontaneous rupture of the urinary bladder with misleading uroperitoneum].

The present paper reports on a case of spontaneous rupture of the urinary bladder in an alcoholic who ingested a large amount of alcoholic drinks. The presented a misleading uroperitoneum, without signs of peritoneal irritation and was operated under emergency conditions. There were no urinary disturbances during the first 48 hours after admission. The diagnosis was established prior to surgery owing to association of the abdominal phenomena (pain, abdominal meteorism with intestinal paresis) with urinary signs (haematuria), against a background of alcoholic intoxication, confirmed by cystography, the only method that can reveal with certainty spontaneous rupture of the urinary bladder.

Abdomen↗
PubMed1984

Interception of lymphatic drainage by Nd:YAG laser irradiation in rat urinary bladder.

Lymphatic drainage can be demonstrated by colloidal indian ink injection. A small intramural indian ink spot in the bladder dome is separated from the rest of the rat urinary bladder by encircling transmural Neodymium-YAG (Nd:YAG) laser irradiation. In untreated animals there is an ink flow via the lymphatic vessels to the regional lymph nodes within several hours. In treated animals, after laser irradiation, the indian ink remains in the bladder dome and a penetration of the irradiated area cannot be found by macroscopic and histologic examination. Indian ink will be found in the regional lymph nodes after the ninth day of absorption of the coagulation necrosis and recanalisation of the intercepted lymphatics. Evidence for the interception of the lymphatic drainage is demonstrated by the distinctly delayed ink flow and the injected ink's remaining in the irradiated area. From this, we conclude that Nd:YAG laser irradiation is especially suitable for tumor coagulation, since simultaneous interception of lymphatic drainage will inhibit the spreading of tumor cells.

Animals↗
PubMed1986

The role of the capsaicin-sensitive innervation of the rat urinary bladder in the activation of micturition reflex.

Capsaicin applied on the serosal surface of the urinary bladder in urethane-anaesthetized rats produces two distinct types of motor effects: a tetrodotoxin-, hexamethonium- and lidocaine-insensitive 'tonic' contraction and a series of tetrodotoxin-, hexamethonium- and lidocaine-sensitive rhythmic contractions. Both 'tonic' and rhythmic contractions are abolished by bladder denervation indicating their neurogenic origin. The rhythmic but not the 'tonic' component of the contractile effect of capsaicin is abolished by spinal cord transection indicating activation of a supraspinal micturition reflex. The motor effects of topical capsaicin are unaffected by pretreatment with indomethacin or diphenhydramine plus cimetidine. Pretreatment with a large dose of subcutaneous (SC) capsaicin increases both volume and pressure threshold for micturition while amplitude of micturition contraction is unaffected. Moreover the spinal somatovesical reflex elicited by pinching of the perineal skin is unaffected by capsaicin-desensitization. The intracerebroventricular (ICV) administration of capsaicin reproduces the effects of SC capsaicin on the bladder response to saline filling. Rats pretreated with ICV capsaicin are as sensitive as controls in reacting to noxious heat (hot plate test) while the wiping response to instillation of capsaicin into one eye was abolished. These findings provide functional evidence for the presence in the rat urinary bladder of a capsaicin-sensitive innervation which subserves a sensory function in relaying volume/pressure information from detrusor muscle to central nervous system. Information carried through these capsaicin-sensitive fibers appears to be relevant for initiation of a supraspinal vesico-vesical micturition reflex. Functional evidence indicates that these fibers may terminate at supraspinal level.

Acetylcholine↗
PubMed1999

Polysomies but not Y chromosome losses have prognostic significance in pTa/pT1 urinary bladder cancer.

A disturbed cellular DNA content is of potential diagnostic and prognostic relevance in urinary bladder cancer. To evaluate the prognostic significance of individual chromosomal aberrations in superficial bladder cancer, specimens of 105 tumors (67 pTa, 38 pT1) were examined by fluorescence in situ hybridization (FISH). FISH allows quantitation of chromosomes on a cell by cell level. Centromere probes for the chromosomes Y, 1, and 17 were used. There was a strong association between polysomies of the chromosomes 1 (found in 46% of tumors) and 17 (40% of tumors, P < .0001). Polysomies (1 and 17) were significantly more frequent in pT1 than in pTa tumors (P < .0001 each). In pTa tumors, polysomies of both chromosomes were linked to a high risk of recurrences; polysomy 17 was associated with an increased risk of progression (P < .05 each). There was no significant association between polysomies and an unfavorable prognosis in pT1 carcinomas. Previous studies had suggested a prognostic role of Y losses in bladder cancer. However, Y losses were not linked to recurrences or tumor progression in pTa or pT1 tumors of 67 male patients. These data show that marked genetic differences exist between pTa and pT1 carcinomas. They also indicate that polysomies of different chromosomes may have prognostic relevance in pTa urinary bladder cancer.

Adult↗
PubMed1989

Effect of ruthenium red on responses mediated by activation of capsaicin-sensitive nerves of the rat urinary bladder.

(1) Topical administration of Ruthenium Red (10-100 microM in saline) to the serosal surface of the urinary bladder in urethane-anesthetized rats prevented the motor response of the urinary bladder to topical administration of capsaicin and protected the sensory fibers from capsaicin desensitization, but had no effect on the volume-evoked contractions (micturition reflex). At 1 mM increased bladder capacity and decreased amplitude of micturition contraction were observed. (2) At 100 microM, topical Ruthenium Red prevented the blood pressure rise produced by topical administration of capsaicin onto the bladder but did not affect the blood pressure rise produced by sudden bladder distension in spinal rats. (3) After intrathecal administration, Ruthenium Red (80-800 ng/rat) produced a long lasting inhibition of the micturition reflex in urethane-anesthetized rats, this effect being evident in both vehicle- or capsaicin- (50 mg/kg s.c. 4 days before) pretreated rats. At 800 ng/rat, intrathecal Ruthenium Red did not affect the blood pressure rise produced by topical administration of capsaicin onto the rat bladder nor that produced by bladder distension. (4) These findings provide further evidence that Ruthenium Red acts quite selectively as a "capsaicin antagonist" preventing both reflex and "efferent" responses activated by peripherally administered capsaicin. By contrast, sensory impulse generation by a natural stimulus such as bladder distension is apparently unaffected by Ruthenium Red. The marked inhibition of the micturition reflex observed after intrathecal administration of Ruthenium Red does probably not involve an interaction with primary afferents in the spinal cord.

Administration, Topical↗
PubMed1993

Functional pathology of urinary bladder muscularis: the new frontier in diagnostic uropathology.

Disorders of micturition (voiding dysfunction), the essence of urinary bladder function, are unknown to the discipline of pathology, despite their prevalence and profound socioeconomic impact. Their pathogenesis has remained largely unknown, their diagnosis often difficult or uncertain, and the outcome of their management generally unpredictable. A new approach to morphologic study of the bladder has been developed to identify microstructural correlates of its function. Application of this approach to endoscopic biopsies culminated in the concept of functional pathology of urinary bladder muscularis. The basis, elements, current status, and diagnostic potential of this new concept are presented in relation to the major forms of clinical voiding dysfunction.

Humans↗
PubMed1997

PCNA and p53 in urinary bladder cancer: correlation with histological findings and prognosis.

BACKGROUND: This study aimed to immunohistochemically examine the expression of proliferating cell nuclear antigens (PCNA) and p53 protein in transitional cell carcinomas (TCC) of the urinary bladder, and to investigate possible correlations of this expression with the tumor grade or stage, tumor recurrence, and prognosis of the disease. MATERIALS AND METHODS: The immunohistochemical status of the PCNA and p53 proteins were determined on paraffin-embedded sections from 128 patients with TCC of the urinary bladder, using PC-10 and DO7 as the primary antibodies. Positive stainings were represented by scores (Labeling Index; LI, %) calculated as the percent of positive cells among all neoplastic cells counted. The findings were compared to the patients' histopathological features. Patients who underwent transurethral resection were divided into groups with "low" and "high" scores for PCNA and p53, respectively, and the tumor recurrence rate was compared among the groups. Patients who underwent total cystectomy were similarly divided into "low" and "high" score groups, and survival rates of the groups were compared. RESULTS: PCNA expression was observed in 66 of 128 patients (51.6%), with a mean labeling index of 26.6%. Overexpression of p53 was observed in 65 of 128 patients (50.8%), with a mean labeling index of 35.3%. There were significant correlations of the PCNA and p53 indices with both histological grade and stage of the tumor. In the TUR group, there were no statistically significant differences in recurrence rate between the groups with high or low scores for either PCNA or p53. In the total cystectomy group, there was a significant correlation between survival rate and positive staining for PCNA, but not for p53. The relationship between 2 parameters, PCNA and p53 scores, was not significant (linear correlation coefficient, r = 0.67). CONCLUSIONS: PCNA and p53 status in transitional cell carcinomas of the urinary bladder is related to the histopathological findings. We also suggest that immunohistochemical staining for PCNA provides significant clinical information which may be useful in the initial selection of therapy. However, overexpression of p53 does not appear to represent an independent prognostic marker in bladder tumors.

Adult↗
PubMed1976

Different susceptibilities of the urinary bladder epithelium of animal species to three nitroso compounds.

Differences in the susceptibilities of the urinary bladder epithelium of Wistar rats, ICR mice, Syrian golden hamsters, and Hartley guinea pigs to three N-nitroso compounds, N-butyl-N-(4-hydroxybutyl)nitrosamine, N-ethyl-N-(4-hydroxybutyl)nitrosamine, and N-butyl-N-(3-carboxypropyl)nitrosamine, were examined histologically. The urinary bladder epithelium of rats was the most susceptible to all three compounds, and especially to N-ethyl-N-(4-hydroxybutyl)nitrosamine, and bladder cancers developed in all the rats given this compound. The bladder epithelium of mice was less susceptible than that of rats but, although the incidence of cancer was lower than in rats, that of cancer with invasion was higher. Hamsters were far less susceptible than mice, and cancer developed only in 3 of 41 animals given N-ethyl-N-(4-hydroxybutyl)nitrosamine. Guinea pigs were the least susceptible of the 4 species and no tumors were found. Hisotlogically, most of the tumors induced in rats and mice were transtitional cell carcinomas. The incidence of undifferentiated carcinoma was higher in mice than in rats and cellular or structural atypism of the cancer was also greater in mice. Cancers induced in hamsters were all transitional cell carcinomas showing invasion.

Animals↗
PubMed1985

Regulation of urinary bladder capacity by endogenous opioid peptides.

Naloxone administered to chloralose or ketamine anesthetized cats reduced urinary bladder capacity. Successive cystometrograms revealed that naloxone in doses of 0.5 microgram./kg. to 15 micrograms./kg. i.v. reduced the volume necessary to evoke micturition by 10 to 50 per cent, respectively. The effect was maximal within a few minutes, remained constant for about 1/2 hour and returned to control values over the next 2 to 3 hours. Following return to control, subsequent doses of naloxone produced no further effect on capacity. In chloralose anesthetized animals naloxone also increased the frequency and amplitude of low amplitude pressure waves on the tonus limb of the cystometrogram. Intrathecal administration of naloxone to the sacral spinal cord did not significantly reduce the volume necessary to evoke micturition even at large doses, but did increase the amplitude of micturition contractions. These data, along with previous reports, suggest that mu receptors in the brainstem alter urinary bladder capacity, while delta receptors in the spinal cord modulate the magnitude of bladder contractions. Pharmacological manipulation of these receptor systems could provide a tool for the management of neurogenic bladder dysfunction.

Animals↗
PubMed1992

[A morphometric grading study on the nucleus shape and DNA-content of transitional cell carcinoma of urinary bladder].

Totally 30 cases of TCC of the urinary bladder were analyzed with IBAS-2000 image analysis system. The nuclear area, perimeter, ellipse factor, etc and nucleus DNA content were measured. The morphometric grading was performed with five correlative factors for classification. They are nucleus perimeter, nucleus ellipse factor, DNA SDE, probability of the cells in C6 zone DNA and probability of the cells in C8 zone DNA. The coincident rate between morphometric grading and WHO grading was 88.9% in G1, 66.7% in G2, and 83.3% in G3. The results indicate that morphometric analysis is a valuable tool in the objective grading of bladder carcinoma.

Carcinoma, Transitional Cell↗
PubMed2002

[A case of spontaneous rupture of the urinary bladder followed by pneumomediastinum].

A 67-year-old male admitted to our hospital with a complaint of gross hematuria and lower abdominal pain. He was being followed up at our hospital for prostate cancer with multiple bone metastases. He was diagnosed with spontaneous rupture of the urinary bladder by abdominal computed tomography. Chest X-ray and chest computed tomography also showed pneumomediastinum. An urgent operation revealed a rupture of the urinary bladder 3 cm in length. We briefly reviewed 122 cases of spontaneous rupture of the urinary bladder reported in the Japanese literature.

Aged↗
PubMed1995

Effect of alpha-chymotrypsin on the nonadrenergic, noncholinergic contraction of the rat urinary bladder in vitro.

The role of peptides in mediating the nonadrenergic, noncholinergic (NANC) response of the rat urinary bladder was studied. Electrical stimulation of muscle strips from 3-month-old female Wistar rat urinary bladders in the presence of autonomic blockers (atropine 10(-6) mol/l, propanolol 10(-6) mol/l, phentolamine 10(-6) mol/l, and guanethidine 10(-6) mol/l) showed NANC contraction accounting for 60% of the maximum contractile responses at 40 Hz. Frequency-response studies showed that in the presence of alpha-chymotrypsin (2 U/ml, 30-min incubation), the NANC contractile responses to electrical stimulation at lower frequencies (3-10 Hz) were enhanced (p < 0.05; n = 9). However, no significant differences were observed at higher frequencies (20-40 Hz). With repetitive 4-Hz stimulation, alpha chymotrypsin caused a 19% increase in the NANC contractile response (p < 0.05; n = 8). It is postulated that the NANC response of the rat bladder smooth muscle is composed of an excitatory (contractile) and an inhibitory (relaxant) component. Some peptide(s) is/are responsible for mediating the inhibitory response.

Acetylcholine↗
PubMed1989

Split-course radiotherapy for urinary bladder cancer.

In this retrospective study 119 patients with T1-T4 carcinoma of the urinary bladder were treated with split-course radiotherapy. The 3-week rest period was compensated with a 10% increase in the total radiation dose to 6600 cGy. Therapy was completed as planned by 86% of the patients. The actuarial 5-year survival for these patients was 20%. Both the 3- and 5-year survival figures were better for patients with local control of the tumour achieved either by combined surgery and radiotherapy or by radiotherapy alone, than for patients with recurrent tumours after radiotherapy. The results of the split-course regimen were comparable to the results of continuous radiotherapy used for urinary bladder cancer.

Age Factors↗
PubMed1989

An adult atypical fibromyxoid tumor of the urinary bladder.

A case of atypical fibromyxoid tumor of the urinary bladder in a 32-year-old woman is reported. The patient had never complained of urinary symptoms, and bladder tumefaction was revealed fortuitously at pelvic ultrasound. Cystoscopy revealed a peanut-sized mass. Microscopically, the lesion was composed of strap- and tadpole-shaped cells resembling rhabdomyoblasts. For this reason, the tumor was initially diagnosed as embryonal rhabdomyosarcoma. However, immuno-histochemical study was negative for muscle origin, and the tumor has subsequently proved benign. The reported case illustrates the value of immuno-histochemical study in the evaluation of the true type of bizarre stroma cells in this pseudo-sarcomatous lesion. Their recognition is important, because the therapeutic consequences of misinterpreting this tumor as a sarcoma are great.

Adult↗
PubMed1989

The response of the rat urinary bladder microcirculation to photodynamic therapy.

Light activation of dihematoporphyrin ether (photofrin II) has been used in the treatment of bladder tumors, yet the effects of this treatment on the normal urinary bladder microcirculation have not been determined. This study involved the use of in vivo television microscopy to observe the effects of light activation (530 to 560 nm., 175 mW/cm.) on the urinary bladder microcirculation of female Sprague-Dawley rats. Animals pretreated with dihematoporphyrin ether 30 minutes prior to light activation had high serum and low tissue concentrations of the photosensitizer and activation resulted in a statistically significant reduction of red blood cell column diameter in both arterioles and venules. The reduction was primarily due to mural thrombus formation with the occlusion remaining 60 minutes after activation. Animals pretreated 48 hours before activation had low serum and high tissue concentrations of dihematoporphyrin ether and activation had no microcirculatory effects apart from occasional platelet aggregation. These results suggest that the photodynamic effect on normal (non-neoplastic) tissue treated more than 48 hours after administration of dihematoporphyrin ether is probably due to a direct effect of light and the sensitizer on the smooth muscle of the bladder rather than an effect on the microcirculation.

Animals↗