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At least 19 recordsLinked to original sources
PubMed1987

A prospective double-blind clinically controlled multicenter trial of sodium pentosanpolysulfate in the treatment of interstitial cystitis and related painful bladder disease.

Painful bladder disease, sensory bladder disease, chronic abacterial cystitis and interstitial cystitis are ill-defined conditions of unknown etiology and pathogenesis, and, therefore, they are without any rational therapy. Pathogenetic theories concerning defects in the epithelium and/or mucous surface coat (including glycosaminoglycans) of the bladder, and theories concerning immunological disturbances predominate. Sodium pentosanpolysulfate (Elmiron) acts by substituting a defective glycosaminoglycan layer and inhibits complement reactions in inflammatory processes. We compared sodium pentosanpolysulfate versus placebo in a prospective double-blind, clinically controlled multicenter trial of 115 patients with painful bladder disease. Two protocols were used. Protocol A included 43 patients with clinically and pathologically anatomically verified interstitial cystitis (28 or more mast cells per mm.2), and protocol B included 72 patients with a painful bladder and unspecific histological findings. The patients were randomized to receive either sodium pentosanpolysulfate (200 mg. twice daily) or placebo capsules for 4 months. Before and after the trial the patients were evaluated with symptom grading, urodynamics and cystoscopy with distension and deep bladder biopsies. The results showed no difference between the pre-trial and post-trial values in the sodium pentosanpolysulfate and placebo groups in both protocols in regard to symptoms, urodynamic parameters, cystoscopic appearance and mast cell counts. A significant increase in the cystoscopically determined bladder capacity in the sodium pentosanpolysulfate group in protocol A was found. We conclude that no statistically or clinically significant effect of sodium pentosanpolysulfate was found compared to placebo in patients with painful bladder disease.

Adult↗
PubMed1989

Pathology and pathophysiology of painful bladder diseases.

Painful bladder disease is an ill-defined disease presenting with chronic cystitis symptoms, despite sterile urine. This report includes only patients with painful bladder diseases of unknown etiology and pathogenesis. We have chosen to classify these patients pathoanatomically as follows: interstitial cystitis, detrusor myopathy, chronic unspecific cystitis and eosinophilic cystitis. The pathoanatomical appearance of the four groups of patients are described in details and certain clinical differences appear between the groups. The etiology and pathogenesis to the inflammatory reactions and muscle changes found in the detrusor biopsies are unknown, but many theories exist. It is suggested that something in the urine gains access to the bladder wall and initiates the pathoanatomical changes through a defective urothelium and glycosaminoglycans layer. In the interstitial cystitis patients, the inflammatory process and mast cell degranulation might be monitored by the urinary excretion of 1,4-methyl-imidazole-acetic acid and eosinophil cationic protein. It is concluded that no specific therapy for the disease exists, since etiology and pathogenesis are still unknown and therefore future research in this field is very important.

Cystitis↗
PubMed1985

Clinical diagnosis of gall-bladder disease.

An investigation into the diagnosis of gall-bladder disease in general practice by simple clinical methods was carried out over seven years; 916 patients were seen in 1018 episodes of illness. These patients were examined particularly for oedema in the skin and subcutaneous tissue of the right hypochondrium, Murphy's sign, clinical jaundice and bilirubinuria.Oedema was found in 89% of the episodes of confirmed gall-bladder disease and in 74% of the suspected cases, but in only 4% of the other abdominal and thoracic conditions studied. Clinical jaundice or bilirubinuria or both occurred in 28% of the confirmed episodes of gall-bladder disease and in 12% of the suspected ones.If oedema, Murphy's sign and jaundice were all present there was a 72% probability of the condition being gall-bladder disease.During the study, there was a 45% increase in the number of new cases of gall-bladder disease correctly diagnosed each year compared with the previous three and a half years, and an 89% decrease in the number of cases missed.

Diagnosis, Differential↗
PubMed1987

Painful bladder disease: clinical and pathoanatomical differences in 115 patients.

The diagnostic criteria for interstitial cystitis considered as a subgroup of painful bladder disease (that is sensory bladder disease and chronic abacterial cystitis) are not well established. Some urologists rely on symptoms, while others rely on cystoscopic appearance or pathological findings. Among 115 patients with painful bladder disease we compared symptoms, and cystoscopic and urodynamic findings in those with and without detrusor mastocytosis (28 or more mast cells per mm.2) and attempted to elucidate possible differences between the groups. We chose the pathological anatomical criterion of detrusor mastocytosis to be diagnostic for interstitial cystitis. A total of 43 patients had detrusor mastocytosis and other pathological anatomical signs of interstitial cystitis, and 72 had no mastocytosis but the pathological diagnoses of chronic unspecific cystitis, fibrosis of the bladder, detrusor myopathy, intestinal metaplasia and normal findings. When the 2 groups of patients were compared we found no differences in regard to symptoms (pain, dysuria, frequency, nocturia and urgency), frequency of allergy and hysterectomy, duration of symptoms, petechial bleeding during cystoscopy with bladder distension and cystometric findings. The patients with mastocytosis differed from those without mastocytosis in that they were older, and had a higher frequency of hematuria, a higher frequency of a red, scarred and richly vascularized bladder at cystoscopy before distension, and a smaller cystoscopic bladder capacity. We conclude that by dividing patients with painful bladder into 2 groups according to the mast cell counts in the detrusor, certain differences in the clinical findings in the groups can be ruled out. However, in individual patients one cannot note with certainty to which pathological anatomical group the patient belongs, since great overlapping between the groups exists. Whether only patients with detrusor mastocytosis have interstitial cystitis depends on definitions and still remains an open question.

Adult↗
PubMed1994

Cigarette smoking and parity as risk factors for the development of symptomatic gall bladder disease in women: results of the Royal College of General Practitioners' oral contraception study.

The effects of cigarette smoking and parity on the development of symptomatic gall bladder disease remain controversial. These relations have been examined in a cohort of 46,000 women followed for up to 19 years during the Royal College of General Practitioners' (RCGP) oral contraception study. During follow up, 1087 women were recorded as experiencing their first ever episode of symptomatic cholelithiasis (International Classification of Diseases, 8th revision (ICD-8) 574) or cholecystitis (ICD-8 575). Smokers were more likely to develop symptomatic gall bladder disease than non-smokers (relative risk 1.19; 95% confidence intervals (95% CI) 1.06 to 1.34) and there was a significant trend with the number of cigarettes smoked daily (test for trend chi 2 = 7.58, p < 0.01). This relation was most apparent among never users of oral contraceptives, although similar trends were found among current and former users. A significant direct relation between symptomatic gall bladder disease and parity was also found (test for trend chi 2 = 21.89, p < 0.001). When all were examined together a trend of increasing risk with lower social class was also found (test for trend chi 2 = 5.72, p = 0.02). Current users of oral contraceptives had a moderately increased risk of symptomatic gall bladder disease (relative risk 1.15; 95% CI 0.99 to 1.34), unlike former users (relative risk 1.03; 95% CI 0.90 to 1.18). These results suggest that smoking and parity are important risk factors for the development of symptomatic gall bladder disease in women.

Adult↗
PubMed1975

[Xenon exhalation measurements in the diagnosis of bladder diseases].

Using an exhalameter radioactive marked Xenon, absorbed following bladder instillation, was determined in the expired air of 111 patients. In 65 of these patients the usual criteria in the diagnosis of bladder diseases were simultaneously ascertained. The functional disturbances of the epithelium of the bladder obtained through 133Xenon exhalation measurements did not correlate with the morphological changes. Especially in the so-called "Reizblase" (irritable bladder) functional disturbances were found without a morphological equivalent. Compared with the low Xenon exhalation found in patients with healthy urinary bladders there is a marked Xenon exhalation increase (10-15 times) in inflammation of the urinary bladder. In our opinion Xenon exhalation measurements is at the present time the most sensitive method for determining inflammatory diseases of the urinary bladder.

Air↗
PubMed2003

[Modified cystectomy with preservation of erectile and ejaculatory functions in men with nonmalignant bladder disease].

OBJECTIVES: To evaluate modified cystectomy with preservation of erectile and ejaculatory functions in men with nonmalignant bladder disease. METHODS: Seven cases with average age of 27 years presented with bladder disease necessitating cystectomy, including 2 cases of tuberculous contractile bladder, 1 case of extensive polypoid cystitis glandularis, 4 cases of late stage of neurogenic bladder. All patients wished to maintain erectile and ejaculatory functions after the operation. We performed a modified simple cystectomy with preservation of the vasa deferens, seminal vesicles, prostate and neurovascular bundles, as well as construction of an Indiana pouch or ileal neobladder. RESULTS: Average operative time was 5 h 45 min without perioperative complications in this group. Follow-up ranged from 9 to 60 months. Erectile and ejaculatory functions were normal in all cases. All patients remained completely continent and no dysuria in neobladder, and there was no difficulty in inserting catheter to empty pouch. Upper urinary tract was in good condition 3 and 24 months after operation. CONCLUSIONS: Modified cystectomy with preservation of the vasa deferens, seminal vesicles, prostate and neurovascular bundles is an effective and reliable option for the patients who wish to maintain their fertility and erectile function after surgery.

Adult↗
PubMed2001

Bladder disease: A report based on the smooth muscle function in health and disease satellite meeting to the International Congress of Physiology.

One of the satellite meetings to the International Congress of Physiological Sciences concerned smooth muscle function in health and disease. In this report I have highlighted one of the areas of disease that were discussed: namely, bladder disease. In the treatment of unstable bladder, antimuscarinic agents are effective but cause unacceptable side effects. Thus, in order to prevent the side effects, new antimuscarinic agents are being prepared that show selectivity for the bladder and new methods for local delivery of antimuscarinics to the bladder are being developed. Potential new targets for the unstable bladder include P2X receptors and the nerve growth factor pathway. In detrusor-external sphincter dyssynergia, there is evidence to support a clinical trial of nitric oxide donors. The unpleasant and painful condition of interstitial cystitis has, to date, proven difficult to treat. Preliminary clinical data suggests that the leukotriene D(4) receptor antagonist montelukast may be useful in the treatment of IC. (c) 2001 Prous Science. All rights reserved.

Journal Article↗
PubMedDate not supplied

Gall bladder disease and ABO blood group.

Because it had been shown that an elevated total serum cholesterol was associated with phenotype A in many western European and Japanese populations as compared to non-A phenotype, a study was conducted to see whether there was any correlation between ABO blood group and gall bladder disease in our environment. No correlation was found between ABO blood group and gall bladder disease. However, the incidence of gall bladder disease was much higher in females than in males and the incidence was found to be highest in the fourth and fifth decades of life.

ABO Blood-Group System↗
PubMed1987

Urine eosinophil cationic protein in painful bladder disease.

Urine eosinophil cationic protein (U-ECP), blood eosinophils and eosinophils in bladder biopsy specimens were studied in 30 patients with painful bladder disease (15 with detrusor mastocytosis, i.e. interstitial cystitis (IC) (greater than or equal to 28 mast cells/mm2 in the detrusor muscle) and 15 patients without detrusor mastocytosis). In patients with IC the median concentration of U-ECP was 140 arbitrary u/l versus 14 arb. u/l in the remaining patients (P less than 0.001). The mean peripheral leukocyte count was significantly lower in the IC group (P less than 0.05). Tissue infiltration with eosinophils was found in 43% of the bladder biopsies from patients with IC compared with 4% of the biopsies in the remaining patients (P less than 0.05). A negative correlation between peripheral eosinophils and U-ECP was found in the patients with IC (r = 0.52, P less than 0.05). These results suggest that eosinophils are attracted to the inflammatory site in the bladder wall where ECP is released. Eosinophils thus seem to participate actively in the inflammatory process. U-ECP seems to provide valuable diagnostic information when diagnosing IC in patients with painful bladder disease. It is suggested that ECP might be involved in the process of tissue destruction in IC.

Adult↗
PubMed1998

Diagnosis and localization of a complicated urinary tract infection in neurogenic bladder disease by tubular proteinuria and serum prostate specific antigen.

INTRODUCTION: Urinary tract infection is the most frequent complication occurring in patients with spinal cord injuries and can cause renal failure and male infertility. We used the urinary alpha-1-microglobulin (alpha 1Mg) as a marker for pyelonephritis and the serum prostate specific antigen (PSA) as a marker for prostatitis with reference to the currently available methods. The aim of our study is (1) to differentiate between upper (pyelonephritis) and lower urinary tract infection (cystitis, prostatitis) in neurogenic bladder disease, (2) to determine if high (< or = 38.5 degrees C) fever in a neurogenic bladder disease patient was due to urological (prostatitis, pyelonephritis) causes or not. PATIENTS AND METHODS: We evaluated 147 patients of whom 27 had acute pyelonephritis, 16 had prostatitis with fever, 13 had chronic pyelonephritis, 68 had cystitis; 23 were control patients of whom nine had fever (< or = 38.5 degrees C) and 14 did not. The diagnoses and localizations were made on the basis of clinical evidence, with a CT scan, urography, bladder wash-out tests, and five glass-specimen tests. The urinary alpha 1Mg was determined using latex enhanced immunonephelometry and the serum PSA was measured using RIA. RESULTS: For the urinary alpha 1Mg, the sensitivity is 96% and the specificity 93% for the diagnosis of acute pyelonephritis. The serum PSA has a sensitivity of 69% and specificity of 96% in the diagnosis of prostatitis. The urinary alpha 1Mg has a sensitivity of 96% and a specificity of 56% and the serum PSA has a sensitivity of 68% and a specificity of 100% in the differential diagnosis of prostatitis and pyelonephritis. The best discriminative parameter between pyelonephritis and prostatitis was the urinary alpha 1Mg/serum PSA ratio with a sensitivity of 92% and specificity of 88%. CONCLUSION: Upper-tract infection with fever can be diagnosed in neurogenic bladder disease by determining the urinary alpha 1Mg. In male patients, the serum PSA should be determined to distinguish upper-tract infection from prostatitis. High fever does not significantly influence our parameters so that we can differentiate whether or not high fever is due to urological causes.

Adult↗
PubMed1984

Periurethral polytetrafluoroethylene injections in incontinent female subjects with neurogenic bladder disease.

Urinary incontinence in female subjects with bladder instability secondary to neurogenic bladder disease is difficult to manage. Many times pharmacologic manipulation and the standard anti-incontinence surgical procedures are unsuccessful. We have found that the urethral occlusive technique using polytetrafluoroethylene (Teflon) paste is highly effective in maintaining continence. We describe 6 patients who achieved complete urinary control and empty the bladder with the use of intermittent catheterization. All of the patients are extremely satisfied with the end results of urinary continence and have accepted self-catheterization well.

Adult↗
PubMed1985

Gall bladder disease complicating pregnancy.

Five cases of gall bladder disease complicating pregnancy are presented. The importance of antenatal cholecystosonography as a safe, simple, noninvasive diagnostic and screening test is stressed.

Adult↗
PubMed1987

Prospective study of intravesical dimethyl sulphoxide in the treatment of chronic inflammatory bladder disease.

Thirty patients with biopsy-proven chronic inflammatory bladder disease were treated with intravesical dimethyl sulphoxide (DMSO). Satisfactory symptomatic relief was achieved in 80% of patients completing treatment and no significant side effects were encountered. Despite the improvement in symptoms there was no significant alteration in the endoscopic or morphological appearance of the bladder after treatment. Intravesical DMSO is safe and relatively easy to administer and seems to have a place in the management of patients with this difficult problem.

Administration, Intravesical↗