Search results for "bladder"
showing 10 items of 628 documents
Endoscopic treatment of the "sump syndrome" after choledochoduodenostomy: a new technique using an amplatzer septal occluder.
2006
A 58-year-old male patient had been suffering for 35 years from recurrent cholangitis, biliary sludge and infection-induced stone formation after open cholecystectomy because of empyema of the gallbladder and severe acute and delayed postoperative complications. The pathophysiological origin of this chronic "sump syndrome" was a choledochoduodenostomy which had been performed prophylactically at the time of the initial operation. The patient agreed to an experimental treatment option with use of an Amplatzer atrial-septal defect (ASD) occluder for closure of the symptomatic choledochoduodenal fistula. The double-disc occluder was introduced through a 9 French diameter and 90 cm long sheath …
Indications for preoperative prostate biopsy in patients undergoing radical cystoprostatectomy for bladder cancer.
2008
We determined indications for preoperative prostate biopsy in patients undergoing radical cystoprostatectomy for bladder cancer.Of 316 cystoprostatectomy specimens concomitant prostate cancer was diagnosed in 21.5%. Prostate cancer was diagnosed preoperatively in 24% of cases (evident prostate cancer), 32% were suspicious for prostate cancer but no biopsy was done (suspected prostate cancer) and in 44% prostate cancer was incidental. Patients were stratified into probability groups of intermediate/high risk prostate cancer by digital rectal examination and prostate specific antigen. The incidence of unfavorable histopathology was determined in each group.Of prostate cancers 85% were organ c…
Complications of trans-anastomotic externalised stents in open pyeloplasty: influence of the method of placement, the duration of stenting, and the a…
2010
To assess the influence of the method for stent placement, the duration of stenting, and the presence of bladder drainage on the complication rate of open pyeloplasty. Patients and methods: Complications were, retrospectively, compared in 228 consecutive open pyeloplasties performed at institution A using a trans-pyelostomic 6-Fr splint/stent for 5 days and no bladder drainage, and 150 consecutive open pyeloplasties performed at institution B using a trans-nephrostomic 6-Fr splint/stent for 9 days plus bladder drainage. Results: Median age at surgery was comparable between groups. The overall complication rate was 13% and was comparable at the two institutions, but for the presence of perio…
Does concomitant diabetes affect treatment responses in overactive bladder patients?
2013
Summary Aims To compare the efficacy and tolerability of a muscarinic receptor antagonist, darifenacin, in the treatment of overactive bladder (OAB) patients with concomitant diabetes as compared with those without comorbidities. Methods Post hoc exploratory analysis of a published, large, non-interventional study in OAB patients treated with darifenacin including 532 diabetics and 1315 controls. Associations of diabetes with treatment responses were evaluated by multiple regression models. Results Diabetics (largely type 2 patients) and controls differed in baseline age, body weight, duration of OAB symptoms and presence of comedications. However, they exhibited similar OAB symptom episode…
Orthotopic Liver Transplantation: T-Tube or Not T-Tube? Systematic Review and Meta-Analysis of Results
2009
Background The purpose of this study was to compare outcomes after duct-to-duct anastomoses with or without biliary T-tube in orthotopic liver transplantation. Methods We pooled the outcomes of 1027 patients undergoing choledocho-choledochostomy with or without T-tube in 9 of 46 screened trials by means of fixed or random effects models. Results The "without T-tube" and "with T-tube" groups had equivalent outcomes for: anastomotic bile leaks or fistulas, choledocho-jejunostomy revisions, dilatation and stenting, hepatic artery thromboses, retransplantation, and mortality due to biliary complications. The "without T-tube" group had better outcomes when considering "fewer episodes of cholangi…
Lower Urinary Tract Symptoms: What's New in Medical Treatment?
2018
Abstract Context Pharmacological treatment is a cornerstone in the management of patients with lower urinary tract symptoms (LUTS). Objective To review emerging evidence in the medical treatment of LUTS. Evidence acquisition An Embase/Pubmed-based literature search was conducted in December 2017, screening for randomized controlled trials (RCTs), prospective and retrospective series, animal model studies, and reviews on medical treatment of LUTS. Evidence synthesis The main medical innovation in recent years in overactive bladder (OAB) has been the approval of the first β 3 -adrenoceptor agonists (mirabegron) and intradetrusor onabotulinum toxin A, while several other drugs such as antiepil…
Two-stage transperineal management of posterior urethral strictures or bladder neck contractures associated with urinary incontinence after prostate …
2007
Objectives: The treatment of posterior urethral strictures or bladder neck contracture associated with severe urinary incontinence after prostate surgery and failure of endoscopic treatments is controversial. We report our experience with a transperineal approach in two steps: end-to-end urethroplasty/anastomosis and subsequent artificial urinary sphincter implantation.Methods: Between September 2001 and January 2005, we observed six patients (58-68 yr old), with a combination of severe urinary incontinence and posterior urethral stricture with anastomotic bladder neck contracture after prostate surgery. In all cases, repeated endoscopic treatments of the strictures failed. The patients und…
Intraoperative identification and neurophysiologic parameters to verify pelvic autonomic nerve function during total mesorectal excision for rectal c…
2003
Abstract Background Preservation of parasympathetic and sympathetic nerves is required to avoid urogenital function disturbances after total mesorectal excision (TME) for rectal carcinoma. This study sought to determine whether intraoperative stimulation of parasympathetic nerves with monitoring of bladder contraction is useful in meeting this demand. Study design In a prospective pilot study, 17 patients, 11 men and 6 women, underwent TME with pelvic autonomic nerve preservation performed by an experienced surgeon. The parasympathetic nerves were stimulated by an electrostimulation device (Screener 3625, Medronic), and the resulting bladder contraction was measured manometrically in all pa…
Bradykinin Contracts Rat Urinary Bladder Largely Independently of Phospholipase C
2014
Several receptor systems in the bladder causing detrusor smooth muscle contraction stimulate phospholipase C (PLC). PLC inhibition abolishes bladder contraction via P2Y6 but not that via M3 muscarinic receptors, indicating a receptor-dependent role of PLC. Therefore, we explored the role of PLC in rat bladder contraction by bradykinin. The PLC inhibitor U 73,122 [1-(6-[([17β]-3-methoxyestra-1,3,5[10]-trien-17-yl)-amino]hexyl)-1H-pyrrole-2,5-dione] did not affect the bradykinin response to a significantly greater degree than its inactive analog U 73,343 [10 μM each; 1-(6-[-([17β]-3-methoxyestra-1,3,5[10]-trien-17-yl)-amino]hexyl)-2,5-pyrrolidinedione], whereas the phospholipase D inhibitor b…
Urethral fixation technique improves urinary continence recovery in men undergoing open radical cystectomy and ileal orthotopic neobladder
2021
Background We assessed urinary continence recovery and perioperative complications in patients operated on with the novel urethral fixation technique during open radical cystectomy (RC) with ileal orthotopic neobladder (IONB). Methods A retrospective cohort of 82 consecutive male patients undergoing open RC with IONB between 07/2013 and 06/2020 was analyzed. A study group of 48 patients operated on with the urethral fixation technique was compared with a control group of 34 patients receiving standard neovesico-urethral anastomosis. In the study group, the urethral stump was fixed to the dorsal median raphe posteriorly and to the medial portion of levator ani muscle postero-laterally in ord…