• 제목/요약/키워드: Urinary Bladder

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Identification of Patients with Microscopic Hematuria who are at Greater Risk for the Presence of Bladder Tumors Using a Dedicated Questionnaire and Point of Care Urine Test - A Study by the Members of Association of Urooncology, Turkey

  • Turkeri, Levent;Mangir, Naside;Gunlusoy, Bulent;Yildirim, Asif;Baltaci, Sumer;Kaplan, Mustafa;Bozlu, Murat;Mungan, Aydin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권15호
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    • pp.6283-6286
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    • 2014
  • In patients with microscopic hematuria there is a need for better identification of those who are at greater risk of harbouring bladder tumors. The RisikoCheck(C) questionnaire has a strong correlation with the presence of urothelial carcinoma (UC) of the bladder and in combination with other available tests may help identify patients who require detailed clinical investigations due to increased risk of presence of bladder tumors. This study aimed to evaluate the efficacy of RisikoCheck(C) questionnaire together with NMP-22(R) (BladderChek(R)) as a point-of-care urine test in predicting the presence of bladder tumors in patients presenting with microscopic hematuria as the sole finding. In this multi-institutional prospective evaluation of 303 consecutive patients without a history of urothelial carcinoma (UC), RisikoCheck(C) risk group assessment, urinary tract imaging and cystourethroscopy as well as urine cytology and Nuclear Matrix Protein-22 (NMP-22 BladderChek) testing were performed where available. The sensitivity, specificity, negative predictive value (NPV), and positive predictive values (PPV) for the risk adapted approach were calculated. All patients underwent cystoscopy, and tumors were detected in 18 (5.9%). Urine cytology and NMP-22 was positive for malignancy in 9 (3.2%) and 12 (7.5%) of patients, respectively. A total of 43 (14%) patients were in the high risk group according to the RisikoCheck(C) questionnaire. The sensitivity and specificity of the questionnaire in detecting a bladder tumor was 61.5 % and 84.0 % in the high risk group. In patients with either a positive NMP-22 test or high risk category RisikoCheck(C), 23.6% had bladder tumors with a corresponding sensitivity of 54.2% and specificity of 88.6%. If both tests were negative only 3.3% of the patients had bladder tumors. The results of our study suggest that the efficacy of diagnostic evaluation of patients with microscopic hematuria may be further enhanced by combining RisikoCheck(C) questionnaire with NMP-22.

A Study on Urinary Tract Infections in Intensive Care Unit Patients with an Indwelling Urinary Catheter

  • Seong, Hee-Kyung;Kim, Yoo-Ho
    • 대한의생명과학회지
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    • 제7권3호
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    • pp.117-125
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    • 2001
  • This study was performed in order to evaluate the risk factors for nosocomial urinary tract infection and the frequencies of organisms isolated, and to provide the epidemiologic and basic data of hospital acquired urinary tract infection in intensive care unit. A prospective analysis was performed with 1,235 urine samples following urinary bladder catheterization in 569 patients, who had no evidence of UTI at the time of catheter insertion, admitted to intensive care unit in Pusan P hospital between June 1997 and May 1998. To identify risk factors for UTI, clinical characteristics of infected patients were analyzed. We analyzed these data by percentage, chi-square and odd ratio. Obtained results were as follows: A total of 569 patients (male 341 and female 228) were an average age of 50.8 years and catheterization of 8.04 days. Incidence of UTI was 16.1% (199/1,235) and The risk factors of UTI were duration of catheterization over 7 days, no use of systemic antibiotics, summer and female, and During the first 7 days these risk factors were no use of systemic antibiotics, summer, place of first catheter insertion (ICU) and type of intensive care unit (NSICU). A total of 220 the isolated strains were Gram negative rod 83 (37.7%), yeast like fungi 74 (33.6%) and Gram positive cocci 63 (28.6%). The common organisms isolated were Enterococcus faecalis 23 (10.5%), Serratia marcescens 19 (8.6%), Pseudomonu spp.17 (7.7%), E. ooh 16 (7.3%), Staphylococcus epidemidis 11 (5.0%) mdklebsiellapneumoniae 8 (3.6%). Therefore, in these results 199 of 569 (35%) patients in ICU with indwelling urinary catheter developed UTI. The risk factors for UTI are prolonged duration of catheterization, no use of systemic antibiotics, summer, and female.

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재가 여성노인의 하부요로증상, 일상생활불편감 및 수면의 질과의 관계 (Relation of Lower Urinary Tract Symptoms, Daily Life Inconvenience, and Sleep Quality in Community Elderly Women)

  • 송민선;최찬헌;양남영
    • 가정간호학회지
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    • 제25권1호
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    • pp.58-66
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    • 2018
  • Purpose: The purpose of this study was to find out lower urinary tract symptoms, daily life inconvenience, and sleep quality in elderly community woman. Methods: Participants were 140 elderly women. Data collection was conducted from September 1 to October 30, 2017. Data were analyzed using descriptive statistics and t-test with the SPSS program. Results: The rate of urge incontinence was 25.0%, stress incontinence 36.4%, unexplained incontinence 15.7%, and nocturnal incontinence 9.3%. Those participants with urge incontinence presented significantly higher daily life inconvenience scores; urge incontinence, stress incontinence, and unexplained incontinence were significantly associated with lower sleep quality scores. Furthermore, frequent urination, nocturia, and incomplete emptying were significantly higher daily life inconvenience scores; and frequent urination, nocturia, hesitancy, straining, intermittent stream, burning, incomplete emptying, bladder pain, and abnormal strength of stream were significantly related to lower sleep quality scores. Conclusion: It is necessary to develop intervention strategies considering incontinence and urination symptoms to reduce daily life inconvenience caused by lower urinary tract symptoms and improve sleep quality in elderly women.

이행세포암종의 요 세포학적 소견 - 83예 분석 - (Urinary Cytologic Findings of Transitional Cell Carcinoma - Analysis of 83 Cases-)

  • 김연미;조혜제
    • 대한세포병리학회지
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    • 제6권2호
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    • pp.148-155
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    • 1995
  • Urinary cytology has become an essential element in the diagnosis and management of transitional ceil carcinoma(TCC) of the urinary tract. It has the advantage of being noninvasive, inexpensive, and easily accessible. Besides that it can even detect malignancy when unsuspected at cystoscopy. We report a retrospective review of urine cytology un the diagnosis of 83 TCC cases that underwent 295 cytologic evaluation. All patients had biopsy-proven TCC of the bladder, ureter and renal pelvis, The overall incidence of the positive cytology cases was 66.2%. To define the cytologic features of tumor cells, we tried to use three cytologic gradings such as "grade 1", "grade 2", and "grade 3" according to the cytologic degree of anaplastic neoplastic cells. These cytologic gades of TCC were relatively well correlated with the histologic grade and tumor invasiveness. This result suggests that the recognition of characteristic cellular features of TCC can suspect the histologic grade and tumor stage. The false negative TCC cases were 78.9%. They showed severe inflammatory or bloody background and a few neoplastic cells. Therefore, a cautious approach for accurate interpretation, personal experience, and proper fixation and processing could expand the role of urinary cytology.

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요로상피병변의 요세포학적 소견 (Urinary Cytologic Findings of Urothelial Lesions)

  • 최윤정;이광길
    • 대한세포병리학회지
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    • 제5권2호
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    • pp.130-136
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    • 1994
  • Urinary cytology is increasingly accepted as a diagnostic tool in the detection and follow-up of patients with bladder cancer. However, its value is reduced by several limitations, especially by the lack of cytologic criteria specifically reflecting the morphology of low-grade urothelial neoplasm. We reviewed histologically proven 50 cases of urine cytology with emphasis on cytologic findings of benign atypia and differential findings of urothelial neoplasm according to the grade. The diagnoses included 17 benign lesions(including 5 cases of urine calculi) and 33 malignant lesions (including 28 transitional cell carcinomas, 3 squamous cell carcinomas, 1 adenocarcinoma and 1 prostate adenocarcinoma), Diagnostic accuracy was 92%. Important cytodiagnostic criteria for benign atypia and low grade malignancy were cellularity, number of cell clusters, and morphology and arrangement of urothelial cells. The cytologic findings of urothelial neoplasms according to histologic grade were relatively well correlated with the histologic findings. However, the cytologic criteria were not sufficient to readily distinguish grade I from grade II. In view of this, we think that cytologic nomenclature "low-grade" and "high-grade" is a more reliable criterion. Recognition of subtle cellular morphologic features specific for urothelial lesions(including benign or malignancy) and proper fixation, processing and staining of specimen can expand the role of urinary cytology In detection and follow-up of patients.

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Ultrasonographic and Clinical Findings in Cats with Feline Lower Urinary Tract Disease

  • Seo, Seongeun;Na, Hyemin;Choi, Sooyoung;Choi, Hojung;Lee, Yungwon;Lee, Kija
    • 한국임상수의학회지
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    • 제38권2호
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    • pp.63-68
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    • 2021
  • Urethral obstruction is a life-threatening feline lower urinary tract disease (FLUTD). The rate of recurring urethral obstruction was 14.8-58.1% after the first occurrence. Ultrasonographic findings associated with reobstruction had been rarely reported although ultrasonography was a valuable technique for diagnosing urinary bladder calculi and distinguishing different FLUTD causes. This retrospective study aims to describe the ultrasonographic findings, urinalysis, and serum chemistry profile in cats with FLUTD and determine the associations of reobstruction with ultrasonographic findings, urinalysis, and serum chemistry profile. The present study included 141 cats that were followed up for more than 1 year. The ultrasonographic criteria included the presence of cystolithiasis, urine echogenicity, sediment, suspended linear strand, pericystic effusion, hyperechoic pericystic fat, ureteral dilation, pyelectasia, and perirenal effusion. The urinalysis criteria included hematuria, urine-specific gravity, pH, sediment, and proteinuria. The most common ultrasonographic findings in cats with FLUTD were echogenic urine and sediment. However, this study did not find an association between reobstruction and ultrasonographic findings, urinalysis, and serum chemistry profiles. Thus, an ultrasonographic examination may be insufficient to predict the risk of reobstruction although it is a useful modality for diagnosing FLUTD and making treatment direction.

Poloxamer 407 Hydrogels for Intravesical Instillation to Mouse Bladder: Gel-Forming Capacity and Retention Performance

  • Kim, Sang Hyun;Kim, Sung Rae;Yoon, Ho Yub;Chang, In Ho;Whang, Young Mi;Cho, Min Ji;Kim, Myeong Joo;Kim, Soo Yeon;Lee, Sang Jin;Choi, Young Wook
    • 대한비뇨기종양학회지
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    • 제15권3호
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    • pp.178-186
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    • 2017
  • Purpose: Poloxamer 407 (P407) thermo-sensitive hydrogel formulations were developed to enhance the retention time in the urinary bladder after intravesical instillation. Materials and Methods: P407 hydrogels (P407Gels) containing 0.2 w/w% fluorescein isothiocyanate dextran (FD, MW 4 kDa) as a fluorescent probe were prepared by the cold method with different concentrations of the polymer (20, 25, and 30 w/w%). The gel-forming capacities were characterized in terms of gelation temperature (G-Temp), gelation time (G-Time), and gel duration (G-Dur). Homogenous dispersion of the probe throughout the hydrogel was observed by using fluorescence microscopy. The in vitro bladder simulation model was established to evaluate the retention and drug release properties. P407Gels in the solution state were administered to nude mice via urinary instillation, and the in vivo retention behavior of P407Gels was visualized by using an in vivo imaging system (IVIS). Results: P407Gels showed a thermo-reversible phase transition at $4^{\circ}C$ (refrigerated; sol) and $37^{\circ}C$ (body temperature; gel). The G-Temp, G-Time, and G-Dur of FD-free P407Gels were approximately $10^{\circ}C-20^{\circ}C$, 12-30 seconds, and 12-35 hours, respectively, and were not altered by the addition of FD. Fluorescence imaging showed that FD was spread homogenously in the gelled P407 solution. In a bladder simulation model, even after repeated periodic filling-emptying cycles, the hydrogel formulation displayed excellent retention with continuous release of the probe over 8 hours. The FD release from P407Gels and the erosion of the gel, both of which followed zero-order kinetics, had a linear relationship ($r^2=0.988$). IVIS demonstrated that the intravesical retention time of P407Gels was over 4 hours, which was longer than that of the FD solution (<1 hour), even though periodic urination occurred in the mice. Conclusions: FD release from P407Gels was erosion-controlled. P407Gels represent a promising system to enhance intravesical retention with extended drug delivery.

근치적 방광적출 후 회장 신방광형성술을 시행받은 방광암 환자의 컴퓨터단층촬영: 호두까기 증후군 소견의 분석 및 혈뇨와의 관계 (CT Evaluation of the Findings of Nutcracker Syndrome in Patients with Bladder Cancer after Radical Cystectomy and Ileal Neobladder Formation: A Correlation with Hematuria)

  • 신해민;이중엽;이동현;김승협
    • 대한영상의학회지
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    • 제84권2호
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    • pp.409-417
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    • 2023
  • 목적 근치적 방광적출 후 회장 신방광형성술을 시행 받은 방광암 환자는 수술 후 혈뇨를 보일 수 있는데, 이는 종양 재발에 대한 불안을 유발할 수 있다. 그러나 종양 재발뿐 아니라 호두까기 증후군이 수술 후 혈뇨의 원인이 될 수 있으며, 이는 빈번한 증후군일 수 있음을 증명하려고 한다. 대상과 방법 2011년부터 2016년까지 근치적방광적출 후 회장 신방광형성술을 시행 받은 255명의 방광암 환자를 대상으로 조영증강 복부골반 컴퓨터단층촬영과 소변검사 소견을 후향적으로 분석하였다. 컴퓨터단층촬영에서 호두까기 증후군 소견의 유무는 좌신정맥 흐름 패턴을 평가하여 판단하였다. 소변분석에서는 총 소변검사에서 혈뇨가 양성인 비율에 따라 환자를 분류하였다. 결과 컴퓨터단층촬영에서 호두까기 증후군 소견은 135명의 환자 중 31.9%에서 나타났다. 혈뇨 양성 그룹에서는 호두까기 증후군의 소견이 없는 환자보다 있는 환자가 26% 더 많았다. 결론 호두까기 증후군의 소견은 수술 후 방광암 환자에게 빈번하였으며, 호두까기 증후군 소견과 혈뇨 사이에는 유의미한 상관관계가 있었다. 또한 호두까기 증후군 소견의 유병률은 수술 후 요로의 종양 재발률보다 높았다.

중풍환자의 급성요도염에 대하여 단독 한방처방 투여로 치료한 1례 (A Case of Urinary Tract Infection Treated with Gagamyookmijihwang-tang(Jia-Jian-Liu-Wei-De-Huang-Tang) in Stroke Patient)

  • 한진안;조기호;김정진
    • 대한한방내과학회지
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    • 제23권2호
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    • pp.286-291
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    • 2002
  • Urinary tract infection(UTI) is one of the common complications in stroke patients. As it has negative effect on the recovery of stroke, it should be cured out immediately. But antibiotics might cause some adverse reactions such as diarrhea, eruption, anorexia, nausea and vomiting. so there have been several reports about treating urinary tract infection with Traditional Korean Medication. We treated a 54-year-old male patient with cerebral hemorrhage, who had had neurogenic bladder after stroke and had been urinated by intermittent catheterization. About 10 days later, he could void by himself without catheter, but showing the symptoms of UTI; Voiding pain, hematuria and yellowish pus. The pus culture grew Staphylococcus spp., which was resistant to most of antibiotics except vancomycin and teicoplanin. Based on accompanying symptoms of intermittent dizziness, headache, insomnia, nocturnal sweating, weak pulse, red tongue and urinary problem, we differentiated him as the deficiency of Yin of the Kidney[腎陰虛] and treated with Gagamyookmijihwang-tang (Jia-Jian-Liu-Wei-De- Huang-Tang), which improved his urinary symptoms and other general conditions without any side effect. In next follow-up culture, there was no pathogen. We conclude that Traditional Korean Medicine based on differentiation is useful in the treatment of urinary tract infection.

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요실금의 한의학적 치료에 대한 문헌고찰 (Literature Study about Oriental Medical Treatment on the Urinary Incontinence)

  • 서은비;조한백;김송백;서윤정;최창민;이지현
    • 동의생리병리학회지
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    • 제27권4호
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    • pp.374-382
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    • 2013
  • In Oriental medicine, urinary incontinence is defined involuntary voiding of urine. This study was performed to investigate the treatment on urinary incontinence through the literature of oriental medicine. This study reviews the therapy method of urinary incontinence based on 63 books of oriental medicine and 20 papers about the treatment of urinary incontinence. Herbal medicine has been used as urinary incontinence treatment. One of herbal remedy is selected according to the symptoms, and then herbal products are supplemented such as warm-hot, convergence medicines. Acupuncture and moxibustion therapy has been performed with herbal medicine, electroacupuncture, pharmacopuncture, conservation therapy such as Kegel exercise, timed voiding and extracorporeal magnetic innervation for incontinence treatment. The treatment of urinary incontinence by oriental medicine includes auricular acupuncture, external medical treatment and taoist methods. There is a lack of related study about these therapy.