Obstructive symptoms

  • 文章类型: Review
    一名48岁的男性,有高血压病史,无前列腺癌家族史,出现腹胀,下腹部疼痛,和下尿路症状.体格检查发现下腹部有明显肿块,直肠指检发现直肠前侧有一块坚硬的肿块。实验室测试显示PSA水平升高(7.9ng/mL)。影像学检查显示,一个与前列腺后壁和直肠前壁相连的实体肿块,随着膀胱压缩。经腹膜活检和组织学分析可诊断出具有不确定潜在恶性的间质瘤。考虑到没有明显的恶性体征和肿瘤的光滑外壁,病人经历了,在文献中第一次,机器人辅助的根治性腹膜外前列腺切除术用于完全宏观切除。手术包括切除巨大的骨盆肿块,尿道的保存,解剖重建。术后进展顺利,我们没有并发症就出院了.病理检查证实了多房性前列腺囊腺瘤的诊断。术后随访检查,包括PSA水平和成像扫描,没有肿瘤复发的迹象。在3-,6-,和9个月的随访,病人无症状,已完全康复,无泌尿或性功能障碍报告。
    A 48-year-old man with a medical history of hypertension and no family history of prostate cancer presented with abdominal distension, lower abdominal pain, and lower urinary symptoms. Physical examination revealed a palpable mass in the lower abdomen, and a digital rectal examination detected a firm mass on the anterior side of the rectum. Laboratory tests showed an elevated PSA level (7.9 ng/mL). Imaging studies indicated a solid mass connected to the prostate\'s posterior and rectum\'s anterior walls, along with bladder compression. Transperitoneal biopsy and histological analysis led to a diagnosis of a stromal tumor with uncertain potential malignancy. Considering the absence of apparent malignancy signs and the smooth outer wall of the tumor, the patient underwent, for the first time in the literature, a robot-assisted radical extraperitoneal prostatectomy for complete macroscopic resection. The surgery involved excision of the bulky pelvic mass, preservation of the urethra, and anatomical reconstruction. The postoperative course was uneventful, and we discharged the patient with no complications. The pathological examination documented the diagnosis of multilocular prostatic cystadenoma. Post-surgery follow-up examinations, including PSA levels and imaging scans, showed no signs of tumor recurrence. At the 3-, 6-, and 9-month follow-ups, the patient was asymptomatic and had fully recovered, with no urinary or sexual dysfunction reported.
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  • 文章类型: Case Reports
    腺性膀胱炎(CG)是一种罕见的膀胱增生性疾病。这种情况与慢性炎症或慢性梗阻有关。这种情况通常表现为微观发现,大型宏观病变的存在是罕见的特征。直到现在,从过渡性腺性膀胱炎到腺性膀胱炎的病程尚不清楚,而且CG可能发展为腺癌的不确定性曾经被证明.随此,我们报告了我们的2岁男孩腺性膀胱炎表现为LUTS阻塞性症状的经验,血尿和膀胱肿块。超声检查发现双侧肾积水,输尿管和膀胱壁厚度提示梗阻和慢性炎症。进行膀胱镜检查以确保诊断结果显示突出的肿块部分阻塞膀胱三角区。输尿管口和后尿道。行经尿道切除术,给予COX-2抑制剂和口服类固醇治疗。随着症状的改善,术后病程顺利,尿流图显示出有希望的结果。该病例代表了引起严重阻塞性症状和膀胱肿块的腺性膀胱炎的罕见且有趣的病例,这是内窥镜介入治疗的适当治疗方法。COX-2抑制剂和口服类固醇产生了有希望的结果。随访1年,LUTS症状减少,如紧张和排尿困难。
    Cystitis Glandularis (CG) is an unusual proliferative disease of the bladder. This condition was associated with chronic inflammation or chronic obstruction. This condition usually presents as microscopic finding and the presence of large macroscopic lesion is a rare feature. Until now, the course of disease from transitional to cystitis glandularis is still unclear and the uncertainty of CG to potentially develop into adenocarcinoma has once been documented. Herewith, we report our experience with 2 years old boy with cystitis glandularis presenting with LUTS obstructive symptoms, hematuria and bladder mass. Ultrasound examination revealed bilateral hydronephrosis with hydroureter and bladder wall thickness suggesting the sign of obstruction and chronic inflammation. Cystoscopy examination was performed to ensure the diagnosis with the result revealing protruding mass partially obstructing the bladder trigone, both ureteral orifice and posterior urethra. Transurethral resection was performed and the administration of COX-2 inhibitor and oral steroid therapy were given. Post-operative course was uneventful with the improvement in symptom and uroflowmetry revealed promising result. This case represented an entity of rare and interesting case of cystitis glandularis causing severe obstructive symptoms and urinary bladder mass which appropriate therapy of endoscopic intervention, COX-2 inhibitor and oral steroid resulted in promising outcome. Follow up of 1 year resulted in reduced LUTS symptoms such as straining and difficulty of urination.
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  • 文章类型: Case Reports
    巨大的多房性前列腺囊腺瘤(GMPC)是罕见的前列腺良性肿瘤之一。本报告介绍了一名最近被诊断患有GMPC的年轻人。我们的报告强调了及时诊断和治疗的重要性,考虑到与其他常见泌尿疾病的重叠症状。
    Giant Multilocular Prostatic Cystadenoma (GMPC) is one of the rare benign tumors of the prostate. This report presents a case of a young man who has been recently diagnosed with GMPC. Our report highlights the importance of timely diagnosis and treatment, considering the overlapping symptoms with other common urinary conditions.
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  • 文章类型: Journal Article
    OBJECTIVE: Patients with Hirschsprung disease (HD) can have persistent obstructive symptoms after resection of the aganglionic segment. If obstructive symptoms are treated inadequately, this may lead to recurrent faecal stasis and impaction, and may result in severe distension of the bowel. A permanently distended bowel which not responds to conservative treatment may be an indication for redo surgery. The aim of this study is to describe our experiences and the short-term results of a novel technique: longitudinal antimesenteric resection with a longitudinal anastomosis.
    METHODS: We reviewed the medical records of our three patients who underwent longitudinal resection of severe distended bowel. This technique aims to improve defecation by improving faecal passage and is characterized by resection of the antimesenteric side of the distended intestinal segment, followed by plication with a longitudinal anastomosis. In this paper, this novel technique is described in detail, as well as short-term outcomes.
    RESULTS: All patients had an uneventful recovery after longitudinal antimesenteric resection. During follow-up, the functional outcomes were excellent, with a large improvement of bowel function. All patients were continent for faeces, and treated with low-dose laxatives or occasional preventive irrigation in one patient. There were no more complaints of persistent constipation or soiling.
    CONCLUSIONS: Longitudinal resection is a surgical redo-procedure offering large benefits for patients with Hirschsprung disease with distended bowel after primary surgery.
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