• 文章类型: Case Reports
    甲氨蝶呤(MTX)相关的淋巴增生性疾病(LPD)是与MTX治疗相关的最突出的晚期并发症之一。尽管与MTX相关的LPD表现出相对较高的结外疾病发病率,膀胱的发病率很低。本研究报告了一例与MTX相关的LPD患者,涉及膀胱肿块。一位75岁的女性患者,已经接受MTX约15年了,因发烧和血尿被转诊到医院。计算机断层扫描显示膀胱壁增厚,肾积水和淋巴结肿大。膀胱肿块的组织病理学发现导致MTX相关LPD的诊断。虽然MTX退出没有任何效果,随后的化疗导致完全缓解.尽管膀胱中与MTX相关的LPD很少见,当在MTX治疗期间观察到血尿时,应考虑与MTX相关的LPD.
    Methotrexate (MTX)-related lymphoproliferative disease (LPD) is one of the most prominent late complications associated with MTX treatment. Although MTX-related LPD exhibits a relatively high incidence of extranodal disease, the incidence of disease in a urinary bladder is very low. The present study reports the case of a patient with MTX-related LPD involving a urinary bladder mass. A 75-year-old female patient, who had been receiving MTX for ~15 years, was referred to the hospital due to fever and hematuria. A computed tomography scan revealed the thickening of the urinary bladder wall, hydronephrosis and lymph node swelling. The histopathological findings of the urinary bladder mass resulted in a diagnosis of MTX-related LPD. Although MTX withdrawal did not have any effect, the subsequent chemotherapy resulted in complete remission. Although MTX-related LPD in the bladder is rare, it is pertinent to consider MTX-related LPD when hematuria is observed during MTX therapy.
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  • 文章类型: Case Reports
    膀胱乳头状瘤,一种罕见的尿道良性肿瘤,占膀胱肿瘤的1-4%。其鲜明的特点,通过光学显微镜诊断,包括建筑和细胞学特征。尽管它很罕见,膀胱乳头状瘤由于其独特的特征而具有临床意义,低复发风险,和其他尿路上皮肿瘤的潜在进展。了解这种情况对于早期诊断和最佳患者护理至关重要。
    方法:一名66岁男性良性前列腺增生患者出现1个月的间歇性血尿。体格检查和实验室检查无异常。影像学显示,右侧膀胱壁上有11×10×7mm回声性结节性病变伴钙化。膀胱镜检查发现息肉样病变,导致经尿道切除。组织病理学检查证实膀胱乳头状瘤无恶性特征。
    膀胱乳头状瘤通常表现为血尿,主要是年轻患者,低复发和罕见的进展为侵袭性癌症。诊断涉及内窥镜检查和切除,其次是膀胱镜检查。了解它的分类,特点,和风险因素有助于准确管理。
    结论:膀胱乳头状瘤的诊断依赖于光学显微镜,以血尿为主要症状,通常在年轻患者中。复发风险低,进展为侵袭性癌症的情况很少见。诊断涉及内窥镜检查,切除,膀胱镜随访。这个病例增强了我们对膀胱乳头状瘤的认识,有助于改善护理。
    UNASSIGNED: Bladder papilloma, a rare benign tumor of the urinary tract, accounts for 1-4 % of bladder tumors. Its distinct features, diagnosed through light microscopy, include architectural and cytological characteristics. Despite its rarity, bladder papilloma is clinically significant due to its distinct traits, low recurrence risk, and potential progression to other urothelial neoplasms. Understanding this condition is crucial for early diagnosis and optimal patient care.
    METHODS: A 66-year-old male with benign prostatic hyperplasia presented with one month of intermittent hematuria. Physical examination and laboratory tests were unremarkable. Imaging revealed an 11 × 10 × 7 mm echogenic nodular lesion with calcifications on the right bladder wall. Cystoscopy identified a polypoid lesion, leading to transurethral resection. Histopathological examination confirmed bladder papilloma without malignant features.
    UNASSIGNED: Bladder papilloma typically presents with hematuria, mainly in younger patients, with low recurrence and rare progression to aggressive cancers. Diagnosis involves endoscopy and resection, followed by cystoscopic surveillance. Understanding its classification, characteristics, and risk factors aids in accurate management.
    CONCLUSIONS: Bladder papilloma diagnosis relies on light microscopy, with hematuria as a primary symptom, often in younger patients. Recurrence risk is low, and progression to aggressive cancers is rare. Diagnosis involves endoscopy, resection, and cystoscopic follow-up. This case enhances our understanding of bladder papilloma, contributing to improved care.
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  • 文章类型: Case Reports
    背景:膀胱壁脓肿是一种罕见的泌尿系统疾病,文献中记录了一些案例。本报告的主题是在来访的患者中通过计算机断层扫描(CT)成像发现膀胱壁肿块。
    方法:对一名37岁女性进行了病例研究,该女性在耻骨上区有持续性疼痛和下尿路症状。通过CT扫描发现右膀胱前下部分的结构不均匀。进行膀胱镜检查,然后进行经尿道切除术以去除肿块,被发现是脓肿.手术后使用Foley导管进行冲洗,病人三天后回家。
    结论:随访后,患者下尿路没有症状或不适。尽管膀胱壁脓肿罕见,膀胱镜检查可用于辅助诊断。经尿道膀胱壁电切术可以减少肿块,消除恶性肿瘤的可能性。
    BACKGROUND: Abscess of the bladder wall is a rare urological disorder, with a few cases recorded in the literature. The finding of a bladder wall mass via computed tomography (CT) imaging in a visiting patient is the subject of this report.
    METHODS: A 37-year-old woman with persistent pain in the suprapubic area and lower urinary tract symptoms was examined as a case study. Through a CT scan revealed an inhomogeneous structure in the anteroinferior part of the right bladder. A cystoscopy procedure followed by transurethral resection was performed to remove the mass, which was found to be an abscess. A Foley catheter with irrigation was administered after surgery, and the patient goes home in three days.
    CONCLUSIONS: the patient had no symptoms or discomfort in the lower urinary tract after follow-up. Despite the rarity of bladder wall abscesses, cystoscopy can be used to aid diagnosis. Transurethral resection of bladder wall can reduce the mass and eliminate the possibility of malignancy.
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  • 文章类型: Journal Article
    这项回顾性研究评估了透视引导下导尿术在盲目或膀胱镜辅助导尿失败的患者中的安全性和有效性。我们在2011年1月至2023年3月之间利用了我们的机构数据库,纳入了盲或膀胱镜辅助导尿和随后的透视引导导尿失败的患者。将一根5-Fr导管插入尿道口,并获得逆行尿道造影(RGU)。随后,操作者试图通过亲水导丝进入尿道。如果导丝和引导导管可以成功进入膀胱,但由于尿道狭窄导尿管未能通过,操作者决定再次尝试减小导管直径或根据自己的喜好进行球囊扩张。最后,选择了适当大小的尿道导管,并且使用18号针创建了一个端孔。然后将导管插入线上以将尖端定位在膀胱腔中并膨胀以固定它。我们回顾了病人的病史,血尿的存在,和RGU以确定尿道异常。评估了与程序相关的数据。研究共纳入149例患者(均为男性;平均年龄,73.3±13.3年)。在141例患者中共证实有225例尿道狭窄,而八名患者没有狭窄。62例尿道破裂被证实,34例患者盲目或膀胱镜辅助导尿失败后出现血尿。技术和临床成功率为100%,在4例患者中观察到手术相关并发症(2.2%)。从请求到插入尿道导管的平均时间为129.7±127.8分钟。平均总透视时间为3.5±2.5min,平均总DAP为25.4±25.1Gycm2。77例患者进行了球囊扩张术。总手术时间为9.2±7.6min,无球囊扩张的平均手术时间为7.1±5.7min。对于盲目或膀胱镜辅助尿道插管失败或无法进行膀胱镜-尿道插管的患者,荧光镜引导的尿道插管是一种安全有效的替代方法。
    This retrospective study evaluated the safety and efficacy of fluoroscopy-guided urethral catheterization in patients who failed blind or cystoscopy-assisted urethral catheterization. We utilized our institutional database between January 2011 and March 2023, and patients with failed blind or cystoscopy-assisted urethral catheterization and subsequent fluoroscopy-guided urethral catheterization were included. A 5-Fr catheter was inserted into the urethral orifice, and the retrograde urethrography (RGU) was acquired. Subsequently, the operator attempted to pass a hydrophilic guidewire to the urethra. If the guidewire and guiding catheter could be successfully passed into the bladder, but the urethral catheter failed pass due to urethral stricture, the operator determined either attempted again with a reduced catheter diameter or performed balloon dilation according to their preference. Finally, an appropriately sized urethral catheter was selected, and an endhole was created using an 18-gauge needle. The catheter was then inserted over the wire to position the tip in the bladder lumen and ballooned to secure it. We reviewed patients\' medical histories, the presence of hematuria, and RGU to determine urethral abnormalities. Procedure-related data were assessed. Study enrolled a total of 179 fluoroscopy-guided urethral catheterizations from 149 patients (all males; mean age, 73.3 ± 13.3 years). A total of 225 urethral strictures were confirmed in 141 patients, while eight patients had no strictures. Urethral rupture was confirmed in 62 patients, and hematuria occurred in 34 patients after blind or cystoscopy-assisted urethral catheterization failed. Technical and clinical success rates were 100%, and procedure-related complications were observed in four patients (2.2%). The mean time from request to urethral catheter insertion was 129.7 ± 127.8 min. The mean total fluoroscopy time was 3.5 ± 2.5 min and the mean total DAP was 25.4 ± 25.1 Gy cm2. Balloon dilation was performed in 77 patients. Total procedure time was 9.2 ± 7.6 min, and the mean procedure time without balloon dilation was 7.1 ± 5.7 min. Fluoroscopy-guided urethral catheterization is a safe and efficient alternative in patients where blind or cystoscopy-assisted urethral catheterization has failed or when cystoscopy-urethral catheterization cannot be performed.
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  • 文章类型: Case Reports
    在泌尿外科紧急情况下,膀胱异物是一种罕见的发现。膀胱内异物可以通过几种方式发生,包括医源性损伤,自我插入的乐趣,性虐待,攻击,以及从相邻站点迁移。此病例报告是关于一名36岁的男性的有趣介绍,该男性在排尿1个月时出现灼烧感和运球感。骨盆的X射线显示骨盆软组织中有多种放射密度(形态被认为是磁球)。进行了膀胱镜检查,并使用三管钳去除磁性异物。该患者的住院过程微不足道,并使用镇痛药和抗生素出院。
    A foreign body in the urinary bladder is an uncommon finding in urology emergencies. There are several ways in which intravesical foreign bodies can occur, including iatrogenic injuries, self-insertion for pleasure, sexual abuse, assault, and migration from adjacent sites. This case report is about an interesting presentation of a 36-year-old male who presented to the urology outpatient department with a burning sensation and dribbling while urinating for 1 month. An X-ray of the pelvis revealed multiple radiodensities (morphology was suggested as magnetic balls) in the pelvic soft tissues. Cystoscopy was performed and three-pronged forceps were utilized to remove the magnetic foreign bodies. The patient had an insignificant hospital course and was discharged with analgesics and antibiotics.
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  • 文章类型: Case Reports
    据报道,每插入1000个宫内节育器,宫内节育器迁移和子宫穿孔的发生率为1.9-3.6。重要的是要注意,由错位的IUD引起的膀胱穿孔并不常见,并且被认为在插入期间最频繁发生。这里,我们描述了一名患者,他出现了与膀胱内宫内节育器错位有关的症状。可以得出结论,应将膀胱镜检查技术视为该器官中此类损伤的合适治疗选择。当仅通过膀胱镜检查无法有效治疗问题时,应该考虑剖腹手术.
    According to reports, there are 1.9-3.6 incidences of IUD migration and uterine perforation for every 1000 IUD insertions. It is important to note that bladder perforation caused by a misplaced IUD is uncommon and is thought to happen most frequently during insertion. Here, we describe a patient who presented with symptoms related to the malposition of IUD inside the bladder. It is feasible to draw the conclusion that the cystoscopy technique should be taken into consideration as a suitable therapy option for such injuries in this organ. When a problem cannot be effectively treated by cystoscopy alone, laparotomy should be considered.
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    文章类型: Case Reports
    Mullerianosis是一种罕见的,复杂,良性肿瘤最常见于膀胱,常被误认为是肿瘤。在这里,我们报告了一例65岁女性的苗勒氏病病例,在横断面成像中发现了2厘米的膀胱肿块.在膀胱镜检查中发现了混合的囊性和实体瘤,并对可疑肿瘤进行了经尿道切除,并进行了组织病理学检查,确认了对多发性硬化症的最终诊断。虽然一个不寻常的诊断,需要正确识别膀胱多位症,以提供适当的治疗方法并避免误诊。
    Mullerianosis is a rare, complex, benign tumor most commonly found in the bladder and often mistaken for a neoplastic lesion.  Herein, we report a case of mullerianosis in a 65-year-old woman who presented with an incidental 2 cm bladder mass found on cross-sectional imaging.  A mixed cystic and solid tumor was identified on cystoscopy and a transurethral resection of the suspected tumor was performed with histopathology confirming a final diagnosis of mullerianosis.  While an unusual diagnosis, mullerianosis of the urinary bladder needs to be correctly identified to provide appropriate treatment and avoid misdiagnosis.
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  • 文章类型: Case Reports
    此案例报告描述了演示文稿,诊断,对一名有多次剖宫产史的36岁女性进行了罕见的膀胱异位妊娠的手术治疗。患者出现耻骨上疼痛的症状,发烧,和闭经.最初的超声波显示保留了受孕产物,导致败血症流产的初步诊断。然而,随后重新扫描发现子宫空,膀胱内胎儿无法存活,连接到子宫腔。膀胱镜检查证实膀胱内存在胎儿部位。最后,进行了剖腹手术,将胎儿从膀胱中取出,同时修复了子宫膀胱瘘.随后是一个平稳的术后时期。文献综述显示,以前报道的病例只有4例,总体情况相似。该病例强调了在有剖宫产史和异常症状的患者中考虑膀胱异位妊娠的重要性。因为及时的手术干预对于确保疾病的成功管理至关重要。
    This case report describes the presentation, diagnosis, and surgical management of a rare vesical ectopic pregnancy in a 36-year-old woman with a history of multiple cesarean sections. The patient presented with symptoms of suprapubic pain, fever, and amenorrhea. An initial ultrasound indicated retained products of conception, leading to a preliminary diagnosis of septic miscarriage. However, subsequent rescanning revealed an empty uterus and a non-viable fetus within the bladder, connected to the uterine cavity. Cystoscopy confirmed the presence of fetal parts inside the bladder. Finally, a laparotomy was performed and the fetus was removed from the bladder with repair of the underlying uterovesical fistula. An uneventful postoperative period ensued. The literature review revealed only four previously reported cases with similar overall presentations. This case highlights the importance of considering vesical ectopic pregnancies in patients with a history of cesarean sections and unusual symptoms, as prompt surgical intervention is crucial for ensuring successful management of the condition.
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  • 文章类型: Review
    本研究报告1例肾静脉畸形误诊为肿瘤的临床资料。CT显示左肾盂和输尿管积血。CTU:左肾盂及肾盏呈稍高密度影,尺寸约2.6厘米*1.5厘米,在病变边缘发现轻度至中度增强。增强MR显示在左肾下部花萼观察到不规则的肿块异常信号,病灶呈铸型。短T1和略长T2信号。可疑为低度恶性肿瘤继发出血或粘液。该患者于2021年12月3日在全身麻醉下接受了膀胱镜检查和左输尿管镜检查。左侧可以看到血尿,并且可以检测到左肾盂中的多个血凝块。洗涤后,可以看到暗红色的血腥坏死物质。病理提示肾静脉畸形,伴有出血和血栓形成,位于肾髓质,涉及肾花萼,肾萼破裂和出血,周围肾组织局部出血明显。随访1年以上,患者病情稳定。当患者出现肾绞痛伴血尿时,增强的CT提示肾脏肿块是轻度到中度的持续增强,增强MRI提示短T1和长T2,考虑到肿块可能伴有出血,输尿管镜提示肾静脉畸形的诊断应考虑暗红色血性坏死物质。
    The present study reports the clinical data of a patient with renal venous malformation misdiagnosed as carcinoma. CT revealed hematocele in the left renal pelvis and ureter. CTU: the left renal pelvis and calyces showed a slightly high density shadow, a size of about 2.6 cm*1.5 cm, and mild-to-moderate enhancement was found at the edge of the lesion. Enhanced MR showed that irregular mass abnormal signal was observed in the lower calyx of the left kidney and the lesions were cast, with short T1 and slightly long T2 signals. The secondary bleeding or mucus of low-grade malignant tumor became suspicious. The patient underwent cystoscopy and left ureteroscopy under general anesthesia on December 3, 2021. Bloody urine can be seen on the left side, and multiple blood clots in the left renal pelvis can be detected. After washing, dark red bloody necrotic substances can be seen. Pathology suggests that renal venous malformation, accompanied by bleeding and thrombosis, is located in the renal medulla, involving the renal calyx, rupture and bleeding of the renal calyx, and obvious local bleeding of surrounding renal tissue. Follow-up for more than 1 year showed that the patient\'s condition was stable. When patients have renal colic with hematuria, enhanced CT suggests that renal mass is mild-to-moderate continuous enhancement, enhanced MRI suggests short T1 and long T2, considering that the mass may be accompanied by bleeding, and ureteroscopy suggests that dark red bloody necrotic substances should be considered in the diagnosis of renal venous malformation.
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  • 文章类型: Case Reports
    膀胱尿路上皮癌主要影响成人,在年轻患者中有罕见病例。这篇手稿提出了一个罕见的尿路上皮癌突出的临床特征,诊断,治疗,和这个年龄组的预后。我们的目标是提高医疗保健专业人员对改善儿童和青少年膀胱尿路上皮癌预后的认识。
    方法:一名17岁男性,表现为血尿和泌尿系症状。无吸烟史,酒精,手术,家庭条件,或药物。患者在炼油厂附近有环境化学暴露。最初的超声和膀胱镜检查显示膀胱肿瘤相当大。完成了完整的TURBT,然后烧灼和放置导管。肿瘤被诊断为低度尿路上皮癌(pT1)。术后3个月和9个月随访膀胱镜检查无复发。
    尿路上皮膀胱癌(UBC)与职业暴露和吸烟有关。UBC对年轻患者的研究有限,但是遗传因素和环境暴露可能起作用。在年轻人中,UBC通常表现为低等级,非肌肉浸润性肿瘤(NMIBC)。经尿道电切术可能足以治疗低度肿瘤,术后超声随访很重要。较大的肿瘤具有较高的复发和进展风险。
    结论:本病例强调需要考虑膀胱尿路上皮癌是年轻患者血尿的潜在原因,并对所有危险因素进行全面评估。未来的研究需要建立基于证据的指南来管理儿科和青少年患者的这种情况。
    UNASSIGNED: Urothelial carcinoma of the bladder predominantly affects adults with rare cases in young patients. This manuscript presents a rare case of urothelial carcinoma highlighting clinical characteristics, diagnosis, treatment, and prognosis in this age group. Our aim is to raise awareness among healthcare professionals for improved outcomes in children and adolescents with bladder urothelial carcinoma.
    METHODS: A 17-year-old male presented with hematuria and urinary symptoms. No history of smoking, alcohol, surgeries, family conditions, or medications. The patient had environmental chemical exposure near an oil refinery. An initial ultrasound and Cystoscopy showed a sizable bladder tumor. A complete TURBT was done, followed by cauterization and catheter placement. The tumor was diagnosed as low-grade urothelial carcinoma (pT1). Follow-up cystoscopies after 3 and 9 months showed no recurrence.
    UNASSIGNED: Urothelial bladder carcinoma (UBC) is linked to occupational exposure and smoking. Limited research exists on UBC in young patients, but genetic factors and environmental exposure may play a role. In young individuals, UBC typically presents as low-grade, non-muscle invasive tumors (NMIBC). Transurethral resection may be sufficient for low-grade tumors, and postoperative follow-up with ultrasound is important. Larger tumors have a higher risk of recurrence and progression.
    CONCLUSIONS: The present case emphasizes the need to consider urothelial bladder carcinoma as a potential cause of hematuria in young patients and conduct a thorough evaluation of all risk factors. Future research is needed to establish evidence-based guidelines for managing this condition in pediatric and adolescent patients.
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