Search Results

HAEMATURIA Haematuria is the presence of blood in the urine. It can be clas sified as visible (VH, or macroscopic) and non-visible (NVH, microscopic or dipstick). Microscopic haematuria is defined as the presence of red blood cells (RBCs) on microscopic exam i...

INNERVATION OF THE BLADDER The lower urinary tract (LUT) is innervated by sympathetic, parasympathetic and somatic a ff erent and e ff erent nerves, under higher control from the cerebral cortex and pontine micturition centre (PMC). The actions of the spina...

Intraperitoneal injury Intraperitoneal injuries usually require open surgical repair to reduce the risks of urinary contamination of the peritoneal space. If the injury is small without significant fluid extravasa - tion, a period of catheterisation can be a...

Introduction No content extracted automatically.

Investigation The diagnosis is made on imaging (ultrasound, computed tomography [CT], magnetic resonance imaging [MRI] or cystogram) or through direct vision at cystoscopy ( Figure 83.7 ). Bladder outlet obstruction should be confirmed with urody - namics if s...

Ketamine cystitis Ketamine is an N -methyl-d-aspartate (NMDA) antagonist. It has been used for decades as an anaesthetic agent but has because of its euphoric and psychedelic e ff ects. As a result of long-term ketamine abuse, up to 30% develop the condition o...

Learning objectives To describe: The anatomical, embryological and pharmacological • features of the bladder The physiology of micturition and the neurological basis of • lower urinary tract function The clinical features, investigations and principles of • ma...

Lymphatics /uni25CF Internal iliac, hypogastric, obturator and external iliac chain of nodes. /uni25CF Pelvic lymphadenectomy for bladder cancer should in clude complete clearance of all these nodes. The clinical features, investigations and principles of • ...

Muscle-invasive bladder cancer The two primary radical treatment options for MIBC are radi cal cystectomy with urinary diversion or chemoradiotherapy . Whichever modality is employed, 5-year survival rates are approximately 60%. There is a move towar ds primar...

Non-muscle-invasive bladder cancer The aim of managing patients with NMIBC is to reduce the risk of tumour recurrence and progression to MIBC. Transurethral resection The initial management of bladder tumours consists of TURBT for accurate staging purposes....

Pathogenesis The most common route of infection is ascending UTI; contamination of the vaginal and periurethral area with uropathogenic organisms originating from the gastrointestinal tract leads to adherence and migration of bacteria into the urethra and b...

Pathology The commonest type of bladder cancer is transitional cell (urothelial) carcinoma ( Table 83.17 ). Squamous cell carcinoma occurs secondary to chronic inflammation (e.g. indwelling catheter, stone, schistosomiasis), and primary adenocarcinoma usually o...

Postoperative mitomycin C instillation Approximately 30% of patients with NMIBC will experience early recurrence following initial TURBT and so an immediate bladder. This has been shown to reduce the risk of tumour recurrence by 12%. Risk stratification Based...

Presentation Patients most commonly present with painless haematuria (in 85%). Storage LUTS of frequency , urgency , dysuria and recurrent UTI may be present. Rarely , patients may present Urinary bladder staging Tis: urothelial carcinoma in situ Ta: non-inva...

Radiation cystitis Radiation cystitis is a common complication of pelvic radio therapy with incidence rates ranging from 23% to 80%. Radia tion treatment causes endothelial cell damage and perivascular fibrosis, resulting in ischaemia and obliterative endarter...

Special cases Genitourinary tuberculosis Genitourinary tuberculosis (GU-TB) caused by Mycobacterium tuberculosis can a ff ect any part of the urinary tract. Renal calci fication and ureteric strictures are typical in the upper urinary tract. In the bladder, ini...

Spinal cord injury SCI often results in significant LUT dysfunction with a high risk of UTI/sepsis, renal function deterioration, renal and bladder calculi and autonomic dysreflexia. Urinary tract complications and renal failure were the leading causes of death...

Suprapubic catheterisation Suprapubic catheterisation (SPC) carries a small but significant risk of bowel injury , especially in those who have undergone - previous abdominal or pelvic surgery , and so should be performed under ultrasound and cystoscopic guida...