Recently,clinical and epidemiologic data indicating the involvement of metabolic syndrome(Met S)in the pathogenesis and progression of lower urinary tract symptom(LUTS)/benign prostatic hyperplasia(BPH)are reported.Th...Recently,clinical and epidemiologic data indicating the involvement of metabolic syndrome(Met S)in the pathogenesis and progression of lower urinary tract symptom(LUTS)/benign prostatic hyperplasia(BPH)are reported.This review evaluates the reports on the influence of MetS in the development and progression of LUTS/BPH,and discusses possible clinical implications for the management and treatment of this disease.Recent studies on the epidemiological relationship between MetS and LUTS hypothesize that MetS may be associated with an overactivity of the autonomic nervous system for which hyperinsulinemia,a key element of the Met S,might be responsible.An alternative explanation is that LUTS are associated with chronic ischemia of pelvis resulting from atherosclerotic changes in blood vessels,which leads the production of reactive oxygen species,which can damage the bladder detrusor.Control of autonomic nervous system overactivity and control of chronic bladder ischemia have potential as new targets for LUTS treatment.Studies suggest an association of Met S with LUTS/BPH,although further research is needed to understand how MetS influences LUTS/BPH.Met S should be considered a new domain in basic and clinical research in patients with LUTS/BPH and as a target for treatment.展开更多
In a total of 83 UN specimens were investigated for proto-oncogene mutations, tumor supressor genes promoter methylation status and c-myc and Ki-67 expression. Point mutations in c-myc were detected in cases with high...In a total of 83 UN specimens were investigated for proto-oncogene mutations, tumor supressor genes promoter methylation status and c-myc and Ki-67 expression. Point mutations in c-myc were detected in cases with high grade and proliferation index. Mutated K-ras proto-onco- gene profiles were detected in 17 (21%) tumoral spiecemens that examined. Tumor specimens were also showed hypermethylated promoter domain for the SFRP2, MGMT tumor supressor genes. These findings showed the combine effect of mutated c-myc and K-ras oncogene and epigenetic inactivation of tissue specific tumor supressor genes (TS) play a crucial role in tumor progression and recurrence in UN carcinogenesis.展开更多
Periodontitis has been proposed as a novel risk factor of genitourinary cancers:although periodontitis and genitourinary cancers are two totally distinct types of disorders,epidemiological and clinical studies,have es...Periodontitis has been proposed as a novel risk factor of genitourinary cancers:although periodontitis and genitourinary cancers are two totally distinct types of disorders,epidemiological and clinical studies,have established associations between them.Dysbiosis of oral microbiota has already been established as a major factor contributing to periodontitis.Recent emerging epidemiological evidence and the detection of oral microbiota in genitourinary organs indicate the presence of an oral-genitourinary axis and oral microbiota may be involved in the pathogenesis of genitourinary cancers.Therefore,oral microbiota provides the bridge between periodontitis and genitourinary cancers.We have carried out this narrative review which summarizes epidemiological studies exploring the association between periodontitis and genitourinary cancers.We have also highlighted the current evidence demonstrating the capacity of oral microbiota to regulate almost all hallmarks of cancer,and proposed the potential mechanisms of oral microbiota in the development of genitourinary cancers.展开更多
Robot-assisted radical cystectomy with intracorporeal urinary diversion(RARCICUD)has only recently been explored as a viable surgical option for patients with muscle-invasive bladder cancer seeking satisfactory oncolo...Robot-assisted radical cystectomy with intracorporeal urinary diversion(RARCICUD)has only recently been explored as a viable surgical option for patients with muscle-invasive bladder cancer seeking satisfactory oncologic control while benefiting from minimally invasive surgical techniques.Inspired by earlier open and laparoscopic work,initial descriptions of RARC-ICUD were published in 2003,and have since been followed by multiple larger case series which have suggested promising outcomes for our patients.However,the rate of adoption has remained relatively slow when compared to other robotassisted procedures such as the radical prostatectomy,likely owing to longer operative times,operative complexity,costs,and uncertainty regarding oncologic efficacy.The operative technique for RARC-ICUD has evolved over the past decade and several high-volume centers have shared tips to improve efficiency and make the operation possible for a growing number of urologists.Though there are still questions regarding economic costs,effectiveness,and generalizability of outcomes reported in published data,a growing dataset has brought us ever closer to the answers.Here,we present our current operative technique for RARC-ICUD and discuss the state of the literature so that the urologist may hold an informed discussion with his or her patients.展开更多
The aim of this study was to determine the impact that age and comorbidity status have on both overall and bladder cancer-specific survival of bladder cancer patients. We obtained medical information pertaining to a p...The aim of this study was to determine the impact that age and comorbidity status have on both overall and bladder cancer-specific survival of bladder cancer patients. We obtained medical information pertaining to a population of 528 patients with newly diagnosed bladder cancer from Chung-Ang University Hospital cancer registry. The Adult Comorbidity Evaluation-27 （ACE-27） test, which has been previously validated in adult cancer patients, was used to assess comorbidity. We evaluated differences in the demographic and clinical characteristics of included patients, as well as differences in the treatments they received after categorizing them by age. The median age at the time of bladder cancer diagnosis of the entire cohort was 63 years, and the median follow-up time was 97 months. Of the 528 patients who were included in our study, 303 had at least one comorbid condition and 249 died during the follow-up period. When patients were stratified by age, we found that older patients had a higher proportion of severe comorbidities （P 〈 0.01） than younger patients, and that a lower proportion of them underwent radical cystec- tomy for invasive bladder cancer （IBC） （P 〈 0.01）. By multivariate analysis, we found that older age was predictive of lower overall survival （OS） and bladder cancer-specific survival （BCSS） rates among patients with superficial bladder cancer （SBC） and of lower OS rates among patients with IBC. We also found that moderate-severe comorbidity status and treatment through a bladder-conserving approach were predictive of lower OS and cancer-specific survival rates among patients with IBC. The disparity between overall deaths and bladder cancer deaths was shown in SBC and increased along with age and higher comorbidity. Age and comorbidity were found to be independent predictive factors of OS and BCSS among bladder cancer patients, and explained the disparity that we observed between overall bladder cancer-specific mortality rates.展开更多
Hematuria due to locally advanced or metastatic bladder cancer is a common condition and is often a management problem.Percutaneous embolisation is a mini-invasive option to handle this situation.We report a case of a...Hematuria due to locally advanced or metastatic bladder cancer is a common condition and is often a management problem.Percutaneous embolisation is a mini-invasive option to handle this situation.We report a case of a patient with a metastatic bladder cancer and who presented with an abundant hematuria and severe anemia.After failure of endoscopic resections and“flush”of radiotherapy haemostatic and refusal of cystectomy by the patient,he was treated by superselective embolisation of bilateral superior bladder arteries with excellent immediate results.The technique is safe and effective in the short term.The longterm effectiveness requires further investigation.展开更多
BACKGROUND Neuroblastoma is an extracranial malignant tumor in children that is most often located in the adrenal gland and sympathetic ganglion.Here,we present a rare case of neuroblastoma originating from the urinar...BACKGROUND Neuroblastoma is an extracranial malignant tumor in children that is most often located in the adrenal gland and sympathetic ganglion.Here,we present a rare case of neuroblastoma originating from the urinary bladder.CASE SUMMARY A 3-year-old girl presented with lower abdominal pain with micturition.Ultrasound revealed a lower abdominal mass.Abdominal computed tomography scan displayed a solitary mass at the top of the urinary bladder.Blood levels of neuron-specific enolase and lactate dehydrogenase were elevated.We treated the child with partial cystectomy and six courses of chemotherapy,and the outcome at 4-year follow-up was unremarkable.CONCLUSION Neuroblastoma should be considered when tumors are located in the urinary bladder,especially in the dome;although this presentation is rare,the prognosis is very good.展开更多
BACKGROUND Plasmacytoma is a rare neoplastic disorder that arises from B-lymphocytes.Solitary bladder plasmacytoma,a type of solitary extramedullary plasmacytoma,is even rarer.Treatments for solitary extramedullary pl...BACKGROUND Plasmacytoma is a rare neoplastic disorder that arises from B-lymphocytes.Solitary bladder plasmacytoma,a type of solitary extramedullary plasmacytoma,is even rarer.Treatments for solitary extramedullary plasmacytoma include surgery,chemotherapy,and radiation.However,there are no clinical trials or guidelines specifying which treatment might represent the gold standard.CASE SUMMARY We herein report a case of a 51-year-old woman with solitary bladder plasmacytoma(SBP).There remains no consensus regarding the optimal treatment for SBP.However,we successfully treated her with transurethral resection of bladder tumor followed by postoperative radiotherapy(50 Gy/25 F).The patient remained free of tumor recurrence at a 7-mo follow-up.CONCLUSION Radiation is the potential main treatment for SBP.However,surgery is also necessary.展开更多
Renal cell carcinoma can metastasize to virtually any organ, yet synchronous metastasis to the bladder is extremely rare. A 77-year-old woman presented with gross hematuria. Abdominal and chest computed tomography sho...Renal cell carcinoma can metastasize to virtually any organ, yet synchronous metastasis to the bladder is extremely rare. A 77-year-old woman presented with gross hematuria. Abdominal and chest computed tomography showed a bilateral renal masses, bladder dome mass, and multiple lung metastasis. Transurethral resection of the bladder tumor and sonography guided renal biopsy were performed. Both pathology diagnoses were clear cell renal cell carcinoma. Targeted therapy using pazopanib was administered to the patient without surgical resection of primary tumors and metastatic lung lesions. Herein, we report the synchronous metastasis of renal cell carcinoma to the bladder and lung.展开更多
930159 Transurethral microwave irradiationfor bladder neoplasm.YANG Xuehui(杨学辉),et al.Dept Urol,Beijing Milit Area GeneralHosp,100700.Natl Med J China 1992;72(9):531-533.Forty-two patients with bladder neoplasmwere...930159 Transurethral microwave irradiationfor bladder neoplasm.YANG Xuehui(杨学辉),et al.Dept Urol,Beijing Milit Area GeneralHosp,100700.Natl Med J China 1992;72(9):531-533.Forty-two patients with bladder neoplasmwere treated effectively by transurethral mi-展开更多
文摘Recently,clinical and epidemiologic data indicating the involvement of metabolic syndrome(Met S)in the pathogenesis and progression of lower urinary tract symptom(LUTS)/benign prostatic hyperplasia(BPH)are reported.This review evaluates the reports on the influence of MetS in the development and progression of LUTS/BPH,and discusses possible clinical implications for the management and treatment of this disease.Recent studies on the epidemiological relationship between MetS and LUTS hypothesize that MetS may be associated with an overactivity of the autonomic nervous system for which hyperinsulinemia,a key element of the Met S,might be responsible.An alternative explanation is that LUTS are associated with chronic ischemia of pelvis resulting from atherosclerotic changes in blood vessels,which leads the production of reactive oxygen species,which can damage the bladder detrusor.Control of autonomic nervous system overactivity and control of chronic bladder ischemia have potential as new targets for LUTS treatment.Studies suggest an association of Met S with LUTS/BPH,although further research is needed to understand how MetS influences LUTS/BPH.Met S should be considered a new domain in basic and clinical research in patients with LUTS/BPH and as a target for treatment.
文摘In a total of 83 UN specimens were investigated for proto-oncogene mutations, tumor supressor genes promoter methylation status and c-myc and Ki-67 expression. Point mutations in c-myc were detected in cases with high grade and proliferation index. Mutated K-ras proto-onco- gene profiles were detected in 17 (21%) tumoral spiecemens that examined. Tumor specimens were also showed hypermethylated promoter domain for the SFRP2, MGMT tumor supressor genes. These findings showed the combine effect of mutated c-myc and K-ras oncogene and epigenetic inactivation of tissue specific tumor supressor genes (TS) play a crucial role in tumor progression and recurrence in UN carcinogenesis.
基金the Zhongnan Hospital of Wuhan University Science,Technology and Innovation Seed Fund(No.znpy2019011)the Fundamental Research Funds for the Central Universities(No.2042020kf0130)+1 种基金the Nature Science Foundation of Hubei Province(No.2019FFB03902)the Health Commission of Hubei Province Scientific Research Project(No.WJ2019H035).
文摘Periodontitis has been proposed as a novel risk factor of genitourinary cancers:although periodontitis and genitourinary cancers are two totally distinct types of disorders,epidemiological and clinical studies,have established associations between them.Dysbiosis of oral microbiota has already been established as a major factor contributing to periodontitis.Recent emerging epidemiological evidence and the detection of oral microbiota in genitourinary organs indicate the presence of an oral-genitourinary axis and oral microbiota may be involved in the pathogenesis of genitourinary cancers.Therefore,oral microbiota provides the bridge between periodontitis and genitourinary cancers.We have carried out this narrative review which summarizes epidemiological studies exploring the association between periodontitis and genitourinary cancers.We have also highlighted the current evidence demonstrating the capacity of oral microbiota to regulate almost all hallmarks of cancer,and proposed the potential mechanisms of oral microbiota in the development of genitourinary cancers.
文摘Robot-assisted radical cystectomy with intracorporeal urinary diversion(RARCICUD)has only recently been explored as a viable surgical option for patients with muscle-invasive bladder cancer seeking satisfactory oncologic control while benefiting from minimally invasive surgical techniques.Inspired by earlier open and laparoscopic work,initial descriptions of RARC-ICUD were published in 2003,and have since been followed by multiple larger case series which have suggested promising outcomes for our patients.However,the rate of adoption has remained relatively slow when compared to other robotassisted procedures such as the radical prostatectomy,likely owing to longer operative times,operative complexity,costs,and uncertainty regarding oncologic efficacy.The operative technique for RARC-ICUD has evolved over the past decade and several high-volume centers have shared tips to improve efficiency and make the operation possible for a growing number of urologists.Though there are still questions regarding economic costs,effectiveness,and generalizability of outcomes reported in published data,a growing dataset has brought us ever closer to the answers.Here,we present our current operative technique for RARC-ICUD and discuss the state of the literature so that the urologist may hold an informed discussion with his or her patients.
文摘The aim of this study was to determine the impact that age and comorbidity status have on both overall and bladder cancer-specific survival of bladder cancer patients. We obtained medical information pertaining to a population of 528 patients with newly diagnosed bladder cancer from Chung-Ang University Hospital cancer registry. The Adult Comorbidity Evaluation-27 （ACE-27） test, which has been previously validated in adult cancer patients, was used to assess comorbidity. We evaluated differences in the demographic and clinical characteristics of included patients, as well as differences in the treatments they received after categorizing them by age. The median age at the time of bladder cancer diagnosis of the entire cohort was 63 years, and the median follow-up time was 97 months. Of the 528 patients who were included in our study, 303 had at least one comorbid condition and 249 died during the follow-up period. When patients were stratified by age, we found that older patients had a higher proportion of severe comorbidities （P 〈 0.01） than younger patients, and that a lower proportion of them underwent radical cystec- tomy for invasive bladder cancer （IBC） （P 〈 0.01）. By multivariate analysis, we found that older age was predictive of lower overall survival （OS） and bladder cancer-specific survival （BCSS） rates among patients with superficial bladder cancer （SBC） and of lower OS rates among patients with IBC. We also found that moderate-severe comorbidity status and treatment through a bladder-conserving approach were predictive of lower OS and cancer-specific survival rates among patients with IBC. The disparity between overall deaths and bladder cancer deaths was shown in SBC and increased along with age and higher comorbidity. Age and comorbidity were found to be independent predictive factors of OS and BCSS among bladder cancer patients, and explained the disparity that we observed between overall bladder cancer-specific mortality rates.
文摘Hematuria due to locally advanced or metastatic bladder cancer is a common condition and is often a management problem.Percutaneous embolisation is a mini-invasive option to handle this situation.We report a case of a patient with a metastatic bladder cancer and who presented with an abundant hematuria and severe anemia.After failure of endoscopic resections and“flush”of radiotherapy haemostatic and refusal of cystectomy by the patient,he was treated by superselective embolisation of bilateral superior bladder arteries with excellent immediate results.The technique is safe and effective in the short term.The longterm effectiveness requires further investigation.
基金Supported by Science Technology Research Program of Zhejiang Province,No.2017C33047Scientific research project of Zhejiang education department,No.N20140124)Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2019KY093
文摘BACKGROUND Neuroblastoma is an extracranial malignant tumor in children that is most often located in the adrenal gland and sympathetic ganglion.Here,we present a rare case of neuroblastoma originating from the urinary bladder.CASE SUMMARY A 3-year-old girl presented with lower abdominal pain with micturition.Ultrasound revealed a lower abdominal mass.Abdominal computed tomography scan displayed a solitary mass at the top of the urinary bladder.Blood levels of neuron-specific enolase and lactate dehydrogenase were elevated.We treated the child with partial cystectomy and six courses of chemotherapy,and the outcome at 4-year follow-up was unremarkable.CONCLUSION Neuroblastoma should be considered when tumors are located in the urinary bladder,especially in the dome;although this presentation is rare,the prognosis is very good.
文摘BACKGROUND Plasmacytoma is a rare neoplastic disorder that arises from B-lymphocytes.Solitary bladder plasmacytoma,a type of solitary extramedullary plasmacytoma,is even rarer.Treatments for solitary extramedullary plasmacytoma include surgery,chemotherapy,and radiation.However,there are no clinical trials or guidelines specifying which treatment might represent the gold standard.CASE SUMMARY We herein report a case of a 51-year-old woman with solitary bladder plasmacytoma(SBP).There remains no consensus regarding the optimal treatment for SBP.However,we successfully treated her with transurethral resection of bladder tumor followed by postoperative radiotherapy(50 Gy/25 F).The patient remained free of tumor recurrence at a 7-mo follow-up.CONCLUSION Radiation is the potential main treatment for SBP.However,surgery is also necessary.
文摘Renal cell carcinoma can metastasize to virtually any organ, yet synchronous metastasis to the bladder is extremely rare. A 77-year-old woman presented with gross hematuria. Abdominal and chest computed tomography showed a bilateral renal masses, bladder dome mass, and multiple lung metastasis. Transurethral resection of the bladder tumor and sonography guided renal biopsy were performed. Both pathology diagnoses were clear cell renal cell carcinoma. Targeted therapy using pazopanib was administered to the patient without surgical resection of primary tumors and metastatic lung lesions. Herein, we report the synchronous metastasis of renal cell carcinoma to the bladder and lung.
文摘930159 Transurethral microwave irradiationfor bladder neoplasm.YANG Xuehui(杨学辉),et al.Dept Urol,Beijing Milit Area GeneralHosp,100700.Natl Med J China 1992;72(9):531-533.Forty-two patients with bladder neoplasmwere treated effectively by transurethral mi-
