An 87-year-old-man with prostate-cancer-stage-T1cGleason-6 treated with radiotherapy in 1996, recurrent prostate cancer treated with leuprolide hormonal therapy in 2009, and bladder-urothelial-carcinoma in situ treate...An 87-year-old-man with prostate-cancer-stage-T1cGleason-6 treated with radiotherapy in 1996, recurrent prostate cancer treated with leuprolide hormonal therapy in 2009, and bladder-urothelial-carcinoma in situ treated with Bacillus-Calmette-Guerin and adriamycin in 2010, presented in 2015 with painless, bright red blood per rectum coating stools daily for 5 mo. Rectal examination revealed bright red blood per rectum; and a hard, fixed, 2.5 cm × 2.5 cm mass at the normal prostate location. The hemoglobin was 7.6 g/d L(iron saturation = 8.4%,indicating iron-deficiency-anemia). AbdominopelvicCT-angiography revealed focal wall thickening at the bladder neck; a mass containing an air cavity replacing the normal prostate; and adjacent rectal invasion. Colonoscopy demonstrated an ulcerated, oozing, multinodular, friable, 2.5 cm × 2.5 cm mass in anterior rectal wall, at the usual prostate location. Histologic and immunohistochemical analysis of colonoscopic biopsies of the mass revealed poorly-differentiatedcarcinoma of urothelial origin. At visceral angiography, the right-superior-rectal-artery was embolized to achieve hemostasis. The patient subsequently developed multiple new metastases and expired 13 mo postembolization. Comprehensive literature review revealed 16 previously reported cases of rectal involvement from bladder urothelial carcinoma, including 11 cases from direct extension and 5 cases from metastases. Patient age averaged 63.7 ± 9.6 years(all patients male). Rectal involvement was diagnosed on average 13.5 ± 11.8 mo after initial diagnosis of bladder urothelial carcinoma. Symptoms included constipation/gastrointestinal obstruction-6, weight loss-5, diarrhea-3, anorexia-3, pencil thin stools-3, tenesmus-2, anorectal pain-2, and other-5. Rectal examination in 9 patients revealed annular rectal constriction-6, and rectal mass-3. The current patient had the novel presentation of daily bright red blood per rectum coating the stools simulating hemorrhoidal bleeding; the novel mechanism of direct bladder urothelial carcinoma extension into rectal mucosa via the prostate; and the novel aforementioned colonoscopic findings underlying the clinical presentation.展开更多
<strong>Aim:</strong> To compare and analyze dose constraints and target coverage results and to reduce Bladder Wall (B<sub>wall</sub>) V<sub>18.12</sub> for prostate Stereotactic-B...<strong>Aim:</strong> To compare and analyze dose constraints and target coverage results and to reduce Bladder Wall (B<sub>wall</sub>) V<sub>18.12</sub> for prostate Stereotactic-Body Radiation Therapy (SBRT) when Seminal Vesicles (SSVV) are included or not. Several indicators based on intersection volumes are obtained to predict constraint fulfillment. <strong>Background:</strong> Due to prostate’s low alpha-beta ratio and the possibility of increasing the therapeutic ratio several moderate and extreme hypofractionation schemes have been proposed. The scheme selected was a fivefraction urethra-sparing prostate SBRT. <strong>Materials and Methods:</strong> 150 patients divided into two groups according to the inclusion of SSVV in PTV or not were analyzed. Histograms, average values, standard deviations and degrees of fulfillment were obtained for each constraint or goal and group. A possible reduction of the B<sub>wall</sub> V<sub>18.12</sub> was addressed by re-optimizing fifty randomly chosen patients. Predictors of constraint fulfilling were obtained by using the intersections of B<sub>wall</sub> and Rectum Wall (R<sub>wall</sub>) with the PTV. <strong>Results:</strong> Significant differences in R<sub>wall</sub> V<sub>32.62</sub> and V<sub>29</sub> were obtained when evaluating the influence of SSVV inclusion. A reduction of 12% in the B<sub>wall</sub> V<sub>18.12</sub> constraint was achieved without compromising coverage and OARs doses. No dependence on the inclusion of SSVV was found. <strong>Conclusions:</strong> Statistically significant differences have been found in R<sub>wall</sub> intermediate-dose constraint when SSVV was included. A reduction of 12% in the B<sub>wall</sub> V<sub>18.12</sub> constraint has been achieved without compromising the PTV coverage and the rest of OARs constraints. Constraint fulfillment predictors could be useful to evaluate the feasibility of prostate SBRT prior to the planning process for every single patient.展开更多
Penetrating wound of the anal canal is relatively rare, which is often complicated with injuries of the rectum, urinary bladder or posterior urethra. Misdiagnosis and improper treatments of the disease may lead to pel...Penetrating wound of the anal canal is relatively rare, which is often complicated with injuries of the rectum, urinary bladder or posterior urethra. Misdiagnosis and improper treatments of the disease may lead to pelvic abscess, anal stenosis, fecal incontinence, or rectovesical fistula. From 1985 to 2004, 16 patients with penetrating wounds through the anorectum and urinary bladder or posterior urethra were treated in our hospital.展开更多
目的对2003-2022年骶神经调控术相关文献的研究现状、热点和趋势进行可视化分析。方法检索2003年1月1日至2022年12月31日Web of Science核心合集收录的骶神经调控术相关文献,采用CiteSpace 6.1.R6软件进行可视化分析。结果共纳入文献173...目的对2003-2022年骶神经调控术相关文献的研究现状、热点和趋势进行可视化分析。方法检索2003年1月1日至2022年12月31日Web of Science核心合集收录的骶神经调控术相关文献,采用CiteSpace 6.1.R6软件进行可视化分析。结果共纳入文献1738篇、涉及57个国家/地区、543个机构、689位作者。其中Neurourology and Urodynamics杂志发文量最多,Journal of Urology杂志被引用量第一。共有602个关键词,形成10个关键词聚类,聚类词有“骶神经调控术”“排尿功能障碍”“大便失禁”等。30个突现词,近些年的突现词有“胫神经刺激”“植入式神经刺激器”“骶神经调控术”等。结论骶神经调控术领域的研究热度呈上升趋势,以知识图谱的形式对该领域的研究特点及趋势作出直观展示,为该领域研究提供方向及思路。展开更多
文摘An 87-year-old-man with prostate-cancer-stage-T1cGleason-6 treated with radiotherapy in 1996, recurrent prostate cancer treated with leuprolide hormonal therapy in 2009, and bladder-urothelial-carcinoma in situ treated with Bacillus-Calmette-Guerin and adriamycin in 2010, presented in 2015 with painless, bright red blood per rectum coating stools daily for 5 mo. Rectal examination revealed bright red blood per rectum; and a hard, fixed, 2.5 cm × 2.5 cm mass at the normal prostate location. The hemoglobin was 7.6 g/d L(iron saturation = 8.4%,indicating iron-deficiency-anemia). AbdominopelvicCT-angiography revealed focal wall thickening at the bladder neck; a mass containing an air cavity replacing the normal prostate; and adjacent rectal invasion. Colonoscopy demonstrated an ulcerated, oozing, multinodular, friable, 2.5 cm × 2.5 cm mass in anterior rectal wall, at the usual prostate location. Histologic and immunohistochemical analysis of colonoscopic biopsies of the mass revealed poorly-differentiatedcarcinoma of urothelial origin. At visceral angiography, the right-superior-rectal-artery was embolized to achieve hemostasis. The patient subsequently developed multiple new metastases and expired 13 mo postembolization. Comprehensive literature review revealed 16 previously reported cases of rectal involvement from bladder urothelial carcinoma, including 11 cases from direct extension and 5 cases from metastases. Patient age averaged 63.7 ± 9.6 years(all patients male). Rectal involvement was diagnosed on average 13.5 ± 11.8 mo after initial diagnosis of bladder urothelial carcinoma. Symptoms included constipation/gastrointestinal obstruction-6, weight loss-5, diarrhea-3, anorexia-3, pencil thin stools-3, tenesmus-2, anorectal pain-2, and other-5. Rectal examination in 9 patients revealed annular rectal constriction-6, and rectal mass-3. The current patient had the novel presentation of daily bright red blood per rectum coating the stools simulating hemorrhoidal bleeding; the novel mechanism of direct bladder urothelial carcinoma extension into rectal mucosa via the prostate; and the novel aforementioned colonoscopic findings underlying the clinical presentation.
文摘<strong>Aim:</strong> To compare and analyze dose constraints and target coverage results and to reduce Bladder Wall (B<sub>wall</sub>) V<sub>18.12</sub> for prostate Stereotactic-Body Radiation Therapy (SBRT) when Seminal Vesicles (SSVV) are included or not. Several indicators based on intersection volumes are obtained to predict constraint fulfillment. <strong>Background:</strong> Due to prostate’s low alpha-beta ratio and the possibility of increasing the therapeutic ratio several moderate and extreme hypofractionation schemes have been proposed. The scheme selected was a fivefraction urethra-sparing prostate SBRT. <strong>Materials and Methods:</strong> 150 patients divided into two groups according to the inclusion of SSVV in PTV or not were analyzed. Histograms, average values, standard deviations and degrees of fulfillment were obtained for each constraint or goal and group. A possible reduction of the B<sub>wall</sub> V<sub>18.12</sub> was addressed by re-optimizing fifty randomly chosen patients. Predictors of constraint fulfilling were obtained by using the intersections of B<sub>wall</sub> and Rectum Wall (R<sub>wall</sub>) with the PTV. <strong>Results:</strong> Significant differences in R<sub>wall</sub> V<sub>32.62</sub> and V<sub>29</sub> were obtained when evaluating the influence of SSVV inclusion. A reduction of 12% in the B<sub>wall</sub> V<sub>18.12</sub> constraint was achieved without compromising coverage and OARs doses. No dependence on the inclusion of SSVV was found. <strong>Conclusions:</strong> Statistically significant differences have been found in R<sub>wall</sub> intermediate-dose constraint when SSVV was included. A reduction of 12% in the B<sub>wall</sub> V<sub>18.12</sub> constraint has been achieved without compromising the PTV coverage and the rest of OARs constraints. Constraint fulfillment predictors could be useful to evaluate the feasibility of prostate SBRT prior to the planning process for every single patient.
文摘Penetrating wound of the anal canal is relatively rare, which is often complicated with injuries of the rectum, urinary bladder or posterior urethra. Misdiagnosis and improper treatments of the disease may lead to pelvic abscess, anal stenosis, fecal incontinence, or rectovesical fistula. From 1985 to 2004, 16 patients with penetrating wounds through the anorectum and urinary bladder or posterior urethra were treated in our hospital.
文摘目的对2003-2022年骶神经调控术相关文献的研究现状、热点和趋势进行可视化分析。方法检索2003年1月1日至2022年12月31日Web of Science核心合集收录的骶神经调控术相关文献,采用CiteSpace 6.1.R6软件进行可视化分析。结果共纳入文献1738篇、涉及57个国家/地区、543个机构、689位作者。其中Neurourology and Urodynamics杂志发文量最多,Journal of Urology杂志被引用量第一。共有602个关键词,形成10个关键词聚类,聚类词有“骶神经调控术”“排尿功能障碍”“大便失禁”等。30个突现词,近些年的突现词有“胫神经刺激”“植入式神经刺激器”“骶神经调控术”等。结论骶神经调控术领域的研究热度呈上升趋势,以知识图谱的形式对该领域的研究特点及趋势作出直观展示,为该领域研究提供方向及思路。
