Lipomatosis of the bladder presenting as bladder cancer

A case of bladder lipomatosis in an 81-year-old man is presented. The preoperative diagnosis was bladder tumor. A transurethral resection of the bladder was performed and a pathological examination revealed lipomatosis of the bladder. This entity is extremely rare and, to our knowledge, this is the second case reported in the English published works.     

Relationship between the size of the bladder template and the subsequent bladder capacity in bladder exstrophy

AimThe aim of this study is to evaluate the relationship between the size of the bladder template in infants born with bladder exstrophy and the subsequent bladder capacity at the age of 1 and 5 years.Materials and MethodsInfants with bladder exstrophy were photographed at birth, and 2 parallel lines were drawn transversally on the photograph across the anterior-superior iliac spines and on the bladder template. The ratio between the 2 lines was calculated, and the bladder templates categorized as (a) small (≥4), (b) medium (3-4), and (c) large (<3). Bladder capacity was subsequently measured at 1 and 5 years and considered satisfactory when 60 mL or greater at the age of 1 year and 100 mL or greater at the age of 5 years.ResultsSixteen patients were identified. At the age of 1 and 5 years, 81% and 94% had achieved a satisfactory bladder capacity, irrespective of their original template group. Nonetheless, those in group C still showed significantly larger capacities at the age of 5 years than those in groups A and B (P < .05).ConclusionBladder exstrophy patients, who undergo a successful primary closure, can achieve satisfactory capacities despite smaller bladder templates at birth.     

Leiomyoma of the urinary bladder with bladder stone

Leiomyoma of the urinary bladder is a rare benign mesenchymal tumour. We describe here a case of leiomyoma of the urinary bladder in a 65-year-old gentleman who presented with haematuria, passage of clots and combined obstructive and irritative urinary symptoms. The investigations revealed a vesical calculus and a mass on the left lateral wall of the urinary bladder. Cystolitholapaxy and transurethral resection of the tumour was performed. Histopathological report of the resected tumour revealed a leiomyoma of the urinary bladder. So far, a leiomyoma of the urinary bladder and a concomitant vesical calculus have not been described in literature.     

Rectal bladder in the treatment of bladder exstrophy.

Satisfactory results were obtained in 25 patients with bladder exstrophy treated by the Heitz-Boyer-Hovelacque operation.     

Prolonged bladder distension in the treatment of the unstable bladder.

11 patients underwent 12 prolonged bladder distensions for bladder instability. In no case did the cystometrogram revert from an unstable to a stable pattern, through 6 patients noted symptomatic improvement which was attested as moderate by 2 and marginal by 4.     

Sonography of the bladder

Ultrasonography (US) is the method of choice for the diagnosis of bladder disease. It is superior to other imaging techniques, such as urography and cystography, in depicting certain structures and abnormalities. US examination of the bladder should include a study of the ureterovesical junction and the structures round the vesical neck. The examination technique may be transabdominal, transrectal or transvaginal, or transurethral. The bladder pathology that can be studied by US includes cystitis, calculi, clots, diverticula, trauma and tumors. The sensitivity and the specificity of the method are very high and sometimes superior to cystoscopy. Sonography can be used to explore patients with stress incontinence and those with abdominal trauma. The ureterovesical junction may be clearly examined by US and the pathology of the papilla clearly defined.     

Cancer of the bladder

The important clinical and particularly the diagnostic features of carcinoma of the bladder have been examined. The value of the case history, physical examination, urinalysis, classification of epithelial tumors, cystoscopy, biopsy, roentgen studies and differential diagnosis have been outlined. Certain points have been emphasized by reference to cases which the writers have examined. The writers believe that the problem of cancer of the bladder can be handled in a more satisfactory manner if the surgeon is fortified with complete knowledge of the urinary tract prior to operation.     

Pheochromocytoma of the bladder

Summary We report three cases of pheochromocytoma of the bladder and review the literature. Often, the clinical manifestations of this rare neoplasm are elusive; however, a classic triad of symptoms, initiated by voiding, is well documented. Current localizing diagnostic modalities include measurement of plasma and urinary catecholamines, cystoscopy, computed tomographic (CT) scanning, andm[¹³¹I]iodobenzylguanidine (MIBG) radioactive scanning. When feasible, the treatment of choice is partial cystectomy, with appropriate control of blood pressure and blood volume. Histologic determination of malignancy is equivocal and can complicate therapeutic options. Postoperative follow-up is required, as recurrence has been observed.     

Malakoplakia of the bladder

Malakoplakia is a disease which most commonly affects the bladder. It is probably more common than is realised because the appearance of the lesions is variable and the diagnosis can be difficult to make histologically. It should be considered in patients with recurring Escherichia coli infections and is also associated with immunosuppression and carcinoma. Three patients with malakoplakia of the bladder are reported: two had recurrent Esch. coli urinary tract infections and one had widespread urological malignancy. The pathogenesis is discussed and a simple treatment regime, which was rapidly successful in the patient who received it, is recommended.