scholarly journals Bladder Obstruction

2020 ◽  
Author(s):  
Keyword(s):  
Bladder Obstruction

MO228NATIVE KIDNEY BIOPSIES: DIAGNOCTIC VALUE AND COMPLICATIONS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Vadim Stepanov ◽  
Elena Prokopenko ◽  
Aleksei Zulkarnaev ◽  
Olga Vetchinnikova ◽  
Andrey Yankovoy
Keyword(s):  
Serum Creatinine ◽  
Al Amyloidosis ◽  
Safe Procedure ◽  
Gross Hematuria ◽  
Bladder Obstruction ◽  
Vital Signs Monitoring ◽  
Native Kidney ◽  
Nephritic Syndrome ◽  
The Impact ◽  
Biopsy Complications

Abstract Background and Aims Percutaneous renal biopsy is essential tool in nephrology but it is invasive procedure that can lead to complications, including gross hematuria, clinical significant haematoma and infection. The aim of the study was to determine the nature and incidence of PRB complications and the impact of biopsy results on treatment strategy. Method 82 patients (male – 42, female – 40) with a median age of 43.5 (Q1; Q3 – 34;71) years, BMI 26.4 (22.9; 30.6) were included in retrospective study of all native kidney biopsies performed at our institute from January 1, 2016 to December 31, 2019. An informed consent was mandatory in all patients. The indications for biopsies were nephrotic syndrome, 24-hour proteinuria ≥ 1g, nephritic syndrome, renal failure of unknown origin. The median duration of kidney disease was 9.5 (3.0; 26.6) months, serum creatinine level - 135 (87; 197) μmol/l, eGFR (CKD-EPI formula) – 52.9 (26.6; 83.7) ml/min/1.73 m2, 24-hour proteinuria – 2.8 (1.2; 5.4) g. All biopsies were percutaneous, ultrasound-guided and were performed under local anesthesia in prone position with a 16G needle. Medications that may increase bleeding risk (anticoagulants, antiplatelet agents, and nonsteroidal anti–inflammatory drugs) was stopped before PRB. Immediately after the biopsy, bed rest and vital signs monitoring was prescribed for 12 hours. In the absence of complications, a control kidneys ultrasound was performed 24 hours after biopsy; if complications were suspected, regarding to the local protocol. We prescribed prophylactic antibiotics to the patients with a hematoma volume > 100 ml. All biopsy specimens were sent to tertiary laboratory of renal pathology and evaluated by light and immunofluorescence (IF) microscopy; electron microscopy was not used in our study. Biopsy samples were considered satisfactory for diagnosis if they contained five or more glomeruli. Results Post-biopsy complications included gross hematuria – 19 of 82 (23.5%) patients, haematomas ≤ 100 ml – 17 (20.7%), haematomas > 100 ml – 8 (20.7%), pain in the puncture site requiring the administration of analgesics – 2 (2.4%). No death, infections, bladder obstruction or nephrectomy due to biopsy complications was registered. One (1.2%) patient required blood transfusion. We identified renal arteriovenous fistula which did not require special treatment in one (1.2%) patient 2 months after PRB. We found no differences in the incidence of post-biopsy haematomas by gender, age, or BMI. Haematomas were significantly more common in patients with higher mean blood pressure and serum creatinine levels (Fig.1, A, B). In one case (1.2%) the biopsy was inadequate. The results of PRB were varied, including unexpected findings. IgA nephropathy was found in 23 of 81 (28.4%) patients, focal segmental glomerulosclerosis – in 21 (25.9%), membranous nephropathy – in 9 (11.1%), pauci-immune crescentic glomerulonephritis – in 6 (7,4%), lupus nephritis – in 2 (2.4%), membranoproliferative glomerulonephritis – in 2 (2.4%) - one with polyclonal Ig+/C3+ on IF and one - with monoclonal IgG kappa+, C3 nephropathy – in 1 (1.2%), AL-amyloidosis – in 2 (2.4%), light chain deposit disease – in 1 (1.2%), hypertensive nephropathy – in 1 (1.2%), diabetic nephropathy – in 3 (3.7%), tubulointerstitial nephritis – 5 (6.2%), thrombotic microangiopathy – in 2 (2.4%), diffuse nephrosclerosis – in 2 (2.4%), renal tuberculosis – in 1 (1.2%). According to the results of the biopsy, pathogenetic treatment was first prescribed to 43 of 81 (53.1%) patients, changed – in 17 (21%), treatment remained unchanged – in 8 (9.9%) cases. Thirteen (16%) patients were referred for additional examination by a hematologist and rheumatologist. Conclusion Biopsy of native kidney is a high diagnostic value and safe procedure with a low risk of major complications. Treatment was changed significantly after biopsy in 74% of patients in our study.

Megacystis-Microcolon-Intestinal Hypoperistalsis Syndrome

PEDIATRICS ◽  
1979 ◽  
Vol 63 (5) ◽  
pp. 805-808
Author(s):  
Thomas E. Wiswell ◽  
James S. Rawlings ◽  
James L. Wilson ◽  
Gary Pettett
Keyword(s):  
Neonatal Period ◽  
Ganglion Cells ◽  
Plain Film ◽  
Rectal Biopsy ◽  
Exploratory Laparotomy ◽  
Nerve Fibers ◽  
Bladder Obstruction ◽  
Distended Abdomen ◽  
Biopsy Specimens ◽  
Hypoperistalsis Syndrome

The syndrome of megacystis-microcolon-intestinal hypoperistalsis has been reported in a total of seven female infants. Massive abdominal distention secondary to a distended urinary Fig 1. Plain film of markedly distended abdomen with no air beyond stomach. Stomach is displaced upward toward left. der was the major presenting characteristic. Iutestinal hypoperistalsis, apparent in the early neonatal period, persists without improvement. Exploratory laparotomy reveals malrotation and malfixation of a small microcolon. No anatomic cause of intestinal or bladder obstruction can be found. Intestinal and/or rectal biopsy specimens contain abundant ganglion cells and nerve fibers. The outcome has been uniformly fatal, with survival in the reported cases ranging from two days to 34 months.

Angiotensin II and bladder obstruction in the rat: influence on hypertrophic growth and contractility

1996 ◽  
Vol 271 (5) ◽  
pp. R1186-R1192 ◽  
Author(s):  
K. Persson ◽  
R. K. Pandita ◽  
K. Waldeck ◽  
K. E. Andersson
Keyword(s):  
Angiotensin Ii ◽  
Protein Content ◽  
Contractile Response ◽  
Fold Increase ◽  
Urethral Obstruction ◽  
Bladder Function ◽  
Ang Ii ◽  
Hypertrophic Growth ◽  
Bladder Obstruction ◽  
Bladder Weight

The mechanisms and mediators of hypertrophic growth secondary to infravesical urinary outflow obstruction are unknown. The renin-angiotensin system has been implicated in vascular and cardiac hypertrophy, but the involvement of angiotensin II (ANG II) as a trophic factor in the lower urinary tract has not been investigated. In this study, the ANG II subtype AT1 receptor antagonist losartan (DuP 753) was administered perorally (15 mg.kg-1.day-1) for 28 days to rats subjected to partial urethral obstruction or sham surgery. Partial urethral obstruction caused a 3.5-fold increase in bladder weight and a 3-fold increase in bladder protein content compared with sham rats. However, no difference was observed in bladder weight or bladder protein content between losartan-treated rats and rats receiving no drug. Cystometric evaluation of bladder function revealed significant increases in micturition volume, bladder capacity, bladder compliance, and spontaneous contractile activity in rats subjected to partial urethral obstruction compared with sham rats. However, bladder function in rats treated with losartan was not different from bladder function in rats receiving no drug. In vitro studies of isolated bladder tissue showed a weak contractile response to ANG II (1 microM) that amounted to 4.4 +/- 1.0% of the response to K+ (124 mM). The ANG II-induced contraction was abolished by losartan (10 microM) and indomethacin (10 microM). The contractile response to ANG II (1 microM), K+ (124 mM), and transmural nerve stimulation (2 Hz) was reduced in bladder strips from obstructed rats. In conclusion, no evidence was found for involvement of ANG II in development of bladder hypertrophy. The effect of ANG II on bladder smooth muscle tone was minor but was mediated by stimulation of the AT1 subtype receptor.

Bladder Obstruction in Monochorionic Monoamniotic Twins

2005 ◽  
Vol 24 (6) ◽  
pp. 869-871 ◽  
Author(s):  
Eftichia V. Kontopoulos ◽  
Karen L. Koscica ◽  
Joseph C. Canterino ◽  
Thomas Vates ◽  
Anthony M. Vintzileos
Keyword(s):  
Bladder Obstruction

Protein kinase C in cyclic stretch-induced nerve growth factor production by urinary tract smooth muscle cells

1995 ◽  
Vol 269 (4) ◽  
pp. C1018-C1024 ◽  
Author(s):  
K. Persson ◽  
J. J. Sando ◽  
J. B. Tuttle ◽  
W. D. Steers
Keyword(s):  
Smooth Muscle ◽  
Protein Kinase C ◽  
Urinary Tract ◽  
Nerve Growth Factor ◽  
Growth Factor ◽  
Protein Kinase ◽  
Phorbol Ester ◽  
Cyclic Stretch ◽  
Bladder Obstruction ◽  
Kinase C

Cyclic stretch of cultured urinary tract smooth muscle cells has been used to mimic some of the events that occur with bladder obstruction. The stretch stimulus induces production of nerve growth factor (NGF), which has been implicated in changes in bladder innervation. Stretch-induced NGF production was blocked by actinomycin. Involvement of protein kinase C (PKC) in the stretch-induced NGF production is strongly suggested by the following observations. Phorbol ester activators of PKC mimicked the stretch response as did platelet-derived growth factor (PDGF), which acts, in part, through generation of endogenous diacylglycerols. Both stretch- and PDGF-induced NGF production were blocked by prolonged incubation with phorbol ester to downregulate PKC. Western blot analysis confirmed partial downregulation of the Ca(2+)-dependent PKC-alpha and PKC-beta 1 and near complete downregulation of the Ca(2+)-independent PKC isozymes delta, epsilon, and zeta. The involvement of PKC in transducing a physical stimulus (stretch) into a biochemical response (NGF production) has implications for novel types of therapeutic intervention in ailments such as bladder obstruction.

Mobility of Trigone a Cause of Bladder Obstruction

1931 ◽  
Vol 26 (4) ◽  
pp. 591-597 ◽  
Author(s):  
Thomas N. Hepburn
Keyword(s):  
Bladder Obstruction

A 12-year review of cases of adult tetanus managed at the University College Hospital, Ibadan, Nigeria

2007 ◽  
Vol 37 (3) ◽  
pp. 170-173 ◽  
Author(s):  
E O Sanya ◽  
S S Taiwo ◽  
J K Olarinoye ◽  
A Aje ◽  
O O M Daramola ◽  
...  
Keyword(s):  
Post Injury ◽  
Tertiary Institution ◽  
Southwestern Nigeria ◽  
College Hospital ◽  
Factors Associated ◽  
Bladder Obstruction ◽  
The Mean ◽  
The University ◽  
Overall Mortality ◽  
Ibadan Nigeria

In this review, hospital case records of 202 adult tetanus managed between January 1990 and December 2001 in a tertiary institution in Southwestern Nigeria were reviewed. The mean age of the patients was 36.1±17.8 years with male:female ratio of 2.2:1 and an overall mortality rate of 64%. Patients with unfavourable outcomes spent 4.5±0.41 days compared with 16.6±1.2 days by those who survived. Factors associated with poor prognosis are age >60 years ( P=0.029), incubation period <7 days ( P=0.007), period of onset <48 h ( P=0.0001), tachycardia with pulse rate >120/min ( P=0.001) and spasm ( P=0.002). Gender ( P=0.11), post-injury vaccination ( P=0.48) and types of antibiotics administered ( P=0.49) were not significantly associated with increased mortality. The three most common complications were aspiration pneumonitis, sepsis and urinary bladder obstruction while complications with highest mortality (100%) were sepsis and cardiac arrest.

scholarly journals Inverted bladder diverticulum with sigmoid colon herniation masquerading as bowel and bladder obstruction

2018 ◽  
Vol 5 (11) ◽  
pp. 3767
Author(s):  
Pratima . ◽  
Abhilash . ◽  
Suma S ◽  
Krishna Prasad
Keyword(s):  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Internal Hernia ◽  
Bladder Diverticulum ◽  
Surgical Experience ◽  
Bladder Obstruction ◽  
Internal Hernias ◽  
Abdominal Organs ◽  
Bladder Diverticula ◽  
Primary Bladder

Urinary bladder diverticula can be congenital or acquired, and the latter tends to occur in older men and results from urinary obstruction. Primary bladder diverticula are congenital, smooth walled, solitary in nature and rarely diagnosed in adults. An internal hernia (IH) is a protrusion of intestines or other abdominal organs through a normal or abnormal orifice in the peritoneum or mesentery, occasionally leading to strangulation or incarceration. Internal hernias (IH) are rare causes of acute abdomen and intestinal obstruction in adults. Here we present a case report detailing the authors' surgical experience with inverted bladder diverticulum, presenting as internal hernia with sigmoid colon herniating through it, with features of acute intestinal obstruction and urinary dysfunction.

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