Anatomy Of Bladder Research Articles

Medical outcomes research and benign prostatic hyperplasia

Increasing health care costs and growing interest in quality care have focused attention on medical outcomes research. With regard to symptomatic BPH, patients deciding between different treatment choices need to know the likely outcomes of these alternatives, including chances for symptom responses and improved functional health and well-being. There is a paucity of high-quality outcomes research in medicine, including research that would clarify treatment outcomes for BPH. The relationship between physiologic and anatomic bladder outlet obstruction due to BPH and its symptoms, as well as quality of life, needs further study to elucidate how BPH affects health. A number of ongoing studies should provide information on the outcomes of alternative treatment strategies for BPH, the relationship between anatomic and physiologic BPH, and higher-level outcomes, such as symptom levels and quality of life.

Misleading appearances of the bladder on pediatric genitourinary imaging.

The authors reviewed images of the bladder on 100 consecutive Tc-99m DTPA pediatric renograms for any abnormal distribution of radionuclide or asymmetry suggestive of anatomic bladder abnormality. The results were correlated with radiographic contrast voiding cystourethrograms and ultrasound examination. Of 81 patients with adequate bladder imaging, 50 (62%) had symmetric and uniform distribution of radioactivity within the bladder. Thirty-one patients (38%) had a sufficiently abnormal bladder appearance to suggest anatomic abnormality. Of these 31 patients, 27 had contrast cystograms and ultrasound evaluation; only one (4%) had a proven bladder abnormality which correlated with the abnormal scintigraphic appearance. The appearance of the bladder on pediatric genitourinary imaging is a nonspecific and unreliable indicator of anatomic bladder abnormality.

Long-Term Followup of 207 Patients with Bladder Exstrophy: An Evolution in Treatment

Between 1945 and 1985 a total of 207 patients (male-to-female ratio 2:1) was treated at our institution for exstrophy of the bladder. Primary anatomical bladder closure was performed in 137 patients, of whom 42 (31 per cent) eventually required urinary diversion. Primary urinary diversion was the initial treatment in 70 patients, including ureterosigmoidostomy in 40, ileal conduit in 17, colon conduit in 11 and cutaneous ureterostomy in 2. Secondary urinary diversion was necessary in 35 patients and included continent diversion in 7. Primary anatomical bladder closure, done within 72hours of birth and followed by staged reconstruction of the bladder neck, was the most successful surgical regimen for the treatment of bladder exstrophy. Acceptable urinary continence was achieved in 82 per cent of our patients with this approach. However, multiple procedures often were required to achieve continence.

Primary closure of bladder exstrophy: Long-term functional results in 137 patients

Between 1945 and 1985, 207 patients were treated at our institution for exstrophy of the urinary bladder. Primary anatomical bladder closure was performed in 137 patients. In 97 patients treated prior to 1975, bladder closure was performed at a median age of 1 year and continence in this group was only 16%. Forty patients treated after 1975 underwent closure at a median age of 72 hours followed by staged reconstruction of the bladder neck. Continence in this group was 82%; however, the average number of surgical procedures was five as compared with two in the first group. Early bladder closure and staged reconstruction can achieve acceptable urinary continence, but multiple surgical procedures may be required.

Uroflowmetry in neurologically normal children with voiding disorders.

A prospective study was undertaken to delineate the role of spontaneous uroflowmetry as screening procedure for functional infravesical obstruction (detrusor/sphincter dyssynergia). More than 70% of thirty-nine children referred for urinary tract infections and/or enuresis in the absence of neurological deficits underwent a complete diagnostic program including intravenous urography, voiding cystography and cystoscopy as well as spontaneous uroflowmetry, cystometry-emg and pressure-flow-emg study. The incidence of dyssynergia was 22%. However, neither the flow curve pattern nor single flow variables were able to identify children with dyssynergia. Consequently uroflowmetry seems inefficient in the screening for dyssynergia in neurological normal children with voiding disorders in the absence of anatomical bladder outlet obstruction.

Anatomy of the Rabbit Bladder

Anatomy of the Rabbit Bladder