Distended Urinary Bladder Research Articles

Distended urinary bladder drainage practices among hospital nurses

Distended urinary bladder drainage practices among hospital nurses

False-Positive Radionuclide Venography Caused by Distended Urinary Bladder

A 60-year-old man with a history of prostatic carcinoma presented with left lower extremity swelling. A massively distended urinary bladder produced a false-positive radionuclide venogram.

The missing balloon sign

The balloon of the self-retaining Foley catheter should be readily visible during ultrasound scanning of the distended urinary bladder. Its absence should prompt a search for its location since extra-vesical inflation may result in local trauma and confusing appearances.

Technical factors responsible for "placental migration": sonographic assessment.

Whether placental migration occurs is debatable. To determine the incidence of placenta previa in early pregnancy and the frequency of placental migration, a retrospective analysis was undertaken of 2,087 consecutive obstetrical sonograms obtained during a 23-month period. Among 849 patients scanned between 14 and 26 weeks after conception, placenta previa was diagnosed using ultrasonography (US) in 53 patients (6.2%). This diagnosis was confirmed at surgery in 15 patients (1.8%); there were 12 cases of central previa and three cases of partial previa. Retrospective analysis revealed that in 25 cases, technical factors, such as an overly distended urinary bladder (19 cases) or focal uterine contractions (six cases), were responsible for the false-positive diagnoses. In the 13 remaining patients, however, there were no obvious technical difficulties to account for the diagnosis of previa. Migration did not occur in any of the patients with central previa. It appears that placental migration may occur, although less frequently than has previously been reported. Furthermore, this study suggests that migration does not occur in patients with central previa.

Intraperitoneal paravesical spaces: CT delineation with US correlation.

The urinary bladder, obliterated umbilical arteries, and inferior epigastric vessels located within the extraperitoneal space of the anterior abdominal wall indent the anterior parietal peritoneum, forming intraperitoneal paravesical fossae. These are the supravesical space and the medial and lateral inguinal fossae. More posteriorly, the peritoneum covering the bladder is reflected onto the rectum to form the rectovesical space, which is divided by the uterus into an anterior vesicouterine recess and a posterior rectouterine pouch, or cul-de-sac. The cul-de-sac is continuous with the pararectal and ovarian fossae and is bounded posterolaterally by the rectouterine (sacrogenital) folds. These peritoneal compartments form a large potential space for the accumulation of ascites and are separated from the equally large extraperitoneal paravesical spaces by only a thin layer of peritoneum or peritoneum and umbilicovesical fascia. The computed tomographic scans of 100 patients with ascites were reviewed, with particular attention to the differentiation between intraperitoneal and extraperitoneal paravesical collections. The scans of intraperitoneal collections were found to have certain characteristic appearances, including inferior displacement of the distended urinary bladder, visualization of the umbilical folds, and preservation of the preperitoneal fat.

Hyperplasia and hypertrophia in the denervated and distended rat urinary bladder.

The parasympathetically denervated and distended rat urinary bladder was found to have increased fourfold in weight when examined 3 weeks postoperatively. Both in muscularis and mucosa of such a bladder the synthesis of proteins, RNA and DNA was increased severalfold. An increase in the polyamines putrescine, spermidine and spermine was also found; these polyamines are usually linked to protein synthesis. The results suggest that the cells of the two layers increase both in size and number. Hyperplasia was, in a previous study, suggested as a possible explanation for a right-ward shift of the active length-tension curve of muscle strips in the denervated rat urinary bladder.

Sonographic detection of subtle pelvic fluid collections.

The sonographic demonstration of small quantities of free intraperitoneal fluid often indicates significant pelvic pathology. In a review of pelvic fluid collections in 146 female patients, however, it became apparent that an overly distended urinary bladder may mask small quantities of free intraperitoneal fluid. The "mass effect" of a distended bladder may cause fluid in the pouch of Douglas to migrate to other parts of the peritoneal cavity, such as the peritoneal reflection over the fundus of the uterus. Fluid in this location produces a characteristic triangular "cap" and was present in 42 patients (29% of the study group). In 10 patients (6.9%) this was the only visible fluid collection. In addition, sonograms obtained after partial voiding demonstrated small quantities of free pelvic fluid in 14 patients (9.6% of the study group) that were not detected on routine full bladder scans. The sonographic appearance of small amounts of intraperitoneal fluid seen over the uterine fundus and the value of post-void scans are stressed in the demonstration of small quantities of intraperitoneal fluid.

Hyperthermic perfusion of the distended urinary bladder in the management of recurrent transitional cell carcinoma. A review after 6 years.

Hyperthermic perfusion of the distended urinary bladder in the management of recurrent transitional cell carcinoma. A review after 6 years.

Neoplastic Epidural Spinal Cord Compression

<h3>To the Editor.—</h3> A TOPICS IN RADIOLOGY/<i>Therapy</i>titled "Neoplastic Epidural Spinal Cord Compression: A Current Perspective" (240:2771, 1978) neglected to mention urinary retention as an additional clinical finding when metastatic carcinoma encroaches on the spinal cord. The observation of an abnormally distended urinary bladder on a radionuclide bone scan, especially when associated with a local increase in spine activity, should prompt careful neurological evaluation.¹

The effect of the distended urinary bladder on placental position and its importance in amniocentesis.

Ultrasonography was performed using the full-bladder technique in 58 patients with intrauterine gestations. Postvoiding scans were then obtained to assess changes in placental position and determine the optimal window for amniocentesis. Twenty-two of the 41 patients with gestations between 13 and 21 weeks and 4 of the 17 with gestations between 24 and 34 weeks had changes in placental position after voiding, presumably due to the effect of the distended bladder on uterine position. These findings should be considered when using ultrasound to locate a suitable window for amniocentesis.

Water enema: A new ultrasound technique in defining pelvic anatomy

A new technique is described for delineating pelvic structures by using a distended bladder in combination with a water enema. The distended urinary bladder, which acts as a sonic window to the pelvis, fully defines only the portion of structures that abut against the surface. With fluid in both the bladder and rectosigmoid colon, and occasionally the cecum, a 'sandwich effect' can be obtained, resulting in a more complete definition of interposed structures. Questionable masses that might be feces in the bowel can be easily distinguished from significant pathology. This new technique has the potential for increasing accuracy of diagnosis of pelvic masses and delineating tumor extension of masses arising in such pelvic organs as the bladder, prostate, and uterus.

Megacystis-microcolon-intestinal hypoperistalsis syndrome: A cause of intestinal obstruction in the newborn period

A 2992 g full term girl was born with marked abdominal distension. Aspiration of thestomach yielded thick bilious fluid. She was transferred to The Children’s Mercy Hospital for further evaluation. The abdomen was distended and nontender with no discrete masses. The remainder of the examination was unremarkable except for slightly webbed neck folds. Serum electrolytes and blood urea nitrogen were normal on admission. Supine roentgenograms showed elevated diaphragms, prominent flanks, a ground glass appearance of the abdomen and a small amount of intestinal air. The findings suggested ascites, but there was no fluid wave and the intestine was displaced laterally rather than centrally. The stomach was displaced upward by a grossly distended urinary bladder (Fig. IA). At 9 hr of age the bladder was easily catheterized with recovery of 150 ml of c/ear dilute urine, under some pressure. Abdominal distension lessened. resulting in a “prune belly” appearance. The baby voided a small volume of urine once but thereafter required a catheter for bladder drainage. The following day intravenous pyelography showed severely hydronephrotic kidneys and dilated intestine in the midabdomen with no air in the rectum (Fig. IB). Cystogram outlined a large bladder with no vesicoureteral reflux. Because of bilious vomiting and failure to pass meconium, intestinal atresia was suspected. Barium enema demonstrated a microcolon with the entire colon appearing “unused” (Fig. IC). At operation (at 39 hr of age) cystoscopy showed a normal female urethra with no bladder outlet obstruction and no ureteroceles. At exploration the abdominal wall musculature was thin but present. There was no ascites. Both kidneys were markedly enlarged with virtually no parenchyma remaining. The ureters were tortuous, moderately dilated and emptied into an enlarged. thick walled bladder. The small intestine was strikingly foreshortened and suspended on a primitive dorsal mesentery. It contained meconium and dark, hemorrhagic fluid suggesting necrotizing enteritis. Intramural hematomas were noted in the ileum after minimal handling. The jejunum and proximal ileum were moderately dilated and the distal ileum was small. The colon was small throughout and nonrotated. There \cas no anatomic site of obstruction. It was felt that the baby’s renal parenchyma was inadequate for long term survival. The serum creatinine was found to be elevated to 1.32/mg/dl. The baby was septic terminally with a blood culture positive for E. coli and Pseudomonas. She died on the third postoperative day.

Hyperthermic perfusion of the distended urinary bladder in the management of recurrent transitional cell carcinoma.

The clinical and histological changes following hyperthermic perfusion of the distended urinary bladder have been studied in 13 patients with transitional cell carcinoma, persistent after radical radiotherapy. Continuous epidural anaesthesia was necessary to achieve a constant state of bladder relaxation during irrigation of the distended bladder. This form of hyperthermic perfusion of the bladder was effective in arresting uncontrollable haemorrhage from bladder tumours and may be of value in the treatment of this complication. Perfusion at an outflow temperature of 44 degrees C for 4 hours caused tumour necrosis. It was, however, associated with damage to the vasculature of the bladder and frequency of micturition which persisted after mucosal recovery. Perfusion at 43 degrees C also caused tumour necrosis and the after effects were less severe.

Vesical Hemorrhages in Male Aleutian Mink Caused by Hypersensitivity to Sulphadimidine

During an outbreak of Salmonella abortion in mink farms receiving food from a central feed plant, sulphamezathine (a 16 % solution of sulphadimidine sodium) was added to the food to combat the infection. After 3 days of medication, some males of the Aleutian type developed severe urinary bleedings. The serum concentration of the drug was not above the recommended value in 2 severely affected animals (1.5 and 1.7 mg/100 ml, respectively). Screening tests for the extrinsic (Thrombotest and Normotest) and intrinsic (cephalin time) coagulation mechanism, fibrinogen assay, fibrinolysis (plasma clot lysis time), and platelet count were not much different from normal. Coagulation or platelet defects did not therefore seem to be the cause of the bleedings. Some of the diseased animals died, and the only necropsy finding was a greatly distended urinary bladder filled with clotted blood. Histologically, hemorrhages and necrotic changes of varying severity were found in the vesical wall. In several cases, the arteries were the structures most evidently affected, indicating that the hemorrhages were due to vascular injury (Fig. 1). The damaged vessels were sporadically occluded by thrombi. The lesions were often most evident in subserosal arteries and in the relatively large arteries situated between the inner circular and the outer longitudinal muscular layer, whereas the submucosal structures were obscured by massive extravasations of red blood cells. Occasionally, the necrotic arteries were surrounded by incipient circumferential cellular accumulations, predominantly mononuclear cells, but some eosinophils were also present (Fig. 2). Thus, in these cases the vascular damage was similar to vascular lesions frequently accompanying viral plasmacytosis (periarteritis nodosa). The possibility exists that the animals were in an early developmental stage of plasmacytosis, but no extravesical changes suggesting plasmacytosis were discovered during the microscopic examination. Although other sulphonamides have occasionally shown toxic properties when administered to mink, this preparation has not, to the authors’knowledge, previously been recorded as injurious to this species. The following experiment was performed to elucidate the toxicity of sulphadimidine sodium to male Aleutian mink.

Electron microscopic observations on the collapsed and distended mammalian urinary bladder (transitional epithelium)

During the course of our electron microscopic studies on the normal structure of transitional epithelium, we observed some characteristics of the cell wall which could provide for the epithelial stretching present in the distended urinary bladder. We have observed an elaborate infolding of the two opposing cell walls in the collapsed bladder. This, along with grossly visible folding of the entire epithelium, could greatly increase the effective cell surface when unfolded and when the cell is flattened and elongated. Desmosomes were observed indicating that these cells are strongly attached to each other, precluding any sliding movement between cells.

Cystitis and ureteritis emphysematosa.

Several articles have appeared recently regarding cystitis emphysematosa, indicating the increasing interest in this entity and showing the value of early diagnosis and treatment. So far as we are aware, however, the complication of ureteritis emphysematosa has not been reported previously. Case Report A 68-year-old white woman with poorly controlled diabetes was admitted to the hospital for gastrointestinal study because of vague abdominal complaints, diarrhea, weakness, and anemia. On the day of the gastrointestinal examination, nausea and vomiting developed and the gallbladder was found to be filled with calculi. The patient improved under conservative management, but two days later experienced sudden lower abdominal pain with urgency and frequency. A tender mass, which proved to be a distended urinary bladder, was palpated in the lower abdomen. The patient was sent to the x-ray department with a clinical diagnosis of “acute abdomen.” Roentgenograms showed the characteristic findings of cystitis emphys...

Sudden and Complete Decompression Versus Slow Emptying of the Distended Urinary Bladder

No AccessJournal of Urology1 Mar 1949Sudden and Complete Decompression Versus Slow Emptying of the Distended Urinary Bladder Theodor Hryntschak Theodor HryntschakTheodor Hryntschak More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)69104-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1949 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited by Ahmed M, Abubakar A, Lawal A, Bello A, Maitama H and Mbibu H (2013) Rapid and complete decompression of chronic urinary retention: a safe and effective practiceTropical Doctor, 10.1177/0049475512472432, VOL. 43, NO. 1, (13-16), Online publication date: 1-Jan-2013. Osius T and Hinman F (2018) Dynamics of Acute Urinary Retention: A Manometric, Radiographic and Clinical StudyJournal of Urology, VOL. 90, NO. 6, (702-712), Online publication date: 1-Dec-1963.Maluf N (2018) Transvesical Prostato-Adenomectomy with Primary Closure of the Bladder. II. Report on 180 Unselected CasesJournal of Urology, VOL. 82, NO. 4, (531-545), Online publication date: 1-Oct-1959.Lawson J, Schneeberg A and Tomlinson W (2018) Observations on Dynamics of Acute Urinary Retention in ManJournal of Urology, VOL. 67, NO. 6, (951-956), Online publication date: 1-Jun-1952. Gee A (1951) UROLOGICAL EMERGENCIESMedical Journal of Australia, 10.5694/j.1326-5377.1951.tb55841.x, VOL. 1, NO. 12, (436-440), Online publication date: 1-Mar-1951. (2016) Discussion on Chronic Retention of UrineProceedings of the Royal Society of Medicine, 10.1177/003591574904201207, VOL. 42, NO. 12, (987-1004), Online publication date: 1-Dec-1949. Volume 61Issue 3March 1949Page: 545-549 Advertisement Copyright & Permissions© 1949 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Theodor Hryntschak More articles by this author Expand All Advertisement PDF downloadLoading ...

DISTENTION OF THE URINARY BLADDER

Sudden emptying of the chronically distended urinary bladder, especially in prostatic hypertrophy, has been condemned as hazardous for so long that the idea has become a tradition. The Ebers papyrus gives a prescription to prevent the too rapid escape of urine.1The conception that one must withdraw the urine slowly first received wide recognition early in the nineteenth century. It was then gradually lost to view, only to reappear with the comparatively recent development of prostatic surgery. I recently reviewed the literature dealing with the reaction to rapid decompression of the distended bladder; at this time only the portion which refers to the relationship of rapid decompression and bleeding will be reviewed in detail. The most widely accepted explanation of the supposed danger of rapid emptying of the bladder in cases of chronic retention maintains that the intravesical pressure is elevated as a result of the retention. This elevated

On Some Dangers Connected with the Use of the Aspirator as a Means of Relieving the Distended Urinary Bladder, with Suggestions for the Treatment of Certain Cases of Retention of Urine

On Some Dangers Connected with the Use of the Aspirator as a Means of Relieving the Distended Urinary Bladder, with Suggestions for the Treatment of Certain Cases of Retention of Urine