Defect In Urinary Bladder Research Articles

EP118 - Chronic Vesicouterine Fistula (Youssef's syndrome) Complete Opening of Anterior Uterine Wall in the Urinary Bladder: A- very rare case

Abstract Background Vesicouterine fistula is an uncommon urogenital condition typically following Caesarean sections (C/S). Youssef syndrome, characterized by haematuria, amenorrhea, and urinary incontinence, poses a diagnostic challenge and demands comprehensive assessment. Case report We present a case of a 40-year-old woman with persistent urine incontinence and haematuria for three years post her fourth C/S. Clinical evaluation revealed periodic lower abdominal pain, haematuria, amenorrhea, and urine incontinence. sonography was normally reported, while cystoscopy revealed a complete 5x2 cm opening between the anterior uterine wall and the posterior bladder wall, confirming Youssef syndrome. After a course of antibiotic therapy, surgical intervention was planned. Transabdominal total hysterectomy, partial cystectomy, and repair were performed following meticulous anatomical delineation using cystoscopy. The procedure involved dissecting the vesicouterine attachment, performing partial cystectomy, and eventually total hysterectomy. Closure of the urinary bladder defect with absorbable sutures and a negative leak test concluded the surgery. The patient showed no postoperative complications, with follow-ups at 6 and 12 months indicating complete recovery without complaints.

Histological Study On Using Ileal Submucosa In Repairing Urinary Bladder Defect In Adult Albino Rat

Abstract Background Repairing urinary bladder (UB) defect by enterocystoplasty remains the gold standard surgical bladder reconstruction procedure to increase the capacity and compliance of dysfunctional bladders. However, many complications were recorded. Aim of the work This work aimed to compare the consequences of reconstruction of urinary bladder defect using untreated small intestinal submucosal (SIS) matrix versus seeded and unseeded decellularized SIS matrix. Material and Methods Fifty female albino rats were used in this study. The animals were divided into three groups: Group I (Control) included ten adult rats from which ileal tissue was obtained. Group II included ten adult rats in which their UB defect was repaired by untreated cellular SIS. Group III included twenty adult rats that were subdivided into two subgroups, 10 rats each; Subgroup IIIA where rats had their UB defect repaired by acellular SIS and subgroup IIIb where rats had their UB defect repaired by acellular SIS seeded with adipose mesenchymal stem cells (AMSCs).Ten young rats were used for preparation of AMSCs. Morphometric and statistical analysis were also performed. Results In rats where UB defect was repaired by untreated cellular SIS, the graft area showed loss of epithelial polarity, presence of intraepithelial cysts and occasional extension of urothelium to the outer surface forming fistula. There were areas of metaplasia with the appearance PAS positive cells. In the lamina propria, there was areas of lymphocytic infiltration together with significant increase in the collagen fiber deposition (p < 0.05). There was a significant decrease thickness of muscle layer as compared to control (p < 0.05). In rats where UB defect was repaired by acellular SIS, urothelium in the graft area showed occasional squamous metaplasia and often the urothelium extended to the deeper layers forming Brunn's nest. There was minimal muscle regeneration in the graft area. However, in rats where UB defect was repaired by acellular SIS seeded with AMSCs, the urothelium in the graft area was nearly similar to control group with uniform urothelium thickness, minimal collagen fibers deposition and thick muscle layer that showed no significant difference from the control (p > 0.05). Conclusion Acellular SIS seeded with AMSCs showed better results compared to non-seeded and cellular SIS in reconstructing urinary bladder defects.

Двухэтапное лечение глубокой перипротезной инфекции тазобедренного сустава, осложненной забрюшинным дефектом мочевого пузыря

emphasize the importance of preoperative preparation and well-coordinated work of related specialists using a specific clinical instance. Case report Reported is a successful experience of two-stage treatment of the patient with hip PJI complicated with urinary bladder defect. A 40-year old male patient diagnosed with left-sided deep hip PJI Tsukayama type 3 was treated at department of infection surgery, Rostov Regional Clinical Hospital No. 2 in January 2019. Total hip arthroplasty performed in 2008 was complicated by migration of acetabulum component. A retroperitoneal bladder defect (pressure ulcer) was detected during the first stage of resection arthroplasty and placement of an antibacterial spacer. Urological procedure was performed in a delayed manner due to technical difficulties of implant removal, prolonged and traumatic procedure, and high blood loss. With the patient's condition stabilized cystoscopy and bilateral ultrasound guided percutaneous nephroureterostomy were performed. Prolonged antibacterial aetiotropic treatment was administered. The second stage of surgical treatment included revision hip arthroplasty using a tailored acetabular component and a standard revision femoral component performed at 6 months of debridement. Results Short- and long-term results were good with sustained remission achieved. Patient could walk unassisted using a cane and had a satisfactory ROM in the left hip with HHS scored 76.255. Conclusion Multiple disciplinary teamwork is appropriate for treatment of deep PJI with much coherence, coordinated efforts and expertise from diverse professionals.

Cystosonographic and Cystographic Evaluations of Urinary Bladder Defects Managed with Composite Colo-Peritoneal Grafts in Dogs

Radiographic and ultrasonographic evaluations of the urinary bladder architecture following autologous composite colo-peritoneal pedicle graft, as alternative tissue for urinary bladder reconstruction, in the surgical repair of experimental urinary bladder defects were carried out in two dogs. Predetermined 2 ´ 4 cm dimension of urinary bladder defect was created on the dorsum of the urinary bladder, and was patched with harvested 3 ´ 5 cm composite colo-peritoneal pedicle flap. All operations were aseptically and humanely conducted. The gross anatomical evaluation of the urinary bladder architecture was performed by ultrasonography and contrast radiography of the repaired urinary bladder. Post-surgical cystosonographic assessments on day 8 showed thickened urinary bladder wall at the point of the graft, which decreased markedly on day 21. Cystographic evaluation revealed gradual transition of the urinary bladder architecture at the point of graft with clear delineation and minimal blurring at week 2 post-operation, which gradually disappeared at weeks 10 and 14. The cystosonographic and cystographic evaluations demonstrated evidence of advanced healing and well-preserved urinary bladder architecture with no evidence of leaks. The imaging modalities are adequately diagnostic to assess urinary bladder repairs following its management with composite colo-peritoneal graft in dogs.

Evaluation of autologous composite colo-peritoneal grafts in the repair of experimental urinary bladder defects in dogs

Background: Urinary bladder (UB) defects are most often associated with embryologic development and pelvic trauma. The cause of the defects could be congenital abnormalities or various aetiologies connected with modern life, including road traffic accidents, assault (gunshot injuries) and occupational hazards (neoplasia). industrial, and criminal activities. Medical treatment for these defects is mostly limited thereby necessitating surgical intervention. This study was aimed at finding alternative reconstruction tissue for restoring bladder storage and voiding capability. Materials and Methods: The surgical procedure was aseptically performed under general anesthesia. The dorsal aspect of the urinary bladder served as the recipient site, while sero-muscular colonic pedicle flap of the descending colon along with free peritoneal sheath formed a composite tissue (donor), colo-peritoneal pedicle graft. The surgical procedure included preparation of the colonic pedicle flap, preparation of free peritoneal flap, formation of composite colo-peritoneal graft, preparation of urinary bladder graft bed, and colo-peritoneo-cystoplasty. The dogs were evaluated in the post-operative period by physical examination, urinalysis, and cystography within the duration of 14 weeks. Results: Cystographic evaluations performed on the 2nd, 10th, and 14th weeks post surgery revealed gradual transition of the urinary bladder architecture at the point of graft with clear delineation and minimal blurring at initial assessment, which gradually disappeared later. Complications observed were straining and constipation, which responded positively following appropriate interventions. Post surgical urinalysis showed transient changes in specific gravity and urine pH values, but returned to pre surgical level after day 18 post surgery. Post surgical proteinuria was observed for the first 7 days, but disappeared on day 12. Hematuria occurred within the first 16 days post surgery. Conclusion: It was concluded that autologous composite colo-peritoneal tissue graft was successfully formed and effectively used in the repair of urinary bladder defects in the dogs. This surgical management intervention could be evaluated in human subjects with similar urinary bladder defects.

Use of fascia lata autograft for repair of urinary bladder defect in rabbits

The aim of this study was to investigate the compatibility of a fascia lata autograft for urinary bladder tissue defect, to evaluate the biomechanical, radiographical, macroscopical, biochemical, and histopathological test findings, and early and late complications of the surgical processes in rabbits. Thirty two adult healthy New Zealand rabbits were randomly allocated to 4 different groups of 8 animals. A 2 × 2 cm urinary bladder defect was repaired by the same size of fascia lata in experimental groups (Group 1, 2, 3). Rabbits in Group 1, 2 and 3 were euthanized at the end of the 4th, 8thand 12thweek after surgeries, respectively. No surgical procedure was carried out for the urinary bladder of the rabbits in the control group, but their urinary bladders were used for biomechanical tests and the values compared with those of Group 1, 2 and 3. Histopathological examination of the grafted area was performed. The grafted area was consistent with that of the tissue of urinary bladder. No significant difference was found between the urinary bladder and the grafted area. No differences in biomechanical tests were recorded between grafted and ungrafted urinary bladders. Histopathologically, fascia lata turned into a normal urinary bladder tissue. Therefore, a fascia lata autograft can be succesfully used in urinary bladder defects. Fascia lata grafts can be used successfully in pathological conditions of the urinary bladder that require a new tissue.

Purely Transurethral Suture Cystorrhaphy

Abstract Introduction: This video shows the novel technique and our experience of repairing urinary bladder defect with purely transurethral approach. Materials and Methods: We performed cystoscopy...

Polymeric film of 6-arm-poly(ethylene glycol) amine graphene oxide with poly (ε-caprolactone): Adherence and growth of adipose derived mesenchymal stromal cells culture on rat bladder

Nanotechnology has been more present in different fields related to health. The need to find a durable material, of easy use, and which does not interfere significantly in the growth and differentiation of stem cells for the construction of a scaffold for use in urologic surgery, with the purpose of reducing infections, regeneration times and even graft rejection during reconstitution in patients with urethral stricture was conducted a broad survey of information about this and came to the consensus of this project: using graphene oxide, a widely studied nanomaterials which has been presenting numerous beneficial results when in contact with the adipose-derived stem cells. Advanced techniques for the growth, differentiation and proliferation of adipose-derived stem cells were used, as well as the characterization of graphene oxide sheets. For this study, it was prepared the graphene oxide/6 ARM-Poly (ethylene glycol) amine films with poly (ε-caprolactone). The graphene suspension in organic solvent was prepared by using an ultrasonicator bath and subsequently, the film was formed by solvent evaporation. Total characterization of graphene oxide/6 ARM-PEG-amine/ poly (ε-caprolactone) film was carried out. It was tested growth and adhesion of adipose-derived stem cells on the film, as well as, were verified the histopathological effects of this scaffold when implanted in the urinary bladder to repair the lesion. Our results demonstrated that this scaffold with adipose-derived stem cells enhanced the repair in rat urinary bladder defect model, resulting in a regular bladder. Improved organized muscle bundles and urothelial layer were observed in animals treated with this scaffold with adipose-derived stem cells compared with those treated only suture thread or scaffold. Thus, our biomaterial could be suitable for tissue engineered urinary tract reconstruction.

Radiographic Evaluation of “Graft take” Following Ileocystoplasty of Extensive Urinary Bladder Defects in Dogs

This study evaluated radiographic take of urinary bladder following its reconstruction with ileal pedicle graft to correct experimentally created extensive urinary bladder defects in dogs. Two male Nigerian dogs weighing 15 and 20 kg underwent partial cystectomy. A 2x4 cm (dimension) defect at the dorsal aspect of the urinary bladder on one dog and ventral aspect of the other dog was experimentally created. The defect created on each was patched with harvested ileal pedicle graft. The dogs were monitored post-surgery closely for over 7 weeks within which cystography was carried out. The dogs survived throughout the period of the study. The cystograhs of the dogs taken revealed distinctive urinary bladder silhouettes without evidence of pathological changes or urine leakage on day 21 and 49 after surgery. Ileal pedicle graft is anatomically suitable and should be considered in correction of extensive urinary bladder defects whenever there is need for enterocystoplasty in animals.

V2091 THE USE OF THE URETHRA AS A NOTS (NATURAL ORIFICE TRANS-ENDOSCOPIC SURGERY) FOR URETHERAL CLOSURE AND URINARY BLADDER SUTURE IN PATIENT WHO WAS TAKEN TO LAPAROSCOPIC NEPHREOURETERECTOMY

You have accessJournal of UrologySingle Port Surgery1 Apr 2011V2091 THE USE OF THE URETHRA AS A NOTS (NATURAL ORIFICE TRANS-ENDOSCOPIC SURGERY) FOR URETHERAL CLOSURE AND URINARY BLADDER SUTURE IN PATIENT WHO WAS TAKEN TO LAPAROSCOPIC NEPHREOURETERECTOMY Manuel Duque and Natalia Victoria Manuel DuqueManuel Duque Cali, Colombia More articles by this author and Natalia VictoriaNatalia Victoria Cali, Colombia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2388AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There's always been doubts concerning that in the nephroureterectomy procedures by the time of the release of the urether, tumoral cells could fall into the retroperitoneum, therefore causing potentially carcinogenic spreads in that area. NOTES, is a state of the art procedure that could successfully avoid this complication. METHODS Female Patient. 56 years old. The patient complains from blood in her urine. Smoker for 35 years. Female patient with gross haematuria. No symptoms for abdominal pain other than occasional cramping. CAT Scan shows tumoral lesion between the distal portion of the urether and dispaired function. RESULTS The ureteroscopy shows an ureteral tumor. A PDS 3 0 stitch is passed through the nephroscope sheet; the sheet is then removed and a laparoscopic needle handler is placed as well as the nephroscope. The needle is secured, then a stitching point is placed in the uretheral meatus. The needle is then removed. External knot maid in the suture. The uretheral meatus is released. The electroscalpel and the sheet are pushed into the retroperitoneum for latter closure of the urinary bladder defect in a similar way. Urinary catether is placed and then nephroureterectomy is performed. The distal portion of the urether is observed along with the PDS 3 0 stitching points. Total Surgical Time 2 hours and 30 minutes. Total Blood Loss: 100 cc. Inpatient Care: 1 day. Non opioid pain relief medication required. CONCLUSIONS NOTES could be the answer to the concern that's been around the procedure in terms of the risk of tumoral cells in the retroperitoneum. At the present time five procedures have been performed: Two males; three females, so far in a safe way and with no major complications. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e836 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Manuel Duque Cali, Colombia More articles by this author Natalia Victoria Cali, Colombia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Stem cells and regenerative medicine: principles, prospects and problems

Stem cells have been used routinely for more than three decades to repair tissues and organs damaged by injury or disease, most notably haematopoietic stem cells taken from bone marrow, umbilical cord or, increasingly, from peripheral blood. Other examples, such as grafts of skin to treat severe burns, entail transplantation of stem cells within organized tissue rather than following isolation. The prospect of exploiting stem cells more widely in regenerative medicine was encouraged both by the development of human assisted conception and growing evidence that various adult cells retained greater versatility than had been suspected hitherto. The aim is to employ stem cells as a source of appropriately differentiated cells to replace those lost through physical, chemical or ischaemic injury, or as a result of degenerative disease. This may entail transplantation of just a single type of cell or, more challengingly, require a complex of several different types of cells possessing a defined architecture. Cardiomyocytes, hepatocytes or neuronal cells producing specific transmitters offer promising examples of the former, although how transplanted healthy cells will function in a perturbed tissue environment remains to be established. Recent success in repairing urinary bladder defects with grafts of urothelial and muscle cells seeded on a biodegradable collagen scaffold is an encouraging step towards assembling organs in vitro. Nevertheless, this is still far removed from the level of sophistication required to counter the ever increasing shortfall in supply of kidneys for transplantation. Various problems must be addressed if recent advances in the laboratory are to be translated into clinical practice. In many cases, it has yet to be established that cells derived from adults that retain plasticity are actually stem cells. There is also a pressing need for appropriate assays to ensure that, regardless of source, stem cells maintained in vitro are safe to transplant. Assays currently available for human ES cells are far from ideal. It is, in addition, important to ensure that differentiated cultures are pure and, depending on whether cell renewal is required or to be avoided, retain or lack appropriate stem cells. Neither autografts nor those obtained by so-called ‘therapeutic cloning’ are options for treating condition with an obvious genetic basis. Moreover, claims that some stem cells are more likely than others to yield successful allografts have yet to be confirmed and explained. To cite this article: R.L. Gardner, C. R. Biologies 330 (2007).

Comparison of rectus abdominis muscle and musculoperitoneal flap in closure of urinary bladder defects in a rat model

To study the histological differences between a muscle flap and a musculoperitoneal flap used as a urinary bladder wall substitute, we prospectively studied these flaps in 24 Wistar albino rats. In 12 rats a rectus abdominis muscle flap including the overlying peritoneum (RAMP flap) was sutured into a surgical defect of the bladder wall. The rectus abdominis muscle flap was interposed without peritoneum (RAM flap) in the other 12 rats. The animals were killed on postoperative day 6 (6 RAMP flaps and 6 RAM flaps) and day 90 (5 RAMP flaps and 5 RAM flaps) to obtain early and late histological results. The 2 remaining rats (1 RAMP flap and 1 RAM flap) died before 90 days. Partial resurfacing of the flaps’ muscle surface with urothelium was observed on the sixth postoperative day in both the RAMP and the RAM group. At that time, no significant histological difference in the urothelium was observed between the RAMP and the RAM flaps. After 90 days, resurfacing with urothelium was complete in both groups. We concluded that a urothelium or peritoneum lining is not needed to protect a muscle flap against contact with urine. Histologically, the presence of peritoneum in the early postoperative period seems to have had a positive effect on the quality of neo-urothelium.

Calcification Potential of Small Intestinal Submucosa in a Rat Subcutaneous Model

Glutaraldehyde treatment of collagen biomaterials promotes calcification, poor host–tissue incorporation, and ultimately mechanical failure of bioprotheses. Porcine small-intestinal submucosa (SIS) is a biomaterial which has been investigated for several applications including arterial and venous grafts and repair of tendon, ligament, body wall, and urinary bladder defects. The calcification potential of peracetic acid (PAA)-sterilized SIS was studied. Four test samples, (1) native (cleaned, untreated) SIS, (2) SIS sterilized with 0.1% PAA, (3) SIS treated with 0.25% glutaraldehyde for 20 min, and (4) commercially available glutaraldehyde-preserved porcine bioprosthetic heart valve cusp segments (GPV), were each implanted subcutaneously in each of 24 weanling rats. Six rats were euthanatized at 1, 2, 4, and 8 weeks. Evaluation of calcium concentration by atomic absorption spectroscopy and extent of mineralization and fibrosis by light microscopy were performed. Atomic absorption revealed no calcification in native or peracetic acid-treated SIS at any time point compared with preimplant calcium concentration. Statistically significant (P< 0.0001) calcification occurred in glutaraldehyde-treated materials (SIS and GPV) at each evaluation as compared to native and peracetic acid-treated samples. Histopathology indicated native and peracetic acid-treated SIS showed no implant mineralization (P< 0.0001) and little peri-implant fibrosis (P< 0.0001). Results suggested that native and peracetic acid-treated SIS have a low calcification potential and further study of this biomaterial is warranted.