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International Urogynecology Journal Jun 2015Cystoscopy is frequently performed by gynecologists to ensure ureteral patency and to prevent bladder injury when performing concomitant gynecological procedures....
INTRODUCTION AND HYPOTHESIS
Cystoscopy is frequently performed by gynecologists to ensure ureteral patency and to prevent bladder injury when performing concomitant gynecological procedures. Generally, there are no additional findings on cystoscopy; however, when abnormalities arise, they may require either observation or intervention. Our aim was to create a visual library of benign, malignant, and foreign-body pathological conditions incidentally encountered on cystoscopy.
METHOD
Cystoscopic findings were videotaped at the time of routine surgical care. Regarding Institutional Review Board approval, individual consent was waived as the videos were de-identified and collected for educational purposes.
RESULTS
Benign pathological conditions: squamous metaplasia, duplicated ureteral orifice, ureterocele, Hutch diverticulum, bladder trabeculation, urachal cyst, interstitial cystitis with and without Hunner's lesion, endometriosis in the bladder, port-wine stain due to Klippel-Trénaunay-Weber syndrome, nephrogenic (mesonephric) metaplasia, and cystitis glandularis (intestinal metaplasia). Malignant pathological conditions: papillary urothelial neoplasm of low malignant potential (PUNLMP), carcinoma in situ (CIS), high-grade urothelial carcinoma, and urachal cancer. Foreign-body pathological conditions: edema from ureteral stents and stone-encrusted mesh.
CONCLUSION
This video is intended to educate the audience on some incidental bladder findings seen on female cystoscopy. Many pathological conditions can be biopsied or treated immediately during the procedure; hence, early urology consultation is encouraged for most abnormalities.
Topics: Cystitis, Interstitial; Cystoscopy; Female; Foreign Bodies; Gynecologic Surgical Procedures; Humans; Incidental Findings; Intraoperative Complications; Urethra; Urinary Bladder; Urinary Bladder Diseases; Urinary Bladder Neoplasms
PubMed: 25619539
DOI: 10.1007/s00192-014-2614-4 -
BMJ Case Reports Apr 2022Combination of posterior urethral valves and urachus remnants has been described as rare occurrence. We report a case of a baby boy with normal antenatal scans, in whom...
Combination of posterior urethral valves and urachus remnants has been described as rare occurrence. We report a case of a baby boy with normal antenatal scans, in whom the presence of large urachal cyst and posterior urethral valves causing high pressure bladder and chronic kidney disease was found. The patient underwent ablation of posterior urethral valves at 23 days of life and urachal cyst removal at age of 4 and a half months.
Topics: Female; Humans; Infant; Male; Pregnancy; Urachal Cyst; Urachus; Urethral Obstruction; Urinary Bladder; Urinary Tract
PubMed: 35418380
DOI: 10.1136/bcr-2021-248460 -
Journal of Cancer Research and... 2022The urachus is a canal between the allantois and the early fetal bladder. Urachal carcinoma is a rare and aggressive type of bladder cancer. This cancer usually presents... (Review)
Review
The urachus is a canal between the allantois and the early fetal bladder. Urachal carcinoma is a rare and aggressive type of bladder cancer. This cancer usually presents at an advanced stage. We report a 70-year-old patient with malignant transformation of urachal cyst several years later. The patient was treated with partial cystectomy and adjuvant radiotherapy. A review of the published literature is also presented.
Topics: Adenocarcinoma; Aged; Cystectomy; Humans; Urachus; Urinary Bladder Neoplasms
PubMed: 35381804
DOI: 10.4103/jcrt.JCRT_28_20 -
Ultrasound in Obstetrics & Gynecology :... Sep 2010This study was carried out to determine the prognosis, and the clinical approach, in fetuses with umbilical cord cysts, during the second and third trimesters of... (Review)
Review
OBJECTIVES
This study was carried out to determine the prognosis, and the clinical approach, in fetuses with umbilical cord cysts, during the second and third trimesters of gestation, according to our experience and data in the current literature.
METHODS
We identified 10 fetuses with umbilical cord cysts that were diagnosed during the second and third trimesters of pregnancy at three referral centers. All underwent detailed ultrasound evaluation at the time of diagnosis and during follow-up. Prenatal karyotype testing was offered to all women. A MEDLINE review of the literature published from 1980 to 2009 was carried out to identify previous studies and case reports of fetuses with umbilical cord cysts.
RESULTS
In our series of 10 cases, significant additional abnormalities were observed in two during a detailed sonogram. In one case, trisomy 18 was diagnosed, leading to pregnancy termination, and in the other case a neonate with heart defects and a normal karyotype was born. These results differ from those reported in the literature, in which the association between second- and third-trimester umbilical cord cysts and fetal anomalies ranged from 38 to 100%.
CONCLUSIONS
In our study, as in other publications, an association was found between the presence of second- and third-trimester umbilical cord cysts and fetal anomalies. The strong association between second- and third-trimester umbilical cord cysts and aneuploidy in the literature seems to be biased, mainly because of the tendency to report abnormal cases. When these findings are accompanied by additional sonographic abnormalities, the association with aneuploidy is clear and should be an indication for fetal karyotype testing.
Topics: Adult; Female; Humans; Karyotyping; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Prognosis; Trisomy; Ultrasonography, Prenatal; Urachal Cyst; Young Adult
PubMed: 20131340
DOI: 10.1002/uog.7576 -
Journal of Surgical Case Reports Apr 2011We report a baby with an unusual umbilical cord swelling. On the antenatal scans, a cystic area within the umbilical cord near its insertion onto the abdominal wall was...
We report a baby with an unusual umbilical cord swelling. On the antenatal scans, a cystic area within the umbilical cord near its insertion onto the abdominal wall was detected. Postnatally an unusually thick umbilical cord with a yellow fluid filled cyst at the base was noted. The fluid from the cyst was confirmed as urine and ultrasound confirmed patent urachus. The baby underwent a cystoscopy and excision of patent urachus with associated allantoic cyst. Allantoic cyst is a rare swelling formed at the base of umbilicus associated with a patent urachus which results from an allantoic remnant. Paediatricians need to be aware about this condition as investigation is required to differentiate allantois cysts from umbilical pseudocysts. A patent urachus with allantoic cyst requires surgical excision.
PubMed: 24950576
DOI: 10.1093/jscr/2011.4.5 -
The New England Journal of Medicine Dec 2016
Topics: Arnold-Chiari Malformation; Escherichia coli; Escherichia coli Infections; Female; Humans; Infant; Leukocyte Count; Meningomyelocele; Staphylococcal Infections; Staphylococcus; Suppuration; Urachal Cyst
PubMed: 28029928
DOI: 10.1056/NEJMicm1601380 -
CMAJ : Canadian Medical Association... May 2019
Topics: Adolescent; Anti-Bacterial Agents; Bacterial Infections; Cephalexin; Humans; Laparoscopy; Male; Multimodal Imaging; Recurrence; Tomography, X-Ray Computed; Ultrasonography; Urachal Cyst; Urachus
PubMed: 31113786
DOI: 10.1503/cmaj.181400 -
International Journal of Surgery Case... 2020Incomplete obliteration of the urachal lumen could cause different types of anomalies and urachal cyst is the most common among these in the adult population. It is...
INTRODUCTION
Incomplete obliteration of the urachal lumen could cause different types of anomalies and urachal cyst is the most common among these in the adult population. It is usually asymptomatic and may be an incidental finding during a surgical exploration for other reasons. However, it can be subject to complications.
PRESENTATION OF CASE
A 38-year-old female patient with history of worsening lower-quadrants abdominal pain, associated with fever and chills, presented to emergency room; clinical examination revealed a painful, tender, and fixed lump to the left inferior abdominal quadrant. Ultrasound reveled a left adnexal mass and, along the midline, between the adnexal mass, the bladder and the uterus, was evident a 3-cm unilocular cyst with regular walls and hypoechoic content. MRI confirmed the suspicion of a left tubo-ovarian abscess and suggested a diagnosis of urachal remnant for the smaller midline cyst. In this report, we describe the step-by-step laparoscopic management of the case, paying attention to "the tips and tricks" for urachal cyst excision.
DISCUSSION
The urachal cyst, which results from the accumulations of secretions in urachal remnant, presents as a single or multiple parietal abdominal mass, per se asymptomatic. However, this condition is not without risk and infection represents the most common complication. Ultrasound is very useful in the diagnostic phase. Today, the main approach has become laparoscopic excision, with particular attention to a radical removing of the mass, due to high recurrence rate and the risk of malignancy.
CONCLUSION
In our experience, laparoscopy represents an excellent diagnostic and therapeutic tool for urachal cyst, especially for patients with acute urgent conditions, doubtful clinical history, and no clear signs or symptoms.
PubMed: 33039342
DOI: 10.1016/j.ijscr.2020.09.013 -
Molecular and Cellular Biochemistry Jun 2021Aggressive inflammatory response leading to hypercoagulability has been found to be associated with disease severity in COVID-19 patients and portends bad treatment... (Review)
Review
Aggressive inflammatory response leading to hypercoagulability has been found to be associated with disease severity in COVID-19 patients and portends bad treatment outcome. A state of acute disseminated intravascular coagulation (DIC), along with pulmonary embolism and/or deep vein thrombosis, has been observed in critically ill ICU patients. Autopsy reports of COVID-19 patients demonstrated microthrombi in lungs and in other organs, as well as marked inflammatory changes, characteristic clinicopathological features that exacerbate disease severity. Vitamin D supplementation was recommended by many clinicians across the globe to improve clinical symptoms of COVID-19 patients, mainly because of its immunomodulatory roles on immune cells. Furthermore, vitamin D and its associated molecules are also known to directly or indirectly regulate various thrombotic pathways. We propose that vitamin D supplementation not only attenuates the risk of Acute Respiratory Disease Syndrome (ARDS) but it also may have a role in reducing coagulation abnormalities in critically ill COVID-19 patients. The overarching goal of this review is to discuss the effects of vitamin D on coagulation pathways and other intertwined processes leading to thrombosis. Many clinical trials are currently investigating the efficacy of vitamin D supplementation in reducing the risk of COVID-19 infection. However, randomized placebo control clinical trials are also necessary to ascertain the effect of vitamin D supplementation on reducing the risk of coagulopathy in COVID-19 patients.
Topics: Blood Coagulation Disorders; COVID-19; Humans; Urachal Cyst; Vitamin D; Vitamin D Deficiency; COVID-19 Drug Treatment
PubMed: 33604809
DOI: 10.1007/s11010-021-04093-6 -
Journal of Pediatric Urology Aug 2020In 2017, UCSF established a formal Transitional Urology (TU) clinic co-run by pediatric and adult urology aimed at providing comprehensive urologic care for people...
INTRODUCTION
In 2017, UCSF established a formal Transitional Urology (TU) clinic co-run by pediatric and adult urology aimed at providing comprehensive urologic care for people progressing into adulthood with complex urologic histories.
OBJECTIVE
We aim to describe baseline demographic and disease characteristics of this population, understand gaps in care, and gauge follow-through.
STUDY DESIGN
We performed a retrospective chart review of all new patients in the TU clinic at UCSF from February 2017 through January 2019. After approval from an institutional review board, demographic and clinical data were collected from medical records.
RESULTS
39 new patients were seen in UCSF's TU clinic during a 23-month period. Our cohort included 20 patients with spina bifida and neurogenic bladder, 5 with bladder exstrophy, 3 with disorders of sexual development (DSD), 5 with obstructive uropathy, 2 with cloacal anomalies, and 1 patient each with calcinuria, reflux nephropathy, prune belly syndrome, and urachal cyst. Mean age of patients was 26 years, 63% were male, 88% spoke English, and 70% had public insurance. Patients lived an average of 94 miles from the clinic and had a mean zipcode-based household income of $70,110. There was an average of 19 months between the initial TU visit and the most recent prior urology visit. The median time since last creatinine as well as last renal ultrasound was 9 months. 19 (54%) patients warranted a total of 28 referrals to other providers at their initial visit, and 42% of these were obtained within 6 months.
DISCUSSION
According to our demographic data, TU patients are likely to have public insurance, live far from the TU clinic, and come from low SES backgrounds. At initial presentation over half of patients warranted updated tests like creatinine and renal ultrasound. Furthermore, nearly two-thirds of patients required at least one referral to a different provider, suggesting a majority of these patients had unmet medical needs at the time of presentation to the TU clinic.
CONCLUSION
Our data indicate that new patients to the TU clinic often warrant additional workup, updated testing, and referrals to sub-specialty care as these needs are often unmet at the time of presentation. The etiology of this is unclear and it may be due to insurance difficulties, inability to identify an appropriate adult subspecialty provider or access to care issues. Further investigation into barriers to implementation of transitional care is needed to provide comprehensive management to this challenging patient population.
Topics: Adult; Child; Demography; Female; Humans; Male; Retrospective Studies; Transition to Adult Care; Urinary Bladder, Neurogenic; Urology
PubMed: 32593616
DOI: 10.1016/j.jpurol.2020.05.167