Bladder diagnosis

Urinary incontinence can result from abnormalities within (intrinsic to) and outside of (extrinsic to) the urinary tract. Within the urinary tract, abnormalities may occur in the urethra (including the bladder outlet and urinary sphincters), the bladder, or a combination of both structures. Focusing on abnormalities in these two structures, a simple classification scheme emerges for all but the rarest intrinsic causes of UI. Accurate diagnosis and classification of UI type is critical to the selection of appropriate drug therapy. 

Bladder tumor-associated antigen (BTA), a human complement factor H, is produced by bladder cancer cells (men two to three times as often as women). Cancer cells are sometimes seen in urine samples by microscope cytoscopy (examination of the bladder with an instrument inserted into the urethra), which can reveal abnormal areas. Biopsy is needed to confirm the diagnosis. Early stage cancer confined to the bladder wall can often be removed with a cytoscope. If several tumors are present, they are removed by infusing the bladder with a solution containing bacteria able to stimulate the immune system. 

Diagnosis of BPH requires a careful medical history, physical examination, objective measures of bladder emptying (e.g., peak and average urinary... 

Turner WH, Brading AF 1997 Smooth muscle of the bladder in the normal and the diseased state pathophysiology, diagnosis and treatment. Pharmacol Ther 75 77—110 van Breemen C, Chen Q, Laher I 1995 Superficial buffer barrier function of smooth muscle sarcoplasmic reticulum. Trends Pharmacol Sci 16 98-105 Wray S 1993 Uterine contraction and physiological mechanisms of modulation. Am J Physiol 264 C1-C18... 

The aberrant expression of MARBPs upon malignant transformation makes them a reliable marker for diagnosis of advanced diseased conditions. For instance, the NMP 22 levels in urine have now been routinely used to identify bladder and ductal cancer. Similarly, pi 14 MAR-binding activity has been detected in aggressive mmors, while significantly weaker pi 14 activity has been observed in... 

Badalament RA. 1998. Diagnosis and treatment of bladder cancer. httr) //www.cancemews.com/bladdercn.htm. 

Progress has been made using the ALA-protoporphyrin IX photosensitiser system in in vivo fluorimetry, because the fluorescent protoporphyrin concentration in tumour cells is much higher than in healthy cells. An example of its use is in the successful diagnosis of bladder tumours, giving superior results to visual examination. Anew generation of pentyl and hexyl esters show an even more intense fluorescence. 

Moreover, Cellis et al. have been working on identifying protein markers that may be valuable for diagnosis and follow-up of bladder cancer patients. To achieve this goal, they have focused on the establishment of a comprehensive 2D gel database of urine proteins. 

Intraoperative cholangiography was introduced into biliary diagnosis by RL. Mirizzi in 1932. Since then, this technique has been under development and it is (still) used as an indispensable, additional intraoperative diagnostic tool in borderline cases. Interventions in the area of the gall bladder or bile ducts are generally unacceptable without the possibility of a cholangiographic ex-... 

CT This technique is useful for assessing intrahepatic carcinoma and detecting peripheral CCC. Occasionally, proximally dilated bile ducts can also be visualized. The gall bladder and the common bile duct are inconspicuous. Differential diagnosis of metastases or HCC can be extremely difficult. (214, 215) MR cholangiography has become an important procedure due to more sophisticated technology, (s. fig. 37.13)... 

A further bladder follow-up of these kidney recipients (cystoscopy and biopsies per 6 months) resulted in the diagnosis of 8 urothelial carcinoma in situ, 4 non-invasive low-grade papillary urothehal carcinoma and 3 infiltrating urothelial cancer, 68 to 169 months after cessation of AA exposure (cumulative incidence of 39.5%). Despite local and/or systemic chemotherapy, 3 patients died and 2 radical cystectomies had to be performed [41]. 

The diagnosis and treatment of bladder dysfunction and urinary incontinence in horses is rather primitive compared with that in human patients with these problems (Wise Cardozo 1994). In humans, the management of these conditions includes a variety of procedures (e.g. exercises, behavioral therapy and surgery) as well as adjunctive drug treatment. Finally, urine scalding is not a problem in human patients with incontinence because they can either wear protective garments or be taught to self-catheterize. 

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