Twenty cases of hypospadiasundergone urethro-plasty with blad-der mucosa and correction of cordein one stage surgery are reported.Sixteen of 20 cases had satisfactoryresults .Two cases with structureof anastomosis have been improvedby urethral dilatation and the othertwo cases complicated with urethral-cutaneous fistula have gradually heal-ed with prolonged diversion of cysto- tomy. The indication and techniqueof this surgery are discussed indetail.
Objective To establish the artificial bladder reflex arc by the normal body reflex pathway above the horizon of spinal cord injury to reinnervate the flaccid bladder and restore bladder micturition function. Methods An intradural microanastomosis was performed on the L6 ventral root tothe S2 ventral root. After axonal regeneration,the “patellar ligament-spinal cord center-bladder” reflex pathway was reestablished. A longterm function of the reflex arc was observed in the nerve electrophysiological experiment, detrusor electromyography experiment, and urodynamic testing 8 months after anastomosis. Results Trains of the stimuli(200 μV,5 ms) in the left L6 dorsal root and the nerve at the anastomosizedsite resulted in motor evoked potential from the disal to the anastomosized site before and after the spinal cord was destroyed horizontally between S1 and S4 segment levels in 2 Beegle dogs.The figure and amplitude of the evoked potential were similar to those of the control and general stability which showed anoninterventional wave. The urodynamic test revealed a rapid increase of the bladder pressure and a minor increase in the abdominal pressure. This showed that the bladder detrusor mainly resulted in the pressure increase.The bladder pressure increased to 60% of the normal on average compared with the controls when resulted in the left L6 dorsal root and the nerve anastomosized site were stinulated. Conclusion The long-term observation by the nerveelectrophysiological experiment, detrusor electromyography experiment, and urodynamic test indicate that the new artificial reflex arc can be established successfully. The somatic motor axons can regenerate into the parasympathetic endoneurial tubes of the autonomic nerve.
Previous studies have shown that growth arrest, dedifferentiation, and loss of original function occur in cells after multiple generations of culture, which are attributed to the lack of stress stimulation. To investigate the effects of multi-modal biomimetic stress (MMBS) on the biological function of human bladder smooth muscle cells (HBSMCs), a MMBS culture system was established to simulate the stress environment suffered by the bladder, and HBSMCs were loaded with different biomimetic stress for 24 h. Then, cell growth, proliferation and functional differentiation were detected. The results showed that MMBS promoted the growth and proliferation of HBSMCs, and 80 cm H2O pressure with 4% stretch stress were the most effective in promoting the growth and proliferation of HBSMCs and the expression level of α-smooth muscle actin and smooth muscle protein 22-α. These results suggest that the MMBS culture system will be beneficial in regulating the growth and functional differentiation of HBSMCs in the construction of tissue engineered bladder.
Objective To investigate the safety, efficacy and morbidity of onestage urethroplasty by using bladder mucosa for treatment of hypospadias. Methods From August 1991 to August 2003, 38 cases of congenital hypospadias were given bladder mucosa flap procedure and one stage urethroplasty. Results Thirty-eight cases of hypospadias treated with one stageurethroplasty by using bladder mucosa were followed up 6 months-9 years afterthe procedure. The success rate of the operation was 95%. Three cases of urethral fistula after the procedure were surgically repaired again, 2 cases of urethral stricture recovered after distension. The complication markedly lessened, micturation became normal with the reconstructed meatussituated at the proper site on the glands. Conclusion one stage urethroplastyby using bladder mucosa for treatment of hypospadias is a simple, effective andsafe surgery.
During apt. 1986 to Dec. 1988. the axial flap methodwas used for the treatment of the congenital blakker exstro-phy. The preliminary is reported in this paper. This group in-cluded 10 patients, 4 men and 6 women, and their agesranged from 4 to 20. Seven patients had experienced 1-3 op-erations with failure to repair the exstrophy or to urinarycontinence before admission to our hospetal. Using the axialflap method only 1 in 10 cases can not control the urinationwell, the others achive well the requcirement of functional bladder. The longest follow-up pcriod has lasted for more than 2 years. and the renal and bladder function ars completely normal. the axial flaps of the present method included skin flap, facial and vascular pedicles of 8 types. The application of the flaps has developed a new serjies of procedures that ars suitable for the treatmen of a varicty of extrophy deformities.
Bladder cancer is the most common malignant tumor in the urinary system. The standard treatment of muscle-invasive bladder cancer (MIBC) is the radical cystectomy combined with pelvic lymphadenectomy. In recent years, radiotherapy has played an important role in the MIBC bladder-preserving treatment model. This article will review the advances in the application of radiotherapy for bladder preservation in MIBC, and introduce the application progress of radiotherapy in trimodality therapy of adjuvant radiotherapy and chemotherapy after transurethral resection of bladder tumors, radical radiotherapy, preoperative radiotherapy, radiotherapy combined with immunotherapy, the development and challenges of radiotherapy technology, and radiotherapy-related adverse reactions. The aim of this article is to provide a reference for further exploration of a more scientific and effective comprehensive treatment mode for bladder preservation.
目的:探討ΔNp63和Ki67在膀胱移行上皮癌(transitional cell carcinoma of bladder,TCCB)中的免疫組化表達及與膀胱癌病理分級、臨床病理分期和預后的相關性。方法:隨機選擇2006～2007年間56例TCCB和12例正常膀胱黏膜病理切片用SP免疫組化行ΔNp63和Ki67檢測,將結果與病理分級、分期和預后進行分析。結果:ΔNp63和Ki67在膀胱移行細胞癌中的陽性表達率明顯高于正常膀胱黏膜(Plt;005)。ΔNp63和Ki67在低分化、浸潤性癌組織中的陽性表達率明顯高于高分化、淺表性癌組織,在膀胱癌的病理分級和臨床分期之間表達差異有統計學意義(Plt;005)。ΔNp63和Ki67在復發病例中的陽性表達率顯著高于初發病例(Plt;005)。采用Spearman等級相關性分析對ΔNp63和Ki67在TCCB中的表達進行比較,ΔNp63與Ki67呈正相關,rs′為0316,且Plt;005。結論:ΔNp63和Ki67與膀胱癌的臨床病理分級和分期及預后密切相關,隨膀胱癌分化程度的降低和浸潤程度的增加而增強。ΔNp63和Ki67在TCCB的進展中可能有相互協同作用,ΔNp63可能通過促進細胞增殖發揮促癌作用,聯合檢測ΔNp63和Ki67可以作為判斷TCCB的預后的腫瘤標記物。