Research Article
Adenocarcinoma of the Bladder in Exstrophy-Epispadias Complex in Adult Patients: About Two Cases
Babacar Sine*,
Mouhamed Feki,
Ndéye Aissatou Bagayogo,
Alioune Sarr,
Abdoulaye Ndiath,
Amath Thiam,
Ndiaga Seck Ndour,
Ousmane Sow,
El Hadji Malick Diaw,
Cyrille Ze Ondo,
Yaya Sow,
Alain Khassim Ndoye
Issue:
Volume 8, Issue 1, June 2024
Pages:
1-3
Received:
4 December 2023
Accepted:
18 January 2024
Published:
1 February 2024
Abstract: The primary mucinous adenocarcinoma of the bladder is an extremely rare urologic entity, which is found in less than 2% of all urinary bladder tumors and is often presented as metastatic. The authors report two cases of bladder adenocarcinoma with epispadias bladder exstrophy complex in two adults. The first case was about a 40-year-old patient referred for management of an EEC evolving since birth. The examination on admission revealed a deterioration in general condition and a bladder plate seat of an ulcero-necrotic tumefaction 3 x 2,5 cm with complete epispadias. The ureteral meatus were visible on each side at the lower part of the plate. Biopsy of the ulcero-necrotic mass revealed a well-differentiated bladder adenocarcinoma. Radical cystectomy and urinary diversion with an ileal conduit, and an expanded local lymphadenectomy was Indicated but the patient died before performing surgery. The second case is about a 28-year-old patient referred for management of an EEC evolving since birth associated with bilateral groin hernia. He had a good general condition, a bladder plate with complete epispadias. Treatment was cystectomy with Bricker urinary. Histo-pathological examination of the specimen reveled mucinous adenocarcinoma of the bladder. After review of the literature, it is a histological type with a poor prognosis and the role of surgery and adjuvant treatment remains to be defined.
Abstract: The primary mucinous adenocarcinoma of the bladder is an extremely rare urologic entity, which is found in less than 2% of all urinary bladder tumors and is often presented as metastatic. The authors report two cases of bladder adenocarcinoma with epispadias bladder exstrophy complex in two adults. The first case was about a 40-year-old patient ref...
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Methodology Article
Rate of Post Obstructive Diuresis in Rapid Versus Gradual Bladder Decompression in Patients with Chronic Urinary Retention
Peter Olalekan Odeyemi*
,
Najeem Adedamola Idowu,
Is'haq Ishola Aremu,
Musa Ayinde,
Olusola Oyewole Oladosu,
Olaolu Olusegun Olanipekun,
Ibukun Adewumi Okunade,
Olalere Ayankemi Adenike,
Stephen Ishola Adedokun,
Olusola Tunde Ekunnrin,
Wakeel Okanlawon Muritala,
Olusola Olateju Akanbi
Issue:
Volume 8, Issue 1, June 2024
Pages:
4-11
Received:
27 January 2024
Accepted:
5 February 2024
Published:
10 May 2024
Abstract: Background: Post-obstructive diuresis (POD) is a polyuric state in which copious amounts of salt and water are eliminated after the relief of a urinary tract obstruction. POD is a clinical diagnosis based on urine output exceeding 200 mL per hour for two or more consecutives hours or 3L in 24 hours after decompressing an obstructed bladder, bilateral ureteric obstruction or unilateral ureteric obstruction in a solitary kidney. Methodology: This was a prospective, randomized study in which patients with chronic urinary retention were randomized into two groups: A and B. Group A had rapid urinary decompression with 18Fr urethral catheter attached to a urine bag, while group B had gradual decompression using a urethral catheter attached to an intravenous fluid giving set which was then attached to urine bag. Post obstructive diuresis in each group were assessed at designated times. Data Analysis and Result Presentation: Data was analyzed using the Statistical Package for Social Sciences (IBM) SPSS version 21. Data was summarized by descriptive statistics. The two arms were compared for similarities in demographic variables. Continuous and categorical variables were compared using student t- test and Pearsons‘ Chi – square respectively. Significant p value was 0.05. Result: Sixty patients were recruited into the study and randomized into group A (rapid urinary decompression) and B (gradual urinary decompression) with 30 patients in each group. Thirteen patients (43.33%) had post obstructive diuresis in group A compared to 15 patients (50%) in group B. p value of 0.584. Diuresis resolved within 24 hours in 9 patients (30%) in group A and 11 patients (36.7%) in group B. p value of 0.999. The mean reduction in systolic blood pressure was 8.21 ± 2.63mmHg in group A and 7.63 ± 2.14mmHg in group B. p value of 0.583. The mean reduction diastolic blood pressure was 3.84 ± 1.31mmHg in group A and 3.41 ± 1.16mmHg in group B. P value of 0.624. No patient in both groups developed hypotension (BP of <90/60). Conclusion: There was no statistically significant different in post obstructive diuresis. However, over 46.7% of patients had diuresis in both groups without any one developing hypotension. This may be due to routine prophylactic fluid and electrolyte replacement using normal saline.
Abstract: Background: Post-obstructive diuresis (POD) is a polyuric state in which copious amounts of salt and water are eliminated after the relief of a urinary tract obstruction. POD is a clinical diagnosis based on urine output exceeding 200 mL per hour for two or more consecutives hours or 3L in 24 hours after decompressing an obstructed bladder, bilater...
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