Radiation disease of the urinary tract: histological features of 18 cases.

Suresh, U R; Smith, VV; Lupton, E. W.; Haboubi, Najib

doi:10.1136/jcp.46.3.228

Cited by 42 publications

(16 citation statements)

References 3 publications

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“…The inflammatory cells were predominantly lymphocytes, but occasional mast cells were again also noted. Perineural inflammation has also been noted previously in superficial bladder biopsies taken after radiotherapy 36 . At this site this also comprises large numbers of eosinophils 30 .…”

Section: Prostatic Radiation Changes 343supporting

confidence: 68%

Effects of radiation on the normal prostate gland

Sheaff

Baithun

1997

Histopathology

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Prostate cancer is one of the commonest tumours of adult males. It shows a range of biological behaviour: many tumours are discovered incidentally; others will kill by producing widespread metastatic disease. Despite the fact that radiation is frequently used in the treatment of a range of pelvic lesions, including adenocarcinoma of the prostate itself, studies on the morphological changes in the normal prostate gland after irradiation are limited. This seems particularly surprising following the increasing use of needle biopsy specimens to assess the prostate. Patients who receive pelvic irradiation often suffer from lower urinary tract symptoms such as frequency and dysuria and it is possible that these may be related to prostatic and/or periprostatic injury. We therefore investigated the prostate glands removed at cystoprostatectomy for transitional cell carcinomas of the bladder which had received radiotherapy pre-operatively. The changes were compared to control prostatic tissue from transurethral resection specimens for benign myoadenomatous hyperplasia. We found a range of inflammatory, fibrotic and reactive cytological features, including many of the changes seen in benign hyperplasia, but these were significantly more exaggerated in the post-radiation group. In addition intraprostatic vascular and neural changes were prominent. This study documents radiation-induced changes throughout the normal prostate gland and neighbouring soft tissue and has particular importance in current pathological practice with the increasing and widespread use of needle biopsies in the diagnosis and follow-up of prostate cancer.

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Section: Prostatic Radiation Changes 343supporting

confidence: 68%

Effects of radiation on the normal prostate gland

Sheaff

Baithun

1997

Histopathology

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“…In human bladders, subepithelial fibrosis became more extensive with time after irradiation (1). The loss of bladder muscle and damage to vascular endothelial cells and bladder neurons was also evident (39). Thus irradiation may result in damage to multiple bladder cell types, including urothelium, nerve, and muscle.…”

mentioning

confidence: 97%

Manganese superoxide dismutase gene therapy protects against irradiation-induced cystitis

Kanai¹,

Zeidel²,

Lavelle³

et al. 2002

American Journal of Physiology-Renal Physiology

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Urinary bladder cystitis occurs in patients receiving radiation therapy for pelvic tumors. Radiation-induced formation of superoxide radicals is believed to damage the urothelium, exposing the underlying bladder smooth muscle to urine, culminating in nerve irritation and muscle dysfunction. We tested whether overexpression of MnSOD could decrease superoxide levels and protect the bladder from radiation damage. Pelvic irradiation led to sloughing of urothelial umbrella cells, with decreased transepithelial resistance, increased water and urea permeabilities, and increased expression of inducible nitric oxide synthase. Six months after irradiation, cystometrograms showed elevated intravesical pressures and prolonged voiding patterns. However, urothelia transfected with the MnSOD transgene recovered from radiation injury more rapidly, and detrusor function was much closer to that of control bladders than irradiated bladders without the transgene. We conclude that MnSOD gene therapy is protective, which could lead to its use in mitigating radiation cystitis and preventing dysfunction of the urinary bladder.

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“…The mass palpated at the prostatic base, presumably a result of local recurrence of the prostate cancer, most likely caused partial obstruction of the lower tract at the level of the membranous urethra. 4 The nephrostograms showed that each ureter had developed strictures, possibly due to ncpneph_2007_137f2.eps previous radiation ureteritis, 6,7 and high grade stenoses in each distal ureter at the level of the UVJ. Perhaps these multiple partial obstructions led to the decrease in glomerular filtration rate (GFR) and the loss of ureteral peristalsis, both of which might have contributed to the delay between placement of the bladder catheter and initial improvement.…”

Section: Discussion Of Pathophysiology and Managementmentioning

confidence: 98%

“…These ureteral strictures were most likely complications of the previous radiation treatment. [5][6][7] Definitive treatment was provided by the placement of bilateral internal ureteral stents. A nephroureterocystogram performed just after placement of the stents is shown in Figure 2C.…”

Section: Discussion Of Diagnosismentioning

confidence: 99%