Transurethral resection in women with symptomatic keratinizing squamous metaplasia of urinary bladder: A retrospective study of 92 cases

Abstract

Objectives: To investigate the efficacy of transurethral resection (TUR) on relieving urinary symptoms in patients with keratinizing squamous metaplasia (KSM) of the urinary bladder.Methods: Data were analyzed from a retrospective study of patients receiving transurethral bipolar plasma resection (bi-TUR) treatment for symptomatic KSM. Urinary symptoms were assessed by the International Prostate Symptom Score (IPSS) and a numeric rating scale pain score. Efficacy was assessed using the IPSS to determine changes from baseline in lower urinary tract symptoms (LUTS). Self-reported quality of life (QoL) was assessed by the last question of the IPSS questionnaire.Results: A total of 92 female patients were included in the analysis. The median age was 42 years. LUTS, pain, and hematuria were the most common symptoms that affected patients. The median follow-up duration was 51 months. There were significant improvements in LUTS from baseline IPSS after TUR (P < .001). The percentage of the patients with moderate to severe LUTS went down from 52.2% to 18.5%. The median Numeric Rating Scale (NRS)-11 pain score reduced from 3 at baseline to 0 at the last visit. Twentyone out of 40 patients reported that the pain symptoms disappeared completely. No patients reported hematuria symptoms at the final follow-up. Improvement of selfreported QoL was significant (P < .001). A total of 57.6% of patients reported an improvement, 26.1% of patients reported no improvement, and 16.3% reported deterioration.Conclusions: Bi-TUR therapy significantly relieved urinary symptoms in women with KSM. Improvement of QoL was acceptable with a success rate of 57.6%. Considering the very low complication rate, our study supported bi-TUR as an alternative treatment for patients who are resistant to medical therapy. K E Y W O R D S female, LUTS, squamous metaplasia, transurethral resection

Diffuse Leukoplakia of the Bladder Ostium-Sparing in Patient Treated with Leuprorelin for Breast Cancer

“…Improvement of quality of life has a success rate of 57.6%. Considering the very low complication rate, our study supports transurethral resection as an alternative treatment for patients who are resistant to medical therapy [6]. Recently, Benelli et al [7] manage a man affected by LV with hyaluronic acid instillations with resolution of clinical symptoms.…”

Leukoplakia of the bladder in adolescence: clinical observation

“…), обладая в настоящее время наибольшим опытом ТУР лейкоплакии (92 пациентки 19-85 лет, средний возраст 42 года), считает биполярную ТУР методом выбора, который позволяет помимо устранения риска развития рака мочевого пузыря избежать осложнений лейкоплакии (выраженная гематурия); снизить выраженность, а в 45-50 % случаев устранить симптомы нижних мочевых путей; повысить качество жизни у 56,7 % пациентов. По мнению автора, данная методика является методом выбора, особенно при резистентности к консервативной терапии [4].…”

“…Некоторыми авторами сам по себе диагноз «лейкоплакия» и соответствующие ему морфологические изменения уротелия не рассматриваются как руководство к каким-либо императивным действиям [1]. Большие серии наблюдений, охватывающие, как правило, значительный временной промежуток описываются крайне редко, единичными авторами [2][3][4]. Данные литературы представлены преимущественно описаниями отдельных клинических случаев или малых серий, не подлежащих статистическому анализу [5,6].…”

Familial aggregation of keratinising desquamative squamous metaplasia in the urinary tract

“…Upper tract KDSM was historically treated with nephrectomy [3]; however, several case reports have documented progressive disease to include the contralateral side and consequently, a nephron-sparing approach is now recommended [7]. Current treatment options for KDSM affecting the bladder include cystodiathermy and transurethral resection of the bladder for lower tract disease [8] but there are no formalised treatment recommendations for upper tract disease [7]. In our family, management of urinary tract symptoms, particularly renal colic in the two women with upper tract disease, was best achieved through surgical clearance of excess keratin debris at routine ureteroscopy, and notably, ureteric stents were not tolerated.…”