World journal of urology
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World journal of urology · Nov 2002
Case ReportsInterstitial cystitis, pelvic pain, and the relationship to myofascial pain and dysfunction: a report on four patients.
Treatment of chronic pelvic pain (CPP), interstitial cystitis (IC), prostatodynia, and irritative voiding symptoms can be frustrating for both patients and physicians. The usual approaches do not always produce the desired results. We found that when we treated myofascial trigger points (TrP) in pelvic floor muscles as well as the gluteus, piriform, infraspinatus, and supraspinatus muscles, symptoms improved or resolved. ⋯ The patients were asked to verbally describe exactly where the flash of distant pain was felt, a process that permitted an accurate recording of the precise pattern of pain referred by that TrP. The findings involved with the four patients substantiate the need for myofascial evaluation prior to considering more invasive treatments for IC, CPP, and irritative voiding symptoms. Referred pain and motor activity to the pelvic floor muscles (sphincters), as well as to the pelvic organs, can be the sole cause of IC, CPP, and irritative voiding dysfunction and certainly needs further investigation.
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The diagnosis and management of pelvic pain presents a challenge to the medical practitioner. The approach should be systematic and organized to provide the best possible care. The aim of this article is to increase awareness among urologists so that they may be more able to understand and support their patients.
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World journal of urology · Apr 2001
Biography Historical ArticleLudwig Rehn (1849-1930)--pioneering findings on the aetiology of bladder tumours.
One hundred and six years ago, the surgeon Ludwig Rehn from Frankfurt am Main held a pioneering lecture in Berlin about the possible origins of bladder tumours. He thereby gave the decisive impulse for cancer research in general and specifically for the investigation of aetiological factors involved in the development of urogenital tract tumours. Thereafter, this resulted in an intensified scientific discussion addressing this issue. Although the detailed evaluation of the causes finally contributing to tumour growth is still ongoing, the work of Ludwig Rehn on bladder tumours among aniline workers considerably promoted the establishment of urology as a specialised field within German clinical medicine and is therefore a milestone in the history of medicine.
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World journal of urology · Apr 2001
ReviewThe role of adjuvant chemotherapy for locally advanced bladder cancer.
The incidence of locally advanced bladder cancer is estimated at 5 new cases per 100,000 of the population annually in North America and most European countries. Radical cystectomy for muscle-invasive organ-confined tumors and locally advanced disease, which is defined as extravesical tumor growth or involvement of regional lymph nodes, is the preferred treatment in Japan, the United States, and in some countries of Europe. The clinical outcome of radical cystectomy has improved remarkably over the past 20 years as a result of advances in operative technique and perioperative care. ⋯ These studies demonstrated a disease-free survival benefit of 17-50% within the first 3-5 years when applying adjuvant systemic chemotherapy after radical cystectomy. Patients who most likely benefit from adjuvant chemotherapy are those with limited node-positive disease, extravesical tumor, and direct invasion into adjacent viscera, such as prostate, uterus, or vagina. This review will summarize past, current, and future aspects of systemic adjuvant chemotherapy for transitional cell carcinoma of the bladder.