What is exstrophy?
Bladder opens directly through the abdomen
What is the urachus? What can go wrong with it?
It is the track between the bladder and the umbilical cord that should be obliterated soon after birth
- Can become a cyst, diverticulum, or remain completely patent
What happens if ureter is denervated?
Loss of peristalsis and appropriate movement of urine > infection
What is a weird cause of UTI? How does it occur?
TB that is shed from renal TB into bladder
What is interstitial cystitis? Who gets it? What is a major concern associated with it?
An extremely painful condition driven by hypersenstive nerves due to excessive T-Cell signaling / Idiopathic disease in women
- Concern: Suicide rate is high
What is nephrogenic adenoma / metaplasia?
Tubular epithelial cells that are sloughed off bind to bladder and grow there
Most common causes of urethritis?
STDs - Gonorrhea, chlamydia, mycoplasma, ureaplasma
- Also from catherization
Bladder that has lost nerves > becomes bloated b/c of lack of signaling > produces tons of cytokines > massively swollen
Cystitis cystica / cystitis glandularis histological transformation:
Many goblet cells producing mucin are seen
Most common bladder tumor?
When do they become an issue?
How do you grade the tumor?
Urothelial (AKA transitional cell carcinoma) = Papillary and noninvasive tumors of low grade
- Problems: 1. Invasion / 2. Grow to obstruct bladder > cystectomy needed
- Grade: nuclear atypia + mitotic figures
Name the infectious disease and bladder tumor commonly seen together
Schistosomiasis + squamous cell carcinoma
Number one risk factor of bladder tumors?
Which tumors are more likely invasive - flat or papillary?
Marker of invasion and prognosis?
Flat are much more likely to be invasive, but both can become invasive
DEPTH of downward invasion (flat can move down without moving upward!)
Rhabdomyosarcoma occurs in what age group?
Describe its appearance.
Describe difference in males and females
1. Bladder tumor seen in children
2. Grape=like "Polypoid / "sarcoma botryoides"
3. Females: protrudes thru introitus / Males: Bladder obstruction
What drives prostatic hyperplasia
Describe growth and measuring scale.
Differentiate from prostatic cancer
- ANDROGENS (inhibition of androgens > atrophy)
- Growth is symmetric, circular and outward (Like a ball of tissue growing out) - Measured via Gleason Scale
- Cancer grows ASYMMETRICALLY in random directions!
Complications of prostatic cancer?
1. Perineural invasion - grows along nerve
2. Prostatic intraepithelial neoplasia (PIN)
3. Spread to vertebrae
4. Spread to lungs