Posted by Guan Chou on February 19, 1998 at 09:46:46:
In Reply to: Re: ca bladder posted by C S Loh on February 18, 1998 at 10:40:32:
The patient actually had 2 biopsies (second one actually was
done under anasethesia with resection down deep muscles layer
. The histology of both specimen was TCC G1 with no muscle
invasion.
The KUB and spine doesn had sign suggestive of spina bifida and
neurological examination is normal
Regarding CMG at this stage. This patient had TCC bladder
and on top of it he had renal failure secondary to sever
bilateral UVJ obstruction . His creatinin (after bilateral stenting)
is 300umol/l now (with CBD in for about 2 weeks. TO relieve subvesical
obstruction if there is any). His creatinin doesn seem to
improve further.
I agree with Ding that the clinical picture doesn't fit in with
some one with low grade, low stage TCC as bilateral UVJ
obstruction often suggest muscles invasion. That is Why
we repeated the biopsy.
I think he needs to have cystectomy and ileal conduit.
orthotopic reconstruction or continence diversion is out as his
s. creatinin is > 200umol/l. Whether CMG will change the
course of management is dabatable.
Can CMG tracing be interpreted in the normal manner when patient
had stent in the bladder?
Please comment.