pituitrin and Urinary-Bladder-Neoplasms

Topics: Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Female; Humans; Inappropriate ADH Syndrome; Middle Aged; Research Report; Sodium; Urinary Bladder Neoplasms; Vasopressins

A 72-year-old man with end-stage renal disease (ESRD) undergoing transurethral resection of a bladder tumor experienced severe and prolonged hypotension after receiving oral 5-aminolevulinic acid (5-ALA). Continuous infusions of norepinephrine and vasopressin ultimately resolved the hypotension over the course of 26 hours. It is uncertain whether 5-ALA is causative or is a contributing factor that influences other factors, such as hypovolemia after hemodialysis and autonomic nerve dysfunction associated with ESRD. Our findings suggest that anesthesiologists should be aware of the possible occurrence of hypotension after administration of 5-ALA, and urologists should consider intravesical 5-ALA administration in patients with ESRD.

Topics: Administration, Oral; Aged; Aminolevulinic Acid; Humans; Hypotension; Kidney Failure, Chronic; Norepinephrine; Treatment Outcome; Urinary Bladder Neoplasms; Urologic Surgical Procedures; Vasopressins

We report a case that was successfully treated for massive lower gastrointestinal (LGI) bleeding due to a recurrent urinary bladder carcinoma. Treatment consisted of combination therapy including embolization of an inferior gluteal artery (IGA) pseudoaneurysm and low-dose arterial vasopressin infusion via a sigmoid artery (SA). A 57-year-old man presented with life-threatening sudden, massive LGI bleeding due to an obturator lymph node (LN) metastasis from a urinary bladder carcinoma. Computed tomography showed that the LN recurrence had invaded all the way to the sigmoid colon, and there was a pseudoaneurysm with extravasation inside the recurrence. An angiogram revealed a left IGA pseudoaneurysm. We therefore excluded the pseudoaneurysm by embolization with microcoils. Following this treatment the bleeding decreased, but intermittent LGI bleeding continued. Endoscopic examination showed the tumor with a huge ulcer inside the colonic lumen, and continuous oozing was confirmed. A second angiogram showed no recurrence of the IGA pseudoaneurysm and no apparent findings of bleeding. Then a 3F microcatheter was placed in the SA selectively using a coaxial catheter system, and vasopressin was infused at a rate 0.05 U/min for 12 h. Bleeding completely ceased 2 days later. There were no signs of ischemic gastrointestinal complications. Massive LGI bleeding has not recurred in 5 months.

Topics: Aneurysm, False; Combined Modality Therapy; Embolization, Therapeutic; Gastrointestinal Hemorrhage; Hemostatics; Humans; Infusions, Intravenous; Male; Middle Aged; Neoplasm Recurrence, Local; Recurrence; Treatment Outcome; Urinary Bladder Neoplasms; Vasopressins

A 66-year-old Japanese man presented with persistent hyponatremia without polydipsia and polyuria. Laboratory examination showed serum sodium of 117 mEq/l, plasma osmolality 239 mosm/kg, urine sodium 108 mEq/l, urine osmolality 577 mosm/kg, and normal levels (less than 2.0 pg/ml) of serum antidiuretic hormone (ADH). ADH release was regulated normally with changes in plasma osmolality. No obvious cause for the syndrome of inappropriate secretion of ADH (SIADH) could be detected. However, 20 months later, the patient had bouts of hematuria and was found to have cancer of the urinary bladder. Increased renal sensitivity to ADH was suspected as the underlying mechanism of SIADH.

Topics: Aged; Carcinoma, Squamous Cell; Diuresis; Humans; Inappropriate ADH Syndrome; Kidney; Male; Urinary Bladder Neoplasms; Vasopressins

A case of carcinoma of the bladder complicated by the syndrome of inappropriate anti-diuretic hormone secretion is reported. Management of the syndrome is discussed.

Topics: Aged; Carcinoma, Squamous Cell; Female; Fludrocortisone; Hormones, Ectopic; Humans; Hyponatremia; Urinary Bladder Neoplasms; Vasopressins

Topics: Aged; Drug Combinations; Female; Hemorrhage; Hemostasis; Humans; Male; Middle Aged; Ornithine; Postoperative Complications; Prostatectomy; Prostatic Hyperplasia; Tyrosine; Urinary Bladder; Urinary Bladder Neoplasms; Urologic Diseases; Vasopressins

Topics: Female; Hemorrhage; Hemostasis; Humans; Male; Postoperative Complications; Prostatectomy; Urethra; Urinary Bladder Diseases; Urinary Bladder Neoplasms; Vasopressins