Evaluation of Immunological Disorders of T Lymphocytes and Endocrinological Disorders as Pathogen Factors in Patients With Metaplasia of Urinary Bladder

Study Overview
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Brief Summary
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Background: Squamous metaplasia refers to the pathological transformation of the urothelium leading to non-keratinised stratified squamous metaplasia (N-KSM). Objective: To present the investigators experiences in the diagnosis and treatment of N-KSM of the urinary bladder in children.

Detailed Description
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Design, setting, and participants: In this study, the investigators present their experiences in the diagnosis and treatment of N-KSM of the urinary bladder in children aged from 5 to 17 years. From 2005 to 2013, metaplasia was diagnosed in 119 patients - 116 girls and 3 boys. The reasons behind visiting the hospital were non-specific intense pain in the abdomen, recurrent urinary tract infections, and urination disorders. The most common symptoms of urinary bladder dysfunction were pollakiuria and difficulties in initiating micturition and retention of urine (reduced detrusor muscle activity). Outcome measurements and statistical analysis: In 20 patients (16.8%), metaplasia was incidentally diagnosed during cystoscopy performed for other causes. Only the children whose bladders showed metaplastic changes on cystoscopy were subjected to a bladder biopsy for collecting specimens for further histopathological examination.

Conditions
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The Follow-up Duration Was 1-8 Years., The Main Reasons Behind Visiting the Hospital Were Recurrent Urinary Tract Infection,, Urinary Urgencies, Pollakiuria, Difficulty in Initiating Micturition, Pain in Hypogastrium,, Night Wetting and Day Wetting, Menstruation's Disorders, Urolithiasis, Defects of Urinary, System and Hematuria.

Intervention / Treatment
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* Drug: Second-generation cephalosporin, nitrofurantoin, 1% aminoglycoside solution
* Drug: cephalosporin with chemotherapeutics


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The follow-up duration was 1-8 years. The main reasons behind visiting the hospital were: recurrent urinary tract infection, urinary urgencies, pollakiuria, difficulty in initiating micturition, pain in hypogastrium, night wetting and day wetting, menstruation's disorders, urolithiasis, defects of urinary system and hematuria. Exclusion Criteria: No confirmation of squamous metaplasia of the urinary bladder in diagnostic cystoscopy

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Female 1<br>Owing to the absence of an established treatment modality for squamous metaplasia of the urinary bladder in children, we developed our own treatment modalities. Children presenting with recurrent urinary tract infections on medical interview, were subjected to ultrasonography of the urinary system, repeated urinalysis, and urine culture tests. Then, on the basis of antibiogram findings, antibiotic and chemotherapeutic treatment was administered to eliminate the bacteriological factors. Second-generation cephalosporin was prescribed for 10 days, and then treatment crossover with chemotherapeutics in therapeutic dose (change in every week) during 3 months. | Drug: Second-generation cephalosporin, nitrofurantoin, 1% aminoglycoside solution<br> <br> |
| Male 2<br>Owing to the absence of an established treatment modality for squamous metaplasia of the urinary bladder in children, we developed our own treatment modalities. Children presenting with recurrent urinary tract infections on medical interview, were subjected to ultrasonography of the urinary system, repeated urinalysis, and urine culture tests. Then, on the basis of antibiogram findings, antibiotic and chemotherapeutic treatment was administered to eliminate the bacteriological factors. Second-generation cephalosporin was prescribed for 10 days, and then treatment crossover with chemotherapeutics in therapeutic dose (change in every week) during 3 months. | Drug: cephalosporin with chemotherapeutics<br>* Second-generation cephalosporin was prescribed for 10 days, and then treatment crossover with chemotherapeutics in therapeutic dose (change in every week) during 3 months<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Symptoms of stratified squamous metaplasia of urinary bladder and treatment's ways |  | 5 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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metaplasia, dysfunction, urinary bladder, children