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Congenital obstruction of the male urethra is usually caused by posterior urethral valves. Anterior urethral valves (AUV) represent a rare anomaly with a wide spectrum of presentation varying from mild voiding difficulties to end-stage renal disease. Prompt diagnosis and appropriate treatment is essential to prevent renal impairment. We report the case of a 13 month-old boy who presented with deterioration of kidney function caused by unrecognized AUV disorder. Temporary cutaneous vesicostomy was necessary to protect the upper urinary tract from further damage and to stabilize renal function. Even though a voiding cystourethrogram (VCUG) demonstrated obstruction of distal urethra, AUV were initially overlooked but finally diagnosed on additional VCUG followed by urethroscopy.
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We compared the intensity of staining of interstitial cells (ICs) and neural tissue in the lower urinary tract of rabbits with diabetes with the intensity in normal subjects. Diabetes was induced by injecting alloxane (65mg/kg) in adult male rabbits. After 3 days, rabbits with a blood glucose level >300 mg/dL were considered to have diabetes. After 8 weeks, the rabbits were killed, and tissue specimens from the bladder, prostate and urethra were obtained. ICs were stained with anti-human CD117 (c-kit) rabbit polyclonal antibody, and neural tissue was stained with synaptophysin. The streptavidin-biotin method was used for immunohistochemical staining. The intensity of c-kit and synaptophysin staining were scored as negative (0), weak (+), moderate (++), and strong (+++). Staining intensity of ICs and neural tissue was assessed and compared in tissues obtained from rabbits with diabetes (n=8) and from control subjects (n=7). Although staining intensity of both ICs and neural tissue was found to be significantly decreased in the bladder tissue of rabbits with diabetes compared to that in the control group (p=0.0001 [ICs] and p=0.021 [neural tissue]), no significant differences in staining intensity of ICs and neural tissue in the urethra and in the prostate was found when rabbits with diabetes were compared to the control group. Diabetes may cause dysfunction of the lower urinary tract, particularly in the urinary bladder, as shown by the staining intensity of ICs and neural tissue.
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