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# Bladder Bulge: Unifying Old and New Sonographic Bladder Wall Abnormalities in Ureterolithiasis

, DO * , , BSc, MBBS * , , MD , , MD

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### Most cited references16

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### Urinary bladder contraction and relaxation: physiology and pathophysiology.

(2004)
The detrusor smooth muscle is the main muscle component of the urinary bladder wall. Its ability to contract over a large length interval and to relax determines the bladder function during filling and micturition. These processes are regulated by several external nervous and hormonal control systems, and the detrusor contains multiple receptors and signaling pathways. Functional changes of the detrusor can be found in several clinically important conditions, e.g., lower urinary tract symptoms (LUTS) and bladder outlet obstruction. The aim of this review is to summarize and synthesize basic information and recent advances in the understanding of the properties of the detrusor smooth muscle, its contractile system, cellular signaling, membrane properties, and cellular receptors. Alterations in these systems in pathological conditions of the bladder wall are described, and some areas for future research are suggested.
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### Urologic diseases in America project: urolithiasis.

(2005)
We quantified the burden of urolithiasis in the United States by identifying trends in the use of health care resources and estimating the economic impact of the disease. The analytical methods used to generate these results have been described previously. The rate of national inpatient hospitalizations for a diagnosis of urolithiasis decreased by 15% and hospital length of stay decreased from 2.6 to 2.2 days between 1994 and 2000. Rates of hospitalization were 2.5 to 3-fold higher for Medicare beneficiaries with little change between 1992 and 1998. Almost 2 million outpatient visits for a primary diagnosis of urolithiasis were recorded in 2000. Hospital outpatient visits increased by 40% between 1994 and 2000 and physician office visits increased by 43% between 1992 and 2000. In the Medicare population hospital outpatient and office visits increased by 29% and 41%, respectively, between 1992 and 1998. The distribution of surgical procedures remained relatively stable through the 1990s. Shock wave lithotripsy was the most commonly performed procedure, followed closely by ureteroscopy. Overall the total estimated annual expenditure for individuals with claims for a diagnosis of urolithiasis was almost $2.1 billion in 2000, representing a 50% increase since 1994. The cost of urolithiasis is estimated at almost$2 billion annually and it appears to be increasing with time despite a shift in inpatient to outpatient treatment and the emergence of minimally invasive treatment modalities, perhaps because the prevalence of stone disease is increasing.
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### Diagnostic CT scans: assessment of patient, physician, and radiologist awareness of radiation dose and possible risks.

(2004)
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### Author and article information

###### Journal
West J Emerg Med
West J Emerg Med
WestJEM
Western Journal of Emergency Medicine
Department of Emergency Medicine, University of California, Irvine School of Medicine
1936-900X
1936-9018
December 2012
: 13
: 6
: 517-523
###### Affiliations
[* ]Wellington Regional Hospital, Department of Emergency Medicine, Wellington, New Zealand
[]KaiserPermanenteSantaClaraMedicalCenter,DepartmentofEmergencyMedicine, Santa Clara, California
###### Author notes
Address for Correspondence: Scott Bomann, DO, Wellington Hospital, Department of Emergency Medicine, Wellington Regional Hospital, Wellington New Zealand. Email: sbomann@ 123456msn.com .

Supervising Section Editor: Rick A McPheeters, DO

Full text available through open access at http://escholarship.org/uc/uciem_westjem

###### Article
wjem-13-517
10.5811/westjem.2012.4.11960
3555570
23358632

This is an Open Access article distributed under the terms of the Creative Commons Non-Commercial Attribution License, which permits its use in any digital medium, provided the original work is properly cited and not altered. For details, please refer to http://creativecommons.org/licenses/by-nc-nd/3.0/. Authors grant Western Journal of Emergency Medicine a nonexclusive license to publish the manuscript.

###### Categories
Technology in Emergency Care
Case Series

Emergency medicine & Trauma