[Clinical findings of neurogenic bladder in patients with Parkinson’s disease, multiple sclerosis and spinocerebellar degeneration]:
[Clinical findings of neurogenic bladder in patients with Parkinson’s disease, multiple sclerosis and spinocerebellar degeneration]
Hinyokika Kiyo. 1997 Nov;43(11):765-9
Authors: Shimizu K, Yasukawa M, Yamamoto M, Hirao Y, Momose H, Kashiwai H, Kawata Y, Yamada K
Clinical symptoms, urodynamic findings, and urological treatment of 35 patients with neurogenic bladder dysfunction caused by Parkinson’s disease (11 patients), multiple sclerosis (10 patients), and spinocerebellar degeneration (14 patients) were reviewed retrospectively. Most of the patients had a relatively low stage of disease, when they were first seen by their urologists. Chief urological complaints were of irritation in 63.6% of Parkinson’s disease and 64.3% of spinocerebellar degeneration cases, compared with obstruction in 80.0% of multiple sclerosis cases. Cystometry revealed underactive detrusor function in 69.2% of the patients with spinocerebellar degeneration but no abnormalities in the patients with Parkinson’s disease or multiple sclerosis. Of 34 patients, excluding one patient lost to follow-up, the period of urological management ranged from one to 44 weeks with a mean of 11.0. The final methods of urinary drainage in 34 patients consisted of voluntary voiding in 20, clean intermittent catheterization in 11 including eight by self catheterization, incontinence into diaper in two, and indwelling catheter in one. Five patients were compelled to change urinary drainage method from voluntary voiding to clean intermittent catheterization because of increasing residual volume in four and progressing bladder deformity in one. However, none of them showed the clinical signs of primary disease progression. These findings indicate that in patients with Parkinson’s disease, multiple sclerosis, and spinocerebellar degeneration, the urological symptoms can appear even in the early stage of disease. In addition, close follow-up is important in the urological management of neurogenic bladder patients with these diseases, because the disorders of the lower urinary tract may progress regardless of the status of the primary disease.
PMID: 9436018 [PubMed – indexed for MEDLINE]
Last Updated: July 27, 2020 by uabadmin
Urinary disorders associated with bilharziasis. Urodynamic evaluation. Findings in 10 cases.
Urinary disorders associated with bilharziasis. Urodynamic evaluation. Findings in 10 cases.:
Urinary disorders associated with bilharziasis. Urodynamic evaluation. Findings in 10 cases.
Med Trop (Mars). 2011 Dec;71(6):572-4
Authors: Guinet A, Jousse M, Verollet D, Le Breton F, Amarenco G
Abstract
Bilharziasis urinary disorders are characterized by recurent hematuria, overactive bladder symptoms (urgency, frequency and urge incontinence) and sometimes weak stream with or without urinary retention. We report 10 cases of urodynamic assessment. RESULTS: The main urodynamic symptom was overactive detrusor with uninhibited detrusor contraction during the filling phase. Only 1 patient had underactive detrusor leading to urinary retention. Urinary symptoms were secondary to a neurogenic abnormality (spinal lesion) in 2 cases, and to a specific lesion of bladder mucosa in 8 cases. CONCLUSION: Urodynamic investigations are usefull in bilharziasis urinary disorders in order to specify the pathophysiology of urinary symptoms and to point a specific neurogenic (spinal) alteration in the genesis of the urinary symptoms.
PMID: 22393623 [PubMed – in process]
Last Updated: July 27, 2020 by uabadmin
Women with pure stress urinary incontinence symptoms assessed by the initial standard evaluation including measurement of post-void residual volume and a stress test: Are urodynamic studies still needed?
Women with pure stress urinary incontinence symptoms assessed by the initial standard evaluation including measurement of post-void residual volume and a stress test: Are urodynamic studies still needed?:
Women with pure stress urinary incontinence symptoms assessed by the initial standard evaluation including measurement of post-void residual volume and a stress test: Are urodynamic studies still needed?
Neurourol Urodyn. 2012 Feb 28;
Authors: Jeong SJ, Kim HJ, Lee BK, Rha W, Oh JJ, Jeong CW, Kim JH, Yoon CY, Hong SK, Byun SS, Lee SE
Abstract
AIMS: The significance of preoperative urodynamic studies in women with a “clinically-defined pure stress urinary incontinence (SUI) symptom” has been debated in recent years. We evaluated changes of reliability of pure SUI symptoms for prediction of pure urodynamic SUI (USUI) when the assessment of post-void residual (PVR) volume and a stress test, designated as the initial standard evaluation in the NICE and AUA guidelines, were added to the process for the diagnosis of pure SUI symptoms. METHODS: We reviewed records of 1,019 women aged 30-80 who underwent urodynamic study for incontinence. Criteria for pure SUI symptoms were defined as absence of overactive bladder symptoms and voiding difficulties based on a frequency-volume chart and AUA Symptom Index. We then added assessment of PVR volume and a stress test to the process for clinical diagnosis. RESULTS: Of subjects, 211 (20.7%) could be classified as having a pure SUI symptom. Of these, only 167 (79.1%) had pure USUI and 33 (15.7%) had detrusor overactivity. Eight (3.8%) had detrusor underactivity/bladder outlet obstruction. Sensitivity and specificity of pure SUI symptoms for pure USUI were 28.6% and 89.9%. Addition of assessment of PVR volume and a stress test resulted in an increase of predictive accuracy of only 3.6%. CONCLUSIONS: As one-fifth of women with pure SUI symptoms exhibit the pathophysiologies that could affect the surgical outcomes despite additional use of PVR assessment and a stress test in the clinical diagnostic process, urodynamic evaluation is considered necessary before anti-incontinence surgery in this population. Neurourol. Urodynam. © 2012 Wiley Periodicals, Inc.
PMID: 22374678 [PubMed – as supplied by publisher]
Last Updated: July 27, 2020 by uabadmin
[The association between diabetes mellitus and lower urinary tract dysfunctions in women assisted in a reference service].
[The association between diabetes mellitus and lower urinary tract dysfunctions in women assisted in a reference service].:
[The association between diabetes mellitus and lower urinary tract dysfunctions in women assisted in a reference service].
Rev Bras Ginecol Obstet. 2011 Dec;33(12):414-20
Authors: Oliveira EG, Marinheiro LP, Silva KS
Abstract
PURPOSE: to describe lower urinary tract dysfunctions and clinical demographic characteristics of patients with urinary symptoms. This study assessed the prevalence of diabetes mellitus and urodynamic changes in these women.
METHODS: We conducted a cross-sectional, retrospective study on 578 women. The prevalence of diabetes mellitus and urodynamic diagnoses was assessed in patients with lower urinary tract dysfunctions, with their respective 95% confidence intervals. The prevalence ratios of urodynamic alterations were calculated according to the diabetes mellitus diagnoses.
RESULTS: Seventy-seven patients (13.3%) had diabetes and type 2 diabetes was predominant (96.1%). Stress urinary incontinence was the most frequent urodynamic diagnosis (39%) in diabetic patients, followed by detrusor overactivity (23.4%). The prevalence of urodynamic alterations was associated with diabetes (PR=1.31; 95%CI=1.17-1.48). Changes in detrusor contractility (over- or underactivity) were diagnosed in 42.8% diabetic patients and in 31.5% non-diabetic patients.
CONCLUSIONS: Diabetic women had a greater prevalence of urodynamic alterations than the non-diabetic ones. There was no association between diabetes mellitus and detrusor contractility alterations (p=0.80).
PMID: 22282030 [PubMed – in process]
Last Updated: July 27, 2020 by uabadmin
How does the urothelium affect bladder function in health and disease?
How does the urothelium affect bladder function in health and disease?:
How does the urothelium affect bladder function in health and disease?
Neurourol Urodyn. 2012 Jan 24;
Authors: Birder L, Ruggieri M, Takeda M, van Koeveringe G, Veltkamp S, Korstanje C, Parsons B, Fry C
Abstract
The urothelium is a multifunctional tissue that not only acts as a barrier between the vesical contents of the lower urinary tract and the underlying tissues but also acts as a sensory organ by transducing physical and chemical stresses to the attendant afferent nervous system and underlying smooth muscle. This review will consider the nature of the stresses that the urothelium can transduce; the transmitters that mediate the transduction process; and how lower urinary pathologies, including overactive bladder syndrome, painful bladder syndrome and bacterial infections, are associated with alterations to this sensory system. In particular, the role of muscarinic receptors and the TRPV channels system will be discussed in this context. The urothelium also influences the contractile state of detrusor smooth muscle, both through modifying its contractility and the extent of spontaneous activity; potential pathways are discussed. The potential role that the urothelium may play in bladder underactivity is introduced, as well as potential biomarkers for the condition that may cross the urothelium to the urine. Finally, consideration is given to vesical administration of therapeutic agents that influence urinary tract function and how the properties of the urothelium may determine the effectiveness of this mode of delivery. Neurourol. Urodynam. © 2012 Wiley Periodicals, Inc.
PMID: 22275289 [PubMed – as supplied by publisher]
Last Updated: July 27, 2020 by uabadmin
Detrusor underactivity is prevalent after radical prostatectomy: a urodynamic study including risk factors.
Detrusor underactivity is prevalent after radical prostatectomy: a urodynamic study including risk factors.:
Detrusor underactivity is prevalent after radical prostatectomy: a urodynamic study including risk factors.
Can Urol Assoc J. 2012 Jan 24;:1-5
Authors: Chung DE, Dillon B, Kurta J, Maschino A, Cronin A, Sandhu JS
Abstract
INTRODUCTION: The objective was to determine the prevalence of, and factors that predict, detrusor underactivity (DU) in patients presenting with incontinence or lower urinary tract symptoms (LUTS) following radical prostatectomy (RP). We also determined the prevalence of bladder outlet obstruction (BOO) and detrusor overactivity (DO) in this population. METHODS: Patients who underwent urodynamics post-RP were identified. Detrusor underactivity was defined as a maximum flow rate (Qmax) of ≤ 15 mL/s and detrusor pressure (Pdet) Qmax <20 cmH20 or maximum Pdet <20 cmH20 during attempted voiding. Abdominal voiding (AV) was defined as sustained increase in abdominal pressure during voiding. Bladder outlet obstruction and DO were identified using the Abrams-Griffiths nomogram and the International Continence Society criteria. Univariate logistic regression was used to determine factors predicting DU. The following factors were analyzed: age, year of RP, procedure type (minimally-invasive surgery [MIS] or open), postoperative radiation, nerve-sparing, clinical stage, biopsy Gleason grade and interval between RP and evaluation. RESULTS: Between 2005 and 2008, 264 patients underwent urodynamics post-RP. Detrusor underactivity was observed in 108 patients (41%; 95% CI 35%, 47%), of whom 48% demonstrated AV. Overall, BOO and DO were present in 17% (95% CI 12%, 22%) and 27% (95% CI 22%, 33%), respectively. On univariate analysis, only MIS RP was predictive of DU (univariate odds ratio 2.05 for MIS vs. open; p = 0.009). CONCLUSIONS: Detrusor underactivity and AV are common in patients presenting for evaluation of incontinence or LUTS following RP. The etiology of DU in this setting is likely related to the surgical approach. Because DU may affect the success of male incontinence treatment with the male sling or artificial urinary sphincter, it is useful to document its presence prior to treatment. More studies are needed to elucidate the influence of DU on treatment success for male urinary incontinence following RP.
PMID: 22277630 [PubMed – as supplied by publisher]
Last Updated: July 27, 2020 by uabadmin
Is There Any Role for Urodynamic Study in Children with High-grade Vesicoureteral Reflux?
Is There Any Role for Urodynamic Study in Children with High-grade Vesicoureteral Reflux?:
Is There Any Role for Urodynamic Study in Children with High-grade Vesicoureteral Reflux?
Urology. 2012 Jan 12;
Authors: Karami H, Razi A, Mazloomfard MM, Javanmard B
Abstract
OBJECTIVE: To determine the clinical symptoms and urodynamic characteristics among children with primary high-grade vesicoureteral reflux (VUR). MATERIALS AND METHODS: We prospectively studied clinical symptoms and urodynamic parameters in 147 consecutive patients ≤12 years old with idiopathic high-grade VUR referred to our hospital. RESULTS: Of 147 patients with high-grade VUR, 139 cases with mean age of 5.3 years met our inclusion criteria (88.5% females, 11.5% males). The most common symptom was recurrent urinary tract infection (57%) and urgency (59%) followed by enuresis (31.6%) and frequency (26.6%). Normal urodynamic findings were observed in 23% of patients. Overactive bladder (74%), high-end filling pressure (72.7%), low-compliance bladder (56%), and low bladder capacity (51%) were the most common urodynamic reports in this study. Other urodynamic findings were underactive bladder (1.5%), hypersensitive bladder (1.5%), hyposensitive bladder (3%), and high capacity bladder (2.2%). CONCLUSION: Proper management of VUR is very important because of its harmful potential effects on kidney function in children. With regard to the issue that most children with grade III and higher VUR had overactive bladder, high-end filling pressure, and other urodynamic disorders in their urodynamic study, it seems that these urodynamic disorders could be the basic cause of reflux.
PMID: 22245307 [PubMed – as supplied by publisher]
Last Updated: July 27, 2020 by uabadmin
Neuropathic bladder dysfunction in patients with ossification of the posterior longitudinal ligament.
Neuropathic bladder dysfunction in patients with ossification of the posterior longitudinal ligament.:
Neuropathic bladder dysfunction in patients with ossification of the posterior longitudinal ligament.
Int J Urol. 1998 Nov;5(6):540-5
Authors: Miyata M, Mizunaga M, Taniguchi N, Kaneko S, Yachiku S, Atsuta Y
BACKGROUND: Ossification of the posterior longitudinal ligament (OPLL) may cause neuropathic bladder dysfunction due to spinal cord involvement. OPLL, unlike a traumatic spinal cord lesion, progresses insidiously and sometimes affects longer cord segments. As the manifestation of bladder dysfunction may depend on the development of OPLL, we studied the relationship between bladder function and roentgenographic changes in the spinal canals of OPLL patients. PATIENTS AND METHODS: Eighteen surgical candidates (11 males and 7 females, 34 to 85 years old) were studied urodynamically. Sixteen underwent CO2-filling cystometry, uroflowmetry and measurement of their residual urine volume. Cystometry was omitted in the remaining 2 patients. The vertical extent of OPLL and the degree of stenosis in the spinal canal was estimated by x-ray films and CT. RESULTS: The cystometric study revealed detrusor hyperreflexia in 2 patients and areflexic or underactive detrusors in 5 patients. Intermittent flows or considerable amounts of residual urine were also observed in the arefilexia/underactive group. Uroflowmetry showed a normal flow with little residual urine in both patients in whom cystometry was omitted. Bladder sensation was maintained in all patients. The occurrence of abnormal detrusor activity had no relationship to the degree of canal stenosis, while the occurrence of an areflexic or underactive detrusor correlated with the vertical extent of OPLL. CONCLUSION: Although detrusor hyperreflexia is common in an upper spinal cord lesion, attention should also be paid to the development of detrusor underactivity in patients with a wide vertical extent of OPLL.
PMID: 9855121 [PubMed – indexed for MEDLINE]
Last Updated: July 27, 2020 by uabadmin
[Studies on neurogenic bladder due to human T-lymphotropic virus type-I associated myelopathy (HAM)]
[Studies on neurogenic bladder due to human T-lymphotropic virus type-I associated myelopathy (HAM)]:
[Studies on neurogenic bladder due to human T-lymphotropic virus type-I associated myelopathy (HAM)]
Nippon Hinyokika Gakkai Zasshi. 1994 Jul;85(7):1106-15
Authors: Imamura A
Fifty cases of untreated human T-cell lymphotropic virus type I (HTLV-I) associated myelopathy (HAM) were evaluated by urodynamic studies to clarify the nature of urinary disturbance and to find out suitable urological treatment. Both irritative and obstructive symptoms coexisted in the HAM patients. 38% of the patients experienced only urinary symptoms throughout the affected period. A main cause of frequency was detrusor hyperreflexia at filling phase, which was found in 58% of the patients. However, decreased effective bladder capacity due to large amount of residual urine was possibly an another cause of frequency. Detrusor sphincter dyssynergia was the main cause of difficulty of urination, but in some cases underactive detrusor at voiding phase was also the cause of difficulty of urination. Hydronephrosis was observed in only 5 kidneys, although as many as 30 out of 46 cases (65.2%) showed bladder deformity. 17 cases (34%) had urinary tract infection at first visit. As the activity of daily living was deteriorated, the mean volume of residual urine, incidence of detrusor hyperreflexia and detrusor sphincter dyssynergia were all increased. Medical treatment was effective to relieve subjective symptoms, but urodynamic examination did not necessarily review improvement. Intermittent catheterization was needed and successful in 64% of all cases. Patients with HAM must be carefully followed up by urologists.
PMID: 8078228 [PubMed – indexed for MEDLINE]
Last Updated: July 27, 2020 by uabadmin
Intravesical electrical stimulation in the treatment of micturition dysfunction in children.
Intravesical electrical stimulation in the treatment of micturition dysfunction in children.:
Intravesical electrical stimulation in the treatment of micturition dysfunction in children.
Neurourol Urodyn. 2003;22(3):233-42
Authors: Gladh G, Mattsson S, Lindström S
AIMS: To evaluate the results of intravesical electrical stimulation (IVES) in an open prospective study to treat underactive detrusor in children. The treatment was offered as an alternative to clean intermittent catheterization (CIC). METHODS: Forty-four children were included, 21 girls and 3 boys (6-16 years, md 10) with idiopathic, 9 girls and 11 boys (4-18 years; md 13) with neurogenic underactive detrusor. IVES was given by a catheter electrode in the bladder (cathode) with the anode attached to the suprapubic abdominal skin. Continuous stimulation at 20 or 25 Hz was delivered by battery powered stimulators giving unipolar square-wave pulses (0,2 or 0,7 ms). Stimulation intensity was adjusted individually according to the acceptance of the child (12-64 mA). IVES was initially given at the clinic but 18 children had additional treatment at home. Effect of treatment was monitored by micturiton/incontinence diary, reports of bladder sensation, recordings of urinary flow, residual volume and frequency of urinary tract infections. RESULTS: The IVES-treatment was completed by 39/44 children. Long term normalization of the voiding (md 2,5 years follow up) was obtained for 20/24 children with idiopathic problems (83%) and 8/20 with neurogenic problems (40%). Another four had much improved bladder function. The neurogenic group required more stimulation sessions than the idiopathic group. Of those on CIC, 11/15 who completed IVES could discontinue the catheterization. The frequency of urinary tract infections and incontinence decreased significantly (P < 0.01). CONCLUSIONS: It is concluded that IVES is a promising method to treat the underactive detrusor in children.
PMID: 12707874 [PubMed – indexed for MEDLINE]
Last Updated: July 27, 2020 by uabadmin
[Clinical findings of neurogenic bladder in patients with Parkinson’s disease, multiple sclerosis and spinocerebellar degeneration]
[Clinical findings of neurogenic bladder in patients with Parkinson’s disease, multiple sclerosis and spinocerebellar degeneration]:
[Clinical findings of neurogenic bladder in patients with Parkinson’s disease, multiple sclerosis and spinocerebellar degeneration]
Hinyokika Kiyo. 1997 Nov;43(11):765-9
Authors: Shimizu K, Yasukawa M, Yamamoto M, Hirao Y, Momose H, Kashiwai H, Kawata Y, Yamada K
Clinical symptoms, urodynamic findings, and urological treatment of 35 patients with neurogenic bladder dysfunction caused by Parkinson’s disease (11 patients), multiple sclerosis (10 patients), and spinocerebellar degeneration (14 patients) were reviewed retrospectively. Most of the patients had a relatively low stage of disease, when they were first seen by their urologists. Chief urological complaints were of irritation in 63.6% of Parkinson’s disease and 64.3% of spinocerebellar degeneration cases, compared with obstruction in 80.0% of multiple sclerosis cases. Cystometry revealed underactive detrusor function in 69.2% of the patients with spinocerebellar degeneration but no abnormalities in the patients with Parkinson’s disease or multiple sclerosis. Of 34 patients, excluding one patient lost to follow-up, the period of urological management ranged from one to 44 weeks with a mean of 11.0. The final methods of urinary drainage in 34 patients consisted of voluntary voiding in 20, clean intermittent catheterization in 11 including eight by self catheterization, incontinence into diaper in two, and indwelling catheter in one. Five patients were compelled to change urinary drainage method from voluntary voiding to clean intermittent catheterization because of increasing residual volume in four and progressing bladder deformity in one. However, none of them showed the clinical signs of primary disease progression. These findings indicate that in patients with Parkinson’s disease, multiple sclerosis, and spinocerebellar degeneration, the urological symptoms can appear even in the early stage of disease. In addition, close follow-up is important in the urological management of neurogenic bladder patients with these diseases, because the disorders of the lower urinary tract may progress regardless of the status of the primary disease.
PMID: 9436018 [PubMed – indexed for MEDLINE]
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