Urinary dysfunction in early and untreated Parkinson’s disease.: “
Urinary dysfunction in early and untreated Parkinson’s disease.
J Neurol Neurosurg Psychiatry. 2011 Jun 13;
Authors: Uchiyama T, Sakakibara R, Yamamoto T, Ito T, Yamaguchi C, Awa Y, Yanagisawa M, Higuchi Y, Sato Y, Ichikawa T, Yamanishi T, Hattori T, Kuwabara S
Background Urinary dysfunction is common in Parkinson’s disease (PD); however, little is known about urinary dysfunction in early and untreated PD patients. Methods Fifty consecutive untreated PD patients (mean age, 66.7; mean disease duration, 23.6 months; and mean Hoehn & Yahr scale, 1.9) were recruited; those with other conditions that might have influenced urinary function were excluded. Patients were evaluated using a urinary questionnaire and urodynamic studies. Results Sixty-four per cent complained of urinary symptoms (storage, 64.0%; voiding, 28.0%). Urodynamic studies showed abnormal findings in the storage phase in 84%, with detrusor overactivity (DO) and increased bladder sensation without DO in 58.0% and 12.0% of patients, respectively. In the voiding phase, detrusor underactivity, impaired urethral relaxation such as detrusor sphincter dyssynergia, and bladder outlet obstruction were present in 50.0%, 8.0% and 16% of patients, respectively. In patients with both storage and voiding phase abnormalities, DO+detrusor underactivity was the most common finding. Few patients experienced urge incontinence and/or quality-of-life impairment owing to urinary dysfunction; none had low-compliance bladder or abnormal anal-sphincter motor unit potential. These urinary symptoms and urodynamic findings were not correlated with gender, disease severity or motor symptom type. Conclusion Urinary dysfunction, manifested primarily as storage disorders with subclinical voiding disorders and normal anal-sphincter electromyography, occurs in early and untreated PD patients. In cases with severe voiding disorder and/or abnormal anal-sphincter electromyography, other diagnoses should be considered.
PMID: 21670077 [PubMed – as supplied by publisher]
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Last Updated: July 27, 2020 by uabadmin
Urodynamic findings in young men with chronic lower urinary tract symptoms.
Urodynamic findings in young men with chronic lower urinary tract symptoms.: “
Urodynamic findings in young men with chronic lower urinary tract symptoms.
Neurourol Urodyn. 2011 Jul 20;
Authors: Karami H, Valipour R, Lotfi B, Mokhtarpour H, Razi A
AIM: To assess frequency of urodynamic abnormalities in young men with chronic lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: We assessed 456 men (18-40 years old) with chronic LUTS. Those with the history of urogenital malignancies, neurological disease, urethral stricture or trauma, acute UTI, congenital urological disease, and diabetes mellitus were excluded. Patients were classified by special urodynamic diagnosis. RESULTS: Mean patient age was 25.8 ± 5.9 years old and the mean symptom duration was 12.3 ± 3.2 months. Urodynamic studies showed bladder neck dysfunction in 96 of cases (21%), dysfunctional voiding in 69 (15.1%), detrusor overactivity in 62 (13.6%), small cystometric capacity in 49 (10.7%), and acontractile detrusor in 48 (10.5%), underactive detrusor in 11 (2.4%), low compliance in 18 (3.9%), detrusor overactivity plus acontractile detrusor in 6 (1.3%), low compliance plus small cystometric capacity in 5 (1.0%), detrusor overactivity plus small cystometric capacity together with low compliance in 4 (0.8%), low compliance plus Underactive detrusor in 3 (0.6%) and normal urodynamics in 85 (18.6%). Mean Q(max) in patients with bladder neck dysfunction, dysfunctional voiding, underactive detrusor, acontractile detrusor, underactive detrusor plus low compliance, and acontractile detrusor plus detrusor overactivity were lower than those of the other groups. Mean postvoid residues in patients with underactive detrusor, and underactive detrusor plus low compliance, were higher than those in the remaining groups. Positive four-glass test in patient with normal urodynamic was greater than those in the remaining groups. CONCLUSION: A few clinical symptoms or noninvasive tests were useful in young men with chronic LUTS; hence, urodynamics are advised to make the correct diagnosis in this regard. Neurourol. Urodynam. © 2011 Wiley-Liss, Inc.
PMID: 21780163 [PubMed – as supplied by publisher]
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Last Updated: July 27, 2020 by uabadmin
Urinary dysfunction in early and untreated Parkinson’s disease.
Urinary dysfunction in early and untreated Parkinson’s disease.: “
Urinary dysfunction in early and untreated Parkinson’s disease.
J Neurol Neurosurg Psychiatry. 2011 Jun 13;
Authors: Uchiyama T, Sakakibara R, Yamamoto T, Ito T, Yamaguchi C, Awa Y, Yanagisawa M, Higuchi Y, Sato Y, Ichikawa T, Yamanishi T, Hattori T, Kuwabara S
Background Urinary dysfunction is common in Parkinson’s disease (PD); however, little is known about urinary dysfunction in early and untreated PD patients. Methods Fifty consecutive untreated PD patients (mean age, 66.7; mean disease duration, 23.6 months; and mean Hoehn & Yahr scale, 1.9) were recruited; those with other conditions that might have influenced urinary function were excluded. Patients were evaluated using a urinary questionnaire and urodynamic studies. Results Sixty-four per cent complained of urinary symptoms (storage, 64.0%; voiding, 28.0%). Urodynamic studies showed abnormal findings in the storage phase in 84%, with detrusor overactivity (DO) and increased bladder sensation without DO in 58.0% and 12.0% of patients, respectively. In the voiding phase, detrusor underactivity, impaired urethral relaxation such as detrusor sphincter dyssynergia, and bladder outlet obstruction were present in 50.0%, 8.0% and 16% of patients, respectively. In patients with both storage and voiding phase abnormalities, DO+detrusor underactivity was the most common finding. Few patients experienced urge incontinence and/or quality-of-life impairment owing to urinary dysfunction; none had low-compliance bladder or abnormal anal-sphincter motor unit potential. These urinary symptoms and urodynamic findings were not correlated with gender, disease severity or motor symptom type. Conclusion Urinary dysfunction, manifested primarily as storage disorders with subclinical voiding disorders and normal anal-sphincter electromyography, occurs in early and untreated PD patients. In cases with severe voiding disorder and/or abnormal anal-sphincter electromyography, other diagnoses should be considered.
PMID: 21670077 [PubMed – as supplied by publisher]
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Last Updated: July 27, 2020 by uabadmin
Detrusor underactivity: A plea for new approaches to a common bladder dysfunction.
Detrusor underactivity: A plea for new approaches to a common bladder dysfunction.: “
Detrusor underactivity: A plea for new approaches to a common bladder dysfunction.
Neurourol Urodyn. 2011 Jun;30(5):723-8
Authors: van Koeveringe GA, Vahabi B, Andersson KE, Kirschner-Herrmans R, Oelke M
Detrusor underactivity (DU) is defined by the International Continence Society as a contraction of reduced strength and/or duration resulting in prolonged or incomplete emptying of the bladder but has yet received only little attention. The purpose of this report is to summarize the ICI-RS meeting in Bristol in 2010 exploring current knowledge on DU and outline directions for future research.
PMID: 21661020 [PubMed – in process]
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Last Updated: July 27, 2020 by uabadmin
Urodynamic Parameters Development and Complications of Clean Intermittent Self-Catheterization in Chinese Schoolchildren with Neurogenic Underactive Bladder.
Urodynamic Parameters Development and Complications of Clean Intermittent Self-Catheterization in Chinese Schoolchildren with Neurogenic Underactive Bladder.: “
Urodynamic Parameters Development and Complications of Clean Intermittent Self-Catheterization in Chinese Schoolchildren with Neurogenic Underactive Bladder.
Urol Int. 2011 May 10;
Authors: Wang QW, Song DK, Zhang XP, Wu YD, Zhang RL, Wei JX, Wen JG
Objective: To evaluate the urodynamic parameters, development of bladder function and complications of clean intermittent self-catheterization (CIC) in Chinese schoolchildren with neurogenic underactive bladder. Methods: Ninety-three children with neurogenic underactive bladder were successfully treated with CIC or combined with oxybutynin for two years follow-up. According to bladder compliance before CIC, they were subdivided into a normal bladder compliance (NBC) group and a low bladder compliance (LBC) group. Urodynamic parameters and complications were recorded. Results: At follow-up, the incidence of neurogenic detrusor overactivity was found to have significantly decreased in both groups. Moreover, maximum cystometric capacity (CC) and relatively safe CC in the NBC group was significantly higher than those before CIC. However, relatively safe CC was significantly lower than that before CIC, and detrusor leakage point pressure was significantly higher than that before CIC in the LBC group. The incidences of bacteriuria, vesicureteral reflux (VUR), febrile urinary tract infections (UTI) and macroscopic hematuria were, respectively, 62, 13, 25 and 15%, and those of VUR and febrile UTI in the LBC group were significantly higher than those in the NBC group. Conclusion: For these cases, the complications of CIC are rare, and bladder compliance seems to be correlated with the development of bladder function and complications during CIC.
PMID: 21555862 [PubMed – as supplied by publisher]
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Last Updated: July 27, 2020 by uabadmin
Urological outcome after myelomeningocele: 20 years of follow-up.
Urological outcome after myelomeningocele: 20 years of follow-up.: “
Urological outcome after myelomeningocele: 20 years of follow-up.
BJU Int. 2011 Mar;107(6):994-9
Authors: Thorup J, Biering-Sorensen F, Cortes D
• To evaluate the urological outcome in a long-term follow-up of individuals with myelomeningocele and relate the findings obtained to urodynamic variables in childhood.
PMID: 20860652 [PubMed – indexed for MEDLINE]
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Last Updated: July 27, 2020 by uabadmin
Detrusor Arreflexia as an End Stage of Neurogenic Bladder in HAM/TSP?
Detrusor Arreflexia as an End Stage of Neurogenic Bladder in HAM/TSP?: “
Detrusor Arreflexia as an End Stage of Neurogenic Bladder in HAM/TSP?
Case Report Med. 2011;2011:289389
Authors: Tannus M, Tanajura D, Sundberg MA, Oliveira P, Castro N, Santos AM
The HTLV-1 virus is a known agent involved in the development of HAM/TSP. Past studies have typically observed patients with autonomic dysfunction consisting of detrusor overactivity and detrusor-sphincter dyssynergia, with the occasional observation of underactive detrusor or detrusor arreflexia. However, studies have not yet evaluated the progression of neurogenic bladder over time. In this paper, we describe a HAM/TSP patient with the initial development of overactive detrusor, and subsequent development of detrusor arreflexia. Given a paucity of studies characterizing the effects of HTLV-1 on the autonomic nervous system, particularly aspects controlling continence, this patient’s clinical course may represent one type of end point for patients with HAM/TSP and neurogenic bladder. Further cohort or case-series studies, with particular emphasis on the progression of neurogenic bladder, are needed to evaluate the significance of this described case in relation to typical disease progression patterns.
PMID: 21541226 [PubMed – in process]
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Last Updated: July 27, 2020 by uabadmin
Acute urinary retention in a 23-year-old woman with mild encephalopathy with a reversible splenial lesion: a case report.
Acute urinary retention in a 23-year-old woman with mild encephalopathy with a reversible splenial lesion: a case report.: “
Acute urinary retention in a 23-year-old woman with mild encephalopathy with a reversible splenial lesion: a case report.
J Med Case Reports. 2011 Apr 20;5(1):159
Authors: Kitami M, Kubo SI, Nakamura S, Shiozawa S, Isobe H, Furukawa Y
ABSTRACT: INTRODUCTION: Patients with clinically mild encephalitis/encephalopathy with a reversible splenial lesion present with relatively mild central nervous system disturbances. Although the exact etiology of the condition remains poorly understood, it is thought to be associated with infective agents. We present a case of a patient with mild encephalitis/encephalopathy with a reversible splenial lesion, who had the unusual feature of acute urinary retention. Case presentation A 23-year-old Japanese woman developed mild confusion, gait ataxia, and urinary retention seven days after onset of fever and headache. Magnetic resonance imaging demonstrated T2 prolongation in the splenium of the corpus callosum and bilateral cerebral white matter. These magnetic resonance imaging abnormalities disappeared two weeks later, and all of the symptoms resolved completely within four weeks. Except for the presence of acute urinary retention (due to underactive detrusor without hyper-reflexia), the clinical and radiologic features of our patient were consistent with those of previously reported patients with mild encephalitis/encephalopathy with a reversible splenial lesion. To the best of our knowledge, this is the first report of acute urinary retention recognized in a patient with mild encephalitis/encephalopathy with a reversible splenial lesion. Conclusion Our findings suggest that mild encephalitis/encephalopathy with a reversible splenial lesion can be associated with impaired bladder function and indicate that acute urinary retention in this benign disorder should be treated immediately to avoid bladder injury.
PMID: 21507219 [PubMed – as supplied by publisher]
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Last Updated: July 27, 2020 by uabadmin
Two screening tests for urinary voiding dysfunction used in 209 consecutive patients undergoing lumbar spine operations.
Two screening tests for urinary voiding dysfunction used in 209 consecutive patients undergoing lumbar spine operations.: “
Two screening tests for urinary voiding dysfunction used in 209 consecutive patients undergoing lumbar spine operations.
Scand J Urol Nephrol. 2010 Mar;44(2):106-12
Authors: Orlin JR, Klevmark B, Bjørnsen L, Hermansen P, Sanchez M
OBJECTIVE: A study of the prevalence of urinary voiding dysfunction was carried out preoperatively in 209 patients undergoing lumbar spine operations, using two non-invasive screening tests: free uroflowmetry and ultrasound measurement of residual urine. The value of using the two urodynamic screening tests in the evaluation of a larger group of patients with sciatica from disc lesions or spinal stenosis has not been published as an article before. MATERIAL AND METHODS: In 209 consecutive patients, 159 with lumbar disc lesions and 50 with lumbar spinal stenosis, the main indications for operative treatment were pain and/or somatic paresis. In preoperative interviews, information about voiding, anal and sexual functions were obtained. Then uroflowmetry was performed and the volume of residual urine was measured. In this study, the definition of normal bladder function is based on normal flow rates, the shape of the curves, normal voided volumes and the absence of significant residual urine. Bladder dysfunction differs from normal function by one, two, three or all four of these parameters. RESULTS: Normal bladder function was found in 66 patients (31.6%). The other 143 (68.4%) had signs that could indicate sensory paresis and/or neurogenic detrusor underactivity. Seventy-nine of the 143 were also tested 3 months postoperatively. In 58% the bladder function had improved. CONCLUSIONS: The very high prevalence of abnormal uroflowmetry and/or postvoiding residual urine suggestive of possible bladder dysfunction (68.4%) indicates that the two tests should be used routinely in cases of lumbar disc lesions and spinal stenosis. The two tests provide documentation of preoperative voiding function and a possibility of comparison with postoperative findings.
PMID: 20095869 [PubMed – in process]
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Last Updated: July 27, 2020 by uabadmin
Lower urinary tract function in patients with pituitary adenoma compressing hypothalamus.
Lower urinary tract function in patients with pituitary adenoma compressing hypothalamus.: “
Lower urinary tract function in patients with pituitary adenoma compressing hypothalamus.
J Neurol Neurosurg Psychiatry. 2005 Mar;76(3):390-4
Authors: Yamamoto T, Sakakibara R, Uchiyama T, Liu Z, Ito T, Yamanishi T, Hattori T
BACKGROUND: The micturition reflex is under the tonic influence of suprapontine structures including the anteromedial frontal cortex, basal ganglia, and hypothalamus. However, there have been few reports about the role of the hypothalamus on the lower urinary tract (LUT) function in humans. OBJECTIVE: To investigate LUT function in patients with pituitary adenomas. METHODS: Urodynamic studies were carried out in three patients with LUT symptoms who had pituitary adenomas extending upwards to the hypothalamus. RESULTS: All three male patients (age 28 to 62 years) developed LUT symptoms (urinary urgency and frequency (3); urinary incontinence (3); voiding difficulty and retention (2)) along with weight loss, psychiatric symptoms, unsteady gait, and/or visual disturbances. One had the syndrome of inappropriate secretion of antidiuretic hormone, but none had diabetes insipidus. Two had resection of the tumour and subsequent radiation therapy, but LUT dysfunction persisted. The third patient had partial resection of the tumour to ameliorate hydrocephalus. Urodynamic studies showed detrusor overactivity during the storage phase in all patients; during the voiding phase there was underactive detrusor in two and non-relaxing sphincter in one. CONCLUSIONS: Hypothalamic lesions can cause severe LUT dysfunction in both the storage and voiding phases of micturition. This may reflect the crucial role of the hypothalamus in regulating micturition in humans.
PMID: 15716534 [PubMed – indexed for MEDLINE]
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Last Updated: July 27, 2020 by uabadmin
Sacral neuromodulation in patients with multiple sclerosis.
Sacral neuromodulation in patients with multiple sclerosis.: “
Sacral neuromodulation in patients with multiple sclerosis.
World J Urol. 2011 Mar 15;
Authors: Minardi D, Muzzonigro G
PURPOSE: We present a case series of patients with multiple sclerosis (MS) and neurogenic lower urinary tract dysfunction treated by sacral neuromodulation (SNM). METHODS: We reviewed charts of 25 patients who were treated for refractory lower urinary tract symptoms; during the SNM testing phase, patient management included evaluation of number of daily voiding, number of episodes of incontinence, residual urine and quality of life score. Patients who experienced greater than 50% improvement in symptoms of frequency and incontinence episodes and/or a greater than 50% decrease in the number of catheterizations and a greater than 50% increase in voided volumes were offered placement of the permanent InterStim(TM) . RESULTS: Fifteen patients were implanted with InterStim(TM); mean duration of MS was 13.66 years; mean follow-up of patients was 49.4 months. Nine patients were on clean intermittent catheterization, and in all of them, a significant decrease in residual volume with increase in voided volume and number of voiding per day; in 6 patients, the main problem was incontinence, and in them incontinence, episodes decreased and voided volume increased. Sixty-six per cent of patients have a functioning device after a mean follow-up of 61.2 months. CONCLUSIONS: SNM is a good option in the treatment of voiding dysfunction in patients with MS in a medium to long-term follow-up. Urinary retention due to detrusor underactivity is not a good indication for SNM; it should be offered to MS patients with refractory urgency urinary incontinence and MS patients with urinary retention due to detrusor-sphincter dyssynergia (DSD).
PMID: 21400258 [PubMed – as supplied by publisher]
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