Ultrasound estimated bladder weight in men attending the uroflowmetry clinic.: “
Ultrasound estimated bladder weight in men attending the uroflowmetry clinic.
Neurourol Urodyn. 2011 Feb 9;
Authors: Bright E, Pearcy R, Abrams P
AIMS: To determine if measurements of ultrasound estimated bladder weight (UEBW) provide an additional diagnostic tool when assessing men with lower urinary tract symptoms (LUTS) in the uroflowmetry clinic. METHODS: One hundred men with LUTS attending the uroflowmetry clinic underwent transabdominal ultrasound measurement of bladder weight, using the BVM 9500 bladder scanner (Verathon Medical, Bothell, WA). These data were explored for any correlation between measurements of maximum flow rate (Q(max) ) with UEBW, age, height, weight, body mass index (BMI), ICIQ M-LUTS score, M-LUTS voiding score, M-LUTS incontinence score, IPSS, IPSS quality of life score, voided volume, and post-void residual urine. Based on previously reported probabilities of bladder outlet obstruction (BOO), patients were grouped for analysis (Group 1 = Q(max) <10, Group 2 = Q(max) 10-15, Group 3 = Q(max) >15). A one-way ANOVA was undertaken to assess any difference in mean UEBW between the three groups. RESULTS: Statistically significant negative correlations between Q(max) and age (r = -0.308, P = 0.002), M-LUTS voiding score (r = -0.298, P = 0.003), IPSS (r = -0.295, P = 0.003), and post-void residual (r = -0.213, P = 0.033) were observed. A statistically significant positive correlation between Q(max) and voided volume (r = 0.503, P < 0.01) was observed. No association between Q(max) and UEBW was observed (r = 0.12, P = 0.243). Mean UEBW for the three groups was remarkably similar. One-way ANOVA identified there was no statistically significant effect of UEBW on Q(max) F(2, 97) = 0.175, P = 0.840. CONCLUSION: Mean UEBW did not differ significantly between the three Q(max) groups. Further work is required to investigate the relationship of Q(max) and UEBW in men with urodynamic confirmation of either BOO or detrusor underactivity. Neurourol. Urodynam. © 2011 Wiley-Liss, Inc.
PMID: 21308749 [PubMed – as supplied by publisher]
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Last Updated: July 27, 2020 by uabadmin
Idiopathic Parkinson’s disease patients at the urologic clinic.
Idiopathic Parkinson’s disease patients at the urologic clinic.: “
Idiopathic Parkinson’s disease patients at the urologic clinic.
Neurourol Urodyn. 2011 Mar 14;
Authors: Ragab MM, Mohammed ES
AIMS: To quantitatively evaluate the urinary symptoms at different stages of idiopathic Parkinson’s disease (IPD) severity and its relation to urodynamic parameters. METHODS: This study was conducted on 49 patients with probable IPD to quantitatively evaluate their urinary symptoms using International Prostate Symptom Score and urodynamic tests. Four, 10, 29, 5, and 1 cases were classified as stages 1-5, respectively, according to Hoehn and Yahr staging of IPD severity. RESULTS: The most prevailing urinary symptom in IPD was nocturia (77.5%) followed by urgency (36.7%) and frequency (32.6%). Urodynamic tests revealed neurogenic detrusor overactivity in 33 patients (67.3%), detrusor underactivity in 6 patients (12.2%), and 10 (20.4%) patients with normal detrusor function. Irritative symptom index score correlated significantly with disease severity as well as the volume at initial desire to void and maximum bladder capacity meanwhile obstructive symptom index score had no significant correlation with any of the urodynamic parameters or disease severity. Total IPSS symptoms score significantly correlated with quality of life score. The mean of urodynamic parameters did not differ in IPD patients who did or did not receive anticholinergic or dopaminergic drugs. CONCLUSION: The irritative urinary symptoms manifested urodynamically as neurogenic detrusor overactivity are more common in IPD patients than obstructive symptoms. These irritative symptoms deteriorate progressively with the disease severity and significantly affect the quality of life of these patients. The International Prostate Symptom Score is a valuable tool in evaluating the urinary dysfunction in such patients. © 2011 Wiley-Liss, Inc.
PMID: 21404318 [PubMed – as supplied by publisher]
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Last Updated: July 27, 2020 by uabadmin
Is lumbar spondylosis a cause of urinary retention in elderly women?
Is lumbar spondylosis a cause of urinary retention in elderly women?: “
Is lumbar spondylosis a cause of urinary retention in elderly women?
J Neurol. 2005 Aug;252(8):953-7
Authors: Sakakibara R, Yamamoto T, Uchiyama T, Liu Z, Ito T, Yamazaki M, Awa Y, Yamanishi T, Hattori T
OBJECTIVES: Lumbar spondylosis (LS) is a common spinal degenerative disorder which causes various types of lower urinary tract dysfunction (LUTD). However, it is not certain whether LS may cause urinary retention in elderly women. METHODS: In a period covering the past 3 years, we retrospectively reviewed: a) urodynamic case records of women with urinary retention (post-void residuals, PVR > 100 ml), b) the records of women with LUTD due to LS (cauda equina syndrome and spinal canal narrowing by MRI), and c) uro-neurological features of women who belonged to both a) and b). RESULTS: a) One-hundred women with a mean age of 58 years had urinary retention. The most common underlying disease was multiple system atrophy [19], followed by multiple sclerosis [13] and cervical/thoracic tumours [8]. LS was the fourth most common [5], with the highest age (71 years) of all diseases. b) Nineteen women with LUTD had LS (12, canal narrowing of 50-70%; 7 > 70 %), with a mean PVR volume of 60 ml. A fourth [5] of them had urinary retention, with severe spinal canal narrowing (all 5 > 70%). c) Thus, 5 women belonged to both a) and b). In 4 of these women, LUTD followed or occurred together with typical cauda equina syndrome symptoms such as sciatica and saddle anesthesia. However, one elderly woman presented with painless urinary retention, and absent ankle reflexes were the sole neurological abnormality. The urodynamic abnormalities underlying urinary retention included an underactive detrusor in all 5, bladder sensory impairment in 3, an unrelaxing sphincter in 2, a low compliance detrusor in one, neurogenic sphincter motor unit potentials in 2 of 4 studied, and cholinergic supersensitivity of the detrusor in one of 3 studied. Surgical decompression ameliorated urinary retention in 1 of 2 women who had surgery. CONCLUSIONS: In our series, only 5 percent of the women with urinary retention had LS, but LS poses a potential risk for retention, particularly in elderly women with severe spinal canal narrowing. Preganglionic somato-autonomic dysfunctions underlie this condition. It may appear as the sole initial complaint in cases in which no other obvious neurological abnormalities are found.
PMID: 15778810 [PubMed – indexed for MEDLINE]
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Last Updated: July 27, 2020 by uabadmin
Urodynamics in women from menopause to oldest age: What motive? What diagnosis?
Urodynamics in women from menopause to oldest age: What motive? What diagnosis?: “
Urodynamics in women from menopause to oldest age: What motive? What diagnosis?
Int Braz J Urol. 2011 Jan-Feb;37(1):100-7
Authors: Valentini FA, Robain G, Marti BG
Purpose: To analyze age-associated changes as a motive for urodynamics and urodynamic diagnosis in community-dwelling menopausal women and to discuss the role of menopause and ageing. Materials and Methods: Four hundred and forty nine consecutive menopausal women referred for urodynamic evaluation of lower urinary tract (LUT) symptoms, met the inclusion criteria and were stratified into 3 age groups: 55-64 years (A), 65-74 years (B), and 75-93 years (C). Comprehensive assessment included previous medical history and clinical examination. Studied items were motive for urodynamics, results of uroflows (free flow and intubated flow) and cystometry, urethral pressure profilometry, and final urodynamic diagnosis. Results: The main motive was incontinence (66.3%) with significant increase of mixed incontinence in group C (p = 0.028). Detrusor function significantly deteriorated in the oldest group, mainly in absence of neurological disease (overactivity p = 0.019; impaired contractility p = 0.028). In the entire population, underactivity predominated in group C (p = 0.0024). A progressive decrease of maximum urethral closure pressure occurred with ageing. In subjects with no detrusor overactivity there was a decrease with age of detrusor pressure at opening and at maximum flow, and of maximum flow while post void residual increased only in the C group. Conclusion: In our population of community-dwelling menopausal women, incontinence was the main motive for urodynamics increasing with ageing. A brisk change in LUT function of women older than 75 years underlined deterioration in bladder function with a high incidence of detrusor hyperactivity with or without impaired contractility while change in urethral function was progressive. Effect of ageing appears to be predominant compared to menopause.
PMID: 21385486 [PubMed – in process]
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Last Updated: July 27, 2020 by uabadmin
Alteration of autonomic function in female urinary incontinence.
Alteration of autonomic function in female urinary incontinence.: “
Alteration of autonomic function in female urinary incontinence.
Int Neurourol J. 2010 Dec;14(4):232-7
Authors: Kim JC, Joo KJ, Kim JT, Choi JB, Cho DS, Won YY
Stress urinary incontinence (SUI) and urge urinary incontinence (UUI) have different mechanisms of action. We believe that alteration of autonomic nervous system (ANS) activity may contribute to UUI because the lower urinary tract is regulated through the sympathetic and parasympathetic nervous systems. Heart rate variability (HRV) allows measurement of autonomic nervous function, therefore we measured and compared HRV parameters in women with urinary incontinence.
PMID: 21253334 [PubMed – in process]
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Last Updated: July 27, 2020 by uabadmin
Ultrasound estimated bladder weight in men attending the uroflowmetry clinic.
Ultrasound estimated bladder weight in men attending the uroflowmetry clinic.: “
Ultrasound estimated bladder weight in men attending the uroflowmetry clinic.
Neurourol Urodyn. 2011 Feb 9;
Authors: Bright E, Pearcy R, Abrams P
AIMS: To determine if measurements of ultrasound estimated bladder weight (UEBW) provide an additional diagnostic tool when assessing men with lower urinary tract symptoms (LUTS) in the uroflowmetry clinic. METHODS: One hundred men with LUTS attending the uroflowmetry clinic underwent transabdominal ultrasound measurement of bladder weight, using the BVM 9500 bladder scanner (Verathon Medical, Bothell, WA). These data were explored for any correlation between measurements of maximum flow rate (Q(max) ) with UEBW, age, height, weight, body mass index (BMI), ICIQ M-LUTS score, M-LUTS voiding score, M-LUTS incontinence score, IPSS, IPSS quality of life score, voided volume, and post-void residual urine. Based on previously reported probabilities of bladder outlet obstruction (BOO), patients were grouped for analysis (Group 1 = Q(max) <10, Group 2 = Q(max) 10-15, Group 3 = Q(max) >15). A one-way ANOVA was undertaken to assess any difference in mean UEBW between the three groups. RESULTS: Statistically significant negative correlations between Q(max) and age (r = -0.308, P = 0.002), M-LUTS voiding score (r = -0.298, P = 0.003), IPSS (r = -0.295, P = 0.003), and post-void residual (r = -0.213, P = 0.033) were observed. A statistically significant positive correlation between Q(max) and voided volume (r = 0.503, P < 0.01) was observed. No association between Q(max) and UEBW was observed (r = 0.12, P = 0.243). Mean UEBW for the three groups was remarkably similar. One-way ANOVA identified there was no statistically significant effect of UEBW on Q(max) F(2, 97) = 0.175, P = 0.840. CONCLUSION: Mean UEBW did not differ significantly between the three Q(max) groups. Further work is required to investigate the relationship of Q(max) and UEBW in men with urodynamic confirmation of either BOO or detrusor underactivity. Neurourol. Urodynam. © 2011 Wiley-Liss, Inc.
PMID: 21308749 [PubMed – as supplied by publisher]
“
Last Updated: July 27, 2020 by uabadmin
Progressive supranuclear palsy presenting with urinary retention and sleep apnea.
Progressive supranuclear palsy presenting with urinary retention and sleep apnea.: “
Progressive supranuclear palsy presenting with urinary retention and sleep apnea.
Clin Auton Res. 2011 Jan 6;
Authors: Tateno F, Sakakibara R, Kishi M, Yuasa T, Ogawa E, Takahashi O, Yoshio S, Sugiyama M, Uchiyama T, Yamamoto T, Yamanishi T
We report a case of a 62-year-old Japanese-Australian woman with progressive supranuclear palsy (PSP) who presented with prominent urinary retention, neurogenic changes in sphincter electromyography, and obstructive sleep apnea syndrome. Urodynamic study revealed a combination of detrusor overactivity during filling and underactivity during voiding. All these non-motor symptoms in PSP mimicked those of multiple system atrophy.
PMID: 21210294 [PubMed – as supplied by publisher]
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Last Updated: July 27, 2020 by uabadmin
Videourodynamics in patients with neurogenic bladder due to multiple sclerosis: our experience.
Videourodynamics in patients with neurogenic bladder due to multiple sclerosis: our experience.: “
Videourodynamics in patients with neurogenic bladder due to multiple sclerosis: our experience.
Radiol Med. 2011 Jan 12;
Authors: Caramella D, Donatelli G, Armillotta N, Manassero F, Traversi C, Frumento P, Pistolesi D, Selli C
PURPOSE: The aims of this study were to: (a) analyse the most frequent morphofunctional features of the lower urinary tract observed during videourodynamic examination in patients with neurogenic bladder due to multiple sclerosis; (b) investigate the role of the videourodynamic examination in the clinical management of these patients; and (c) demonstrate the relationship between morphological and functional variables. MATERIALS AND METHODS: We performed videourodynamic examinations in 75 patients affected by neurogenic bladder secondary to multiple sclerosis. RESULTS: The introduction of pharmacological therapy, based on clinical and functional evaluation of the lower urinary tract, is correlated with satisfactory morphofunctional outcomes, reducing moderate-to-severe postvoid residual (PVR; p < 0.1) and compliance (p < 0.05) at the price of reduced bladder sensation. Clinical management of these patients based on morphological evaluation of the lower urinary tract decreased the occurrence of detrusor-sphincter dyssynergy (DSD) and detrusor overactivity incontinence at the following examination. CONCLUSIONS: Our study confirmed a relationship between detrusor overactivity and hypertonic bladder, bladder diverticula, vesicoureteral reflux, between detrusor underactivity and PVR and between DSD and bladder diverticula. Our data show how the videourodynamic examination may improve evaluation and urological management of these patients.
PMID: 21225364 [PubMed – as supplied by publisher]
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Last Updated: July 27, 2020 by uabadmin
Overactive and underactive bladder dysfunction is reflected by alterations in urothelial ATP and NO release.
Overactive and underactive bladder dysfunction is reflected by alterations in urothelial ATP and NO release.: “
Overactive and underactive bladder dysfunction is reflected by alterations in urothelial ATP and NO release.
Neurochem Int. 2010 Dec 8;
Authors: Munoz A, Smith CP, Boone TB, Somogyi GT
ATP and NO are released from the urothelium in the bladder. Detrusor overactivity (DO) following spinal cord injury results in higher ATP and lower NO release from the bladder urothelium. Our aim was to study the relationship between ATP and NO release in (1) early diabetic bladders, an overactive bladder model; and (2) ‘diuretic’ bladders, an underactive bladder model. To induce diabetes mellitus female rats received 65mg/kg streptozocin (i.v.). To induce chronic diuresis rats were fed with 5% sucrose. At 28 days, in vivo open cystometry was performed. Bladder wash was collected to analyze the amount of ATP and NO released into the bladder lumen. For in vitro analysis of ATP and NO release, a Ussing chamber was utilized and hypoosmotic Krebs was perfused on the urothelial side of the chamber. ATP was analyzed with luminometry or HPLC-fluorometry while NO was measured with a Sievers NO-analyzer. In vivo ATP release was increased in diabetic bladders and unchanged in diuretic bladders. In vitro release from the urothelium followed the same pattern. NO release was unchanged both in vitro and in vivo in overactive bladders whereas it was enhanced in underactive bladders. We found that the ratio of ATP/NO, representing sensory transmission in the bladder, was high in overactive and low in underactive bladder dysfunction. In summary, ATP release has a positive correlation while NO release has a negative correlation with the bladder contraction frequency. The urinary ATP/NO ratio may be a clinically relevant biomarker to characterize the extent of bladder dysfunction.
PMID: 21145365 [PubMed – as supplied by publisher]
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Last Updated: July 27, 2020 by uabadmin
Voiding dynamics in women with stress urinary incontinence and high-stage cystocele.
Voiding dynamics in women with stress urinary incontinence and high-stage cystocele.: “
Voiding dynamics in women with stress urinary incontinence and high-stage cystocele.
Int J Urol. 2011 Jan 10;
Authors: Seki N, Shahab N, Hara R, Takei M, Yamaguchi A, Naito S
Objectives: The aim of this study was to identify the urodynamic features of women with stress urinary incontinence (SUI) or with high-stage (stage 3 or greater) cystocele (HSC) as compared with symptom-free women. Methods: Fifty-six neurologically intact women with SUI and 47 women with HSC but without SUI were prospectively evaluated. All patients underwent full urodynamics, in addition to basic clinical evaluations. The urodynamic parameters of SUI and HSC were compared to the ones obtained from 78 urologically symptom-free normal women over the same period. Results: Patients with HSC, after correction of cystocele using a temporary vaginal pessary, had consistently lower maximum urinary flow rate with a lower detrusor pressure during micturition than the controls or those with SUI. On the other hand, patients with SUI had an equivalent to higher maximum urinary flow rate, normal detrusor contraction strength with a lower detrusor pressure during micturition than the controls. Both maximum Watts factor and bladder contractility index were significantly lower in the whole HSC cohort in comparison to the controls and patients with SUI. The urodynamic characteristics observed among the three groups were all maintained even after adjusting for age. Conclusions: Women with SUI demonstrate voiding with low-pressure, normal contraction strength with an equivalent to high urinary flow rate. Women with HSC demonstrate voiding with low pressures with weak contraction strengths and low urinary flow rates, suggesting a higher prevalence of detrusor underactivity. Chronically decreased or increased urethral resistance might alter voiding dynamics and performance.
PMID: 21219445 [PubMed – as supplied by publisher]
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Last Updated: July 27, 2020 by uabadmin
Overactive and underactive bladder Dysfunction Is Reflected by Alterations in Urothelial ATP and NO release.
Overactive and underactive bladder Dysfunction Is Reflected by Alterations in Urothelial ATP and NO release.: “
Overactive and underactive bladder Dysfunction Is Reflected by Alterations in Urothelial ATP and NO release.
Neurochem Int. 2010 Dec 7;
Authors: Munoz A, Smith CP, Boone TB, Somogyi GT
ATP and NO are released from the urothelium in the bladder. Detrusor Overactivity (DO) following spinal cord injury results in higher ATP and lower NO release from the bladder urothelium. Our aim was to study the relationship between ATP and NO release in 1) early diabetic bladders, an overactive bladder model; and 2) in ‘diuretic’ bladders, an underactive bladder model. To induce diabetes mellitus female rats received 65mg/kg streptozocin (i.v.). To induce chronic diuresis rats were fed with 5% sucrose. At 28 days, in vivo open cystometry was performed. Bladder wash was collected to analyze the amount of ATP and NO released into the bladder lumen. For in vitro analysis of ATP and NO release, a Ussing chamber was utilized and hypoosmotic Krebs was perfused on the urothelial side of the chamber. ATP was analyzed with luminometry or HPLC-fluorometry while NO was measured with a Sievers NO-analyzer. In vivo ATP release was increased in diabetic bladders and unchanged in diuretic bladders. In vitro release from the urothelium followed the same pattern. NO release was unchanged both in vitro and in vivo in overactive bladders whereas it was enhanced in underactive bladders. We found that the ratio of ATP/NO, representing sensory transmission in the bladder, was high in overactive and low in underactive bladder dysfunction. In summary, ATP release has a positive correlation while NO release has a negative correlation with the bladder contraction frequency. The urinary ATP/NO ratio may be a clinically relevant biomarker to characterize the extent of bladder dysfunction.
PMID: 21145365 [PubMed – as supplied by publisher]
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