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1.
Int. braz. j. urol ; 47(6): 1189-1194, Nov.-Dec. 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1340022

RESUMO

ABSTRACT Introduction: The 24-hour bladder diary is considered to be the gold standard for evaluating maximum voided volume (MVV). However, we observed that patients often have a greater MVV during office uroflowmetry than that seen in the bladder diary. The purpose of this study is to compare these two non-invasive methods by which MVV can be determined - at the time of uroflowmetry (Q-MVV), or by 24hour bladder diary (BD-MVV). Materials and Methods: This was an Institutional Review Board approved retrospective study of patients evaluated for LUTS who completed a 24hour bladder diary and contemporaneous uroflowmetry. For Q-MVV, the patient was instructed to wait to void until their bladder felt full. Sample means were compared, and Pearson's correlations were calculated between the Q-MVV and BD-MVV data across the total sample, women, and men. Results: Seven hundred seventy one patients with LUTS completed bladder diaries. Of these, 400 patients, 205 women and 195 men, had contemporaneous Q-MVV. Mean BD-MVV was greater than mean Q-MVV. However, Q-MVV was larger in a sizable minority of patients. There was a weak correlation between BD-MVV and Q-MVV. Furthermore, there was a difference ≥50% between Q-MVV and BD-MVV in 165 patients (41%). Conclusions: The data suggest that there is a difference between the two measurement tools, and that the BD-MVV was greater than Q-MVV. For a more reliable assessment of MVV, this study suggests that both Q-MVV and BD-MVV should be assessed and that the larger of the two values is a more reliable assessment of MVV.


Assuntos
Humanos , Masculino , Feminino , Urodinâmica , Bexiga Urinária , Procedimentos Cirúrgicos Urológicos , Micção , Estudos Retrospectivos
2.
Int. braz. j. urol ; 47(6): 1178-1188, Nov.-Dec. 2021. tab
Artigo em Inglês | LILACS | ID: biblio-1340032

RESUMO

ABSTRACT Aims: To evaluate autonomic activity in children/adolescents with isolated overactive bladder. Materials and Methods: Descriptive, analytical, non-interventional, cross-sectional study conducted between February 2017 and January 2018 with individuals aged between 5 and 17 years old, with overactive bladder (OAB group) or asymptomatic (control). Neurological or anatomical abnormalities, diabetes mellitus and kidney failure constituted exclusion criteria. The DVSS and the Rome III questionnaire were applied, and heart rate variability (HRV) was assessed. The chi-square test, Student's t-test, ANOVA and the Mann Whitney U test were used in the statistical analysis. Results: 41 patients with OAB and 20 controls were included. In the OAB group, there were more girls (p=0.23), more overweight/obese and constipated patients. The DVSS score was higher in the OAB group. HRV showed a higher heart rate variability at the frequency domain and LF/HF variation in the control group (p=0.02 and p=0.05 respectively). In the intergroup evaluation, LF (Hz) was predominant in the control group at the post-voiding evaluation moment (p=0.03). Conclusion: The control group demonstrated a physiological heart rate variation during the voiding process, with a predominance of sympathetic activity during urinary storage.


Assuntos
Humanos , Feminino , Pré-Escolar , Criança , Adolescente , Bexiga Urinária Hiperativa , Sistema Nervoso Autônomo , Micção , Estudos Transversais , Frequência Cardíaca
5.
Bol. méd. postgrado ; 36(2): 43-47, dic.2020. tab, graf
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1117899

RESUMO

La uroflujometría es un estudio no invasivo del tracto urinario inferior que entrega información objetiva del flujo urinario y es ampliamente recomendado por las guías europeas en el estudio de pacientes con sintomatología urinaria baja. Se realizó un estudio descriptivo transversal cuyo propósito fue describir el uso de la uroflujometría en el estudio de síntomas del tracto urinario bajo en pacientes masculinos que acudieron a la consulta de Servicio de Urología del Hospital Central Universitario Dr. Antonio María Pineda de la ciudad de Barquisimeto, estado Lara durante el lapso 2018- 2019. La muestra estuvo conformada por 150 pacientes. Los resultados indican que el 62% de la muestra corresponde a pacientes entre 60 y 70 años de edad de los cuales 52% manifestaron síntomas urinarios leves. La uroflujometría evidenció que 56% de los pacientes tienen un flujo máximo entre 10 y 20 ml/seg lo cual sugiere una probable obstrucción al flujo de salida; 78% de los pacientes presentan un flujo promedio entre 0 a 10 ml/seg. El 53% de los pacientes mostró un volumen de vaciado < 300 ml y 49% un tiempo de flujo máximo entre 30 y 50 segundos. En conclusión, la uroflujometría es un examen simple y rápido que proporciona información útil sobre la salud de las vías urinarias inferiores(AU)


Uroflowmetry is a non-invasive study of the lower urinary tract that provides objective information on urinary flow and is widely recommended by European guidelines for the study of patients with lower urinary tract symptoms. We performed a cross-sectional descriptive study to describe the use of uroflowmetry for the study of lower urinary tract symptoms in males who attended the Servicio de Urología of the Hospital Central Universitario Dr. Antonio María Pineda (Barquisimeto, Lara state) during the 2018- 2019 period. The sample was made up of 150 males. The results show that 62% of the sample included males between 60 and 70 years old and 52% complained of mild urinary symptoms. Uroflowmetry results showed that 56% of patients had a maximum flow between 10 and 20 ml/sec suggestive of urinary tract obstruction; 78% had an average flow between 0 and 10 ml/sec while 53% had a micturition volume < 300 ml and 49% had a maximum flow time between 30 and 50 seconds. Uroflowmetry is a simple and fast test which provides useful information about the health of lower urinary tract(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Obstrução Uretral , Sistema Urinário , Prostatismo/diagnóstico por imagem , Tratamento Conservador/métodos , Micção , Doenças Urológicas , Ultrassonografia
6.
Prensa méd. argent ; 106(9): 550-554, 20200000.
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1362905

RESUMO

Objectives: This study aimed to assess the accuracy of post-void residual (PVR) urine volume measurements in patients with moderate bladder outlet obstruction. Materials and Methods: This prospective observational study was conducted between January and December 2019. The inclusion criteria were male patients with symptoms of moderate bladder outlet obstruction. On the other hand, patients with a history of diabetes, symptoms of urinary tract infection, and positive urine for pyuria, as well as patients using medications, such as diuretics, alpha-blockers, and anticholinergic drugs, were excluded. The patients were asked to drink 1000 mL of water one to two hours before the initial ultrasound scan. Pre-void bladder capacity was measured, followed by a post-void ultrasound for residual urine volume measurement at three intervals: immediately after voiding, 15-20 minutes after the first void, and one week later with an empty bladder. Assessment of per-void capacity was carried out, based on the patient's subjective sensation of bladder fullness (a strong desire to void). Results: A total of 78 male patients, with the mean age of 60 years, were included in this study (27 cases in group I; 37 cases in group II; and 14 cases in group III). The mean PVR volume was 92 mL in the first measurement, 62 mL in the second measurement, and 60 mL in the third measurement. Significant differences were found between the first and second PVR measurements and between the first and third PVR measurements (P<0.05). However, no significant difference was found between the second and third PVR measurements (P=0.107). On the other hand, significant differences were found between groups I and II and between groups I and III (P<0.05) in the three PVR measurements. Nevertheless, there was no significant difference between groups II and III in the three PVR measurements (P=0.204, 0.56, and 0.487 for the first, second, and third PVR measurements, respectively). Conclusion: A bladder ultrasound must be performed and interpreted carefully to avoid further unnecessary medications, investigations, or procedures. We recommend a second PVR measurement in patients with bladder outlet obstruction. Also, it is suggested to conduct similar studies in different conditions to confirm our findings.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Obstrução Uretral/complicações , Micção , Urina , Bexiga Urinária/patologia , Ultrassonografia
7.
Prensa méd. argent ; 106(8): 503-507, 20200000.
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1363926

RESUMO

Objectives: This study aimed to assess the accuracy of post-void residual (PVR) urine volume measurements in patients with moderate bladder outlet obstruction. Materials and Methods: This prospective observational study was conducted between January and December 2019. The inclusion criteria were male patients with symptoms of moderate bladder outlet obstruction. On the other hand, patients with a history of diabetes, symptoms of urinary tract infection, and positive urine for pyuria, as well as patients using medications, such as diuretics, alphablockers, and anticholinergic drugs, were excluded. The patients were asked to drink 1000 mL of water one to two hours before the initial ultrasound scan. Pre-void bladder capacity was measured, followed by a post-void ultrasound for residual urine volume measurement at three intervals: immediately after voiding, 15-20 minutes after the first void, and one week later with an empty bladder. Assessment of per-void capacity was carried out, based on the patient's subjective sensation of bladder fullness (a strong desire to void). Results: A total of 78 male patients, with the mean age of 60 years, were included in this study (27 cases in group I; 37 cases in group II; and 14 cases in group III). The mean PVR volume was 92 mL in the first measurement, 62 mL in the second measurement, and 60 mL in the third measurement. Significant differences were found between the first and second PVR measurements and between the first and third PVR measurements (P<0.05). However, no significant difference was found between the second and third PVR measurements (P=0.107). On the other hand, significant differences were found between groups I and II and between groups I and III (P<0.05) in the three PVR measurements. Nevertheless, there was no significant difference between groups II and III in the three PVR measurements (P=0.204, 0.56, and 0.487 for the first, second, and third PVR measurements, respectively). Conclusion: A bladder ultrasound must be performed and interpreted carefully to avoid further unnecessary medications, investigations, or procedures. We recommend a second PVR measurement in patients with bladder outlet obstruction. Also, it is suggested to conduct similar studies in different conditions to confirm our findings.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Obstrução Uretral , Micção , Obstrução do Colo da Bexiga Urinária/urina , Estudos Prospectivos , Ultrassonografia , Coleta de Urina
8.
Rev. Col. Bras. Cir ; 47: e20202605, 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1136559

RESUMO

ABSTRACT Introduction: despite being infrequent, urinary incontinence has a huge impact on the quality of life of patients undergoing radical prostatectomy, even with the robotic-assisted technique. Objective: to assess the evolution of urinary symptoms from preoperative to 12 months after robotic-assisted radical prostatectomy. Methods: data was collected from 998 patients who underwent robotic-assisted radical prostatectomy. Demographic data, preoperative and postoperative information on patients were documented. The ICIQ and IPSS questionnaires were also applied preoperatively and after 1, 3, 6 and 12 months after the operation. Results: Out of 998 patients, 257 correctly completed all questionnaires. The mean age of the patients was 60 ± 0.74 years. We found that the total IPSS increased initially and at 6 months after the operation, it was already lower than the initial preoperative value (7.76 at 6 months vs. 9.90 preoperative, p <0.001), being that questions regarding voiding symptoms were the first to improve followed by the questions regarding post micturition and storage symptoms. As for the ICIQ variables, there was an increase with radical prostatectomy and none of them returned to the preoperative level (p<0.001). Conclusions: robotic assisted radical prostatectomy causes, at first, a worsening of urinary symptoms in the lower tract with subsequent recovery. Recovery begins with voiding symptoms, followed by post micturition and storage symptoms. The symptoms assessed by the IPSS evolve to better parameters even than those of the preoperative period, while the symptoms of incontinence assessed by the ICIQ do not reach the preoperative levels in the studied interval.


RESUMO Introdução: apesar de infrequente, a incontinência urinária gera imenso impacto na qualidade de vida dos pacientes submetidos a prostatectomia radical, mesmo com a técnica robótica-assistida. Objetivo: avaliar a evolução dos sintomas urinários desde o pré-operatório até 12 meses após a prostatectomia radical robótica-assistida. Métodos: foram coletados os dados de 998 pacientes submetidos à prostatectomia radical robótica-assistida. Foram documentados dados demográficos, informações pré-operatórias e pós-operatórias dos pacientes. Também foram aplicados os questionários ICIQ e IPSS no pré-operatório e após 1, 3, 6 e 12 meses de pós-operatório. Resultados: de 998 pacientes, 257 preencheram corretamente todos os questionários. A idade média dos pacientes foi de 60±0,74 anos. Verificou-se que o IPSS total subia inicialmente e aos 6 meses após a operação, este já se tornava inferior ao valor inicial pré-operatório (7,76 aos 6 meses vs. 9,90 pré-operatório, p<0.001), sendo que as questões referentes a sintomas de esvaziamento foram as primeiras a melhorar e posteriormente as questões referentes a sintomas pós-miccionais e de armazenamento. Quanto às variáveis do ICIQ, houve elevação com a prostatectomia radical e nenhuma delas retornou ao patamar pré-operatório (p<0,001). Conclusões: a prostatectomia radical robótica assistida causa num primeiro momento uma piora nos sintomas urinários do trato inferior com uma recuperação subsequente. A recuperação se inicia pelos sintomas de esvaziamento, seguido dos sintomas pós-miccionais e de armazenamento. Os sintomas avaliados pelo IPSS acabam evoluindo a parâmetros melhores inclusive que os do pré-operatório, enquanto os sintomas de perda urinária avaliados pelo ICIQ não atingem os níveis pré-operatórios no intervalo estudado.


Assuntos
Humanos , Masculino , Idoso , Prostatectomia/efeitos adversos , Neoplasias da Próstata/cirurgia , Qualidade de Vida , Incontinência Urinária/etiologia , Transtornos Urinários/etiologia , Sintomas do Trato Urinário Inferior/complicações , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Prostatectomia/métodos , Micção , Resultado do Tratamento , Pessoa de Meia-Idade
9.
Fisioter. Bras ; 20(5): 675-680, Outubro 24, 2019.
Artigo em Português | LILACS | ID: biblio-1281736

RESUMO

A dengue pode desencadear manifestações neurológicas como a Síndrome de Encefalomielite Aguda Disseminada (ADEM), de caráter inflamatório, desmielinizante, que pode ter dentre as consequências déficits motores e sensitivos, neurite ótica e disfunções vesicais, como a retenção urinária, tornando o indivíduo dependente da realização do cateterismo vesical intermitente (CVI). Desta forma, o objetivo deste estudo é descrever o tratamento fisioterapêutico de uma paciente com retenção urinária, decorrente de Síndrome de ADEM pós-dengue. Paciente do sexo feminino, 52 anos, internada em hospital de média complexidade com diagnóstico de ADEM. Na avaliação inicial apresentava grau de força muscular 3 de membros inferiores e 4 de membros superiores, 2 de musculatura do assoalho pélvico (MAP) e retenção urinária, necessitando realizar CVI. Foram realizados 32 atendimentos com duração de uma hora, incluindo o treinamento do assoalho pélvico em diferentes posturas e eletroestimulação de superfície da MAP com equipamento da marca Ibramed. Paciente recebeu alta hospitalar com evidente melhora da força muscular global e sem necessidade de CVI, apresentando micção voluntária e sem resíduo pós-miccional, favorecendo a prevenção de agravos do trato urinário inferior e superior. (AU)


Dengue can trigger neurological manifestations such as Acute Disseminated Encephalomyelitis (ADEM), with inflammatory, demyelinating condition, which may have, among the consequences, motor and sensory deficits, optic neuritis and bladder dysfunctions, such as urinary retention, making the individual dependent on intermittent bladder catheterization (IBC). Therefore, the objective of this study was to describe the physiotherapeutic treatment of a patient with urinary retention, due to ADEM syndrome after dengue. A 52-year-old female patient admitted to a hospital of medium complexity with a diagnosis of ADEM. In the initial evaluation, she presented a degree 3 of muscular strength in the lower limbs and 4 in the upper limbs, 2 in pelvic floor musculature (PFM) and urinary retention, requiring IBC. We performed 32 one hour sessions, including pelvic floor muscle training in different positions and surface electrostimulation of PFM with Ibramed brand equipment. Patient was discharged with evident improvement of global muscle strength and without IBC, presenting voluntary voiding and without post void residual, favoring the prevention of lower and upper urinary tract injuries. (AU)


Assuntos
Humanos , Retenção Urinária , Diafragma da Pelve , Encefalomielite Aguda Disseminada , Micção , Bexiga Urinaria Neurogênica , Dengue , Força Muscular
10.
São Paulo med. j ; 137(5): 446-453, Sept.-Oct. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1059096

RESUMO

ABSTRACT BACKGROUND: Lower urinary tract symptoms significantly worsen quality of life. The hypothesis that they might lead to serious systolic blood pressure alterations through inducing sympathetic nervous activity has not been studied so far. OBJECTIVES: To investigate the relationship between benign prostate enlargement-related storage and voiding symptoms and systolic blood pressure. DESIGN AND SETTING: Cross-sectional single-center study on data from a hospital patient record system. METHODS: We evaluated the medical records of all consecutive patients with benign prostate enlargement-related lower urinary tract symptoms admitted between January 2012 and December 2017. Storage and voiding symptoms were assessed separately. International Prostate Symptom Score, uroflowmetry, postvoiding residual urine volume and systolic blood pressure were recorded. Pearson correlation and linear regression analysis were used. RESULTS: Positive correlations were found between systolic blood pressure and all of the storage symptoms. Among these, urgency had the most significant effect. There were 166 patients (41.4%) with urgency for urination, which increased mean systolic blood pressure from 124.88 mmHg (average value in elevated blood pressure group) to 132.28 mmHg (average value in stage-1 hypertension group). Hesitancy in urinating and feeling of incomplete bladder emptying had weak positive correlations with systolic blood pressure. There was a negative correlation between systolic blood pressure and intermittency of urination. CONCLUSIONS: With increasing numbers of urine storage symptoms, systolic blood pressure also increases, while the opposite occurs for voiding symptoms in patients with benign prostate enlargement. We conjecture that storage symptoms may lead to this increase through inducing sympathetic hyperactivity. Further prospective studies with larger groups are needed to confirm these findings.


Assuntos
Masculino , Pessoa de Meia-Idade , Idoso , Hiperplasia Prostática/complicações , Micção/fisiologia , Pressão Sanguínea/fisiologia , Sintomas do Trato Urinário Inferior/complicações , Hipertensão/complicações , Tamanho do Órgão , Próstata/fisiopatologia , Índice de Gravidade de Doença , Estudos Transversais , Sintomas do Trato Urinário Inferior/fisiopatologia , Hipertensão/fisiopatologia
12.
Int. braz. j. urol ; 45(4): 703-712, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1019887

RESUMO

ABSTRACT Introduction Robot-assisted radical prostatectomy (RARP) is the most recent surgical technique for localized prostate cancer. The Da Vinci (Intuitive Surgical, Sunnyvale, CA) system was first introduced in Brazil in 2008, with a fast growing number of surgeries performed each year. Objective Our primary endpoint is to analyze possible predictors of functional outcomes, related to patient and tumor features. As secondary endpoint, describe functional outcomes (urinary continence and sexual potency) from RARP performed in the Sírio-Libanês Hospital (SLH), a private institution, in São Paulo, from April 2008 to December 2015. Materials and Method Data from 104 consecutive patients operated by two surgeons from the SLH (MA and SA) between 2008 and 2015, with a minimum 12 months follow-up, were collected. Patient features (age, body mass index - BMI, PSA, date of surgery and sexual function), tumor features (tumor stage, Gleason and surgical margins) and follow-up data (time to reach urinary continence and sexual potency) were the variables collected at 1, 3, 6 and 12 month and every 6 months thereafter. Continence was defined as the use of no pad on medical interview and sexual potency defined as the capability for vaginal penetration with or without fosphodiesterase type 5 inhibitors. Results Mean age was 60 years old and mean BMI was 28.45 kg/m2. BMI >30kg/m2 (p<0.001) and age (p=0.011) were significant predictors for worse sexual potency after surgery. After 1, 3, 6 and 12 months, 20.7%, 45.7%, 60.9% and 71.8% from patients were potent, respectively. The urinary continence was reached in 36.5%, 80.3%, 88.6% and 92.8% after 1, 3, 6 and 12 months, respectively. Until the end of the study, only one patient was incontinent and 20.7% were impotent. Conclusion Age was a predictor of urinary and erectile function recovery in 12 months. BMI was significant factor for potency recovery. We obtained in a private hospital good functional results after 12 months of follow-up.


Assuntos
Humanos , Masculino , Adulto , Idoso , Idoso de 80 Anos ou mais , Prostatectomia/métodos , Micção/fisiologia , Ereção Peniana/fisiologia , Recuperação de Função Fisiológica/fisiologia , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias da Próstata/cirurgia , Neoplasias da Próstata/fisiopatologia , Fatores de Tempo , Incontinência Urinária/fisiopatologia , Brasil , Adenocarcinoma/cirurgia , Adenocarcinoma/fisiopatologia , Índice de Massa Corporal , Estudos Retrospectivos , Fatores Etários , Resultado do Tratamento , Estimativa de Kaplan-Meier , Disfunção Erétil/fisiopatologia , Pessoa de Meia-Idade
13.
Int. braz. j. urol ; 45(4): 775-781, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1019893

RESUMO

ABSTRACT Purpose To identify how the most frequently used parameters in daily clinical practice diagnosing bladder outlet obstruction (BOO) due to benign prostate hyperplasia (BPH) correlate to each other. Materials and methods The study included 452 patients with lower urinary tract symptoms (LUTS) of the UNICAMP urology outpatient clinic of LUTS. Inclusion criteria: patients with BOO due to BPH who agreed to participate in the study. Exclusion criteria: patients with urinary tract infection, neurological diseases that compromised the lower urinary tract, prior prostatic surgery, radiotherapy or urethral stenosis. Patient assessment: history, international prostate symptoms score (IPSS), nocturnal quality of life score (NQoL) questionnaires, physical and digital rectal examination (DRE), PSA, transabdominal ultrasound with intravesical prostate protrusion (IPP), post-mictional residue and free uroflowmetry. Results There was no strong Spearman correlation among the studied variables. The only moderate correlations occurred between IPSS and NQoL (p <0001; c=0.56) and between IPP and prostate volume (p <0001; c=0.57). Weak correlations between IPP and post-mictional residue (p <0001; c=0.31) and free uroflowmetry (p <0001; c=-0.26); and between IPSS and free uroflowmetry (p <0001, c=-0.21) were observed. Conclusion In this study, we found moderate, weak, very weak and absent correlation among the various parameters used in the diagnosis and management of BOO due to BPH. As the value of these tools is variable, the creation of a logical and objective algorithm was not possible and the treatment is based on the interpretation of clinical symptoms.


Assuntos
Humanos , Masculino , Adulto , Idoso , Idoso de 80 Anos ou mais , Hiperplasia Prostática/diagnóstico , Obstrução do Colo da Bexiga Urinária/diagnóstico , Sintomas do Trato Urinário Inferior/diagnóstico , Tamanho do Órgão , Próstata/patologia , Hiperplasia Prostática/fisiopatologia , Hiperplasia Prostática/patologia , Qualidade de Vida , Padrões de Referência , Micção/fisiologia , Urodinâmica/fisiologia , Obstrução do Colo da Bexiga Urinária/fisiopatologia , Obstrução do Colo da Bexiga Urinária/patologia , Inquéritos e Questionários , Análise de Regressão , Ultrassonografia/métodos , Estatísticas não Paramétricas , Exame Retal Digital , Sintomas do Trato Urinário Inferior/fisiopatologia , Sintomas do Trato Urinário Inferior/patologia , Pessoa de Meia-Idade
14.
Acta cir. bras ; 34(2): e201900205, 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-989052

RESUMO

Abstract Purpose: To evaluate the impact of the combination of BRL 37344 and tadalafil (TDF) on the reduction of overactive bladder (OB) symptoms. Methods: Thirty mice were randomized into 5 groups (G) of 6 animals each. L-NAME was used to induce DO. G1: Control; G2: L-NAME; G3: L-NAME + TDF; G4: L-NAME + BRL 37344; G5: L-NAME + TDF + BRL 37344. After 30 days of treatment, the animals were submitted to cystometry to evaluate non-voiding contractions (NVC), threshold pressure (TP), baseline pressure (BP), frequency of micturition (FM) and threshold volume (TV). Differences between the groups were analyzed with ANOVA followed by the Tukey test. Results: NVC increased in G2 (4.33±2.58) in relation to G1 (1.50±0.55). NVC decreased in G3 (2.00±1.10), G4 (1.50±1.52) and G5 (2.00±1.26) compared to G2 (p<0.05). FM decreased in G3 (0.97±0.71), G4 (0.92±0.38) and G5 (1.05±0.44) compared to G2 (p<0.05). However, the combination of TDF and BRL37344 was not more effective at increasing NVC and improving FM than either drug alone. The five groups did not differ significantly with regard to TV. Conclusion: The combination of BRL 37344 and TDF produced no measurable additive effect on reduction of OB symptoms.


Assuntos
Animais , Masculino , Ratos , Etanolaminas/administração & dosagem , Bexiga Urinária Hiperativa/tratamento farmacológico , Agentes Urológicos/administração & dosagem , Tadalafila/administração & dosagem , Micção/efeitos dos fármacos , Distribuição Aleatória , NG-Nitroarginina Metil Éster/farmacologia , Modelos Animais de Doenças , Quimioterapia Combinada
15.
INSPILIP ; 2(2): 1-15, jul.-dic. 2018.
Artigo em Espanhol | LILACS | ID: biblio-980300

RESUMO

El objetivo de este estudio fue comparar los resultados de la culdoplastía de Mayo con la colposacropexia abdominal en la corrección del prolapso de la cúpula vaginal poshisterectomía. Se revisaron las historias clínicas de 155 pacientes con prolapso de cúpula vaginal poshisterectomía en las que se procedió a la corrección quirúrgica entre febrero 2013 y noviembre 2017. Se realizó seguimiento para evaluar la satisfacción del paciente y el resultado a largo plazo. La edad promedio de las pacientes al momento de la cirugía fue de 67,1 +/- 5,6 años y 69,0 % de las pacientes tenían antecedentes de haber sido sometidas a histerectomía abdominal. El tiempo medio entre la histerectomía y la cirugía de corrección fue de 16,9 +/- 3,6 años. Ciento diecinueve pacientes se sometieron a abordaje vaginal utilizando la técnica de culdoplastía de Mayo (grupo A) y 36 pacientes se sometieron a colposacropexia abdominal (grupo B). Durante la cirugía se produjeron tres casos (2,5 %) de lesión vesical inadvertida en el grupo A. En el grupo A se observaron 2 casos de recurrencia comparado con un solo caso en las pacientes del grupo B (p = ns). Al analizar la satisfacción de la cirugía, 84,9 % de las pacientes del grupo A y 77,7 % de las pacientes del grupo B se declararon satisfechas con los resultados quirúrgicos. Se concluye que la corrección del prolapso de la cúpula vaginal mediante colposacropexia abdominal y culdoplastía de Mayo son procedimientos seguros y efectivos.


The aim of this study was to compare the results of the Mayo culdoplasty with abdominal colposacropexy in the correction of post-hysterectomy vaginal vault prolapse. Medical records of 155 patients with post-hysterectomy vaginal vault prolapse were reviewed in which the surgical correction was carried out between February 2013 and November 2017. Follow-up was performed to evaluate the patient's satisfaction and the long-term result. The average age of the patients at the time of surgery was 67.1 +/- 5.6 years and 69.0% of the patients had a history of having undergone an abdominal hysterectomy. The mean time between hysterectomy and correction surgery was 16.9 +/- 3.6 years. One hundred and nineteen patients underwent vaginal access using the Mayo culdoplasty technique (group A) and 36 patients underwent abdominal colposacropexy (group B). During surgery there were three cases (2,5 %) of inadvertent bladder injury in group A. In group A, 2 cases of recurrence were observed compared with a single case in patients in group B (p = ns). When analyzing the satisfaction of the surgery, 84,9 % of the patients of group A and 77,7 % of the patients of group B declared themselves satisfied with the surgical results. It is concluded that the correction of vaginal vault prolapse by abdominal colposacropexy and Mayo culdoplasty are safe and effective procedures.


Assuntos
Humanos , Feminino , Cirurgia Geral , Prolapso Uterino , Histerectomia Vaginal , Micção , Venezuela , Satisfação do Paciente
16.
Int. braz. j. urol ; 44(6): 1207-1214, Nov.-Dec. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-975659

RESUMO

ABSTRACT Objective: To determine the different urine flow patterns and active pelvic floor electromyography (EMG) during voiding in children with vesicoureteral reflux (VUR) as well as presenting the prevalence of lower urinary tract symptoms in these patients. Materials and Methods: We retrospectively reviewed the charts of children diagnosed with VUR after toilet training from Sep 2013 to Jan 2016. 225 anatomically and neurologically normal children were included. The reflux was diagnosed with voiding cystourethrography. The study was comprised an interview by means of a symptom questionnaire, a voiding diary, uroflowmetry with EMG and kidney and bladder ultrasounds. Urine flow patterns were classified as bell shape, staccato, interrupted, tower and plateau based on the current International Children's Continence Society guidelines. Results: Of 225 children with VUR (175 girls, 50 boys), underwent uroflowmetry + EMG, 151 (67.1%) had an abnormal urine flow pattern. An active pelvic floor EMG during voiding was confirmed in 113 (50.2%) children. The flow patterns were staccato in 76 (33.7 %), interrupted in 41 (18.2%), Plateau in 26 (11.5%), tower in 12 (5.3%) and a bell shape or normal pattern in 70 (31.5%). Urinary tract infection, enuresis and constipation respectively, were more frequent symptoms in these patients. Conclusions: Bladder/bowel dysfunction is common in patients with VUR that increases the risk of breakthrough urinary tract infections in children receiving antibiotic prophylaxis and reduces the success rate for endoscopic injection therapy. Therefore investigation of voiding dysfunction with primary assessment tools can be used prior to treating VUR.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Micção/fisiologia , Refluxo Vesicoureteral/fisiopatologia , Diafragma da Pelve/fisiopatologia , Sintomas do Trato Urinário Inferior/fisiopatologia , Refluxo Vesicoureteral/complicações , Estudos Retrospectivos , Eletromiografia , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/etiologia
17.
Rev. ciênc. méd., (Campinas) ; 27(1): 47-57, jan.-abr. 2018. ilus
Artigo em Português | LILACS | ID: biblio-948444

RESUMO

As disfunções do trato urinário inferior impactam a qualidade de vida de crianças ao causarem incontinência urinária e infecções do trato urinário. Dentre estas tem destaque a disfunção miccional, caracterizada por um padrão miccional incomum, onde ocorre a perda da capacidade de armazenamento, estocagem e esvaziamento. A fi sioterapia emerge como técnica promissora no tratamento destas crianças, mas não há clareza sobre quais técnicas são as mais usadas e mais efi cazes neste tipo de tratamento. Revisão sistemática sobre as técnicas fi sioterápicas para o tratamento da disfunção miccional infantil nas bases SciELO, LILACS e PubMed, restrita a ensaios clínicos randomizados. De um total de 99 artigos retornados apenas oito tratavam sobre disfunção miccional. As técnicas mais utilizadas foram a uroterapia comportamental (hidratação, diário miccional, treino miccional, dieta) e reeducação do assoalho pélvico, e as mais eficazes foram a uroterapia comportamental junto a redução do assoalho pélvico associada ao biofeedback. A literatura é parca sobre o tema, mas todas as técnicas apresentaram resultados, apesar da grande heterogeneidade metodológica que impediu qualquer análise comparativa mais precisa. A uroterapia comportamental associada ao treinamento dos músculos do assoalho pélvico auxiliado por biofeedback foi a técnica que apresentou melhores resultados.


Lower urinary tract dysfunctions impact the quality of life of children, by causing urinary incontinence and urinary tract infections. Among these, voiding dysfunction stands out, characterized by an unusual voiding pattern, with loss of storage capacity and bladder emptying. Physiotherapy emerges as a promising technique in the treatment of these children, but there is no clarity about which techniques are the most used and most effective in this type of treatment. Systematic review of physiotherapeutic techniques for the treatment of voiding dysfunction in children in three databases: SciELO, LILACS and PubMed, restricted to randomized controlled trials. From a total of 99 articles, only eight were about voiding dysfunction. The most used techniques were behavioral urotherapy (hydration, voiding diary, bladder training, diet) and reeducation of the pelvic floor, where the most expressive results were a combination between urotherapy with pelvic floor muscle exercise aided by biofeedback. The literature is sparse on the issue, but all the techniques showed satisfying results, despite the large methodological heterogeneity that prevented any further precise comparative analysis. Behavioral urotherapy associated with pelvic floor muscle training aided by biofeedback was the technique that presented better results.


Assuntos
Humanos , Pré-Escolar , Criança , Sistema Urinário , Criança , Diafragma da Pelve , Especialidade de Fisioterapia , Micção
18.
Int. braz. j. urol ; 44(4): 805-811, July-Aug. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-954065

RESUMO

ABSTRACT Objectives: To examine the benefits of repetitive uroflowmetry and post void residual urine (PVR) tests in children with primary nocturnal enuresis (PNE). Material and methods: Children aged ≥6 years with PNE who visited our clinics for management of enuresis were included for study. Patients were requested to complete a questionnaire including baseline characteristics and Dysfunctional Voiding Symptom Score (DVSS), 2-day bladder diary, and Rome III criteria for constipation. Two uroflowmetry and PVR tests were requested. Children with congenital or neurogenic genitourinary tract disorders were excluded. All children underwent urotherapy and desmopressin combined with anticholinergics or laxatives if indicated. The definition of abnormal flow patterns (≥1 abnormal), elevated PVR (≥1 abnormal), small maximal voided volume (MVV), nocturnal polyuria (NP) and response to treatment complied with the ICCS standardization document. Kaplan-Meier survival analysis and Cox proportional-hazards regression tests were used to evaluate the predictors of response. Results: In total, 100 children aged 8.5±2.3 years were enrolled for study (M: F=66:34) with 7.3±7.4 months of follow-up. Poor correlation was observed between DVSS/small MVV and PVR (p>0.05). Univariate analysis revealed that elevated PVR is associated with significantly less hazard of complete response to medical treatment (HR: 0.52, p=0.03), while not significantly associated with abnormal flow patterns, NP, constipation or small MVV. Multivariate analysis revealed that only elevated PVR (HR 0.30, 95% CI 0.12-0.80) and NP (HR 2.8, 95% CI 1.10-7.28) were significant predictors for complete response. Conclusions: In managing pediatric enuresis, elevated PVR is a significant predictor for lower chance of complete response to treatment whether they had high DVSS or not.


Assuntos
Humanos , Masculino , Feminino , Criança , Micção/fisiologia , Retenção Urinária/diagnóstico , Retenção Urinária/fisiopatologia , Enurese Noturna/diagnóstico , Enurese Noturna/fisiopatologia , Prognóstico , Fatores de Tempo , Urodinâmica/fisiologia , Bexiga Urinária/fisiopatologia , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco , Retenção Urinária/complicações , Resultado do Tratamento , Estatísticas não Paramétricas , Enurese Noturna/etiologia , Enurese Noturna/terapia
19.
Int. braz. j. urol ; 44(3): 536-542, May-June 2018. tab
Artigo em Inglês | LILACS | ID: biblio-954047

RESUMO

ABSTRACT Objective: To evaluate urodynamic alterations after sub-urethral sling surgery (SSU) in patients with post-prostatectomy urinary incontinence (PPUI). Materials and Methods: We evaluated data of 22 patients submitted to radical prosta- tectomy (RP) or transurethral resection of prostate (TURP) that presented post-surgical urinary incontinence and were treated with SSU implant in a pilot study previously performed in our institution. Methods: Those patients with PPUI were evaluated by urodynamic exam (UD) before and after surgery, and the parameters were compared, including uroflow, cystometry and micturition study. Exclusion criteria included patients without pre-operatory urodynamic study, those with urethral stenosis, those not healed of prostate cancer, pa- tients without clinical conditions to be submitted to urodynamic study and those with severe neurological diseases or that refused to sign the consent form. Results were analyzed statistically by Fisher, Wilcoxon or Mann-Whitney tests. Results: During free uroflow, none parameters showed any statistical significant differ- ences. During cystometry, there were also no statistical differences and the same was observed at pressure versus flow study; the exception was at maximal flow detrusor pressure (PdetQmax), that was lower at post-operatory (p=0.028). In relation to the presence of urinary dysfunctions associated to PPUI, we observed a significant reduc- tion of detrusor overactivity (p=0.035) in relation to pre-operatory period. Conclusion: SSU surgery significantly reduced detrusor overactivity and PdetQMax; however, there were no alterations of other evaluated urodynamic parameters.


Assuntos
Humanos , Masculino , Prostatectomia/efeitos adversos , Incontinência Urinária/cirurgia , Incontinência Urinária/etiologia , Urodinâmica/fisiologia , Slings Suburetrais , Período Pós-Operatório , Valores de Referência , Incontinência Urinária/fisiopatologia , Micção/fisiologia , Bexiga Urinária/fisiopatologia , Estudos Retrospectivos , Resultado do Tratamento , Estatísticas não Paramétricas , Implantação de Prótese/métodos , Período Pré-Operatório , Pessoa de Meia-Idade
20.
Rev. baiana enferm ; 32: e23812, 2018. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-977319

RESUMO

Objetivo analisar a associação entre a região do trauma perineal e os problemas locais, as atividades habituais e as necessidades fisiológicas dificultadas em puérperas no pós-parto vaginal imediato. Método estudo transversal, realizado em uma maternidade pública de Feira de Santana, Bahia, Brasil, de maio de 2013 a dezembro de 2015, com aplicação de formulários, coleta em prontuário e exame vulvoperineal de 684 puérperas. Resultados houve maior prevalência de dor (RP=3,4; p=0,000) edema (RP=2,5; p=0,028), dificuldade para dormir (RP=2,0; p-valor=0,013), deambular (RP=1,6; p=0,033) e sentar (RP=2,4; p=0,001) entre puérperas com trauma no períneo posterior. Relatos de ardor (RP=0,5; p=0,01) e dificuldade na micção (RP=0,5; p=0,002) apresentaram maior probabilidade de ocorrer entre mulheres com trauma na região anterior. Conclusão os traumas no períneo posterior causam mais dor, edema e dificuldade para dormir, sentar e deambular, ao passo que os traumas na região anterior provocam maior relato de ardor e dificuldade na micção.


Objetivo analizar la asociación entre región del trauma perineal y problemas locales, actividades usuales y necesidades fisiológicas dificultadas en puérperas durante el posparto vaginal inmediato. Método estudio transversal realizado en maternidad pública de Feira de Santana, Bahia, Brasil, de mayo de 2013 a diciembre de 2015, aplicándose formularios, recolección desde historias clínicas y examen vulvoperineal en 684 puérperas. Resultados hubo mayor prevalencia de dolor (RP=3,4; p=0,000) edema (RP=2,5; p=0,028), dificultad para dormir (RP=2,0; p=0,013), deambular (RP=1,6; p=0,033) y sentarse (RP=2,4; p=0,001) entre puérperas con trauma del perineo posterior. Reportes de ardor (RP=0,5; p=0,01) y dificultad en la micción (RP=0,5; p=0,002) tienen mayor posibilidad de ocurrencia entre mujeres con trauma en la región anterior. Conclusión los traumas del perineo posterior provocan mayor dolor, edema y dificultad para dormir, sentarse y deambular, mientras que los traumas en la región anterior provocan más reportes de ardor y dificultad en la micción.


Objective to analyze the association between region of perineal trauma, local problems, and impaired habitual activities, and physiological needs in postpartum women in the immediate vaginal postpartum. Methods cross-sectional study, carried out in a public maternity in Feira de Santana, state of Bahia, Brazil, from May 2013 to December 2015, by applying forms, collecting information in medical records, and conducting a vulvoperineal exam in 684 postpartum women. Results there was a higher prevalence of pain (PR=3.4; p=0.000), edema (PR=2.5; p=0.028), and difficulty to sleep (PR=2.0; p=0.013), walk (PR=1.6; p=0.033), and sit (PR=2.4; p=0.001) among postpartum women with a trauma in the posterior perineum. Reports of burning sensations (PR=0.5; p=0.01) and difficulty to urinate (PR=0.5; p=0.002) were more likely to occur in women with a trauma in the anterior region. Conclusion traumas in the posterior perineum cause more pain, edema, and difficulty to sleep, walk and sit, whereas traumas in the anterior region are more related to reports of burning sensations and difficulty to urinate.


Assuntos
Humanos , Feminino , Períneo/lesões , Período Pós-Parto , Episiotomia , Enfermagem Obstétrica , Dor , Sono , Micção , Ferimentos e Lesões , Prevalência , Estudos Transversais , Parto , Cuidados de Enfermagem
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