Maternal Anxiety Associated with Nocturnal Childhood Enuresis.

Introduction: Nocturnal enuresis is a common problem affecting 20% of 5-year-old children; its prevalence decreases with age. Nocturnal bedwetting in children younger than 5 is generally accepted by parents and society, but the expectation of parents is that children will achieve a higher degree of responsibility and increased control with age. Some studies have identified maternal distress as a factor associated with childhood urinary incontinence; specifically, maternal stress, maternal depression, and maternal anxiety. The aim of this study was to compare the degree of anxiety (trait and state) among mothers of children with nocturnal enuresis and mothers of healthy children. Methods: This was a prospective, cross-sectional, comparative study including two groups: a control group of 25 mothers of healthy children from open population, and an enuresis group of 25 mothers of children with nocturnal enuresis of the pediatric urology clinic of a third-level Mexican Hospital. STAI-T and STAI-S tests were performed and assessed blindly. Quantitative variables were compared using the Mann−Whitney U test, and qualitative determinations using a chi-square test or Fischer's exact test. Results: The STAI-S and STAI-T tests results identified 14 (56%) mothers of enuretic children with moderate-to-severe trait anxiety versus 4 (16%) mothers from the control group and moderate-to-severe state anxiety in 23 (92%) of the mothers of enuretic children compared to 7 (28%) control-group mothers. The anxiety scores were significantly higher for the enuresis group for both tests: STAI-T: 53.00 ± 8.39 versus 41.52 ± 9.61 (p < 0.001) and STAI-S: 56.48 ± 6.83 versus 43.84 ± 10.57 (p < 0.001). Conclusion: Mothers of children with nocturnal enuresis present state anxiety ranging from moderate to severe. In clinical practice, our results indicate that the transitory emotion experienced by mothers of enuretic children cannot be neglected in an enuresis treatment program, state anxiety needs to be evaluated, and psychological interventions need to be implemented.

Papel del alopurinol en las adherencias peritoneales al colocar una malla de polipropileno: Estudio experimental en ratas / Role of alopurinol in peritoneal adherences when placing a polypropylene mesh: Experimental study in rats

Objetivo: Determinar el efecto del alopurinol en las adherencias peritoneales al colocar una malla de polipropileno. Sede: Cirugía Experimental de la Universidad de Guanajuato. Diseño: Estudio experimental, prospectivo, comparativo, controlado, doble ciego, con asignación al azar. Análisis estadístico: χ². Material y métodos: Se compararon dos grupos de 30 ratas Wistar cada uno, a quienes se les colocó una malla de polipropileno: el grupo A, sin tratamiento versus el grupo B, alopurinol a 25 mg/kg/día por sonda orogástrica. Resultados: Este estudio determinó que la prevalencia de adherencias protésicas-peritoneales viscerales en ratas Wistar, al colocar una malla de polipropileno, es del 100% sin tratamiento y con alopurinol. Conclusiones: No obtuvimos diferencia estadística del efecto beneficioso del alopurinol en la prevención de adherencias, esto puede hablarnos de que la acción del alopurinol sólo se ejerce en la prevención de adherencias cuando su etiología es la isquemia y no debido a la presencia de reacción a cuerpo extraño de tipo granulomatoso.

Objective: To determine the effect of allopurinol on peritoneal adhesions when placing a polypropylene mesh. Setting: Experimental Surgery Unit of the University of Guanajuato, México. Design: Experimental, prospective, comparative, controlled, double-blinded, randomized assignment study. Statistical analysis: χ². Material and Methods: We compared two groups of 30 Wistar rats each, in which we placed a polypropylene mesh: Group A, without treatment, versus group B with allopurinol at mg/kg per day administered through an orogastric catheter. Results: This study determined that the prevalence of visceral peritoneal-prosthetic adhesions in Wistar rats when placing a polypropylene mesh is of 100% with and without allopurinol treatment. Conclusions: We did not obtain statistical differences of the beneficial effect of allopurinol in preventing adhesions, this can indicate that allopurinol's effect is only exerted in preventing adhesions when they are due to ischemia but not when they are caused by a granulomatous-type foreign body reaction.

Complete bladder and urethral duplication with normal urodynamic function associated with visceral sequestration.

Complete bladder and urethra duplication is an extremely rare condition. It can occur in the sagittal or coronal plane, depending on the axis of the septum. Most cases are associated with other congenital defects. We present a case of complete duplication of the bladder and urethra in the sagittal plane with normal urodynamic function associated with bowel sequestration.

Bladder augmentation in a young adult female exstrophy patient with associated omphalocele: an extremely unusual case.

We present the case of a 20-year-old woman with uncorrected bladder exstrophy and omphalocele treated with ileocystoplasty and continent urinary stoma. To our knowledge this is the first reported case of a young adult patient presenting with both congenital anomalies. The treatment result suggests that bladder preservation is a safe and feasible therapeutic option in bladder exstrophy.

[Effect of hyaluronic acid on ureteropyelic anastomosis healing. Experimental study]. / Efecto del ácido hialurónico en la cicatrización de la anastomosis ureteropiélica. Estudio experimental.

BACKGROUND: Ureteropyelic obstruction is the most frequent congenital cause of obstructive uropathy in the newborn. Its repair is based on surgical procedures and has a very high rate of relapse of secondary stenosis to fibrosis (5-12%) in open repair and 10-20% in endo-urological pyeloplasties. Hyaluronic acid has demonstrated therapeutic utility in modulating the healing process and its effect in scar formation from ureteropyelic anastomosis is determined. METHODS: An experimental, controlled, comparative, double blind study was performed. Sample n = 20 per protocol with d = 26%, alpha = 0.05, beta = 0.80. Two groups of Wistar rats, 4 months of age and weighing between 250 and 350 g, were used. Under general anesthesia, Vision 12 x was used and bevel section was realized in the left ureteropyelic union and end-to-end anastomosis with Vicryl 7-0. Experimental group was treated with 25 microg of hyaluronic acid and group B was treated with placebo. The rats were reoperated on the 15th day and adherences in cavity were quantified. To quantify the degree of fibrosis, samples of ureteropyelic anastomosis tissue were dyed with Masson Trichrome and observed microscopically. Inferential statistics were used with a = 0.05. RESULTS: Macroscopic: there were adherences in 75 % of group A and 90 % of the group B (p >0.05). Microscopic: anastomotic fibrosis in group A (534 +/- 292 micro) was significantly lower (p = 0.043) than that of group B (728 +/- 295 micro). CONCLUSIONS: Hyaluronic acid plays a role in diminishing the formation of fibrosis from ureteropyelic anastomosis in an animal model.