The effects of a heating pad on anxiety, pain, and distress during urodynamic study in the female patients with stress urinary incontinence.

AIMS: Although generally well tolerated, a urodynamic study is an unpleasant and stressful procedure for some patients. This study evaluated the effects of a heating pad on anxiety, pain, and distress during urodynamic studies in female patients with stress urinary incontinence. METHODS: A total of 74 female patients with stress urinary incontinence who underwent a urodynamic study between May 2015 and October 2015 were randomized to either the experimental group using a heating pad (n = 37) or control group (n = 37). In the experimental group, a heating pad was applied on the patient's sacrum during the urodynamic study. All patients completed the State-Trait Anxiety Inventory (20-80) before and after the procedure and assessed their degree of pain and distress after the procedure by the visual analog scale (0-10). Systolic and diastolic blood pressure and pulse rate were also checked before and after the procedure. RESULTS: Demographic characteristics, mean age, procedure duration, pre and post-procedural systolic, and diastolic blood pressures, and pulse rate were statistically similar between the experimental and control groups. The mean State-Trait Anxiety Inventory was significantly lower in the experimental group than in the control group (30.9 ± 7.5 vs 42.5 ± 10.1, P < 0.001). The experimental group showed significantly lower pain and distress scores (Visual Analog Scale, 2.7 ± 1.5, 3.0 ± 1.5) compared with the control group (4.0 ± 1.6, 4.7 ± 2.0, both P < 0.001). CONCLUSIONS: Using a heating pad for female patients with stress urinary incontinence during a urodynamic study is a simple, economical, and effective therapy that enhances patient comfort and decreases anxiety, pain, and distress.

Intravesical prostatic protrusion is a risk factor for bladder stone in patients with benign prostatic hyperplasia.

OBJECTIVE: To assess the risk factor that influences bladder stone formation in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: We reviewed the data of 271 consecutive patients with BPH who underwent transurethral resection of the prostate between January 2008 and December 2012. Patients were classified into 2 groups based on the presence of a bladder stone: Group 1 had a bladder stone and group 2 did not. Univariate analysis was performed to determine the association between the presence of bladder stone and the patients' age, body mass index, International Prostate Symptom Score, total prostate volume (TPV), transitional zone volume, intravesical prostatic protrusion (IPP), uroflow parameters, and urodynamic parameters. RESULTS: The overall rate of bladder stone in patients with BPH was 9.9%. The patients' body mass index, International Prostate Symptom Score, and urodynamic parameters did not significantly differ between the 2 groups. The patients' age, TPV, transitional zone volume, and IPP were all significantly higher and the Qmax was significantly lower in group 1 than that in group 2. Multivariate analysis revealed that age (hazard ratio [HR] = 1.089; P = .020), IPP (HR = 1.145; P <.001), and Qmax (HR = 0.866; P = .019) significantly affected the presence of bladder stone in patients with BPH. A predictive model using logistic regression for bladder stone in BPH patients was defined as follows: probability = 1/[1 + exp (-8.499 + 0.085 (age) + 0.009 (TPV) + 0.136 (IPP) - 0.143 (Qmax))] with area under the curve of 0.850 obtained from the receiver operating characteristic curve analysis. CONCLUSION: This study demonstrated that older age, longer IPP, and lower Qmax are independent factors that associated with the presence of bladder stone in patients with BPH.

High-dose dietary zinc promotes prostate intraepithelial neoplasia in a murine tumor induction model.

To evaluate the role of high-dose dietary zinc in the process of prostate malignancy, 60 Sprague-Dawley rats were randomly divided into four groups: tumor induction with carcinogen and hormone (group 1), oral zinc administration without tumor induction (group 2), oral zinc administration with tumor induction (group 3) and a control without zinc administration or tumor induction (group 4). Zinc was supplied orally in the form of zinc sulfate heptahydrate dissolved in drinking water to groups 2 and 3 for 20 weeks. Although the serum level of zinc measured at 20 weeks was maintained similarly in each group (P = 0.082), intraprostatic zinc concentrations were statistically different. Group 1 prostates contained the least amount of zinc in both the dorsolateral and ventral lobes at levels of 36.3 and 4.8 microg g(-1), respectively. However, in group 3, zinc levels increased in both lobes to 59.3 and 12.1 microg g(-1), respectively, comparable with that of group 4 (54.5 +/- 14.6 and 14.1 +/- 2.4 microg g(-1)). In spite of these increases in zinc concentration, the prevalence of prostate intraepithelial neoplasm was rather increased in group 3 (53.3% and 46.7%) compared with group 1 (33.3% and 33.3%) in both dorsolateral and ventral prostate lobes. Although prostate intraepithelial neoplasm did not develop in any prostate in group 4, zinc administration did induce prostate intraepithelial neoplasm in group 2 (46.7% and 40.0%). Thus, although high dietary zinc increased intraprostatic zinc concentrations, it promoted, instead of preventing, prostate intraepithelial neoplasm in a murine prostate malignancy induction model.

Extracorporeal magnetic innervation therapy in children with refractory monosymptomatic nocturnal enuresis.

OBJECTIVES: To evaluate the effect of extracorporeal magnetic innervation (ExMI) therapy in children with refractory monosymptomatic nocturnal enuresis (MNE). METHODS: A total of 55 children (34 boys and 21 girls, median age 8.0 years, range 5 to 13) who wetted the bed more than twice per week because of MNE that was refractory to treatment with desmopressin, anticholinergics, and enuretic alarm were assessed prospectively using a voiding diary before and after ExMI, administered once a week for at least 4 weeks with a size-adjusted magnetic chair (each session lasted 20 minutes). RESULTS: After all sessions of ExMI, the mean frequency of nocturnal enuresis decreased significantly to 2.09 +/- 2.47 in all patients (P = 0.04), and the mean functional bladder capacity increased 1.88 times in all patients (P = 0.00). In total, 63.6% of our patients had a nocturnal enuresis frequency of less than 50% after a mean of 6.62 +/- 4.26 ExMI sessions. CONCLUSIONS: From our results, reduced functional bladder capacity might be the main pathophysiologic cause in children with MNE refractory to established treatment. ExMI might have an acute inhibitory effect in these children with refractory MNE by increasing functional bladder capacity. However, long-term follow-up data and controlled study with a sham-stimulation group are necessary to determine the durability of this new therapy for refractory MNE.