New device for intermittent emptying of the bladder in female children and adolescents: A pilot study.

INTRODUCTION: Urinary incontinence (UI) is a challenging problem for the urological community. Clean intermittent catheterization (CIC) is the most commonly used method to restore bladder emptying to the state close to the physiological condition. This procedure can cause negative aspects such as pain and possible urethral injury. In addition, there is a negative impact on self-image and decline in quality of patient's life. The aim of the present study was to evaluate the safety and efficacy of a new intraurethral self-retaining device (ISRD), in female children and adolescents, as an attractive alternative to CIC. MATERIALS AND METHODS: A prospective clinical pilot study was performed, in a single-institution, including female children and adolescent patients with urinary incontinence secondary to myelomeningocele who were already in an intermittent bladder catheterization program. Assessments included the use of a visual analogue scale in diagnosis of UI, reported adverse events, and the King's Health Questionnaire (KHQ) to evaluate quality of life, which was answered by patients and the caregivers of younger patients before and 6 months after enrolment. DISCUSSION: The device was efficient and well tolerated by most patients (84%). The ISRD significantly improved quality of life in children and adolescents (p<0.0001 for both) (Table). The safe insertion and removal of the ISRD can be considered an advantage compared with CIC as eventual urethral trauma is significantly minimized. It was found that one of the main advantages of the ISRD is the possibility of management as an outpatient procedure both for initial insertion and replacement. The autonomy of patients to perform the bladder emptying process by themselves indicates the importance of this study, especially for school life and social interaction. ISRD use showed a tendency to improve the QoL. CONCLUSIONS: This new bladder-draining device (ISRD) was effective and secure in terms of insertion technique, and improved QoL of patients with urinary retention and incontinence, according to domains evaluated in the KHQ.

Effects of L-Glutamine oral supplementation on prostate of irradiated rats.

OBJECTIVES: To investigate the protective effect of L-Glutamine in animals undergone to ventral radiation when the target organ is not the prostate. MATERIALS AND METHODS: Wistar rats were divided into groups of 10 animals each: Controls (C), maintained under standard conditions and not exposed to radiation, Radiated group (R) undergone to abdominal radiation only and Radiated plus supplemented by L-glutamine group (R+G). The animals of group R+G were supplemented with L-glutamine at the beginning of the experiment until death in the 22nd day. The ventral prostate was dissected and processed for morphometrical analysis. The epithelial height, collagen density and acinar area were objectively assessed in histological sections. RESULTS: Epithelial height was significantly reduced in R group in comparison to C group (p= 0.005). However, there was no statistical difference between the C and R+G groups. Collagen surface density in the C and R groups were not statistically different, but a significant difference was observed when comparing groups R+G and R (p=0.040). The R+G group values did not differ significantly from C group. The acinar prostate area of group R was similar to that of C (p= 0.971), but in R+G it was significantly reduced when compared with the C (p= 0.038) and R (p= 0.001) groups. CONCLUSIONS: Pelvic radiation promotes structural modifications in ventral prostate of rats, which can be reduced by L-Glutamine.

Effects of L-Glutamine oral supplementation on prostate of irradiated rats

ABSTRACT Objectives To investigate the protective effect of L-Glutamine in animals undergone to ventral radiation when the target organ is not the prostate. Materials and Methods Wistar rats were divided into groups of 10 animals each: Controls (C), maintained under standard conditions and not exposed to radiation, Radiated group (R) undergone to abdominal radiation only and Radiated plus supplemented by L-glutamine group (R+G). The animals of group R+G were supplemented with L-glutamine at the beginning of the experiment until death in the 22nd day. The ventral prostate was dissected and processed for morphometrical analysis. The epithelial height, collagen density and acinar area were objectively assessed in histological sections. Results Epithelial height was significantly reduced in R group in comparison to C group (p= 0.005). However, there was no statistical difference between the C and R+G groups. Collagen surface density in the C and R groups were not statistically different, but a significant difference was observed when comparing groups R+G and R (p= 0.040). The R+G group values did not differ significantly from C group. The acinar prostate area of group R was similar to that of C (p= 0.971), but in R+G it was significantly reduced when compared with the C (p= 0.038) and R (p= 0.001) groups. Conclusions Pelvic radiation promotes structural modifications in ventral prostate of rats, which can be reduced by L-Glutamine.