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Complementary water splitting electrocatalysts used simultaneously in the hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) can simplify water splitting systems. Herein, earth-abundant NiMoFe (NMF) and phosphorized NiMoFeP (NMFP) are synthesized as complementary overall water splitting (OWS) catalysts. First, NMF is tested as both the HER and OER promoter, which exhibits low overpotentials of 68 (HER) and 337 mV (OER). A quaternary NMFP is then prepared by simple phosphorization of NMF, which shows a much lower OER overpotential of 286 mV. The enhanced OER activity is attributed to the unique surface/core structure of NMFP. The surface phosphate acts as a proton transport mediator and expedites the rate-determining step. With the application of OER potential, the NMFP surface is composed of Ni(OH)2 and FeOOH, active sites for OER, but the inner core consists of Ni, Mo, and Fe metals, serving as a conductive electron pathway. OWS with NMF-NMFP requires an applied voltage of 1.452 V to generate 10 mA cm-2 , which is one of the lowest values among OWS results with transition-metal-based electrocatalysts. Furthermore, the catalysts are combined with tandem perovskite solar cells for photovoltaic (PV)-electrolysis, producing a high solar-to-hydrogen (STH) conversion efficiency of 12.3%.
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This study reports the fabrication of a Petri dish patterned with cylindrical micro-cavities that are produced using a one-step solvent-immersion phase-separation process. The developed 3D honeycomb Petri dish is coated with a Au film through a sputtering method to be an efficient Au-coated FTO-free electrode for quantum-dot-sensitized solar cells. Due to the high specific active surface area of the electrode with the Au-coated honeycomb structure, the energy conversion efficiency of devices that use this electrode is 5.2 % compared to 4.4 and 4.7 % by devices using an Au-coated flat Petri dish and an Au-coated FTO electrode, respectively. This design strategy offers excellent potential for the fabrication of highly efficient counter electrodes with FTO-free substrates of flexible photovoltaic devices.
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Due to its high light absorption coefficient and appropriate bandgap, CuInS2 (CIS) has been receiving much attention as an absorber material for thin film solar cells and also as a visible light photocatalyst. Herein we present heterostructured CIS/ZnO nanorods (NRs) in an attempt to enhance light absorption and facilitate charge separation/transfer in the photocatalysis system. CIS nanoparticles (NPs) were directly deposited on ZnO nanorod arrays (NRAs) to fabricate heterostructured CIS/ZnO NRAs using an environmentally benign, non-hydrazine solution reaction. These heterostructured NRAs are immobilized on FTO glass, which has additional merits of recyclability and bias-applicability. The ideal type-II band structure of CIS/ZnO enables efficient charge separation/transfer, which is confirmed by PL (photoluminescence) decay measurements. Also, the 1D-ZnO NR structure facilitates fast charge transfer along with enhancing light absorption via light scattering. These synergistic effects improved the photocatalytic activity in both organic dye and bacteria decomposition. The photodecomposition efficiency was further enhanced with an aid of external bias. The underlying photocatalytic mechanism was also investigated through controlled experiments under various scavenging conditions. The results suggest that reactive oxygen species (ROS) formed by multistep reduction of O2 play a main role in photocatalysis, while hole-induced photodecomposition is relatively deactivated due to the band structure of the heterostructures of CIS/ZnO.
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[This corrects the article on p. 1550 in vol. 29, PMID: 25408588.].
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BACKGROUND: The aim of this study was to compare the efficacy of combination therapy with desmopressin and an anticholinergic to desmopressin monotherapy for the first-line treatment of children with primary monosymptomatic nocturnal enuresis (PMNE). METHODS: A total of 98 children with PMNE (male:female 71:27) aged 5-16 (mean age 7.18 ± 1.8) years were retrospectively analyzed. The patients were divided into two groups: the monotherapy group (n = 49) was given oral desmopressin alone, and the combination therapy group (n = 49) was given desmopressin plus an anticholinergic (propiverine 10 mg) as a first-line treatment. The two groups were matched according to the following criteria: age, gender, and baseline frequency of nocturnal enuresis. The efficacy was evaluated by International Children's Continence Society criteria at 1 and 3 months after treatment initiation. RESULTS: The combination therapy group showed a higher rate of complete response than the monotherapy group (20.4 vs. 6.1% at 1 month of treatment; 46.9 vs. 22.4% at 3 months of treatment). In terms of success (response and complete response), there was a significant difference between the two groups after 3 months of treatment (P = 0.002). CONCLUSIONS: Our results indicate that combination therapy with desmopressin plus an anticholinergic is quicker and more effective than desmopressin monotherapy in reducing PMNE.
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Antagonistas Colinérgicos/administración & dosificación , Desamino Arginina Vasopresina/uso terapéutico , Enuresis Nocturna/tratamiento farmacológico , Adolescente , Niño , Preescolar , Desamino Arginina Vasopresina/administración & dosificación , Quimioterapia Combinada , Femenino , Humanos , Masculino , Estudios RetrospectivosRESUMEN
Testicular torsion is a surgical emergency in the field of urology. Knowledge of the epidemiology and pathophysiology is significant to an urologist. However, the epidemiology of testicular torsion in Korea has not been studied. We performed a nationwide epidemiological study to improve knowledge of the epidemiology of testicular torsion. From 2006-2011, the Korean Urologic Association began the patient registry service. The annual number of patients with testicular torsion from 2006 to 2011 were 225, 250, 271, 277, 345, and 210, respectively. The overall incidence of testicular torsion in males was 1.1 per 100,000; However, the incidence in men less than 25 yr old was 2.9 per 100,000. Adolescents showed the highest incidence. Total testicular salvage rate was 75.7% in this survey. There was no geographic difference of testicular salvage rate. Minimizing the possibility of orchiectomy for testicular torsion is important to improve public awareness to expedite presentation and provider education to improve diagnosis and surgery.
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Orquiectomía/estadística & datos numéricos , Torsión del Cordón Espermático/epidemiología , Torsión del Cordón Espermático/cirugía , Adolescente , Distribución por Edad , Niño , Preescolar , Humanos , Incidencia , Lactante , Recién Nacido , Corea (Geográfico)/epidemiología , Masculino , República de Corea/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Torsión del Cordón Espermático/diagnóstico , Resultado del Tratamiento , Adulto JovenRESUMEN
We investigated the efficacy and tolerability of various anticholinergics in Korean children with non-neurogenic overactive bladder (OAB). A total of 326 children (males:females= 157:169) aged under 18 yr (mean age 7.3±2.6 yr) who were diagnosed with OAB from 2008 to 2011 were retrospectively reviewed. The mean duration of OAB symptoms before anticholinergic treatment was 16.9±19.0 months. The mean duration of medication was 5.6±7.3 months. Urgency urinary incontinence episodes per week decreased from 1.9±3.1 to 0.4±1.5 times (P<0.001). The median voiding frequency during daytime was decreased from 9.2±5.4 to 6.3±4.2 times (P<0.001). According to 3-day voiding diaries, the maximum and average bladder capacity were increased from 145.5±66.9 to 196.8±80.3 mL and from 80.8±39.6 to 121.8±56.5 mL, respectively (P<0.001). On uroflowmetry, maximum flow rate was increased from 17.6±8.4 to 20.5±8.2 mL/sec (P<0.001). Adverse effects were reported in 14 (4.3%) children and six children (1.8%) discontinued medication due to adverse effects. Our results indicate that anticholinergics are effective to improve OAB symptoms and tolerability was acceptable without severe complications in children.
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Antagonistas Colinérgicos/uso terapéutico , Vejiga Urinaria Hiperactiva/tratamiento farmacológico , Niño , Preescolar , Antagonistas Colinérgicos/efectos adversos , Estreñimiento/etiología , Mareo/etiología , Femenino , Humanos , Masculino , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Hematuria is a relatively common condition among school-aged children. Because international guidelines for asymptomatic hematuria in children are unavailable, developing practical guidelines for the diagnosis and management of asymptomatic hematuria based on scientific evidence while considering real-world practice settings, values, and patient and physician preferences is essential. The Korean Society of Pediatric Nephrology developed clinical guidelines to address key questions regarding the diagnosis and management of asymptomatic hematuria in children.
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PURPOSE: This study aimed to evaluate the efficacy of computed tomography (CT)-based acute pyelonephritis (APN) grades for predicting clinical severity and disease course. MATERIALS AND METHODS: This study involved the analysis of the data of 204 consecutive patients with APN who underwent a CT examination at admission. Patients who had undergone prior treatment and those with ureteral calculi or an abscess by CT were excluded. Computed tomographic findings were divided into 4 grades according to renal parenchymal involvement, as follows: no renal parenchyma involvement (grade 1), less than 25% involvement (grade 2), 25% to 50% involvement (grade 3), and greater than 50% (grade 4). Patients with these grades were compared with respect to APN severity index (highest body temperature, initial C-reactive protein, and leukocytosis) and recovery index (hospital stay, fever duration, and leukocytosis duration). RESULTS: A total of 204 patients of mean age 39.3 years were included. Acute pyelonephritis severity indices and recovery indices increased with APN grade. Mean highest body temperature values were 38.3°C and 38.9°C in grades 1 and 4, respectively (P = 0.002). Mean hospital stay increased from 5.7 days for grade 1 to 7.6 days for grade 4 (P < 0.001). Initial C-reactive protein, initial leukocytosis, fever duration, and leukocytosis duration also increased with APN grade. CONCLUSIONS: This study suggests that APN grades, as determined by CT examination, valuably predict the clinical course of APN.
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Pielonefritis/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pielonefritis/patología , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
We aimed to investigate the clinical value of persistent but downgraded vesicoureteral reflux (VUR) after dextranomer/hyaluronic acid (Dx/HA) injection in children. The medical records of 128 children (195 ureters) who underwent Dx/HA injections for VUR were reviewed. The incidences of pre- and post-operative febrile urinary tract infections (UTIs) were analyzed in children with or without persistent VUR on voiding cystourethrography (VCUG) 3 months postoperatively. The surgical results of VUR persistent children who underwent a single additional injection were assessed. The VUR resolved completely in 100 ureters (51.3%), was persistent in 95 ureters, and newly developed in 2 ureters. The incidence of pre/post-operative febrile UTIs were 0.35 ± 0.39 per year and 0.07 ± 0.32 per year in VUR resolved children (P < 0.001), and 0.76 ± 1.18 per year and 0.20 ± 0.61 per year in VUR persistent children (P < 0.001). A single additional Dx/HA injection (44 ureters) resolved VUR in 29 ureters (65.9%), and also reduced the VUR to grade I in 7 ureters (15.9%), II in 4 (9.1%), and III in 4 (9.1%). Even in children with persistent VUR after Dx/HA injection, the incidence of febrile UTIs decreased markedly. The VUR grade significantly decreases after single additional Dx/HA injection.
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Dextranos/uso terapéutico , Ácido Hialurónico/uso terapéutico , Infecciones Urinarias/epidemiología , Reflujo Vesicoureteral/tratamiento farmacológico , Profilaxis Antibiótica , Niño , Preescolar , Femenino , Fiebre/complicaciones , Fiebre/epidemiología , Humanos , Incidencia , Masculino , Estudios Retrospectivos , Resultado del Tratamiento , Infecciones Urinarias/complicaciones , Infecciones Urinarias/tratamiento farmacológico , Reflujo Vesicoureteral/cirugíaRESUMEN
We performed a nationwide epidemiological study to evaluate the prevalence and characteristics of nocturnal enuresis (NE) in Korean adolescents and adults. A questionnaire was sent via e-mail to 51,073 people aged 16-40 yr by stratified sampling according to age, sex, and region among a 200,000 internet survey panel pool. The questionnaire included following information; presence or absence of NE, frequency of NE, possible risk factors for NE, self-esteem scale score and depression score results, and measures for the treatment of NE. Among the 2,117 responders, 54 (2.6%) had NE (≥1 enuretic episode within 6 months). Of 54 bedwetters, 9.3% wet ≥1 night per week and 20.5% wet ≥1 per month. The prevalence rates remained relatively stable with no apparent trend of reduction with age. The presence of sleep disturbance, family history, urgency, or urge incontinence increased the probability of NE episode significantly. The self-esteem score was lower (P=0.053) and the depression scale score was higher (P=0.003) in bedwetters compared with non-bedwetters. Overall 2.6% of Korean aged 16-40 yr have NE. The higher rate of urgency and urge incontinence in adolescent and adult enuretics suggests that bladder function has an important role in adolescent and adult NE.
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Enuresis Nocturna/epidemiología , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , República de Corea/epidemiología , Factores de Riesgo , Trastornos del Sueño-Vigilia , Encuestas y Cuestionarios , Incontinencia Urinaria/epidemiología , Adulto JovenRESUMEN
PURPOSE: We investigated whether endoscopic interventions, including laser endoureterotomy and balloon dilatation following hormone therapy, are a good choice to treat ureteral obstruction due to ureteral endometriosis instead of laparoscopic or open surgery. MATERIALS AND METHODS: Patients with ureteral obstruction due to endometriosis who underwent endoscopic intervention between 2004 and 2021 were reviewed. Patients with other causes of ureteral obstruction or previous ureteral surgery were excluded from the study. The primary endpoint was the 3-month success rate of endoscopic intervention with or without hormone therapy. Secondary endpoints were the success rate of endoscopic intervention between the hormone-treated and hormone-untreated groups at 6 months and the success rate according to the hormone therapy response of endometriosis at 3 and 6 months. RESULTS: Eighteen patients with 19 ureter units were evaluated in this study, including 12 patients receiving hormone therapy and six patients not receiving hormone therapy. Among patients receiving hormone therapy, one patient had bilateral ureteral obstruction. The success rate of endoscopic intervention was higher in patients who received hormone therapy than in those who did not receive hormone therapy three months after endoscopic intervention (76.9% vs. 0.0%, p=0.003). The same result was also found 6 months after endoscopic intervention (75.0% vs. 0.0%, p=0.005). In addition, the success rates were higher in the hormone-responsive group than in the non-responsive group (100.0% vs. 57.1%), although the difference was not statistically significant (p=0.122). CONCLUSIONS: Ureteral obstruction caused by endometriosis can be effectively treated by endoscopic intervention with hormone therapy in select patients.
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Endometriosis , Uréter , Obstrucción Ureteral , Femenino , Humanos , Obstrucción Ureteral/cirugía , Obstrucción Ureteral/complicaciones , Ureteroscopía/efectos adversos , Endometriosis/complicaciones , Endometriosis/cirugía , Uréter/cirugía , HormonasRESUMEN
Purpose: Tc-99m dimercaptosuccinic acid (99mTc-DMSA) renal scan is an important tool for the assessment of childhood urinary tract infection (UTI), vesicoureteral reflux (VUR), and renal scarring. We evaluated whether a deep learning (DL) analysis of 99mTc-DMSA renal scans could predict the recurrence of UTI better than conventional clinical factors. Methods: the subjects were 180 paediatric patients diagnosed with UTI, who underwent immediate post-therapeutic 99mTc-DMSA renal scans. The primary outcome was the recurrence of UTI during the follow-up period. For the DL analysis, a convolutional neural network (CNN) model was used. Age, sex, the presence of VUR, the presence of cortical defects on the 99mTc-DMSA renal scan, split renal function (SRF), and DL prediction results were used as independent factors for predicting recurrent UTI. The diagnostic accuracy for predicting recurrent UTI was statistically compared between independent factors. Results: The sensitivity, specificity and accuracy for predicting recurrent UTI were 44.4%, 88.9%, and 82.2% by the presence of VUR; 44.4%, 76.5%, and 71.7% by the presence of cortical defect; 74.1%, 80.4%, and 79.4% by SRF (optimal cut-off = 45.93%); and 70.4%, 94.8%, and 91.1% by the DL prediction results. There were no significant differences in sensitivity between all independent factors (p > 0.05, for all). The specificity and accuracy of the DL prediction results were significantly higher than those of the other factors. Conclusion: DL analysis of 99mTc-DMSA renal scans may be useful for predicting recurrent UTI in paediatric patients. It is an efficient supportive tool to predict poor prognosis without visually demonstrable cortical defects in 99mTc-DMSA renal scans.
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PURPOSE: To diagnose lower urinary tract symptoms (LUTS) in a noninvasive manner, we created a prediction model for bladder outlet obstruction (BOO) and detrusor underactivity (DUA) using simple uroflowmetry. In this study, we used deep learning to analyze simple uroflowmetry. MATERIALS AND METHODS: We performed a retrospective review of 4,835 male patients aged ≥40 years who underwent a urodynamic study at a single center. We excluded patients with a disease or a history of surgery that could affect LUTS. A total of 1,792 patients were included in the study. We extracted a simple uroflowmetry graph automatically using the ABBYY Flexicapture® image capture program (ABBYY, Moscow, Russia). We applied a convolutional neural network (CNN), a deep learning method to predict DUA and BOO. A 5-fold cross-validation average value of the area under the receiver operating characteristic (AUROC) curve was chosen as an evaluation metric. When it comes to binary classification, this metric provides a richer measure of classification performance. Additionally, we provided the corresponding average precision-recall (PR) curves. RESULTS: Among the 1,792 patients, 482 (26.90%) had BOO, and 893 (49.83%) had DUA. The average AUROC scores of DUA and BOO, which were measured using 5-fold cross-validation, were 73.30% (mean average precision [mAP]=0.70) and 72.23% (mAP=0.45), respectively. CONCLUSIONS: Our study suggests that it is possible to differentiate DUA from non-DUA and BOO from non-BOO using a simple uroflowmetry graph with a fine-tuned VGG16, which is a well-known CNN model.
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Aprendizaje Profundo , Síntomas del Sistema Urinario Inferior , Obstrucción del Cuello de la Vejiga Urinaria , Estudios de Factibilidad , Femenino , Humanos , Síntomas del Sistema Urinario Inferior/diagnóstico , Masculino , Vejiga Urinaria , Obstrucción del Cuello de la Vejiga Urinaria/diagnóstico , UrodinámicaRESUMEN
We aimed to develop and validate a scoring system as an objective assessment tool for predicting clinical failure after pediatric robotic extravesical ureteral reimplantation. Data for this multi-institutional retrospective cohort was obtained from two tertiary referral hospitals. We defined clinical failure as incomplete radiographic resolution or post-operative febrile UTI. Patients were stratified into low, intermediate, and high-risk groups according to the score. External validation was performed using the model projected to the external validation cohort. An amount of 115 renal units in the development cohort and 46 renal units in the validation cohort were analyzed. The prediction score was calculated with weighted points to each variable according to their regression coefficient as age (year) + BMI + BBD times 10 + VUR grade times 7 + console time (h) + hospital stay times 6. The C-index of our scoring system was 0.850 and 0.770 in the development and validation cohorts, respectively. Clinical failure was significantly different among risk groups: 0% (low-risk), 3.3% (intermediate-risk), and 22.2% (high-risk) (p = 0.004) in the development cohort. A novel scoring system using multiple pre- and intra-operative variables provides a prediction of children at risk of failure after robotic extravesical ureteral reimplantation.
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Denys-Drash syndrome (DDS) is a rare genetic disorder featuring the triad of Wilms' tumor, early-onset renal failure, and 46, XY disorder of sex development. DDS is usually caused by heterozygous missense mutations in the zinc-finger region of the WT1 gene. The most frequent constitutional WT1 mutations in DDS patients are missense mutations in exons 8 and 9. We present a new case of variable DDS in a child who was found to have a novel heterozygous missense mutation in exon 7 (c.905G>T) and a splicing mutation in exon 6 (IVS6-1G>T).
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Síndrome de Denys-Drash/genética , Genes del Tumor de Wilms , Mutación Missense , Síndrome de Denys-Drash/diagnóstico , Femenino , Heterocigoto , Humanos , LactanteRESUMEN
OBJECTIVE: We carried out a nationwide epidemiological study to evaluate the prevalence and effect of varicoceles on testicular volume in South Korean adolescents. We also investigated the correlation between varicoceles and body mass index (BMI). METHODS: In this prospective study, physical examinations were carried out to assess the presence and severity of varicoceles in middle school boys from six regions of South Korea. Testicular volume, height and weight of all boys were measured. The prevalence of varicoceles was assessed. The associations between age, testicular volume, BMI, and the presence and severity of varicoceles were examined. RESULTS: A total of 1938 boys with a mean age of 14.1 years (range 13-16 years) were screened. A varicocele was found on the left side in 295 (15.2%) boys and on the right side in 8 (0.4%) boys. Bilateral varicoceles were found in 17 (0.9%) individuals. Of the subjects with a left varicocele, 151 (51.2%), 80 (27.1%) and 64 (25.1%) boys had a grade 1, 2 or 3 varicocele, respectively. The prevalence of varicoceles did not increase with age. The proportion of boys with testicular size discrepancies increased with the severity of the varicocele. After adjusting for age, BMI had a negative correlation with the presence of varicoceles. CONCLUSIONS: The prevalence of varicoceles in South Korean middle school boys is 16.5%. The presence of varicoceles seems to have a negative effect on testicular growth. BMI has a significant inverse relationship with the occurrence of varicoceles.
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Varicocele/epidemiología , Adolescente , Índice de Masa Corporal , Estudios Transversales , Humanos , Masculino , Prevalencia , Estudios Prospectivos , República de Corea/epidemiología , Testículo/patología , Varicocele/patologíaRESUMEN
Objective: Recently, retrograde intrarenal surgery (RIRS) using laser lithotripsy has become popular. However, the optimal laser energy setting for pop-dusting has not been established. In this study, we report our experiences of RIRS using the high-power (up to 100 W) pop-dusting (HPPD) technique. Methods: This study retrospectively assessed 82 cases with RIRS using HPPD. Patients who underwent abdominal CT or mercaptoacetyltriglycine (MAG3) diuretic renal scan at 3 months postoperatively were included in this study. Patient and stone characteristics and perioperative and postoperative outcomes were evaluated. Results: The average number of renal stones was 3.67 ± 4.11, and the average length of the largest stones was 13.30 ± 6.41 mm. The mean Hounsfield units was 959.99 ± 384.73. The operation time was 58.10 ± 26.67 minutes. The mean HPPD time was 11.93 ± 9.48 minutes, with settings of 1.97 ± 0.25 J and 48.78 ± 3.29 Hz. The stone-free rate was 89%. The mean hospital stay was 1.68 ± 1.29 days. Pelvicaliceal and ureter injuries were observed in 9.8% and 32.9% of the study population, respectively. However, there was no transfusion, subcapsular hematoma, persistent urinary leakage, ureteral or infundibular stricture, or renal functional deterioration. There was transient postoperative fever in 12.2% of the study population. Conclusions: HPPD could be performed safely during RIRS for renal stones without significant complications such as collecting system injury or bleeding. High-power laser mode (up to 100 W) can be a safe and effective choice for pop-dusting during RIRS, especially for large and hard stones.
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Cálculos Renales , Láseres de Estado Sólido , Litotripsia por Láser , Estudios de Factibilidad , Humanos , Cálculos Renales/cirugía , Láseres de Estado Sólido/uso terapéutico , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Introduction: Postoperative acute urinary retention (pAUR) is a known occurrence after robot-assisted laparoscopic ureteral reimplantation via an extravesical approach (RALUR-EV). We hypothesized that the risk factor of pAUR after RALUR-EV might be similar to that of pAUR after open reimplantation. We aimed at performing a retrospective multi-institutional study to evaluate the risk factors for pAUR after RALUR-EV. Materials and Methods: Perioperative data collected from two tertiary referral hospitals included demographics and perioperative variables such as bladder bowel dysfunction (BBD) status, vesicoureteral reflux (VUR) grade, and laterality. pAUR was defined as the need for urethral catheter replacement after removal of the initial postoperative catheter. Univariate and multivariate analyses were performed to identify risk factors for pAUR. Results: A total of 117 patients with 174 renal units from the 2 hospitals were enrolled in this study. The median age at the time of surgery was 5 (0.3-19) years. Bilateral RALUR-EV was performed in 57 (48.7%) cases. pAUR rate was 3.4% in all patients and 7.0% in 57 patients with bilateral VUR. All four cases of pAUR occurred after bilateral surgery. Univariate analysis showed age (p = 0.037), weight (p = 0.039), height (p = 0.040), and bilaterality (p = 0.037) as risk factors of pAUR. In a multivariate analysis, BBD was the only significant risk factor of pAUR (p = 0.037). Conclusion: Urinary retention after RALUR-EV occurred less frequently when compared with the previously reported open surgery series. pAUR was seen only in bilateral cases in our series. Preoperative history of BBD, but not male gender or length of surgical time, was the only risk factor of pAUR after RALUR-EV.
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Laparoscopía , Procedimientos Quirúrgicos Robotizados , Robótica , Uréter , Retención Urinaria , Reflujo Vesicoureteral , Humanos , Laparoscopía/efectos adversos , Reimplantación/efectos adversos , Estudios Retrospectivos , Procedimientos Quirúrgicos Robotizados/efectos adversos , Resultado del Tratamiento , Uréter/cirugía , Vejiga Urinaria/cirugía , Retención Urinaria/etiología , Reflujo Vesicoureteral/cirugíaRESUMEN
PURPOSE: We compared the efficacy of desmopressin and enuresis alarm as first and second line treatment options for monosymptomatic nocturnal enuresis. MATERIALS AND METHODS: A total of 104 children with monosymptomatic nocturnal enuresis were randomly assigned to either desmopressin (54) or enuresis alarm (50) as first line treatment. Following 12 weeks of first line treatment children with a full response were evaluated for relapse 12 weeks after withdrawal of treatment. Children with partial or no response were switched to the alternative treatment and then evaluated after 12 weeks of crossover treatment. Relapse was defined as more than 1 episode of bedwetting monthly. RESULTS: Following first line treatment 77.8% of the desmopressin group and 82% of the enuresis alarm group achieved a successful result, including full response in 37% and 50% of the groups, respectively (p=0.433). Of the children with a full response 50% in the desmopressin group and 12% in the enuresis alarm group experienced a relapse when treatment stopped (p=0.005). Following second line crossover treatment 71.4% of the enuresis alarm-desmopressin group and 67.8% of the desmopressin-enuresis alarm group achieved a successful result, including full response in 47.6% and 45.2% of the groups, respectively (p=0.961). CONCLUSIONS: There was no difference between desmopressin and enuresis alarm during treatment for achieving dryness, but the chance of relapse after treatment stopped was higher following desmopressin. Switching to the alternative treatment following partial or no response provided an additional benefit.