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2.
J Coll Physicians Surg Pak ; 29(3): 281-283, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30823960

RESUMO

Ectopic prostatic tissue detected outside the genitourinary system has been rarely reported. A case with a giant pelvic adenoma that originated from ectopic prostatic tissue is presented. A 71-year male was detected with lower abdominal mass for eight months and recurrent acute urinary retention for one week. This patient already had mild lower urinary tract symptoms for three years. The physical examination, laboratory tests, ultrasonography, and MRI of this patient were analysed, and the pathological diagnosis was ectopic prostatic adenoma. The suprapubic incision for pelvic exploration and tumorectomy was chosen. The recognition and awareness of this unusual lesion is important, in order not to confuse this particular lesion with other pelvic tumors.


Assuntos
Coristoma/patologia , Neoplasias Pélvicas/diagnóstico por imagem , Próstata , Hiperplasia Prostática/diagnóstico por imagem , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Biópsia por Agulha , China , Coristoma/diagnóstico por imagem , Humanos , Imuno-Histoquímica , Laparotomia/métodos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Neoplasias Pélvicas/cirurgia , Hiperplasia Prostática/cirurgia , Doenças Raras , Resultado do Tratamento , Ultrassonografia Doppler/métodos , Retenção Urinária/diagnóstico , Retenção Urinária/etiologia
3.
Urology ; 127: 86-90, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30817961

RESUMO

OBJECTIVE: To study the feasibility of transvesical prostate resection and its effect on urethral stricture. MATERIALS AND METHODS: We included 99 patients with symptomatic bladder outlet obstruction who underwent transvesical resection of prostate (TVRP; n = 48) and transurethral (TURP; n = 51) prostatectomy. We examined all the patients by means of digital rectal examination, transrectal ultrasound, and evaluated them by international prostate symptom score, quality of life score, uroflowmetric assessment and PSA level, and established definitive diagnosis. We followed up the patients in first month, third month, and the first year of the operation and monitored once a year in the following years. RESULTS: In this study, totally 99 symptomatic bladder outlet obstruction patients were included (TVRP = 48 and TURP = 51). Mean age of the patients were 66.5 ± 8.2vs 68 ± 9.8years for our patients with TVRP and TURP, respectively. Two groups displayed similar values in terms of improvements in the Qmax and PVR, and there were no statistically significant differences in between. We obtained similar values for resection time and weight of resected prostate tissue in both groups. Urethral stricture was not observed in TVRP group. In TURP group however, stricture was observed in 4 (7.8%) patients in bulbar urethra in sixth month at average. And there was also a concomitant urethral meatal stricture in one of these patients. When the 2 groups were compared, the rate of urethral stricture was statistically significantly higher in the TURP group (P = .001). CONCLUSION: Resection of prostate without using urethra significantly reduces the incidence of urethral stricture due to mucosal damage.


Assuntos
Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata/métodos , Obstrução do Colo da Bexiga Urinária/diagnóstico , Obstrução do Colo da Bexiga Urinária/cirurgia , Idoso , Estudos de Casos e Controles , Estudos de Coortes , Estudos de Viabilidade , Seguimentos , Hematúria/diagnóstico , Hematúria/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/fisiopatologia , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Medição de Risco , Índice de Gravidade de Doença , Ressecção Transuretral da Próstata/efeitos adversos , Resultado do Tratamento , Ultrassom Focalizado Transretal de Alta Intensidade/métodos , Estreitamento Uretral/diagnóstico por imagem , Estreitamento Uretral/cirurgia , Retenção Urinária/diagnóstico , Retenção Urinária/epidemiologia , Infecções Urinárias/diagnóstico , Infecções Urinárias/epidemiologia
4.
BJOG ; 126(6): 804-813, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30548529

RESUMO

OBJECTIVE: To evaluate if immediate catheter removal (ICR) after laparoscopic hysterectomy is associated with similar retention outcomes compared with delayed removal (DCR). STUDY DESIGN: Non-inferiority randomised controlled trial. POPULATION: Women undergoing laparoscopic hysterectomy in six hospitals in the Netherlands. METHODS: Women were randomised to ICR or DCR (between 18 and 24 hours after surgery). PRIMARY OUTCOME: The inability to void within 6 hours after catheter removal. RESULTS: One hundred and fifty-five women were randomised to ICR (n = 74) and DCR (n = 81). The intention-to-treat and per-protocol analysis could not demonstrate the non-inferiority of ICR: ten women with ICR could not urinate spontaneously within 6 hours compared with none in the delayed group (risk difference 13.5%, 5.6-24.8, P = 0.88). However, seven of these women could void spontaneously within 9 hours without additional intervention. Regarding the secondary outcomes, eight women from the delayed group requested earlier catheter removal because of complaints (9.9%). Three women with ICR (4.1%) had a urinary tract infection postoperatively versus eight with DCR (9.9%, risk difference -5.8%, -15.1 to 3.5, P = 0.215). Women with ICR mobilised significantly earlier (5.7 hours, 0.8-23.3 versus 21.0 hours, 1.4-29.9; P ≤ 0.001). CONCLUSION: The non-inferiority of ICR could not be demonstrated in terms of urinary retention 6 hours after procedure. However, 70% of the women with voiding difficulties could void spontaneously within 9 hours after laparoscopic hysterectomy. It is therefore questionable if all observed urinary retention cases were clinically relevant. As a result, the clinical advantages of ICR may still outweigh the risk of bladder retention and it should therefore be considered after uncomplicated laparoscopic hysterectomy. TWEETABLE ABSTRACT: The advantages of immediate catheter removal after laparoscopic hysterectomy seem to outweigh the risk of bladder retention.


Assuntos
Remoção de Dispositivo/métodos , Histerectomia/efeitos adversos , Laparoscopia/efeitos adversos , Cuidados Pós-Operatórios , Cateterismo Urinário/métodos , Retenção Urinária , Adulto , Feminino , Humanos , Histerectomia/métodos , Laparoscopia/métodos , Pessoa de Meia-Idade , Avaliação de Resultados (Cuidados de Saúde) , Cuidados Pós-Operatórios/efeitos adversos , Cuidados Pós-Operatórios/instrumentação , Cuidados Pós-Operatórios/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/terapia , Fatores de Tempo , Cateteres Urinários , Retenção Urinária/diagnóstico , Retenção Urinária/etiologia , Retenção Urinária/fisiopatologia , Retenção Urinária/terapia , Micção/fisiologia
5.
Rev. enferm. UERJ ; 26: e25840, jan.-dez. 2018. ilus
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-991144

RESUMO

Objetivo: identificar evidências científicas sobre as práticas para o diagnóstico da retenção urinária. Método: trata-se de uma Scoping Review. A busca foi realizada nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library e SCOPUS. Das 2482 referências encontradas, 23 foram selecionadas. Resultados: os 23 artigos que foram agrupados de acordo com a clínica do paciente: clínica cirúrgica, clínica de reabilitação e clínica obstétrica. E as práticas utilizadas para o diagnóstico da retenção urinária: cateterismo urinário de alívio, por meio do ultrassom portátil de bexiga, com a associação do ultrassom portátil de bexiga e do cateterismo urinário e/ou com medidas não invasivas. Conclusão: o diagnóstico da retenção urinária é um assunto que vem sendo discutido há algum tempo, no entanto, ainda não há um consenso, e a sua prática é realizada muitas vezes sem eficácia.


Objective: to identify scientific evidence on urinary retention diagnostic practices. Method: this scoping review searched the Latin American & Caribbean Health Sciences Literature, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library and SCOPUS databases. Of the 2482 references found, 23 were selected. Results: the 23 articles were grouped by patient clinic (surgery, rehabilitation or obstetrics) and by urinary retention diagnostic practices (intermittent urinary catheterization, by portable bladder ultrasound, combination of portable bladder ultrasound and urinary catheterization and/ or non-invasive measures). Conclusion: diagnosis of urinary retention is an issue that has been discussed for some time. However, there is still no consensus, and in practice it is often performed ineffectively.


Objetivo:identificar evidencias científicas sobre las prácticas para el diagnóstico de la retención urinaria. Método: se trata de una Scoping Review. Se realizó la búsqueda en las bases de datos Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library y SCOPUS. De las 2482 referencias encontradas, se seleccionaron 23. Resultados: los 23 artículos se agruparon según la clínica del paciente: clínica quirúrgica, clínica de rehabilitación y clínica de obstetricia. Y las prácticas utilizadas para el diagnóstico de retención urinaria: cateterismo urinario de alivio, a través de ecografía (portátil) de vejiga, con la combinación de ecografía de vejiga y del cateterismo urinario y/o con medidas no invasivas. Conclusión: el diagnóstico de la retención urinaria es un tema que está siendo discutido desde hace algún tiempo, sin embargo, todavía no existe un consenso y su práctica se realiza a menudo ineficazmente.


Assuntos
Humanos , Retenção Urinária/diagnóstico , Cuidados de Enfermagem , Pesquisa em Enfermagem , Revisão , Prática Clínica Baseada em Evidências
6.
Int Braz J Urol ; 44(4): 805-811, 2018 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29697936

RESUMO

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
Enurese Noturna/diagnóstico , Enurese Noturna/fisiopatologia , Retenção Urinária/diagnóstico , Retenção Urinária/fisiopatologia , Micção/fisiologia , Criança , Feminino , Humanos , Masculino , Enurese Noturna/etiologia , Enurese Noturna/terapia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento , Bexiga Urinária/fisiopatologia , Retenção Urinária/complicações , Urodinâmica/fisiologia
7.
J Med Case Rep ; 12(1): 26, 2018 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-29391072

RESUMO

BACKGROUND: Labial fusion is defined as adhesions of the labia minora or majora. Labial fusion may cause urinary retention. Surgical treatment based on an accurate anatomic assessment may be needed, but the usefulness of endoscopic examination for this disease has not been reported. CASE PRESENTATION: A 76-year-old Japanese woman undergoing chemoradiation treatment for esophageal cancer was referred to our department for evaluation of high accumulation in the vagina on a positron emission tomography scan. On physical examination, her labia were noted to be extensively fused with a pinhole opening at the midline. Endoscopic examination revealed that her vagina was filled with urine and there were no abnormalities in her urethral meatus and cervix. The adhesions were separated under anesthesia and there has been no recurrence during follow-up. CONCLUSIONS: We present a case of a postmenopausal patient with labial fusion who underwent successful surgical management. An endoscopic examination enabled us to determine the precise anatomic position and adopt a safe surgical procedure.


Assuntos
Endoscopia , Neoplasias Esofágicas/complicações , Aderências Teciduais/complicações , Aderências Teciduais/cirurgia , Retenção Urinária/complicações , Doenças da Vulva/complicações , Doenças da Vulva/cirurgia , Idoso , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/radioterapia , Feminino , Humanos , Exame Físico , Aderências Teciduais/diagnóstico , Resultado do Tratamento , Retenção Urinária/diagnóstico , Retenção Urinária/etiologia , Retenção Urinária/cirurgia , Doenças da Vulva/diagnóstico
8.
Med Clin North Am ; 102(2): 373-385, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29406065

RESUMO

Urologic emergencies can involve the kidneys, ureters, bladder, urethra, penis, scrotum, or testicles. History and physical examination are essential to diagnosis, whereas imaging is increasingly used to confirm diagnoses. Acute urinary retention should be relieved with Foley placement. Penile emergencies include paraphimosis, which can be treated by foreskin reduction, whereas penile fracture and priapism require urologic intervention. Fournier gangrene and testicular torsion are scrotal emergencies requiring emergent surgery. Nephrolithiasis, although painful, is not an emergency unless there is concern for concomitant urinary tract infection, both ureters are obstructed by stones, or there is an obstructing stone in a solitary kidney.


Assuntos
Doenças Urológicas/diagnóstico , Doenças Urológicas/terapia , Doença Aguda , Emergências , Feminino , Doenças Urogenitais Femininas/diagnóstico , Doenças Urogenitais Femininas/terapia , Gangrena de Fournier/diagnóstico , Gangrena de Fournier/terapia , Humanos , Masculino , Doenças Urogenitais Masculinas/diagnóstico , Doenças Urogenitais Masculinas/terapia , Nefrolitíase/diagnóstico , Nefrolitíase/microbiologia , Nefrolitíase/terapia , Parafimose/diagnóstico , Parafimose/terapia , Pênis/lesões , Priapismo/diagnóstico , Priapismo/terapia , Encaminhamento e Consulta , Ruptura , Torção do Cordão Espermático/diagnóstico , Torção do Cordão Espermático/terapia , Retenção Urinária/diagnóstico , Retenção Urinária/terapia
9.
Trop Doct ; 48(1): 80-84, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28637376

RESUMO

Cystometrography (CMG) is a means of studying bladder pressure. It is a very useful diagnostic tool in patients with lower urinary tract symptoms for which a simple cystoscopy will not offer sufficient information to form a diagnosis. Of the 8893 patients who underwent screening for urological conditions in rural northeast India during 2010-2014, 280 with lower urinary tract symptoms were investigated with a combination of cystoscopy and CMG. By corresponding CMG diagnosis and treatment, we could examine patients' overall satisfaction with both the procedure and the treatment. We describe a low-cost method of CMG and our results using this method in rural areas of India.


Assuntos
Cistoscopia , Obstrução do Colo da Bexiga Urinária/diagnóstico , Bexiga Urinária/fisiopatologia , Retenção Urinária/diagnóstico , Adulto , Idoso , Cistoscopia/economia , Cistoscopia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , População Rural , Obstrução do Colo da Bexiga Urinária/fisiopatologia , Retenção Urinária/fisiopatologia , Urodinâmica
10.
World J Urol ; 35(12): 1907-1911, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28929299

RESUMO

PURPOSE: To determine success rate (SR), functional outcome, and patient satisfaction of a modified YV-plasty for reconstruction of the bladder neck in case of recurrent bladder neck stenosis (BNS) after transurethral surgery of the prostate: the T-plasty. PATIENTS AND METHODS: We identified all patients who underwent T-plasty at our center between December 2008 and July 2016. Patients' charts were reviewed. Patients were queried by telephone and by mail at time of follow-up (FU). Primary endpoint was SR. Secondary endpoints were complications, continence, satisfaction, and changes in quality of life measured by validated questionnaires. RESULTS: Thirty patients underwent the T-plasty. Median age at surgery was 69 (IQR 62-73) years. Most patients had BNS due to TUR-P [n = 25 (83.3%)]. No severe blood loss or severe complications occurred perioperatively. Median FU was 45 (IQR 18-64) months. Three patients were lost to FU. Success rate was 100%. Compared to pre-OP Q max, mean Q max post-OP improved significantly [pre-OP 6.79 (SD ± 4.76) ml/s vs post-OP was 24.42 (SD ± 12.61) ml/s; (t(5) = 4.12, p = 0.009)]. Mean post-void residual urine decreased significantly [pre-OP 140.77 (SD ± 105.41) ml vs post-OP 14.5 (SD ± 22.42) ml; (t(9) = -3.86, p = 0.004)]. One patient developed a de-novo-incontinence post-OP. Mean ICIQ-SF Score was 1.2 (SD ± 2.27). 88.5% of patients were pleased or delighted by surgery. 75% of patients claimed their quality of life has been (strongly) improved. CONCLUSIONS: The T-plasty is a valuable option as treatment of recurrent BNS. SR, rates of continence, and high patient satisfaction are very encouraging.


Assuntos
Complicações Pós-Operatórias , Qualidade de Vida , Procedimentos Cirúrgicos Reconstrutivos , Reoperação , Ressecção Transuretral da Próstata/efeitos adversos , Obstrução do Colo da Bexiga Urinária/cirurgia , Idoso , Seguimentos , Alemanha/epidemiologia , Humanos , Masculino , Preferência do Paciente , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/psicologia , Complicações Pós-Operatórias/cirurgia , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Recuperação de Função Fisiológica , Recidiva , Reoperação/efeitos adversos , Reoperação/métodos , Ressecção Transuretral da Próstata/métodos , Resultado do Tratamento , Obstrução do Colo da Bexiga Urinária/diagnóstico , Obstrução do Colo da Bexiga Urinária/etiologia , Obstrução do Colo da Bexiga Urinária/fisiopatologia , Incontinência Urinária/diagnóstico , Incontinência Urinária/etiologia , Retenção Urinária/diagnóstico , Retenção Urinária/etiologia
12.
Urol Oncol ; 35(12): 671.e11-671.e16, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28843339

RESUMO

PURPOSE: To investigate the long-term cumulative incidence of chronic urinary retention (CUR) after radical cystectomy (RC) and orthotopic neobladder (ONB) in women and the possible risk factors. MATERIAL AND METHODS: We retrospectively analyzed a prospectively evaluated cohort of women for whom RC and ONB were performed. Patients in CUR were evaluated for the cumulative incidence of CUR using Kaplan-Meier curve and for the possible risk factors using log rank and Cox regression analysis. RESULTS: A total of 234 women with mean age ± SD of 52.3 ± 9 years and a median (range) of follow-up of 92 (12-247) months were included. The incidence of CUR increased with time, where 12 (5.2%), 21 (8.97%), 35 (14.9%), 53 (22.6%), and 56 (24%) patients started clean intermittent catheterization in 1, 2, 2 to 5 years, 5 to 10 years, and after 10 years of follow-up, respectively. In univariate and multivariate analysis, diabetes mellitus and urethral Kock pouch were independent predictors of CUR development (HR [95% CI] = 2.45 [1.2-5.1], and 2.1 [1.05-4.2], P = 0.01 and 0.03, respectively). Genital- sparing RC and surgical modification to provide pouch back support were independent factors that reduce CUR development (HR [95% CI] = 9.3 [1.25-69.9], and 2.1 [1.19-3.9], P = 0.02 and 0.01, respectively). CONCLUSION: The incidence of CUR after RC and ONB in women increases with time even after 10 years of follow-up. Presence of diabetes mellitus increases the risk of CUR development. Genital-sparing RC and modification to prevent CUR reduced the likelihood of CUR development.


Assuntos
Cistectomia/métodos , Neoplasias da Bexiga Urinária/cirurgia , Derivação Urinária/métodos , Coletores de Urina , Retenção Urinária/diagnóstico , Adulto , Doença Crônica , Cistectomia/efeitos adversos , Feminino , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Avaliação de Resultados (Cuidados de Saúde)/métodos , Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Derivação Urinária/efeitos adversos , Retenção Urinária/etiologia
13.
Curr Urol Rep ; 18(9): 74, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28730405

RESUMO

PURPOSE OF REVIEW: This review examines current terminology used to define non-neurogenic chronic urinary retention (CUR), describes the pathophysiology of urinary retention, and highlights contemporary diagnostic and treatment algorithms. RECENT FINDINGS: There is no standardized definition for the condition, but volumes >300 ml are commonly used to describe CUR. It is a clinical diagnosis which does not require urodynamics. Pathophysiologic causes of CUR be from myogenic, neurogenic, bladder outlet obstruction, or a combination of these sources. Treatment algorithms recommend stratifying patients with chronic urinary retention by risk and by symptoms before initiating treatment. Common CUR outcome endpoints need to be better utilized so that treatment modalities can be compared. Non-neurogenic CUR is a heterogeneous condition that has multiple definitions, underlying physiologies, and possible endpoints. Standardization is needed to better understand and treat CUR.


Assuntos
Retenção Urinária/etiologia , Retenção Urinária/fisiopatologia , Algoritmos , Doença Crônica , Humanos , Músculo Liso/fisiopatologia , Guias de Prática Clínica como Assunto , Insuficiência Renal Crônica/etiologia , Fatores de Risco , Bexiga Urinária/fisiopatologia , Obstrução do Colo da Bexiga Urinária/complicações , Obstrução do Colo da Bexiga Urinária/fisiopatologia , Cálculos Urinários/etiologia , Retenção Urinária/diagnóstico , Infecções Urinárias/etiologia , Urodinâmica/fisiologia
14.
Urol Clin North Am ; 44(3): 429-439, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28716323

RESUMO

Many multiple sclerosis (MS) patients are affected by urinary retention. Common causes include neurogenic underactive bladder and/or bladder outlet obstruction from detrusor sphincter dyssynergia. Systemic review of contemporary MS urodynamic studies demonstrates that 53% of MS patients have detrusor overactivity, 43% have detrusor sphincter dyssynergia, and 12% have atonic bladder (12 studies, 1524 patients). There is no standard definition of MS-related urinary retention, but greater than 300 mL is a proposed threshold value for the condition based on literature review. Treatment should be based on stratifying patients by risk from morbidity from retention and by symptoms caused by retention.


Assuntos
Esclerose Múltipla/complicações , Retenção Urinária/fisiopatologia , Retenção Urinária/terapia , Doença Crônica , Humanos , Guias de Prática Clínica como Assunto , Retenção Urinária/diagnóstico , Retenção Urinária/etiologia , Urodinâmica
15.
BMJ Case Rep ; 20172017 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-28724598

RESUMO

Although the combination of acute urinary retention and aseptic meningitis has not been well recognised, this combination can be referred to as meningitis-retention syndrome (MRS). We report a case of MRS with urodynamic follow-up. A 29-year-old man developed fever and headache, and after 7 days, he developed sudden urinary retention. Neurological examination indicated stiff neck, hyper-reflexes of the lower extremities. Cerebrospinal fluid examination showed mononuclear leucocytosis, increased protein level. Myelin basic protein was absent. MRI of the brain and spinal cord were normal. Cystometrography revealed an atonic bladder. The diagnosis was MRS. After 11 days of hospital day, his symptoms reduced rapidly, and on the 12th day, cystometrography revealed normal pattern. In mild cases, the symptoms reduced and the urodynamic examination improved rapidly. Although MRS is a rare symptom, its urodynamic assessment is important.


Assuntos
Meningite Asséptica/diagnóstico , Bexiga Urinaria Neurogênica/diagnóstico , Retenção Urinária/diagnóstico , Urodinâmica , Adulto , Humanos , Imagem por Ressonância Magnética , Masculino , Meningite Asséptica/complicações , Exame Neurológico , Síndrome , Bexiga Urinaria Neurogênica/etiologia , Retenção Urinária/etiologia
16.
Urol Int ; 99(1): 51-55, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28478446

RESUMO

OBJECTIVES: The study aimed to evaluate whether the duration of complaints in patients with overactive bladder syndrome or non-obstructive urinary retention predicts the outcome of sacral neuromodulation (SNM). METHODS: All patients that underwent a SNM test period evaluation between 2011 and 2014, were included in this study. The duration of complaints was listed in 3 categories: (a) 0-5 years, (b) 5-10 years and (c) 10 years or longer. Analyses with chi square tests were performed to evaluate whether the duration of complaints are associated with outcome of SNM. RESULTS: In total, 130 patients were included. Most patients had a complaint duration of 0-5 years (n = 60). The test period was successful in 56% (n = 74) of the total group. Analyses showed that the duration of complaints is not significantly associated with outcome of SNM (p = 0.752), even when subdivided per indication, and also when possible confounders such as age at test and indication are taken into account (p = 0.720). CONCLUSION: Based on the results of this study, there is no relationship between duration of complaints and SNM outcome. SNM seems to remain a feasible treatment option, despite of possible anatomical or physiological changes within the lower urinary tract.


Assuntos
Terapia por Estimulação Elétrica/métodos , Plexo Lombossacral/fisiopatologia , Bexiga Urinária Hiperativa/terapia , Bexiga Urinária/inervação , Retenção Urinária/terapia , Adulto , Distribuição de Qui-Quadrado , Terapia por Estimulação Elétrica/efeitos adversos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Bexiga Urinária Hiperativa/diagnóstico , Bexiga Urinária Hiperativa/fisiopatologia , Retenção Urinária/diagnóstico , Retenção Urinária/fisiopatologia
17.
Eur Urol ; 72(3): 402-407, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28400168

RESUMO

BACKGROUND: Underactive bladder (UAB) is considered the symptom complex associated with the urodynamic diagnosis of detrusor underactivity. OBJECTIVE: The aim of this research was to investigate the patient reported experience of the symptoms, signs, and impact of UAB. This research is also part of the initial qualitative phase for the development of a new patient reported outcome measure for the assessment of UAB. DESIGN, SETTING, AND PARTICIPANTS: Qualitative methods were used to understand the experience of UAB from a patient perspective, in a purposive sample of male (n=29) and female (n=15) patients aged 27-88 yr (mean: 64 yr), diagnosed with a primary diagnosis of detrusor underactivity, with or without coexisting urological conditions. Semistructured interviews were conducted in Bristol, UK. RESULTS: Male and female patients reported a variety of lower urinary tract symptoms and associated impact on quality of life. Storage symptoms of nocturia, increased daytime frequency, and urgency, and the voiding symptoms of slow stream, hesitancy, and straining were reported by over half of the patients. A sensation of incomplete emptying and postmicturition dribble were also frequently described. Most had a post void residual >30ml (n=34, 77%, median: 199ml) with many reporting urinary tract infections, a history of self-catheterisation, and some experiencing occasional acute retention episodes. These symptoms and signs can have a broad impact on quality of life including having to plan their daily activities around the location of toilets, disruption to sleep, social life, and associated effect on family and friends. CONCLUSIONS: Knowledge of the lived experience of UAB obtained in the current study will be used for the development of a new patient reported outcome measure and help inform the current working definition of UAB. PATIENT SUMMARY: The symptoms, signs, and impact on quality of life of underactive bladder are described by patients with the condition.


Assuntos
Efeitos Psicossociais da Doença , Sintomas do Trato Urinário Inferior/fisiopatologia , Sintomas do Trato Urinário Inferior/psicologia , Qualidade de Vida , Doenças da Bexiga Urinária/fisiopatologia , Doenças da Bexiga Urinária/psicologia , Bexiga Urinária/fisiopatologia , Atividades Cotidianas , Adulto , Idoso , Idoso de 80 Anos ou mais , Inglaterra , Feminino , Humanos , Relações Interpessoais , Entrevistas como Assunto , Sintomas do Trato Urinário Inferior/diagnóstico , Masculino , Pessoa de Meia-Idade , Noctúria/diagnóstico , Noctúria/fisiopatologia , Noctúria/psicologia , Medidas de Resultados Relatados pelo Paciente , Pesquisa Qualitativa , Comportamento Social , Doenças da Bexiga Urinária/diagnóstico , Incontinência Urinária/diagnóstico , Incontinência Urinária/fisiopatologia , Incontinência Urinária/psicologia , Retenção Urinária/diagnóstico , Retenção Urinária/fisiopatologia , Retenção Urinária/psicologia , Infecções Urinárias/diagnóstico , Infecções Urinárias/fisiopatologia , Infecções Urinárias/psicologia , Urodinâmica
18.
Clin Neurol Neurosurg ; 157: 17-18, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28363090

RESUMO

A 70-year-old man developed urinary retention in the early stages of herpes simplex virus (HSV) type-1 encephalitis. A nerve conduction study suggested latent myeloradiculitis. This is the first report of human herpes simplex virus-1 encephalitis followed by urinary retention at early stage from the onset like the Elsberg syndrome. Although relatively few similar cases have been reported, we consider that urinary retention is common in HSV-1 encephalitis, in which disturbances of consciousness usually require bladder catheterization from the onset. We further emphasize that urinary retention may occasionally occur in early stages of HSV-1 encephalitis, with a significant possibility of recovery.


Assuntos
Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Encefalite por Herpes Simples/tratamento farmacológico , Herpesvirus Humano 1 , Retenção Urinária/tratamento farmacológico , Idoso , Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Encefalite por Herpes Simples/diagnóstico , Encefalite por Herpes Simples/virologia , Herpesvirus Humano 1/efeitos dos fármacos , Humanos , Masculino , Resultado do Tratamento , Retenção Urinária/diagnóstico , Retenção Urinária/virologia
19.
PLoS One ; 12(2): e0170726, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28166296

RESUMO

INTRODUCTION: The emergence of urinary retention (UR), specifically acute urinary retention (AUR), has been a concern when treating men with lower urinary tract symptoms (LUTS) with antimuscarinic drugs. MATERIALS AND METHODS: In NEPTUNE (12-week, double-blind), men (≥45 years) with LUTS were randomized to receive tamsulosin oral-controlled absorption system (TOCAS) 0.4 mg, fixed-dose combination (FDC) of solifenacin (Soli) 6 mg + TOCAS 0.4 mg, FDC Soli 9 mg + TOCAS 0.4 mg, or placebo. In NEPTUNE II (40-week, open-label extension of NEPTUNE), continuing patients received 4-week FDC Soli 6 mg + TOCAS, then FDC Soli 6 mg or 9 mg + TOCAS for the remainder of the study, switchable every 3 months. RESULTS: Across both studies, 1208 men received ≥1 dose of FDC Soli 6 mg or 9 mg + TOCAS for up to 52 weeks; 1199 men completed NEPTUNE and 1066 received ≥1 dose in NEPTUNE II. In total, 13 men (1.1%; 95% CI, 0.6%-1.8%) reported a UR event while receiving FDC, eight of which were AUR (0.7%; 95% CI, 0.3%-1.3%, incidence 7/1000 man-years). Six men reported UR events while taking Soli 6 mg + TOCAS (three AUR), and seven men reported a UR event while taking Soli 9 mg + TOCAS (five AUR). One man developed AUR while taking TOCAS alone and four reported UR (three AUR) during placebo run-in. Most AUR/UR events occurred within 4 months of treatment initiation. CONCLUSIONS: FDC Soli and TOCAS was associated with a low rate of UR and AUR in men with LUTS.


Assuntos
Sintomas do Trato Urinário Inferior/complicações , Succinato de Solifenacina/efeitos adversos , Sulfonamidas/efeitos adversos , Retenção Urinária/epidemiologia , Retenção Urinária/etiologia , Agentes Urológicos/efeitos adversos , Combinação de Medicamentos , Humanos , Incidência , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Masculino , Fatores de Risco , Succinato de Solifenacina/administração & dosagem , Sulfonamidas/administração & dosagem , Comprimidos , Tansulosina , Fatores de Tempo , Retenção Urinária/diagnóstico , Agentes Urológicos/administração & dosagem
20.
Neurourol Urodyn ; 36(3): 794-797, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27176656

RESUMO

AIM: To assess the incidence and associated risk factors of asymptomatic urinary retention in elderly women upon admission to the Internal Medicine department. METHODS: Two hundred and two consecutive elderly women (mean age 84.4 ± 5.7 years) who were admitted to four Internal Medicine departments at a tertiary medical center were prospectively enrolled. All patients underwent post-void residual urine (PVR) measurements on the morning following the admission day. The measurements were undertaken by using a portable ultrasound bladder scan. Asymptomatic urinary retention was defined as PVR ≥ 200 ml without lower urinary tract symptoms, or abdominal pain, in two consecutive measurements. RESULTS: Asymptomatic urinary retention was diagnosed in 29 (14.4%) women (mean PVR: 353.1 ± 155.2 ml; range: 200-712 ml). The mean age, prevalence of chronic diseases, and the use of opioid and antimuscarinic drugs were similar in women with versus without asymptomatic urinary retention. A binary logistic regression analysis showed that asymptomatic urinary retention was significantly and independently associated with low mobility, measured by the functional independence measure (FIM) scale (odds ratio = 0.7, 95% confidence interval 0.6-0.9, P = 0.026), and hypothyroidism (odds ratio = 2.4, 95% confidence interval 1.0-5.8, P = 0.049). Among 174 (86.1%) patients in whom thyroid-stimulating hormone (TSH) serum levels were measured, a statistically significant correlation was demonstrated between TSH values and PVR measurements. CONCLUSIONS: Asymptomatic urinary retention in elderly women upon admission to the Internal Medicine department is not infrequent and is independently associated with hypothyroidism and low mobility. PVR measurements should, therefore, be considered in all women with a low level of mobility and/or hypothyroidism upon admission to the Internal Medicine department. Neurourol. Urodynam. 36:794-797, 2017. © 2016 Wiley Periodicals, Inc.


Assuntos
Retenção Urinária/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Admissão do Paciente , Prevalência , Estudos Prospectivos , Fatores de Risco , Retenção Urinária/diagnóstico , Retenção Urinária/etiologia
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