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1.
Artigo em Inglês | LILACS | ID: biblio-1088038

RESUMO

This letter to the Editor aims to provide suggestions and recommendations for the management of urological conditions in times of COVID-19 crisis in Brazil and other low- and middle-income countries. It is important to highlight that one of the main characteristics of this pandemic is the oversaturation of the health system capacity, mostly due to a high demand for personal protective equipment (PPE), Hospital/ICU beds, as well as ventilators. In places with limited resources and where the health care systems are already saturated, such consideration is even more worrisome. Therefore, most worldwide authorities are recommending to avoid, as much as possible, patient's elective visits to hospitals, as well as a judicious use of the operating room in order to mitigate the strain put on the health system. While efforts should be directed to the care of COVID-19 patients, other conditions (especially urgencies and oncological cases) must continue to be assisted. Thus, through a panel of experts, we have prepared a practical guide for urologists based on the recommendations from the main Urologic Associations, as well as data from the literature to support the suggested management. We will try to follow the standard guideline recommendations from the American Urological Association (AUA) and European Association of Urology (EAU), with the aim of pursuing the best outcomes possible. However, some recommendations were based on the consensus of the panel, taking into consideration the reality of developing countries and the unprecedented situation caused by the COVID-19 crisis. Most importantly, all recommendations on this manuscript are based on the expectancy of a maximum 3-month duration of the crisis. If this period shall extended, these recommendations will be revised and updated. The format of the text will be given through questions and answers.(AU)


Assuntos
Procedimentos Cirúrgicos Urológicos/normas , Infecções por Coronavirus/epidemiologia , Países em Desenvolvimento , Técnicas de Diagnóstico Urológico/normas , Pandemias , Brasil
2.
Rev. colomb. obstet. ginecol ; 70(4): 243-252, oct.-dic. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1093047

RESUMO

RESUMEN Objetivo: determinar la prevalencia de infección del tracto urinario (ITU), el perfil microbiológico y la resistencia a los antibióticos en mujeres gestantes con sospecha de infección del tracto urinario. Materiales y métodos: estudio de corte transversal. Ingresaron gestantes con sospecha de infección del tracto urinario adquirida en la comunidad, remitidas a consulta externa desde su control prenatal o atención por urgencias, y hospitalizadas entre agosto de 2013 y septiembre de 2015 en un hospital universitario de referencia ubicado en Medellín, Colombia. Se excluyeron gestantes que hubieran recibido antibióticos el día anterior a la admisión. Muestreo aleatorio simple. Variables medidas: sociodemográficas, clínicas y bacteriológicos. Se aplicó estadística descriptiva. Resultados: la prevalencia de infección del tracto urinario fue del 29 %. Predominaron los aislamientos de bacterias Gram negativas, principalmente E. coli y K. pneumoniae en un 57,7 y 11,4 % respectivamente. Se observó resistencia a trimetoprim-sulfametoxazol en el 19,5 % y ampicilina-sulbactam en el 17,5 % de los aislamientos. Conclusiones: se requieren estudios de base poblacional para una mejor aproximación a la resistencia de las bacterias causantes de la ITU en la comunidad. Por otra parte, la alta resistencia observada podría sugerir que algunos antibióticos expuestos no sean incluidos en las guías locales de manejo de la ITU.


ABSTRACT Objective: To determine the prevalence of urinary tract infections (UTIs), the microbiological profile and antibiotic resistance in pregnant women with suspected urinary tract infection. Materials and methods: Cross-sectional study of pregnant women with suspected community- acquired urinary tract infection referred to the outpatient clinic by prenatal care practitioners or seen in the emergency room, and hospitalized between August 2013 and September 2015 in a referral teaching hospital located in Medellin, Colombia. Pregnant women who had received antibiotics on the day before admission were excluded. Random sampling. Measured variables: sociodemographic, clinical and bacteriological. Descriptive statistics were applied. Results: The prevalence of urinary tract infections was 29%. Gram negative bacteria isolates were found predominantly, the main ones being E. coli and K. pneumoniae at 57.7 and 11.4%, respectively. Resistance to trimethoprim- sulfamethoxazole and to ampicillin-sulbactam was observed in 19.5% and 17.5% of isolates, respectively. Conclusions: Population-based studies are needed to provide a better approach to bacterial resistance in community-acquired UTIs. On the other hand, the high resistance observed may suggest that some of the exposed antibiotics might not be included in the local guidelines for the management of UTIs.


Assuntos
Humanos , Feminino , Gravidez , Complicações Infecciosas na Gravidez , Infecções Urinárias , Urinálise , Técnicas de Diagnóstico Urológico
3.
Medicine (Baltimore) ; 98(41): e17389, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593090

RESUMO

To examine whether scrotoscopy could be used to diagnose testicular rupture (TR) with accuracy.This retrospective study included all patients receiving scrotoscopy followed by immediate open exploration (OE) for suspected TR at two Chinese tertiary care centers between March 2014 and March 2018.Fifteen patients suspected of having TR were included. TR was considered in 8 patients (8/15) via emergency scrotal ultrasound (ESU) examination. Of these 8 patients, 6 cases as well as 3 other cases, a total of 9 cases (9/15) were confirmed TR by scrotoscopy and OE; the remaining 6 patients (6/15) were found disease free. The presence/absence of TR was identified correctly with scrotoscopy in all 15 cases. The rupture size of the testicular tunica albuginea (TTA) varied from 0.5 to 2 cm. Only 3 cases (3/15) had scrotal wall edema and all quickly recovered. The testis was normal in size and blood flow at 6-month follow-up visit.Scrotoscopy accurately diagnoses TR, and may avoid unnecessary OE, especially for the patients confirmed free of disease.


Assuntos
Técnicas de Diagnóstico Urológico , Doenças Testiculares/diagnóstico por imagem , Ultrassonografia/métodos , Adolescente , Adulto , Humanos , Masculino , Projetos Piloto , Estudos Retrospectivos , Ruptura Espontânea/diagnóstico por imagem , Escroto/diagnóstico por imagem , Testículo/diagnóstico por imagem , Adulto Jovem
5.
Urologiia ; (4 ()): 25-27, 2019 Sep.
Artigo em Russo | MEDLINE | ID: mdl-31535794

RESUMO

Imaging studies play a crucial role in the diagnosis of urologic diseases. X-ray and ultrasound studies are used as first-line diagnostic methods. Computed tomography and magnetic resonance imaging (MD-CT and MRI), radionuclide and hybrid methods allow to clarify diagnosis. Currently, the trend "from simple to complex" contributes to obtaining maximum information in the shortest possible time with a minimum cost.


Assuntos
Técnicas de Diagnóstico Urológico/tendências , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X , Doenças Urológicas/diagnóstico por imagem , Urologia/tendências , Alemanha , Humanos , Imagem por Ressonância Magnética/métodos , Imagem por Ressonância Magnética/tendências , Tomografia Computadorizada por Raios X/métodos , Tomografia Computadorizada por Raios X/tendências , Ultrassonografia/métodos , Ultrassonografia/tendências , Urografia
6.
Med Arch ; 73(2): 81-86, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31391692

RESUMO

Aim: To determine the discriminatory power of penile urethral compression-release index (PCRI), clinical prostate score (CLIPS) and bladder outlet obstruction index 2 (BOON2) for the detection of bladder outlet obstruction (BOO), and the associated bladder abnormality in patients with benign prostatic enlargement (BPE). Material and methods: In study was included of 135 patients with proven BPE underwent urodynamic measurement (UDM) and PCR maneuver. PCR Index was calculated following the formula: (Qs-Qss)/Qss x 100(%). CLIPS score was calculated based on non-invasive variables (prostate volume, maximal urinary flow, residual urine and voided volume), while BOON2 was calculated using the formula intravesical prostate protrusion (IPP)-3 x Qmax-0.2 x mean voided volume. UDM results were plotted on Schaefer and URA nomograms. Results: A comparative analysis was made using ROC curves. The area under the curve (AUC) for PCRI is 0.85 (PTP 91.3%), while AUC for CLIPS and BOON2 is 0.8 (PTP 77.6%) and 0.82 (PTP 74.5%), respectively. PCRI with the cut-off point of 96% clearly distinguishes obstructed patients with normocontractile detrusor and the presence of detrusor overactivity (DO), versus those unobstructed. CLIPS (>10) shows good BOO prediction, but without the possibility of distinguishing between detrusor contractility grade and the occurrence of DO. BOON2 has shown that impaired contractility has influence on this number in obstructed patients. Conclusion: PCRI is a very good noninvasive urodynamic test for a group-wise detection of BOO in patients with BPE and associated bladder co-morbidities; it is therefore superior in comparison with to CLIPS or BOON2.


Assuntos
Hiperplasia Prostática/fisiopatologia , Obstrução do Colo da Bexiga Urinária/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Técnicas de Diagnóstico Urológico , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Pênis , Próstata/patologia , Hiperplasia Prostática/complicações , Hiperplasia Prostática/patologia , Medição de Risco , Uretra , Obstrução do Colo da Bexiga Urinária/etiologia , Obstrução do Colo da Bexiga Urinária/fisiopatologia , Urodinâmica
8.
Eur J Obstet Gynecol Reprod Biol ; 237: 13-17, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30978581

RESUMO

OBJECTIVE: The aim of this study was to perform a score predictive of ALPP <60 cm H2O from clinical factors in women with stress urinary incontinence (SUI). STUDY DESIGN: We performed a descriptive and observational study of women referred for a urodynamic study for stress urinary incontinence. Patients were divided into three groups: ALPP: >90 cm H2O, between 60 and 90 cm H2O and <60 cm H2O. A logistic regression study was performed in order to complete clinical predictors of ALPP < 60 cm H2O. Variables that were significant in the multivariate analysis were included in the score. RESULTS: We studied 158 patients: 65 presented ALPP > 90 cm H2O, 64 between 60-90 cm H2O and 29 <60 cm H2O. In the multivariate analysis, were presented as independent predictors of ALPP < 60 cm H2O, the presence of a fixed urethra (p 0.01), empty bladder test positive (p 0.02) and presence of symptoms grade III in the classification of Stamey (p 0.03). The accuracy of the test was: score 0, 42%; score 1, 58%; score 2, 81%. Receiver Operating Characteristic (ROC) analysis for the overall cutoff points revealed an area under the curve of 0,75. CONCLUSIONS: Presence of a fixed urethra, positive empty bladder test and patients with a high degree of SUI symptoms according to the Stamey score are independent clinical predictors of intrinsic sphincter deficiency. This score could represent a useful clinical tool to predict the presence of ALPP <60 cm H2O based on clinical parameters.


Assuntos
Técnicas de Diagnóstico Urológico , Incontinência Urinária por Estresse/diagnóstico , Urodinâmica/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Uretra/fisiopatologia , Bexiga Urinária/fisiopatologia , Incontinência Urinária por Estresse/fisiopatologia
11.
Gynecol Obstet Invest ; 84(5): 472-476, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30897579

RESUMO

AIMS: To determine if findings at urodynamics prognosticate improvements in overactive bladder symptoms among women receiving mirabegron treatment. METHODS: Before treatment, women completed a urodynamic investigation, a micturition diary and the Urinary Distress Inventory (UDI) with the irritative subscale UDIOAB. After 6 months mirabegron treatment, patients were clinically evaluated and completed the UDI. Associations were tested using regression analyses and nonparametric statistics. RESULTS: Testing urodynamic variables for association with treatment effects in multiple linear regression analysis showed that lower volumes at first sensation to void significantly correlated with greater improvement in the UDIOAB after 6 months mirabegron treatment (B = 0.026, 95% CI 0.002-0.049, p = 0.034). Improvements in UDIOAB showed no correlation with presence of nocturia (p = 0.65), previous use of anticholinergics (p = 1), menopausal status (p = 1), any detrusor overactivity during filling (p = 1), phasic detrusor contractions during filling (p = 1), or detrusor overactivity during inhibition (p = 1). CONCLUSIONS: We found limited support for clinically relevant associations between findings at urodynamics and subsequent treatment outcomes for mirabegron in routine clinical practice. Our findings do not support the role of these investigations as predictors of outcomes in patients with overactive bladder symptoms.


Assuntos
Acetanilidas/uso terapêutico , Técnicas de Diagnóstico Urológico/estatística & dados numéricos , Tiazóis/uso terapêutico , Bexiga Urinária Hiperativa/tratamento farmacológico , Urodinâmica/efeitos dos fármacos , Agentes Urológicos/uso terapêutico , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Resultado do Tratamento , Bexiga Urinária/efeitos dos fármacos , Micção/efeitos dos fármacos
12.
Neurourol Urodyn ; 38(4): 1100-1105, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30843290

RESUMO

AIMS: To test the different formulae to calculate the bladder volume using ultrasound; the accuracy of patients hearing/feeling "bubbles" at the end of urodynamics testing as a measure of being empty; and how good we are at estimating PVR using X-ray at the end of video urodynamics testing. METHODS: This was a prospective cohort study. Using Sonosite 180 plus, bladder volumes were calculated as, height × width × depth × proportionality constant (0.52, 0.625, 0.65, and 0.7) Patients were asked whether the patient heard or felt "bubbles" at the end of the investigation. Each patient was fluoroscopically screened and the clinician estimated the volume and compared with single-use catheter volume. RESULTS: A total of 85 patients were assessed. All four formulae were significantly correlated. The PC, 0.52, correlated best (r = 0.938, P < 0.001) with no significant difference with the actual volumes ( P = 0.275). The "bubbles test" had a positive predictive value of 93%. A video postvoid residual (PVR) estimation significantly correlated with catheterised bladder volume ( r = 0.842, P < 0.001). There was no significant difference between the estimated and actual bladder volumes ( P = 0.579). CONCLUSION: This study showed that although all four formulae correlated significantly, the PC of 0.52 was the only formula without a significant difference from the actual volume. More work is needed to produce patient individualised PC. Our clinicians were able to accurately estimate the PVR on X-ray. This study has identified the best formula to accurately estimate bladder volume and that video estimation along with the "bubbles" test can avoid unnecessary intervention.


Assuntos
Cateteres , Técnicas de Diagnóstico Urológico , Bexiga Urinária/diagnóstico por imagem , Retenção Urinária/diagnóstico por imagem , Urodinâmica/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Cateterismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ultrassonografia , Adulto Jovem
13.
Ann Biol Clin (Paris) ; 77(1): 36-40, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30799296

RESUMO

The incidental finding of a proteinuria is a common cause of consultation in pediatric nephrology. Although it is transient in most cases, it may also be indicative of a kidney disease. For this reason, a moderate proteinuria in children should not be overlooked. Moreover, as well as in adults, proteinuria is an essential marker in the monitoring of chronic renal disease in pediatric patients. We propose to review the physiopathology of proteinuria, the screening modalities and how to deal with proteinuria in pediatric.


Assuntos
Técnicas de Diagnóstico Urológico , Nefropatias/diagnóstico , Programas de Rastreamento/métodos , Monitorização Fisiológica/métodos , Pediatria/métodos , Proteinúria , Adulto , Fatores Etários , Criança , Humanos , Nefropatias/epidemiologia , Nefropatias/urina , Proteinúria/diagnóstico , Proteinúria/urina , Urinálise
14.
J Pediatr Urol ; 15(1): 18-26, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30602417

RESUMO

INTRODUCTION: Robert Whitaker, inspired by Dr William W Scott at the Brady Institute at Johns Hopkins and by Sir David Innes Williams at Great Ormond Street Hospital for Children in the late 1960s, spent much of his career exploring the meaning of persistent dilatation of the upper urinary tract, in an attempt to define obstruction and to find a means of diagnosing it accurately. OBJECTIVE: This is a historical review of Bob Whitaker's journey from his definition of obstruction to the inception of his eponymous test. RESULTS: In 1975, he proposed a theory to explain the pathophysiology behind obstructive hydronephrosis and megaureter. He was among the first pediatric urologists to observe that 'it is wrong… to assume that dilatation necessarily indicates obstruction', a statement that was widely stated and even appeared in the textbooks at the time. He defined obstruction as 'an increased pressure in the pelvicalyceal system of the kidney at normal physiological flow rates such that the renal function is adversely affected'. This realization led to the development of a percutaneous pressure-measuring technique at controlled flows, later referred to as the Whitaker test. It predated and later assisted in the interpretation of diuretic renograms. DISCUSSION: Whitaker questioned the etiology of 'hydronephrosis' and challenged other hypotheses proposed at the time, which often included causes of mechanical occlusion at the ureteropelvic junction (UPJ) or ureterovesical junction (UVJ). Whitaker's hypothesis is that 'obstruction' at UPJ and UVJ levels is not mechanical but the result of a failure of normal peristalsis to form and propagate a bolus. This, in turn, depends on the potentially abnormal distensibility of the renal pelvic and ureteric wall whether it be congenital or acquired. The aim of this review is to recall the history of the development of a technique to evaluate dilated upper urinary tracts and to re-evaluate various theories that might explain the etiology of the dilatation in the light of more recent evidence. Robert (or Bob, to his colleagues) Whitaker was among the founder members of the British Association of Paediatric Urologists, which now has more than 50 members, in 1992. Together with his colleagues Philip Ransley and David Thomas, Whitaker established the annual pediatric urology course for pediatric surgery and urology trainees in Cambridge, U.K., which still runs to this day. He retired from his surgical practice in 1990 and up until the present time has taught clinical anatomy in the Cambridge University School of Medicine.


Assuntos
Terminologia como Assunto , Obstrução Ureteral/diagnóstico , Obstrução Ureteral/etiologia , Criança , Técnicas de Diagnóstico Urológico , Humanos
15.
Urology ; 125: 58-63, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30508511

RESUMO

OBJECTIVE: To evaluate the effect of radiation on male stress urinary incontinence (SUI) and to assess the relative value of preoperative urodynamic (UDS) testing in radiated vs nonradiated men with SUI. METHODS: A retrospective chart review of all male patients with SUI who underwent UDS testing from 2010 to 2016 was performed. The impact of UDS findings on treatment decision making was assessed. UDS parameters and treatment patterns of radiated vs nonradiated patients were compared as well as the fates of storage symptoms in each group. RESULTS: Two hundred seven men were identified that underwent UDS with a clinical diagnosis of SUI. Sixty-five out of 207 (31.4%) were exposed to radiation as a treatment modality for prostate cancer. All patients that underwent UDS testing moved on to surgical correction of SUI, and the UDS findings did not alter plan to treat SUI in any patients. Men who were radiated prior to surgical correction of SUI were more likely to have detrusor overactivity (70% vs 38%, P <.0001) and had lower maximum cystometric capacity (255 vs 307.4 mL, P = .01) when compared to nonradiated on UDS. After artificial urinary sphincter or sling implantation, the proportion of patients requiring overactive bladder medications was higher in radiated vs nonradiated men (44.3% vs 25.3%; P = .01). CONCLUSION: Radiation therapy appears to increase the likelihood of bladder dysfunction in male patients with SUI. The UDS findings did not alter the plan to treat SUI in any patients in our series, and its role before SUI surgery in male patients, including those receiving radiation, may be limited.


Assuntos
Radioterapia , Incontinência Urinária por Estresse/fisiopatologia , Incontinência Urinária por Estresse/cirurgia , Urodinâmica , Técnicas de Diagnóstico Urológico , Humanos , Masculino , Cuidados Pré-Operatórios , Estudos Retrospectivos
16.
Neurourol Urodyn ; 38(1): 231-238, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30311676

RESUMO

AIMS: To investigate if the standard protocol for uroflowmetry, recommended by the International Children's Continence Society, remains accurate when integrating EMG measurement by means of superficial electrodes. METHODS: A cross-sectional study was conducted including healthy children. Group A performed two direct repetitions of uroflowmetry in combination with electromyography (uroflow/EMG). Group B performed a preceding measurement of isolated uroflowmetry, followed by two randomized measurements of uroflowmetry with and without EMG. Interpretation of uroflow curve was assessor blinded by a pediatric urologist and secondly performed using the flow index methodology. Statistical analysis compared different voids within each group and between group A and B. RESULTS: Eighty-three children were included and 206 uroflow measurements were obtained. In both groups statistical findings confirmed the hypothesis that it is preferable to perform an additional measurement before the use of uroflow/EMG. Although both groups showed improvement between voids, the group with initial uroflow measurement followed by uroflow/EMG measurement showed more improvement in concern of curve pattern. An initially better first void in group A, but no statistical difference between the second void in group A and uroflow/EMG testing in group B further demonstrates a higher improvement in group B. This suggests the use of a precedent uroflowmetry without EMG is preferable to immediate testing with EMG. CONCLUSIONS: It should be mandatory to perform one measurement in advance to ensure the reliability of the results. It is suggested to initiate the procedure with a single uroflowmetry measurement followed by one measurement of uroflow with EMG testing.


Assuntos
Técnicas de Diagnóstico Urológico , Diafragma da Pelve/fisiologia , Micção/fisiologia , Urodinâmica/fisiologia , Criança , Pré-Escolar , Estudos Transversais , Eletromiografia/métodos , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes
17.
Neurourol Urodyn ; 38(1): 320-329, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30311686

RESUMO

AIMS: To capture in-depth qualitative evidence regarding attitudes to and experiences of urodynamic testing among men with lower urinary tract symptoms (LUTS) at each end of the clinical pathway. METHODS: Semi-structured interview study conducted within the Urodynamics for Prostate Surgery: Randomized Evaluation of Assessment Methods (UPSTREAM) trial, which randomized men to a care pathway including urodynamics or routine non-invasive tests from 26 secondary care urology sites across England. Men were interviewed after assessments but prior to treatment, or after surgery for LUTS. Men were purposively sampled to include those who had urodynamics and those who did not, and diversity in demographic characteristics and symptom burden. Interviews were analyzed using inductive thematic analysis. RESULTS: Forty-one men participated (25 pre-treatment, 16 post-surgery), ages 52-89. The 16 men who had not previously experienced urodynamics said they would accept the test in their assessment, but some were apprehensive or wanted more information. The 25 men who had experienced urodynamics all found it acceptable, though some reported pain, infection, or embarrassment. Embarrassment was minimized by informing patients what the procedure would be like, and ensuring privacy. Urodynamics was valued for its perceived diagnostic insight. Information deficits were reported before, during, and after the test. How and when results were explained and the adequacy of explanations varied. CONCLUSIONS: Urodynamics is acceptable to men with LUTS and generally well-tolerated. To ensure patients are prepared and informed, good communication before and during the procedure is essential. Privacy should be prioritized, and test results discussed promptly and in sufficient detail. Staff require training and guidance in these areas.


Assuntos
Sintomas do Trato Urinário Inferior/diagnóstico , Urodinâmica/fisiologia , Idoso , Idoso de 80 Anos ou mais , Técnicas de Diagnóstico Urológico , Inglaterra , Humanos , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Sistema Urinário
18.
Urologia ; 86(3): 122-125, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30208764

RESUMO

INTRODUCTION AND AIM: The urodynamic study is an invasive examination that allows a thorough evaluation of the functional activity of the lower urinary tract (bladder, urethra). The execution of urodynamic study exposes the patient to the risk of contracting infections of the lower urinary tract. Prevention of urinary tract infections consists in the avoidance of risk factors and prophylaxis with antimicrobial and non-antimicrobial measures. In this article, we aimed to evaluate the effectiveness of a phytotherapeutic product composed of D-mannose, Hibiscus sabdariffa, and Lactobacillus plantarum in the prevention of infectious events following invasive urodynamic examination. MATERIALS AND METHODS: We selected 100 female consecutive patients (age 19-87 years) that underwent urodynamic invasive procedure. We prescribed 14-day therapy with D-mannose, H. sabdariffa, and L. plantarum to these 100 patients after urodynamic invasive test. After that, we have examined urine cultures and urinary symptoms through telephone interviews and hospital outpatient visits to evaluate the possible presence of urinary tract infections. RESULTS: Urinary tract infections were observed through urine culture in 13% of the selected patients; of the 13 urinary tract infections, 9 were observed in patients with urinary tract recurrent infections in the last year and the other 4 cases were associated with patients with no urinary infection in the last year. Three women reported some urinary symptoms and underwent antibiotic therapy. The other 10 cases were classified as asymptomatic bacteriuria. Three cases were related to patients presenting with pelvic organ prolapse. Eight cases were instead related to significant post-voiding residue (>100). Six patients with urinary tract infection reported constipation in the last year. All patients completed the prescribed therapy due to the affordable price of the product and no side effects have been reported. CONCLUSION: Our study about the administration of D-mannose, H. sabdariffa, and L. plantarum after invasive urodynamic examination underlined how this phytotherapeutic product can reduce the risk of bacteriuria and urinary tract infection in women.


Assuntos
Técnicas de Diagnóstico Urológico/efeitos adversos , Hibiscus , Lactobacillus plantarum , Manose/uso terapêutico , Fitoterapia , Extratos Vegetais/uso terapêutico , Infecções Urinárias/etiologia , Infecções Urinárias/prevenção & controle , Urodinâmica , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
19.
Int Urogynecol J ; 30(1): 3-8, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30187093

RESUMO

INTRODUCTION AND HYPOTHESIS: The objective was to review different methods that have been used to assess bladder sensation and to provide an overview of the accuracy and objectivity of the measurement of the subjective perception of the bladder. METHODS: The MEDLINE and PubMed databases were searched to identify articles. References from those articles were also searched. Terms used for the search were: urinary bladder, sensation, cystometry, urodynamics, urinary incontinence and focus group. Eight hundred and fifty abstracts were identified from databases, and 12 from other sources. Twenty-two duplicate articles were removed. Irrelevant articles were excluded after reading their titles. Fifty-four articles were eligible, but 17 were excluded after reading the full text, leaving 37 articles where assessment of bladder sensation was the main aim. RESULTS: Six different methods of measuring bladder sensation have been described in the literature. Although the most frequently used was cystometry, this is an invasive tool and does not reproduce bladder behaviour during daily life because it records bladder sensation as episodic events. The visual analogue scale using a forced diuresis protocol seemed to be an excellent tool. It was non-invasive and evaluated bladder sensation continuously, from an empty to a full bladder. CONCLUSIONS: In some of the studies, the samples were too small to draw any significant conclusions. There were also conflicting data on which tool was the most accurate, especially as each method of evaluating bladder sensation may influence the way it is described by participants.


Assuntos
Técnicas de Diagnóstico Urológico , Sensação , Bexiga Urinária/fisiologia , Micção , Humanos
20.
Urology ; 124: 207-212, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30452966

RESUMO

OBJECTIVE: To determine whether the penile cuff test can predict surgical outcomes prior to Holmium laser enucleation of the prostate for benign prostatic obstruction. METHODS: Men scheduled to undergo Holmium laser enucleation of the prostate were enrolled in this study, and all patients underwent the penile cuff test prior to and 3 months after surgery. Patients were categorized as obstructed, nonobstructed, or uncertain by nomogram. Surgical outcomes were assessed by evaluating changes in their international prostate symptom score, quality of life index, and maximum flow rate preoperatively and 3 months postoperatively. The proportion of patients with good outcomes was compared among nomogram-classified groups, and postoperative changes in position on the nomogram were assessed. RESULTS: A total of 125 patients were analyzed. After surgery, the overall treatment efficacy and symptomatic treatment efficacy were not different between obstructed and nonobstructed patients. However, the maximum flow rate and quality of life score were significantly higher after surgery in obstructed patients compared to nonobstructed patients. After surgery, 75.7% of patients with obstruction and 63.6% of patients categorized as uncertain for obstruction transitioned to the nonobstructed group, while 77.3% of nonobstructed patients remained in the nonobstructed group. CONCLUSION: The penile cuff test can be used in patients with bladder outlet obstruction to predict good functional outcome and improved quality of life following treatment with Holmium laser enucleation. After Holmium laser enucleation of the prostate, the majority of patients were classified as nonobstructed.


Assuntos
Técnicas de Diagnóstico Urológico , Lasers de Estado Sólido/uso terapêutico , Prostatectomia/métodos , Hiperplasia Prostática/cirurgia , Obstrução do Colo da Bexiga Urinária/cirurgia , Técnicas de Diagnóstico Urológico/instrumentação , Humanos , Masculino , Pessoa de Meia-Idade , Pênis , Valor Preditivo dos Testes , Estudos Prospectivos , Hiperplasia Prostática/complicações , Resultado do Tratamento , Obstrução do Colo da Bexiga Urinária/etiologia
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