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1.
Int Braz J Urol ; 48(2): 220-243, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34156189

RESUMEN

INTRODUCTION: Bladder and urinary sphincter malfunctioning that results from some change in the central and/or peripheral nervous system is defined as neurogenic bladder. The urinary tract symptoms that can be related to its filling, emptying, or both have a significant impact on the quality of life of individuals. The present review was based on the document prepared for the public health system in Brazil as a treatment guidelines proposal. MATERIAL AND METHODS: Survey questions were structured as per PICO (Population, Intervention, Control, and Outcome). Search strategies were defined and performed in the MEDLINE/Pubmed, Embase, Epistemonikos and Google Scholar databases. The selection of articles followed the evidence hierarchy concept; evidence body was identified, and the quantitative study data were extracted. The quality of evidence and grade of recommendation were qualitatively assessed according to GRADE (Grading of Recommendations, Assessment, Development and Evaluations). RESULTS: A total of 2.707 articles were identified, with 49 of them being selected to compose the basis for this review. Neurogenic bladder treatments were classified according to their focus on filling or emptying symptoms and sub- classified in pharmacological and surgical treatments. CONCLUSION: Treatment guidelines are important tools for the public health system to promote the best practice when treating neurogenic bladder patients.


Asunto(s)
Vejiga Urinaria Neurogénica , Sistema Urinario , Humanos , Calidad de Vida , Encuestas y Cuestionarios , Vejiga Urinaria , Vejiga Urinaria Neurogénica/terapia
2.
Neurourol Urodyn ; 38(6): 1588-1594, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31025397

RESUMEN

AIMS: Evaluate the efficacy of biofeedback and parassacral electric nerve stimulation (TENS) for the treatment of children with lower urinary tract (LUT) dysfunction. METHODS: A prospective, randomized study was approved by our Hospital Ethics Committee. We enrolled 64 children, 43 girls and 21 boys, average age of 9.39 years. The initial evaluation consisted of history, physical examination, urine analyses, voiding diary, uroflow, and ultrasound. Dysfunction voiding symptom score (DVSS) questionnaires were applied pre- and post-treatment. The children were divided into two treatment groups independent of the predominant type of voiding dysfunction (dysfunctional or overactive bladder): biofeedback group and TENS group. The criteria for assessing the effectiveness of the techniques was the resolution of daytime and nighttime symptoms including urinary leakage, improvements in voiding diary, DVSS, and changes in uroflow. After 6 months, the children were reassessed with the same work-up of baseline. RESULTS: Regarding daytime symptoms, results for complete response were similar between the two groups (P = 0.483); 54.9% of children treated by the biofeedback group and 60.6% in the TENS group. The same have been observed in the nighttime incontinence with complete resolutions in 29.6% and 25%, respectively ( P = 0.461). Analyzing the voiding diary, uroflow and DVSS questionnaires both groups had significant improvement ( P = 0.001) after treatment. The biofeedback group required fewer sessions than TENS group, 10.9 and 18.1, respectively ( P < 0,001). CONCLUSIONS: Both biofeedback and the TENS are equally effective for treating non-neurogenic voiding dysfunction. Biofeedback seems to require a lower number of sessions to obtain similar results of the TENS.


Asunto(s)
Biorretroalimentación Psicológica/métodos , Estimulación Eléctrica Transcutánea del Nervio/métodos , Incontinencia Urinaria/terapia , Niño , Femenino , Humanos , Masculino , Estudios Prospectivos , Encuestas y Cuestionarios , Resultado del Tratamiento , Vejiga Urinaria Hiperactiva/terapia
3.
Int Braz J Urol ; 45(4): 703-712, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31136108

RESUMEN

INTRODUCTION: Robot-assisted radical prostatectomy (RARP) is the most recent surgical technique for localized prostate cancer. The Da Vinci (Intuitive Surgical, Sunnyvale, CA) system was first introduced in Brazil in 2008, with a fast growing number of surgeries performed each year. OBJECTIVE: Our primary endpoint is to analyze possible predictors of functional outcomes, related to patient and tumor features. As secondary endpoint, describe functional outcomes (urinary continence and sexual potency) from RARP performed in the Sírio-Libanês Hospital (SLH), a private institution, in São Paulo, from April 2008 to December 2015. MATERIALS AND METHOD: Data from 104 consecutive patients operated by two surgeons from the SLH (MA and SA) between 2008 and 2015, with a minimum 12 months follow-up, were collected. Patient features (age, body mass index - BMI, PSA, date of surgery and sexual function), tumor features (tumor stage, Gleason and surgical margins) and followup data (time to reach urinary continence and sexual potency) were the variables collected at 1, 3, 6 and 12 month and every 6 months thereafter. Continence was defined as the use of no pad on medical interview and sexual potency defined as the capability for vaginal penetration with or without fosphodiesterase type 5 inhibitors. RESULTS: Mean age was 60 years old and mean BMI was 28.45 kg/m2. BMI >30kg/m2 (p<0.001) and age (p=0.011) were significant predictors for worse sexual potency after surgery. After 1, 3, 6 and 12 months, 20.7%, 45.7%, 60.9% and 71.8% from patients were potent, respectively. The urinary continence was reached in 36.5%, 80.3%, 88.6% and 92.8% after 1, 3, 6 and 12 months, respectively. Until the end of the study, only one patient was incontinent and 20.7% were impotent. CONCLUSION: Age was a predictor of urinary and erectile function recovery in 12 months. BMI was significant factor for potency recovery. We obtained in a private hospital good functional results after 12 months of follow-up.


Asunto(s)
Erección Peniana/fisiología , Prostatectomía/métodos , Recuperación de la Función/fisiología , Procedimientos Quirúrgicos Robotizados/métodos , Micción/fisiología , Adenocarcinoma/fisiopatología , Adenocarcinoma/cirugía , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Brasil , Disfunción Eréctil/fisiopatología , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Neoplasias de la Próstata/fisiopatología , Neoplasias de la Próstata/cirugía , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Incontinencia Urinaria/fisiopatología
4.
J Pediatr (Rio J) ; 99(4): 379-384, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36731540

RESUMEN

OBJECTIVE: Lower urinary tract symptoms (LUTS) affect approximately 10% of children worldwide and are related to psychosocial manifestations and compromised quality of life, both for children and their families. The assessment of emotional conditions of LUTS in children is recommended by International Children's Continence Society; however, there is no specific instrument in the Brazilian Portuguese language. Therefore, the aim of this study was to translate, culturally adapt and assess the internal consistency of the Brazilian Portuguese version of the Pediatric Incontinence Questionnaire (PINQ). MATERIAL AND METHODS: This cross-sectional study was performed at two referral centers for childhood voiding dysfunction. The 20-item PINQ was translated into Brazilian Portuguese and culturally adapted according to Beaton, 2000. His-standard methodology consists of 6 phases: translation, synthesis, back-translation, expert committee, and pre-test. The internal consistency was assessed using Cronbach's alpha. RESULTS: The PINQ-br version was developed, validated by a committee of experts, and pre-tested on 44 children diagnosed with lower urinary tract symptoms, 23 boys and 21 girls (mean age: 9.7 and 9.6 years old respectively), as well as on their parents. The internal consistency was considered satisfactory, reaching Cronbach's alpha coefficient of 0.74 when applied to children and 0.82 when applied to parents. CONCLUSIONS: The PINQ was translated and culturally adapted to Brazilian Portuguese to assess the impact of LUTS on the health-related quality of life in Brazilian children and adolescents.


Asunto(s)
Síntomas del Sistema Urinario Inferior , Calidad de Vida , Masculino , Femenino , Adolescente , Humanos , Niño , Brasil , Estudios Transversales , Encuestas y Cuestionarios , Lenguaje , Traducciones , Síntomas del Sistema Urinario Inferior/diagnóstico , Reproducibilidad de los Resultados , Comparación Transcultural , Psicometría
5.
J. pediatr. (Rio J.) ; 99(4): 379-384, 2023. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1506637

RESUMEN

Abstract Objective Lower urinary tract symptoms (LUTS) affect approximately 10% of children worldwide and are related to psychosocial manifestations and compromised quality of life, both for children and their families. The assessment of emotional conditions of LUTS in children is recommended by International Children's Continence Society; however, there is no specific instrument in the Brazilian Portuguese language. Therefore, the aim of this study was to translate, culturally adapt and assess the internal consistency of the Brazilian Portuguese version of the Pediatric Incontinence Questionnaire (PINQ). Material and methods This cross-sectional study was performed at two referral centers for childhood voiding dysfunction. The 20-item PINQ was translated into Brazilian Portuguese and culturally adapted according to Beaton, 2000. His-standard methodology consists of 6 phases: translation, synthesis, back-translation, expert committee, and pre-test. The internal consistency was assessed using Cronbach's alpha. Results The PINQ-br version was developed, validated by a committee of experts, and pre-tested on 44 children diagnosed with lower urinary tract symptoms, 23 boys and 21 girls (mean age: 9.7 and 9.6 years old respectively), as well as on their parents. The internal consistency was considered satisfactory, reaching Cronbach's alpha coefficient of 0.74 when applied to children and 0.82 when applied to parents. Conclusions The PINQ was translated and culturally adapted to Brazilian Portuguese to assess the impact of LUTS on the health-related quality of life in Brazilian children and adolescents.

6.
Int. braz. j. urol ; 48(2): 220-243, March-Apr. 2022. graf
Artículo en Inglés | LILACS, BIGG | ID: biblio-1364966

RESUMEN

Bladder and urinary sphincter malfunctioning that results from some change in the central and/or peripheral nervous system is defined as neurogenic bladder. The urinary tract symptoms that can be related to its filling, emptying, or both have a significant impact on the quality of life of individuals. The present review was based on the document prepared for the public health system in Brazil as a treatment guidelines proposal. Material and Methods: Survey questions were structured as per PICO (Population, Intervention, Control, and Outcome). Search strategies were defined and performed in the MEDLINE/Pubmed, Embase, Epistemonikos and Google Scholar databases. The selection of articles followed the evidence hierarchy concept; evidence body was identified, and the quantitative study data were extracted. The quality of evidence and grade of recommendation were qualitatively assessed according to GRADE (Grading of Recommendations, Assessment, Development and Evaluations). Results: A total of 2.707 articles were identified, with 49 of them being selected to compose the basis for this review. Neurogenic bladder treatments were classified according to their focus on filling or emptying symptoms and sub- classified in pharmacological and surgical treatments. Conclusion: Treatment guidelines are important tools for the public health system to promote the best practice when treating neurogenic bladder patients.


Asunto(s)
Humanos , Sistema Urinario , Vejiga Urinaria Neurogénica/terapia , Calidad de Vida , Vejiga Urinaria , Encuestas y Cuestionarios
7.
Int. braz. j. urol ; 45(4): 703-712, July-Aug. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1019887

RESUMEN

ABSTRACT Introduction Robot-assisted radical prostatectomy (RARP) is the most recent surgical technique for localized prostate cancer. The Da Vinci (Intuitive Surgical, Sunnyvale, CA) system was first introduced in Brazil in 2008, with a fast growing number of surgeries performed each year. Objective Our primary endpoint is to analyze possible predictors of functional outcomes, related to patient and tumor features. As secondary endpoint, describe functional outcomes (urinary continence and sexual potency) from RARP performed in the Sírio-Libanês Hospital (SLH), a private institution, in São Paulo, from April 2008 to December 2015. Materials and Method Data from 104 consecutive patients operated by two surgeons from the SLH (MA and SA) between 2008 and 2015, with a minimum 12 months follow-up, were collected. Patient features (age, body mass index - BMI, PSA, date of surgery and sexual function), tumor features (tumor stage, Gleason and surgical margins) and follow-up data (time to reach urinary continence and sexual potency) were the variables collected at 1, 3, 6 and 12 month and every 6 months thereafter. Continence was defined as the use of no pad on medical interview and sexual potency defined as the capability for vaginal penetration with or without fosphodiesterase type 5 inhibitors. Results Mean age was 60 years old and mean BMI was 28.45 kg/m2. BMI >30kg/m2 (p<0.001) and age (p=0.011) were significant predictors for worse sexual potency after surgery. After 1, 3, 6 and 12 months, 20.7%, 45.7%, 60.9% and 71.8% from patients were potent, respectively. The urinary continence was reached in 36.5%, 80.3%, 88.6% and 92.8% after 1, 3, 6 and 12 months, respectively. Until the end of the study, only one patient was incontinent and 20.7% were impotent. Conclusion Age was a predictor of urinary and erectile function recovery in 12 months. BMI was significant factor for potency recovery. We obtained in a private hospital good functional results after 12 months of follow-up.


Asunto(s)
Humanos , Masculino , Adulto , Anciano , Anciano de 80 o más Años , Prostatectomía/métodos , Micción/fisiología , Erección Peniana/fisiología , Recuperación de la Función/fisiología , Procedimientos Quirúrgicos Robotizados/métodos , Neoplasias de la Próstata/cirugía , Neoplasias de la Próstata/fisiopatología , Factores de Tiempo , Incontinencia Urinaria/fisiopatología , Brasil , Adenocarcinoma/cirugía , Adenocarcinoma/fisiopatología , Índice de Masa Corporal , Estudios Retrospectivos , Factores de Edad , Resultado del Tratamiento , Estimación de Kaplan-Meier , Disfunción Eréctil/fisiopatología , Persona de Mediana Edad
8.
Mednews ; 4(9): 23-6, out. 1986.
Artículo en Portugués | LILACS | ID: lil-47448

RESUMEN

Os autores apresentam um caso de paciente com feocromocitoma, interna no hospital com diagnóstico de síndrome hipertensiva e tumor de supra-renal, abordando aspectos dos exames laboratoriais e de imagem, do preparo operatório e do tratamento cirúrgico. Uma discusäo atual é apresentada sobre estes aspectos, ressaltando a importância do plano cirúrgico em tumor grande como o do presente caso; além de um resumo sobre os critérios atuais de determinaçäo de malignidade do feocromocitoma e seu prognóstico a longo prazo


Asunto(s)
Adulto , Humanos , Femenino , Neoplasias de las Glándulas Suprarrenales , Feocromocitoma , Cuidados Preoperatorios , Tomografía Computarizada por Rayos X , Urografía
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