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Lower urinary tract obstruction

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https://www.readbyqxmd.com/read/28646935/five-year-results-of-the-prospective-randomized-controlled-prostatic-urethral-l-i-f-t-study
#1
Claus G Roehrborn, Jack Barkin, Steven N Gange, Neal D Shore, Jonathan L Giddens, Damien M Bolton, Barrett E Cowan, Anthony L Cantwell, Kevin T McVary, Alexis E Te, Shahram S Gholami, William G Moseley, Peter T Chin, William T Dowling, Sheldon J Freedman, Peter F Incze, K Scott Coffield, Sean Herron, Prem Rashid, Daniel B Rukstalis
INTRODUCTION: To report the five year results of a prospective, multi-center, randomized, blinded sham control trial of the Prostatic Urethral Lift (PUL) in men with bothersome lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: At 19 centers in North America and Australia, 206 subjects ≥ 50 years old with International Prostate Symptom Score (IPSS ) > 12, peak flow rate (Qmax) ≤ 12 mL/s, and prostate volume 30 cc-80 cc were randomized 2:1 to the PUL procedure or blinded sham control...
June 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28638819/testosterone-modifies-alterations-to-detrusor-muscle-after-partial-bladder-outlet-obstruction-in-juvenile-mice
#2
Andrew S Flum, Paula R Firmiss, Diana K Bowen, Natalie Kukulka, Grace B Delos Santos, Robert W Dettman, Edward M Gong
Lower urinary tract symptoms secondary to posterior urethral valves (PUV) arise in boys during adolescence. The reasons for this have previously been attributed to increased urine output as boys experience increased growth. Additionally, there are few choices for clinicians to effectively treat these complications. We formed the new hypothesis that increased androgen levels at this time of childhood development could play a role at the cellular level in obstructed bladders. To test this hypothesis, we investigated the role of testosterone on bladder detrusor muscle following injury from partial bladder outlet obstruction (PO) in mice...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28637788/the-effects-of-neuromodulation-in-a-novel-obese-prone-rat-model-of-detrusor-underactivity
#3
Eric J Gonzalez, Warren M Grill
Obesity is a global epidemic associated with an increased risk for lower urinary tract dysfunction. Inefficient voiding and urinary retention may arise in late-stage obesity when the expulsive force of the detrusor smooth muscle cannot overcome outlet resistance. Detrusor underactivity (DUA) and impaired contractility may contribute to the pathogenesis of non-obstructive urinary retention. We used cystometry and electrical stimulation of peripheral nerves (pudendal and pelvic n.) to characterize and improve bladder function in urethane-anesthetized obese-prone (OP) and obese-resistant (OR) rats following diet-induced obesity (DIO)...
June 21, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28637056/-urosepsis-in-children
#4
Josef Oswald
Urinary tract infections (UTI) are the most common infectious diseases in children. Urosepsis in childhood, though rare, is the most complicated possible variant. In newborns and infants, unspecific symptoms are a significant barrier to a fast and reliable diagnosis, which is crucial to successful treatment. In addition to urine and laboratory tests as well as non-invasive examinations (ultrasound), there may be an indication for invasive examinations of the kidneys (DMSA scans) in cases of a severe infection...
June 21, 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28631916/-intravesical-prostatic-protrusion-in-diagnosing-infravesical-obstruction-in-men-with-benign-prostatic-hyperplasia
#5
G G Krivoborodov, N S Efremov, A D Bolotov
Infravesical obstruction (IVO) is an important characteristic of the functional state of male lower urinary tract. It is believed that IVO confirmed by pressure-flow study findings warrants switching from a medical to surgical management of lower urinary tract symptoms (LUTS). Intravesical prostatic protrusion (IPP) is a new indicator for detecting IVO secondary to benign prostatic hyperplasia (BPH). This indicator has several advantages over other non-invasive methods for evaluating IVO. The initial findings on the relationship between IPP and IVO suggest the feasibility of its clinical use as a screening tool in men with obstructive voiding symptoms...
June 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28629820/urodynamic-performance-in-boys-with-y-type-urethral-duplication
#6
Ye Zhang, Yanchao Qu, Lili Jiao, Weiping Zhang, Ning Sun, Jun Tian, Minglei Li, Hongcheng Song
PURPOSE: The aim of this study was to elucidate the urodynamic features of patients with Y-type urethral duplication. METHODS: Patients with Y-type urethral duplication were retrospectively analyzed. Clinical presentation, urodynamic findings, surgical methods, and treatment outcomes were reviewed. RESULTS: From 2014 to 2016, six boys were diagnosed with Y-type urethral duplication at our institution. All patients underwent urodynamic testing...
June 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28593170/increased-detrusor-collagen-is-associated-with-detrusor-overactivity-and-decreased-bladder-compliance-in-men-with-benign-prostatic-obstruction
#7
Carlos H S Bellucci, Wesley de O Ribeiro, Thiago S Hemerly, José de Bessa, Alberto A Antunes, Katia R M Leite, Homero Bruschini, Miguel Srougi, Cristiano M Gomes
BACKGROUND: This study aimed to investigate the relationship between detrusor collagen content and urodynamic parameters in men with benign prostatic obstruction. MATERIAL AND METHODS: Nineteen consecutive patients undergoing open prostatectomy for bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH) were evaluated. Urodynamic tests were performed in all patients. BOO and detrusor contractility were assessed with the BOO index (BOOI) and the bladder contractility index (BCI), respectively...
June 2017: Prostate International
https://www.readbyqxmd.com/read/28584678/preventive-effect-of-tamsulosin-on-postoperative-urinary-retention-in-neurosurgical-patients
#8
Azam Basheer, Mohammed Alsaidi, Lonni Schultz, Mokbel Chedid, Muwaffak Abdulhak, Donald Seyfried
BACKGROUND: Postoperative urinary retention (POUR) is common in neurosurgical patients. The use of alpha-blockade therapy, such as tamsulosin, has benefited many patients with a history of obstructive uropathy by decreasing lower urinary tract symptoms such as distension, infections, and stricture formation, as well as the incidence of POUR. For this study, we targeted patients who had undergone spinal surgery to examine the prophylactic effects of tamsulosin. Increased understanding of this therapy will assist in minimizing the morbidity of spinal surgery...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28580571/ultrasound-guided-balloon-catheterisation-a-new-method-of-fetal-lower-urinary-tract-obstruction-management
#9
Marzena Dębska, Adam Koleśnik, Piotr Kretowicz, Anna Olędzka, Piotr Gastoł, Romuald Dębski
OBJECTIVES: Fetal lower urinary tract obstruction (LUTO), most often associated with presence of posterior urethral valves, poses high risk of perinatal mortality or postnatal renal failure. Looking for a method of causative treatment we have devel-oped a technique of fetal urethroplasty with a coronary angioplasty balloon catheter inserted under an ultrasonographic guidance via an 18-gauge needle introduced transabdominally to fetal bladder. MATERIAL AND METHODS: We have used this procedure in three women with singleton pregnancies (two primiparas and one multipara, 32-35 years of age), diagnosed with fetal megacystis at 12-16 weeks of gestation...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28577283/a-giant-pararectal-cyst-successfully-treated-by-robotic-surgery
#10
Abdullah Erdem Canda, Erem Asil, Murat Keske, Fevzi Bedir, Ali Fuat Atmaca
A 50 year-old patient was referred to our department with severe obstructive lower urinary tract symptoms, suprapubic pain and rectal fullness that started after a perianal fistula operation performed one year ago. Radiologic evaluation showed a large pararectal cystic lesion with septa formation on the right side compressing the bladder and prostate. Aspiration of the cystic fluid attempted initially but was not successful. A robotic transperitoneal approach was applied and the cyst was excised completely...
June 2, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28567611/dysfunctional-voiding-the-importance-of-non-invasive-urodynamics-in-diagnosis-and-treatment
#11
Joanna C Clothier, Anne J Wright
In Dysfunctional voiding, failure of the external sphincter-pelvic floor complex to relax during micturition results in bladder outflow obstruction with a spectrum of presentation from more benign lower urinary tract dysfunction including recurrent urinary tract infections, to significant upper tract pathology and end-stage renal failure. There is no underlying neurological or anatomical cause and the condition is postulated to be a largely learnt behavior. Diagnosis relies on non-invasive urodynamics and in particular uroflowmetry, plus or minus EMG, which is also used in biofeedback, the mainstay of treatment...
May 31, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28546038/-pathophysiology-of-detrusor-underactivity-in-the-elderly
#12
J Kerdraon, B Peyronnet, X Gamé, B Fatton, R Haddad, C Hentzen, C Jeandel, P Mares, M Mezzadri, A-C Petit, G Robain, J-M Vetel, G Amarenco
AIM: The aim of this study was to review the evidence regarding the pathophysiology of detrusor underactivity in the elderly. METHODS: A literature review was conducted in July 2016 using the Medline/Pubmed database limiting the search to works in English or French. RESULTS: The prevalence of detrusor underactivity has been reported to range from 8% to 48% depending on the definition used and the age of the population studied. Current data suggest that aging may itself be a causative factor of detrusor underactivity through myogenic dysfunctions (ultrastructural degeneration of the detrusor muscle) and neurogenic dysfunctions (by degeneration of efferent but mostly afferent innervation mechanisms)...
May 22, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28538709/minimal-invasive-cystometry-and-intra-abdominal-pressure-assessments-in-rodents-a-novel-animal-study
#13
Yafei Yang, Jin Yang, Lin Chen, Jianyun Hu, Shasha Xing, Bastian Amend, Arnulf Stenzl, Xin Wei, Haifeng Hu
BACKGROUND The abdominal straining pattern can act as a novel parameter for improving the prediction of bladder outlet obstruction (BOO). To preserve detrusor function in the early stage of urinary system impairment, such as BOO, we establish a novel method for cystometry and Intra-abdominal pressure (IAP) assessments in rodents without cystostomy. MATERIAL AND METHODS Twenty mice and rats were divided into three groups (control, sham-operated and BOO group) respectively. The cystometry and IAP assessments were measured by the pediatric venous indwelling sheath and coronary dilatation catheter connected to Laborie urodynamic system on postoperative day 7...
May 24, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28510274/the-effect-of-prazosin-on-outcome-in-feline-urethral-obstruction
#14
Erica L Reineke, Emily K Thomas, Rebecca S Syring, Jennifer Savini, Kenneth J Drobatz
OBJECTIVE: To determine whether prazosin administration following urethral obstruction (UO) reduces the risk for recurrent urethral obstruction (rUO) or lower urinary tract signs, and to document adverse effects associated with prazosin use in cats. DESIGN: Double-blinded, prospective, interventional study. SETTING: University teaching hospital. ANIMALS: A population of 47 consecutive male cats with UO not associated with urinary tract calculi >2 mm in diameter...
May 16, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28499730/effects-of-withdrawing-alpha-1-blocker-from-the-combination-therapy-with-alpha-1-blocker-and-5-alpha-reductase-inhibitor-in-patients-with-lower-urinary-tract-symptoms-suggestive-of-benign-prostatic-hyperplasia-a-prospective-and-comparative-trial-using-urodynamics
#15
Yoshihisa Matsukawa, Shun Takai, Yasuhito Funahashi, Tsuyoshi Majima, Masashi Kato, Tokunori Yamamoto, Momokazu Gotoh
PURPOSE: To compare the effects on lower urinary tract symptoms (LUTS) and bladder outlet obstruction between combination therapy with α1 blocker and 5α-reductase inhibitor and a switch to 5α-reductase inhibitor monotherapy, and determine the factors influencing changes in LUTS after α1 blocker withdrawal. MATERIALS AND METHODS: One-hundred and forty outpatients with LUTS suggestive of benign prostatic hyperplasia received combination therapy with silodosin 8 mg/day and dutasteride 0...
May 9, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28476482/report-on-the-society-for-fetal-urology-panel-discussion-on-the-selection-criteria-and-intervention-for-fetal-bladder-outlet-obstruction
#16
M K Farrugia, M C Braun, C A Peters, R Ruano, C D Herndon
INTRODUCTION: The Society for Fetal Urology panel section at the 2016 Fall Congress featured a multidisciplinary discussion on appropriate patient selection, the conservative versus surgical management, and postnatal renal outcome of fetuses with lower urinary tract obstruction (LUTO). SELECTION CRITERIA FOR INTERVENTION: Rodrigo Ruano shared his experience of prenatal intervention, presenting the outcome of 111 fetuses with severe LUTO treated with vesicoamniotic shunting (VAS) (n = 16), cystoscopy (n = 34) or no intervention (n = 61) in a non-randomized series...
March 24, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28462172/aggressive-angiomyxoma-involving-penis-and-urethra-a-case-report
#17
Shivashankar Damodaran, Devakannan Gengan, Sashi T Walling
Aggressive angiomyxoma is a rare benign mesenchymal stromal tumour, characterized by locally infiltrative nature and a tendency for recurrence. Only a few cases of penile involvement have been reported in the literature so far. We report a case of aggressive penile angiomyxoma in a sixty-two-year-old obese, diabetic male patient. He presented with obstructive lower urinary tract symptoms (LUTS) and diffuse enlargement of the penis and scrotum. He was managed with excision, reduction scrotoplasty, internal urethrotomy, followed by Leuprolide therapy for prevention of recurrence...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28446011/development-of-decision-support-formulas-for-the-prediction-of-bladder-outlet-obstruction-and-prostatic-surgery-in-patients-with-lower-urinary-tract-symptom-benign-prostatic-hyperplasia-part-ii-external-validation-and-usability-testing-of-a-smartphone-app
#18
Min Soo Choo, Seong Jin Jeong, Sung Yong Cho, Changwon Yoo, Chang Wook Jeong, Ja Hyeon Ku, Seung-June Oh
PURPOSE: We aimed to externally validate the prediction model we developed for having bladder outlet obstruction (BOO) and requiring prostatic surgery using 2 independent data sets from tertiary referral centers, and also aimed to validate a mobile app for using this model through usability testing. METHODS: Formulas and nomograms predicting whether a subject has BOO and needs prostatic surgery were validated with an external validation cohort from Seoul National University Bundang Hospital and Seoul Metropolitan Government-Seoul National University Boramae Medical Center between January 2004 and April 2015...
April 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28446010/development-of-decision-support-formulas-for-the-prediction-of-bladder-outlet-obstruction-and-prostatic-surgery-in-patients-with-lower-urinary-tract-symptom-benign-prostatic-hyperplasia-part-i-development-of-the-formula-and-its-internal-validation
#19
Min Soo Choo, Changwon Yoo, Sung Yong Cho, Seong Jin Jeong, Chang Wook Jeong, Ja Hyeon Ku, Seung-June Oh
PURPOSE: As the elderly population increases, a growing number of patients have lower urinary tract symptom (LUTS)/benign prostatic hyperplasia (BPH). The aim of this study was to develop decision support formulas and nomograms for the prediction of bladder outlet obstruction (BOO) and for BOO-related surgical decision-making, and to validate them in patients with LUTS/BPH. METHODS: Patient with LUTS/BPH between October 2004 and May 2014 were enrolled as a development cohort...
April 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28444709/male-bladder-outlet-obstruction-time-to-re-evaluate-the-definition-and-reconsider-our-diagnostic-pathway-ici-rs-2015
#20
REVIEW
Kevin Rademakers, Marcus J Drake, Andrew Gammie, Jens C Djurhuus, Peter F W M Rosier, Paul Abrams, Christopher Harding
The diagnosis of bladder outlet obstruction (BOO) in the male is dependent on measurements of pressure and flow made during urodynamic studies. The procedure of urodynamics and the indices used to delineate BOO are well standardized largely as a result of the work of the International Continence Society. The clinical utility of the diagnosis of BOO is however, less well defined and there are several shortcomings and gaps in the currently available medical literature. Consequently the International Consultation on Incontinence Research Society (ICI-RS) held a think tank session in 2015 entitled "Male bladder outlet obstruction: Time to re-evaluate the definition and reconsider our diagnostic pathway?" This manuscript details the discussions that took place within that think tank setting out the pros and cons of the current definition of BOO and exploring alternative clinical tests (alone or in combination) which may be useful in the future investigation of male patients with lower urinary tract symptoms...
April 2017: Neurourology and Urodynamics
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