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Lower urinary tract obstruction

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https://www.readbyqxmd.com/read/28730376/lower-urinary-tract-obstruction-fetal-intervention-based-on-prenatal-staging
#1
Rodrigo Ruano, Timothy Dunn, Michael C Braun, Joseph R Angelo, Adnan Safdar
The authors present an overview of lower urinary tract obstruction (LUTO) in the fetus with a particular focus on the insult to the developing renal system. Diagnostic criteria along with the challenges in estimating long-term prognosis are reviewed. A proposed prenatal LUTO disease severity classification to guide management decisions with fetal intervention to maintain or salvage in utero and neonatal pulmonary and renal function is also discussed. Stage I LUTO (mild form) is characterized by normal amniotic fluid index after 18 weeks, normal kidney echogenicity, no renal cortical cysts, no evidence of renal dysplasia, and favorable urinary biochemistries when sampled between 18 and 30 weeks; prenatal surveillance is recommended...
July 21, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28718163/incidence-and-management-of-lower-urinary-tract-symptoms-after-urethral-stricture-repair
#2
REVIEW
Amanda S J Chung, Kurt A McCammon
Lower urinary tract symptoms (LUTS) after urethral stricture repair are not uncommon. Urgency has been reported in 40% of men and urge incontinence in 12% of men after anterior urethroplasty. De novo urgency and urge incontinence is seen in 9 and 5% of men, respectively, after urethroplasty. Once a complication of urethroplasty (such as recurrent urethral stricture or diverticulum) has been excluded as a cause, evaluation of LUTS in such patients should focus on differentiating bladder dysfunction (overactive bladder, underactive bladder), from other outlet obstruction (such as benign prostatic obstruction), dysfunctional voiding, or medical causes (such as nocturnal polyuria)...
September 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28705935/forkhead-box-o3-foxo3-regulates-kidney-tubular-autophagy-following-urinary-tract-obstruction
#3
Ling Li, Ronald Zviti, Catherine Ha, Zhao V Wang, Joseph A Hill, Fangming Lin
Autophagy has been shown to be important for normal homeostasis and adaptation to stress in the kidney. Yet, the molecular mechanisms regulating renal epithelial autophagy are not fully understood. Here, we explored the role of the stress-responsive transcription factor forkhead box O3 (FoxO3) in mediating injury-induced proximal tubular autophagy in mice with unilateral ureteral obstruction (UUO). We show that following UUO, FoxO3 is activated and displays nuclear expression in the hypoxic proximal tubules exhibiting high levels of autophagy...
July 13, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28700992/natural-history-of-fetal-lower-urinary-tract-obstruction-with-normal-amniotic-fluid-volume-at-initial-diagnosis
#4
Mark P Johnson, Enrico Danzer, Jamie Koh, William Polzin, Chris Harman, Richard O'Shaughnessy, Richard Brown, Michael V Zaretsky
OBJECTIVE: The aim of this study was to define the natural history of lower urinary tract obstruction (LUTO) with normal midgestational amniotic fluid volumes. MATERIALS AND METHODS: We performed a retrospective review of 32 consecutive patients with LUTO with normal midgestational amniotic fluid volume followed at 11 North American Fetal Therapy Network (NAFTNet) centers from August 2007 to May 2012. Normal amniotic fluid volume was defined as an amniotic fluid index (AFI) of ≥9 cm...
July 13, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28679181/correlation-between-lower-urinary-tract-symptoms-and-objective-measures-of-uroflowmetry
#5
Hakan Türk, Sıtkı Ün
Indroduction: Benign prostate hyperplasia (BPH) is the most commonly diagnosed benign adenoma which causes serious clinical symptoms by bladder outlet obstruction. BPH patients suffer from negative changes in their quality of life and restriction of their daily activities due to the disease symptoms. Our main objective in this study is to evaluate the relationship between BPH and LUTS as described by International Prostate Symptoms Score and objective non-invasive parameters related to BPH. MATERIALS AND METHODS: 238 Patients over 40 years with clinical BPH, LUTS and/or prostate volumes greater than 25 ml who presented to urology department were included in the study...
June 30, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28658743/correlation-of-prostate-gland-size-and-uroflowmetry-in-patients-with-lower-urinary-tract-symptoms
#6
Deepak Sundaram, Ponnusamy Kasirajan Sankaran, Gunapriya Raghunath, S Vijayalakshmi, J Vijayakumar, Maria Francis Yuvaraj, Munnusamy Kumaresan, Zareena Begum
INTRODUCTION: Benign Prostatic Hyperplasia (BPH) is a common entity among men over 40 years of age with significant disability. It is a condition that occurs when the enlarged prostate gland compresses the urethra leading to Bladder Outlet Obstruction (BOO). AIM: To correlate the size of the prostate gland and uroflowmetry parameters in patients with Lower Urinary Tract Symptoms (LUTS). MATERIALS AND METHODS: One hundred and twenty randomly selected male patients, from the ages of 41 to 70 years, with LUTS, and underwent trans abdominal sonogram and uroflowmetry were included in the study...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28652996/mitochondrial-stress-and-activation-of-pi3k-and-akt-survival-pathway-in-bladder-ischemia
#7
Jing-Hua Yang, Mike B Siroky, Subbarao V Yalla, Kazem M Azadzoi
PURPOSE: Detrusor overactivity contributes to bothersome constellation of lower urinary tract symptoms (LUTS) in men and women as they age. However, the underlying mechanisms of non-obstructive detrusor overactivity and LUTS remain largely unknown. Growing evidence suggests that ischemia may be an independent factor in the development of non-obstructive bladder dysfunction. Our goal was to determine the effects of ischemia on detrusor function and voiding behavior and define redox-mediated cellular stress and cell survival signaling in the ischemic bladder...
2017: Research and Reports in Urology
https://www.readbyqxmd.com/read/28646935/five-year-results-of-the-prospective-randomized-controlled-prostatic-urethral-l-i-f-t-study
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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