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Lower urinary tract obstruction

Cosimo De Nunzio, Fabrizio Presicce, Riccardo Lombardo, Simon Carter, Carlo Vicentini, Andrea Tubaro
AIMS: To evaluate the role of Bladder wall thickness (BWT) as a predictor of Detrusor overactivity (DO) in patients with Lower urinary tract symptoms (LUTS)/Benign prostatic enlargement without Bladder Outlet Obstruction. METHODS: From January 1996 to December 2000, each new patient, aged 45 years or older with LUTS, underwent standard diagnostic assessment, urodynamic studies (cystometry and pressure flow studies), and ultrasound measurements of the bladder wall thickness (BWT) in two centers...
October 24, 2016: Neurourology and Urodynamics
Wei Phin Tan, Ulku C Turba, Leslie A Deane
INTRODUCTION: We describe a case of renal pelvi-ureteric fungus ball managed with placement of two nephrostomy tubes and amphotericin B irrigation through a nephrostomy tube with the other to free drain. CASE REPORT: A 46-year-old man with uncontrolled Type 2 diabetes mellitus was referred to the urology clinic for workup of recurrent urinary tract infection. Urine culture grew Candida albicans. The patient was started on oral fluconazole therapy. Cystoscopy and cystogram revealed a grade 3 left vesicoureteral reflux and right retrograde pyelogram revealed a filling defect in the right renal pelvis extending into the proximal ureter with severe hydroureteronephrosis...
October 15, 2016: Urologia
G Magistro, C G Stief, C Gratzke
Novel minimally invasive treatment options for the management of male lower urinary tract symptoms (LUTS) due to bladder outlet obstruction (BOO) aim to provide equal efficacy compared to standard techniques with a more favourable safety profile. The preservation of all aspects of male sexual function including antegrade ejaculation is increasingly important to patients. It should be ideally performed in an outpatient setting under local anesthesia to assure a short recovery time. Novel injectables for intraprostatic application (botulinum neurotoxin A, NX-1207, PRX302) have emerged and first phase III results could not confirm the promising initial data...
October 19, 2016: Der Urologe. Ausg. A
Claus G Roehrborn, Francisco Cruz, Ferdinando Fusco
Available α1-blockers (ABs) have different profiles of receptor selectivity. Silodosin exhibits the highest selectivity for the α1A adrenergic receptor. This pharmacological feature couples with a singular urodynamic and clinical profile. The magnitude of bladder outlet obstruction improvement in patients receiving silodosin is higher if compared to other ABs. From a clinical point of view, current evidence suggests an advantage in favor of silodosin in terms of nocturia improvement and cardiovascular safety...
October 17, 2016: Advances in Therapy
Lorenz Leitner, Matthias Walter, Ulla Sammer, Stephanie C Knüpfer, Ulrich Mehnert, Thomas M Kessler
OBJECTIVES: To evaluate whether urodynamic investigation (UDI), the gold standard to assess refractory lower urinary tract symptoms (LUTS), is appropriate to select healthy volunteers with apparent normal lower urinary tract function as control subjects for comparative studies. SUBJECTS AND METHODS: 42 healthy subjects (22 women, mean age 32±10 years; 20 men, mean age 37±12 years) without LUTS were included into this prospective single-centre cohort study. All subjects recorded a 3-day bladder diary, completed validated questionnaires regarding LUTS, and underwent neuro-urological assessment as well as free uroflowmetry...
2016: PloS One
Junichiro Kawamura, Masaki Tani, Kimiaki Sumida, Takefumi Yazawa, Junya Kawasoe, Michihiro Yamamoto, Hideki Harada, Hidekazu Yamamoto, Masazumi Zaima
PURPOSE: Cancerous involvement of a ureter is sometimes encountered in pelvic surgery for malignancy. We usually perform transureteroureterostomy (TUU) in cases of unilateral lower ureteral cancerous involvement. We report the outcomes in patients treated with TUU in our institute. METHODS: We retrospectively reviewed the medical records of 11 patients who underwent TUU between June 2006 and September 2015. RESULTS: The primary disease was colon cancer in five patients, rectal cancer in four, and uterine cervical cancer and ovarian cancer in one patient each...
October 6, 2016: International Journal of Colorectal Disease
T R W Herrmann
BACKGROUND: In the last 20 years various transurethral endoscopic enucleation techniques (EEP) have been established as a substitute for open prostatectomy (OP) and TURP. Since the 2016 update of the "EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), including Benign Prostatic Obstruction (BPO)", Holmium laser enucleation of the prostate (HoLEP) and bipolar enucleation being summarized as anatomical enucleating techniques are proposed as first choice for the surgical management of BPO of large volume prostates...
October 6, 2016: Der Urologe. Ausg. A
Mandy Rickard, Armando J Lorenzo, Luis H Braga
OBJECTIVE: To explore the potential value of an objective assessment, renal parenchyma-to-hydronephrosis area ratio (PHAR), as an early predictor of surgery. MATERIALS AND METHODS: Initial sagittal renal ultrasound images of patients prospectively entered into a prenatal hydronephrosis (PHN) database from January 2008-2016 with baseline SFU grades III and IV PHN, without vesicoureteral reflux, were evaluated using NIH-sponsored image-processing software. PHAR, APd, SFU grade and urinary tract dilation (UTD) risk categories were contrasted with nuclear scan data (differential renal function [DRF] and drainage time [t ½]), and analyzed for predictive value in determining the decision to proceed with surgery by drawing receiver operator characteristic curves...
October 3, 2016: Urology
Fabrizio Presicce, Cosimo De Nunzio, Mauro Gacci, Enrico Finazzi Agrò, Andrea Tubaro
BACKGROUND: To evaluate the role of the ultrasound assessments of the bladder/detrusor wall thickness (BWT/DWT) and the ultrasound estimated bladder weight (UEBW) in lower urinary tract symptoms diagnosis and treatment. EVIDENCE ACQUISITION: A systematic literature search from January 1995 until February 2016 was performed on PubMed using the following terms: Bladder Weight, Bladder Wall Thickness, Detrusor Wall Thickness, LUTS, Bladder Outlet Obstruction (BOO), Benign Prostatic Obstruction...
October 5, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Sachin Malde, Arjun K Nambiar, Roland Umbach, Thomas B Lam, Thorsten Bach, Alexander Bachmann, Marcus J Drake, Mauro Gacci, Christian Gratzke, Stephan Madersbacher, Charalampos Mamoulakis, Kari A O Tikkinen, Stavros Gravas
CONTEXT: Several noninvasive tests have been developed for diagnosing bladder outlet obstruction (BOO) in men to avoid the burden and morbidity associated with invasive urodynamics. The diagnostic accuracy of these tests, however, remains uncertain. OBJECTIVE: To systematically review available evidence regarding the diagnostic accuracy of noninvasive tests in diagnosing BOO in men with lower urinary tract symptoms (LUTS) using a pressure-flow study as the reference standard...
September 26, 2016: European Urology
Ali Gürağaç, Zafer Demirer, Bilal Fırat Alp, Emin Aydur
CONTEXT: Prostatic cysts are uncommon. These cysts are usually asymptomatic and are diagnosed incidentally during ultrasonographic examination. On rare occasions, they may cause drastic symptoms. CASE REPORT: We report on a case of severely symptomatic anteriorly located prostatic cyst arising from the bladder neck in a 30-year-old man presenting with lower urinary tract symptoms, without clinical evidence of benign prostatic hyperplasia. Transrectal ultrasonography (TRUS), computed tomography (CT) and cystourethroscopy demonstrated a projecting prostatic cyst that occupied the bladder neck at the precise twelve o'clock position...
September 26, 2016: São Paulo Medical Journal, Revista Paulista de Medicina
Robert A Goldfarb, Yunhua Fan, Stephanie Jarosek, Sean P Elliott
PURPOSE: Ureteral obstruction in cervical cancer occurs in up to 11% of patients, many of whom undergo ureteral stenting. Our aim was to describe the patient burden of chronic ureteral stenting in a population-based cohort by detailing two objectives: (1) the frequency of repeat procedures for ureteral obstruction; and, (2) the frequency of urinary adverse effects (UAEs) (e.g., lower urinary tract symptoms, flank pain). MATERIALS AND METHODS: From SEER-Medicare, we identified 202 women who underwent ureteral stent placement prior to or following cervical cancer treatment...
September 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
M Kurtz, C Koh, H Sangi-Haghpeykar, A Shamshirsaz, J Espinoza, D Cass, O Olutoye, M Braun, D Roth, M Belfort, R Ruano
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
Sundaramoorthy Vijayganapathy, Ashwin Mallya, Vilvapathy Senguttuvan Karthikeyan, Jayaram Sreenivas
The penile circular fasciocutaneous flap (FCF) is employed in the successful single stage reconstruction of long segment complex anterior urethral strictures especially when buccal mucosa is unavailable due to various reasons. A 65-year-old gentleman, chronic smoker and tobacco chewer, hypertensive on treatment, presented with obstructive lower urinary tract symptoms for 8 months. He had no prior urethral catheterization. On examination, he had circumcised penis, with stenosis of the external urethral meatus...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Simone Albisinni, Ibrahim Biaou, Quentin Marcelis, Fouad Aoun, Cosimo De Nunzio, Thierry Roumeguère
BACKGROUND: Lower Urinary Tract Symptoms (LUTS) in men are a common clinical problem in urology and have been historically strictly linked to benign prostatic hyperplasia (BPH), which may lead to bladder outlet obstruction (BOO). New molecules have been approved and have entered the urologists' armamentarium, targeting new signaling pathways and tackling specific aspects of LUTS. Objective of this review is to summarize the evidence regarding the new medical therapies currently available for male non-neurogenic LUTS, including superselective α1-antagonists, PDE-5 inhibitors, anticholinergic drugs and intraprostatic onabotulinum toxin injections...
September 15, 2016: BMC Urology
Donboklang Lynser, Evarisalin Marbaniang, Pynskhemboklang Khongsni
Urinary retention in young children and infancy is relatively rare. The commonest malignancy cause of bladder outlet obstruction in infancy is prostatic rhabdomyosarcoma; the commonest cause of congenital bladder outlet obstruction in a male infantis posterior urethral valve and the commonest cause of urethral obstruction in male children is urethral calculi. We present here a report on three cases of urethral obstruction in male children.
September 2016: Medical Ultrasonography
Andrew H Chon, Gustavo H de Oliveira, Kevin V Lemley, Lisa M Korst, Ryan D Assaf, Ramen H Chmait
INTRODUCTION: Although mortality has decreased for fetuses with lower urinary tract obstruction treated with vesicoamniotic shunt (VAS) placement, survivors remain at risk for long-term renal impairment. We tested the association of fetal serum β2-microglobulin (fsβ2M) with postnatal renal function in these patients, hypothesizing that fsβ2M may predict such renal impairment. MATERIALS AND METHODS: fsβ2M was obtained in patients undergoing VAS placement. The primary outcome was renal function at 3-12 months of life, as assessed by a pediatric nephrologist using medical records...
September 8, 2016: Fetal Diagnosis and Therapy
Abul-Fotouh Ahmed, Mohamed Bedewi
OBJECTIVE: To investigate the accuracy of the bladder and prostate sonomorphologic parameters for the diagnosis of bladder outlet obstruction (BOO) in patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: First-visit men, aged ≥ 50 years, with LUTS/BPH were prospectively enrolled. Added to the initial basic evaluation, all patients underwent pelvic ultrasonography and pressure flow study. The pressure flow study was used as a reference standard for BOO, and according to its results, patients were divided into BOO and non-BOO groups...
August 31, 2016: Urology
Thomas R W Herrmann
The latest update of the EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms, incl. Benign Prostatic Obstruction in 2016 announced a novel acronym for transurethral Endoscopic Enucleation of the Prostate (EEP). This was inspired by a meta-analysis on randomized controlled trials on Holmium Laser Enucleation of the Prostate (HolEP) and bipolar enucleation versus open simple prostatectomy. EEP codes for the common ground of both techniques: "anatomical enucleation." Although study quality with regard to the availability of long-term randomized controlled trials is at the moment mostly available for HoLEP, and bipolar enucleation, the existing data of all other enucleating techniques that have been demonstrated to perform anatomical enucleation as well should also been summarized under the same term...
October 2016: World Journal of Urology
Matthew Ryan Macey, Mathew C Raynor
Benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) is one of the most common ailments affecting aging men. Symptoms typically associated with BPH include weak stream, hesitancy, urgency, frequency, and nocturia. More serious complications of BPH include urinary retention, gross hematuria, bladder calculi, recurrent urinary tract infection, obstructive uropathy, and renal failure. Evaluation of BPH includes a detailed history, objective assessment of urinary symptoms with validated questionnaires, and measurement of bladder function parameters, including uroflowmetry and postvoid residual...
September 2016: Seminars in Interventional Radiology
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