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Lower urinary tract obstruction

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https://www.readbyqxmd.com/read/28092069/treatment-of-concomitant-oab-and-bph
#1
REVIEW
Matthew C Moss, Tameem Rezan, Umar R Karaman, Alex Gomelsky
The etiology of men's lower urinary tract storage and voiding symptoms involves a contribution from both detrusor and outlet. As such, treatment of benign prostatic enlargement (BPE) ± benign prostatic obstruction (BPO) with standard alpha-adrenergic blockade and 5-alpha reductase inhibitor therapy may leave a population of men with persistent and bothersome urinary storage symptoms. An abundance of adequately powered, randomized, placebo-controlled trials indicate that the use of antimuscarinics and beta-3 adrenergic agonists, either alone or in combination with standard BPE/BPO therapy, leads to improvement in storage symptoms...
January 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28079568/two-dimensional-and-three-dimensional-transperineal-ultrasound-findings-in-women-with-high-pressure-voiding-after-midurethral-sling-placement
#2
Kindra Larson, Lauren Scott, Tina D Cunningham, Yili Zhao, Alfred Abuhamad, Peter Takacs
OBJECTIVES: The aim of this study was to evaluate dynamic two-dimensional (2D) and 3D transperineal pelvic ultrasound findings with urodynamic studies in women with lower urinary tract symptoms after midurethral sling placement. METHODS: On 2D images, the sling position, and on 3D imaging the sling angle, urethral diameter, urethral height, and urethral cross sectional area were recorded with and without Valsalva. Patients were categorized into 3 groups based on 2D imaging: group 1-at rest, the sling lies parallel to the urethral lumen, and during Valsalva, the sling becomes C shaped; group 2-both at rest and during Valsalva, the sling runs parallel to the urethral lumen; group 3-at rest, the sling is C shaped, and during Valsalva, this curved shape is maintained...
January 10, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28074677/the-effective-tool-for-self-assessment-of-adherence-to-treatment-in-patients-with-benign-prostatic-obstruction-and-overactive-bladder-symptoms
#3
Kirill Kosilov, Sergey Loparev, Irina Kuzina, Olga Shakirova, Natalya Zhuravskaya, Alexandra Lobodenko
PURPOSE: Study of validity of the Medication Adherence Self-Report Inventory (MASRI) for use in clinical practice to treat patients with benign prostatic obstruction (BPO) accompanied with overactive bladder (OAB) symptoms. METHODS: During 12 weeks of the randomized study, 452 patients with BPO and OAB symptoms (mean age of 61.3 (12.7)) were studied for adherence to the treatment with Tamsulosin, Solifenacin and Trospium using the MASRI. External monitoring instruments included the Brief Medication Questionnaire (BMQ) and the visual remaining pill count...
January 11, 2017: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
https://www.readbyqxmd.com/read/28057997/male-urethral-diverticulum-uncommon-entity-our-experience
#4
Naveen Thakur, Vilas Pandurang Sabale, Deepak Mane, Abhirudra Mullay
Out pouching of the urethral wall could be congenital or acquired. Male urethral diverticulum (UD) is a rare entity. We present 2 cases of acquired and 1 case of congenital male UD. Case 1A: 40 year male presented with SPC and dribbling urine. Clinically he had hard perineal swelling. RGU revealed large diverticulum in proximal bulbar, irregular narrow distal urethra and stricture just beyond diverticulum. Managed with perineal exploration, stone removal, diverticulum repair and urethroplasty using excess diverticular wall...
October 2016: Urology Annals
https://www.readbyqxmd.com/read/28051043/experience-with-neonatal-hydrometrocolpos-in-the-niger-delta-area-of-nigeria-upsurge-or-increased-recognition
#5
Philemon Ekemenye Okoro, C Obiorah, C E Enyindah
BACKGROUND: Hydrometrocolpos (HMC) is a clinical condition in which there is a cystic distension of the vagina (hydrocolpos), uterus and sometimes, fallopian tubes (hydrosalpinx) with fluid. This study described our experience with cases of HMC seen in our practice, and highlighted the flare in our practice. PATIENTS AND METHODS: A retrospective study of cases of HMC managed at the University of Port Harcourt Teaching Hospital between September 2010 and August 2012...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28043111/nocturia-improvement-with-surgical-correction-of-sleep-apnea
#6
Hyoung Keun Park, Sung Hyun Paick, Hyeong Gon Kim, Doo-Heum Park, Jae Hoon Cho, Seok-Chan Hong, Woo Suk Choi
PURPOSE: To evaluate changes in nocturia after surgical correction of obstructive sleep apnea (OSA). METHODS: A total of 66 patients were included in the present study. All had been diagnosed with OSA syndrome by polysomnography and underwent uvulopalatopharyngoplasty (UPPP). Preoperative and postoperative lower urinary tract symptoms (LUTS), quality of life (QoL), and nocturia episodes were evaluated using the International Prostate Symptom Score (IPSS) and overactive bladder symptom score (OABSS) questionnaires...
December 2016: International Neurourology Journal
https://www.readbyqxmd.com/read/28033180/a-woman-with-a-midurethral-sling-and-bladder-outlet-obstruction
#7
Jessica Nelson, Phillipe Zimmern
A midurethral sling is a common procedure for stress urinary incontinence in women. Tensioning of the tape used for the sling is an art, and overtensioning during surgery can lead to obstructive symptoms. A patient with new onset of lower urinary tract symptoms after sling surgery should be evaluated for possible voiding dysfunction. Sling incision does not always correct the obstruction and excision may be needed.
January 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28011273/obstructive-nephropathy-without-hydronephrosis-suspicion-is-the-key
#8
Don H Esprit, Abhilash Koratala, Volodymyr Chornyy, Charles Wingo
Urinary tract obstruction leading to acute kidney injury is usually associated with bilateral hydroureters and hydronephrosis, often accompanied by oliguria. We present an atypical case of obstructive uropathy without these features that presented with severe acute kidney injury. A 64-year-old male with no known past medical history has presented with a 2-week history of nausea, decreased appetite, flank pain, lower extremity edema and was found to have elevated creatinine of 10.5 mg/dL. Renal ultrasound showed mild prominence of the bilateral renal collecting systems with no evidence of hydronephrosis...
December 20, 2016: Urology
https://www.readbyqxmd.com/read/28001177/uromodulin-a-new-biomarker-of-fetal-renal-function
#9
Thais Emanuelle Faria Botelho, Alamanda Kfoury Pereira, Patrícia Gonçalves Teixeira, Eura Martins Lage, Gabriel Costa Osanan, Ana Cristina Simões E Silva
INTRODUCTION: Obstructive uropathies are main diseases affecting the fetus. Early diagnosis allows to establish the appropriate therapy to minimize the risk of damage to kidney function at birth. Biochemical markers have been used to predict the prognosis of renal function in fetuses. Uromodulin, also known by Tamm-Horsfall protein (THP) is exclusively produced in the kidneys and in normal conditions is the protein excreted in larger amounts in human urine. It plays important roles in kidneys and urinary tract...
December 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27993667/convective-radiofrequency-water-vapor-thermal-therapy-with-rez%C3%A5-m-system-durable-two-year-results-of-randomized-controlled-and-prospective-crossover-studies-for-treatment-of-lower-urinary-tract-symptoms-due-to-benign-prostatic-hyperplasia
#10
Claus G Roehrborn, Steven N Gange, Marc C Gittelman, Kenneth A Goldberg, Kalpesh Patel, Neal D Shore, Richard M Levin, Michael Rousseau, J Randolf Beahrs, Jed Kaminetsky, Barrett E Cowan, Christopher H Cantrill, Lance A Mynderse, James C Ulchaker, Thayne R Larson, Christopher M Dixon, Kevin T McVary
PURPOSE: To report two-year outcomes of a multi-center randomized controlled trial plus one-year results of a crossover trial after treatment with convective radiofrequency water vapor thermal energy for lower urinary tract symptoms due to benign prostatic hyperplasia. MATERIALS AND METHODS: 197 men at least 50 years old with International Prostate Symptom Scores 13 or greater, maximum flow rate of 15 ml per second or less and prostate size 30 to 80 cc were randomized 2:1 between thermal therapy with the Rezūm® System and control...
December 16, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27987130/ultrasound-image-features-of-intravesical-prostatic-protrusion-indicated-failure-of-medication-therapy-of-finasteride-and-doxazosin-in-patients-with-benign-prostatic-hyperplasia-luts-bph
#11
Qiang Liu, Yunkai Zhu, Jianping Liu, Jun Qi, Jian Kang
BACKGROUND: Intravesical prostatic protrusion (IPP) is a type of benign prostatic hyperplasia (BPH) adenoma, and it plays a critical role in the pathogenesis of bladder outlet obstruction in patients with lower urinary tract syndromes (LUTS/BPH). AIMS: The goal of this study was to investigate the effect of a combination therapy with finasteride and doxazosin on IPP in BPU/LUTS patients. METHODS: A total of 322 BPH patients with enlarged prostatic volume as well as moderate to severe symptom scores were enrolled and divided into four groups according to the degree of IPP (IPP > 10 mm, 5-10 mm, <5 mm and no IPP) in this study...
December 16, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27958390/prevalence-and-treatment-of-luts-in-patients-with-parkinson-disease-or-multiple-system-atrophy
#12
REVIEW
Teruyuki Ogawa, Ryuji Sakakibara, Sadako Kuno, Osamu Ishizuka, Takeya Kitta, Naoki Yoshimura
The lower urinary tract is controlled by complex neural mechanisms not only in the periphery, but also in the central nervous systems (CNS). Thus, patients with a wide variety of neurological diseases often also have lower urinary tract symptoms (LUTS), including those with Parkinson disease (PD) or multiple system atrophy (MSA). LUTS are common comorbidities associated with both of these neurodegenerative diseases and are likely to impair patients' quality of life. The motor symptoms of PD and MSA often seem similar; however, the pathophysiology, and thus the treatment of LUTS differs considerably...
December 13, 2016: Nature Reviews. Urology
https://www.readbyqxmd.com/read/27928428/evidence-for-the-efficacy-and-safety-of-tadalafil-and-finasteride-in-combination-for-the-treatment-of-lower-urinary-tract-symptoms-and-erectile-dysfunction-in-men-with-benign-prostatic-hyperplasia
#13
REVIEW
Chris Olesovsky, Anil Kapoor
Benign prostatic hyperplasia (BPH) is an age-related phenomenon associated with prostatic enlargement and bladder outlet obstruction that can cause significant lower urinary tract symptoms (LUTS). These LUTS have a negative impact on an individual's quality of life, which is why treatment of symptomatic BPH has become a major priority. Although surgical interventions exist for treating BPH, pharmacological therapies are often preferred due to their minimal invasiveness and high degree of effectiveness. The three classes of drugs approved for treating BPH include α-blockers, 5-α-reductase inhibitors (5-ARIs) and phosphodiesterase 5 (PDE-5) inhibitors...
August 2016: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/27925696/transperineal-sonography-and-urodynamic-findings-in-women-with-lower-urinary-tract-symptoms-after-sling-placement
#14
Peter Takacs, Kindra Larson, Lauren Scott, Tina D Cunningham, Sarah C DeShields, Alfred Abuhamad
OBJECTIVES: To evaluate dynamic 2-dimensional (2D) transperineal pelvic sonographic findings and urodynamic studies in women with lower urinary tract symptoms after midurethral sling placement. METHODS: Transperineal pelvic sonography and urodynamic studies were reviewed from women with a midurethral sling and lower urinary tract symptoms. The shape and sonographic dynamic change of the sling from the rest position to the maximum Valsalva maneuver and back to rest were recorded...
November 30, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27924790/can-the-lower-urinary-tract-storage-symptoms-be-completely-resolved-after-plasmakinetic-enucleation-of-the-prostate
#15
Bing-Kun Li, Bin-Shen Chen, Yu-Hong Xin, Chun-Xiao Liu, Shao-Bo Zheng, Ya-Wen Xu, Hu-Lin Li, Yong Zou, Li-Ping Li
The aim of this study was to determine whether the lower urinary tract storage symptoms of benign prostatic obstruction (BPO) could be completely resolved after plasmakinetic enucleation of the prostate (PKEP) and the possible predictors of persistent symptoms. Two hundred and sixty-seven cases of BPO performed PKEP from July 2008 to June 2009 were retrospectively analyzed. Five-year postoperative data were collected and compared with the preoperative data. According to the urodynamic results, the patients were divided into involuntary detrusor contraction (IDC) group (n = 95) and no IDC group (n = 172) preoperatively; the patients with IDC were divided into IDC-persistent group (n = 33) and IDC-resolved group (n = 62) after PKEP...
December 2, 2016: Asian Journal of Andrology
https://www.readbyqxmd.com/read/27920851/zinner-syndrome-a-rare-developmental-anomaly-of-the-mesonephric-duct-diagnosed-on-magnetic-resonance-imaging
#16
Shibani Mehra, Rajeev Ranjan, Umesh Chandra Garga
Developmental anomalies of the urogenital tract are rare but often encountered. Zinner's syndrome is a rare congenital abnormality of mesonephric (Wolffian) duct consisting of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction due to developmental arrest in early embryogenesis affecting the caudal end of Mullerian duct and only approximately a 100 cases have been reported so far. Radiologic modalities such as intravenous pyelography, ultrasonography, vasovesiculography, contrast enhanced computed tomography, and magnetic resonance imaging are all helpful in diagnosis of this unusual entity...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27905699/green-light-vaporization-of-the-prostate-pvp-is-it-an-adult-technique
#17
Aldo Brassetti, Cosimo De Nunzio, Nicolas Barry Delongchamps, Cristian Fiori, Francesco Porpiglia, Andrea Tubaro
INTRODUCTION: Intending to overcome Transurethral resection of the prostate (TURP) in terms of safety maintaining its efficacy profile, have led to the introduction of minimally invasive laser therapies to treat men with lower urinary tract symptoms (LUTS) secondary to Benign prostatic obstruction (BPO), each one with its unique properties. Aim of this review was to analyse and summarize all the existing data regarding the 180 W Xcelerated Performance System (XPS) Potoselective Vaporization of the Prostate (PVP)...
December 1, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/27905698/bladder-neck-contracture-after-surgery-for-benign-prostatic-obstruction-a-literature-review
#18
Luca Cindolo, Michele Marchioni, Esteban Emiliani, Piergustavo De Francesco, Giulia Primiceri, Pietro Castellan, Luigi Schips
INTRODUCTION: Over the last decades, numerous surgical procedures have been proposed to treat Lower Urinary Tract Symptoms (LUTS) secondary to Benign Prostatic Hyperplasia (BPH). However, all are characterized by a certain rate of treatment failure due to Bladder Neck Contracture (BNC). Treatment of secondary BNC appears to be challenging. The main purpose of this review is to evaluate current published knowledge on this topic. EVIDENCE ACQUISITION: The MEDLINE/Pubmed database was searched for all original articles published between 2000 and 2016 analysing the incidence, prevalence and management of BNC as a post-operative complication following surgical treatment of LUTS/BPH...
December 1, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/27900220/use-of-fibrin-glue-as-a-sealant-at-the-anastomotic-line-in-laparoscopic-pyeloplasty-a-randomised-controlled-trial
#19
Ahmed Farouk, Ahmed Tawfick, Mohamed Kotb, Alaa Abdellmaksoud, Ahmed Safaan, Mohamed Yassin, Hassan Shaker
OBJECTIVE: To assess the effectiveness of fibrin glue as a sealant at the anastomotic line of a stentless laparoscopic pyeloplasty (LPP) repair instead of JJ stent insertion. PATIENTS AND METHODS: In all, 46 patients with pelvi-ureteric junction obstruction scheduled for LPP were randomised into two groups each containing 23 patients. Group A underwent stented repair, while group B had a stentless repair together with sealing of the anastomotic line with fibrin glue...
December 2016: Arab Journal of Urology
https://www.readbyqxmd.com/read/27887933/prostate-artery-embolization-for-benign-prostatic-hyperplasia-current-status
#20
REVIEW
Anirudh Mirakhur, Justin P McWilliams
Prostate artery embolization has garnered much attention as a promising treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. We aim to provide an up-to-date review of this minimally invasive technique, including discussion of potential benefits and technical challenges. Current evidence suggests it is a safe and effective option for patients with medication-refractory urinary obstructive symptoms who are poor surgical candidates or refuse surgical therapy. Larger, randomized studies with long-term follow-up data are needed for this technique to be formally established in the treatment paradigm for benign prostatic hyperplasia...
November 22, 2016: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
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