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Elderly with urinary obstruction

Yuan-Hong Jiang, Hann-Chorng Kuo
OBJECTIVE: Underactive bladder is frequently encountered in elderly patients. It may result from detrusor underactivity (DU) or low detrusor contractility due to a urethral sphincter inhibitory effect. This study analyzed the video-urodynamic study (VUDS) characteristics of patients with underactive bladder in a large cohort of men with lower urinary tract symptoms (LUTS). METHODS: Male patients with LUTS who had failed the initial treatment were consecutively enrolled...
2017: PloS One
Christopher J Gouveia, John D Cramer, Stanley Yung-Chuan Liu, Robson Capasso
Objective Assess the frequency and nature of postoperative complications following sleep surgery. Examine these issues specifically in elderly patients to provide guidance for their perioperative care. Study Design Retrospective cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program. Methods We identified patients with obstructive sleep apnea undergoing sleep surgery procedures from 2006 to 2013 in the American College of Surgeons National Surgical Quality Improvement Program, a multi-institutional outcomes program designed to improve surgical quality...
April 2017: Otolaryngology—Head and Neck Surgery
B Katerberg, F Ter Borg
Faecal impaction is a problem which is becoming more prevalent now that the number of elderly patients is increasing. When not detected and treated inadequately, it can lead to symptoms such as diarrhoea, faecal incontinence and other serious problems like anorexia, vomiting and rectal ulcers with bleeding or even a bowel perforation. We describe two patients with serious and less common complications of faecolithiasis. Patient A, a 79-year-old woman with signs of dementia, presented with faecal incontinence and unexplained worsening of her cognitive symptoms leading to a situation where she could no longer live in her own home...
2017: Nederlands Tijdschrift Voor Geneeskunde
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
Zitong Zhao, Rui Ming Ong, Chin Hong Goh, Hwai Liang Loh
We report a case of pseudotuberculous granulomatous pyelitis in an elderly female patient with hydronephrotic right kidney secondary to obstructing urinary stone. Pseudotuberculous granulomatous pyelitis is a rarely reported entity, characterized by severe granulomatous inflammation limited predominantly to the renal pelvis. It is associated with urinary (pelvicalyceal) obstruction, urolithiasis well as non- Mycobacterial urinary tract infection.
February 2017: International Journal of Surgical Pathology
Sean A Martin, Sarah L Appleton, Robert J Adams, Anne W Taylor, Peter G Catcheside, Andrew Vakulin, R Douglas McEvoy, Nick A Antic, Gary A Wittert
OBJECTIVES: To examine the influence of obstructive sleep apnea (OSA) on nocturia, controlling for their shared co-morbidities, in a population of community-based middle aged to elderly men. METHODS: Participants were drawn from a randomly selected, community-dwelling cohort of men in Adelaide, Australia. Seven hundred and eight men (mean: 60.7 [41.6-88.2] years) who had polysomnography recordings, complete lower urinary tract symptoms (LUTS) measures (International Prostate Symptom Score), without prostate or bladder cancer and/or surgery, and no prior OSA diagnosis were selected...
November 2016: Urology
O Lavergne, Q Bonnet, A Thomas, D Waltregny
Renal colic (RC) represents nearly 2% of emergency department admissions. RC is defined by the occurrence of back pain which may radiate towards the abdomen and external genitals. In adults, the obstruction is caused by a urinary stone in 80% of cases. The 20 % of non-stone related RCs are due either to an intrinsic obstruction (pyeloureteral junction stenosis, ureteral tumor, ...) or an extrinsic compression (pelvic tumor, lymphadenopathy ...). In over 90% of cases, an RC does not require hospitalization and is treated with medication...
May 2016: Revue Médicale de Liège
Guozheng Liu, Fengguo Jian, Xiuqin Wang, Lin Chen
AIM: To study the efficacy of the fast-track surgery (FTS) program combined with laparoscopic radical gastrectomy for elderly gastric cancer (GC) patients. METHODS: Eighty-four elderly patients diagnosed with GC between September 2014 and August 2015 were recruited to participate in this study and were divided into four groups randomly based on the random number table as follows: FTS + laparoscopic group (Group A, n=21), FTS + laparotomy group (Group B, n=21), conventional perioperative care (CC) + laparoscopic group (Group C, n=21), and CC + laparotomy group (Group D, n=21)...
2016: OncoTargets and Therapy
Yong Li, Jiabin Zheng
Gastric cancer is one of the most common digestive malignant tumors. More and more elderly gastric cancer patients are diagnosed and need to undergo surgical treatment as the population ages. Since the elderly patients decrease in organ function and increase in internal diseases, the tolerance to anesthesia and surgery is poor. As a result, the incidence of surgical and postoperative complications is obviously higher. Complications can be divided into surgical complications and non-surgical related complications...
May 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
J-N Cornu, G Amarenco, F Bruyere, E Chartier-Kastler, B Fatton, P Grise, F Haab, R Bourouina
AIMS: To determine the prevalence of overactive bladder (OAB) syndrome in France and gather data about initial patient trajectories in the healthcare system. METHODS: A dedicated questionnaire (41 questions) has been sent to a 12,000 sample of people representative of the global population. The following data were investigated: social and demographic features, medical history, Urinary Symptom Profile questionnaire, bother, history of symptoms, care seeking and treatments received...
June 2016: Progrès en Urologie
Pei Wen Chuang, Bo-Ming Huang, Chung Hsien Liu, Chien-Chin Chen, Ming-Jen Tsai
Appendicitis is a common surgical abdominal disease with various presentations. Its diagnosis may be obscured by asymptomatic congenital anatomical anomalies like midgut malrotation. Midgut malrotation is a rare fetal anomaly resulting from incomplete or failure of midgut rotation and fixation. It is mostly presented with bowel obstruction or volvulus in early life. Presentation in adult is rare. Here, we report an elderly patient presented with left lower abdominal pain and urinary tract infection. Abdominal computed tomography revealed left-sided appendicitis with non-rotational-type midgut malrotation...
December 2015: Indian Journal of Surgery
A Wiedemann, I Füsgen
As people age, they increasingly experience multimorbidity, especially regarding urological conditions. Multimorbidity in elderly patients frequently includes urinary incontinence and subvesical obstruction. While urinary incontinence is often directly associated with other existing diseases or polymedication, subvesical obstruction may be unrelated to other morbidities. Subvesical obstruction often requires polymedication and is therefore a noteworthy condition in urological diagnostics and treatment. First and foremost, a focused diagnostic investigation must be performed, which then enables a systematic therapeutic approach...
February 2016: Aktuelle Urologie
H J Heppner, F Yapan, A Wiedemann
Due to the demographic shift, increasing numbers of geriatric patients are admitted to acute care hospitals of all levels of care. This means that special challenges must be met in the medical care and management of these patients.Immunosenescence and multimorbidity make elderly patients vulnerable to infectious diseases. Urinary tract infections range from "simple" cystitis to pyelonephritis and urosepsis and, at 25%, are the second most common form of infection in geriatric patients. It is often difficult to make a diagnosis because typical symptoms do not always occur...
February 2016: Aktuelle Urologie
Marco Fiorentino, Davide Bolignano, Vladimir Tesar, Anna Pisano, Wim Van Biesen, Graziella D'Arrigo, Giovanni Tripepi, Loreto Gesualdo
BACKGROUND: Although the number of patients reaching end-stage kidney disease without a biopsy-proven diagnosis is increasing, the utility of renal biopsy is still an object of debate. We analyzed epidemiological data and the main indications for renal biopsy with a systematic, evidence-based review at current literature. SUMMARY: There is a high discrepancy observed in biopsy rates and in the epidemiology of glomerular diseases worldwide, related to the different time frame of the analyzed reports, lack of data collection, the different reference source population and the heterogeneity of indications...
2016: American Journal of Nephrology
Portia Thurmond, Jing-Hua Yang, Kazem M Azadzoi
Lower urinary tract symptoms (LUTS) are a group of voiding symptoms affecting both genders as they age. Traditionally, LUTS in men were commonly attributed to bladder outlet obstruction (BOO) due to benign prostatic enlargement (BPE). It was later shown that, in approximately one-third to more than one-half of cases, LUTS in men are not associated with BOO. Urodynamic changes in the male bladder and symptom scores in aging men were found to be identical to their age-matched female counterparts. These observations suggested that LUTS in the elderly do not necessarily relate to BOO and may result from local changes in bladder muscle, nerves, and blood vessels...
April 15, 2016: American Journal of Physiology. Renal Physiology
Sreevathsa Maddibande Ramachar, Nishchit Hegde
INTRODUCTION: Small bowel carcinoid tumours are indolent neuroendocrine tumours usually seen in the 6(th) and 7(th) decades. Most often, they are silent with non-specific symptoms. They generate serotonin, provoking a desmoplastic reaction in the mesentery leading to bowel ischemia and obstruction. While CECT abdomen can help raise suspicion and show regional spread, elevated 24-hour urinary 5-HIAA levels, histopathology and immunohistochemistry for Chromogranin A are confirmatory. AIM: To analyse a single surgeon's experience of clinical features and diagnosis of carcinoid tumours of the small intestine...
November 2015: Journal of Clinical and Diagnostic Research: JCDR
Jan Van Keer, Daan Detroyer, Bert Bammens
Purple urine bag syndrome is a rare condition in which purple discoloration of urine inside its collection bag occurs. We describe two illustrative cases. The first patient is an 81-year-old man who was hospitalized for a newly diagnosed lymphoma with acute obstructive renal failure for which a nephrostomy procedure was performed. During the hospitalization, a sudden purple discoloration of the suprapubic catheter urine was noted, while the nephrostomy urine had a normal color. Urine culture from the suprapubic catheter was positive for Pseudomonas aeruginosa and Enterococcus faecalis; urine from the nephrostomy was sterile...
2015: Case Reports in Nephrology
Vivian Chi Mei Man, Hok Kwok Choi, Wai Lun Law, Dominic Chi Chung Foo
PURPOSE: Low anterior resection is commonly performed for carcinoma of the distal rectum. Diverting ileostomy has been used to decrease the septic consequence of anastomotic leakage and to reduce the re-operation rate. Nevertheless, subsequent closure of ileostomy can be associated with considerable morbidities. This study aimed to evaluate the morbidities after closure of ileostomy and to identify possible risk factors associated with the morbidities. METHODS: Data of patients who underwent closure of ileostomy, after a previous low anterior resection and defunctioning ileostomy for rectal cancer, was reviewed retrospectively...
January 2016: International Journal of Colorectal Disease
Seokchan Hong, Yong-Gil Kim, Soo Min Ahn, Seung-Hyeon Bae, Doo-Ho Lim, Jeong Kon Kim, Chang-Keun Lee, Bin Yoo
AIM: Hydronephrosis is a rare complication of systemic lupus erythematosus (SLE). Bladder and/or gastrointestinal involvement in SLE are associated with development of hydronephrosis, but the management and treatment outcomes of hydronephrosis are largely unknown. Therefore, we investigated the clinical manifestations and factors associated with the treatment response in patients with SLE complicated by hydronephrosis. METHOD: A retrospective analysis was performed of all 634 SLE patients who underwent computed tomography and/or ultrasonography between January 1998 and December 2013...
December 2016: International Journal of Rheumatic Diseases
Carlos Verdejo-Bravo, Francisco Brenes-Bermúdez, Maria Victoria Valverde-Moyar, Antonio Alcántara-Montero, Noemí Pérez-León
Overactive nladder (OAB) is a clinical entity with a high prevalence in the population, having a high impact on quality of life, especially when it occurs with urge urinary incontinence. It is very important to highlight the low rate of consultation of this condition by the older population. This appears to depend on several factors (educational, cultural, professional), and thus leads to the low percentage of older patients who receive appropriate treatment and, on the other hand, a large percentage of older patients with a significant deterioration in their quality of life...
September 2015: Revista Española de Geriatría y Gerontología
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