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Elderly with urinary obstruction

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https://www.readbyqxmd.com/read/28757770/recent-research-on-the-role-of-urodynamic-study-in-the-diagnosis-and-treatment-of-male-lower-urinary-tract-symptoms-and-urinary-incontinence
#1
REVIEW
Yuan-Hong Jiang, Hann-Chorng Kuo
Although evidence shows that urodynamic study may not improve outcomes, it can be used to evaluate men with lower urinary tract symptoms (LUTSs) which have not been adequately delineated and treated. In young men with LUTS not responding to treatment based on clinical examination, or elderly men with LUTS and incontinence, a complete urodynamic evaluation is mandatory to understand the pathophysiology underlying LUTS, such as bladder outlet obstruction (BOO), detrusor overactivity, and detrusor underactivity...
April 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28757756/current-consensus-and-controversy-on-the-treatment-of-male-lower-urinary-tract-symptoms-benign-prostatic-hyperplasia
#2
REVIEW
Chun-Hou Liao, Hann-Chorng Kuo
Lower urinary tract symptoms (LUTS) are highly prevalent in men and increase with age. Because LUTS are common among elderly men, they are usually considered synonymous with benign prostatic hyperplasia (BPH). Drugs should be the first-line treatment for BPH and surgical intervention should be performed only when there are complications or LUTS refractory to medical treatment. In addition to medical treatment, several minimally invasive therapies, such as thermal therapy, prostatic lift, laser evaporation, or laser enucleation techniques have been developed...
January 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28700149/-acute-urinary-retention-a-mechanical-or-functional-emergency
#3
Giacomo Verzotti, Vanessa Fenner, Gregory Wirth, Christophe E Iselin
Acute urinary retention is one of the most frequent urologic emergencies. It occurs mostly in elderly males that suffer from prostate enlargement. Very rare in women, it is essentially caused by vaginal prolapse and neurologic disease. Patients with acute urinary retention suffer from lower abdominal pain and cannot void. Medical history is the cornerstone of diagnosis. Rarely palpable on abdominal examination, an overfilled bladder may be revealed by dullness on supra-pubic percussion. Acute urinary retention may lead to a decrease in kidney function, and on the long term to detrusor hypocontractility...
November 30, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28588799/determining-the-optimum-way-to-maintain-quality-of-life-for-very-elderly-patients-with-advanced-bladder-cancer-and-poor-performance-status-a-case-report
#4
Kenjiro Suzuki, Fuminari Hanashima, Suguru Shirotake, Kiichiro Kodaira, Koshiro Nishimoto, Takao Takahashi, Hideki Onishi, Masafumi Oyama
Locally advanced bladder cancer causes unpleasant symptoms such as irritative voiding symptoms, lower abdominal pain, gross hematuria and urinary retention, and lowers the quality of life. Treatment decisions in elderly patients may be difficult, as elderly patients are physically and psychologically different from younger patients. An 89-year-old male was referred to hospital for the treatment of an invasive bladder tumor with right hydronephrosis from tumor obstruction. The patient was elderly and did not have a good performance status; therefore curative radical cystectomy or chemotherapy was not indicated...
June 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28546038/-pathophysiology-of-detrusor-underactivity-in-the-elderly
#5
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/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
#6
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/28376105/video-urodynamic-characteristics-of-non-neurogenic-idiopathic-underactive-bladder-in-men-a-comparison-of-men-with-normal-tracing-and-bladder-outlet-obstruction
#7
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
https://www.readbyqxmd.com/read/28195824/sleep-surgery-in-the-elderly-lessons-from-the-national-surgical-quality-improvement-program
#8
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
https://www.readbyqxmd.com/read/28145214/-faecolithiasis-straightforward-to-detect-but-often-missed
#9
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
https://www.readbyqxmd.com/read/27582609/medical-and-surgical-treatment-modalities-for-lower-urinary-tract-symptoms-in-the-male-patient-secondary-to-benign-prostatic-hyperplasia-a-review
#10
REVIEW
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
https://www.readbyqxmd.com/read/27440812/pseudotuberculous-granulomatous-pyelitis
#11
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
https://www.readbyqxmd.com/read/27349525/nocturia-other-lower-urinary-tract-symptoms-and-sleep-dysfunction-in-a-community-dwelling-cohort-of-men
#12
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
https://www.readbyqxmd.com/read/27337839/-how-i-treat-a-renal-colic
#13
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
https://www.readbyqxmd.com/read/27330314/fast-track-surgery-protocol-in-elderly-patients-undergoing-laparoscopic-radical-gastrectomy-for-gastric-cancer-a-randomized-controlled-trial
#14
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
https://www.readbyqxmd.com/read/27215514/-therapy-of-both-surgical-and-non-surgical-related-complication-of-gastric-cancer-for-the-elderly
#15
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
https://www.readbyqxmd.com/read/27108102/-prevalence-and-initial-management-of-overactive-bladder-in-france-a-cross-sectional-study
#16
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
https://www.readbyqxmd.com/read/27011586/left-sided-appendicitis-in-an-elderly-patient-with-midgut-malrotation
#17
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
https://www.readbyqxmd.com/read/26916046/-multimorbidity-in-urology
#18
REVIEW
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
https://www.readbyqxmd.com/read/26916045/-urosepsis-in-geriatric-patients
#19
REVIEW
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
https://www.readbyqxmd.com/read/26844777/renal-biopsy-in-2015-from-epidemiology-to-evidence-based-indications
#20
REVIEW
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
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