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intermittent voiding pattern

Daniel Lodwick, Lindsey Asti, Katherine Deans, Peter Minneci, Daryl McLeod
OBJECTIVE: To survey variations in recommended initial management of newborn spina bifida (SB). METHODS: Members of an international pediatric urology listserve and Pediatric Urology Nurse Specialists Organization were surveyed on practice patterns for newborn SB. Pediatric urologists (PU), nurse practitioners (NP) and physician assistants (PA) practicing in the United States were included. RESULTS: 63 practitioners (48% PU and 52% NP/PA) were included...
August 8, 2016: Urology
Katarina Ivana Tudor, Ryuji Sakakibara, Jalesh N Panicker
The lower urinary tract (LUT) in health is regulated by coordinated multi-level neurological inputs which require an intact central and peripheral nervous system. Lower urinary tract dysfunction is, therefore, a common sequelae of neurological disease and the patterns of bladder storage and voiding dysfunction depend upon the level of neurological lesion. Evaluation includes history taking, bladder diary, urological examination when relevant, ultrasonography and urodynamic testing when indicated. Antimuscarinic agents are the first line treatment for patients with storage dysfunction...
July 11, 2016: Journal of Neurology
Mayank Mohan Agarwal, Saurabh Jain, Ravimohan Mavuduru, Shrawan K Singh, Arup K Mandal
INTRODUCTION: Dysfunctional voiding results from a disturbance in the coordination between sphincter relaxation and detrusor contraction. Video urodynamic studies with electromyography (EMG) are used for diagnosis but have limitations of availability and interpretation. We identified a plateau type voiding detrusor pressure tracing pattern in these patients with a potential of helping diagnosis. MATERIALS AND METHODS: Urodynamic data and tracings of adult patients having been diagnosed with external urethral sphincter dysfunction (EUSD) were retrospectively analyzed...
April 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Marie-Aimée Perrouin-Verbe, Emmanuel Chartier-Kastler, Alexia Even, Pierre Denys, Morgan Rouprêt, Véronique Phé
OBJECTIVE: To report the long-term complications of continent cutaneous urinary diversion(CCUD) in spinal cord injured(SCI) patients unable to perform intermittent self-catheterization(ISC) through the urethra. MATERIALS AND METHODS: Between July 2001 and January 2012, adult SCI patients with a neurogenic bladder who underwent CCUD according to Mitrofanoff's/Monti's/Casale's principle were enrolled. A concomitant supratrigonal and augmentation enterocystoplasty were performed because of refractory detrusor overactivity or low bladder compliance...
November 2016: Neurourology and Urodynamics
Jalesh N Panicker, Clare J Fowler, Thomas M Kessler
Lower urinary tract (LUT) dysfunction is a common sequela of neurological disease, resulting in symptoms that have a pronounced effect on quality of life. The site and nature of the neurological lesion affect the pattern of dysfunction. The risk of developing upper urinary tract damage and renal failure is much lower in patients with slowly progressive non-traumatic neurological disorders than in those with spinal cord injury or spina bifida; this difference in morbidity is taken into account in the development of appropriate management algorithms...
July 2015: Lancet Neurology
José Emilio Batista-Miranda, Pablo Martínez, Anaïs Bassas-Parga
OBJECTIVES: To evaluate usefulness and morbidity of clean intermittent catheterization (CIC) using a decreasing pattern in patients with bladder voiding dysfunction (BVD) of varied etiology. METHODS: We performed a retrospective study of patients with BVD in whom CIC was indicated. We evaluated the clinical presentation, post-void residual urine (PVR), results of the urodynamic studies (UDS), and response to CIC in a decreasing pattern, complications espeand patient adherence...
December 2014: Archivos Españoles de Urología
Drew C Baird, Dean A Seehusen, David V Bode
Enuresis is defined as intermittent urinary incontinence during sleep in a child at least five years of age. Approximately 5% to 10% of all seven-year-olds have enuresis, and an estimated 5 to 7 million children in the United States have enuresis. The pathophysiology of primary nocturnal enuresis involves the inability to awaken from sleep in response to a full bladder, coupled with excessive nighttime urine production or a decreased functional capacity of the bladder. Initial evaluation should include a history, physical examination, and urinalysis...
October 15, 2014: American Family Physician
Luis Guerra, Michael Leonard, Marco Castagnetti
The purpose of this article is to review normal developmental bladder physiology in infants and bladder dysfunction in conditions such as neurogenic bladder, posterior urethral valves and high grade vesicoureteric reflux. We contrast the classical concept that bladder function in nontoilet-trained children is thought to be 'reflexive' or 'uninhibited', with the results of more recent research showing that infants most commonly have a stable detrusor. The infant bladder is physiologically distinct from the state seen in older children or adults...
August 2014: Therapeutic Advances in Urology
Atsuko Kitamura, Tatsuro Kondoh, Mitsuru Noguchi, Teppei Hatada, Shohei Tohbu, Ken-ichi Mori, Manabu Matsuo, Ichiro Kunitsugu, Hiroshi Kanetake, Hiroyuki Moriuchi
BACKGROUND: Despite the fact that functional lower urinary tract symptoms are common among people with Down syndrome (DS), their voiding function has not been studied precisely. Our goal was to assess the lower urinary tract functions in DS. METHODS: Fifty-five DS children aged 5-15 years old and 35 age-matched control children were evaluated by ultrasonography and uroflowmetry. RESULTS: Eleven (20%) DS children had no uresiesthesia, 21 (38%) were urinated under guidance, nine (16%) urinated fewer than three times a day, two (4%) urinated more than 10 times a day, three (5%) used diapers, and 26 (47%) had urinary incontinence...
December 2014: Pediatrics International: Official Journal of the Japan Pediatric Society
Ilkka Paananen, Pasi Ohtonen, Ilkka Perttilä, Olof Jonsson, Christer Edlund, Peter Wiklund, Börje Ljungberg, Klaus Möller-Jensen, Eirikur Jonsson, Wiking Månsson
OBJECTIVE: The aim of this study was to evaluate enterocystometry, voiding pattern and urine leakage of four types of orthotopic bladder substitute. MATERIAL AND METHODS: At eight urological departments, 78 consecutive men were studied: 66 with an ileal neobladder [30 Studer pouches (S), 24 Hautmann pouches (H) and 12 T-pouches (T)] and 12 with a right colonic [Goldwasser type (G)] neobladder. Enterocystometry, determination of residual urine, micturition protocol and 24 h pad weight test were performed 6 and 12 months postoperatively...
February 2014: Scandinavian Journal of Urology
Miki Haifler, Kobi Stav
Dysfunctional voiding is characterized by an intermittent and/or fluctuating flow rate due to involuntary intermittent contractions of the periurethral striated or levator muscles during voiding in neurologically normal women (International Continence Society definition). Due to the variable etiology, the diagnosis and treatment of DV is problematic. Frequently, the diagnosis is done at a late stage mainly due to non-specific symptoms and lack of awareness. The objectives of treatment are to normalize micturition patterns and prevent complications such as renal failure and recurrent infections...
May 2013: Israel Medical Association Journal: IMAJ
Bülent Çetinel, Tufan Tarcan, Oktay Demirkesen, Ceyhun Özyurt, İlker Şen, Sarper Erdoğan, Aksel Siva
AIMS: Since lower urinary tract dysfunction (LUTD) related to multiple sclerosis (MS) has a different behavior pattern than other types of neurogenic voiding dysfunction, we aimed to prepare a national consensus report for the management of LUTD due to multiple sclerosis in light of available literature. METHODS: A search of available databases yielded an evidence base of 125 articles after the application of inclusion/exclusion criteria. When sufficient evidence existed, recommendations A (high), B (moderate), or C (low) were made according to the strength of evidence; recommendation D was provided when insufficient evidence existed...
November 2013: Neurourology and Urodynamics
Heidi A Stephany, Douglas W Strand, Christina B Ching, Stacy T Tanaka, Ginger L Milne, Mariana M Cajaiba, John C Thomas, John C Pope, Mark C Adams, John W Brock, Simon W Hayward, Robert J Matusik, Douglass B Clayton
PURPOSE: Bladder over distention secondary to anatomical or functional obstruction can eventually lead to pathological changes, including decreased elasticity and contractile dysfunction. We hypothesized that chronic bladder distention in a murine model would activate hypoxia dependent signaling pathways despite intermittent relief of distention. MATERIALS AND METHODS: Female C57Bl/6 mice were oophorectomized at age 5 to 6 weeks and underwent urethral catheterization and 90-minute bladder distention...
October 2013: Journal of Urology
Yi-Song Lv, You-Sheng Yao, Ming-En Lin, Lu Rong, Bi-Hua Deng, Jian Huang, Wei-Ping Hao
OBJECTIVES: To measure interleukin-6 levels in a protamine sulfate-induced chronic cystitis rat model treated with hyaluronic acid, and to study the correlation among interleukin-6, bladder inflammatory degree and voiding frequency. METHODS: A chronic cystitis model was created in female rats by using long-term intermittent intravesical protamine sulfate (0.5 mL, 30 mg/mL). Then, hyaluronic acid (0.5 mL, 0.8 mg/mL) was also instilled intravesically in the rats...
October 2013: International Journal of Urology: Official Journal of the Japanese Urological Association
Vitor C Zanetta, Brian M Rosman, Bryan Bromley, Thomas D Shipp, Jeanne S Chow, Jeffrey B Campbell, C D Anthony Herndon, Carlo C Passerotti, Marc Cendron, Alan B Retik, Hiep T Nguyen
PURPOSE: There are no current guidelines for diagnosing and managing mild prenatal hydronephrosis. Variations in physician approach make it difficult to analyze outcomes and establish optimal management. We determined the variability of diagnostic approach and management regarding prenatal hydronephrosis among maternal-fetal medicine obstetricians, pediatric urologists and pediatric radiologists. MATERIALS AND METHODS: Online surveys were sent to mailing lists for national societies for each specialty...
November 2012: Journal of Urology
V Zivkovic, M Lazovic, M Vlajkovic, A Slavkovic, L Dimitrijevic, I Stankovic, N Vacic
BACKGROUND: Dysfunctional voiding (DV) in neurologically normal children is characterized by involuntary intermittent contractions of either the striated muscle in external urethral sphincter, or the pelvic floor during voiding. Urinary incontinence, pelvic holding maneuvers, voiding difficulties, urinary tract infections (UTIs), constipation and vesicoureteral reflux are highly associated with DV. AIM: To investigate the role of abdominal and pelvic floor muscle (PFM) retraining in children with DV...
September 2012: European Journal of Physical and Rehabilitation Medicine
Sven Wenske, Andrew J Combs, Jason P Van Batavia, Kenneth I Glassberg
PURPOSE: Worldwide, uroflowmetry without simultaneous electromyography is often the only testing performed during the initial assessment of children with lower urinary tract symptoms. Various alterations in uroflow pattern are thought to indicate particular types of lower urinary tract conditions, specifically staccato uroflow indicating dysfunctional voiding and intermittent/fractionated uroflow indicating detrusor underactivity. We determined how reliable uroflow pattern alone is as a surrogate for simultaneously measured pelvic floor electromyography activity during voiding, and how well staccato and interrupted uroflow actually correlate with the diagnoses they are presumed to represent...
June 2012: Journal of Urology
Adam L Schreiber, Guy W Fried, Christopher S Formal
Objective. To report a case of improved urodynamics in a central cord syndrome spinal cord injury after intrathecal baclofen therapy. Methods. A 47-year-old man fell resulting in C4-C5 disc herniation with ventral spinal cord compression and cord edema. Results. He underwent an anterior cervical discectomy and fusion. Postoperatively, his examination revealed a C4 ASIA D injury in a central cord syndrome pattern. Cystometrogram (CMG) revealed a hyperactive detrusor with sphincter dyssynergia managed with intermittent self-catheterization...
October 2009: Neuromodulation: Journal of the International Neuromodulation Society
David S Finley, Una Lee, Diana McDonough, Shlomo Raz, Jean deKernion
PURPOSE: Urinary retention is a common complication after orthotopic neobladder urinary diversion. We reviewed a case series of women who underwent neobladder creation and discuss anatomical findings, and urinary retention etiology and prevention. MATERIALS AND METHODS: We retrospectively reviewed the records of all orthotopic neobladder urinary diversions in female patients performed at our institution from 1999 through 2010. We abstracted baseline clinical and demographic characteristics, operative information, and postoperative clinical, urodynamic, imaging and secondary procedure followup...
October 2011: Journal of Urology
W S El-Masri, T Chong, A E Kyriakider, D Wang
STUDY DESIGN: Retrospective longitudinal study of short- and long-term urinary complications in chronic spinal cord injury (SCI) patients managed at the Midlands Centre for Spinal Injuries (MCSI). SETTING: MCSI, Oswestry, UK. METHOD: A total of 185 SCI patients were admitted to the MCSI between 1984 and 1989. Only 119 patients who met the following criteria were included: traumatic SCI, Frankel grade A-D, admission within 6 weeks post injury, regular annual follow-up or alternate year at MCSI, follow-up longer than 8 years...
January 2012: Spinal Cord
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