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https://www.readbyqxmd.com/read/28718614/emergency-management-of-renal-and-genitourinary-trauma-best-practices-update
#1
Whitney K. Bryant, Sanjay Shewakramani
In up to 10% of patients who experience abdominal trauma, renal and urogenital systems will be involved. In polytrauma patients with other potentially life-threatening injuries, renal and genitourinary trauma may be overlooked initially, but a delayed or missed diagnosis of these injuries may result in preventable complications. This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy...
August 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28718163/incidence-and-management-of-lower-urinary-tract-symptoms-after-urethral-stricture-repair
#2
REVIEW
Amanda S J Chung, Kurt A McCammon
Lower urinary tract symptoms (LUTS) after urethral stricture repair are not uncommon. Urgency has been reported in 40% of men and urge incontinence in 12% of men after anterior urethroplasty. De novo urgency and urge incontinence is seen in 9 and 5% of men, respectively, after urethroplasty. Once a complication of urethroplasty (such as recurrent urethral stricture or diverticulum) has been excluded as a cause, evaluation of LUTS in such patients should focus on differentiating bladder dysfunction (overactive bladder, underactive bladder), from other outlet obstruction (such as benign prostatic obstruction), dysfunctional voiding, or medical causes (such as nocturnal polyuria)...
September 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28717533/prevalence-of-erectile-dysfunction-in-men-over-40-years-of-age-in-turkey-results-from-the-turkish-society-of-andrology-male-sexual-health-study-group
#3
Selahittin Çayan, Muammer Kendirci, Önder Yaman, Ramazan Aşçı, İrfan Orhan, Mustafa Faruk Usta, Oğuz Ekmekçioğlu, Ateş Kadıoğlu
OBJECTIVE: Previous study conducted by the Turkish Society of Andrology in 1999 reported the prevalence of erectile dysfunction (ED) as 69.2% in men of ≥40 years of age, using a single-item non-validated question. This rate seemed to be higher compared to the studies reported worldwide. So, there was a need to carry out another epidemiological study by using validated questionnaires. Our aim was to investigate ED prevalence, severity, and its correlates in men aged ≥40 years using validated tools...
June 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28717406/neurogenic-bowel-dysfunction-in-patients-with-neurogenic-bladder
#4
Laura Martinez, Leila Neshatian, Rose Khavari
Patients with primary neurologic conditions often experience urinary and bowel dysfunction due to loss of sensory and/or motor control. Neurogenic bowel dysfunction is frequently characterized by both constipation and fecal incontinence. In general, the management of neurogenic bowel dysfunction has been less well studied than bladder dysfunction despite their close association.. It is widely accepted that establishment of a multifaceted bowel regimen is the cornerstone of conservative management. Continuing assessment is necessary to determine need for more invasive interventions...
December 2016: Current Bladder Dysfunction Reports
https://www.readbyqxmd.com/read/28716801/diabetes-mellitus-microalbuminuria-and-subclinical-cardiac-disease-identification-and-monitoring-of-individuals-at-risk-of-heart-failure
#5
Peter P Swoboda, Adam K McDiarmid, Bara Erhayiem, David P Ripley, Laura E Dobson, Pankaj Garg, Tarique A Musa, Klaus K Witte, Mark T Kearney, Julian H Barth, Ramzi Ajjan, John P Greenwood, Sven Plein
BACKGROUND: Patients with type 2 diabetes mellitus and elevated urinary albumin:creatinine ratio (ACR) have increased risk of heart failure. We hypothesized this was because of cardiac tissue changes rather than silent coronary artery disease. METHODS AND RESULTS: In a case-controlled observational study 130 subjects including 50 ACR+ve diabetes mellitus patients with persistent microalbuminuria (ACR >2.5 mg/mol in males and >3.5 mg/mol in females, ≥2 measurements, no previous renin-angiotensin-aldosterone therapy, 50 ACR-ve diabetes mellitus patients and 30 controls underwent cardiovascular magnetic resonance for investigation of myocardial fibrosis, ischemia and infarction, and echocardiography...
July 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28716538/reliability-of-pelvic-floor-muscle-electromyography-tested-on-healthy-women-and-women-with-pelvic-floor-muscle-dysfunction
#6
Irene Koenig, Helena Luginbuehl, Lorenz Radlinger
OBJECTIVES: Electromyography (EMG) is a well-established method to quantify the relative pelvic floor muscle (PFM) activity. PFM EMG has shown good reliability in healthy women. However, its reliability has not been tested in women with PFM dysfunction. The reliability of EMG analysis methods concerning EMG normalization needs to be determined to assess specific therapeutic interventions. Therefore, the aim of this study was to investigate the intra-session reliability of PFM EMG variables by using 3 different analysis methods in women with PFM dysfunction...
July 14, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28716328/new-frontiers-of-basic-science-research-in-neurogenic-lower-urinary-tract%C3%A2-dysfunction
#7
REVIEW
Minoru Miyazato, Katsumi Kadekawa, Takeya Kitta, Naoki Wada, Nobutaka Shimizu, William C de Groat, Lori A Birder, Anthony J Kanai, Seiichi Saito, Naoki Yoshimura
The lower urinary tract's main functions are storage and elimination. The micturition reflex pathway is modulated by the spinobulbospinal reflex pathway as well as higher brain centers involved in the voluntary micturition control. Micturition is sensitive to numerous injuries, resulting in various types of dysfunction. Animal studies indicate that lower urinary tract dysfunction partly depends on plasticity of the neural pathways. Reflex plasticity is associated with changes in ion channels, receptors, and numerous mediators...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28716327/surgical-management-of-neurogenic-lower-urinary-tract-dysfunction
#8
REVIEW
Ronak A Gor, Sean P Elliott
Surgery for patients with neurogenic urinary tract dysfunction (nLUTD) is indicated when medical therapy fails, to correct conditions affecting patient safety, or when surgery can enhance the quality of life better than nonoperative management. Examples include failure of maximal medical therapy, inability to perform or aversion to clean intermittent catheterization, refractory incontinence, and complications from chronic, indwelling catheters. Adults with nLUTD have competing risk factors, including previous operations, obesity, poor nutritional status, complex living arrangements, impaired dexterity/paralysis, and impaired executive and cognitive function...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28716325/peripheral-and-sacral-neuromodulation-in-the-treatment-of-neurogenic-lower-urinary-tract-dysfunction
#9
REVIEW
Paholo G Barboglio Romo, Priyanka Gupta
Sacral and peripheral neuromodulation are minimally invasive surgical procedures that are third-line therapy options for the treatment of patients with idiopathic overactive bladder syndrome. There has been interest in their efficacy in the management of neurogenic lower urinary tract dysfunction (NLUTD). Contemporary data suggest promising outcomes for urinary and bowel symptoms in carefully selected patients with spinal cord injury and/or multiple sclerosis. This article reviews the current literature regarding urinary and bowel outcomes in patients with NLUTD and also discusses contemporary studies that suggest that treatment during particular stages of neurologic injury may prevent long-term urinary sequelae...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28716324/identifying-patients-with-high-risk-neurogenic-bladder-beyond-detrusor-leak-point-pressure
#10
REVIEW
Elizabeth V Dray, Anne P Cameron
More than 12,000 spinal cord injuries occur annually in the United States; more than 80% of these individuals will experience urinary tract dysfunction. Despite the clinical demand, there is a paucity of guidelines for the care of these patients. Although most urologists are familiar with dangerous urodynamic parameters and the benefits of clean intermittent catheterization, these patients face a myriad of risks that may go unrecognized. In this article, the authors discuss the impact of specific neurologic diseases on the urinary tract, examine the risks inherent to each, and determine strategies for screening, prevention, and treatment of these complications...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28716322/parkinson-s-disease-and-its-effect-on-the-lower-urinary-tract-evaluation-of-complications-and-treatment-strategies
#11
REVIEW
Benjamin M Brucker, Sidhartha Kalra
Parkinson's disease (PD) and atypical Parkinsonism are the second most common neurodegenerative movement disorders. Lower urinary tract dysfunction is among the most common types of associated autonomic dysfunctions. Differentiating the subtypes of PD is important for symptom management and understanding prognosis, because Lower urinary tract symptoms (LUTS) can evolve differently depending on the primary disease. LUTS are caused by storage and/or voiding dysfunctions. Urodynamics is a key investigative tool...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28716321/contemporary-evaluation-and-treatment-of-poststroke-lower-urinary-tract-dysfunction
#12
REVIEW
Zachary Panfili, Meredith Metcalf, Tomas L Griebling
Stroke is an extremely common clinical entity, and poststroke incontinence is a major cause of morbidity for stroke survivors. Although patients can experience a wide variety of lower urinary tract symptoms, detrusor overactivity is among the most common clinical findings following stroke. All forms of lower urinary tract symptoms can negatively impact physical and psychosocial function for affected patients and their caregivers and loved ones. Careful evaluation is critical for successful management. Treatment is tailored to the goals and needs of each individual patient...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28716318/surveillance-strategies-for-neurogenic-lower-urinary-tract-dysfunction
#13
REVIEW
Randy A Vince, Adam P Klausner
Patients with neurogenic lower urinary tract dysfunction (NLUTD) experience significant morbidity and mortality due to urological complications including upper tract damage and bladder malignancy. This has led to increased surveillance in patients NLUTD. This article discusses the methods available for surveillance of patients with NLUTD and pulls information from the largest and most established organizations that have produced evidence-based surveillance guidelines for NLUTD. These organizations include the Paralyzed Veterans of America (PVA), US Department of Veterans Affairs, European Association of Urology (EAU), The NICE organization from the UK, and cites additional literature not been included in these documents...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28716317/long-term-complications-of-the-neurogenic-bladder
#14
REVIEW
Unwanaobong Nseyo, Yahir Santiago-Lastra
It is widely accepted that neurogenic lower urinary tract dysfunction, when left untreated, has a natural history that has a potential for causing deterioration of renal function over time. However, certain patient profiles are at risk for this and other complications. This can be linked to their underlying neurologic disease process. Identifying risk profiles allows the provider to determine what surveillance strategies might be adopted. Risk factors for upper urinary tract deterioration include loss of bladder compliance, repeated bouts of pyelonephritis, and chronic indwelling catheterization...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28716316/how-to-measure-quality-of-life-concerns-in-patients-with-neurogenic-lower-urinary-tract-dysfunction
#15
REVIEW
Darshan P Patel, Jeremy B Myers, Sara M Lenherr
There is an evolving role for quality-of-life measures and patient-reported outcomes in the evaluation of neurogenic lower urinary tract dysfunction. We review available health-related quality-of-life instruments and patient-reported outcomes measures used in the assessment of patients with neurogenic bladder. We also discuss considerations for incorporation of these measures into clinical and patient-reported research. Emphasizing patient-reported outcomes in neurogenic bladder research will guide clinicians and other stakeholders to improve quality of life in this patient population...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28716315/understanding-the-economic-impact-of-neurogenic-lower-urinary-tract-dysfunction
#16
REVIEW
Isaac D Palma-Zamora, Humphrey O Atiemo
Neurogenic bladder is a chronic and disabling condition associated with multiple comorbidities and a widespread economic impact. Literature on cost of care and resource utilization is sparse and heterogeneous. Nonstandardized approaches, impact perspectives, and types of costs are used to describe the economic implications of neurogenic bladder. The financial toll is difficult to ascertain due to indirect and intangible costs exacerbated by the underlying disability. Health resource utilization based on clinical manifestations of neurogenic bladder may serve as an alternative measure...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28715352/commensal-bacterial-modulation-of-the-host-immune-response-to-ameliorate-pain-in-a-murine-model-of-chronic-prostatitis
#17
Stephen F Murphy, Anthony J Schaeffer, Joseph D Done, Marsha L Quick, Utkucan Acar, Praveen Thumbikat
The human commensal microflora plays an essential role in modulating the immune response to control homeostasis. Staphylococcus epidermidis, a commensal bacterium most commonly associated with the skin exerts such effects locally, modulating local immune responses during inflammation and preventing superinfection by pathogens such as Staphylococcus aureus. Although the prostate is considered by many to be sterile, multiple investigations have shown that small numbers of gram-positive bacterial species such as S...
August 2017: Pain
https://www.readbyqxmd.com/read/28715147/performance-analysis-of-the-t-doc%C3%A2-air-charged-catheters-an-alternate-technology-for-urodynamics
#18
Bruna M Couri, Stephanie Bitzos, Deepak Bhardwaj, Emily Lockhart, Andy Yue, Ing Goping
AIMS: Urodynamics (UDS) is widely used for the diagnosis of lower urinary tract dysfunction. Air-Charged catheters (ACC), one of the newer technologies for UDS pressure recording, has been adopted in growing numbers around the world for the past 15 years. Currently, there is a lack of published studies characterizing specific performance of the ACC. Since linearity, hysteresis, pressure drift, and frequency response are important components in characterizing accuracy for catheter-manometer systems; this study aimed to assess these four aspects in ACC...
July 17, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28713285/amiloride-improves-endothelial-function-and-reduces-vascular-stiffness-in-female-mice-fed-a-western-diet
#19
Luis A Martinez-Lemus, Annayya R Aroor, Francisco I Ramirez-Perez, Guanghong Jia, Javad Habibi, Vincent G DeMarco, Brady Barron, Adam Whaley-Connell, Ravi Nistala, James R Sowers
Obese premenopausal women lose their sex related cardiovascular disease protection and develop greater arterial stiffening than age matched men. In female mice, we have shown that consumption of a Western diet (WD), high in fat and refined sugars, is associated with endothelial dysfunction and vascular stiffening, which occur via activation of mineralocorticoid receptors and associated increases in epithelial Na(+) channel (ENaC) activity on endothelial cells (EnNaC). Herein our aim was to determine the effect that reducing EnNaC activity with a very-low-dose of amiloride would have on decreasing endothelial and arterial stiffness in young female mice consuming a WD...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28712168/justification-for-re-look-cystoscopy-after-posterior-urethral-valve-fulguration
#20
Gul Nawaz, Ijaz Hussain, Shujah Muhammad, Muhammad Imran Jamil, Asad Ur Rehman, Nadeem Iqbal, Saeed Akhter
BACKGROUND: Posterior urethral valve (PUV) is life-threatening congenital anomaly of the urinary tract that results in vesicoureteric reflux, recurrent UTI, voiding dysfunction and renal insufficiency if not treat timely. Endoscopic ablation of posterior urethral valves using cold knife or laser is the current gold standard therapy. Many urologists go for repeat cystoscopy to see residual valve or stricture while others repeat VCUG to measure the posterior to anterior urethral ratio for residual obstruction...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
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