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bladder outlet obstruction

G Magistro, C G Stief, C Gratzke
Novel minimally invasive treatment options for the management of male lower urinary tract symptoms (LUTS) due to bladder outlet obstruction (BOO) aim to provide equal efficacy compared to standard techniques with a more favourable safety profile. The preservation of all aspects of male sexual function including antegrade ejaculation is increasingly important to patients. It should be ideally performed in an outpatient setting under local anesthesia to assure a short recovery time. Novel injectables for intraprostatic application (botulinum neurotoxin A, NX-1207, PRX302) have emerged and first phase III results could not confirm the promising initial data...
October 19, 2016: Der Urologe. Ausg. A
Mai Michishita, Kazuo Yano, Ken-Ichi Tomita, Osamu Matsuzaki, Ken-Ichi Kasahara
AIMS: For patients with benign prostatic hyperplasia (BPH), storage symptoms due to bladder dysfunction are bothersome, and that mechanism elucidation is needed. Piezo1, a mechanically activated ion channel, is believed to play a role in sensing bladder distension. To investigate the involvement of Piezo1 in bladder dysfunction, we examined the expression and distribution of Piezo1 and neurofilament (NF-L) to understand pathological alterations in rat bladders with partial bladder outlet obstruction (pBOO), an animal model of BPH...
October 15, 2016: Life Sciences
Claus G Roehrborn, Francisco Cruz, Ferdinando Fusco
Available α1-blockers (ABs) have different profiles of receptor selectivity. Silodosin exhibits the highest selectivity for the α1A adrenergic receptor. This pharmacological feature couples with a singular urodynamic and clinical profile. The magnitude of bladder outlet obstruction improvement in patients receiving silodosin is higher if compared to other ABs. From a clinical point of view, current evidence suggests an advantage in favor of silodosin in terms of nocturia improvement and cardiovascular safety...
October 17, 2016: Advances in Therapy
Lorenz Leitner, Matthias Walter, Ulla Sammer, Stephanie C Knüpfer, Ulrich Mehnert, Thomas M Kessler
OBJECTIVES: To evaluate whether urodynamic investigation (UDI), the gold standard to assess refractory lower urinary tract symptoms (LUTS), is appropriate to select healthy volunteers with apparent normal lower urinary tract function as control subjects for comparative studies. SUBJECTS AND METHODS: 42 healthy subjects (22 women, mean age 32±10 years; 20 men, mean age 37±12 years) without LUTS were included into this prospective single-centre cohort study. All subjects recorded a 3-day bladder diary, completed validated questionnaires regarding LUTS, and underwent neuro-urological assessment as well as free uroflowmetry...
2016: PloS One
Shirish Dattatraya Yande, Omkar Vinay Joglekar, Maya Joshi
INTRODUCTION: Role of urodynamics prior to surgery of stress urinary incontinence (SUI) is under constant debate. Demonstration of the presence of detrusor overactivity is the only aspect that has been emphasized in the literature so far. We believe that there are number of other factors which may influence the evaluation and in turn the choice of surgical management and prediction of outcome of treatment. They are as follows: (1) Presence of voiding inefficiency, (2) asymptomatic detrusor overactivity, (3) and severity of SUI...
July 2016: Journal of Mid-life Health
Alice Faure, Rebecca Cooksey, Aurore Bouty, Alan Woodward, John Hutson, Mike O'Brien, Yves Heloury
BACKGROUND: Effective bladder emptying by clean intermittent catheterization for children with severe bladder dysfunction is critical for renal preservation and social integration. Use of a continent catheterizable conduit (CCC) as urethral alternative procedure provides effective bladder drainage. However, it brings a substantive maintenance. METHODS: Retrospective review of the indications and long-term outcomes of 54 patients with a Mitrofanoff procedure in a single center over a 20-year period (1995-2015)...
September 23, 2016: Journal of Pediatric Surgery
Fabrizio Presicce, Cosimo De Nunzio, Mauro Gacci, Enrico Finazzi Agrò, Andrea Tubaro
BACKGROUND: To evaluate the role of the ultrasound assessments of the bladder/detrusor wall thickness (BWT/DWT) and the ultrasound estimated bladder weight (UEBW) in lower urinary tract symptoms diagnosis and treatment. EVIDENCE ACQUISITION: A systematic literature search from January 1995 until February 2016 was performed on PubMed using the following terms: Bladder Weight, Bladder Wall Thickness, Detrusor Wall Thickness, LUTS, Bladder Outlet Obstruction (BOO), Benign Prostatic Obstruction...
October 5, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Michael S Rutenberg, Moshe Meister, Pradip P Amin, Arif Hussain, Michael J Naslund, Young Kwok
PURPOSE: Patients with locally recurrent prostate cancer after definitive prostate brachytherapy have few evidence-based salvage options. We evaluate the efficacy and treatment-related side-effects of salvage external-beam radiotherapy (EBRT) after definitive prostate brachytherapy (PBT). METHODS AND MATERIALS: Eleven patients previously treated with definitive PBT and with biopsy-proven local-only recurrence received salvage reirradiation with EBRT. Genitourinary (GU) function was assessed with International Prostate Symptom Scores...
September 28, 2016: Brachytherapy
Sachin Malde, Arjun K Nambiar, Roland Umbach, Thomas B Lam, Thorsten Bach, Alexander Bachmann, Marcus J Drake, Mauro Gacci, Christian Gratzke, Stephan Madersbacher, Charalampos Mamoulakis, Kari A O Tikkinen, Stavros Gravas
CONTEXT: Several noninvasive tests have been developed for diagnosing bladder outlet obstruction (BOO) in men to avoid the burden and morbidity associated with invasive urodynamics. The diagnostic accuracy of these tests, however, remains uncertain. OBJECTIVE: To systematically review available evidence regarding the diagnostic accuracy of noninvasive tests in diagnosing BOO in men with lower urinary tract symptoms (LUTS) using a pressure-flow study as the reference standard...
September 26, 2016: European Urology
Ali Gürağaç, Zafer Demirer, Bilal Fırat Alp, Emin Aydur
CONTEXT: Prostatic cysts are uncommon. These cysts are usually asymptomatic and are diagnosed incidentally during ultrasonographic examination. On rare occasions, they may cause drastic symptoms. CASE REPORT: We report on a case of severely symptomatic anteriorly located prostatic cyst arising from the bladder neck in a 30-year-old man presenting with lower urinary tract symptoms, without clinical evidence of benign prostatic hyperplasia. Transrectal ultrasonography (TRUS), computed tomography (CT) and cystourethroscopy demonstrated a projecting prostatic cyst that occupied the bladder neck at the precise twelve o'clock position...
September 26, 2016: São Paulo Medical Journal, Revista Paulista de Medicina
Yiming Wang, Christian Gratzke, Alexander Tamalunas, Beata Rutz, Anna Ciotkowska, Frank Strittmatter, Annika Herlemann, Sophie Janich, Raphaela Waidelich, Chunxiao Liu, Christian G Stief, Martin Hennenberg
BACKGROUND AND PURPOSE: In benign prostatic hyperplasia, increased prostate smooth muscle tone and prostate volume may contribute alone or together to urethral obstruction and voiding symptoms. Consequently, connections between smooth muscle tone and growth in the prostate have been assumed, but any molecular basis for such a link is poorly understood. Here, we examined effects of Src family kinase (SFKs) inhibitors on prostate smooth muscle contraction, and growth of stromal cells. EXPERIMENTAL APPROACH: Different SFK inhibitors (AZM475271, PP2) were applied to human prostate tissues to assess effects on smooth muscle contraction, and to cultured stromal cells (WPMY-1) and c-Src-deficient cells, to examine effects on proliferation, actin organization, and viability...
September 17, 2016: British Journal of Pharmacology
Sujit K Chowdhary, Deepak K Kandpal, Anupam Sibal, Rajendra N Srivastava, Anand S Vasudev
AIM: To evaluate the success of endoscopic deroofing with double J (DJ) stenting as a primary treatment modality of uncomplicated ureterocele. PATIENTS AND METHODS: All babies with uncomplicated ureterocele referred to us between 2005 and 2015 were to be prospectively recruited into the study without any exception. The preoperative management would include ultrasound KUB on a fixed protocol, micturating cystourethrogram, DTPA scan and MRU (magnetic resonance urography) or IVP (intravenous pyelography)...
September 2, 2016: Journal of Pediatric Surgery
Bridget Wiafe, Adetola Adesida, Thomas Churchill, Esther Ekpe Adewuyi, Zack Li, Peter Metcalfe
Partial bladder outlet obstruction (pBOO) is characterized by exaggerated stretch, hydrodynamic pressure, and inflammation which cause significant damage and fibrosis to the bladder wall. Several studies have implicated hypoxia in its pathophysiology. However, the isolated progressive effects of hypoxia on bladder cells are not yet defined. Sub-confluent normal human bladder smooth muscle cells (hbSMC) were cultured in 3% O2 tension for 2, 24, 48, and 72 h. RNA, cellular proteins, and secreted proteins were used for gene expression analysis, immunoblotting, and ELISA, respectively...
September 8, 2016: In Vitro Cellular & Developmental Biology. Animal
Simone Albisinni, Ibrahim Biaou, Quentin Marcelis, Fouad Aoun, Cosimo De Nunzio, Thierry Roumeguère
BACKGROUND: Lower Urinary Tract Symptoms (LUTS) in men are a common clinical problem in urology and have been historically strictly linked to benign prostatic hyperplasia (BPH), which may lead to bladder outlet obstruction (BOO). New molecules have been approved and have entered the urologists' armamentarium, targeting new signaling pathways and tackling specific aspects of LUTS. Objective of this review is to summarize the evidence regarding the new medical therapies currently available for male non-neurogenic LUTS, including superselective α1-antagonists, PDE-5 inhibitors, anticholinergic drugs and intraprostatic onabotulinum toxin injections...
September 15, 2016: BMC Urology
Donboklang Lynser, Evarisalin Marbaniang, Pynskhemboklang Khongsni
Urinary retention in young children and infancy is relatively rare. The commonest malignancy cause of bladder outlet obstruction in infancy is prostatic rhabdomyosarcoma; the commonest cause of congenital bladder outlet obstruction in a male infantis posterior urethral valve and the commonest cause of urethral obstruction in male children is urethral calculi. We present here a report on three cases of urethral obstruction in male children.
September 2016: Medical Ultrasonography
Nicola Persico, Alfredo Berettini, Isabella Fabietti, Chiara Dallagiovanna, Dario Minoli, Fabio Mosca, Luigi Fedele, Gianantonio Manzoni
Prenatal ultrasound detection of fetal ureterocele with bilateral hydro-ureteronephrosis, obstruction of the bladder outlet and progressive amniotic fluid reduction can be associated with a significant risk of end-stage chronic renal disease after birth. Fetal cystoscopic laser incision of the ureterocele, with the aim of relieving the bladder outflow obstruction to preserve renal function, has been previously reported in one case, with a favourable outcome. This report employed standard 3.5-mm fetoscopic access to the amniotic cavity and the fetal bladder...
September 8, 2016: Ultrasound in Obstetrics & Gynecology
Abul-Fotouh Ahmed, Mohamed Bedewi
OBJECTIVE: To investigate the accuracy of the bladder and prostate sonomorphologic parameters for the diagnosis of bladder outlet obstruction (BOO) in patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: First-visit men, aged ≥ 50 years, with LUTS/BPH were prospectively enrolled. Added to the initial basic evaluation, all patients underwent pelvic ultrasonography and pressure flow study. The pressure flow study was used as a reference standard for BOO, and according to its results, patients were divided into BOO and non-BOO groups...
August 31, 2016: Urology
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
Katarzyna K Krawczyk, Mari Ekman, Catarina Rippe, Mario Grossi, Bengt-Olof Nilsson, Sebastian Albinsson, Bengt Uvelius, Karl Swärd
Phenotypic modulation of smooth muscle cells is a hallmark of disease. The associated expansion of endoplasmic reticulum (ER) volume remains unexplained. Thrombospondin-4 was recently found to promote ATF6α activation leading to ER expansion. Using bladder outlet obstruction as a paradigm for phenotypic modulation, we tested if thrombospondin-4 is induced in association with ATF6α activation and ER expansion. Thrombospondin-4 was induced and ATF6α was activated after outlet obstruction in rodents. Increased abundance of spliced of Xbp1, another ER-stress sensor, and induction of Atf4 and Creb3l2 was also seen...
2016: Scientific Reports
Zhou Liang, Wei Xin, Liu Qiang, Cai Xiang, Liao Bang-Hua, Yang Jin, Luo De-Yi, Li Hong, Wang Kun-Jie
AIMS: Abnormal intravesical pressure results in a series of pathological changes. We investigated the effects of hydrostatic pressure and muscarinic receptors on the release of inflammatory cytokines in rat and human bladder smooth muscle cells (HBSMCs). METHODS: Animal model of bladder outlet obstruction was induced by urethra ligation. HBSMCs were subjected to elevated hydrostatic pressure and/or acetylcholine (Ach). Macrophage infiltration in the bladder wall was determined by immunohistochemical staining...
August 30, 2016: Neurourology and Urodynamics
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