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Cheng-Ling Lee, Hann-Chorng Kuo
OBJECTIVE: We examined the efficacy and safety of mirabegron in elderly patients with urodynamic detrusor hyperactivity with impaired contractility (DHIC). METHODS: Patients diagnosed with DHIC received daily dose of mirabegron (25mg). Subjective symptom scores, uroflowmetry data, and adverse events (AEs) were recorded for all patients at baseline and after 1, 3, and 6 months treatment. Comparisons were made for each patient individually and between patients with detrusor overactivity (DO)...
April 26, 2018: Lower Urinary Tract Symptoms
Xing Li, Li-Min Liao, Guo-Qing Chen, Zhao-Xia Wang, Tian-Ji Lu, Han Deng
There have no universally accepted criteria and have been established for classification of underactive bladder (UAB) at present. Thus, the study described the comprehensive clinical and urodynamic characteristics of UAB in patients with lower urinary tract symptoms.A total of 1726 patients (1259 men and 467 women; 6-88 years old) who were admitted to our center with a diagnosis of UAB were included in this retrospective study. It was due to the type of rehabilitation hospital, so higher percentage of neurological patients were included...
January 2018: Medicine (Baltimore)
Jun Kamei, Hiroki Ito, Naoki Aizawa, Harumi Hotta, Toshio Kojima, Yasunori Fujita, Masafumi Ito, Yukio Homma, Yasuhiko Igawa
We investigated age-related changes in in vivo and in vitro functions and gene expression of the bladder of male and female mice. Mature and aged (12 and 27-30 month old) C57BL/6 mice of both sexes were used. Frequency volume, conscious free-moving cystometry and detrusor contractile and relaxant properties in in vitro organ bath were evaluated. mRNA expression level of muscarinic, purinergic, and β-adrenergic receptors and gene expression changes by cDNA microarray analysis of the bladder were determined...
February 1, 2018: Scientific Reports
Sheng-Fu Chen, Yuan-Hong Jiang, Hann-Chorng Kuo
PURPOSE: Detrusor underactivity (DU) is frequently encountered in elderly patients. Part of patients with DU might have bladder function recovery after treatment. This study investigated urinary proteins in these DU patients with and without bladder function recovery. METHODS: A total of 37 patients with chronic urinary retention and urodynamically proven DU were enrolled. After treatment, 24 DU patients had bladder function recovery whereas 13 had not, after 1-year follow-up...
October 2017: International Urology and Nephrology
Derek B Hennessey, Nathan Hoag, Johan Gani
INTRODUCTION: Detrusor hyperactivity with impaired contractility (DHIC) is a challenging condition to manage. Sacral neuromodulation (SNM) is a proven treatment modality for both the individual aspects of DHIC. To date, data reporting the outcome of SNM for DHIC are lacking. MATERIALS AND METHODS: Consecutive patients undergoing SNM for DHIC were followed prospectively, from April 2013 to October 2016. Patient demographics, bladder diaries, subjective response rates, ICIQ-OAB, and PGI-I scores were recorded...
November 2017: Neurourology and Urodynamics
Yuan-Hong Jiang, Chun-Hou Liao, Hann-Chorng Kuo
OBJECTIVES: Lower urinary tract symptoms (LUTS) in men result from a complex interplay of pathophysiology, including bladder and bladder outlet dysfunction. This study retrospectively analyzed bladder dysfunction in men with LUTS based on the results of video-urodynamic studies (VUDS). METHODS: Male patients (aged ≥40 years), with LUTS and an International Prostate Symptom Score of 8 or more, who were refractory to alpha-blocker treatment were retrospectively recruited and evaluated with VUDS and total prostate volume (TPV)...
January 2018: Lower Urinary Tract Symptoms
Chung-Cheng Wang, Cheng-Ling Lee, Hann-Chorng Kuo
We investigated the efficacy and safety of intravesical onabotulinumtoxinA injection in patients with detrusor hyperactivity and impaired contractility (DHIC). Twenty-one patients with urodynamically proven DHIC and 21 age-matched patients with overactive bladder (OAB) with urodynamic detrusor overactivity were treated with intravesical injections of 100 U of onabotulinumtoxinA. The overactive bladder symptom score, urgency severity score, patient perception of bladder condition, global response assessment, voiding diary, and procedure-related adverse events (AE) at baseline, two weeks, one, three, and six months after treatment were assessed...
March 18, 2016: Toxins
Michael B Chancellor
The overactive bladder (OAB) is a well-known and common urologic condition. However, the apparent opposite syndrome to the OAB, the underactive bladder (UAB), remains an enigma. Underactive bladder syndrome is complex condition that shares symptoms with other prevalent urologic diagnoses. UAB is not a pure condition-it is not the result of any single factor, but rather, it is multifactorial. As a result, UAB may overlap with OAB, bladder outlet obstruction, or even occur with no symptoms or associated diseases...
September 2014: International Urology and Nephrology
Ning Liu, Feng He, Li-bo Man, Guang-lin Huang, Hai-dong Wang, Hai Wang, Gui-zhong Li, Jian-wei Wang
OBJECTIVE: To explore the differences of urodynamic parameters and lower urinary symptoms between detrusor hyperactivity with impaired contractility (DHIC) patients and DHIC patients with bladder outlet obstruction (BOO) and evaluate the effects and risks of anticholinergic medications in these patients. METHODS: A retrospective analysis was performed in 56 DHIC patients at our hospital between February 2000 to February 2011. Among them, 19 patients were complicated with BOO...
July 10, 2012: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Wei-Chung Chiang, Tsui-Ting Ching, Hee Chul Lee, Carol Mousigian, Ao-Lin Hsu
Extended longevity is often correlated with increased resistance against various stressors. Insulin/IGF-1-like signaling (IIS) is known to have a conserved role in aging and cellular mechanisms against stress. In C. elegans, genetic studies suggest that heat-shock transcription factor HSF-1 is required for IIS to modulate longevity. Here, we report that the activity of HSF-1 is regulated by IIS. This regulation occurs at an early step of HSF-1 activation via two HSF-1 regulators, DDL-1 and DDL-2. Inhibition of DDL-1/2 increases longevity and thermotolerance in an hsf-1-dependent manner...
January 20, 2012: Cell
John A Taylor, George A Kuchel
Urinary incontinence and other lower urinary tract symptoms exert a major influence on the health and independence of frail older people. Detrusor underactivity (DU) is defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emptying within a normal time span. DU may influence the clinical presentation and impede the therapy of disorders as common and as disparate as detrusor overactivity, urinary retention, and benign prostatic hyperplasia...
December 2006: Journal of the American Geriatrics Society
Tatsuya Yamamoto, Ryuji Sakakibara, Tomoyuki Uchiyama, Zhi Liu, Takashi Ito, Yusuke Awa, Tomonori Yamanishi, Takamichi Hattori
AIMS: Detrusor hyperactivity with impaired contractile function (DHIC) was originally described in elderly women. It has not previously been well known whether neurological diseases cause DHIC. We investigated which neurological diseases commonly cause DHIC in our laboratory. MATERIALS AND METHODS: We searched for DHIC in our laboratory's computerized database of 1,514 case records, which included a lower urinary tract (LUT) symptom questionnaire and urodynamic study results...
2006: Neurourology and Urodynamics
Jeffery R Broadbent, Sanjay Gummalla, Joanne E Hughes, Mark E Johnson, Scott A Rankin, Mary Anne Drake
Metabolism of aromatic amino acids by lactic acid bacteria is an important source of off-flavor compounds in Cheddar cheese. Previous work has shown that alpha-keto acids produced from Trp, Tyr, and Phe by aminotransferase enzymes are chemically labile and may degrade spontaneously into a variety of off-flavor compounds. However, dairy lactobacilli can convert unstable alpha-keto acids to more-stable alpha-hydroxy acids via the action of alpha-keto acid dehydrogenases such as d-hydroxyisocaproic acid dehydrogenase...
August 2004: Applied and Environmental Microbiology
Derek J Griffiths, Peter N McCracken, Gloria M Harrison, E Ann Gormley, Katherine N Moore
Among the elderly, both urge incontinence and elevated residual urine are common. When they occur together, they present a challenging clinical problem, called detrusor hyperactivity with impaired contractile function (DHIC). Impaired detrusor contractility has two aspects: elevated post-void residual urine volume and reduced detrusor contraction strength. Geriatric urge incontinence, especially in combination with reduced bladder sensation, is associated with specific cortical abnormalities: frontal and global cortical underperfusion and cognitive impairment...
2002: Neurourology and Urodynamics
Hann-Chorng Kuo
OBJECTIVES: To analyze the pathophysiology of persistent lower urinary tract symptoms (LUTS) in patients after transurethral prostatectomy (TURP). METHODS: A total of 185 patients who had persistent LUTS after TURP were enrolled into this study. All of these patients underwent multichannel videourodynamic studies and were classified into 6 groups according to the urodynamic results. Preoperative prostate volume, resected adenoma weight, and preoperative Q(max) were determined in each of the groups and the symptomatology and urodynamic findings were compared...
2002: Urologia Internationalis
N M Resnick, G H Brandeis, M M Baumann, C E DuBeau, S V Yalla
Because of the high prevalence of detrusor hyperactivity with impaired contractility (DHIC) in incontinent institutionalized women, we postulated that: 1) single-channel cystometry, the most commonly used diagnostic test, would be inadequate when used alone but that 2) its accuracy could be greatly enhanced by combining it with a previously-performed stress test. To test the hypothesis, we used blinded comparison of a clinical stress test and single-channel cystometry with multichannel videourodynamic evaluation (criterion standard), a strategy designed a priori...
1996: Neurourology and Urodynamics
N M Resnick, S V Yalla
Little is known about the causes of urinary incontinence in institutionalized elderly people, despite the fact that $8 billion is annually devoted to diapering those afflicted. We have identified a specific physiological abnormality--detrusor hyperactivity with impaired contractile function (DHIC)--that, although previously unrecognized, is the second most common (33%) cause of incontinence in this setting. Detrusor hyperactivity with impaired contractile function is a distinct physiological subset of detrusor hyperreflexia and presents with a seemingly paradoxical set of findings: the bladder is overactive but empties ineffectively...
June 12, 1987: JAMA: the Journal of the American Medical Association
S Ito
The generally accepted concept that the black melanin eumelanin is made mostly from 5,6-dihydroxyindole but not from 5,6-dihydroxyindole-2-carboxylic acid (DHIC) was reexamined by comparison of synthetic and natural eumelanins. The analytical methods used were elemental analysis and determination of the carboxyl group by acid treatment to yield CO2 and by permanganate oxidation to yield pyrrole-2,3,5-tricarboxylic acid. It was found that DHIC-derived monomer units comprise only approx. 10% of enzymically prepared dopa-melanins but as much as a half of intact, natural eumelanins...
August 6, 1986: Biochimica et Biophysica Acta
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