scholarly journals Temporary urethral stent with perineal fixation for posterior urethral stenosis (preliminary results)

2021 ◽  
Vol 9 (2) ◽  
pp. 80-85
Author(s):  
P. S. Kyzlasov ◽  
A. T. Mustafaev ◽  
D. V. Ostrovsky ◽  
A. G. Martov
Keyword(s):  
Urinary Incontinence ◽  
Single Case ◽  
Stress Component ◽  
Urine Volume ◽  
Stent Migration ◽  
Absorbable Suture ◽  
Urethral Stenosis ◽  
Residual Urine ◽  
Urethral Stent ◽  
Observation Period

Introduction. Urethroplasty is the “gold standard” treatment of urethral stenosis. However, often in connection with old and senile age, as well as due to the presence of concomitant diseases, it is not possible to carry out urethroplasty due to its certain invasiveness. In such cases, one of the methods of treatment is the installation of a urethral stent. But this method has not found practical application due to the frequent migration of stent and the high frequency of its incrustation. The approach developed by us avoids stent migration.Purpose of the study. To evaluate the immediate results of the placement of a urethral stent with fixation through the perineum.Materials and methods. A total of 18 patients with urethral stenosis aged 68 to 84 years have been operated on since February 2019. Ten patients had stenosis of the urethrocystoneoanastomosis after radical prostatectomy, 6 patients had iatrogenic stenosis of the prostatic urethra, 1 patient had post-radiation stenosis of the bulbo-membranous urethra. All patients in the preoperative and postoperative periods underwent: IPSS-QoL questioning, uroflowmetry, bladder ultrasound with residual urine volume evaluation, urethroscopy, ascending and micturition urethrocystography. The first stage was an internal optical urethrotomy according to the standard technique. Then, a urethral stent was installed in the area of dissected stenosis. The second stage was an incision in the perineum, the urethra was isolated, and under optical control, through the perineum, the stent was fixed to the urethra with non-absorbable suture material. The stent was removed endoscopically after 6 months.Results. The median surgery duration averaged 45 minutes. Patients were discharged 2 to 3 days after surgery. The maximum observation period was 20 months. During the observation period, not a single case of stent migration was recorded. All patients showed a persistent increase in Qmax and no residual urine. Six patients had a stress component of urinary incontinence, 4 patients had total urinary incontinence. According to control urethrocystoscopy 6 months after stent removal, clinically insignificant urethral stenosis was noted in all patients. In all cases, moderate signs of stent encrustation were identified. Dysuric phenomena disturbed 5 patients, who were stopped by rectal suppositories with NSAIDs, as well as taking herbal uroseptics. The data from the IPPS-QoL questionnaires confirm the positive effect of the treatment.Conclusions. Temporary placement of a urethral stent for urethral stenosis is an effective minimally invasive treatment. The technique of fixation through the perineum allows preventing migration in all cases. This approach to treatment significantly improves the quality of life of patients who were contraindicated for urethroplasty for one reason or another. However, the technique requires longer observation and analysis.

Causes and Treatment of Residual Urine Volume after Orthotopic Bladder Replacement in Women

2000 ◽  
Vol 38 (6) ◽  
pp. 748-752 ◽  
Author(s):  
L. Jarolím ◽  
M. Babjuk ◽  
S.M. Pecher ◽  
M. Grim ◽  
O. Naňka ◽  
...  
Keyword(s):  
Urine Volume ◽  
Residual Urine Volume ◽  
Residual Urine ◽  
Bladder Replacement

scholarly journals The reliability and reproducibility of ultrasonography for measuring the residual urine volume in men with lower urinary tract symptoms

2014 ◽  
Vol 12 (4) ◽  
pp. 285-289 ◽  
Author(s):  
Hassan A. Abdelwahab ◽  
Housseini M. Abdalla ◽  
Mahmoud H. Sherief ◽  
Mohamed B. Ibrahim ◽  
Mostafa A. Shamaa
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Urine Volume ◽  
Residual Urine Volume ◽  
Residual Urine ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Constitutional, organopathic and combined homeopathic treatment of benign prostatic hypertrophy: a clinical trial

Homeopathy ◽  
2012 ◽  
Vol 101 (04) ◽  
pp. 217-223 ◽  
Author(s):  
A.K. Hati ◽  
B. Paital ◽  
K.N. Naik ◽  
A.K. Mishra ◽  
G.B.N. Chainy ◽  
...  
Keyword(s):  
Specific Antigen ◽  
Urine Volume ◽  
Benign Prostatic Hypertrophy ◽  
Prostatic Hypertrophy ◽  
Intermittent Flow ◽  
Urinary Flow ◽  
Residual Urine Volume ◽  
Homeopathic Treatment ◽  
Presenting Symptoms ◽  
Residual Urine

Background: Benign Prostatic Hypertrophy (BPH) is common in older men. This study compared homeopathic treatment strategies using constitutional medicines (CM) or organopathic medicines (OM) alone or in combination (BCOM) in patients suffering from BPH.Methods: 220 men aged 30–90 years were recruited in Odisha, India. Patients presenting symptoms of prostatism, with or without evidence of bladder outflow obstruction were included in the study. Patients with serum prostate specific antigen (PSA)> 4 nmol/mL, malignancy, complete urine retention, stone formation and gross bilateral hydronephrosis were excluded. Patients were sequentially allocated to OM, CM or BCOM. The main outcome measure was the International Prostate Symptom Score (IPSS).Results: 73, 70 and 77 patients respectively were sequentially allocated to OM, CM or BCOM. 180 patients (60 per group) completed treatment and were included in the final analysis. Overall 85% of patients showed improvement of subjective symptoms such as frequency, urgency, hesitancy, intermittent flow, unsatisfactory urination, feeble stream, diminution of residual urine volume but there was no reduction in prostate size. Treatment response was highest with BCOM (38.24%) compared to OM (31.62%) and CM (30.15%). Effect sizes were highest for the decrease in IPSS, residual urine volume and urinary flow rate.

POST-VOID RESIDUAL URINE VOLUME IN WOMEN WITH OVERACTIVE BLADDER SYMPTOMS

2004 ◽  
Vol 172 (5) ◽  
pp. 1911-1914 ◽  
Author(s):  
MARK MILLEMAN ◽  
PETER LANGENSTROER ◽  
MICHAEL L. GURALNICK
Keyword(s):  
Overactive Bladder ◽  
Urine Volume ◽  
Residual Urine Volume ◽  
Residual Urine ◽  
Overactive Bladder Symptoms ◽  
Bladder Symptoms

scholarly journals Effects of Electroacupuncture on Bladder and Bowel Function in Patients with Transverse Myelitis: A Prospective Observational Study

2018 ◽  
Vol 36 (4) ◽  
pp. 261-266
Author(s):  
Jiani Wu ◽  
Yanjun Cheng ◽  
Zongshi Qin ◽  
Xiaoxu Liu ◽  
Zhishun Liu
Keyword(s):  
Urinary Incontinence ◽  
Prospective Observational Study ◽  
Urine Volume ◽  
Transverse Myelitis ◽  
Bowel Function ◽  
Bowel Dysfunction ◽  
Promising Alternative ◽  
Normal Bowel ◽  
Bowel Movements ◽  
Randomised Controlled

Objective To preliminarily explore the effect of electroacupuncture (EA) on bladder and bowel dysfunction in patients with transverse myelitis. Methods Sixteen participants were treated with EA at bilateral BL32, BL33, and BL35 once a day, five times a week for the first 4 weeks, and once every other day, three times a week for the following 4 weeks. Patients were then followed up for 6 months. Bladder and bowel function, and the safety of EA, were assessed. Results After 8 weeks of treatment, five (5/16, 31%) patients resumed normal voiding, three (6/16, 38%) regained partially normal voiding, and five (5/16, 31%) had no change. After treatment, the residual urine volume decreased by 100 mL (IQR 53–393 mL; P<0.05) in nine patients with bladder voiding dysfunction; in 11 patients with urinary incontinence, the number of weekly urinary incontinence episodes, 24-hour urinary episodes, and nocturia episodes per night diminished by 14 (95% CI 5 to 22), 5 (95% CI 1 to 9), and 4 (95% CI 0 to 7) episodes, respectively (all P<0.05). After 8 weeks of treatment in eight patients with faecal retention, four (4/8, 50%) resumed normal bowel movements, three (3/8, 38%) regained partially normal bowel movements, and one (1/8, 13%) had no change. Conclusions EA might be a promising alternative for the management of bladder and bowel dysfunction in patients with transverse myelitis. Randomised controlled trials are needed to confirm the effectiveness and safety of EA for this condition.

Restoration of Ultrafiltration Capacity of Peritoneal Membrane in Patients on CAPD

1984 ◽  
Vol 7 (2) ◽  
pp. 93-96 ◽  
Author(s):  
G. Bazzato ◽  
U. Coli ◽  
S. Landini ◽  
S. Lucatello ◽  
A. Fracasso ◽  
...  
Keyword(s):  
Body Weight ◽  
Drug Therapy ◽  
Drug Administration ◽  
Urine Output ◽  
Urine Volume ◽  
High Dose ◽  
Peritoneal Membrane ◽  
Technical Approach ◽  
Fluid Removal ◽  
Residual Urine

Among 55 uremic patients who entered our CAPD program, 7 of them showed a reduction or loss of the ultrafiltration capacity (UF) of the peritoneal membrane (PM). They have been treated with high dose of Furosemide (F) to force residual urine output. Four appeared «responders» to drug administration with a significant increase in urine volume, Na excretion and, within a week period gained their dry body weight (BW). In the remaining 3 patients drug therapy resulted ineffective, and fluid removal was obtained by hemofiltration (HF). In both groups we noted an increase in the UF capacity of PM when their dry BW was obtained either by pharmacological or technical approach. These results support the assumption that the overhydration status of the PM plays a major role in maintaining the UF process.

scholarly journals A drug-coated balloon treatment for urethral stricture disease: Two-year results from the ROBUST I study

2020 ◽  
Vol 15 (2) ◽  
Author(s):  
Rachel A. Mann ◽  
Ramon Virasoro ◽  
Jessica M. DeLong ◽  
Rafael E. Estrella ◽  
Merycarla Pichardo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Urethral Stricture ◽  
Flow Rate ◽  
Erectile Function ◽  
Urine Volume ◽  
Urethral Stricture Disease ◽  
Residual Urine ◽  
Drug Coated Balloon

Introduction: Mechanical balloon dilation and direct visualization internal urethrotomy (DVIU) are the most widely used treatments for urethral stricture disease in the U.S., but recurrence rates are high, especially after re-treatment. This study investigates the safety and efficacy of the Optilume™ paclitaxel-coated balloon for the treatment of recurrent strictures. Methods: Men with recurrent bulbar strictures ≤2 cm with 1–4 prior endoscopic treatments were treated with the Optilume™ drug-coated balloon. Patients were evaluated within 14 days, three, six, 12, and 24 months post-treatment. The primary safety endpoint was serious urinary adverse events. The primary efficacy endpoint was ≥50% improvement in International Prostate Symptom Score (IPSS) at 24 months. Secondary outcomes included quality of life, erectile function, flow rate, and post-void residual urine volume. Results: A total of 53 subjects were enrolled and treated; 46 completed the 24-month followup. Forty-three percent of men had undergone >1 previous dilations, with a mean of 1.7 prior dilations. There were no serious adverse events related to treatment at two years. Success was achieved in 32/46 (70%), and baseline IPSS improved from a mean of 25.2 to 6.9 at 24 months (p<0.0001). Quality of life, flow rate, and post-void residual urine volumes improved significantly from baseline. There was no impact on erectile function. Conclusions: Two-year data indicates the Optilume™ paclitaxel-coated balloon is safe for the treatment of recurrent bulbar urethral strictures. Early efficacy results are encouraging and support further followup of these men through five years, as well as further investigation with a randomized trial.

Maternal dehydration-rehydration: fetal plasma and urinary responses

1988 ◽  
Vol 255 (5) ◽  
pp. E674-E679 ◽  
Author(s):  
M. G. Ross ◽  
D. J. Sherman ◽  
M. G. Ervin ◽  
R. Castro ◽  
J. Humme
Keyword(s):  
Glomerular Filtration Rate ◽  
Arginine Vasopressin ◽  
Filtration Rate ◽  
Urine Volume ◽  
Plasma Osmolality ◽  
Urine Osmolality ◽  
Fetal Plasma ◽  
Urine Production ◽  
The Impact ◽  
Observation Period

Pregnant women may be exposed to exercise, thermal, or gastrointestinal (hyperemesis) water loss, all of which commonly induce a greater than 10 mosmol increase in plasma osmolality. Although fetal osmolality is dependent on maternal osmolality, the impact of maternal dehydration and subsequent maternal rehydration on the fetus has not been explored. Five pregnant ewes with singleton fetuses (136 +/- 1 day) were water deprived for 36 h resulting in a significant increase in plasma osmolality (298 +/- 3.4 to 313 +/- 5.0 mosmol). In response to maternal dehydration, fetal plasma osmolality (297.0 +/- 4.1 to 309.3 +/- 4.1 mosmol), arginine vasopressin (AVP) levels (1.5 +/- 0.2 to 7.9 +/- 1.0 pg/ml), hematocrit (35.1 to 38.6%), and urine osmolality (161.3 +/- 10.7 to 348.9 +/- 21.9 mosmol) significantly increased. Subsequently, ewes were rehydrated over 4 h with intravenously infused 0.45% saline (20 ml.kg-1.h-1). In response to maternal rehydration, maternal and fetal plasma osmolality decreased to basal values (298.9 +/- 3.2 and 300.1 +/- 3.8 mosmol, respectively) and fetal glomerular filtration rate (1.72 +/- 0.30 to 3.08 +/- 0.66 ml/min) and urine volume significantly increased (0.33 +/- 0.02 to 0.71 +/- 0.13 ml/min). However, fetal hematocrit (37.4%), plasma AVP (3.1 +/- 0.9 pg/ml), and urine osmolality (255.4 +/- 28.8 mosmol) did not return to basal levels during the observation period. These results demonstrate fetal hyperosmolality, blood volume contraction, AVP secretion, and altered urine production in response to maternal dehydration. Despite maternal rehydration and normalization of maternal and fetal plasma osmolality, fetal endocrine and fluid responses are prolonged.(ABSTRACT TRUNCATED AT 250 WORDS)

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