scholarly journals Diagnostics of anatomical obstruction of the lower urinary tract using uroflowmetry with a pharmacourodynamic test

Urology ◽  
2021 ◽  
Vol 25 (2) ◽  
Author(s):  
E.A. Kvyatkovsky ◽  
T.O. Kvyatkovska ◽  
E.V. Pilin
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Prostate Gland ◽  
Volumetric Flow Rate ◽  
Urethral Obstruction ◽  
Non Invasive ◽  
Lower Urinary Tract Obstruction ◽  
Invasive Method ◽  
Lower Urinary

Uroflowmetry is an effective, non-invasive method for detecting lower urinary tract obstruction. However, by the nature of the uroflowgram, it is impossible to distinguish between the anatomical and functional obstruction of the urethra. The aim of the study was to develop a screening non-invasive method for the diagnosis of anatomical urethral obstruction using uroflowmetry with a pharmacourodynamic test with selective alpha-1-blocker silodosin. The study involved 235 patients aged 66.2±1.8 years (from 30 to 76 years) with symptoms of the lower urinary tract (LUTS). Uroflowmetry was performed using a “Flow-K” uroflowmeter. Ultrasound examinations of the kidneys, prostate and bladder with determination of residual urine were performed using a HONDA HS-2000 ultrasound machine. All patients underwent a pharmacourodynamic test: repeated uroflowmetry 2.5-3 hours after a single dose of 8 mg of silodosin, taking into account the pharmacodynamics of the drug. During the pharmacourodynamic test, 15 patients with obstructive or obstructive-interrupted uroflowgram had no reaction to silodosin, which was considered a positive test for anatomical (mechanical) urethral obstruction. Аn increase the maximum and average volumetric flow rate of urine during urination by 25-30%, respectively from 9.02±0.24 ml/s up to 11.69±0.32 ml/s and from 5.64±0.21 ml/s to 7.03±0.25 ml/s, were noted in 220 patients with obstructive, obstructive-interrupted obstructive-intermittent or intermittent type of uroflowgram when conducting a pharmacaurodynamic test. Such results were considered negative for anatomical (mechanical) urethral obstruction. They testified to functional obstruction of the urethra, which was subsequently successfully corrected with prescribing selective alpha-1-blockers. Patients with a positive pharmacourodynamic test were prescribed further examination using such methods as ureteroscopy, urethrocystoscopy, retrograde urethrography, to confirm the violation of the patency of the urethra or bladder neck. Urethral stricture was diagnosed in 10 patients, a calculus of the posterior urethra in 2 patients, a median lobe of the prostate gland in 3 patients with BPH. In the presence of obstructive or obstructive-interrupted uroflowgram in patients with LUTS, the pharmacourodynamic test with silodosin can be used as a screening non-invasive test to detect anatomical obstruction of the lower urinary tract.

scholarly journals Lower urinary tract obstruction in male children–a report of three cases.

2016 ◽  
Vol 18 (3) ◽  
pp. 400 ◽  
Author(s):  
Donboklang Lynser ◽  
Evarisalin Marbaniang ◽  
Pynskhemboklang Khongsni
Keyword(s):  
Urinary Tract ◽  
Bladder Outlet Obstruction ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Outlet Obstruction ◽  
Posterior Urethral Valve ◽  
Urethral Obstruction ◽  
Lower Urinary Tract Obstruction ◽  
Urethral Valve ◽  
Lower Urinary

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. 

Myokardiale Funktion bei Feten mit Lower Urinary Tract Obstruction

2018 ◽  
Author(s):  
O Graupner ◽  
C Enzensberger ◽  
M Götte ◽  
A Wolter ◽  
V Müller ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Lower Urinary Tract Obstruction ◽  
Lower Urinary

Evaluation of the Fetal Therapy Evidence in Lower Urinary Tract Obstruction: Would an ERAS Guideline Improve Outcomes?

2021 ◽  
pp. 1-13
Author(s):  
R. Douglas Wilson ◽  
Gregg Nelson
Keyword(s):  
Quality Improvement ◽  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Fetal Surgery ◽  
Fetal Therapy ◽  
Lower Urinary Tract Obstruction ◽  
Evidenced Based ◽  
Process Elements ◽  
Lower Urinary

<b><i>Background:</i></b> Pregnancies that are prenatally identified to have fetal anomalies are complex and require expert multidisciplinary care. As many conditions can impact the fetus prenatally and require intervention, an enhanced recovery after surgery (ERAS) for lower urinary tract obstruction (LUTO) is being evaluated to determine the level of evidenced-based data available. <b><i>Problem:</i></b> The percutaneous ultrasound-guided fetal surgery procedure for bladder neck obstruction is the focus for elements of preoperative counseling, intraoperative procedure/risk complications, and postoperative management. <b><i>Methods:</i></b> A quality improvement review Squire 2.0 (2000–2020) was undertaken for the percutaneous LUTO fetal surgery shunting (lower urinary tract obstruction), process and procedure which require 2 process pathways, one to evaluate the fetal candidate and a second to treat. This structured review is focused on identifying the process elements to allow the determination of the number of evidenced-based elements that would allow for audit and measurement of the clinical element variance for comparative feedback to the individual surgical provider or surgery center. <b><i>Interventions:</i></b> Titles and abstracts were screened to identify potentially relevant articles with priority given to meta-analyses, systematic reviews, randomized controlled studies, nonrandomized controlled studies, reviews, and case series. <b><i>Results:</i></b> A series of potential clinical elements for the diagnostic fetal evaluation and for the 3 protocol areas of surgical care for the procedures (pre-, intra-, and postoperative care) are identified using an ERAS-like process. <b><i>Conclusions:</i></b> The identified clinical elements have the potential for ERAS-LUTO fetal therapy guideline. Multidisciplinary collaboration (surgeon, anesthesia, nursing, imaging, and laboratory) is required for ERAS quality improvement in the pre-, intra-, and postoperative processes. Process elements in each of the operative areas can be audited, evaluated, compared, and modified/improved.

PERCUTANEOUS BLADDER ASPIRATION AND OTHER METHODS OF URINE COLLECTION FOR BACTERIOLOGIC STUDY

PEDIATRICS ◽  
1965 ◽  
Vol 36 (1) ◽  
pp. 128-131
Author(s):  
Charles V. Pryles
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Needle Aspiration ◽  
Percutaneous Aspiration ◽  
Term Neonates ◽  
The Past ◽  
Lower Urinary Tract Obstruction ◽  
Bladder Urine ◽  
Lower Urinary

IN THE PAST FEW YEARS, a great deal of interest has been focused on the problem of distinguishing true bacteriuria from contamination. The normal urethra is known to harbor bacteria which may contaminate specimens obtained either by voiding or by catheterization. The latter method of obtaining samples may well be the means of introducing organisms that might not have been present before or of replacing sensitive with resistant organisms. Moreover the risk of producing such an infection is greater with the incompletely emptying bladder of lower urinary tract obstruction It has been suggested that percutaneous needle aspiration of the bladder urine may not only be safer than catheterization in some circumstances, but would also obviate contamination of samples during voiding or catheterization. Elsewhere in this issue, Nelson and Peters relate their experience with suprapubic percutaneous aspiration of the urinary bladder in premature and full-term neonates. Aspiration of bladder urine for bacteriologic purposes was first reported in 1956 by Guze and Beeson, who compared colony counts in urine samples obtained both by bladder aspiration and catheter in a small group of women free from urinary tract infection. The following year a comparison of bacterial counts of the urine obtained by needle aspiration of the bladder, catheterization, and midstream collection was described by Manzon and her associates. In 1959 we obtained samples of urine by percutaneous needle aspiration of the bladder and compared the quantitative cultures with those obtained immediately thereafter by catheterization; all these samples were from infants and children prior to elective laparotomies.

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