lower urinary
Recently Published Documents


TOTAL DOCUMENTS

9675
(FIVE YEARS 1973)

H-INDEX

118
(FIVE YEARS 11)

2022 ◽  
Vol 8 ◽  
Author(s):  
Qi-Xiang Song ◽  
Jiayi Li ◽  
Yiyuan Gu ◽  
Lei Xu ◽  
Paul Abrams ◽  
...  

ObjectiveOur current knowledge on nocturnal enuresis (NE) in adults is scarce due to its uncommon nature. The present study was designed to investigate symptom characteristics and risk factors of NE in adult women to improve the current clinical understanding and management of this rare disease.MethodsOver a 3-year period, we enrolled 70 adult women who complained of bedwetting, with a frequency of at least once per week and a symptom duration of 3 months or longer. Patients were excluded if they had known pregnancy, current urinary tract infection, untreated malignancies, anatomical abnormalities, and irregular sleep cycle. The International Consultation on Incontinence Modular Questionnaire—female lower urinary tract symptoms and bladder diary were employed to appraise lower urinary tract symptoms and voiding behavior. Urodynamics was performed to assess the bladder function. A linear regression analysis was applied to determine potential risk factors for NE frequency.ResultsAmong the recruited subjects, comorbidities and lower urinary tract symptoms were frequently reported. On bladder diary, patients commonly presented with nocturnal polyuria (NP), reduced nocturnal voided volumes (RNVVs), or both. Urodynamics revealed multiple dysfunctions, namely, detrusor overactivity (DO), urodynamic stress incontinence (USI), reduced compliance, bladder outlet obstruction, detrusor underactivity (DU), and simultaneous DO and DU. Patients with more frequent NE (≥4/week) demonstrated markedly increased body mass index, more comorbid conditions, worse incontinence symptoms, NP or NP plus RNVVs, reduced compliance, and poorer voiding possibly owing to DU. Whereas, RNVVs alone and worse overactive bladder-related parameters were associated with milder NE. Multivariate analysis indicated that frequency/urgency quality of life, incontinence symptom, NP + RNVVs, poor flow, increased bladder sensation, USI, and simultaneous detrusor overactivity plus DU were independent risk factors for NE severity.ConclusionNE in adult women may have both urological and non-urological pathophysiology. Imbalanced circadian urine production, jeopardized continence mechanisms, overactive bladder, and DU-induced poor voiding are major factors that contribute to the pathogenesis of NE in adult women. Focused treatments on restoring these functions should be individually considered.


Author(s):  
Homeira Alamdari ◽  
Sakineh Hajebrahimi ◽  
Nasrin Abolhasanpour ◽  
Hanieh Salehi‐Pourmehr ◽  
Golsa Alamdari ◽  
...  

Cureus ◽  
2022 ◽  
Author(s):  
Fouad Hajji ◽  
Abderrazak Benazzouz ◽  
Yassine Karmouch ◽  
Nabil Hammoune ◽  
Omar Ghoundale

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 191
Author(s):  
Janina Beck ◽  
Anke Kirsten Jaekel ◽  
Federico Leopoldo Zeller ◽  
Michael Kowollik ◽  
Ines Kurze ◽  
...  

Background: Multiple sclerosis patients often develop neurogenic lower urinary tract dysfunction with a potential risk of upper urinary tract damage. Diagnostic tools are urodynamics, bladder diary, uroflowmetry, and post-void residual, but recommendations for their use are controversial. Objective: We aimed to identify clinical parameters indicative of neurogenic lower urinary tract dysfunction in multiple sclerosis patients. Methods: 207 patients were prospectively assessed independent of the presence of lower urinary tract symptoms. We analyzed Expanded Disability Status Scale scores, uroflowmetry, post-void residual, rate of urinary tract infections, standardized voiding frequency, and voided volume in correlation with urodynamic findings. Results: We found a significant correlation between post-void residual (odds ratio (OR) 4.17, confidence interval (CI) 1.20–22.46), urinary tract infection rate (OR 3.91, CI 1.13–21.0), voided volume (OR 4.53, CI 1.85–11.99), increased standardized voiding frequency (OR 7.40, CI 2.15–39.66), and urodynamic findings indicative of neurogenic lower urinary tract dysfunction. Expanded Disability Status Scale shows no correlation. Those parameters (except post-void residual) are also associated with reduced bladder compliance, as potential risk for kidney damage. Conclusion: Therefore, bladder diary and urinary tract infection rate should be routinely assessed to identify patients who require urodynamics.


Author(s):  
Alvarado-García Sharon Denise ◽  
Villatoro-Chacón Daniela Mariel ◽  
Arizandieta-Altán Carmen Grizelda

If determined the casuistry of diseases that affect the urinary system in dogs and cats. A retrospective study was carried out at the Veterinary Hospital of the University of San Carlos de Guatemala. It was characterizing patients with diseases of the urinary system. 1,205canine and feline medical records were evaluated in 2019. The variables breed, sex, age, pathology and geographic area were considered. The prevalence of urinary system diseases in dogs and cats in 2019 was 10.45%, 9.21% corresponding to dogs and 1.24% tocats. In both species, males had a higher frequency of urinary system disease, compared to females (dog = 58.56% and cat = 66.67%). The most common etiologies in dogs were lower urinary tract infections (24.65%), bladder urolithiasis (16.90%), and acute and chronic kidney disease (28.16%); while in cats lower urinary tract disease (100%) and kidney disease (5.26%) were the main pathologies observed. In dogs, the most affected age range was in patients older than 8 years (52.25%), while in cats it ranged from 3 to 8 years (73.34%).


Author(s):  
Martin C. Michel ◽  
David Staskin

Combination treatment, i.e., the use of two or more drugs for the same condition, is frequent in medicine if monotherapy yields an insufficient therapeutic response. We here review and challenge clinical study designs and formats of reporting outcomes for the evaluation of the benefit/risk ratio of combination treatment over monotherapy. We demonstrate that benefits of combination treatment at the group level over-estimate the probability of benefit at the single patient level based on outcome simulations under almost any imaginable setting. Based on these findings we propose that studies testing combination treatment should always report on percentages of responders to monotherapy and combination treatment. We provide equations that allow calculation of the percentage of patients truly benefitting from combination (responders to both monotherapies) and that of patients exposed to risk of harm from adverse effects without a reasonable expectation of individual benefit. These considerations are explained based on real clinical data, mostly from the field of functional urology (male lower urinary tract symptoms).


Sign in / Sign up

Export Citation Format

Share Document