AIMS: Nervous system involvement occurs in about half of patients with systemic lupus erythematosis (SLE). Seizures and psychiatric disorders are the most common manifestations; spinal cord lesions are uncommon. We had eight such patients who presented with urinary dysfunction. METHODS: The patients consisted of two men and six women, mean ...

AIMS: Spina bifida is a rare but well-documented congenital spinal anomaly comprising a cystic form, which appears in infancy, and an occult form, which appears in late childhood and in adulthood. Herein, we report the results of uroneurological assessment in patients with spina bifida cystica and occulta, with respect to ...

INTRODUCTION: Augmentation cystoplasty is an effective approach to the detrusor hyperreflexia which is refractory to conservative treatment. Sporadic data have been published in patients with progressive diseases such as multiple sclerosis (MS). MATERIALS AND METHODS: Augmentation ileocystoplasty (Goodwin 'cup-patch') was performed in 9 patients (7 females, 2 males). The average ...

Prospective investigation using serial urodynamic studies. To evaluate type of neurogenic bladder and to observe changes of autonomous detrusor contraction (ADC) after the normalization of the compliance and capacity of the bladder in cauda equina injury. Spinal Cord Injury Unit, Yonsei Rehabilitation Hospital, Seoul, Korea. Urodynamic studies were performed in ...

PURPOSE: Bilateral sacral nerve neuromodulation has been proposed as a more effective treatment for chronic voiding dysfunction. However no comparison with the unilateral approach has been performed. We investigated the possible advantage of bilateral sacral neuromodulation. MATERIALS AND METHODS: In a prospective randomized crossover trial we investigated 33 patients who ...

AIMS: Dyschesia can be provoked by inappropriate defecation movements. The aim of this prospective study was to demonstrate dysfunction of the anal sphincter and/or the musculus (m.) puborectalis in patients with dyschesia using anorectal endosonography. METHODS: Twenty consecutive patients with a medical history of dyschesia and a control group of ...

OBJECTIVES: To evaluate the impact of a second transurethral resection (TUR) on the pathologic stage in a unique patient population with T1 tumors. METHODS: Seventy-one patients with Stage T1 transitional cell carcinoma of the bladder were prospectively enrolled and underwent restaging TUR. Fifteen patients underwent immediate cystectomy and 56 patients ...

We compared the frequency of Hypermobility Syndrome (HS) in 105 patients with urinary stress incontinence (USI) with the frequency of HS in 105 healthy controls that matched for age and parity. A Beighton score (BS) of more than 3 was used to make the clinical diagnosis of HS. Thirty-six patients ...

INTRODUCTION: Acute urinary retention caused by bladder outlet obstruction resulting from prostatic enlargement is one of the commonest causes for acute admission to urology wards. More recently, there has been a trend to commence treatment with alpha-blockers after catheterisation followed by a trial without catheter (TWOC), in the hope that ...

BACKGROUND AND AIMS: Fecal incontinence is common. The potential contribution of colon function to continence has not been studied. Treatment is poorly codified. To evaluate colonic transit time (CTT) and its importance in the management of fecal incontinence we analyzed in a retrospective study the CTT in patients with fecal ...

OBJECTIVE: For patients with the combination of severe bladder outlet obstruction (BOO) and severe overactive bladder (OB), no straightforward and safe treatment exists due to the risk of urge incontinence after TURP. In this study we have used a biodegradable polyglycolic stent to simulate the status after TURP and register ...

BACKGROUND: Voiding before discharge is usually required after outpatient epidural or spinal anesthesia because of concern about bladder overdistention and dysfunction. Shorter duration spinal and epidural anesthesia may allow return of bladder function before overdistention occurs in low-risk patients (those younger than age 70, not having hernia, rectal, or urologic ...

OBJECTIVE: To evaluate the diurnal and nocturnal bladder reservoir function in patients with refractory primary nocturnal enuresis (PNE). PATIENTS AND METHODS: Ninety-five children (68 boys, 27 girls, mean age 9.3 years) with significant PNE (>/=3 wet nights/week) that was refractory to treatment with desmopressin +/- an enuretic alarm were assessed ...

AIMS: To evaluate micturition abnormalities in acute transverse myelitis and correlate these with evoked potentials, magnetic resonance imaging (MRI), and urodynamic findings. SETTING: Tertiary care teaching hospital. PATIENTS: 18 patients with acute transverse myelitis, aged 4-50 years; 15 had paraparesis and three quadriparesis. METHODS: Patients with acute transverse myelitis had ...

Spinal cord injury (SCI) produces profound alterations in lower urinary tract function. Incontinence, elevated intravesical pressure, reflux, stones, and neurological obstruction, commonly found in the spinal cord-injured population, increase the risk of urinary infection. The overall rate of urinary infection in SCI patient is about 2.5 episodes per patient per ...

OBJECTIVE: To study the factors that affect the prognosis of the patients with benign prostatic hypertrophy (BPH) after prostatectomy. METHODS: Using urodynamic methods, we studied 50 BPH patients with embarrassing outcomes after prostatectomy. RESULTS: Detrusor instability (Dl) appeared in 20 (40%) patients. Twelve (24%) patients suffered from weak contractility of ...

OBJECTIVE: The purpose of this study was to determine the postoperative postvoid residual volume that predicts a voiding efficiency after operation for incontinence and prolapse. STUDY DESIGN: Ninety-nine patients met the criteria for inclusion. The patients' bladders were filled retrograde through gravity, through a Foley catheter, with 300 mL of ...

Three patients (males, black, ages 37, 40 and 57) attended a university clinic with a progressive paraparesis of obscure origin. One patient who referred disease duration of more than 16 years, showed diminished deep reflexes, bilateral Babinski's sign, diminished sensation of vibration, abnormal bladder function and back pain. The other ...

OBJECTIVE: To examine the hypothesis that because most patients with myelomeningocele and a positive anocutaneous reflex have a competent sphincteric mechanism they are more likely to be continent on intermittent catheterization than those with a negative reflex, and to become so with less need for adjunctive surgical treatment. PATIENTS AND ...

AIMS: To compare the long term functional and psychosocial outcomes following surgical treatment for total colonic aganglionosis (TCA) with those in an age and gender matched group of patients with rectosigmoid aganglionosis (RSA). METHODS: Fifteen patients with TCA matched for age and gender with 15 patients with RSA were studied ...

OBJECTIVE: Hospital-acquired urinary tract infections (HUTI) represent a significant impairment in the quality of health care. Incidence in catheterized patients has been estimated at approximately 20%, however few data are available in urologic patients. We report a prospective surveillance program over 6 years in our urologic department and evaluate its ...

BACKGROUND: In spinal cord injury (SCI) patients, no correlation was found between the number of bladder infections per year, the period since injury, the neurologic level of the spinal cord lesion and the histopathology of the urinary bladder mucosa. The use of chronic indwelling urethral and/or suprapubic catheters in SCI ...

Munchausen syndrome is an uncommon disorder in which patients present with fictitious disorders and a self-destructive urge to undergo invasive procedures. We present 2 cases of nurses who presented with recurrent urinary tract infections, flank pain, and gross hematuria. One patient had such severe hematuria as to require transfusions of ...

The infravesical obstruction created by posterior urethral valves produces a series of structural, biochemical, and functional changes in these boys' bladders that begins during fetal life. Any change can be irreversible and result in the alterations in bladder function that can be found in some of these patients. Bladder instability, ...

PURPOSE: To determine awareness of bladder dysfunction and attitudes towards its management among office-based physicians. MATERIALS AND METHODS: A total of 211,648 patients consulting office-based primary care physicians (PCPs), gynaecologists (OBGs) or urologists (UROs) for any reason were given a questionnaire of four questions related to symptoms of bladder dysfunction. ...

BACKGROUND AND AIMS: This study determined correlations of clinical and manometric features with those of anal endosonography (AES). PATIENTS AND METHODS: Between 1996 and 1999 we examined 58 patients suffering from anal incontinence (AI) by AES using a linear probe and anorectal manometry following a standardized protocol. RESULTS: Twelve of ...

S3 nerve root neuromodulation is becoming an accepted therapy for individuals afflicted with lower urinary tract symptoms, such as idiopathic urinary urge incontinence, frequency, urgency, and urinary retention, who fail current standard therapies. This patient population is difficult to treat, and this therapy offers an option that can restore quality ...

<b>Objective: </b>Our aim is reappraisal of Mitrofanoff prin-ciple in a wide array of diverse clinical situations like pelvic tumors, myelodysplasia, irreparably damaged ure-thra and sphincters and with total bladder substitution. <b>Materials and Methods: </b>24 patients underwent the con-struction of a continent catheterisable stoma based on the Mitrofanoff principle between February ...

Pyocystis is an important complication of non-functioning urinary bladder, which often poses diagnostic difficulties. We present a case of pyocystis in a patient on chronic hemodialysis who was anuric for one year. The patient was initially diagnosed with diverticulitis. An abdominal C-T scan suggested the diagnosis of pyocystis, which was ...

OBJECTIVE: To determine whether sonographic urethral sphincter morphology is different in patients with detrusor instability than in those with normal urodynamic testing. METHODS: Patients from a population of women presenting for evaluation of urinary incontinence or pelvic organ prolapse underwent intraurethral ultrasonography before multichannel urodynamic testing. Maximal rhabdosphincter thickness, total ...

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 ...

Overactive bladder dysfunction is an expression of defective neuromuscular control of the lower urinary tract. The causes and the way to classify this problem are currently under debate. In some patients the overactive bladder is one sign of a neurological disorder, in so called "idiopathic detrusor instability" the cause is ...

OBJECTIVE: To determine whether transcutaneous electrical nerve stimulation (TENS) benefits patients with urinary symptoms caused by neurological diseases. PATIENTS AND METHODS: Patients with urinary symptoms from any kind of neurological disease were prospectively recruited between October 1996 and July 1998. Before attending the first assessment patients were asked to complete ...

One of the most common "treatment" alternatives in suspected outflow obstruction due to bladder outlet obstruction (BOO) is watchful waiting (WW). The aim of this study was to see whether there were any differences in outcome between patients with slight, moderate or severe obstruction due to BOO as classified by ...

BACKGROUND: Cross-section studies have shown the diagnostic characteristics of certain urinary tumor markers for the detection of bladder carcinoma. However, the role of serial urinary tumor markers in the monitoring of patients with bladder carcinoma in daily clinical surveillance has not been completely defined yet. METHODS: The study comprised 1185 ...

PURPOSE: We reviewed our experience with a conservative medical program and computer game assisted pelvic floor muscle retraining in patients with voiding dysfunction to substantiate our previous findings that demonstrated improvement and/or cure in a majority of patients, and identify factors that may be associated with unsuccessful treatment. MATERIALS AND ...

Most of the 13 million Americans who have urinary incontinence are adults, and a significant number are never treated. Undertreatment is due in part to reluctance by patients and physicians to discuss an uncomfortable topic. Unmanaged incontinence restricts normal daily activity and fundamental human interactions. Intervention is important not only ...

Ultrasound scanning using a 13 MHz probe was performed on 158 infants, aged 12 weeks or less, presenting with conjugated hyperbilirubinaemia. The gall bladder was identified in 156 infants, 35 of whom had biliary atresia. The two patients in whom no gall bladder was seen both had biliary atresia. The ...

OBJECTIVE: The frequency of bacteriuria is high in children with neurogenic bladder on intermittent catheterization for bladder emptying. In an effort to decrease bacteriuria, we examined whether the method of catheter care was responsible for the high rate of bacteriuria. For this, the frequency of bacteriuria was examined in the ...

We evaluated the clinical and radiologic features of patients with lumbar spinal stenosis with neuropathic bladder. Based on cystometrogram analysis, the patients were divided into two groups--the neuropathic bladder (NB) group: the NB+ group (23 patients), and the nonneuropathic bladder group: the NB- group (14 patients). The symptom of incontinence ...

Many patients with faecal incontinence can be cured using a simple anal sphincter repair. Some patients are unsuitable for this either because the sphincter is absent, too extensively damaged or anal sphincter repair has failed. In these patients novel treatments have been introduced to augment, replace and stimulate the anal ...

OBJECTIVE: To evaluate the association of urodynamic variables with continence and upper tract status after reconstruction in patients with classical bladder exstrophy. PATIENTS AND METHODS: Thirty-one patients with bladder exstrophy were assessed 1 year after a modified bladder neck reconstruction. The evaluation included a detailed history, radioisotope renography, voiding cysto-urethrography, ...

OBJECTIVE: Perianal infection arises in small intersphincteric anal glands predominantly located at the dentate line. Documentation of fluid collections and the relationship of inflammatory tracts to the sphincter mechanism is important for surgical treatment. Transanal sonography for assessment of perianal inflammatory disease is limited because placement of the rigid probe ...

OBJECTIVE: Various types of defaecography have been reported for research purposes. A simplified method for clinical use has not been devised for the assessment of disordered defaecation. The aim of this study was to describe a simplified procedure of defaecography and evaluate its usefulness in the diagnosis of faecal incontinence ...

OBJECTIVE: To determine whether oral cimetidine, which reportedly improves symptoms in 60-70% of patients with painful bladder syndrome/interstitial cystitis has a similar mechanism of action on the human bladder and involving a similar peptidergic pathway as it has in human stomach, where it alters histamine-gastrin reactions mediated via H2 receptors ...

BACKGROUND AND PURPOSE: We previously demonstrated that obstructed ureteropelvic junction (UPJ) segments from patients who had secondary pyeloplasty after endopyelotomy failure expressed transforming growth factor-beta1 (TGF-beta1) at levels significantly lower than patients who had primary pyeloplasty. In order to determine whether these differences in secreted TGF-beta1 are detectable preoperatively in ...

PURPOSE: We evaluated the correlation of lower urinary tract symptoms suggestive of detrusor instability with urodynamic findings in men. MATERIALS AND METHODS: Enrolled in our prospective study were 160 consecutive neurologically intact men referred for urodynamic evaluation of persistent lower urinary tract symptoms. All patients had storage symptoms suggestive of ...

PURPOSE: Objective of this study was to determine possible changes in the quantity of type III collagen in women with genuine stress incontinence (GSI) and with pelvic relaxation or not. MATERIAL AND METHODS: Ninety-four women participated in the study and they were divided in to three groups as follow: 34 ...

One hundred Egyptian beta-thalassaemic patients on a long-term transfusion/chelation programme were evaluated for the prevalence of gall bladder sludge and stones and the associated risk factors. Fifty healthy individuals served as controls. Abdominal ultrasonography revealed that 14% of the thalassaemic patients had gall bladder sludge or stones (6% stones and ...

OBJECTIVES: Detrusor hyperreflexia after spinal cord injury may cause urinary incontinence and chronic renal failure. In patients refractory to conservative treatment and not eligible for ventral sacral root stimulation for electrically induced micturition, we investigated the therapeutic value of sacral bladder denervation as a stand-alone procedure. METHODS: Nine patients (8 ...