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Taking Guigang People's Hospital of Guangxi Province as an example,the paper introduces the implementation background of cloud computing and the operation status of Hospital Information System (HIS) on the desktop cloud,points out the problems of the application of cloud computing in the hospital environment and provides solution ideas,states the process of virtual environment system management,provides valuable reference for hospitals.
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Objective To explore the diagnosis and treatment of female bladder outlet obstruction (BOO) with bladder pain as major symptom.Methods From November 2008 to December 2012,21 female patients suffered from urinary frequency,urgency,pain in suprapubic area during bladder filling phase were enrolled in the study.Video-urodynamics (VUD) study combined with free urinary flow rate andresidual urine were performed in all patients in order to make the diagnosis of BOO clearly.The mean maximum urinary flow rate was (11.5±3.6) ml/s,and the mean maximal detrusor pressure was (39.1±17.8) cmH2O.Combining with the voiding radiography,19 patients were diagnosed as bladder neck obstruction,and the other 2 were diagnosed as urethral stricture.All patients were accepted the hydrodistension under the epidural anesthesia.The bladder biopsy was performed if the typical glomerulations were observed under the cystoscopy.Bladder neck incision and urethral dilatation were performed on these patients respectively.Symptom changes of bladder pain were recorded by using O'Leary-Sant scale,the pain,urgency,frequency symptom (PUF) scale and quality of Life (QOL) Scale.The data were collected within 48 months postoperation,respectively.Results The pathological findings of bladder mucosa biopsy showed acute or chronic inflammation in all patients.The mean follow-up was 6.7±5.9 months.We compared the corresponding data such as:voiding times per day,nocturnal frequency,O'Leary Sant scores,PUF and QOL between pre and post-treatment.Significant differences were observed during all corresponding data (P＜0.05).The voiding times per day changed from 24.3± 11.8 to 13.0±5.9.The nocturnal frequency decreased from 6.5±2.7 to 3.3± 1.6.O'Leary Sant scores changed from 24.6±7.3 to 14.7±7.4.The PUF scores changed from 22.9±6.2 to 12.0± 7.1.And the QOL scores changed from 5.0±0.8 to 2.9±1.5.Conclusions Free urinary flow rate and residual urine combined with VUD are very important in diagnosing female BOO with bladder pain as major symptom.Bladder pain symptoms will be significantly improved after the obstruction was relieved according to VUD results.
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Objective To study the influence of overactive bladder (OAB) on the symptoms and quality of life (QoL) in patients after Transvaginal Tape-Obturator (TVT-O) treatment for stress urinary incontinence (SUI).Methods Eighty-two SUI women underwent TVT-O were included in this study.The perioperative ICI-Q-SF scores,including frequency of leakage,volume of leakage,and QOL scores,were collected to study the perioperative OAB prevalence and the influence of OAB on the improvement on the symptoms and QOL after TVT-O.Results The total efficacy of TVT-O was 95%.The average symptom and QOL scores in all patients decrease from (8.17±2.29)and (7.95±2.16)to (1.84±2.34)and(1.32±2.24)after TVT-O,P＜0.05.The prevalence of OAB decreased from 46% to 24% after TVT-O,P＜0.05.The average post-operation symptom and QOL scores of the pre-operation non-OAB group were (1.09±1.60)and(0.82±1.45),while those of the OAB group were (2.71±2.75) and (1.89±2.82),P＜0.05.The average post-operation symptom and QOL scores of the post-operation non-OAB group were (1.06±1.68) and (0.56±1.15),while those of the OAB group were (4.25±2.49) and (3.65±3.10),P＜0.05.Conclusions TVT-O is effective for female stress urinary incontinence and contributes to the significant improvement of symptoms and QOL in patients with OAB.The treatment will not raise the prevalence of OAB in itself.
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Objective To elucidate if detrusor overactivity(DO)has influence on patients with benign prostate hyperplasia.Methods Forty-seven patients who were suspected to suffered from BPH were divided into two groups according to whether have DO in pre-operative urodynamic analysis.There were 22 patients in DO group and 25 in non-DO group.All patients received transurethral resection of prostate (TURP).Pre-operative variables such as relevant clinical data,International Prostate Symptom Score (IPSS),quality of life (QOL) index,maximum urine flow rate(Q~(max)) and pressure-flow study data were recorded.Patients were monitored after operation and the corresponding data were recorded.Results Prostate size in DO group was (77±25)ml,and in non-DO group was (56±27) ml,P=0.02;first desire bladder volume in DO group was (104±36) ml,and in non-DO group was (161±54) ml,P=0.001;urgent desire bladder volume in DO group was (245±73) ml,and in non-DO group was (328±94)ml,P=0.006;pre-operative residual urine in DO group was (71±49)ml,and in non-DO group was (149±125)ml,P=0.015;linPURR obstruction grade in DO group was 4.63±0.95,and in non-DO group was 3.35±1.90,P=0.014.The IPSS and QOL before and after operation had no significant differences between the 2 groups.Conclusions The patients with larger prostates and more severe bladder outlet obstruction are more likely to have DO.Patients with DO had smaller bladder volume and residual urine volume before operation.DO has no significant effect on BPH patient's IPSS and QOL.
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Objective To study the changes of the symptoms and quality of life (QOL) in patients after the Transvaginal tape-obturator (TVT-O) treatment and weather would this treatment lead to bladder outlet obstruction (BOO) and bladder function change. Methods A total of 82 stress urinary incontinence (SUI) women who had underwent TVT-O were included, age from 39-82 years, 3-60 months after operation. All patients were divided into 5 groups by the time post-operation. The ICI-Q-SF scores were collected to study the change of the symptoms and QOL of each group perioperation. Qmax, PVR, bladder weight, wall thickness of each group were collected to study whether would TVT-O lead to BOO and bladder function change. Results Forty-five (55%) patients were cured and 33(40 %) improved after TVT-O. Total cure rate was 95 %. There was a significant improvement of average symptom and QOL in all of the 5 groups (3-month, 6-month, 1-year, 2-year, above-2-year) (P＜0. 05). Qmax changed from (32. 17±10.74), (25.64±6.05), (25.68±11.36), (25.70±10. 28), (25.29±15. 10)ml/s pre-operation to (28.30±15.21), (25.64±10. 48), (24. 49±7.96),(25.43±11.92), (25. 92± 10. 17)ml/s post-operation in 5 groups(P＞0. 05). PVR changed from (0.04±0.20), (0. 00±0.00), (0. 17±0. 39), (2.70±6.01), (1. 96±5.10)ml pre-operation to (1. 79±6.16), (0.00±0.00), (12. 50±29.89), (5.00±15. 54), (33. 70±92.10)ml post-operation in 5 groups(P＞0.05). The bladder weight changed from (43. 62±7.81), (41. 57±8. 63), (46.11±8.12), (42. 50±3. 85), (44. 52±4. 38)g pre-operation to (45. 62±5.32), (47.21±5. 47),(44.89±4. 65), (45. 14±4. 13), (46. 70±5.84)g post-operation, which differed significantly in 6-month, 2-year, above-2-year groups (P＜0. 05). The bladder wall thickness changed from (2.23±0.51), (2.22±0.47), (2.04±0.38), (2. 19±0. 43), (2. 19±0. 38)mm pre-operation to (2.25±0. 40), (2. 18±0.47), (2. 07±0.47), (2.22±0. 47), (2. 20±0. 44)mm post-operation(P＞0. 05).Conclusions TVT-O has a high cure rate for SUI and there was a significant improvement of average symptom and QOL of all patients after the treatment. But TVT-O may lead to BOO and bladder function change since bladder weight increases significantly in some patients.
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Objective To investigate changes in symptoms and quality of life (QOL) score before and after transurethral resection of the prostate ( TURP), and their related factors. Methods Forty-seven elderly male patients of benign prostate hyperplasia (BPH) with lower urinary tract symptoms were enrolled in the study, with an average age of 72 years. They all were undergone with TURP and evaluated with international prostate symptoms score (IPSS), QOL score, maximal urine flow rate (Qmax), residual urine volume, pressure-urine flow rate and prostate size before and after the procedure. Changes in these parameters and their related factors were analyzed. Results No complication was observed during TURP in the 47 patients. After TURP, two patients suffered from distal urethra stricture, one from retrograde ejaculation and six from aggravated urgent incontinence, and symptoms relieved with symptomatic treatment in all of them. Significant difference in overall IPSS, irritant score and obstructive score pre- and post-operation was observed P ＜ 0.01, i. e. , 22.7 ±4.9 and 10.5 ± 5.8, 10.5 ± 5.8 and 6.3 ± 3.5, and 12.1± 3.9 and 4.2 ± 3.3, respectively. QOL score was 4.6 ± 0.9 and 2.3 ± 1.3, Qmax (5.8 ± 2.9 ) ml/s and (12.4 ±5.2) ml/s and residual urine volume (99 ± 16) ml and (34 ± 19) ml pre- and post-operation,respectively ( all P ＜ 0.01 ). Follow-up time after the procedure, prostate volume and bladder volume at urgent urination desire all correlated with post-operation IPSS ( r = 0.751, P ＜ 0.05 ), and follow-up time after the procedure and age also significant correlated with post-operation QOL score (r = 0.470, P ＜ 0.05 ).Conclusions Overall IPSS, irritant score, obstructive score and QOL score improved significantly after TURP in symptomatic BPH patients, probably by varied related factors.
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@#Objective To evaluate the surgical approaches,complications,safety and efficacy of the suprapubic arc sling(SPARC) applied for stress urinary incontinence(SUI).Methods 30 female patients with SUI accepted SPARC through the anterior vaginal wall.Results All the cases clinically improved.1 patient experienced bladder injury,and get well 5 d after the operation;1 patient experienced post-procedure voiding dysfunction,but got well after the tape was cut 2 weeks later.All of the cases were followed up for 12～20 months with good results.Complete dryness was seen in 93.3%(28/30),6.7%(2/30) showed significant improvement.No leakage occurred.Conclusion SPARC is a simple,reliable procedure for anti-incontinence with good results.
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@#Objective To evaluate the safety and efficacy of transobturator tension-free vaginal tape(TVT-O)by 1-year follow-up.Methods The data of 112 female patients with stress urinary incontinence(SUI)were analyzed retrospectively.Preoperative and postoperative evaluations included physical examination,and urinary symptom,Qmax,post-voiding residual(PVR),and quality of life scale questionnaires.The anti-incontinence procedure was TVT-O through the anterior vaginal wall.Results All cases clinically improved,one patient experienced recurrence after 2 weeks,and got another TVT procedure 8 weeks later,and got well after the operation.All cases were followed up for 2～20 months in good result.The complete dryness rate was 94.64%(106/112),5.36% of patients(6/112)showed significant improvement.No leakage occurred.Most patients reported a significant decrease in incontinence severity and improvement in quality of life(P<0.01).Conclusion The TVT-O procedure is a safe and efficient surgical treatment method for female SUI.
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<p><b>OBJECTIVE</b>To study the relationship between the degree of bladder outlet obstruction (BOO), detrusor contractility and residual urine in patients suffering from benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>In 181 patients with BPH, degree of BOO, detrusor contractility, residual urine caculated from cathetering combined with the difference between the filling and the voiding were recorded and analysized statistically using urodynamic technique.</p><p><b>RESULTS</b>Residual urine increased when the detusor contractility was weakened (F = 12.134, P = 0.001). In patients wih severe BOO, there was no significant difference in residual urine (F = 2.386, P = 0.071).</p><p><b>CONCLUSIONS</b>Increased residual urine is mainly resulted from decreased detrusor contractility. BOO has no significant influence on residual urine. Some patients with normal or weakened detrusor contractility may have more residual urine.</p>
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Aged , Aged, 80 and over , Humans , Male , Middle Aged , Muscle Contraction , Physiology , Muscle Hypertonia , Prostatic Hyperplasia , Urinary Bladder , Urinary Bladder Neck Obstruction , Urination Disorders , Urodynamics , PhysiologyABSTRACT
<p><b>OBJECTIVE</b>To study the factors that affect the prognosis of the patients with benign prostatic hypertrophy (BPH) after prostatectomy.</p><p><b>METHODS</b>Using urodynamic methods, we studied 50 BPH patients with embarrassing outcomes after prostatectomy.</p><p><b>RESULTS</b>Detrusor instability (Dl) appeared in 20 (40%) patients. Twelve (24%) patients suffered from weak contractility of the detrusor and 18 (36%) patients had bladder outlet obstruction.</p><p><b>CONCLUSIONS</b>Dl, weak contractility of the detrusor and bladder outlet obstruction are the most frequent causes affecting the prognosis of BPH patients after prostatectomy. Urodynamics may play a significant role in the identification of the causes of unsatisfied prognosis of BPH patients.</p>
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Aged , Aged, 80 and over , Humans , Male , Middle Aged , Prostatectomy , Prostatic Hyperplasia , General Surgery , UrodynamicsABSTRACT
0.05) respectively.The maximum free uroflow rate was (9.55?4.10)ml/s,and the maximum catheter's uroflow rate was (7.32? 3.28)ml/s(P=0.000).The difference of uroflometry between two voids was (2.22?3.07)ml/s.Paired t-test showed that there was significant difference between the maximum free uroflow rate and maximum catheter's uroflow rate (P0.05) when LPURR lie in Ⅱ,Ⅴ～Ⅵ grade. Conclusions 7 F urethral catheter appeared to have a significant impact on maximum uroflow rate.
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100 ml). Conclusions The increase of residual urine is the consequence of the decreased detrusor contractility whereas BOO has no significant effect on the residual urine.