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Article in Chinese | WPRIM | ID: wpr-930471


Objective:To investigate the prevalence of overactive bladder (OAB) in Chinese boys and risk factors, and to evaluate the psychological and behavioral status of OAB patients.Methods:Cross-sectional study.From October 2020 to July 2021, 2 800 boys aged 6-15 years from 6 primary and secondary schools in a county of Henan Province were selected by stratified random cluster sampling method.An anonymous questionnaire was used to investigate the epidemiological situation of OAB, including the basic information, lower urinary tract symptoms, Overactive Bladder Score Scale (OABSS) scores, pediatric sleep questionnaire (PSQ) and strengths and difficulties questionnaire (SDQ). In addition, the correlation between OAB and residence, body mass index (BMI), nocturnal enuresis (NE), overuse of diapers, history of urinary tract infection, abnormal stool, phimosis, redundant prepuce, and concealed penis by Chi- square test, Logistic multivariate regression analysis, and t-test. Results:A total of 2 333 valid questionnaires were collected.The overall prevalence of OAB in boys was 6.0%(141/2 333 cases). NE, history of urinary tract infection, abnormal stool, overuse of diapers, phimosis, redundant prepuce, concealed penis were risk factors for OAB in boys ( OR>1, P<0.05), while BMI was not a risk factor for OAB in boys ( OR<1, P>0.05). The emotional symptoms[ (7.64±2.03) scores vs.(6.51±2.53) scores], conduct problems [(8.14±1.62) scores vs.(7.31±1.88) scores], hyperactivity[(5.64±2.27) scores vs.(4.98±2.03) scores], peer communication problems [(7.16±1.63) scores vs.(6.59±1.60) scores], difficulty scores[(30.26±6.48) scores vs.(27.69±6.44) scores] and PSQ scores [(5.36±3.00) scores vs.(3.94±2.53) scores] in OAB group were significantly higher than those of non-OAB group ( t=-5.117, -5.005, -3.310, -4.056, -4.553, -5.006, respectively, all P<0.05). Conclusions:OAB in boys is common and affects mental health and sleep quality.Meanwhile, NE, history of urinary tract infection, abnormal stool, overuse of diapers, phimosis, redundant prepuce, or concealed penis are the risk factors for OAB in boys.

Chinese Journal of Geriatrics ; (12): 886-889, 2021.
Article in Chinese | WPRIM | ID: wpr-910935


Objective:To analyze the urodynamic and clinical features of detrusor underactivity(DU)in elderly men aged 60 years and over.Methods:Five hundred and seventy-three men aged 60 years and over underwent urodynamic measurements due to dysuria were retrospectively analyzed.According to the urodynamic parameters of bladder contractibility index(BCI)and bladder outlet obstruction index(BOOI), they were divided into the three groups: only detrusor underactivity(DU group)(BCI<100 and BOOI<20), only bladder outlet obstruction(BOO group)(BCI≥100 and BOOI≥40), and the combined non-DU and non-BOO group(NDB group)(BCI≥100 and BOOI<20). The urodynamic and clinical features were compared between the three groups.Results:The internalized 323 patients meeting inclusion and exclusion criteria were divided into 3 groups: 75 in the DU, 207 in the BOO and 41 in the NDB.The age was higher in DU and BOO groups than in NDB group( P<0.05). The DU group versus the NDB group showed the higher levels or values in the volume at first desire(FDV)[(279±80)ml vs.(238±72)ml], the proportions of incomplete bladder emptying(41% vs.17%), urine flow interruption(39% vs.15%)and retention(26% vs.7%), and the lower levels in the voiding efficiency(VE)[(61±32)% vs.(110±41)%], (all P<0.05). The DU group vs.the BOO group showed the increased levels or values in the FDV[(279±80)ml vs.(206±67)ml]and maximum cytometric capacity(MCC)(353±113 ml vs.281±94 ml)and the proportions of urine flow interruption(39% vs.22%), TURP(26% vs.6%), and retention(26% vs.14%), and the decreased levels or values in the VE[(61±32)% vs.(78±37%)], the proportions of DO(41% vs.77%), urgency(26% vs.43%)and nocturia(23% vs.39%)(all P<0.05). Conclusions:The main urodynamic and clinical features are manifested as the reduction of bladder sensation and bladder emptying rate, urine flow interruption, urinary retention and having a TURP history in elderly man with detrusor underactivity.The proportions of DU and BOO are increased along with aging.

Article in Chinese | WPRIM | ID: wpr-907898


Pediatric neurogenic bladder (PNB) is mostly caused by the dysplasia of lumbosacral spinal cord and nerve, and there is no effective treatment available at present.Bladder fibrosis occurs frequently in PNB, and the prevention and treatment of PNB fibrosis is still a challenge worldwide.Most PNBs develop bladder fibrosis over time, which is characterized by the thickened bladder wall, decreased bladder compliance, and obstruction of the bladder outlet.According to some studies, bladder fibrosis is not only related to bladder smooth muscle cells, but also epithelial cells and mesenchymal cells of bladder.However, the mechanism of fibrosis remains unclear.It has been reported that it is associated with the changes of transforming growth factor-β 1 (TGF-β 1)/ Smad, bladder high pressure and related angiotensin Ⅱ signal pathways.Although anti-fibrotic therapies that target a variety of factors have been employed in animal models, the clinical validation is still needed.It is required to conduct a further exploration on whether early clean intermittent catheterization could prevent the fibrosis in PNB patients with increased residual urine.In this paper, the research progress in PNB fibrosis would be reviewed, in order to provide reference for clinical practice.

Article in Chinese | WPRIM | ID: wpr-864221


Objective:To investigate changes in the bladder morphological structure and function and the expression of transforming growth factor-beta1 (TGF-β1) pathway-related proteins in the bilateral spinal nerve amputated neurogenic bladder(NB) rat.Methods:A total of 64 female SD rats were included, and 32 of them underwent bilateral spinal nerve L6+ S1 amputation to construct the NB model and the others were used as sham operation controls.Rats in both NB and control groups received bladder cystometry 3, 6, 12, 24 weeks after corresponding operation.Collagen fibers in their bladder tissues were detected by Masson staining and Sirius scarlet staining.TGF-β1, Smad2 and Smad6 proteins were checked by immunohistochemical staining.TGF-β1 receptor Ⅰ protein was measured by Western blot.Results:Bladders in the NB group were instable, with bladder leak point pressure(BLPP) and underactive voiding pressures.The basal pressure [(22.10±2.51), (18.20±1.52), (31.20±2.82), (41.10±3.41) cmH 2O(1 cmH 2O=0.098 kPa)] and bladder volume [(22.30±1.72), (49.10±5.54), (30.30±2.68), (13.50±1.52) mL] of the NB rats at 3, 6, 12 and 24 weeks were significantly higher than those of the sham operation controls[(3.51±0.45) cmH 2O and (0.52±0.04) mL], and the difference were significant(all P<0.05). The bladder size and thickness in the NB group firstly increased (3, 6 weeks) and then decreased (12, 24 weeks), but the bladder weight increased continuously.Masson staining showed disordered fibrous connective tissues, disintegrated layered bla-dder wall, hypertrophied smooth muscle tissues and deposited intramuscular collagen on the nerve-amputated bladder wall.Sirius scarlet staining suggested that 24 weeks after nerve amputation, collagen Ⅲ increased greatly, and the ratio of type Ⅲ/Ⅰ collagen fibers (3.14±0.71) was significantly higher than that in the sham group (0.88±0.21) ( t= 7.48, P<0.01). According to the immunohistochemical staining results, the expressions of TGF-1β and Smad2 increased while the pathway inhibitory protein Smad6 decreased with time in the NB group.Western blot showed that the expression of TGF-β1 receptor Ⅰ in the amputated bladder was 1.3 and 1.6 folds higher than that in the sham group 12 weeks and 24 weeks after operation( t=6.06, 14.45, all P<0.01). Conclusions:In NB rats with bilateral spinal nerve amputated, bladder contraction becomes paralysis, intravesical pressure increases, bladder normal structure disintegrates and the fibrosis pathway TGF-β1/Smads is activated.Therefore, the key step of development of pediatric NB is bladder fibrosis, which should be prevented as early as possibly in the clinical practice.