Exploration on the Clinical Application of Ephedrae Herba in Stimulating Yang Qi / 广州中医药大学学报

Based on the literature review and the analysis of specific cases of postpartum frequent micturition,pediatric enuresis,elderly uremia complicated with bradyarrhythmia in clinic,the clinical application of the action of Ephedrae Herba in stimulating yang qi is discussed.Ephedrae Herba has the meridian tropism of the lung and bladder meridians,and is pungent,warm and dispersing,which is the most important medicine for the treatment of external contraction.Ephedrae Herba has the actions of inducing diaphoresis,calming asthma and inducing diuresis,and is widely used for the treatment of external contraction,coughing and asthma,and edema.For the patients with deficiency of both kidney yin and kidney yang without obvious bias of yin-yang consumption which result from the postpartum impairment of qi and blood,deficient innate endowment,and gradually exhaustion of essence in the kidney in the elderly or during chronic illness,a small dosage of Ephedrae Herba can stimulate yang qi during the treatment of warming kidney yang,which is helpful for promoting the drug arriving at the back shu-points of the internal organs distributed along the bladder meridian and enhancing the recovery of zang-fu organ function.Ephedrae Herba is strong in inducing diaphoresis with an intense action.When Ephedrae Herba is used to stimulate yang,the dosage of 3～9 g is appropriate,and medicines for warming yang are needs to be used together.The course of treatment with Ephedrae Herba should be avoided to be too long,in order to prevent the vital energy from the damage by its large cumulative dose.

Application and prospect of reconstructing bladder micturition reflex in neurogenic bladder after spinal cord injury / 中国组织工程研究

BACKGROUND:The dysfunction of bladder function caused by spinal cord injury is a difficult point in clinical treatment and a hot spot in research.Repairing the injured spinal cord and remodeling the bladder micturition reflex pathway are the fundamental treatment methods. OBJECTIVE:To summarize the reconstruction of the bladder innervation pathway after spinal cord transection injury and its related influencing factors. METHODS:The relevant literature concerning the reconstruction of bladder micturition reflex,neurogenic bladder and urinary reflex and spinal cord repair was retrieved on CNKI,WanFang Data,PubMed and Web of Science.Chinese and English search terms were"neurogenic bladder;spinal cord injury;micturition reflex;spinal cord repair". RESULTS AND CONCLUSION:In the process of reconstructing the bladder micturition reflex,there are many factors involved,including the repair and reconstruction of the injured spinal cord,the remodeling of micturition center,the changes of bladder tissue and substances and hormones in and out of the body.In this process,there are mainly the following problems:(1)As a complex process,there are many sites involved in the reconstruction of the micturition reflex,so the main sites of action can be selected for in-depth study,so as to break through the doubts existing in the reconstruction of the micturition reflex pathway.(2)The mechanism of the normal micturition reflex is complex.After spinal cord transection injury,whether the central nucleus mass controlling or participating in the micturition reflex is compensated and the corresponding compensatory mechanism needs to be further investigated.(3)Information communication between the center and the bladder is interrupted after spinal cord transection injury.Whether there is a direct information connection between the center and the bladder remains to be further investigated.(4)The relationship between reconstructing micturition reflex and body fluid after spinal cord transection injury needs further study.In the reconstruction of the bladder micturition reflex,the key treatment is to promote spinal cord repair,nerve reflex reconstruction,substance metabolism and bladder tissue structure adjustment through intervention.Chinese medicine and Western medicine have their methods.

Effect of functional magnetic stimulation at different frequencies on urination rehabilitation of patients with urinary retention after stroke / 实用医学杂志

Objective To analyze the effect of functional magnetic stimulation(FMS)at different frequen-cies on the recovery of urination function in patients with urinary retention after stroke.Methods A total of 200 patients with urinary retention after stroke admitted to our hospital from January 2020 to January 2022 were recruited as the research objects.They were divided into 5 Hz,10 Hz,20 Hz,and control groups by simple random method,with 50 patients in each group.All four groups were treated with conventional medication,rehabilitation therapy,and intermittent catheterization.The 5 Hz group,10 Hz group,and 20 Hz group were treated with FMS at 5 Hz,10 Hz,and 20 Hz,respectively,and the control group was treated with sham stimulation at the same site and parameters as the 5 Hz group.Bladder pressure volume index,urination status,recovery time of spontaneous urina-tion,Quality of Life Questionnaire(SQLP)score,and urinary retention efficacy were compared among the four groups.Results There were no significant differences in bladder pressure volume,urination,recovery time of spontaneous urination,and SQLP score among the four groups before treatment(P>0.05).After treatment,the bladder volume and pressure of the first four groups were both increased,with those of the 5 Hz group,10 Hz group,and 20 Hz group significantly higher than those of the control group,while the residual urine volume of the first four groups was significantly lowered,with that of the 5 Hz group,10 Hz group,and 20 Hz group significantly lower than that of the control group(P<0.05),even showing an effect of dose-response;The average daily urination frequency and average single urination volume of the first four groups were all increased,with those of the 5 Hz group,10 Hz group and 20 Hz group all significantly higher than those of the control group,while the average daily urination frequency was all reduced,with that of the 5 Hz group,10 Hz group and 20 Hz group significantly less than the control group(P<0.05),even showing an effect of dose-response;The SQLP scores of the first four groups were all lowered,with those of the 5 Hz,10 Hz and 20 Hz groups significantly lower than those of the control group(P<0.05),and the recovery time of spontaneous urination in the 5 Hz,10 Hz,and 20 Hz groups was significantly shorter than that of the control group,showing an effect of dose-response;The total effective rate of urinary retention in the 5 Hz,10 Hz and 20 Hz groups was significantly higher than that in the control group(P<0.05),showing an effect of dose-response.Conclusion FMS at 5 Hz,10 Hz and 20 Hz can improve the urination function and quality of life of patients with urinary retention after stroke,showing a dose-responsive efficacy.The clinical efficacy by FMS at 20 Hz is better than that at 5 Hz and 10 Hz.

Bladder Innervation and Types of Neurogenic Bladder

Bladder innervation is a complex network integrating the activation of Autonomic Nervous System and somatic Nervous System controlled by Central Nervous System. Due to the intricacies of the Neural mechanisms involved, this whole process of Bladder control and Micturition is subject to varied pathological insults at various levels. Neurogenic Bladder is classified depending on the location of the lesion. Only a clear understanding of these mechanisms will allow us to obtain a detailed history and thus initiate appropriate treatment strategies. This review highlights the Anatomy and Physiology of variou Neural Networks regulating the Bladder function and also the variedmanifestations of Neurogenic Bladder, which will guide us in successful therapeutic intervention

Functional connectivity within prefrontal cortex in patients with overactive bladder based on rs-fNIRS measurement synchronous urodynamic monitoring / 中华泌尿外科杂志

Objective:To detect the abnormalities within the functional connectivity (FC) of the prefrontal cortex (PFC) in patients with overactive bladder (OAB) and to explore its central pathogenesis.Methods:Seven OAB patients (OAB group, 6 females, mean age 47.6±16.0 years) and 13 healthy controls [HC] (HC group, 10 females, mean age 49.9±9.2 years) were prospectively enrolled from August to December 2020. All subjects underwent rs-fNIRS scanning synchronized with urodynamic monitoring, and two rs-fNIRS scans were performed when the bladder was empty and when the desire to void was strong/urodynamic monitoring indicated detrusor hyperactivity (DO). The Pearson's correlation coefficients (r value, i. e., FC value) between time series of the 22 channels were calculated, and a 22×22 FC matrix for each subject was obtained. A paired-sample t-test ( P<0.05, FDR corrected) was used to compare the difference in FC values between the HC group and the OAB group when the bladder was empty and the desire to void was strong. A two-sample t-test ( P<0.05, FDR corrected) was used to compare the group differences in FC values between OAB and HC groups. Results:In this study, 7 patients were included in the OAB group, including 1 male and 6 female. The mean age was (47.6±16.0) years old. In HC group, 13 healthy subjects were included, including 3 males and 10 females. The mean age was (49.9±9.2) years. There was no significant difference in baseline data between the two groups, including age, sex composition, years of education, handedness and urgency score at the second scan ( P>0.05). Residual urine volume in both groups was less than 10 ml. The OABSS score, 3-day urine diary parameters (frequency of urination/24 h, frequency of urinary incontinence/24 h, frequency of urgency/24 h) and maximum detrusor pressure during urine storage in OAB group were significantly higher than those in HC group, with statistical significance ( P<0.01). The average urination volume/time, bladder capacity at first sensation and maximum bladder capacity in OAB group were significantly lower than those in HC group, and the differences were statistically significant ( P<0.01). In the process of bladder filling to strong desire to void, the detrusor pressure in HC group was stable without DO, and 6 cases in OAB group had DO. Compared to empty bladder state, healthy subjects with strong desire to void showed significantly increased FC within PFC in 5 Brodmann area (BA9, BA10, BA44, BA45, BA46)and 13 edges, such as the BA9(left dorsolateral prefrontal cortex [DLPFC]: ch 4, 5, 7 and right DLPFC: ch 3), BA10(left frontopolar area: ch 12, 21 and right frontopolar area: ch 10, 18), BA44(left pars opercularis Broca's area: ch 15), BA45(left pars triangularis: ch 22), BA46(left DLPFC: ch 6, 14); significantly decreased FC in 3 brain regions (BA9, BA10 and BA46) and 2 edges, such as the BA9(left DLPFC: ch 7), BA10(left frontopolar area: ch21 and right frontopolar area: ch 17), BA46(right DLPFC: ch 9). There was no significant difference in FC within PFC between OAB and HC groups with empty bladder. However, during the strong desire to void state, the FC within PFC in OAB patients was significantly abnormal when compared with HC. OAB patients showed significantly increased FC within PFC in 4 brain regions (BA9, BA10, BA45 and BA46) and 4 edges, such as the BA9(right DLPFC: ch 1 and left DLPFC: ch 7), BA10(right frontopolar area: ch 17), BA45(left pars triangularis: ch 22), BA46(right DLPFC: ch 9, 16); significantly decreased FC in 3 brain regions (BA9, BA10 and BA46) and 4 edges, such as the BA9 (right DLPFC: ch 3 and left DLPFC: ch 4), BA10(left frontopolar area: ch 12, 21), BA46(left DLPFC: ch 14) Conclusion:Compared with HC group, the PFC in OAB group showed significant abnormalities, which may lead to "dyssynergia" of PFC internal functions, result in frontal lobe dysfunction, involving sensory integration, motivation drive, emotional control and decision whether to urinate or not, etc., leading to urinary control dysfunction, which manifested as typical clinical symptoms of OAB. Our findings contribute to the understanding of the central pathogenesis of OAB and may provide a theoretical basis for the emergence of targeted brain therapy in the future.

Uso de la uroflujometría en el estudio de síntomas del tracto urinario bajo en pacientes masculinos. Hospital Central Universitario Dr. Antonio María Pineda / Use of uroflowmetry in the study of lower urinary tract symptoms in male patients. Central University Hospital Dr. Antonio María Pineda

La uroflujometría es un estudio no invasivo del tracto urinario inferior que entrega información objetiva del flujo urinario y es ampliamente recomendado por las guías europeas en el estudio de pacientes con sintomatología urinaria baja. Se realizó un estudio descriptivo transversal cuyo propósito fue describir el uso de la uroflujometría en el estudio de síntomas del tracto urinario bajo en pacientes masculinos que acudieron a la consulta de Servicio de Urología del Hospital Central Universitario Dr. Antonio María Pineda de la ciudad de Barquisimeto, estado Lara durante el lapso 2018- 2019. La muestra estuvo conformada por 150 pacientes. Los resultados indican que el 62% de la muestra corresponde a pacientes entre 60 y 70 años de edad de los cuales 52% manifestaron síntomas urinarios leves. La uroflujometría evidenció que 56% de los pacientes tienen un flujo máximo entre 10 y 20 ml/seg lo cual sugiere una probable obstrucción al flujo de salida; 78% de los pacientes presentan un flujo promedio entre 0 a 10 ml/seg. El 53% de los pacientes mostró un volumen de vaciado < 300 ml y 49% un tiempo de flujo máximo entre 30 y 50 segundos. En conclusión, la uroflujometría es un examen simple y rápido que proporciona información útil sobre la salud de las vías urinarias inferiores(AU)

Uroflowmetry is a non-invasive study of the lower urinary tract that provides objective information on urinary flow and is widely recommended by European guidelines for the study of patients with lower urinary tract symptoms. We performed a cross-sectional descriptive study to describe the use of uroflowmetry for the study of lower urinary tract symptoms in males who attended the Servicio de Urología of the Hospital Central Universitario Dr. Antonio María Pineda (Barquisimeto, Lara state) during the 2018- 2019 period. The sample was made up of 150 males. The results show that 62% of the sample included males between 60 and 70 years old and 52% complained of mild urinary symptoms. Uroflowmetry results showed that 56% of patients had a maximum flow between 10 and 20 ml/sec suggestive of urinary tract obstruction; 78% had an average flow between 0 and 10 ml/sec while 53% had a micturition volume < 300 ml and 49% had a maximum flow time between 30 and 50 seconds. Uroflowmetry is a simple and fast test which provides useful information about the health of lower urinary tract(AU)

Effect of " trigger point" stimulation combined with idea training on the recovery of automatic micturition function for early stroke patients / 中国脑血管病杂志

Objective: To observe the effect of sensitive "trigger point" stimulation combined with idea training on the recovery of automatic micturition function in patients with dysuria after early stroke. Methods: Fifty-two patients with indwelling catheter after stroke met inclusion and exclusion criteria and admitted to the Rehabilitation Medical Center, the First Affiliated Hospital of Nanjing Medical University from January 2016 to April 2018 were enrolled prospectively. They were randomly divided into control group and treatment group according to the random number table (n = 26 each group). The control group was treated with clean intermittent catheterization after bladder function assessment. The observation group determined the sensitive "trigger point" by bladder pressure monitoring,carried out precise stimulation,and combined with the idea urination training,observed the recovery of automatic micturition and residual urine volume in the two groups at three and seven d of treatment. Results: (1) At three days of treatment, the observation group resumed automatic micturition with residual urine volume ≤50 ml,and the patients who resumed automatic micturition but had residual urine volume > 50 ml and the numbers of urinary retention were 15,10, and 1, respectively, and the control group was 6, 15, and 5, respectively. At seven days of treatment, the observation group resumed automatic micturition with residual urine volume ≤ 50 ml, but residual urine volume > 50 ml, and the numbers of urinary retention were 21,4, and 1, respectively, and the control group was 13,9 and 4,respectively. At three and seven days of treatment,the urination disorder in the observation group was significantly improved compared with the control group, and the difference was statistically significant (χ2 = 6. 47 and 5. 44 respectively, all P 50ml was lower than that of the control group (88 ±21 ml vs. 120 ± 47 ml,73 ±29 ml vs. 107 ± 42ml;t=2.233 and 2. 286, respectively, P = 0. 039 and 0.033 respectively). Conclusion: "Trigger point" stimulation induction combined with idea micturition training may promote the recovery of automatic micturition in patients with early stroke micturition disorder,and effectively reduce residual urine volume.

Association between low body mass indeX and flag－raising syncope in children and adolescents / 中华实用儿科临床杂志

Objective To discuss the relationship between body mass index(BMI)and flag_raising syncope ( PS)and micturition syncope(MS)in children and adolescents. Methods One hundred and six children and adoles_cents with PS or MS diagnosed at the Department of Dediatric Cardiovasology,Childrenˊs Medical Center,the Second Xiangya Hospital,Central South University from January 2003 to September 2017 were studied,including 51 males and 55 females,and their ages ranged from 5 to 18 years. There were 63 cases in the PS group(21 males and 42 females) and 43 cases in the MS group(30 males and 13 females). One hundred healthy children and adolescents including 50 males and 50 females who had routine healthy examinations at the hospital in the same period were selected as control subjects(healthy control group). Body length and body mass were measured,and BMI was calculated. Statistical inves_tigations were conducted with SDSS 22. 0 software. Results (1)The body mass and BMI in the PS group were lower than those in the MS group[(36. 33 ± 9. 85)kg vs.(42. 85 ± 12. 44)kg;(16. 56 ± 2. 41)kg∕m2 vs.(18. 48 ± 3. 04) kg∕m2],and the differences were statistically significant(F﹦7. 529,12. 411,all P〈0. 05). There was no difference in body length among the PS group,the MS group and the healthy control group[(146. 62 ± 12. 89)cm vs.(150. 79 ± 12. 78)cm vs.( 149. 75 ± 16. 02 )cm,F ﹦1. 314,P 〉0. 05 ]. No differences were found in age,frequency,body length,body mass and BMI between the PS syncope group and the MS group with different genders(all P〉0. 05).(2) The number of BMI_underweight children increased in the PS group(82. 53%,52∕63 cases)compared with that of the MS group(58. 14%,25∕43 cases)and that of the healthy control group( 52. 00%,52∕100 cases),and the difference was statistically significant(χ2 ﹦14. 556,P〈0. 01).(3)The positive rate by head_up tilt test(HUTT)was 72. 64%(77∕104 cases),and HUTT of the PS group was higher than that of the MS group[82. 53%(52∕63 cases)vs. 58. 14%(25∕43 cases)],and there was a significant difference statistically(χ2 ﹦7. 656,P〈0. 01). Conclusions Low BMI is prone to PS in children and adolescents.

Clinical observation on electroacupuncture at four sacral points for overactive bladder syndrome / 针灸推拿医学（英文版）

Objective:To observe the clinical effect of electroacupuncture (EA) at four sacral points on overactive bladder syndrome.Methods:A total of 120 female patients with overactive bladder syndrome were allocated to a treatment group of 80 cases and a control group of 40 cases on a voluntary basis.The patients in the treatment group received EA at four sacral points,and the treatment was given three times a week for 6 consecutive weeks,while the patients in the control group received oral administration of M-receptor antagonist tolterodine tartrate,which was given 4 mg each time,once a day for 6 consecutive weeks.Then the symptom scores were compared between the two groups before and after treatment.Results:At the end of treatment,the symptom scores showed statistical significant differences in comparing with those before treatment in both groups (both P＜0.01);the symptom score in the treatment group was lower than that in the control group,showing a statistically significant difference (P＜0.05).Conclusion:EA at four sacral points is an effective method for overactive bladder syndrome.

Synergistic Activities of Abdominal Muscles Are Required for Efficient Micturition in Anesthetized Female Mice / 대한배뇨장애요실금학회지

PURPOSE: To characterize the electromyographic activity of abdominal striated muscles during micturition in urethane-anesthetized female mice, and to quantitatively evaluate the contribution of abdominal responses to efficient voiding. METHODS: Cystometric and multichannel electromyographic recordings were integrated to enable a comprehensive evaluation during micturition in urethane-anesthetized female mice. Four major abdominal muscle domains were evaluated: the external oblique, internal oblique, and superior and inferior rectus abdominis. To further characterize the functionality of the abdominal muscles, pancuronium bromide (25 μg/mL or 50 μg/mL, abdominal surface) was applied as a blocking agent of neuromuscular junctions. RESULTS: We observed a robust activation of the abdominal muscles during voiding, with a consistent onset/offset concomitant with the bladder pressure threshold. Pancuronium was effective, in a dose-dependent fashion, for partial and complete blockage of abdominal activity. Electromyographic discharges during voiding were significantly inhibited by applying pancuronium. Decreased cystometric parameters were recorded, including the peak pressure, pressure threshold, intercontractile interval, and voiding duration, suggesting that the voiding efficiency was significantly compromised by abdominal muscle relaxation. CONCLUSIONS: The relevance of the abdominal striated musculature for micturition has remained a topic of debate in human physiology. Although the study was performed on anesthetized mice, these results support the existence of synergistic abdominal electromyographic activity facilitating voiding in anesthetized mice. Further, our study presents a rodent model that can be used for future investigations into micturition-related abdominal activity.

Central Regulation of Micturition and Its Association With Epilepsy / 대한배뇨장애요실금학회지

Micturition is a complex process involving the bladder, spinal cord, and the brain. Highly sophisticated central neural program controls bladder function by utilizing multiple brain regions, including pons and suprapontine structures. Periaqueductal grey, insula, anterior cingulate cortex, and medial prefrontal cortex are components of suprapontine micturition centers. Under pathologic conditions such as epilepsy, urinary dysfunction is a frequent symptom and it seems to be associated with increased suprapontine cortical activity. Interestingly, micturition can also trigger seizures known as reflex epilepsy. During voiding behavior, frontotemporal cortical activation has been reported and it may induce reflex seizures. As current researches are only limited to present clinical cases, more rigorous investigations are needed to elucidate biological mechanisms of micturition to advance our knowledge on the process of micturition in physiology and pathology.

Analysis of lower urinary tract disease of dogs / Análise de doenças do trato urinário inferior em cães

Lower urinary tract diseases (LUTD) include different conditions that affect the urinary bladder, urethra and prostate. The objective of this study was to determine the frequency of different related diseases, to characterize the population affected, and to determine risk factors in dogs. The clinical cases were diagnosed with LUTD through physical examination, and clinical laboratory and imaging studies. Male dogs had a greater predisposition to present a LUTD. Dogs from 3 months to 18 years with a median of 8 years were affected, and the most affected breeds were Poodle, Labrador, German shepherd, Schnauzer, Cocker Spaniel and Chihuahua. The LUTD presented with the following frequencies: bacterial urinary tract infection 34.02%; micturition disorders 22.68%; urolithiasis 20.61%; prostatic disease 14.43%; traumatic problems 8.24%. Sixty-seven per cent of the cases were specific diseases, such as uncomplicated and complicated bacterial urinary tract infections, urinary retention of neurologic origin and silica urolithiasis.(AU)

Doenças do trato urinário inferior (DTUI) incluem várias condições clínicas que afetam a bexiga, próstata e uretra. O objetivo deste estudo foi determinar a frequência de diferentes doenças relacionadas, caracterizar a população afetada, e determinar os fatores de risco em cães. Os casos clínicos com DTUI foram diagnosticados através de exame físico, estudos laboratoriais e de imagem. Os cães machos apresentam uma maior predisposição para DTUI. Foram afectados cães com idades compreendidas entre os 3 meses a 18 anos, com uma mediana de oito anos, sendo as raças mais predispostas os Poodle, Labrador, Pastor Alemão, Schnauzer, Cocker Spaniel e Chihuahua. A etiologia DTUI apresentou as seguintes frequências: 34,02% foram originadas em infecção do trato urinário inferior; 22,68% em distúrbios miccionais; 20,61% em urolitíase; 14,43% em doença prostática; 8,24% em problemas traumáticos. Sessenta e sete por cento dos casos de DTUI estavam associados a doenças específicas, tais como infecções bacterianas do trato urinário não complicadas e complicadas, retenção urinária neurogénica e urolitíase por sílica.(AU)

Tibial nerve stimulation to inhibit the micturition reflex by an implantable wireless drivermicrostimulator in cats / 中华泌尿外科杂志

Objective Objective To evaluate the effects of a new type of tibial nerve microstimulator on the micturition reflex in cats.Methods From March to May in 2017,the implantable wireless driver micro-stimulator was implanted around the tibial nerve in 9 α-chloralose anesthetized domestic shorthairs cats (2.5-3.5 kg,6-12 months old).The stimulator was placed near the neurovascular bundle parallel to the tibial nerve and its cathode perpendicular to the cushion.The intensity which can induce toe movement was defined as threshold (T).The ureters were isolated via an abdominal incision.The ureters were cut and drained externally.The bladder was inserted via a double lumen catheter through the urethra.The catheter was then secured by a ligature around the urethra.One lumen of the catheter was used to infuse the bladder with either 0.9％ normal saline (NS) or 0.25％ AA at a rate of 1 to 2 ml/min after connecting to a pump.The other lumen was connected to a pressure transducer to measure the bladder pressure.The bladder capacity was used to test the inhibitory effect of the stimulator.After the appearance of the first large-amplitude (＞ 30 cmH2O) bladder contraction,the bladder infusion was stopped.First,after emptying the bladder,2 or 3 cystometrograms with NS were performed without stimulation to obtain the control bladder capacity.After the bladder was stabilized,TNS (6 Hz,1-2 T) was applied during 2 sequential cystometrograms.Second,after emptying the bladder,0.25 ％ AA was infused into the bladder to irritate and induce bladder overactivity.After the bladder stabilized,TNS (6 Hz,1-2 T) was applied again during 2-3 sequential cystometrograms.If bladder capacity increased significantly,the stimulationhad an inhibitory effect on the micturition reflex.Results During normal saline infusion,the bladder baseline was (17.03 ± 4.10) ml.TNS at 1T did not change the bladder capacity [(18.56 ±0.81)ml] (P ＞0.05).TNS at 2T significantly increased the bladder capacity [(25.05 ± 1.19) ml] (P ＜ 0.05).Compared to normal saline infusion,bladder overactivity was irritated by the intravesical infusion of 0.25％ acetic acid,which significantly reduced the bladder capacity [(9.34 ± 0.75) ml] (P ＜ 0.05).Compared to acetic acid infusion,TNS at 1T did not change the bladder capacity [(11.32 ± 0.82) ml] (P ＞ 0.05).TNS at 2T significantly increased the bladder capacity [(14.82 ± 1.15) ml] (P ＜ 0.05).Conclusions The implantable wireless driver tibial nerve micro-stimulator appears to be effective in inhibiting the micturition reflex during physiologic and pathologic conditions.The implantable wireless driver tibial nerve microstimulator was excepted to be used to treat overactive bladder (OAB).

Contexto escolar e hábitos miccionais: estudo transversal com escolares do distrito federal / Contexto escolar y hábitos miccionales: estudio transversal con escolares del distrito federal / School setting and voiding habits: a cross-sectional study among school-aged children from the federal district

RESUMO Estudo transversal realizado em oito escolas públicas e particulares do Riacho Fundo,(Distrito Federal),com escolares deseis a 12 anos, com o objetivo de avaliar a frequência de ida e permissão para uso do toalete na escola, sob a perspectiva do escolar, assim como mensurar a taxa de ocorrência e o impacto da experiência de ter tido alguma vez na vida um evento de perda urinária no contexto escolar. A coleta de dados incluiu entrevista por meio de perguntas-chave desenvolvidas pelas pesquisadoras. A análise dos dados incluiu técnicas básicas de análise exploratória de dados como,frequência absoluta e relativa, calculadas no programa Statistical Package for the Social Sciences. Das 86 crianças participantes da pesquisa, 73% (n=63) relataram irtodos os dias ao toalete escolar, ao passo que as que afirmam não utilizar o toalete apontaram como justificativas a falta de vontade, a falta de papel higiênico nos toaletes e a falta de privacidade ou problema com as portas. Quanto à permissão para o uso do toalete, 66% (n=57) afirmaram poder ir sempre que tivessem vontade. A experiência de perda urinária na escola foi relatada por17 (20%) crianças e apresentou impacto altamente negativo sob a perspectiva do escolar.

RESUMEN Se realizó un estudio transversal en 8 escuelas públicas y privadas del Riacho Fundo (Distrito Federal) con escolares de 6 a 12 años que tuvo como objetivo evaluar la frecuencia de idas y permiso al baño en la escuela bajo la perspectiva del escolar, así como medir la tasa de ocurrencia y el impacto de la experiencia de haber tenido alguna vez en la vida pérdida urinaria en el contexto escolar. La recolección de datos incluyó entrevistas con preguntas claves desarrolladas por los investigadores. El análisis de datos incluyó las técnicas básicas de análisis exploratorio de datos como la frecuencia absoluta y relativa, calculada utilizando el programa Statistical Package for the Social Sciences. De los 86 niños participantes, el 73% (n = 63) informaron ir todos los días al baño de la escuela, las justificaciones para no ir fueron falta de voluntad, la falta de papel higiénico y la falta privacidad o problemas con las puertas. En referencia al uso del baño, el 66% (n = 57) dijo que podían ir cuando tuviesen necesidad. La experiencia de pérdida urinaria en la escuela fue reportada por 17 (20%) niños y presentó un impacto muy negativo desde la perspectiva del escolar.

ABSTRACT This was a cross-sectional study conducted in 8 public and private schools of Riacho Fundo (Federal District), with children between 6 and 12 years old, that aimed to evaluate their frequency of going to the school restroom and permission to use it from the children's perspective, as well as to measure the rate of occurrence and impact of the experience of having had some once in a lifetime urinary leakage in the school setting. Data collection included interviews with key questions developed by the researchers. Data analysis included basic techniques of exploratory data analysis such as absolute and relative frequencies calculated using the Statistical Package for Social Sciences program. Out of 86 participating children, 73% (n = 63) reported going every day to the school restroom while those reporting not going pointed out reasons as they did not need to, lack of toilet paper, and lack of privacy or problems with the stalls' doors. Regarding permission to use the restroom, 66% (n = 57) stated being allowed to go whenever they needed. The experience of urinary incontinence at school was reported by 17 (20%) children and presented as a highly negative impact from their perspective.

Micturition Induction Therapy for Recovery of Continence in Stroke Patients without Uresiesthesia : A Retrospective Study / The Japanese Journal of Rehabilitation Medicine

<p>Objective：To investigate the efficacy of micturition induction therapy (MIT) for recovery of urinary continence in stroke patients without uresiesthesia.<br>Methods：We retrospectively examined the efficacy of MIT for recovery of continence in stroke patients without uresiesthesia and assessed improvement in the Functional Independence Measure (FIM) score in 201 stroke patients admitted to our rehabilitation hospital.<br>Results：Of the 201 patients, 160 had uresiesthesia. The 41 patients without uresiesthesia were significantly older and had lower FIM scores on admission than those with uresiesthesia. Of 41 patients without uresiesthesia, 15 received MIT. There was no difference between the groups in terms of age or FIM scores on admission. Nine of 15 (60％) patients who received MIT recovered continence, whereas only 7 of 26 (26.7％) who did not receive MIT recovered continence. MIT was significantly effective for recovery of continence in patients without uresiesthesia (<i>p </i>＜0.05). The gain in FIM scores was significantly higher in patients who recovered continence than in those who did not recover continence, irrespective of whether MIT was provided (<i>p </i>0.05).<br>Conclusion：MIT was effective for recovery of uresiesthesia and continence in patients without uresiesthesia after stroke.</p>

The age and mode of presentation of benign prostatic hyperplasia at Hubli in Karnataka.

Background: The peculiarities of the prostate are that in old age when most of organ regresses in size it enlarges and causes trouble. By virtue of its position, it guards outlet of urinary bladder. It must be admitted that even today the extent nature of etiology, pathogenesis and diagnosis are all-debatable. Therefore, the present study was aimed at elucidating the age and mode of Benign Prostatic Hyperplasia among the patients in and around Hubli, Karnataka. Methods: The study was conducted after the institutional ethical committee approval and written informed consent from all the patients. 21 cases of BPH were included in the present study. The signs and symptoms of mode of presentation were recorded. The urine was examined for the presence of albumin, pus cells, epithelial cells and RBCs. Results: The maximum incidence of the disease was in the age group of 60-69 years. Majority of the patients had difficulty in micturition followed by increased frequency of micturition both during day and night Patient with retention usually had distension of bladder. These patients complained of dull aching pain in the suprapubic area and in the groin region. Burning micturition (14.28%), dribbling of urine (4.76%), urgency (4.76%), and haematuria (4.76%) were present. Routine urine examination showed albumin (28.56%), pus cells (23.80%), epithelial cells (19.04%) and haematuria (4.76%). Conclusion: Incidence of BPH at Hubli region of Karnataka is 0.3001% of total hospital admission. The maximum age incidence of BPH is in the age group of 60-69 years. Majority of the patients had difficulty in micturition increased frequency of micturition both during day and night a large number of cases show association with presence of urinary tract infection.

Thunderclap-like headache triggered by micturition and angina as an initial manifestation of bladder pheochromocytoma. A case report / Cefaleia trovoada-símile desencadeada pela micção e angina como manifestação inicial de feocromocitoma de bexiga. Um relato de caso

CONTEXT: Pheochromocytoma is a catecholamine-producing tumor characterized by hypertension, headache, tachycardia, excessive diaphoresis and angina. The thunderclap headache is so named because the pain strikes suddenly and severely. Although the symptoms of bladder pheochromocytoma are rather evident, the diagnosis of this rare neuroendocrine tumor can be missed. CASE REPORT: This study reports the case of a woman diagnosed with bladder pheochromocytoma who experienced thunderclap headache triggered by micturition and angina as an initial manifestation. CONCLUSION: This case study suggests that thunderclap headache and angina occurring concurrently with sudden blood pressure elevation during or immediately after micturition are important diagnostic clues for bladder pheochromocytoma. .

CONTEXTO: Feocromocitoma é um tumor produtor de catecolaminas, caracterizado por hipertensão, cefaleia, taquicardia, sudorese excessiva e angina. A dor de cabeça trovão é assim chamada porque a dor ataca de repente e intensamente. Embora os sintomas de feocromocitoma de bexiga sejam bastante evidentes, o diagnóstico deste tumor neuroendócrino raro pode ser perdido. RELATO DE CASO: Este estudo relata o caso de uma mulher diagnosticada com feocromocitoma na bexiga que sentiu a dor de cabeça trovão, desencadeada pela micção e angina como manifestação inicial. CONCLUSÃO: Este estudo de caso sugere que a dor de cabeça trovão e angina ocorrendo simultaneamente com a elevação da pressão de sangue repentina durante ou imediatamente após a micção são dicas importantes de diagnósticos de feocromocitoma na bexiga. .

Contexto escolar e sintomas de trato urinário inferior: Revisão integrativa da literatura / The school context and lower urinary tract symptoms: An integrative literature review / Contexto escolar y síntomas de tracto urinario inferior: revisión integrativa de la literatura

Trata-se de uma revisão integrativa com o objetivo de identificar fatores associados à ocorrência de sintomas de trato urinário inferior em crianças no contexto escolar. A busca foi realizada em novembro de 2013, nas bases de dados: Medical Literature Analysis and Retrievel System Online, Cumulative Index to Nursing and Allied Health Literature e Literatura Latino-Americana e do Caribe em Ciências da Saúde, sem emprego de limite temporal. A amostra foi composta por 12 artigos. A maioria dos estudos abordou medidas de prevalência segundo sexo, faixa etária e sintoma investigado. Também foram identificadas três categorias temáticas: fatores associados aos sintomas urinários, condições para uso do toalete na escola, e percepção de professores e enfermeiros escolares quanto a padrões de eliminação infantil. A literatura aponta a influência do contexto escolar no comportamento miccional da criança, sendo o enfermeiro escolar citado como um agente estratégico na promoção de hábitos miccionais saudáveis na infância (AU).

This is an integrative review undertaken with the objective of identifying factors associated with the occurrence of lower urinary tract symptoms among children in the school context. The search was undertaken in November 2013, in the following databases: Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health, and the Latin American and Caribbean Center on Health Sciences Information, without the use of a time limit. The sample was made up of 12 articles. The majority of the studies addressed measures of prevalence according to sex, age range and symptom investigated. Three thematic categories were also identified: factors associated with urinary symptoms, conditions for using toilets in school, and the perception of teachers and school nurses regarding patterns of child elimination. The literature indicates the influence of the school context on children's micturition behavior, the school nurse being mentioned as a strategic agent in the promotion of healthy micturition habits in childhood (AU)

Es una revisión integrativa cuyo objetivo fue identificar factores asociados a la ocurrencia de síntomas de tracto urinario inferior en niños en el contexto escolar. La búsqueda fue realizada en noviembre de 2013, en las bases de datos: Medical Literature Analysisand Retrievel System Online, Cumulative Index to Nursing and Allied Health Literature y Literatura Latinoamericana y de Caribe en Ciencias de la Salud, sin empleo de límite temporal. La muestra fue compuesta por 12 artículos. La mayoria de los estudios abordó medidas de prevalencia de acuerdo al sexo, a la franja etaria y síntoma investigado. También fueron identificadas tres categorías temáticas: factores asociados a los síntomas urinarios, condiciones para uso del baño en la escuela, y percepción de profesores y enfermeros escolares acerca de comportamientos de eliminación infantil. La literatura apunta la influencia del contexto escolar en el comportamiento de micción del niño, siendo el enfermero escolar citado como un agente estratégico en la promoción de hábitos de micción saludables en la infancia (AU)

Observations on the Therapeutic Effect of Electroacupuncture at Specific Points on Urgency-frequency Syndrome / 上海针灸杂志

Objective To investigate the clinical efficacy of electroacupuncture at specific points in treating different degrees of urgency-frequency syndrome. Methods Sixty patients with urgency-frequency syndrome were randomly allocated, according to the symptom score, to groups A (the symptom score≤ 24) and B (the symptom score>24), 30 cases each. Both groups received electroacupuncture at specific points (four sacral points and four abdominal points). In the two groups, the symptoms were scored before and after treatment and the clinical therapeutic effects were evaluated.Results There was a statistically significant pre-/post-treatment difference in the symptom score in the two groups (P0.05).Conclusion Electroacupuncture at specific points is an effective way to treat urgency-frequency syndrome.

Effect of Warming on Detrusor Muscle Contraction and the Micturition Reflex in Rats / 日本温泉気候物理医学会雑誌

<b>Objectives:</b> To investigate the effect of warming on contraction of the detrusor muscle and the micturition reflex in rats.<BR><b>Methods:</b> Female Sprague-Dawley rats were used in this study. Changes in the contractile response of detrusor smooth muscle strips to 40 mM KCl caused by warming to 40°C and 42°C were evaluated by an isometric tension recording study. The effect of intravesical warming at 40.7±1.0°C on the micturition reflex was evaluated by continuous infusion cystometry in conscious rats.<BR><b>Results:</b> Warming to 40°C and 42°C inhibited 40 mM KCl-induced contractions of detrusor smooth muscle strips by 10% and 15.5%, respectively. Intravesical warming at 40.7±1.0°C decreased the pressure threshold for inducing micturition by 14%, resting pressure by 30%, closing peak pressure by 22%, 2nd phase contraction duration by 36%, bladder contraction duration by 26%, and increased bladder compliance by 17%. Maximal voiding pressure and 1st phase contraction duration were unaltered.<BR><b>Conclusions:</b> Our results demonstrated that warming relaxed the detrusor muscle and increased bladder compliance. This suggests that warming might be useful for treatment of low compliance bladder observed in the neurogenic bladder due to neurological diseases such as spinal cord injury. To clarify the usefulness of warming or hot springs for the treatment of neurogenic bladder, the effect of warming on the body surface on the micturition reflex should be investigated.