ABSTRACT
OBJECTIVES@#The objectives of this study were to compare the voiding pattern of toilet-trained patientswith and without recurrent UTI, to describe the voiding pattern of toilet-trained patients withoutUTI aged 2 to 15 years old and to describe the voiding pattern of toilet trained patients with recurrentUTI aged 2 to 15 years old.@*MATERIALS AND METHODS@#A total of 80 toilet-trained Filipino children divided into two groups with 40each were included. R-UTI group consisted of patients aged 2 to 15 years old who presented withrecurrent UTI. The control (No-UTI) group consisted of children aged 2 to 15 years old without anyurinary symptoms and without history of urinary tract infection. Parents completed a 72-hour bladderchart at home. All participants answered Farhat's DVSS. Patients underwent uroflowmetry,uroflowmetry with EMG and post void residual assessment (PVR). Qmax, uroflowmetry pattern,bladder wall thickness and PVR were recorded and analyzed using independent t-test.@*RESULTS@#The mean age of subjects with UTI was 6.32 ± 2.77 years and those in the control group havea mean age 6.67 ± 2.77 years old. Of patients of R-UTI group the following were statisticallysignificant compared to No-UTI : Constipation (48% vs 15%), mean frequency of voiding volumesgreater than 125% of the estimated bladder capacity (EBC) at daytime (0.8 ± 0.22 vs 0.05 ± 1.20p=0.0002), frequency (45% vs 5%), mean average voided volume (126.54 ± 56.05 mL vs 84.34 ±34.26 mL p=0.0001), mean daytime average voided volume (121.33 ± 59.59 mL vs 87.90 ± 36.41mL p =0.0033), mean maximum voided volume (232.25 ± 113.99 mL vs 130.85 ± 49.99 mLp<0.0001), mean bladder thickness (3.83 ± 0.68 mm vs 3.38 ± 0.62 mm p = 0.0030), mean PVR(12.96 ± 10.54 mL vs 5.21 ± 5.68 mL p=0.0001). PVR was significant in 45% of cases compared to3% significant PVR (when 4-6 years old defined as >10ml or >10%of EBC, and if >7 years old >20mlor >15% of EBC). When mean PVR was computed as percentage of EBC, R-UTI group had astatistically higher percentage compared to the no-UTI group (6.27 ± 2.52 % vs 2.52 ± 2.75 %p=0.0001). Mean observed bladder capacity (OBC) was found to be more than the EBC in 35% ofcases in the R-UTI group compared to 12% of No-UTI group (p=0.018). Uroflow-EMG in the R-UTI group were, 85% synergic, 12% dyssynergic and 3% interrupted pattern. EMG in the No-UTIgroup were, 38% synergic, 55% dyssynergic, 2% delayed relaxation, 5% interrupted. The EMGpatterns were statistically significant between the groups (p<0.0001). Uroflow patterns werecomparable between the two groups (p=1.000).@*CONCLUSION@#Constipation was more frequent in the R-UTI group. R-UTI group had a higher meanfrequency of EBC > 125% during daytime, frequency, mean average voided volume, mean averagevoided volume during daytime, mean maximum voided volume, mean bladder thickness, mean PVRcompared to the without UTI group. Mean observed bladder capacity was observed to be greater thanthe EBC in the R-UTI group compared to the No-UTI group. R-UTI group was synergic compared toNo-UTI group which were dyssynergic.
ABSTRACT
Lower urinary tract symptoms (LUTS),consisting storage,voiding and postmicturition symptoms,is a comprehensive definition involving multiple organs.There has been an increasing emphasis on the integrated management of non-neurogenic male lower urinary tract symptoms.Instead of focusing on the enlarged prostate,the current treatment has paid more attention on the entire urinary tract as well as multiple organ factors.Therefore,we provided a literature review and summarized the key points during the management of male LUTS as 3B,namely beyond prostate,beyond surgery and beyond urology.
ABSTRACT
Irritative voiding symptoms, urinary urgency, frequency, nocturia, painful voiding, bladder discomfort or stranguria, are to the urinary tract much as a cough is to the pulmonary system, i.e., they are a nonspecific manifestation of multiple potential underlying causes. Urinary tract infections (UTIs) are usually associated with irritative voiding symptoms, such as painful urination (dysuria), urinary urgency and frequency. Anticholinergic drugs like flavoxate, oxybutynin provide beneficial symptomatic relief. However, they have associated adverse anticholinergic effects, such as dry mouth, which hinders patient compliance. Phenazopyridine hydrochloride acts as a topical analgesic on the mucosal lining of the urinary tract and thus relieves the irritative symptoms associated with UTI. It is compatible with antibiotics and relieves pain during the interval before the antibiotic begins to control the infection. It is well-tolerated as it lacks the anticholinergic side effects of other anticholinergics.
ABSTRACT
PURPOSE: There is no consensus about a definition of benign prostatic hyperplasia, but there are various definitions based on a combination of clinical parameters used to describe the properties of BPH: symptoms of prostatism, increase of prostate volume, and bladder outlet obstruction. The prevalence of clinical BPH in Asian was believed to be lower than Caucasian. The lower urinary tract symptoms associated with BPH in Korea was reported by some authors and it was similar to the results of other studies in western countries. We report the prevalence of BPH in Korean men through a community-based study in Jeong-Eup county, Korea. MATERIALS AND METHODS: A total of 653 men aged 50 and over in Jeong-Eup area, Korea was randomly selected for determination of the prevalence of BPH. The definition of BPH in this study was combination of moderate(8-19) to severe(>19) I-PSS, enlargement of the prostate over 30gms on digital rectal examination by one board certified urologist, and decreased peak flow rate below 15ml/sec. Men with abnormal digital rectal examination(DRE) and elevated serum prostate specific antigen(PSA) above 3.5ng/ml were undergone sextant prostate biopsy to exclude the prostate cancer. RESULTS: I-PSS questionnaires were completed in 431 men and the response rate was 66.1%. Based on I-PSS, 162 men(37.6%) had moderate symptoms and 51 men(11.9%) severe symptoms. Of 213 men with moderate to severe symptoms, 35.7% had enlarged prostate by DRE, and 63.1% decreased flow rate. The prevalence of BPH by the definition in this study was 4.3% in their fifties, 13.2% in sixties and 16.3% in seventies and over eighty(overall, 11.1%). The population-adjusted prevalence of BPH in Korean men aged 50 and over was 8.7%. A good correlation was found between the total symptom score and the quality of life score that is included in the I-PSS. CONCLUSIONS: Men with moderate to severe I-PSS was 49.5%, which was similar to the results from other studies in Caucasian and Japanese. The prevalence of BPH in Korea by aforementioned definition was 8.7%, which seems to be lower than Caucasian. This results suggest that approximately 1,600,000 Korean men had moderate to severe urinary symptoms and 300,000 clinical BPH by the definition in this study.