Evaluating bladder function is important in prostatic hyperplasia surgery / 现代泌尿外科杂志

Benign prostatic hyperplasia (BPH) may lead to benign prostatic obstruction (BPO), which may result in bladder dysfunction. Based on the urodynamic analysis of bladder function of 793 BPO patients, bladder function could be classified into 3 stages and 6 types. Detrusor overactivity with impaired contractility (DHIC) is the transitional period of bladder function from compensation to decompensation. The indications of surgical therapy of bladder outlet obstruction (BOO) in different guidelines do not consider the bladder function. This paper emphasizes the importance of bladder function in the surgical choices for BOO, in order to select targeted and individualized surgical methods, and discusses the choice of surgical treatment for BPO from the perspective of bladder function.

Urodynamic evaluation of functional urinary incontinence in children / 现代泌尿外科杂志

Pediatric urinary incontinence (PUI) is common in clinical practice and seriously affects the quality of life as well as physical and mental health of patients. PUI is a multi-factorial related abnormality, very complex in etiology and types. The occurrence of PUI is mostly associated with abnormal vesicourethral function. Urodynamic examination (UDS) is the golden standard to assess voiding function and diagnose the type of bladder and urethral function in children with PUI. UDS of PUI is of great clinical value in determining the cause, making treatment protocol as well as evaluating the therapeutic response. However, UDS in children has not been popularized in China, which seriously affects the diagnosis and treatment of PUI. This article reviews the research progress in the clinical application of UDS in the evaluation of PUI, in order to provide reference for improving the diagnosis and treatment of this disease.

Timing of urinary catheter removal after radical hysterectomy for cancer of the cervix and uterus: A single-institution observational study / Philippine Journal of Obstetrics and Gynecology

Background and Objective@#Radical hysterectomy remains to be the first surgery for early‑stage cervical and selected stage 2 endometrial carcinoma. Functional disorders of the lower urinary tract are the foremost common complications following radical surgery necessitating catheterization. This study was undertaken to determine the number of postoperative days (POD) of the removal of urinary catheters after hysterectomy and assess the practicability of earlier removal of the catheter without compromising the bladder function@*Methodology@#A descriptive observational study of patients who underwent Type 2 or 3 hysterectomy for cervical or endometrial carcinoma. Clinical, intraoperative, and anesthesia records and results of the histopathologic reports of every patient were reviewed. Demographic, clinical, and histopathologic data needed during this review were recorded. Descriptive statistics were used.@*Results@#Between January 2016 and December 2019, a complete 45 patients underwent radical hysterectomy (43 patients for cervical cancer and a pair for endometrial carcinoma), with a median age of 50 years. The mean operative time is 2.5 h and also the average blood loss is 500 ml. The mean size of the cervical tumor was 2.2 cm, the mean length of the vagina was 2.5 cm, and the mean lateral width of parametria was 3.6 cm. Catheters were removed between the 3rd and 20th (mean = 6 days) POD. All patients had adequate spontaneous void within 6 h after removal. Five patients had their catheters removed beyond 7 days, 3 patients between POD 8 and POD 14, and 2 patients between days POD 15 and POD 20. All patients were able to return to bladder function within 3 weeks of catheterization.@*Conclusion@#The outcome showed that earlier removal of catheter seems to be a practical and safe option compared to long‑term catheterization for patients who underwent radical hysterectomy without causing morbidities

Research on the application of bladder volume evaluation under ultrasound radiography for early removal of indwelling catheter in critical patients / 中国实用护理杂志

Objective@#To evaluate the influence of bedside ultrasound on indwelling catheter removal and bladder function recovery for critically ill patients with long-term indwelling catheter.@*Methods@#Use random sampling to choose 92 patients during October 2018 to December 2018 as research objects, objects were allocated into observation group and control group by random digits table method with 46 cases each. All patients had their indwelling catheter clamped 72 hours after insertion as per routine practice, control group had clamp opened and indwelling catheter drained third hourly during the day and fourth hourly through the night; for patients in observation group, bladder volume were evaluated with USS scanner hourly, indwelling catheter was opened and drained when bladder urine volume was about 300 ml, use the shortest bladder-filling time as the interval for indwelling catheter opening time, increasing the interval by one hour through the night. the leakage rate, first urination time, first urination volume, bladder residual volume, indwelling catheter reinsertion rate, voluntary urination rate for patients from two groups were compared.@*Results@#The incidence of urinary leakage in the observation group was 7.14%(3/42),which lower than that in the control group (25.58%, 11/43), the difference was statistically significant (χ2=5.251, P<0.05). The residual urine volume in the bladder was 16 (8.50, 37.00) ml in the observation group, which lower than that in the control group 41 (13.75, 130.25) ml, the difference was statistically significant (t=2.103, P<0.05). The rate of self-urination was 57.15%(24/42) in the observation group, which higher than that in the control group (34.88%,15/43), the difference was statistically significant (χ2=4.24, P<0.05). Induced urination rate and urethral replacement rate were 7.14%(3/42), 11.9%(5/42), 30.95%(13/42) in the observation group and 9.3%(4/43), 16.28%(7/43), 48.84%(21/43) in the control group respectively. There was no significant difference between the two groups (χ2= 0.131, 0.335, 2.832, P > 0.05). The first urination time was (144.66± 66.13) in the observation group and (179.55± 87.50) in the control group, respectively. There was no significant difference between the two groups(t= 1.623, P > 0.05).@*Conclusions@#The use of bedside USS scan to evaluate the bladder volume of critical patients with indwelling catheter can help facilitate early indwelling catheter removal and encourage patients to regain bladder function.

Robot-assisted training can improve the bladder and intestinal functions of paraplegic patients / 中华物理医学与康复杂志

Objective To explore the clinical effect of training assisted by a lower limb rehabilitation robot on the bladder and intestinal function of paraplegic spinal cord injury survivors. Methods Thirty-eight paraplegic patients with spinal cord injury were divided according to their admission order into an experimental group ( n=19) and a control group (n=19). Both groups were given conventional rehabilitation training, while the experimental group was additionally provided with robot-assisted lower limb training in three stages:adaptation, training and con-solidation. It lasted 30 minutes daily, 5 days per week for 12 weeks. Before and after the training, an urodynamics examination system was used to evaluate the maximum urine flow, bladder capacity, residual urine volume, bladder pressure and detrusor pressure. Colon transit time, mean rectal pressure and intestinal function were measured using the colon transit test, a mean rectal pressure test, and the Functional Independence Measure ( FIM) scale respective-ly. Results The average bladder volume, maximum urine flow rate, average urine flow rate, detrusor pressure, bladder compliance, average rectal pressure and intestinal FIM score of the robot training group after training were all significantly better than before the training, as were the average residual urine volume and colon transit time. After the training, the average bladder volume, maximum urine flow rate, average urine flow rate, detrusor pressure, bladder compliance and average rectal pressure of the robot training group were all significantly higher than those of the control group, while the average residual urine volume and colon transit time were significantly smaller. Then, 32％ of the patients in the experimental group achieved no less than 6 points for their average FIM score, significantly higher than in the control group. Conclusion Robot-assisted lower limb training combined with comprehensive rehabilitation training can effectively improve the bladder and intestinal function of paraplegic patients after a spinal cord injury.

Construct bladder function training model of orthotopicilealneobladder according to the results of urodynamic examination / 中华泌尿外科杂志

Objective To stage orthotopicilealneobladder function and construct the corresponding training mode according to the results of urodynamic examination.Methods 38 patients with bladder cancer underwent radical resection+orthotopicilealneobladder surgery between August 2013 and August 2017,and the urodynamic examination results of 3 months,6 months,1 year,2 years,3 years of were retrospectively analyzed.The bladder function of the patients with orthotopicilealneobladder was staged according to urodynamic examination,and the bladder function training mode was formed.Results As the follow-up time increased after surgery,day/night urine control increased,the maximum urine flow rate,the average urine flow rate increased,urination time shortening,bladder capacity increased,bladder basic pressure decreased,bladder filling state pressure,bladder compliance increased,micturition maximal bladder pressure,maximum abdominal pressure and maximum detrusor pressure increased,and all the indexes tended to be stable after 1 year.Bladder function training orthotopicilealneobladder is divided into four periods,respectively are Hospitalization period,recovery period(3 months after surgery),rehabilitation period(3 months to 1 year after surgery),stable period(1 year after surgery),and formed different stages of orthotopicilealneobladder bladder function training content.The focus nursing of each stage is that early period-drainage tube care,recovery period-incontinence care,rehabilitation period-urinary training,stable period-complications handling.Conclusions According to the results of urodynamic examination,it is possible to propose a targeted,scientific and practical bladder function training model for the orthotopicilealneobladder.

"3+1" bladder function restoration combined with holmium laser enucleation of the prostate for benign prostatic hyperplasia with acontractile detrusor / 中华男科学杂志

Objective@#To investigate the clinical effect of "3+1" bladder function restoration combined with holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with acontractile detrusor (ACD).@*METHODS@#We treated 35 BPH patients with ACD by HoLEP followed by "3+1" bladder function restoration, that is, a 3-phase bladder function training plus simultaneous 1-drug medication after surgery. We recorded and analyzed the detrusor pressure, post-void residual urine volume (PVR), maximum urinary flow rate (Qmax), International Prognostic Scoring System (IPSS) scores, quality of life (QoL), voluntary micturition, satisfaction with the bladder function, hydronephrosis, ureterectasia, renal function, and urinary tract infection of the patients before and after treatment.@*RESULTS@#Compared with the base line, at 6 months treatment, the patients showed significantly increased detrusor pressure (［35.1±2.7］vs ［50.2±2.3］ cmH2O, P<0.05) and Qmax (［4.2±2.7］vs ［21.1±4.1］ ml/s, P<0.05) but decreases in PVR (［173.0±31.6］ vs ［30.5±12.9］ml, IPSS score (27.3±3.2 vs 5.1±1.4, P<0.05) and QoL (4.1±0.8 vs 0.8±0.1, P<0.05), elevated rates of voluntary urination (0% ［0/35］ vs 100% ［35/35］, P<0.05), regularurination (0% ［0/35］ vs 85.71% ［30/35］, P<0.05), grade Ⅰ satisfaction with bladder function (0% ［0/35］ vs 85.71% ［30/35］, P<0.05), reduced rate of overflowing urinary incontinence (28.57% ［10/35］ vs 5.71% ［2/35］, P<0.05), and increased percentages of normal renal function (34.29% ［12/35］ vs 85.71% ［30/35］, P<0.05) and non-infection of the urinary system (17.14% ［6/35］ vs 94.29% ［33/35］, P<0.05). After treatment, urination was markedly improved in 94.29% (33/35) of the patients.@*CONCLUSIONS@#"3+1" bladder function restoration combined with HoLEP produced a desirable effect on BPH with ACD, though its long-term effect remains to be further investigated.

Clinical study on post-stroke urinary retention treated with acupuncture at the twelve-well points and bladder function training / 中国针灸

<p><b>OBJECTIVE</b>To explore the methods for the therapeutic effect improvement in the treatment of post-stroke urinary retention.</p><p><b>METHODS</b>Sixty-three patients of post-stroke urinary retention were randomized into an observation group (32 cases) and a control group (31 cases). The routine clinical medication of neurology and basic rehabilitation were adopted in the two groups. Additionally, in the control group, the intermittent urinary catheterization and bladder function training were applied. The duration and frequency of catheterization were determined by the autonomic urination and residual urine volume every day. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to the twelve-well points in the sequence offlowing among the twelve meridians [Shaoshang (LU 11), Shangyang (LI 1), Lidui (ST 45), Yinbai (SP 1), Shaochong (HT 9), Shaoze (SI 1), Zhiyin (BL 67), Yongquan (KI 1), Zhongchong (PC 9), Guanchong (TE 1), Zuqiaoyin (GB 44) and Dadun (LR 1)]. Acupuncture was given once a day, 20 treatments were required. In 20 treatments, the clinical therapeutic effects and the residual urine volume were observed.</p><p><b>RESULTS</b>The total effective rate was 90.6% (29/32) in the observation group, better than 67.7% (21/31) in the control group (<0.01)). After treatment, the residue urine volume was all reduced apparently in the patients of the two groups (both<0.01). The result of the residue urine volume in the observation group was lower apparently than that in the control group (<0.01).</p><p><b>CONCLUSION</b>Acupuncture at the-well points in the sequence offlowing among meridians combined with bladder function training achieve the apparent therapeutic effects on post-stroke urinary retention. The results are better than those achieved by the routine western medicine with bladder function training involved.</p>

Effect of initiative bladder function training on uroschesis and urinary tract infections after caesarean section / 现代临床护理

Objective To evaluate the effect of initiative bladder function training on uroschesis and urinary tract infections after caesarean section. Methods Toally 200 puerperas with caesarean section and indwelling catheter were divided into observation group and control group, 100 cases in each group. The control group was given passive bladder function training, and the observation group was given initiative bladder function training. The two groups were compared in terms of postoperative infections in the urinary tract, time for first micturition, residual urine volume and micturition effect. Result After intervention, the rate of urinary tract infections in the observation group was lower than that of the control one , the time for and effect of first micturition were shorter and better than those of in the control group, the residual urine volume was shorter (P<0.05). Conclusion The initiative bladder function training by exercising abdominal muscle combined with levator ani muscle exercise can effectively promote the recovery of bladder function and reduce uroschesis and the rate of postoperative urinary tract infections.

Effects of Acupuncture in Different Stages on Pelvic Floor Muscles and Urinary Function in Patients with Spinal Cord Injury / 中国康复理论与实践

Objective To investigate the therapeutic effects of acupuncture on pelvic floor muscles and urinary function in patients with spinal cord injury. Methods From March, 2012 to March, 2015, 23 patients with spinal cord injury were divided into control group (n=8), early intervention group (n=8) and later intervention group (n=7). The control group received routine rehabilitation, the intervention groups received acupuncture at Baliao (BL-31, BL-32, BL-33 BL-34), Yanglingquan (GB-34), Sanyinjiao (SP-6) and Taichong (LR-3) acupoints in addition. The early intervention group was acupunctured one week before removal of catheter, and the later intervention group adopted inter-mittent catheterization after removal of catheter, and then received acupuncture. The pelvic floor muscles strength, the urine function and quality of life were recorded before and six weeks after intervention. Results There was no significant difference in all the indices before in-tervention (P>0.05). After intervention, the pelvic floor muscles strength improved in the intervention groups compared with the control group (P0.05). The quality of life improved in all the groups after inter-vention (F>0.864, P<0.05), however, no significant difference was found among three groups (F=1.558, P<0.05). Conclusion Acupuncture, especially early acupuncture, could improve the pelvic floor muscle strength and bladder function in spinal cord injury patients.

Urodynamic characteristics of awake rats under retrained versus freely moving condition: Using a novel model / 华中科技大学学报（医学）（英德文版）

Urodynamic investigation in conscious rats is widely employed to explore functional bladder disorders of various etiologies and pathogeneses. Rats can be placed in restraining cages or wide cabinets where they are allowed to move freely during cystometry. However, the requirements of special devices hampered the application of urodynamic test in freely moving rats, and whether the restraint has any effects on urodynamic parameters in conscious rats remains obscure. In the present study, we described a novel approach for urodynamic investigation in both restrained and freely moving conscious rats. In addition, we for the first time systematically compared the urodynamic parameters of rats in the two conditions. With the current method, we successfully recorded stable and repeatable intravesical pressure traces and collected expected reliable data, which supported the idea that the restraint does not affect the activity of the micturition reflex in rats, provided sufficient and appropriate measures could be applied during cystometry. Fewer technique problems were encountered during urodynamic examination in restrained rats than in freely moving ones. Taken together, conscious cystometry in rats placed in restraining cages with proper managements is a reliable and practical approach for evaluating the detrusor activity and bladder function.

Comparison of Mechanical Allodynia and Recovery of Locomotion and Bladder Function by Different Parameters of Low Thoracic Spinal Contusion Injury in Rats

BACKGROUND: The present study was designed to examine the functional recovery following spinal cord injury (SCI) by adjusting the parameters of impact force and dwell-time using the Infinite Horizon (IH) impactor device. METHODS: Sprague-Dawley rats (225-240 g) were divided into eight injury groups based on force of injury (Kdyn) and dwell time (seconds), indicated as Force-Dwell time: 150-4, 150-3, 150-2, 150-1, 150-0, 200-0, 90-2 and sham controls, respectively. RESULTS: After T10 SCI, higher injury force produced greater spinal cord displacement (P < 0.05) and showed a significant correlation (r = 0.813) between the displacement and the force (P < 0.05). In neuropathic pain-like behavior, the percent of paw withdrawals scores in the hindpaw for the 150-4, 150-3, 150-2, 150-1 and the 200-0 injury groups were significantly lowered compared with sham controls (P < 0.05). The recovery of locomotion had a significant within-subjects effect of time (P < 0.05) and the 150-0 group had increased recovery compared to other groups (P < 0.05). In addition, the 200-0 and the 90-2 recovered significantly better than all the 150 kdyn impact groups that included a dwell-time (P < 0.05). In recovery of spontaneous bladder function, the 150-4 injury group took significantly longer recovery time whereas the 150-0 and the 90-2 groups had the shortest recovery times. CONCLUSIONS: The present study demonstrates SCI parameters optimize development of mechanical allodynia and other pathological outcomes.

Application of detrusor power curve analysis in urodynaimc studies / 中华泌尿外科杂志

Objective To establish a calculation method for the voiding work parameters by using the detrusor power curve and to evaluate its clinic efficacy.Methods From January 2001 to January 2011,132 male patients with benign prostate hyperplasia who underwent urodynamic tests were retrospectively reviewed.The patients' age ranged from 45 to 84 years old (mean 57 years old).All patients had no previous history of neurological disease and no positive findings in neurological examinations.The voiding work of bladder,the voiding power of bladder and voiding energy consumption were calculated by using the detrusor power curve method and the linearized passive urethral resistance relation analysis was conducted.According to the detrusor status,all patients were divided into the decreased detrusor pressure group,the normal detrusor pressure group and the increased detrusor pressure group.Meanwhile,normal urethral resistance group and the increased urethral resistance group were classified according to the urethral resistance status.The detrusor pressure at maximal flow rate (PdetQmax),the maximal flow rate (Qmax),the projected isovolumetric pressure (PIP),the voiding work,the voiding power and the voiding energy consumption were compared among the different groups.Results There were 56 cases,58 cases,18 cases in the decreased,normal and the increased detrusor pressure group respectively.The voiding work were (1.1 ± 0.5)J,(1.7± 0.7)J,(2.1±1.2)J; the voiding power were (15.3±7.3)mW,(31.9±12.6)mW,(42.5±21.1)mW; and the voiding energy consumption were (3.9± 1.2) J/L,(5.2± 1.9) J/L,(6.2±3.2) J/L in those three groups,respectively.With the increasing of detrusor pressure,PdetQ Q PIP,the voiding work,the voiding power and the voiding energy consumption all increased among three groups with significant difference (P＜ 0.05).There were 51 cases,81 cases in the normal and the increased urethral resistance group.The voiding work were (1.5±0.7)J and (1.5±0.8)J;the voiding power were (32.3±13.2)mW and (22.6±16.3)mW and the voiding energy consumption were (3.8±0.7) J/L and (5.4±2.4) J/L in two groups.The increased urethral resistance group had higher PdetQmax and voiding energy consumption (P＜0.05) and lower Qmax and voiding power (P＜0.05) than those in the normal urethral resistance group.However,the differences of PIP (P =0.438) and the voiding work (P =0.546) between the two groups were not determined.Conclusions The detrusor power curve method can be used to calculate the work parameters of voiding.This method can be applied to evaluate the compensatory state of bladder and is conductive to urodynamic analysis in low detrusor pressure status.Both detrusor pressure and urethral resistance had significant impact on the work capacity of bladder.

Effect of bladder function training on urinary incontinence for patients with mild cognitive impairment after radical prostatectomy / 现代临床护理

Objective To explore the effect of bladder function training on urinary incontinence for patients with mild cognitive impairment after radical prostatectomy . Methods A skill training group was established to provide Cognitive and bladder function training for 48 patients with mild cognitive impairment after laparoscopic radical prostatectomy. Three months after training, the patients were observed in terms of occurrence of urinary incontinence, quality of life and self-efficacy. Result After training, the occurrence of urinary incontinence significantly fell, while quality of life and self-efficacy were significantly improved as compared to pro-training (P<0.05). Conclusion Cognitive and bladder function training can exert positive impacts on self-efficacy and quality of life of patients with mild cognitive impairment after radial prostatectomy.

Acupuncture point stimulation and the urodynamics of spinal cord injury patients / 中华物理医学与康复杂志

Objective To evaluate the effect of acupuncture point stimulation on the urodynamics of spinal cord injury patients.Methods Sixty spinal cord injury cases were divided into a research group and a comparison group.Both groups were given bladder training, but the research group also received acupuncture point stimulation.The subjects' maximum cystometric capacity, maximum detrusor pressure and residual urine were measured, along with renal function and any urinary tract infections.The scale of activity of their daily lives was compared before and 3 months and 6 months after the treatment.Results There were no statistically significant differences between the groups before the treatment.There were statistically significant differences in maximum cystometric capacity, maximum detrusor pressure, residual urine and Barthel index (BI) after 3 and 6 months of treatment.In the research group, maximum detrusor pressure, residual urine and BI scores had all improved after 6 months compared with the 3 month values.In the comparison group only the BI score had improved significantly between 3 and 6 months, and this was not reflected in a significant change in the scale of activity in daily life.After 3 months, only the average BI differed significantly between the two groups.After 6 months all indexes except the BI and maximum cystometric capacity differed significantly.There were also significant differences between the groups in reflex voiding, percussion voiding, and abdominal pressure voiding.Conclusions Acupuncture point stimulation can improve the bladder function of spinal cord injury patients.It can also decrease the incidence of urinary tract infection and the possibility of renal dysfunction.

Clinical survey of the effect of acupuncture,moxibustion combined with bladder function training on the neu-rogenic bladder / 中国基层医药

Objective To observe the effect of acupuncture, moxibustion combined with bladder function training on the neurogenic bladder.Methods 64 patients were randomly divided into the treatment group and control group,treatment group was given acupuncture,moxibustion combined with bladder function training,while the control group was treated with simple bladder function training, then comparing the bladder function changes between two groups after a month.Results In the treatment group,the bladder capacity,residual urine volume,urinate rate were respectively ( 349.4 ±13.5 ) mL, ( 98.7 ±15.3 ) mL, 92.26% and the control group respectively ( 323.4 ± 17.8)mL,(127.8 ±17.8) mL,51.85%,the difference between the two groups were statistically significant ( t =5.48,5.60,χ2 =3.97,all P<0.05).Conclusion Acupuncture,moxibustion combined with bladder function train-ing can be effective in the treatment of neurogenic bladder,while improve the quality of patient's life.

Efficacy of Process Management on Bladder Function among Traumatic Brain Injury Patients Admitted to Inten-sive Rehabilitation and Care Unit / 中国康复理论与实践

@#Objective To explore the efficacy of process management on bladder function among traumatic brain injury (TBI) patients admitted to intensive rehabilitation and care unit (IRCU). Methods 33 cases were collected to control group who were cared with routing nursing during February, 2011 to December, 2012. Other 39 cases were recruited to trial group cared with process management of bladder function during January, 2013 to December, 2014. Process management of bladder function contained the establishment of process manage-ment guide, evaluation of removing catheter, nursing of bladder based on residue of urine volume and keeping a diary of urination, etc. Re-sults There were more cases with residue of urine volume less than 100 ml and less with catheter associated urinary tract infection in the tri-al group than in the control group (P<0.05). Conclusion Process management of bladder function can improve the recovery of bladder func-tion of TBI patients, shorten rehabilitation time and decrease the risk of catheter associated urinary tract infection.

Various types of total laparoscopic nerve-sparing radical hysterectomies and their effects on bladder function / 부인종양

OBJECTIVE: This study was conducted to ascertain the correlation between preserved pelvic nerve networks and bladder function after laparoscopic nerve-sparing radical hysterectomy. METHODS: Between 2009 and 2011, 53 patients underwent total laparoscopic radical hysterectomies. They were categorized into groups A, B, and C based on the status of preserved pelvic nerve networks: complete preservation of the pelvic nerve plexus (group A, 27 cases); partial preservation (group B, 13 cases); and complete sacrifice (group C, 13 cases). To evaluate bladder function, urodynamic studies were conducted preoperatively and postoperatively at 1, 3, 6, and 12 months after surgery. RESULTS: No significant difference in sensory function was found between groups A and B. However, the sensory function of group C was significantly lower than that of the other groups. Group A had significantly better motor function than groups B and C. No significant difference in motor function was found between groups B and C. Results showed that the sensory nerve is distributed predominantly at the dorsal half of the pelvic nerve networks, but the motor nerve is predominantly distributed at the ventral half. CONCLUSION: Various types of total laparoscopic nerve-sparing radical hysterectomies can be tailored to patients with cervical carcinomas.

Urinary Bladder Detrusor Dysfunction Symptoms in Lyme Disease / 대한배뇨장애요실금학회지

PURPOSE: Symptoms of urinary bladder detrusor dysfunction have been rarely reported in Lyme disease. The aim was to carry out the first systematic study to compare the prevalence of such symptoms in a group of Lyme disease patients and a group of matched controls. METHODS: A questionnaire relating to detrusor function was administered to 17 serologically positive Lyme disease patients and to 18 control subjects. RESULTS: The two groups were matched in respect of age, sex, body mass, and mean arterial blood pressure. None of the 35 subjects was taking medication which might affect urinary function and none had undergone a previous operative procedure on the lower urinary tract. Six of the Lyme patients (35%) and none of the controls (0%) had symptoms of detrusor dysfunction (P<0.01). CONCLUSIONS: This first systematic controlled study confirms that Lyme disease is associated with urinary bladder detrusor dysfunction. Further evaluation of detrusor function is warranted in this disease.

Long-Term Urinary Bladder Function Following Unilateral Refluxing Low Loop Cutaneous Ureterostomy

PURPOSE: Unilateral low loop cutaneous ureterostomy (LLCU) has been offered as the preferred method of temporary urinary diversion in cases of massively dilated and refluxing ureters. We sought to explore whether LLCU is effective in preserving urinary bladder function in the long term. MATERIALS AND METHODS: The charts of all patients who had undergone temporary unilateral LLCU as newborns in the presence of massive vesico-ureteric reflux were retrospectively reviewed. Demographic data, follow-up length, and presence of incontinence were recorded. Patients were interviewed regarding lower urinary tract symptoms (LUTS), and their urination patterns were recorded by using uroflow and post-void residual (PVR) measurements. RESULTS: Between 1972 and 2003, a total of 24 patients underwent unilateral LLCU in the presence of massively refluxing ureters. Eight patients were included in the final analysis. The median age at diversion was 12 days, the median time to closure was 22.5 months, and the median follow-up was 12.5 years. Urinary bladders showed normal contour, normal capacities, and minimal PVRs in most cases. None of the patients required augmentation cystoplasty. One patient suffered from urinary leakage and few demonstrated minimal LUTS. CONCLUSIONS: Unilateral refluxing LLCU is an effective method of urinary diversion that preserves urinary bladder function for the long term. Larger studies are required to confirm this finding.