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OBJETIVO: Descrever a produção de protótipo de história digital baseada na experiência de sintomas urinários e intestinais em crianças. MÉTODO: Trata-se de pesquisa aplicada, com abordagem multimétodo, dividida em 2 fases: fase 1 consistiu em uma revisão sistemática de métodos mistos e um estudo de método misto (etapa quantitativa baseada em estudo retrospectivo do tipo documental por meio da análise de prontuários, e etapa qualitativa baseada em entrevistas com profissionais especialistas, responsáveis e crianças com sintomas urinários e intestinais em idade escolar). A fase 2 foi uma pesquisa metodológica de produção tecnológica do protótipo de história digital. RESULTADOS: A partir da triangulação dos dados obtidos nas 2 fases da pesquisa multimétodo, a história desenvolvida trouxe personagens representativos do perfil de crianças com os sintomas estudados e uma narrativa com elementos da experiência desses sintomas. CONCLUSÃO: A história buscou dar protagonismo e encorajar crianças com tais sintomas para tratamento e autocuidado.
OBJECTIVE: To describe the production of a prototype digital story based on the experience of bladder and bowel symptoms in children. METHOD: This is an applied research with a multimethod approach, divided into two phases: Phase 1 consisted of a systematic review of mixed methods and a mixed methods study (quantitative phase based on retrospective documentary analysis of medical records, and qualitative phase based on interviews with health professionals, caregivers, and children with bladder and bowel symptoms of school age). Phase 2 consisted of a methodological study of the technological production of the digital story prototype. RESULTS: Based on the triangulation of data obtained in the two phases of the multimethod research, the developed story brought representative characters of the profile of children with the studied symptoms and a narrative with elements of the experience of these symptoms. CONCLUSION: The story sought to give protagonism and encourage children with such symptoms to treatment and self-care.
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The microbiome plays a role in the development of lower urinary tract diseases, but the impact of viruses on these conditions remains unclear. In recent years, research has emerged demonstrating a potential link between viruses and lower urinary tract diseases, including bladder cancer, prostate cancer, and overactive bladder. In this paper, the research of the correlation between viruses and lower urinary tract diseases and the related mechanisms were reviewed.
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【Objective】 To evaluate the efficacy of sacral neuromodulation (SNM) in the treatment of neurogenic bladder (NB) with Meta-analysis, so as to provide reference for clinical treatment options for NB. 【Methods】 Relevant literatures regarding the efficacy of SNM in treating NB during Jan.2010 and Dec.2022 were collected from the PubMed and CNKI databases, and screened with inclusion and exclusion criteria.After the quality of literatures was assessed, data were extracted and then analyzed using Review Manager 5.3. 【Results】 The research included 14 studies involving 601 patients.Meta-analysis showed that SNM significantly improved urinary frequency (WMD=4.30, 95%CI: 2.84-5.77, P<0.01), daily episodes of urinary incontinence (WMD=2.92, 95%CI: 2.76-3.07, P<0.01), single void volume (WMD=-113.93, 95%CI: -159.91- -67.98, P<0.01), maximum flow rate (WMD=-3.23, 95%CI: -4.04- -2.42, P<0.01), residual urine (WMD=111.79, 95%CI: 79.93-143.64, P<0.01), maximum bladder capacity (WMD=-65.63, 95%CI: -84.38- -46.88, P<0.01), and bladder compliance (WMD=-4.65, 95%CI: -8.75- -0.55, P=0.03). 【Conclusion】 SNM is effective in the treatment of NB, but more randomized controlled trials are needed to verify the efficacy.
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【Objective】 To explore the factors influencing erectile dysfunction (ED) in male patients after renal transplantation, so as to provide basis for the prevention and treatment of this disease. 【Methods】 Kidney transplant recipients followed up in the Kidney Transplant Clinic of Xijing Hospital during Sep.1, 2022 and May 1, 2023 were selected as the study objects.Questionnaires were distributed, and the erectile function was measured with Sexual Health Inventory for Men (SHIM).Factors associated with ED were analyzed with multivariate logistic regression. 【Results】 A total of 300 questionnaires were distributed, and 276 valid ones were collected, including 182 cases (65.9%) suffering from ED of varying degrees.Multivariate logistic regression analysis showed that age [(50 years, OR: 0.120, 95%CI: 0.033-0.405, P50 years, OR: 0.223, 95%CI: 0.102-0.463, P40-50 years/>50 years, OR: 0.320, 95%CI: 0.139-0.719, P<0.01)], level of International Prostate Symptom Score (IPSS) (OR: 1.95, 95%CI: 1.211-3.248, P<0.01), International Prostate Symptom Score-Quality of Life item (IPSS-QoL) (OR: 1.482, 95%CI: 1.201-1.854, P<0.01), and income [(≥10 000 Yuan/<3 000 Yuan, OR: 0.156, 95%CI: 0.053-0.429, P<0.001), (5 000-<10 000 Yuan/<3 000 Yuan, OR: 0.418, 95%CI: 0.199-0.864, P<0.05), (≥10 000 Yuan/3 000-<5 000 Yuan, OR: 0.205, 95%CI: 0.069-0.573, P<0.01)] were independent and significant factors of ED. 【Conclusion】 The prevalence of ED in renal transplantation recipients is high.Age, income, IPSS and IPSS-QoL are the influencing factors.ED after renal transplantation is not only determined by physical and functional factors, but also closely related to social and psychological factors.
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Stress urinary incontinence (SUI) and underactive bladder (UAB) are common types of lower urinary tract dysfunction in women.As the treatment mechanisms of the two conditions are contradictory, the treatment of SUI patients complicated with UAB remains a difficult clinical problem.In order to improve the treatment rate of such patients and promote research, this paper reviews the latest domestic and overseas diagnostic criteria of UAB, summarizes the treatment experience of conventional midurethral sling (tension-free vaginal tape or outside-in transobturator tape) and adjustable sling procedures (transobturator adjustable tape or Remeex system) combined with medication or intermittent catheterization, and the application prospects of cutting-edge technologies such as stem cell injection, cytokine therapy and gene therapy, so as to provide reference for clinicians and researchers.
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In recent years,with the continuous innovation of modern war mode,weapons and protective equipment,the mechanism and mode of war trauma have also produced great changes.The widespread use of bulletproof vest and improvised explosive devices has led to increasing incidence of genitourinary trauma.The pattern of genitourinary trauma has also transformed from internal structures(kidney,ureters,bladder)to external structures(scrotum,testes,penis,urethra),suggesting that the research focus of genitourinary system war trauma should be gradually transformed to trauma research of lower urinary tract and external genitalia.This article reviews the incidence,treatment and prognosis of genitourinary trauma in several modern wars,and mainly describes the relevant conditions of lower urinary tract and external genitalia trauma and the relevant progress in the treatment in recent years.
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Resumo Objetivo Identificar a prevalência e fatores relacionados à noctúria em mulheres que apresentam sintomas do trato urinário inferior. Métodos Inquérito observacional transversal, individuado, de base hospitalar, envolvendo mulheres atendidas pelo Sistema Único de Saúde em ambulatórios de uroginecologia em Niterói e Petrópolis, RJ, Brasil. Foram coletados dados sociodemográficos, clínicos e hábitos de vida. Foram considerados dois desfechos de noctúria: uma ou mais micções e duas ou mais micções, o segundo devido ao maior impacto na qualidade de vida. As associações entre as variáveis investigadas e os desfechos foram avaliadas por modelo de regressão logística, e obtidas razões de chances brutas e ajustadas. Resultados Foram incluídas 132 participantes. A prevalência de noctúria foi 71,2% e, de duas ou mais micções, 56,8%. Houve associação de menor escolaridade (OR: 0,260 [0,106;0,637], p=0,003), incontinência urinária mista (OR: 2,533 [1,103;5,817], p=0,028) e três ou mais comorbidades (OR: 3,105 [1,340;7,196], p=0,008) com maior chance de noctúria. Menor escolaridade (OR: 0,324 [0,148;0,709], p=0,005), menor consumo de cafeína (OR: 0,995 [0,990;1,000], p=0,041) e síndrome da bexiga hiperativa (OR: 2,761 [1,189;6,409], p=0,018) mostraram-se associadas a uma maior chance de duas ou mais micções. Conclusões Na população atendida em serviços especializados, a prevalência de noctúria foi semelhante à da população em geral e à de serviços semelhantes, mas a prevalência de duas ou mais micções foi superior. Mostrou-se importante a busca ativa de noctúria em mulheres com comorbidades, em especial três ou mais, e a adequada compensação das mesmas no manejo do sintoma.
Abstract Objective To identify the prevalence and factors related to nocturia in women presenting lower urinary tract symptoms. Methods Observational cross-sectional survey, individualized, hospital-based, involving women attended by the Unified Health System in urogynecology outpatient clinics in Niterói and Petrópolis, RJ, Brazil. Sociodemographic, clinical, and lifestyle data were collected. Two outcomes of nocturia were considered: one or more nocturnal voids and two or more nocturnal voids, the latter due to its greater impact on quality of life. Associations between the investigated variables and the outcomes were assessed by logistic regression models, and crude and adjusted odds ratios were obtained. Results A total of 132 participants were included. The prevalence of nocturia was 71.2%, and of two or more voids, 56.8%. Lower education level OR 0,260 (0,106; 0,637), mixed urinary incontinence OR 2,533 (1,103; 5,817), and three or more comorbidities OR 3,105 (1,340; 7,196) were associated with a higher chance of nocturia. Lower education level OR 0,324 (0,148; 0,709), lower caffeine consumption OR 0,995 (0,990; 1,000), and overactive bladder syndrome OR 2,761 (1,189; 6,409) were associated with a higher chance of two or more voids. Conclusions In the population attending specialized services, the prevalence of nocturia was similar to that of the general population and to that of similar services, but the prevalence of two or more voids was higher. Active screening for nocturia in women with comorbidities, especially three or more, and their adequate management, proved to be important in addressing the symptom.
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Humans , Female , Women , Quality of Life , Aged , Activities of Daily Living , NocturiaABSTRACT
ABSTRACT Objective: To understand Primary Health Care nurses' role in treating Lower Urinary Tract Dysfunction. Method: Cross-sectional multi-methodological research, composed of quantitative and qualitative steps, independently and sequentially. Data collected remotely, through a questionnaire and focus group, analyzed using descriptive statistics and thematic analysis by Braun and Clarke, respectively. The project was approved under Opinion 22691119.0.0000.0030. Results: A total of 145 nurses participated in the study in the quantitative step and 20 in the qualitative step, working in Primary Health Care in Brazil. Of the 93.1% nurses who reported having already cared for people with Urinary Tract Dysfunction, only 54.4% provided guidance, mainly for training the pelvic floor muscles. Conclusion: Even though they have legal support and access to demand, nurses do not have the knowledge to offer conservative treatment for Lower Urinary Tract Dysfunction. Despite this, they were motivated to do so as long as they received specific training.
RESUMEN Objetivo: Comprender el papel del enfermero de Atención Primaria de Salud en el tratamiento de la Disfunción del Tracto Urinario Inferior. Método: Investigación transversal multimetodológica, compuesta por etapas cuantitativas y cualitativas, de forma independiente y secuencial. Datos recopilados de forma remota, a través de un cuestionario y un grupo focal, analizados mediante estadística descriptiva y análisis temático de Braun y Clarke, respectivamente. El proyecto fue aprobado bajo Opinión 22691119.0.0000.0030. Resultados: Participaron del estudio 145 enfermeros en la etapa cuantitativa y 20 en la cualitativa, actuando en la Atención Primaria de Salud en Brasil. Del 93,1% de los enfermeros que afirmaron haber atendido ya a personas con Disfunción del Tracto Urinario, sólo el 54,4% brindó orientación, principalmente para el entrenamiento de los músculos del suelo pélvico. Conclusión: Incluso con apoyo legal y acceso a la demanda, los enfermeros no tienen el conocimiento para ofrecer tratamiento conservador para la Disfunción del Tracto Urinario Inferior. Pese a ello, estaban motivados para hacerlo siempre que recibieran una formación específica.
RESUMO Objetivo: Compreender a atuação dos enfermeiros da Atenção Primaria à Saúde no tratamento da Disfunção do Trato Urinário Inferior. Método: Pesquisa transversal multi-metodológica, composta por etapas quantitativa e qualitativa, de forma independente e sequencial. Dados coletados de forma remota, por meio de questionário e grupo focal, analisados por estatística descritiva e análise temática de Braun e Clarke, respectivamente. O projeto foi aprovado sob Parecer no. 22691119.0.0000.0030. Resultados: Participaram do estudo 145 enfermeiros na etapa quantitativa e 20 na qualitativa, atuantes na Atenção Primária à Saúde do Brasil. Dos 93,1% enfermeiros que referiram já terem atendido pessoas com Disfunção do Trato Urinário, apenas 54,4% prestaram orientações, sendo principalmente para treinamento da musculatura do assoalho pélvico. Conclusão: Mesmo possuindo respaldo legal e acesso à demanda, os enfermeiros não têm conhecimento para oferecer tratamento conservador para Disfunção do Trato Urinário Inferior. Apesar disso, mostraram-se motivados para tal atuação desde que recebam capacitação específica.
Subject(s)
Humans , Primary Health Care , Education, Nursing , Enterostomal Therapy , Lower Urinary Tract SymptomsABSTRACT
ABSTRACT Purpose: Parasacral Transcutaneous Electrical Stimulation (TENS) is one of the treatments for children with Bladder and Bowel Dysfunction (BBD). Some studies showed that children with increased Rectal Diameter (RD) have more Functional Constipation (FC). However, RD prediction in maintenance of BBD after treatment was never evaluated. Our aim is to evaluate the association between RD and response to treatment in children and adolescents with BBD. Materials and Methods: This study evaluated patients from 5-17 years old with BBD. Dysfunctional Voiding Scoring System (DVSS), Rome IV criteria, and the Constipation Score were used. RD was measured using abdominal ultrasound before treatment according to the technique established by Klijn et al. and was considered enlarged when >3cm. No laxatives were used during treatment. Descriptive analysis and binary regression were performed and the area under the ROC curve was calculated. Results: Forty children were included (mean age 8.4±2.8 years, 52.5% male). Before treatment, RD was enlarged in 15 children (37.5%) (mean diameter 3.84±0.6cm), with FC persisting post-treatment in 11/15(73.3%). Those patients also required more laxatives following treatment and had more severe FC. Binary regression showed pretreatment RD to be an independent predictor of the persistence of FC post-treatment (OR=9.56; 95%CI:2.05-44.60). In ROC curve analysis, the sensitivity was 100% (95%CI: 0.49-1.0) and specificity 77.14% (95%CI:0.60-0.90) for rectal diameter >3 cm. The likelihood ratio was 4.38 (95%CI:2.40-8.0) for the persistence of BBD following treatment. Conclusion: RD appears to be relevant in the evaluation of children with BBD, not only as a diagnostic tool but also as a predictor of treatment outcome.
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ABSTRACT Introduction: Voiding diary (VD) is an important tool in the evaluation of children with voiding symptoms. Voiding frequency, maximal voided volume (MVV), average voided volume (AVV) and nocturnal volume (NV) can be extracted and are valuable in diagnosing and monitoring these disorders. Recently, ICCS has reduced the period of data recording on VD from 3 to 2 days. We hypothesized that one day voiding diary would be enough for guiding treatment. Materials and Methods: Children with overactive bladder (OAB) and primary monosymptomatic enuresis (PMNE) were oriented to fulfill a 3-day VD. Data obtained from VD were evaluated for the first day (1dVD), the first two days (2dVD), and all 3 days (3dVD) and compared according to the MVV, AVV, frequency, NV and expected bladder capacity (EBC). The Friedman, Student's t test and the Fisher's exact was used. ANOVA was used for multiple comparisons. We also used Pearson correlation test. Results: Ninety-eight children were included, 59 had PMNE and 30 OAB. Frequency, AVV and VN were similar regardless how many days the voiding episodes were recorded. Only MVV was higher by a mean of only 32 mL on 3dVD compared to 1dVD. A 1dVD has a sensitivity of 93,9% and a positive likelihood ratio of 2.2. As for the correlation of MVV and EBC it was observed that in 83% of children, MVV was lower than EBC. MVV corresponds to 67% and 69% of EBC in children with PMNE and OAB, respectively. Conclusion: We believe that 1dVD is sufficient to assess these children. It has a high sensitivity and good correlation to 3dVD in evaluating these children. Bladder capacity in this population, evaluated by maximum voided volume, was close to 68% of that obtained by the EBC.
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Background: Benign prostatic hyperplasia (BPH) is the most common cause for the lower urinary tract symptoms in men. The conservative management of BPH comprises of alpha blockers, especially selective alpha 1 adrenergic blockers for symptomatic relief. Aims and Objectives: We aimed to evaluate the efficacy and adverse effects of alpha blockers in managing BPH. Materials and Methods: After getting approval from the Institutional Human Ethics Committee and consent from subjects, this prospective, randomized, and controlled trial was conducted. In this study, patients under inclusion criteria were divided into two groups. Group I received silodosin 8 mg once daily for 8 weeks. Group II received tamsulosin 0.4 mg once daily for 8 weeks. Primary outcome measure was reduction in international prostate symptom score (IPSS). Adverse events during study period were recorded. Results: A total of 90 patients were enrolled in this study. Ten patients were excluded and remaining 80 patients were divided as 40 in Group I (Silodosin) and 40 in Group II (Tamsulosin), patients were followed up for 8 weeks. As primary outcome, the IPSS at 8th week was significantly <0 week, that is, baseline in both the groups. The comparison of IPSS within Group I and Group II at 0 week and 8th week was significant (P < 0.05). The quality of life comparison within Group I and Group II at 0 week and 8th week was significant (P < 0.05). Both the drugs were well tolerated. Retrograde ejaculation and diarrhea were noted with silodosin (Group I), dizziness and orthostatic hypotension were noted with Tamsulosin (Group II). Conclusion: The obtained results showed that both silodosin and tamsulosin produced significant improvement in IPSS and quality of Life in BPH patients. In silodosin group, retrograde ejaculation and diarrhea were notable adverse effects and in tamsulosin group, dizziness and orthostatic hypotension were noted.
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Objective:To evaluate the clinical efficacy of Bazheng Powder combined with Traditional Chinese Medicine (TCM) fumigation in the treatment of refractory urinary tract infection patients with Yin deficiency damp-heat syndrome.Methods:Randomized controlled trial design. Ninety-seven patients with Yin deficiency and damp-heat syndrome of refractory urinary tract infection in our hospital from April 2021 to May 2022 were selected as observation objects, and were divided into observation group (49 cases) and control group (48 cases) by random number table method. The control group was treated with antibiotics, and the observation group was treated with Bazheng powder plus or minus plus TCM fumigation on the basis of control group. Both groups were treated for 14 days. TCM syndrome score was performed before and after treatment. Test tube method was used to measure WBC, urine routine nitrite was used to measure urinary bacteria count, and the time to return to normal urine routine, symptom remission time and symptom disappearance time were recorded. Adverse reactions were recorded and clinical efficacy was evaluated.Results:The total effective rate was 95.92% (47/49) in the observation group and 81.25% (39/48) in the control group, and the difference between the two groups was statistically significant ( χ2=5.19, P=0.022). After treatment, TCM syndrome score of observation group was significantly lower than that of the control group ( t=13.18, P<0.01), WBC and urinary bacteria count were significantly lower than those in the control group ( t values were 19.77 and 22.99, P<0.01). The time of urine routine recovery, symptom remission and symptom disappearance in the observation group were significantly faster than those in the control group ( t values were 23.61, 9.80, 7.34, P<0.01). During the treatment period, the incidence of adverse reactions was 8.33% (4/48) in the control group, and no adverse reactions occurred in the observation group, the difference between the two groups was statistically significant ( χ2=4.26, P=0.039). Conclusion:The addition and reduction of Bazheng Powder combined with TCM fumigation can improve the clinical symptoms and clinical efficacy of patients with Yin deficiency damp-heat syndrome of refractory urinary tract infection, and no adverse reactions occurred.
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Parkinson's disease(PD)and multiple system atrophy(MSA)are two common Parkinsonian syndromes with overlapping clinical manifestations, and clinical differential diagnosis is difficult.Lower urinary tract symptoms are one of the common non-motor symptoms of the two diseases.The incidence of lower urinary tract symptoms in MSA is higher, the onset is earlier, and the micturition period is more prominent.The urinary dysfunction in patients with PD is mainly caused by the central mechanism, leading to overactive bladder.MSA has more extensive lesions with both central and peripheral involvement, leading to overactive bladder and severe voiding dysfunction.Urodynamics can be used to evaluate bladder and urethral function.MSA has more prominent weak detrusor activity, residual urine volume, and early changes of urethral sphincter.The treatment of lower urinary tract symptoms in patients with PD is mainly based on anticholinergic drugs to improve overactive bladder, while in MSA patients with increased residual urine volume, intermittent catheterization is the main method to improve lower urinary tract symptoms.This article reviewed the epidemiology, pathological mechanism, urodynamics and treatment of lower urinary tract symptoms of the two diseases, so as to assist in their differential diagnosis and treatment.
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Objective:To evaluate the efficacy and safety of Rezūm Water Vapor Thermal Therapy system in the treatment of patients with benign prostatic hyperplasia (BPH).Methods:The clinical data of 22 patients with benign prostatic hyperplasia treated with Rezūm Water Vapor Thermal Therapy system in Boao Yiling Life Care Center in Hainan from December 2020 to January 2021 were retrospectively analyzed, with age of (61.0±5.9) years, prostate volume of (43.7±8.4) ml. international prostate symptom score (IPSS) of (19.3±3.7), quality of life (QOL) score of (4.2±0.8), maximum urinary flow rate (Q max) of (11.9±3.4) ml ml/s, and residual urine volume (PVR) of (14.0±19.0). For 19 patients with sexual life, the International Index of Erectile Function Questionnaire-5 (IIEF-5) were 17.0±5.5, the Men's Sexual Health Questionnaire-Ejaculatory Dysfunction Score (MSHQ-EjD) ejaculatory function score were 10.0±3.2, and the ejaculatory satisfaction score were 1.5±1.0. Twenty-two patients underwent Rezūm Water Vapor Thermal Therapy under intravenous anesthesia (general anesthesia without intubation) in the dorsal lithotomy position. The Rezūm system consisted of reusable thermal steam treatment device and disposable prostate thermal steam treatment instrument. The thermal steam treatment device used radiofrequency energy to heat sterile distilled water, generating high-temperature steam at 103℃. In a 9-second timeframe, the tissue temperature within each treatment area was raised approximately 70℃, causing cell death and resulting in a shrink in prostate tissue volume. The disposable prostate thermal steam treatment instrument could be inserted through a cystoscope and had a retractable needle tip that extends to a length of 10.25 mm. The needle tip had 12 evenly distributed holes arranged in three rows of four holes each, with a spacing of 120° between rows, allowing for even diffusion of thermal steam along the circumference. The patient was placed in a lithotomy position, and the disposable prostate thermal steam treatment instrument was used to examine the prostate, urethra, and bladder via cystoscopy, assessing the lateral lobes and median lobe of the prostate. The tissue spacing within each field of view of the treatment instrument is 0.5 cm, and the distance from the bladder neck to the verumontanum is calculated. The first needle was injected at 3 o’clock along the left lobe, withdrawing 2 fields of view each time. During the release of thermal steam, the needle tip was positioned perpendicular to the prostate urethral mucosa, and each needle injection delivered 0.42 ml of sterile distilled water-formed thermal steam into the prostate tissue. The thermal steam injection lasted for 9 seconds, followed by a 2-3 seconds waiting period before retracting the needle tip. One needle was injected per 2 fields of view, progressing towards the proximal urethra of the verumontanum. The same method was used to treat the right lobe. For cases with significant median lobe enlargement, two fields of view were retracted at the bladder neck, and the needle was inserted at a 45° angle. The second needle was injected at intervals determined by the extent of median lobe enlargement. Each puncture point was observed for no significant bleeding, and the instrument was then removed, with an F16/F18 silicone catheter left in place. The operative time as well as indwelling catheter time were recorded. The clinical parameters such as IPSS, QOL, prostate volume, Qmax, PVR, QOL, IIEF-5 and MSHQ-EjD at preoperative and 12 to 22 weeks post operation were compared. Adverse events from the Rezūm procedure to 12-22 weeks postoperatively were recorded. Results:All the operations were successfully completed. The operation time of Rezūm system was 3.9±1.6 min, and the indwelling catheter time after operation was 4.8±1.1 days. The IPSS scores of 22 patients at 12-22 weeks after operation were 4.4±3.3, whose reduction was 14.9±4.4 compared with these at baseline( P<0.01). The PV was (37.7±8.4)ml, Qmax was (25.5±9.6)ml/s, PVR was (6.2±8.1)ml, and QOL was 1.6±0.9, all demonstrating statistically significant differences compared to preoperative values ( P<0.05). Among the 19 cases with sexual activity, the IIEF-5 score was 20.4±3.2, and the ejaculatory function score of MSHQ-EjD was 13.1±3.1, both showing statistically significant differences compared to preoperative scores ( P<0.05). The ejaculatory satisfaction score of MSHQ-EjD was 1.1±0.5, and there was no statistically significant difference compared to preoperative scores ( P>0.05). None of the 22 cases required medication or further surgical treatment for BPH after surgery. There were no urethral injuries, rectal or bladder perforations during the surgeries, and no severe complications such as rectal fistula or bladder neck contracture occurred postoperatively. There were no deaths reported. Postoperative discomfort in the urethra occurred in 19 cases, urethral pain in 8 cases, hematuria in 15 cases, poor sleep quality in 2 cases, and constipation in 1 case, all of which resolved within 7 to 10 days after surgery. Erectile dysfunction and retrograde ejaculation occurred in one case each at 4 to 5 weeks postoperatively but did not reoccur thereafter. Prostatitis and nodular hyperplasia of the middle lobe of the prostate occurred in one case each at 21 weeks and 25 weeks postoperatively, respectively, and no treatment was administered. Conclusions:In the real world, the short-term overall effect of Rezūm Water Vapor Thermal Therapy system in the treatment of benign prostatic hyperplasia is satisfactory, which shows good efficacy and safety.
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A total of 360 patients with prostate hyperplasia underwent transurethral holmium laser enucleation of the prostate in Department of Urology of Jinhua People′s Hospital from July 2019 to December 2022. Among 360 patients, lower urinary tract symptoms occurred one month after operation in 40 cases with an incidence rate of 11.11%. The age, body mass index (BMI), course of disease, nature of disease, preoperative prostate volume, postoperative prostate volume, preoperative IPSS score, postoperative IPSS score, preoperative maximum urine flow rate, postoperative maximum urine flow rate, preoperative residual urine volume, postoperative residual urine volume, postoperative urinary tract infection, operative time, postoperative catheter retention time were compared between patients with lower urinary tract symptoms (study group) and those without (control group). There were significant differences in the course of disease, preoperative prostate volume, preoperative IPSS score, preoperative maximum urine flow rate, preoperative residual urine volume, postoperative urinary tract infection and postoperative catheter retention time between two groups ( t=28.01, 6.35, 8.79, 17.92, 34.84, 11.45;all P<0.05). Multivariate logistic analysis showed that the course of disease, preoperative prostate volume, preoperative IPSS score, postoperative urinary tract infection, and postoperative catheter retention time were independent risk factors for postoperative lower urinary tract symptoms ( OR=6.964, 3.442, 1.944, 4.836, 4.225, 4.894; all P<0.05); while the preoperative maximum urinary flow rate was the protective factor( OR=0.043, P<0.05). The incidence of postoperative lower urinary tract symptoms in patients undergoing transurethral holmium laser enucleation of prostate is high. Effective protective measures should be taken based on the risk factors to reduce the incidence of postoperative lower urinary tract symptoms and to promote the early recovery of patients.
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A cross-sectional study was conducted to estimate the age-stratified normal levels and age-related changes in the risk predictors of benign prostatic hyperplasia (BPH) progression. A total of 4706 male participants aged 40 years or older in Zhengzhou (China) were enrolled. The values of the International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA), prostate volume (PV), and postvoid residual urine volume (PVR) significantly increased with age. Nonlinear relationships between age and IPSS scores ≥8 (P for nonlinearity = 0.046), PSA level ≥1.6 ng ml-1, PV ≥31 ml, or PVR ≥39 ml (all P for nonlinearity <0.001) were observed. After the age of 61 years, the risk indicators related to BPH progression were positively correlated with age (odds ratio [OR] >1), regardless of the predictors of the IPSS score, PSA level, PV, or PVR; and the OR values increased gradually. Therefore, after the age of 61 years, the risk predictors related to BPH progression were positively correlated with age.
Subject(s)
Humans , Male , Prostatic Hyperplasia/diagnosis , Prostate-Specific Antigen , Cross-Sectional Studies , East Asian People , Risk FactorsABSTRACT
【Objective】 To analyze the results, characteristics and clinical value of video urodynamic study (VUD) of lower urinary tract symptoms (LUTS) in young male. 【Methods】 A total of 106 young male LUTS patients (18-45 years old) who received VUD in our hospital during Jan.2016 and Sep.2021 were collected to analyze the clinical and imaging urodynamic characteristics. 【Results】 Of the 106 patients, 55 (52.44%) had neurogenic lower urinary tract dysfunction (NLUTD)with clear neurological etiology, and 51 (48%) had non-neurogenic lower urinary tract dysfunction (NNLUTD). In NLUTD patients, dysuria was the most common symptom (76.74%); lumbosacral lesions were the main cause (76.36%); imaging urodynamics indicated weakening of detrusor muscle in different degrees. In NNLUTD patients,the main symptoms were frequent urination (48.72%) and dysuria (48.72%); about 58.97% of patients had two or more LUTS, and the main diagnosis was detrusor underactivity (DU)(35.90%). 【Conclusion】 NLUTD in young male is characterized by varying degrees of detrusor muscle weakness, detrusor sphincter dyscoordination, and decreased bladder compliance. NNLUTD is mostly caused by detrusor overactivity (DO) and DU.
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【Objective】 To investigate the application value of three-dimensional printed guiding device in sacral neuromodulation in children. 【Methods】 A total of 17 patients admitted during Jan.2017 and Nov.2022 were divided into two groups: control group (n=8), using traditional method to locate sacral foramen for puncture; three-dimensional printed guiding device group (n=5), using three-dimensional printing technology to make individual guiding device for puncture. The clinical indexes of the two groups were evaluated, including puncture time, puncture numbers, intraoperative X-ray exposure times, postoperative evaluation time and second-stage conversion rate. The evaluation indexes of postoperative complications were wound bleeding, wound infection, wound rupture, electrode fracture, displacement or prolapse. 【Results】 In the control group, 1 case was diagnosed as bladder-bowel dysfunction, the remaining 7 were neurogenic bladder; in the three-dimensional printed guiding device group, all 9 cases were diagnosed as neurogenic bladder. The puncture time was shorter in the three-dimensional printed guiding device group than in the control group [85(70-90) min vs.138(133-208) min], the puncture numbers were fewer [15(12-20) vs.22(18-26)], and the X-ray exposure times were fewer [12(12-17) vs.19(16-23)] (all P<0.05). The initial stimulation voltage, postoperative evaluation time and second-stage conversion rate were not statistically significant. 【Conclusion】 Compared with the traditional method, the use of three-dimensional printed guiding device can reduce the puncture numbers and shorten the puncture time in the process of sacral neuromodulation in children.
ABSTRACT
【Objective】 To investigate the prevalence and risk factors of lower urinary tract symptoms (LUTS) in rural children and adolescents. 【Methods】 An epidemiological LUTS survey was carried out on 4 100 children and adolescents (aged 6-16 years) in five primary and secondary schools in rural Henan by means of stratified random cluster sampling using anonymous questionnaires. Daytime urinary incontinence (DUI), nocturnal enuresis (NE), and postnatal diaper use and toilet training were investigated. 【Results】 A total of 3 885 valid questionnaires were recovered (with a recovery rate of 94.76%). The total prevalence of the four symptoms of LUTS, including urgency, frequency, DUI and NE, were 16.42%, 10.91%, 7.41% and 7.95%, respectively. As much as 21.13% subjects had at least one symptom. The prevalence of the four symptoms decreased gradually with age, decreased sharply in those aged 6 to 12 years, and then decreased slowly. The prevalence of LUTS in children who stopped using diapers and stared urine training after 1 year of age was significantly higher than that of those within 1 year of age (χ2=21.605, 23.111, 24.189, 23.509, all P<0.05; χ2=102.17, 72.168, 53.656, 197.76, all P<0.05). There were significant differences in the prevalence of LUTS between those with and without toilet training (χ2=315.273, 198.438, 105.723, 272.502, all P<0.05). The prevalence of LUTS in males was significantly higher than that in females (P<0.05). Constipation, prepuce and phimosis in boys were significantly associated with the prevalence of LUTS (P<0.05). 【Conclusion】 Rural children and adolescents have a high prevalence of LUTS. Diaper use after 1 year of age, history of urinary tract infection (UTI), lack of toilet training, constipation, and abnormal prepuce are risk factors of LUTS. Urine training before 1 year of age is a protective factor of LUTS.
ABSTRACT
【Objective】 To investigate the clinical characteristics and treatment strategy of giant multilocular prostatic cystadenoma(GMPC). 【Methods】 The clinical data of a GMPC patient treated in our hospital in July 2021 were retrospectively analyzed. The patient was 73 years old. The clinical manifestations were urgent urination and frequent urination. The prostate specific antigen (PSA) increased slightly. MRI showed giant cystic solid space occupying lesion of the prostate. Domestic and foreign cases of prostate cystadenoma from 2000 to 2021 were retrieved for literature review. 【Results】 Transabdominal laparoscopic radical prostatectomy was performed successfully. The postoperative pathological diagnosis was GMPC. Two weeks after operation, the urinary catheter was removed, and there was no discomfort such as urinary frequency or urinary incontinence. After follow-up for more than 8 months, there was no tumor recurrence or metastasis. 【Conclusion】 There are still some disputes about the oncological characteristics and diagnosis and treatment of GMPC, and there is a lack of long-term follow-up results. Laparoscopic prostatectomy is safe and feasible. Most patients have a good prognosis after surgical treatment. It is necessary to formulate an individualized standard treatment plan based on surgery combined with different patients’ conditions to actively improve the prognosis.