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2.
Ciênc. cuid. saúde ; 20: e57337, 2021. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1356118

ABSTRACT

RESUMO Introdução: A Disfunção do Trato Urinário Inferior (DTUI) é uma complicação do Diabetes Mellitus (DM) e embora cause impacto negativo na qualidade de vida, não é contemplada nos programas de atenção a essa população. Objetivo: Levantar a ocorrência de DTUI em uma população com DM Tipo 2e avaliar sua associação com a história clínica. Método: Estudo transversal. Entrevista com 60 pacientes de um centro privado de DM por meio de instrumento contendo dados sociodemográficos, clínicos e sintomas de armazenamento e esvaziamento vesical apresentados nos últimos 30 dias. Análise estatística por meio do programa computacional IBM SPSS Statistics, v20.0. Resultados: Amostra predominantemente aposentada com alta escolaridade, bom padrão alimentar e intestinal, sedentária, obesa ou em sobrepeso, com taxas de hemoglobina glicada elevadas. Do total, 25% apresentavam incontinência urinária aos esforços, 60% pelo menos um sintoma de bexiga hiperativa, 41,7% pelo menos um sintoma de esvaziamento vesical incompleto, 70,1% pelo menos um sintoma de DTUI. Foi encontrada associação entre os sintomas urinários e o tempo de diagnóstico de DM. Conclusão: A população com DM tipo 2 apresenta alta ocorrência de DTUI, com predominância de sintomas de bexiga hiperativa, associada ao tempo de diagnóstico de DM.


RESUMEN Introducción: la Disfunción del Tracto Urinario Inferior (DTUI) es una complicación de la Diabetes Mellitus (DM) y aunque cause impacto negativo en la calidad de vida, no es contemplada en los programas de atención a esa población. Objetivo: obtener la incidencia de DTUI en una población con DM Tipo 2 y evaluar su asociación con la historia clínica. Método: estudio transversal. Entrevista con 60 pacientes de un centro privado de DM a través de un instrumento que contiene datos sociodemográficos, clínicos y síntomas de almacenamiento y vaciado vesical presentados en los últimos 30 días. Análisis estadístico por medio del programa computacional IBM SPSS Statistics, v20.0. Resultados: muestra predominantemente jubilada con alta escolaridad, buen patrón alimentario e intestinal, sedentaria, obesa o en sobrepeso, con niveles de hemoglobina glicosilada elevados. Del total, el 25% presentaba incontinencia urinaria a los esfuerzos, el 60% por lo menos un síntoma de vejiga hiperactiva, el 41,7% por lo menos un síntoma de vaciado vesical incompleto, el 70,1% por lo menos un síntoma de DTUI. Se encontró asociación entre los síntomas urinarios y el tiempo de diagnóstico de DM. Conclusión: la población con DM tipo 2 presenta alta incidencia de DTUI, con predominancia de síntomas de vejiga hiperactiva, asociada al tiempo de diagnóstico de DM.


ABSTRACT Introduction: Lower Urinary Tract Symptoms(LUTS) are a complication of Diabetes Mellitus (DM) and although it negatively impactsthe quality of life, it is not considered in care programs for this population. Objective: To survey the occurrence of LUTS in a population with Type 2 DM and assess its association with clinical history. Method: Cross-sectional study. Interview with 60 patients from a private DM clinic using a tool with sociodemographic and clinical data and symptoms of bladder storage and voiding in the last 30 days. Statistical analysis was performed using the computer program IBM SPSS Statistics, v20.0. Results: Most of the participants were retired with high education, good dietary, and intestinal pattern, sedentary, obese, or overweight, with high glycated hemoglobin rates. Of the total, 25% had stress urinary incontinence, 60% had at least one symptom of overactive bladder, 41.7% had at least one symptom of incomplete bladder voiding, 70.1% had at least one LUTsymptom. An association was found between urinary symptoms and time since DM diagnosis. Conclusion: The population with type 2 DM has a high occurrence of LUTS, with a predominance of symptoms of overactive bladder, associated with the time of DM diagnosis.


Subject(s)
Humans , Male , Female , Urinary Tract , Diabetes Mellitus, Type 2 , Patients , Quality of Life , Urinary Incontinence , Urinary Bladder , Glycated Hemoglobin A , Urinary Retention , Nursing , Diet , Disease Prevention , Overweight , Urinary Bladder, Overactive , Sedentary Behavior
3.
Rev. gaúch. enferm ; 42: e20200014, 2021. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1289599

ABSTRACT

ABSTRACT Objective To describe the frequency of urinary complaints, bladder globe, and need for bladder relief catheterization according to ultrasound; to investigate the relationship between the urinary volume estimated by ultrasound and the one drained in catheterization; and to describe the relationship of patient's complaints and detection of bladder globe with the diagnosis of urinary retention. Method A cross-sectional study with clinical patients with suspected urinary retention in a tertiary hospital, conducted from February to September 2018. Urinary volume ≥500 mL in ultrasound was considered urinary retention. Results Two hundred and five evaluations were performed in 44 patients. Urinary retention was detected by ultrasound in 33.2% of the evaluations. There was a strong correlation between ultrasound and bladder catheterization. There was a higher frequency of identification of bladder globe in urinary volumes ≥300 mL. Conclusion The incidence of urinary retention was higher when ultrasound was used for the diagnosis, when compared to patient's complaint and physical examination. Ultrasound showed to be accurate in establishing urinary volume.


RESUMEN Objetivo Describir la frecuencia de las quejas urinarias, el globo vesical y la necesidad del cateterismo de la vejiga por ultrasonido; verificar la relación entre el volumen urinario estimado por ultrasonido y drenado en el cateterismo y describir la relación entre las quejas de los pacientes y la detección de globo vesical y el diagnóstico de retención urinaria. Método Estudio transversal con pacientes clínicos con sospecha de retención urinaria, realizado entre febrero y septiembre de 2018 en un hospital de nivel terciario. El volumen urinario ≥500 mL en el ultrasonido se consideró retención urinaria. Resultados Se realizaron 205 evaluaciones en 44 pacientes. La retención urinaria se detectó por ultrasonido en el 33,2% de las evaluaciones. Hubo una fuerte correlación entre el ultrasonido y el cateterismo vesical. Se registró una mayor frecuencia de identificación de globo vesical en volúmenes urinarios superiores a 300 mL. Conclusión La incidencia de la RU fue mayor cuando se empleó ultrasonografía para el diagnóstico, comparado con la queja del paciente y el examen físico. La ultrasonografía se mostró precisa en determinar el volumen urinario.


RESUMO Objetivos Descrever frequência de queixas urinárias, globo vesical e necessidade de cateterismo vesical de alívio a partir da realização da ultrassonografia; verificar relação entre volume urinário estimado pela ultrassonografia e drenado no cateterismo e descrever relação entre queixas dos pacientes e detecção de globo vesical com o diagnóstico de retenção urinária. Método Estudo transversal com pacientes clínicos com suspeita de retenção urinária, no período de fevereiro a setembro de 2018, em um hospital terciário. Volume urinário ≥500mL na ultrassonografia foi considerado retenção urinária. Resultados Realizaram-se 205 avaliações, em 44 pacientes. Detectou-se retenção urinária pela ultrassonografia em 33,2% das avaliações. Houve forte correlação entre ultrassonografia e cateterismo vesical. Verificou-se maior frequência de identificação de globo vesical em volumes urinários ≥300mL. Conclusão Incidência de retenção urinária foi maior quando a ultrassonografia foi empregada para o diagnóstico, quando comparado à queixa do paciente e exame físico. Ultrassonografia mostrou-se precisa em determinar volume urinário.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Physical Examination , Urinary Bladder , Urinary Retention/diagnosis , Ultrasonography/methods , Hospitals, University , Nurses , Cross-Sectional Studies , Patient Safety
4.
Rev. bras. anestesiol ; 70(6): 613-619, Nov.-Dec. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1155774

ABSTRACT

Abstract Background and objectives There are no consensus of the ideal technique to provide analgesia in knee ligament reconstructions. The aim of this study was to compare the intensity of postoperative pain in these patients under different modalities of analgesia. Method Randomized and controlled clinical trial of patients undergoing reconstruction of the Anterior Cruciate Ligament (ACL) with flexor tendons between December 2013 and 2014. All patients underwent spinal anesthesia and rescue analgesia with tramadol. The groups C, M, R0,375 and R0,25 was compared with only the previously described technique, subarachnoid morphine (100░µg), or Femoral Nerve Block (BNF) with 25░mL of 0.375% ropivacaine and 0.25%, respectively. Pain intensity at 6, 12 and 24░hours, age, sex, rescue analgesia, adverse reactions and satisfaction were evaluated. Results Among the 83 eligible patients, a predominance of males (85.7%) was observed, between 28 and 31 years. The group C requested more opioid (27.3%) than the other groups, without significance when compared. There were no significant differences in pain intensity at 6, 12 and 24░hours. There was a higher incidence of urinary retention in the M group (23.8%) than in the R0,375 (0%) and prolonged quadriceps motor block in the R0,375 group (30%) than in the M and C groups (0%), with statistical significance (p░<░0.05). Conclusion There was no difference in the intensity of postoperative pain in patients submitted to ACL reconstruction with flexor tendons under the analgesic modalities evaluated, despite the predominance of urinary retention in the M group and motor block in the R0,375 group.


Resumo Justificativa e objetivos Não há consenso sobre qual é a técnica ideal para prover analgesia em reconstruções ligamentares de joelho. Objetivou‐se comparar a intensidade da dor pós‐operatória desses pacientes sob diferentes modalidades de analgesia. Método Ensaio clínico randomizado e controlado de pacientes submetidos à reconstrução do ligamento cruzado anterior com tendões flexores entre dezembro de 2013 e 2014. Todos os pacientes foram submetidos a raquianestesia e analgesia de resgate com tramadol. Compararam‐se os grupos C, M, R0,375 e R0,25; aos quais se ofertou apenas a técnica anteriormente descrita, morfina subaracnóidea (100 µg) ou bloqueio de nervo femoral com 25 mL de ropivacaína 0,375% e 0,25%, respectivamente. Avaliou‐se intensidade da dor em 6, 12 e 24 horas, idade, sexo, analgesia de resgate, reações adversas e satisfação. Resultados Entre os 83 pacientes elegíveis, observou‐se predomínio do sexo masculino (85,7%) entre 28 e 31 anos. O Grupo C solicitou mais opioide (27,3%) do que os demais grupos, sem significância quando comparados. Não houve diferenças significativas na intensidade da dor em 6, 12 e 24 horas. Houve maior incidência de retenção urinária no Grupo M (23,8%) do que no R0,375 (0%) e de bloqueio motor prolongado do quadríceps no Grupo R0,375 (30%) do que nos Grupos M e C (0%), com significância estatística (p< 0,05). Conclusão Não houve diferença na intensidade da dor pós‐operatória nos pacientes submetidos à reconstrução de ligamento cruzado anterior com tendões flexores sob as modalidades analgésicas avaliadas, apesar do predomínio de retenção urinária no Grupo M e bloqueio motor no Grupo R0,375.


Subject(s)
Humans , Male , Female , Adult , Pain, Postoperative/drug therapy , Femoral Nerve , Anterior Cruciate Ligament Reconstruction , Analgesics, Opioid/administration & dosage , Anesthesia, Spinal/methods , Morphine/administration & dosage , Nerve Block/methods , Time Factors , Tramadol/administration & dosage , Pain Measurement , Urinary Retention/chemically induced , Quadriceps Muscle/drug effects , Acute Pain/drug therapy , Ropivacaine/administration & dosage , Analgesia/methods , Anesthetics, Local/administration & dosage
5.
Más Vita ; 2(1): 16-20, mar 2020. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1255332

ABSTRACT

Los pacientes con insuficiencia renal crónica se realizan hemodiálisis 3 veces a la semana. Una de las principales situaciones que se da, es la ganancia de peso o sobrecarga hídrica entre una diálisis y otra, ocasionando una serie de complicaciones que ponen en riesgo la vida del paciente. Objetivo: Determinar los factores que incrementan el peso interdialisis de pacientes sometidos a hemodiálisis. Método: El diseño de la investigación que se empleó fue cuantitativo, de tipo no experimental, transversal y descriptivo. La muestra estuvo representada por 14 pacientes adultos con enfermedad renal crónica. El análisis de los resultados se realizó a través del programa de IBM SPSS Statistcs versión 22. Resultados: A pesar de que el centro de diálisis tiene un programa de educación continua con temas de alimentación orientada hacia los pacientes, estos no siguen las recomendaciones ingiriendo líquidos a libre demanda provocando sobre peso al realizarse las hemodiálisis generalmente ocasionando dificultad en su tratamiento de hemodiálisis Conclusión: Los conocimientos de autocuidado que posee cada paciente, que presenta una enfermedad crónica como la insuficiencia renal, son esenciales porque pueden evitar las repetidas hospitalizaciones(AU)


Patients with chronic renal failure are performed hemodialysis 3 times a week. One of the main situations that occurs is the weight gain or water overload between one dialysis and another, causing a series of complications that put the patient's life at risk. Objective: To determine the factors that increase the interdialisis weight of patients undergoing hemodialysis. Method: The research design was quantitative, non-experimental, transversal and descriptive. And14 adult patients with chronic kidney disease represented the sample. The analysis of the results was carried out through the IBM SPSS Statistcs version 22 program. Even though the dialysis center has a continuous education program with patient-oriented feeding issues, they do not follow the recommendations, and ingest liquids on free demand, causing overweight at hemodialysis usually causing difficulty in hemodialysis treatment. Conclusion: The self-care knowledge that each patient has, which represents a chronic disease such as kidney failure, are essential because can avoid repeated hospitalizations(AU)


Subject(s)
Humans , Male , Female , Renal Dialysis , Diet Therapy , Renal Insufficiency/complications , Kidney Diseases , Self Care , Urinary Retention , Overweight
6.
Article in Chinese | WPRIM | ID: wpr-826685

ABSTRACT

OBJECTIVE@#To explore the preventive effect of acupuncture at Ciliao (BL 32) on postpartum urinary retention as well as the time and volume of the first urination after delivery in elderly parturient women undergoing vaginal delivery.@*METHODS@#A total of 180 elderly parturient women (≥35 years old) undergoing vaginal delivery were randomly divided into a blank control group, a conditional control group and an observation group, 60 cases in each group. The patients in the blank control group were treated with routine nursing plan; based on the treatment of the blank control group, the patients in the conditional control group were treated with additional intervention measures such as applying hot towel on the bladder and fingers pressing to stimulate urination; based on the treatment of the blank control group, the patients in the observation group were treated with acupuncture at bilateral Ciliao (BL 32) one hour after delivery for 20 min (the acupuncture was given only once). The incidence rate of postpartum urinary retention as well as the time and volume of the first urination among the women without urinary retention were observed; the satisfaction rate of the 3 groups was recorded.@*RESULTS@#The incidence rate of postpartum urinary retention in the observation group was 5.0% (3/60), which was significantly lower than 26.7% (16/60) in the blank control group (<0.01) and 16.7% (10/60) in the conditional control group (<0.05); the incidence rate of postpartum urinary retention in the conditional control group was significantly lower than that in the blank control group [16.7% (10/60) vs 26.7%(16/60), <0.05]. In the elderly women without urinary retention, the first urination time in the observation group was significantly earlier than that in the blank control group and conditional control group (<0.01), and the first urination time in the conditional control group was earlier than that in the blank control group (<0.01). The volume of first urination in the observation group was higher than that in the blank control group and the conditional control group (<0.05, <0.01). The satisfaction rates in the observation group and conditional control group were higher than that in the blank control group (<0.01).@*CONCLUSION@#Acupuncture at Ciliao (BL 32) could effectively prevent the postpartum urinary retention, improve the time and volume of the first urination in elderly parturient women undergoing vaginal delivery.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Adult , Female , Humans , Postpartum Period , Pregnancy , Urinary Bladder , Urinary Retention , Therapeutics , Urination
7.
Fisioter. Bras ; 20(5): 675-680, Outubro 24, 2019.
Article in Portuguese | LILACS | ID: biblio-1281736

ABSTRACT

A dengue pode desencadear manifestações neurológicas como a Síndrome de Encefalomielite Aguda Disseminada (ADEM), de caráter inflamatório, desmielinizante, que pode ter dentre as consequências déficits motores e sensitivos, neurite ótica e disfunções vesicais, como a retenção urinária, tornando o indivíduo dependente da realização do cateterismo vesical intermitente (CVI). Desta forma, o objetivo deste estudo é descrever o tratamento fisioterapêutico de uma paciente com retenção urinária, decorrente de Síndrome de ADEM pós-dengue. Paciente do sexo feminino, 52 anos, internada em hospital de média complexidade com diagnóstico de ADEM. Na avaliação inicial apresentava grau de força muscular 3 de membros inferiores e 4 de membros superiores, 2 de musculatura do assoalho pélvico (MAP) e retenção urinária, necessitando realizar CVI. Foram realizados 32 atendimentos com duração de uma hora, incluindo o treinamento do assoalho pélvico em diferentes posturas e eletroestimulação de superfície da MAP com equipamento da marca Ibramed. Paciente recebeu alta hospitalar com evidente melhora da força muscular global e sem necessidade de CVI, apresentando micção voluntária e sem resíduo pós-miccional, favorecendo a prevenção de agravos do trato urinário inferior e superior. (AU)


Dengue can trigger neurological manifestations such as Acute Disseminated Encephalomyelitis (ADEM), with inflammatory, demyelinating condition, which may have, among the consequences, motor and sensory deficits, optic neuritis and bladder dysfunctions, such as urinary retention, making the individual dependent on intermittent bladder catheterization (IBC). Therefore, the objective of this study was to describe the physiotherapeutic treatment of a patient with urinary retention, due to ADEM syndrome after dengue. A 52-year-old female patient admitted to a hospital of medium complexity with a diagnosis of ADEM. In the initial evaluation, she presented a degree 3 of muscular strength in the lower limbs and 4 in the upper limbs, 2 in pelvic floor musculature (PFM) and urinary retention, requiring IBC. We performed 32 one hour sessions, including pelvic floor muscle training in different positions and surface electrostimulation of PFM with Ibramed brand equipment. Patient was discharged with evident improvement of global muscle strength and without IBC, presenting voluntary voiding and without post void residual, favoring the prevention of lower and upper urinary tract injuries. (AU)


Subject(s)
Humans , Urinary Retention , Pelvic Floor , Encephalomyelitis, Acute Disseminated , Urination , Urinary Bladder, Neurogenic , Dengue , Muscle Strength
8.
Rev. SOBECC ; 24(2): 91-98, abr-.jun.2019.
Article in Portuguese | LILACS, BDENF | ID: biblio-1006173

ABSTRACT

Objetivo: Verificar a opinião dos enfermeiros em relação à utilização do ultrassom portátil para detectar retenção urinária na recuperação anestésica. Método: Pesquisa de campo, descritivo-exploratória, quantitativa; com 34 enfermeiros de dois blocos cirúrgicos de um hospital privado de São Paulo; aplicado questionário com duas partes: caracterização do profissional e questões sobre o uso do ultrassom portátil. A coleta deu-se entre maio e junho de 2018, após cumpridas as recomendações da Resolução nº 466/2012. Resultados descritos e analisados quantitativamente, utilizando-se técnicas estatísticas e apresentados em tabelas; avaliados individualmente e comparativamente, de forma horizontal e vertical. Resultados: Todos os enfermeiros opinaram em alternativas que demonstraram que a tecnologia do ultrassom é facilitadora no diagnóstico da retenção; o grau de confiança e segurança constatado foi alto e muito alto; se mostraram satisfeitos com a tecnologia; consideraram importante seu uso para autonomia do enfermeiro e opinaram que o uso do ultrassom portátil para detecção de retenção urinária na recuperação anestésica só apresentou vantagens. Em relação ao treinamento, a maioria considerou que o tempo foi suficiente, se mostrou satisfeita com os materiais apresentados e teve facilidade em usar o dispositivo. Conclusão: Os resultados demonstraram que a tecnologia é eficaz na prática clínica dos enfermeiros da recuperação anestésica da instituição pesquisada. O tema é pertinente à realização de novos trabalhos e intervenções para melhoria contínua dos processos de enfermagem, oferecendo maior segurança e menor dificuldade no manuseio do dispositivo.


Objective: To assess the opinion of nurses as to the use of portable ultrasounds to detect urinary retention during patients' recovery from anesthesia. Method: Field research, descriptive-exploratory and quantitative study; conducted with 34 nurses from two surgical suites at a private hospital in São Paulo. A questionnaire with two parts was applied: the characterization of professionals and questions about the use of portable ultrasounds. The collection took place between May and June 2018, after complying with the recommendations of Resolution No. 466/2012. The results were described and analyzed quantitatively, using statistical techniques and presented in tables; they were evaluated individually and comparatively, horizontally and vertically. Results: All nurses expressed their opinion on alternatives, which showed that ultrasound technology enables the diagnose of urinary retention. The confidence and reliability levels were high and very high. Nurses stated they were satisfied with the technology and considered their use important for the autonomy of nurses. Moreover, the use of portable ultrasounds to detect urinary retention during recovery from anesthesia was said to present only advantages. As to the training, most considered the time enough and approved the presented material. The device was easy to use. Conclusion: Regarding recovery from anesthesia, results showed that the technology is effective in the clinical practice of nurses at the research institution. The theme is pertinent to the accomplishment of new studies and interventions for continuous improvement of nursing processes, offering greater reliability and less difficulty to handle the device.


Objetivo: Verificar la opinión de los enfermeros em relación a la utilización del ultrasonido portátil para detectar retención urinaria em la recuperación anestésica. Método: Investigación de campo, descriptivo-exploratoria, cuantitativa; con 34 enfermeros de dos bloques quirúrgicos de un hospital privado de São Paulo; aplicado cuestionario con dos partes: caracterización del profesional y cuestiones sobre el uso del ultrasonido portátil. La recolección se dio entre mayo y junio de 2018, después de cumplidas las recomendaciones de la Resolución 466/2012. Resultados descritos y analizados cuantitativamente, utilizando técnicas estadísticas y presentadas en tablas; evaluados individualmente y comparativamente, de forma horizontal y vertical. Resultados: Todos los enfermeros opinaron em alternativas que demostraron que la tecnología del ultrasonido es facilitadora en el diagnóstico de la retención; el grado de confianza y seguridad constatado fue alto y muy alto; se mostraron satisfechos con la tecnología; consideraron importante su uso para autonomía del enfermero y opinaron que el uso del ultrasonido portátil para detección de retención urinaria em la recuperación anestésica sólo presentó ventajas. Em cuanto al entrenamiento, la mayoría consideró que el tiempo fue suficiente, se mostró satisfecha con los materiales presentados y tuvo facilidad em usar el dispositivo. Conclusión: Los resultados demostraron que la tecnología es eficaz em la práctica clínica de los enfermeros de la recuperación anestésica de la institución investigada. El tema es pertinente a la realización de nuevos trabajos e intervenciones para la mejora continua de los procesos de enfermería, ofreciendo mayor seguridad y menor dificultad em el manejo del dispositivo


Subject(s)
Humans , Ultrasonics , Urinary Tract , Postoperative Period , Evaluation Studies as Topic , Urinary Retention , Nursing Care
9.
Revista Digital de Postgrado ; 8(1): 153, 2019. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1022854

ABSTRACT

La presencia de gasas intracavitarias posterior a procedimientos quirúrgicos es una situación que genera importantes complicaciones, con graves repercusiones médico-legales. El objetivo de este estudio es describir la presencia de un cuerpo extraño vesical como complicación iatrogénica. Se presentan dos casos, el primero es de un hombre de 63 años de edad, con antecedente de prostatectomía simple por hiperplasia prostática benigna, quien acude por episodio de retención aguda de orina (RAO); y el segundo es de una mujer de 65 años, con antecedente de histerectomía abdominal por leiomiomatosis uterina, quien presenta dolor pélvico crónico e infecciones urinarias a repetición. A los pacientes se les realizó un ecosonograma pélvico que reportó lesión ocupante de espacio en vejiga, la urotomografia (urotac) evidencia un cuerpo extraño intravesical de apariencia radiopaca, y en la uretrocistoscopia se visualiza material sintético intravesical flotando. Al primer paciente se le realiza una cistotomía con extracción de material compatible con gasa y a la segunda paciente se le realiza extracción endoscópica de la misma, ambos presentando evolución satisfactoria. La revisión del sitio quirúrgico y el contaje transoperatorio de gasas antes de la síntesis final de los tejidos es un paso fundamental para el éxito de una cirugía pélvica(AU)


The presence of intracavitary gauzes after the surgical procedures is a situation that generates important complications, with serious medico-legal repercussions. The objective of this study is describe the presence of a bladder foreign body as an iatrogenic complication. Two cases are presented, the first is from a 63-year-old man with a history of simple prostatectomy for benign prostatic hyperplasia who presents with episodes of acute urinary retention; and the second is a 65-year-old woman with a history of abdominal hysterectomy due to leiomyomatosis that presents with chronic pelvic pain and recurrent urinary tract infections. A pelvic ecosonogram was performed on the patients who reported a bladder space-occupying lesion, urotac showed an intravesical foreign body with a radiopaque appearance, and intravesical synthetic flotation material was visualized in the urethrocystoscopy. The patient underwent a cystotomy with gas-compatible material extraction and the patient underwent endoscopic extraction, both showing a satisfactory evolution. Surgical site revision and transoperative gauze infection before the final synthesis of tissues is a fundamental step for the success of pelvic surgery(AU)


Subject(s)
Humans , Male , Middle Aged , Aged , Prostatic Hyperplasia , Urinary Retention , Foreign Bodies/complications , Hysterectomy , Pain, Postoperative/etiology , Pelvic Pain
10.
HU rev ; 45(3): 341-351, 2019.
Article in Portuguese | LILACS | ID: biblio-1049336

ABSTRACT

Introdução: O modelo tradicional de referenciamento ao radiologista para a realização de ultrassonografia ou ecografia tem se modificado nos últimos 25 anos. Com a diminuição do tamanho e do custo dos aparelhos de ultrassom (hoje já existem mais de 10 unidades "handheld" no mercado), cada vez mais médicos de diferentes especialidades estão utilizando a ultrassonografia a beira do leito, como extensão do exame físico. Objetivo: Destacar a importância do uso da ultrassonografia a beira do leito na avaliação objetiva e ampliada dos pacientes renais. Materiais e Métodos:Revisão narrativa com seleção dos estudos e a interpretação das informações baseados na escolha arbitrária dos autores. Resultados: Na nefrologia, a ecografia ainda tem sido pouco utilizada, sendo o seu maior uso na identificação renal e venosa quando da realização da biópsia renal e do acesso vascular, respectivamente. Contudo, o papel fundamental dos rins no controle da volemia e da pressão arterial, eventualmente quando se tornam disfuncionais, demanda avaliações multiorgânicas. Assim, a utilização da ultrassonografia na nefrologia não deveria se restringir aos procedimentos mencionados ou a avaliação da retenção urinária. As ecografias "focadas" dos pulmões, do coração e da veia cava inferior permite o diagnóstico de complicações frequentes observadas nas doenças renais, como por exemplo, congestão pulmonar, derrame pleural, pneumotórax, disfunção sistólica, diastólica, derrame pericárdico e, assim, incorporadas como extensão do exame físico em nefrologia. Conclusão: A multifuncionalidade renal implica em grande número de complicações renais e extra-renais quando os rins são funcionalmente acometidos, o que justifica o uso da POCUS não somente na avaliação do trato urinário, mas também dos pulmões, coração, veia cava inferior, entre outros.


Introduction: The traditional model of reference ultrasound to radiologist has changed over the past 25 years. With the reductions in size and cost of ultrasound devices (today there are more than 10 handheld units on the market), medical specialists are increasingly using bedside ultrasound as an extension of the physical examination. Objective:To highlight the importance of using bedside ultrasound in the objective and expanded evaluation of renal patients. Material and Methods: Narrative review with study selection and interpretation of information based on arbitrary choice of authors. Results: In nephrology, ultrasound has not been widely used, and its major uses are in renal and venous identifications in renal biopsy and vascular access, respectively. However, the fundamental role of the kidneys in controlling body volume and blood pressure, eventually when they become dysfunctional, requires multiorgan evaluations. Thus, the use of ultrasound in nephrology should not be restricted to the procedures mentioned or the assessment of urinary retention. "Focused" ultrasound of the lungs, heart, and inferior vena cava allows the diagnosis of frequent complications observed in renal diseases, such as pulmonary congestion, pleural effusion, pneumothorax, systolic and diastolic dysfunction, pericardial effusion, and thus be incorporated as extension of physical examination in nephrology. In the present review, the authors highlight the importance of using bedside ultrasound in the objective and expanded evaluation of renal patients. Conclusion: Renal multifunctionality implies a large number of renal and extrarenal complications when the kidneys are functionally affected, which justifies the use of POCUS not only in the evaluation of the urinary tract, but also in the lungs, heart, inferior vena cava, among others.


Subject(s)
Humans , Male , Female , Patients , Physical Examination , Urinary Tract , Urinary Retention , Ultrasonography , Equipment and Supplies , Control , Radiologists , Kidney , Kidney Diseases , Methods , Nephrology
11.
Article in English | WPRIM | ID: wpr-764123

ABSTRACT

PURPOSE: The brainstem plays an important role in the control of micturition, and brainstem strokes are known to present with micturition dysfunction. Micturition dysfunction in cases of lateral medullary infarction (LMI) is uncommon, but often manifests as urinary retention. In this study, we investigated the neuro-anatomical correlates of urinary retention in patients with LMI. METHODS: This was a hospital-based retrospective study conducted in the neurology unit of a quaternary-level teaching hospital. Inpatient records from January 2008 to May 2018 were searched using a computerized database. Cases of isolated LMI were identified and those with micturition dysfunction were reviewed. MRI brain images of all patients were viewed, and individual lesions were mapped onto the Montreal Neurological Institute (MNI) space manually using MRIcron. Nonparametric mapping toolbox software was used for voxel-based lesion-symptom analysis. The Liebermeister test was used for statistical analysis, and the resultant statistical map was displayed on the MNI template using MRIcron. RESULTS: During the study period, 31 patients with isolated LMI were identified. Their mean age was 48 years and 28 (90%) were male. Six of these patients (19%) developed micturition dysfunction. All 6 patients had urinary retention and 1 patient each had urge incontinence and overflow incontinence. In patients with LMI, the lateral tegmentum of the medulla showed a significant association with urinary retention. CONCLUSIONS: In patients with isolated LMI, we postulate that disruption of the descending pathway from the pontine micturition centre to the sacral spinal cord at the level of the lateral tegmentum results in urinary retention.


Subject(s)
Brain , Brain Stem , Hospitals, Teaching , Humans , Infarction , Inpatients , Magnetic Resonance Imaging , Male , Neurology , Retrospective Studies , Spinal Cord , Stroke , Urinary Incontinence, Urge , Urinary Retention , Urination
12.
Article in English | WPRIM | ID: wpr-764104

ABSTRACT

Prostate cancer (CaP) is the most common cancer diagnosed among men in the United States and the fifth most common cancer among men in Korea. Unfortunately, the early stages of CaP may have no symptoms. Thus, early detection is very important and physicians managing voiding dysfunction must have awareness about CaP. The traditional tests used for early detection of CaP are the prostate-specific antigen (PSA) blood test and digital rectal examination. However, a high PSA level is not specific for CaP. Benign prostatic hyperplasia, prostatitis, urinary tract infection, and urinary retention can all cause a high PSA level. Thus, no test shows sufficient accuracy to truly be useful for screening men for CaP. A prostate biopsy is the only method that yields a definitive diagnosis of CaP; however, this test is invasive and uncomfortable. Recently, new biomarkers for CaP detection have been proposed to improve the accuracy of the PSA test. In this review, we summarize our knowledge of various new biomarkers, including PSA-associated biomarkers (the prostate health index and 4Kscore), molecular biomarkers (PCA3, TMPRSS2: ERG fusion gene, and various miRNAs), and proteomics-associated biomarkers, and the ways in which they may improve the detection rate of CaP. Accordingly, this review can raise awareness about CaP to physicians managing voiding dysfunction and be a good reference for them.


Subject(s)
Biomarkers , Biopsy , Diagnosis , Digital Rectal Examination , Discrimination, Psychological , Early Detection of Cancer , Hematologic Tests , Humans , Korea , Male , Mass Screening , Methods , Prostate , Prostate-Specific Antigen , Prostatic Hyperplasia , Prostatic Neoplasms , Prostatitis , United States , Urinary Retention , Urinary Tract Infections
13.
Article in English | WPRIM | ID: wpr-764101

ABSTRACT

PURPOSE: OnabotulinumtoxinA has demonstrated efficacy and safety in the treatment of urinary incontinence (UI) associated with neurogenic detrusor overactivity (NDO) and idiopathic overactive bladder (OAB); however, real-world evidence is limited. This postmarketing surveillance study aimed to assess the effectiveness and safety of onabotulinumtoxinA in Korean patients with UI associated with NDO or OAB with an inadequate response or intolerance to anticholinergics. METHODS: Patients received 200 U (NDO) or 100 U (OAB) of onabotulinumtoxinA. Effectiveness (assessed using the validated International Consultation on Incontinence Questionnaire-Short Form [ICIQ-SF]) and safety were assessed for 1–4 months after onabotulinumtoxinA administration. RESULTS: Overall, 686 patients (NDO, 161; OAB, 525) comprised the safety population; of these, 612 patients were analyzed for effectiveness. There was a significant decrease (P5 points from baseline in the ICIQ-SF score was observed in 64.9% and 47.3% of patients in the NDO and OAB groups, respectively. Following treatment, 59.9% in the NDO group and 43.0% in the OAB group were dry. There was no effect of age on effectiveness in either group. Only 10 adverse drug reactions (ADRs) were reported in 5.6% of NDO patients and 20 ADRs in 3.2% of OAB patients. Most ADRs in both groups were related to the lower urinary tract such as dysuria (NDO, 1.2%; OAB, 0.6%) and urinary retention (NDO, 0.6%; OAB, 1.5%). CONCLUSIONS: Effectiveness and safety of onabotulinumtoxinA in Korea in a real-world setting was demonstrated.


Subject(s)
Cholinergic Antagonists , Drug-Related Side Effects and Adverse Reactions , Dysuria , Humans , Korea , Outcome Assessment, Health Care , Urinary Bladder, Neurogenic , Urinary Bladder, Overactive , Urinary Incontinence , Urinary Retention , Urinary Tract
14.
Article in Chinese | WPRIM | ID: wpr-773890

ABSTRACT

OBJECTIVE@#To explore the clinical significance of elongated needle in the treatment of urinary retention after spinal cord injury.@*METHODS@#From January 2016 to June 2018, 60 patients with urinary retention after spinal cord injury were divided into elongated needle acupuncture group and needle acupuncture group, 30 cases in each group. The Shuidao(ST28) and Zhibian(BL54) were selected as the treatment of acupoints. In the elongated needle group, there were 23 males and 7 females, with a mean age of(52±9) years old. The patients in this group were treated on both sides, and the electro-acupuncture apparatus was used for 30 minutes at frequencies of 3 Hz for 30 minutes. In needle group, there were 24 males and 6 females, with a mean age of (56±10) years old. After treatment, the needles were retained for 30 minutes. The treatment frequencies of both groups were once every other day and passed for 2 months. After 2 months of treatment, the clinical significances of the treatment of the disease were explored by analyzing the time between the two groups of patients to reach the equilibrium bladder, diary urinary diary, urodynamics and urinary tract infection between the two groups.@*RESULTS@#(1)Time to reach the equilibrium bladder:(39.5±1.2) days in elongated needle group and (46.5±2.1) days in needle group; the time to reach the equilibrium bladder in the two groups was significantly different(<0.05). (2)Comparison of urination diary between the two groups:the daily number of catheterization, the amount of each catheterization, the number of daily urination, and the amount of urine per urination after treatment were better than those before treatment by intra-group comparison(<0.05); the number of daily catheterization, the amount of daily catheterization, the number of daily urination, and the amount of urine output per patient in elongated needle group were better than those in needle group by comparison between two groups(<0.05). (3)Comparison of improvement of urinary tract infection between the two groups:the urinary tract infection were better than that before treatmant in each group by intra-group comparison; the improvement rate of urinary tract infection in awn needle group (1/3.3%) was higher than that in needle group(5/16.7%), with significantly differences. (4)Comparison of urodynamic index between two groups:by intra-group comparison, the VH2O, Pves, Pdet, Qave, Qmax, and BC of the two groups were better than those before treatment(<0.05); By comparison between two groups, the improvement of VH2O, Pves, Pdet, Qave, Qmax and BC were better than those of the needle group (all <0.05).@*CONCLUSIONS@#The elongated needle is better than conventional needle in improving urinary retention, urinary tract infection and urodynamic index in patients with urinary retention after spinal cord injury. It has positive significance in improving patients' quality of life and is worth applying to clinical.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Needles , Quality of Life , Spinal Cord Injuries , Urinary Retention , Urodynamics
15.
Article in Chinese | WPRIM | ID: wpr-776278

ABSTRACT

OBJECTIVE@#To observe the efficacy differences between acupuncture combined with grain-moxibustion and acupuncture on acute urinary retention after epidural anaesthesia for anorectal diseases.@*METHODS@#A total of 60 patients were randomized into an acupuncture combined with grain-moxibustion group and an acupuncture group, 31 cases in each one. In the acupuncture group, acupuncture was applied at Zhongji (CV 3), Guanyuan (CV 4), Qihai (CV 6), Shuidao (ST 28), Pangguangshu (BL 28), Sanyinjiao (SP 6) and Yinlingquan (SP 9). In the acupuncture combined with grain-moxibustion group, grain-moxibustion was given at Zhongji (CV 3), Guanyuan (CV 4), Qihai (CV 6) and Shuidao (ST 28) on the basis of acupuncture. Those who failed to urinate 60 min after the first treatment received the second treatment. 30 min after the second treatment, the lower abdominal symptom scores before and after treatment as well as the bladder residual urine volume after the first urination after treatment were compared between the two groups. In addition, the clinical efficacy and security were evaluated.@*RESULTS@#Compared before treatment, the symptom scores after treatment were reduced in the two groups (<0.05), and the score in the acupuncture combined with grain-moxibustion group was lower than that in the acupuncture group after treatment (<0.05). The bladder residual urine volume in the acupuncture combined with grain-moxibustion group was (26.71±17.01) mL, which was lower than (35.32±20.76) mL in the acupuncture group (<0.05). The total effective rate was 93.5% (29/31) in the acupuncture combined with grain-moxibustion group, which was superior to 71.0% (22/31) in the acupuncture group (<0.05).@*CONCLUSION@#The efficacy of acupuncture combined with grain-moxibustion is superior to simple acupuncture on acute urinary retention after epidural anaesthesia for anorectal diseases, which is safe and reliable.


Subject(s)
Acupuncture Therapy , Humans , Moxibustion , Rectal Diseases , Therapeutics , Urinary Retention
16.
Article in Chinese | WPRIM | ID: wpr-776259

ABSTRACT

OBJECTIVE@#To investigate the effect of electroacupuncture preconditioning combined with induced urination on urinary retention after milligan-morgan hemorrhoidectomy.@*METHODS@#Eighty patients with mixed hemorrhoids were randomly divided into an electroacupuncture group and a routine group, 40 cases in each group. Anesthesia at Yaoshu (GV 2) was given in the two groups. In the electroacupuncture group, electroacupuncture at Zhongji (CV 3),Guanyuan (CV 4),Pangguangshu (BL 28) and Sanyinjiao (SP 6) was applied with tolerant intensity for 30 min before operation, 2 Hz/100 Hz in frequency. After operation, induced urination was given, namely hot compress of bladder area and sound of hearing water. In the routine group,induced urination was given after operation. The score of the first urination waiting time, the distension of lower abdomen on the evening of the postoperative, the first time urinary volume and incidence of urinary retention were compared between the two groups.@*RESULTS@#The scores of the first urination waiting time after operation and distension of lower abdomen in the evening of the postoperative in the electroacupuncture group were lower than those in the routine group, the first time urinary volume was more than that in the routine group, and the incidence of urinary retention was lower than that in the routine group (5.0% (2/40) vs 22.5% (9/40), all <0.05).@*CONCLUSION@#Electroacupuncture preconditioning combined with induced urination can effectively prevent the incidence of urinary retention after milligan-morgan hemorrhoidectomy.


Subject(s)
Electroacupuncture , Hemorrhoidectomy , Hemorrhoids , Humans , Urinary Retention , Therapeutics , Urination
17.
Article in Chinese | WPRIM | ID: wpr-776234

ABSTRACT

OBJECTIVE@#To compare the clinical effect of the herbal cake-separated moxibustion with new-type moxibustion device combined with bladder function exercise and simple bladder function exercise on improving urinary retention after spinal cord injury.@*METHODS@#Sixty-eight patients were randomly divided into a control group and an observation group, 34 cases in each group. The bladder function exercise was given in the control group. On the basis of the treatment in the control group, herbal cake-separated moxibustion with new-type moxibustion decice was applied at Shenque (CV 8), Guanyuan (CV 4), Qihai (CV 6), Zhongji (CV 3) for 30 min, once a day in the observation group. The two groups were treated for 4 weeks as a course, 2 courses of treatment were needed. Bladder maximum volume, bladder residual urine volume and urinary tract infection before and after treatment were compared, and the clinical efficacy was evaluated in the two groups.@*RESULTS@#The total effective rate in the observation group was 88.2% (30/34), which was better than 64.7% (22/34) in the control group (<0.05). The increase of bladder maximum volume and decrease of bladder residual urine volume in the observation group were significantly better than those in the control group (<0.01). At the 4th, 6th and 8th weeks for treatment, the improvement of urinary tract infection in the observation group was better than that in the control group (<0.05).@*CONCLUSION@#At the same time of bladder function training, herbal cake-separated moxibustion with new-type moxibustion device could improve urinary retention after spinal cord injury.


Subject(s)
Humans , Moxibustion , Spinal Cord Injuries , Therapeutics , Treatment Outcome , Urinary Bladder , Urinary Retention , Therapeutics
18.
Article in Chinese | WPRIM | ID: wpr-775938

ABSTRACT

OBJECTIVE@#To explore the clinical effect of rapid massage at Shuidao (ST 28) to prevent puerpera from postpartum urinary retention.@*METHODS@#A total of 200 puerpera giving birth through vagina were enrolled and divided into an observation group and a control group according to the random number table method, 100 cases in each group. In the observation group, rapid massage at Shuidao (ST 28) was applied. In the control group,there was no intervention and urinated naturally. The traditional Chinese medicine syndrome scale was used to evaluate poor sense of urination, and record puerpera with or without postpartum urinary retention, the poor sense of first urination, the first time of urination, the amount of first urination and postpartum hemorrhage.@*RESULTS@#The poor sense of first urination in the observation group was significantly lower than that in the control (<0.001), the first time of urination in the observation group was significantly earlier than that in the control group (<0.001), the amount of first urination in the observation group was significantly more than that in the control group (<0.001), the observation group was superior to the control group to prevent postpartum urinary retention (<0.05).@*CONCLUSION@#Rapid massage at Shuidao (ST 28) can reduce the poor sense of first urination, significantly advance the time of spontaneous urination, significantly increase the amount of first urination and effectively prevent postpartum urinary retention.


Subject(s)
Acupuncture Points , Female , Humans , Massage , Postpartum Period , Pregnancy , Urinary Retention , Therapeutics , Urination
19.
Article in Chinese | WPRIM | ID: wpr-775901

ABSTRACT

OBJECTIVE@#To explore the clinical effects of acupuncture with elongated needle on urinary retention after spinal cord injury.@*METHODS@#A total of 66 patients with urinary retention after spinal cord injury were randomized into an elongated needle group (34 cases) and a filiform needle group (32 cases). In both of the groups, the routine orthopedic treatment and the bladder function training were adopted. Additionally, in the elongated needle group, the acupuncture at Zhibian (BL 54) and Shuidao (ST 28) was used with the elongated needle. In the filiform needle group, the acupuncture with filiform needle was used at Zhibian (BL 54) and Shuidao (ST 28). In both of the groups, acupuncture treatment was provided once every two days, for 2 months consecutively. Separately, before treatment and after 1, 2 month treatment, the residual urine volume, urodynamic parameters (bladder capacity, peak urinary flow rate and bladder pressure) and safety indicators were observed in the patients of the two groups. The clinical therapeutic effects were compared between the two groups.@*RESULTS@#As compared with the results before treatment, the residual urine volume was reduced obviously (all <0.01), bladder capacity, peak urinary flow rate and bladder pressure were improved obviously (all <0.01) after 1, 2 month treatment in the two groups. After 1, 2 month treatment, the residual urine volume in the elongated needle group was lower than the filiform needle group (both <0.01). The improvements in bladder capacity, peak urinary flow rate and bladder pressure in the elongated needle group were superior to the filiform needle (all <0.01). The total effective rate was 94.1% (32/34) in the elongated needle group, higher than 71.9% (23/32) in the filiform needle group (<0.01). During treatment, there was no damage of kidney function, no fainting or broken needle happened in the two groups.@*CONCLUSION@#Acupuncture with elongated needle achieves the significant effects on urinary retention after spinal cord injury. This therapy is better than acupuncture with filiform needle and safe in operation.


Subject(s)
Acupuncture Therapy , Humans , Needles , Spinal Cord Injuries , Urinary Retention , Therapeutics
20.
Rev. enferm. UERJ ; 26: e25840, jan.-dez. 2018. ilus
Article in Portuguese | LILACS, BDENF | ID: biblio-991144

ABSTRACT

Objetivo: identificar evidências científicas sobre as práticas para o diagnóstico da retenção urinária. Método: trata-se de uma Scoping Review. A busca foi realizada nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library e SCOPUS. Das 2482 referências encontradas, 23 foram selecionadas. Resultados: os 23 artigos que foram agrupados de acordo com a clínica do paciente: clínica cirúrgica, clínica de reabilitação e clínica obstétrica. E as práticas utilizadas para o diagnóstico da retenção urinária: cateterismo urinário de alívio, por meio do ultrassom portátil de bexiga, com a associação do ultrassom portátil de bexiga e do cateterismo urinário e/ou com medidas não invasivas. Conclusão: o diagnóstico da retenção urinária é um assunto que vem sendo discutido há algum tempo, no entanto, ainda não há um consenso, e a sua prática é realizada muitas vezes sem eficácia.


Objective: to identify scientific evidence on urinary retention diagnostic practices. Method: this scoping review searched the Latin American & Caribbean Health Sciences Literature, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library and SCOPUS databases. Of the 2482 references found, 23 were selected. Results: the 23 articles were grouped by patient clinic (surgery, rehabilitation or obstetrics) and by urinary retention diagnostic practices (intermittent urinary catheterization, by portable bladder ultrasound, combination of portable bladder ultrasound and urinary catheterization and/ or non-invasive measures). Conclusion: diagnosis of urinary retention is an issue that has been discussed for some time. However, there is still no consensus, and in practice it is often performed ineffectively.


Objetivo:identificar evidencias científicas sobre las prácticas para el diagnóstico de la retención urinaria. Método: se trata de una Scoping Review. Se realizó la búsqueda en las bases de datos Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library y SCOPUS. De las 2482 referencias encontradas, se seleccionaron 23. Resultados: los 23 artículos se agruparon según la clínica del paciente: clínica quirúrgica, clínica de rehabilitación y clínica de obstetricia. Y las prácticas utilizadas para el diagnóstico de retención urinaria: cateterismo urinario de alivio, a través de ecografía (portátil) de vejiga, con la combinación de ecografía de vejiga y del cateterismo urinario y/o con medidas no invasivas. Conclusión: el diagnóstico de la retención urinaria es un tema que está siendo discutido desde hace algún tiempo, sin embargo, todavía no existe un consenso y su práctica se realiza a menudo ineficazmente.


Subject(s)
Humans , Urinary Retention/diagnosis , Nursing Care , Nursing Research , Review , Evidence-Based Practice
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