Enuresis of Elementary School Children in Seoul and Gyeonggi Province: Results according to the Treatment Experiences / 대한비뇨기과학회지

PURPOSE: To acquire the information necessary to educate the public about enuresis, and provide direction for its treatment, we tried to evaluate the treatment experiences and results, according to treatment methods used in elementary school children experiencing bed-wetting. MATERIALS AND METHODS: A total of 10,000 questionnaires were distributed to the parents of elementary school children living in the Seoul and Gyeonggi provinces, of which 7,813 were collected, ad 6,026 were fit for evaluation. RESULTS: There were 1,307 (21.7%) bed-wetters, but only 345 (26.4%) of these gave affirmative answers to having a specialized form of treatment. Of the 345, 232 (67.2%) took herbal medicine, while 113 (24.6%) received medical treatment, with 174 (50.4%) taking either herbal medicine or medical treatment; and 171 (49.6%) having tried both herbal medicine and medical treatment. Using herbal medicine, 29 (28.4%) were cured and 18 (17.6%) showed marked improvements. Using medical treatment, 19 (26.4%) were cured and 25 (34.7%) showed marked improvements. Using a combination of the treatments, 44 (25.7%) were cured and 53 (31.0%) showed marked improvements. As for the treatment recommendation, of the 345 who received at least one treatment modality, 64 (18.6%) were recommended herbal medicine, and 135 (39.1%) a medical treatment. CONCLUSIONS: The herb medicine was the preferred treatment method. However, the medical treatment was superior in relation to its treatment results and recommendations. Therefore, the active promotion for the education and treatment of this disorder is required in order to minimize the negative psychological impact on bed-wetting children.

Pubovaginal Sling Operation Using Cadaveric Fascia Lata for the Female Stress Urinary Incontinence

PURPOSE: Pubovaginal sling operation has been main treatment procedure for female stress urinary incontinence. Allografts have been substituted for autografts as the material of pubovaginal sling operation to decrease postoperative morbidity, although to our knowledge their long-term durability is unknown. Therefore, we investigated the outcome and efficacy of pubovaginal sling operation using allograft cacaveric fascia lata. MATERIALS AND METHODS: From September 2000 to December 2001, 47 patients with stress urinary incontinence underwent pubovaginal sling operation using cadaveric fascia lata and had been followed up more than 10 months. Preoperative evaluation included medical history, physical examination, SEAPI score and urodynamic study including Abdominal leak point pressure (ALPP). All patients were assessed for the outcome of the procedure with subjective satisfaction by scores of SEAPI classification. RESULTS: With a mean follow-up of 18.2 months(range 10 to 25), urinary incontinence completely disappeared in 42 patients(89.4%), significantly improved in 4 patients(8.5%), not improve in 1 patient(2.1%). Marked improvement was shown in all patients according to the SEAPI score. Postoperative de novo urge incontinence was not found. Complication included suprapublic pain in 4 patients and transient urinary retention in 7 patients, but these were disappeared later in all patients. Operations with allograft fascia lata slings were tolerated, and neither infection nor erosion was encountered. CONCLUSIONS: Pubovaginal sling operation with a allograft cadaveric fascia lata is an effective treatment for stress urinary incontinence with high cure rate and minimal complication.

Multiple Cystic Lymphangiomas of the Penis, Scrotum and Lower Abdomen / 대한비뇨기과학회지

Lymphangiomas result from a failure of lymphatic drainage into the venous system due to atresia or an insufficiency of the efferent lymphatic channels. The neck and axillary regions are most commonly affected, while the condition is rarely found in the inguinal area, scrotum, retroperitoneal space, abdominal viscera, arm, pelvis or bones. We report a case of a cystic lymphangioma of the lower abdomen, penis and scrotum in a 29-year-old man.

The Effect of Pelvic Floor Muscle Exercise Using Biofeedback for Stress Urinary Incontinence

PURPOSE: Pelvic floor muscle exercise, biofeedback and electrical stimulation have been known as initial treatment options for women with stress urinary incontinence. We evaluated the clinical outcome of pelvic floor muscle exercise in combination with biofeedback and electrical stimulation as a treatment for stress urinary incontinence. MATERIALS AND METHODS: Twenty three patients with stress urinary incontinence who had been treated with biofeedback and electrical stimulation from June 1999 to March 2000 were analyzed. Patients were evaluated with their medical history, physical examination, SEAPI score, and urodynamic study including Valsalva leak point pressure(VLPP). All patients were assessed for the outcome of the procedure with subjective satisfaction by scores of SEAPI classification and the relative strength of pelvic floor muscle by maximal vaginal pressure and contraction time. RESULTS: Among 23 women followed up for 6 month to 1 year, urinary incontinence completely disappeared in 6 patients(26.1%), significantly improved in 13(56.5%) and not improved in 4(17.4%). There was a significant increase in maximal vaginal pressure, contraction time and decrease in the scores of SEAPI classification. CONLUSIONS: Pelvic floor muscle exercise in combination with biofeedback and electrical stimulation is a simple, safe, and effective treatment of stress urinary incontinence. The patient compliance is closely related to the success rate.

The Anterior Vaginal Wall Sling Operation for Female Stress Urinary Incontinence: long-term follow-up results

PURPOSE: Sling operation has been known the best treatment of woman with anatomical urinary incontinence(AI) and intrinsic sphincteric deficiency(ISD). We evaluated the clinical outcome of anterior vaginal wall sling as a treatment for stress urinary incontinence. MATERIALS AND METHODS: Thirty three patients with stress urinary incontinence who treated with anterior vaginal wall sling from October 1995 to March 2000 were analyzed. Patients were evaluated preoperatively with history, physical examination, voiding cystourethrography, evaluation with SEAPI classification and urodynamic study including of Valsalva leak point pressure(VLPP) and maximal urethral closing pressure(MUCP). All patients were assessed for the outcome of the procedure and subjective satisfaction by questionnaires. Surgical outcomes were then analyzed in relation to VLPP , MUCP and subjective SEAPI score. Of the total 33 patients, 26(78.8%) had AI and 7(21.2%) had ISD. According to the Stamey grades, 6(18.2%) were grade I, 23(69.7%) were grade II and 4(12.1%) were grade III. RESULTS: With a mean follow-up of 42.4 months (range 14 to 66). Urinary incontinence completely disappeared in 20 patients(60.6%), significantly improved in 8 patients(24.2%), failed in 5 patients(15.2%). Complication included urinary retention in two patients, suprapubic pain in two patients, and urge incontinence in two patients. Pre- and postoperative urge incontinence was major factor for failure rate. CONCLUSIONS: Anterior vaginal sling operation is a simple, safe and effective procedure for treatment of both AI and ISD. The urge incontinence is closely related to success rate.