Quality of life evaluation of patients with neurogenic bladder submitted to reconstructive urological surgeries preserving the bladder

Treatment of neurogenic bladder (BN) aims to upper urinary tract protection. When the conservative clinical measures are insufficient, surgical treatment is indicated. Though admittedly important, the quality of life (QoL) has been little studied in these patients, there are even contradictory results. The aim of this study was to evaluate QoL before and after bladder augmentation in patients with BN refractory to medical treatment. We analyzed, prospectively, the data of 67 patients who underwent surgical treatment for BN by questionnaire SF-36® and Qualiveen® QoL before and after six months of operation. Comparisons using paired t-tests and Wilcoxon and the assumption of normality was assessed using the Shapiro-Wilk test were made. According to the analysis of the SF-36® questionnaire, the patients had higher QoL indices in the postoperative period in the areas functional capacity, general state of health, vitality, social aspects, emotional aspects and mental health (n = 67; p <0.05). The questionnaire also revealed Qualiveen® best result in quality of life index in the postoperative period, and show lower specific negative impact by urinary problems (n = 36; p <0.05). The results show that, despite not being the main objective, the bladder augmentation results in significant improvement in QoL, probably related to the perception of better health and the resolution of urinary incontinence. Thus, the bladder augmentation associated with other urologic reconstruction techniques allows the upper urinary tract protection, and contribute to a better quality of life of patients with BN.

Doença de Graves neonatal / Neonatal Graves disease

A doença de Graves neonatal é observada em baixa porcentagem de crianças nascidas de mães portadoras dessa doença. Pode ser grave, com risco de morte e com efeitos deletérios sobre o desenvolvimento neural, embora seja geralmente autolimitada. A maioria dos recém-nascidos com hipertireoidismo pode melhorar rapidamente, desde que a terapia adequada seja logo iniciada, o que evita lesões sobre o sistema nervoso. (AU)

The neonatal Graves 'disease refers to hyperthyroidism, which is observed in a small percentage of children born to mothers with this disease. Although neonatal Graves' disease is usually self-limited, can be severe, life-threatening, and harmful effects on neural development. With appropriate therapy, started immediately, most newborns with hyperthyroidism may have improved rapidly, avoiding the negative consequences of hyperthyroidism in the developing nervous system. (AU)