A current perspective on geriatric lower urinary tract dysfunction

Lower urinary tract dysfunction-such as urinary incontinence (UI), detrusor overactivity, and benign prostatic hyperplasia-is prevalent in elderly persons. These conditions can interfere with daily life and normal functioning and lead to negative effects on health-related quality of life. UI is one of the most common urologic conditions but is poorly understood elderly persons. The overall prevalence of UI increases with age in both men and women. Elderly persons often neglect UI or dismiss it as part of the normal aging process. However, UI can have significant negative effects on self-esteem and has been associated with increased rates of depression. UI also affects quality of life and activities of daily living. Although UI is more common in elderly than in younger persons, it should not be considered a normal part of aging. UI is abnormal at any age. The goal of this review is to provide an overview of the cause, classification, evaluation, and management of geriatric lower urinary tract dysfunction.

Development of Korean Academy of Medical Sciences Guideline Rating the Physical Impairment; Kidney, Bladder, Urethra, Male and Female Reproductive Systems (Preliminary Report)

For the evaluation of the kidney impairment, serum creatinine concentrations or glomerular filtration rates are mainly used, and the conditions of solitary or transplanted kidney and chronic dialysis are also taken into the considerations. Some symptoms and signs of the chronic renal disability in spite of adequate treatment add one additional grade. For evaluating bladder and urethral impairment, the criteria include voiding symptoms and signs. The patients with urinary diversions have impairment grades depending on the alteration of upper urinary tract function. For penile impairment, the degrees are evaluated using the international index of erectile function, nocturnal penile tumescence and color doppler ultrasonography. For evaluating impairment of other male reproductive organs, functional and anatomical changes of these organs, analysis of the semen or hormones and the state of solitary testis are used as the criteria. For evaluating impairment of female reproductive organs, pregnancy potential, requirement of continuous treatment and the ability of sexual intercourse are used. Also, degree of impairment is modified according to the ages in evaluating female reproductive systems. We have tried to make this evaluation system objective, scientific, and convenient, but still find it leaving much to be desired.

Cirugía reconstructiva del tracto urogenital. / Reconstructive surgery of urogenital tract.

Se presenta un estudio retrospectivo en 63 pacientes con patología del tracto urogenital, ocupando las anomalías congénitas el primer lugar con 43 casos(68%), las lesiones traumáticas el segundo lugar con 12 casos(19%) y el tercer lugar las lesiones vesicales tuberculosas con 8 casos(13%). El propósito es hacer una revisión de los procedimientos diagnósticos y de las técnicas quirúrgicas utilizadas, analizando los resultados obtenidos y evaluando las complicaciones. Encontramos que los procedimientos diagnósticos usados han sido adeucados, que las técnicas quirúrgicas empleadas han dado buenos resultados, con restablecimiento anatómico y funcional del aparato Urogenital en unos casos y solo funcional en otros y que las complicaciones posoperatorias presentadas han sido mínimas. Se recomienda el uso de la ecografía, desde la vida prenatal para hacer diagnóstico precoz de las anomalías congénitas del tracto urinario y que el tratamiento quirúrgico de las anomalías congénitas del tracto urinario, sea realizado precozmente para restituir la función renal.