Improved model for the establishment and evaluation of detrusor overactivity in female Wistar rats

Objective To improve the model for establishment and evaluation of detrusor overactivity in female Wistar rats. Materials and Methods We ligated the perineal urethra of female Wistar rats and then performed filling cystometry. The probability of detrusor overactivity, bladder capacity, peak voiding pressure and histological changes were investigated. Results Detrusor overactivity ratio of the obstruction group was 32.4%. Bladder capacity increased from 0.273 ± 0.036mL in control group to 0.89 ± 0.19mL in detrusor overactivity group (P < 0.001), and peak voiding pressure increased from 45.9 ± 4.1 cm.H2O to 63.5 ± 17.4cm.H2O (P = 0.007). For obstruction group, compared to no detrusor overactivity rats, detrusor overactivity rats had higher bladder capacity (0.89 ± 0.19mL versus 0.43 ± 0.09mL, P < 0.001) and higher peak voiding pressure (63.5 ± 17.4cm.H2O versus 44.8 ± 6.2cm.H2O, P = 0.005). Detrusor overactivity rats were classified according to peak voiding pressure (49.2 ± 4.2cm.H2O versus 80.8 ± 7.1cm.H2O, P < 0.001). Moreover, bladder weight increased significantly in detrusor overactivity rats (P = 0.003, P = 0.028) and detrusor histological hypertrophy was observed. Conclusions Ligating perineal urethra and filling cystometry with intra-urethral cannula approach is a simple and easily reproducible method to establish and evaluate the model of detrusor overactivity in rats. .

Antegrade pressure measurement of urinary tract in children with persistent hydronephrosis

INTRODUCTION: Dilation of urinary tract occurs without the presence of obstruction. Diagnostic methods that depend on renal function may elicit mistaken diagnosis. Whitaker (1973) proposed the evaluation of urinary tract pressure submitted to constant flow. Other investigators proposed perfusion of renal pelvis under controlled pressure, making the method more physiological and reproducible. The objective of the present study was to evaluate the results of the anterograde pressure measurement (APM) of the urinary tract of children with persistent hydronephrosis after surgery suspected to present persistent obstruction. MATERIALS AND METHODS: Along 12 years, 26 renal units with persistent hydronephrosis after surgery (12 PUJ and 14 VUJ) were submitted to evaluation of the renal tract pressure in order to decide the form of treatment. Previous radionuclide scans with DTPA, intravenous pyelographies and ultrasounds were considered undetermined in relation to obstruction in 10 occasions and obstructive in 16. APM was performed under radioscopy through renal pelvis puncture or previous stoma. Saline with methylene blue + iodine contrast was infused under constant pressure of 40 cm H2O to fill the urinary system. The ureteral opening pressure was measured following the opening of the system and stabilization of the water column. RESULTS: Among the 10 cases with undetermined previous diagnosis, APM was considered non-obstructive in two and those were treated clinically and eight were considered obstructive and were submitted to surgery. Among the 16 cases previously classified as obstructive, nine confirmed obstruction and were submitted to surgery. Seven cases were considered non-obstructive, and were treated clinically, with stable DMSA and hydronephrosis. CONCLUSIONS: APM avoided unnecessary surgery in one third of the cases and was important to treatment decision in 100%. We believe that this simple test is an excellent diagnostic tool when selectively applied mainly in the presence of functional deficit.

Valvas de uretra anterior: causas de obstrucción infravesical / Anterior urethral valves as a cause of infravesical obstruction

Las valvas de uretra anterior como causa de obstrucción infravesical congénita son poco frecuentes en niños, pues se informan 47 casos en la literatura. En éste informe se presentan forma de aparición, evaluación sistemática, conductas terapéuticas y resultados obtenidos. El uso de vesicostomía en el periodo neonatal previene las potenciales complicaciones con el uso de eletrofulguración transuretral que pueden ocurrir por el tamaño pequeño de la uretra. Así mismo, se ofrece la clasificación de las valvas de uretra anterior de conformidad con los hallazgos radiográficos

Hemodinámica renal en pacientes con obstrucción uretral: evaluación con ultrasonografía Doppler / Renal hemodynamics in patients with ureteral stenosis: evaluation with Doppler ultrasonography

Durante la obstrucción ureteral se presentan cambios en el flujo arterial al riñon afectado. Este estudio tuvo como finalidad determinar estos cambios mediante ultrasonografía Doppler de la arteria renal. Estas determinaciones se llevaron a cabo en seis unidades renales con obstrucción ureteral, en las seis unidades renales contralaterales a la obstruida y en 14 unidades renales testigos. Se encontró que las características de flujo de la arteria renal manifestaban diferencias estadísticamente significativas entre la unidad renal obstruida y las unidades renales contralaterales y testigos

Obstrucción urinaria debida a vasos aberrantes: comunicación de 14 casos / Urinary obstruction secondary to aberrant vessels: report of 14 cases

Se revisaron 2184 expedientes de losw ingresos al servicio de urología y nefrología del Hospital General de México SS durante 1988 y se encontraron historias clínicas de 58 pacientes (2.65 porciento) con diagnóstico de obstrucción ureteropiélioca. Fueron 14 individuos (24 porciento) con afección de vasos aberrantes, a todos ellos se les solicitaron exámenes de laboratorio y gabinete, así como prueba de Whitaker. Según el tipo de vaso aberrante, arterial o venoso, y del lugar de urgencia se efectuó el tratamiento quirúrgico pertinente. El tratamiento postoperatorio se hizo con antimicrobianos y el promedio de días de hospitalización fue de seis. Los pacientes fueron citados a consulta externa; transcurridos tres meses se repitieron los exámenes de laboratorio, la urografía excretora y se practicó la prueba de Whitaker.