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Pediatric urinary incontinence (PUI) is common in clinical practice and seriously affects the quality of life as well as physical and mental health of patients. PUI is a multi-factorial related abnormality, very complex in etiology and types. The occurrence of PUI is mostly associated with abnormal vesicourethral function. Urodynamic examination (UDS) is the golden standard to assess voiding function and diagnose the type of bladder and urethral function in children with PUI. UDS of PUI is of great clinical value in determining the cause, making treatment protocol as well as evaluating the therapeutic response. However, UDS in children has not been popularized in China, which seriously affects the diagnosis and treatment of PUI. This article reviews the research progress in the clinical application of UDS in the evaluation of PUI, in order to provide reference for improving the diagnosis and treatment of this disease.
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Objective:To probe into the influence of adhesive tape and string fixation on postoperative catheter-associated urinary tract infection(CAUTI) and comfort degree of patients undergoing percutaneous nephrolithotomy.Methods:A total of 106 cases of male urinary tract calculi patients undergoing percutaneous nephrolithotomy in Urology Department of First Affiliated Hospital of Zhengzhou University from January 2018 to April 2019 were selected. They were divided into the experimental group (55 cases) and the control group (51 cases) by random digits tbale method. The control group received platform fixation method, the experimental group implemented adhesive tape and string fixation method for catheter fixation. The incidence of CAUTI were compared between two groups, the catheter exposed length changes and catheter-related discomfort changes was also compared.Results:The incidence of CAUTI were 3.9%(2/51) in the experimental group, significantly lower than 16.7%(8/48) in the control group, the difference was statistically significant ( χ2=4.42, P<0.05). After 3 days, 5 days and 7 days of indwelling catheter, the catheter exposed length were (17.76 ± 1.41), (17.12 ± 1.28), (16.49 ± 1.63) cm, significantly longer than those in the control group (16.04 ± 1.96), (15.81 ± 1.78), (15.29 ± 1.96) cm ( t=5.00, 4.17, 3.32, all P<0.05); the catheter-related discomfort symptom scores at above mentioned time were 0.82 ± 0.09, 0.53 ± 0.07, 0.49 ± 0.08, significantly lower than those in the control group (1.17 ± 0.23, 0.92 ± 0.09, 0.77 ± 0.11), the differences were statistically significant ( t=2.10, 2.88, 2.46, all P<0.05). Conclusions:Adhesive tape and string fixation method for catheter fixation can reduce the incidence of CAUTI of patients with urinary tract calculi, improve the catheter fixed state as well as reduce the patient′s catheter-related discomfort.
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Objective:To explore the effects of video combined with action-oriented teaching on self-management skill and complications in patients with urinary calculus after indwelling tube, and to provide basis for improving the effect of clinical health education.Methods:A total of 100 patients with urinary calculus after indwelling double J tube from department of urological surgery of the First Affiliated Hospital of Zhengzhou University from March 2018 to October 2019 were divided into experimental group and control group, 45 cases in each group by ramdom digits table method. The patients in the control group recieved routine care and oral health education, the experimental group implemented video combined with action-oriented teaching. The levels of health self-management skill as well as complications were compared between the two groups.Results:After extubation, self-management behavioral scores, self-management cognitive scores, self-management environment scores and total scores in Adults Health Self-Management Skill Rating Scale were (54.26 ± 4.39), (57.22 ± 6.93), (39.91 ± 7.91), (151.39 ± 13.37) points, which were significantly higher than those in the control group (47.92 ± 6.96) , (52.69 ± 6.45), (34.63 ± 8.53), (135.24 ± 12.71) points, the difference were statistically significant ( t values were 2.64-6.04, all P<0.05). The total incidence of tube related complications was 39.1% (18/46) in the experimental group, which was significantly lower than that in the control group 61.2% (30/49). The incidence of lumbago, bladder irritation symptom and shematuria were 10.9% (5/46), 13.0% (6/46), 10.9% (5/46) in the experimental group, significantly lower than those in the control group 28.6% (14/49), 32.7% (16/49), 30.6%(15/49), the differences were statistically significant ( χ2 values were 4.63-5.56, all P<0.05). Conclusions:Video combined with action-oriented teaching can effectively improve self-management skill and reduce tube-related complications of patients with urinary calculi after indwelling double J tube.
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Objective:To analyze the urodynamic and clinical features of detrusor underactivity(DU)in elderly men aged 60 years and over.Methods:Five hundred and seventy-three men aged 60 years and over underwent urodynamic measurements due to dysuria were retrospectively analyzed.According to the urodynamic parameters of bladder contractibility index(BCI)and bladder outlet obstruction index(BOOI), they were divided into the three groups: only detrusor underactivity(DU group)(BCI<100 and BOOI<20), only bladder outlet obstruction(BOO group)(BCI≥100 and BOOI≥40), and the combined non-DU and non-BOO group(NDB group)(BCI≥100 and BOOI<20). The urodynamic and clinical features were compared between the three groups.Results:The internalized 323 patients meeting inclusion and exclusion criteria were divided into 3 groups: 75 in the DU, 207 in the BOO and 41 in the NDB.The age was higher in DU and BOO groups than in NDB group( P<0.05). The DU group versus the NDB group showed the higher levels or values in the volume at first desire(FDV)[(279±80)ml vs.(238±72)ml], the proportions of incomplete bladder emptying(41% vs.17%), urine flow interruption(39% vs.15%)and retention(26% vs.7%), and the lower levels in the voiding efficiency(VE)[(61±32)% vs.(110±41)%], (all P<0.05). The DU group vs.the BOO group showed the increased levels or values in the FDV[(279±80)ml vs.(206±67)ml]and maximum cytometric capacity(MCC)(353±113 ml vs.281±94 ml)and the proportions of urine flow interruption(39% vs.22%), TURP(26% vs.6%), and retention(26% vs.14%), and the decreased levels or values in the VE[(61±32)% vs.(78±37%)], the proportions of DO(41% vs.77%), urgency(26% vs.43%)and nocturia(23% vs.39%)(all P<0.05). Conclusions:The main urodynamic and clinical features are manifested as the reduction of bladder sensation and bladder emptying rate, urine flow interruption, urinary retention and having a TURP history in elderly man with detrusor underactivity.The proportions of DU and BOO are increased along with aging.
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Objective To investigate the voiding patterns of term and preterm newborns and whether voiding in term and preterm neonates was accompanied by any cortical arousal. Methods Between May 2013 and September 2013,64 hospitalized newborns at Neonatal Intensive Cave Unit in the Frist Affiliated Hospital of Zhengzhou University were recruited in this study. In these patients,31 cases were term newborns(20 male,11 female)and 33 cases were preterm newborns(19 male,14 female). The term and preterm newborns gestational ages at birth were(38. 2 ± 1. 2) weeks and(32. 1 ± 1. 6)weeks,weighted(3. 3 ± 0. 4)kg and(1. 7 ± 0. 3)kg,respectively and postnatal ages at study were[4 - 16(10. 5 ± 3. 6)]days and[4 - 16(11. 2 ± 3. 1)]days. The voiding volume(VV),post - void residual volumes(PRV),body movement rate and voiding frequency(VF)in 4 hours as well as the volume of milk and liquid fed at the same time frame were recorded and analyzed,retrospectively. At the same time electrocardiogram(ECG)and electroencephalogram(EEG)were recorded. The changes of heart rate(HR),EEG frequency,respiratory frequency (RF)during the 5 s period and 30 s before and after voiding onset were compared respectively. For cortical arousal definition the recommendations of the International Pediatric Work Group on Arousals(2005)were used. Results A total of 184 times of voiding were recorded. In preterm newborns,the VV and body movements rate were significantly lower compared with the term newborns[(21. 8 ± 7. 9)mL and(41 ± 21)% vs(26. 4 ± 8. 7)mL and(62 ± 19)% , t = 3. 75,4. 20,all P ﹤ 0. 05]. However,the VF and PRV were significantly higher in preterm newborns[(1. 7 ± 0. 9) mL and(3. 2 ± 1. 1)times vs(1. 2 ± 0. 7)mL and(2. 6 ± 0. 9)times,t = 2. 47,2. 38,all P ﹤ 0. 05]. Bladder voiding in these infants happened only during QS. In term newborns,HR frequency was higher during the 5 s interval before and after voiding onset when compared with the 30 s period before voiding onset[(152 ± 6)times/ min and(152 ± 5) times/ min vs(147 ± 6)times/ min,t = 5. 30,5. 76,all P ﹤ 0. 05]and the EEG frequency[(2. 6 ± 0. 1)Hz and (2. 6 ± 0. 1)Hz vs(1. 5 ± 0. 1)Hz,t = 70. 0,70. 0,all P ﹤ 0. 05]. While the HR and EEG frequency of preterm neo-nate was not changed before and after bladder voiding onset. The RF of both term and preterm neonates were not changed before and after bladder voiding onset. Conclusions The voiding patterns between term and preterm were sig-nificantly different and cortical arousal was found only in term neonates,which indicate the term newborns have better mature bladder function and development of nervous system.