RESUMEN
Overactive bladder syndrome (OAB) is common chronic medical condition which has a major impact on health and quality of life. This condition affects daily activities, performance and social function and servers as a real challenge for care giver in attempt to treat patients' symptoms. Given the fact that therapy rarely results in cure and the high rate of discontinuation, treatment should primarily aim to reduce social and psychological disability. The purpose of our update is to give an overview of recent data regarding OAB, and to provide practical clinical tools for evaluation and management of OAB syndrome according to current literature evidence.
Asunto(s)
Vejiga Urinaria Hiperactiva/terapia , Árboles de Decisión , Femenino , Humanos , Vejiga Urinaria Hiperactiva/diagnósticoRESUMEN
OBJECTIVE: Three-dimensional (3D) ultrasound facilitates assessment of the anatomy of the urethral sphincter, a decrease in sphincter volume being associated with stress incontinence. Urethral pressure profilometry (UPP) is used to assess urethral sphincter function although it is not diagnostic of stress incontinence. The aim of this pilot study was to determine whether 3D sphincter volume can be correlated with the area under the UPP curve. METHODS: Primigravid women were recruited antenatally between 32 and 42 weeks' gestation. 3D transvaginal ultrasound scans of the urethra were performed in modified lithotomy position with a comfortably full bladder. Length and cross-sectional area were measured allowing the sphincter volume to be calculated. UPP measurements were performed with a Gaeltec solid-state pressure transducer and the area under the curve mapped out and calculated. All scans and measurements were repeated between 3 and 6 months postpartum. RESULTS: Nineteen women participated in the study. Antenatal and postnatal data were available in all cases. There was a statistically significant correlation between antenatal sphincter volumes and area under the UPP curve although this relationship was lost following delivery. CONCLUSIONS: There appears to be a correlation between structural anatomy and functional anatomy in the antenatal period although following delivery this is lost.
Asunto(s)
Embarazo/fisiología , Uretra/diagnóstico por imagen , Uretra/fisiología , Adulto , Área Bajo la Curva , Femenino , Estudios de Seguimiento , Humanos , Imagenología Tridimensional/métodos , Proyectos Piloto , Periodo Posparto/fisiología , Presión , Estudios Prospectivos , Transductores de Presión , Ultrasonografía Prenatal , Uretra/anatomía & histologíaRESUMEN
Metastatic involvement of the spleen in patients with ovarian cancer is unusual. Solitary splenic metastasis in the absence of disseminated disease are rare. Three cases of advanced ovarian cancer with splenic involvement are reported. The splenectomy was adopted in two patients.