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Urinary frequency [keywords]
- Tolterodine to relieve urinary symptoms following transurethral resection of the prostate: a double-blind placebo-controlled randomized clinical trial. [Journal Article]
- Korean J Urol 2014 Apr; 55(4):260-4.
To evaluate the effect of tolterodine on early storage symptoms following transurethral resection of the prostate.Seventy patients over 55 years of age who underwent transurethral resection of the prostate owing to benign prostatic hyperplasia were randomly assigned to receive either 2 mg of tolterodine twice daily (treatment group) or matched placebo during a 1-month study period. Before and 1 month after the procedure, they were asked to complete the International Prostate Symptom Score (IPSS) questionnaire and quality of life subscale to assess their symptoms. Also, analgesic use and adverse drug events were determined at follow-up.Of 70 allocated patients, 64 patients (91.4%), including 33 in the treatment group and 31 in the placebo group, completed the study. The mean age of the patients was 67 years. None of the patients' basic clinical characteristics were significantly different. At the end of the follow-up period, the total IPSS and quality of life score had significantly improved in the patients receiving tolterodine compared with those receiving placebo (p=0.001 and p=0.036, respectively). The treatment group compared with placebo demonstrated significant improvements in frequency and urgency but not in nocturia. The amount of consumed painkiller was also significantly lower in the tolterodine group than in the placebo group (p=0.0001). The rate of side effects was not significantly different between the groups.Administering 2 mg of tolterodine twice daily is an effective and well-tolerated regimen to relieve early storage symptoms, quality of life, and the amount of analgesic consumption following transurethral resection of the prostate.
- Laparoscopic-assisted transanal pull-through for Hirschsprung's disease: Comparison between partial and near total laparoscopic mobilization of rectum. [Journal Article]
- J Indian Assoc Pediatr Surg 2014 Apr; 19(2):70-5.
Transanal pull-through with laparoscopic assistance is gaining popularity. How much rectal dissection to do laparoscopically and how much transanally is not clear. Laparoscopic rectal mobilization is akin to open pelvic dissection of Swenson's operation - the most physiological procedure. Through this comparative study, we aim to evolve a technique that maximizes the benefits of Swenson's technique and minimizes the problems of a transanal procedure.Twenty patients (19 boys and one girl, newborn to 6 years) with Hirschsprung's disease (HD) were randomized for laparoscopic-assisted transanal pull-through (LATAPT) either by near complete (Group A) or partial (Group B) laparoscopic mobilization of rectum. Patients were followed up for at least 3 months. Demographic profile; operative details (time taken, blood loss, operative difficulty, and complications); postoperative course (duration of urinary catheter, oral feeding, and hospital stay); and follow-up stooling pattern, consistency, and continence were compared in the two groups.The time taken for laparoscopic mobilization was marginally higher in group A, but the time taken for transanal dissection in this group was significantly less than in group B. All other comparisons showed no significant difference in the two groups. Stool frequency and continence improved with time in both groups.Extent of laparoscopic mobilization of rectum does not appear to be a factor deciding the outcomes. No recommendations could be made in view of the small number of cases. However, it shows that laparoscopic assistance can be used to maximize the benefits of Swenson type of operation and a transanal pull-through.
- The Effects of Suburethral Tape on the Symptoms of Overactive Bladder. [JOURNAL ARTICLE]
- Geburtshilfe Frauenheilkd 2014 Jan; 74(1):63-68.
Suburethral tension-free vaginal tape is used for the treatment of stress urinary incontinence with a high success rate. Often patients report having stress incontinence, as well as co-existing micturition problems which are attributable to overactive bladder syndrome (OAB). The present study examines the effect of suburethral tape on the symptoms of OAB. In the study, we used the transobturator vaginal tape inside-out technique (TVT-O). Materials and Methods: 53 patients were included in the study, all had proven urodynamic stress incontinence and symptoms of overactive bladder. The patients were examined preoperatively and 3 months after the TVT-O placement. Results: The individual OAB symptoms improved significantly, with urinary frequency and urge incontinence improving more than nocturia. The frequency of micturition decreased on average from 16.1 to 10.1 episodes/24 hours, while nocturnal frequency of micturition decreased from 2.2 to 1.1. Not a single patient experienced the simultaneous worsening of all three measured variables, however 19 % of patients did report their simultaneous disappearance. Their quality of life that had been affected by OAB was measured on the basis of validated questionnaires, and found to have improved significantly. Only 28 % of patients reported a desire for drug treatment of OAB symptoms following tape placement. Conclusions: TVT-O placement leads to a significant improvement of the symptoms of overactive bladder syndrome. Patient quality of life - which was affected by OAB - was also enhanced by the tape placement. This accounts for a substantial share of the overall success of the suburethral tape.
- Cocaine- and Amphetamine-Regulated Transcript Peptide (CARTp): Distribution and Function in Rat Urinary Bladder. [JOURNAL ARTICLE]
- J Mol Neurosci 2014 Apr 17.
We investigated the distribution of CARTp(55-102) in rat lower urinary tract and evaluated its effect on urinary bladder function in vitro. Immunohistochemistry and a vertical isolated tissue bath system were used. Neurons, clusters of nonneuronal endocrine cells, and nerve fibers stained positive for CARTp(55-102) in young adult rat urinary bladder. The CARTp-expressing neuronal elements were nitric oxide synthase (NOS)- and tyrosine hydroxylase (TH)-IR, whereas all nonneuronal CARTp-IR elements stained positively only for TH (100 %). In isolated bladder strips, CARTp significantly increased the amplitude of electric field stimulation (EFS)-induced detrusor contractions at stimulation frequencies ≤12.5 Hz (p ≤ 0.001) as well as amplitude and frequency of spontaneous phasic urinary bladder smooth muscle (UBSM) contractions (p ≤ 0.05). The responses to CARTp stimulation were dose-dependent and increased in the presence of the urothelium. To determine if the CARTp increase in nerve-mediated contractions may involve an action of CARTp on specific neural pathways, we blocked cholinergic, purinergic, and adrenergic pathways and determined CARTp actions on EFS-medicated contractions. CARTp enhancement of EFS-mediated contractions does not involve alteration in purinergic, adrenergic, or cholinergic pathways. The study demonstrates that CARTp(55-102) is highly expressed in rat urinary bladder. CARTp increased the amplitude of EFS-induced detrusor contractions as well as the amplitude and frequency of spontaneous phasic urinary bladder smooth muscle contractions. We conclude that CARTp may alter the release of compounds from the urothelium that leads to an enhancement of UBSM contractility/excitability.
- Functional electrical stimulation for management of urinary incontinence in children with myelomeningocele: a randomized trial. [JOURNAL ARTICLE]
- Pediatr Surg Int 2014 Apr 17.
To report the efficacy of transcutaneous functional electrical stimulation (FES) in children with refractory neuropathic urinary incontinence secondary to myelomeningocele (MMC).Thirty children with history of MMC (12 girls and 18 boys, mean age 6.7 ± 3.6 years) with refractory urinary incontinence were enrolled in this study. They were randomly allocated to treatment (FES, 15 children) and control (sham stimulation, 15 children) groups. All patients underwent urodynamic study (UDS) before and 6 months after FES considering detrusor leak point pressure (DLPP), mean maximal detrusor pressure, and mean maximal bladder capacity. Daily incontinence score, frequency of pad changing, and enuresis were also assessed before and 6 months after treatment. A 15-course FES was performed for 15 min and 3 times per week. Children were followed for at least 6 months.Of UDS variables, DLPP increased significantly from 32 ± 10.7 cmH2O before treatment to 55.6 ± 24.9 cmH2O in treatment group after 6 months (P < 0.03). Daily incontinence score (range 0-3) improved significantly in treatment group from 2.7 ± 0.4 before treatment to 1.3 ± 0.9 after treatment compared with sham stimulation group (P < 0.02).This type of electrical stimulation is a safe, noninvasive, and effective modality to improve urinary incontinence in myelomeningocele children and can be used at home.
- An Ethnobotanical study of Medicinal Plants in high mountainous region of Chail valley (District Swat- Pakistan). [JOURNAL ARTICLE]
- J Ethnobiol Ethnomed 2014 Apr 16; 10(1):36.
This paper represents the first ethnobotanical study in Chail valley of district Swat-Pakistan and provides significant information on medicinal plants use among the tribal people of the area. The aim of this study was to document the medicinal uses of local plants and to develop an ethnobotanical inventory of the species diversity.In present study, semi-structured interviews with 142 inhabitants (age range between 31-75 years) were conducted. Ethnobotanical data was analyzed using relative frequency of citation (RFC) to determine the well-known and most useful species in the area.Current research work reports total of 50 plant species belonging to 48 genera of 35 families from Chail valley. Origanum vulgare, Geranium wallichianum and Skimmia laureola have the highest values of relative frequency of citation (RFC) and are widely known by the inhabitants of the valley. The majority of the documented plants were herbs (58%) followed by shrubs (28%), trees (12%) and then climbers (2%). The part of the plant most frequently used was the leaves (33%) followed by roots (17%), fruits (14%), whole plant (12%), rhizomes (9%), stems (6%), barks (5%) and seeds (4%). Decoction was the most common preparation method use in herbal recipes. The most frequently treated diseases in the valley were urinary disorders, skin infections, digestive disorders, asthma, jaundice, angina, chronic dysentery and diarrhea.This study contributes an ethnobotanical inventory of medicinal plants with their frequency of citations together with the part used, disease treated and methods of application among the tribal communities of Chail valley. The present survey has documented from this valley considerable indigenous knowledge about the local medicinal plants for treating number of common diseases that is ready to be further investigated for biological, pharmacological and toxicological screening. This study also provides some socio-economic aspects which are associated to the local tribal communities.
- Reproducibility of urinary bisphenol A concentrations measured during pregnancy in the Generation R Study. [JOURNAL ARTICLE]
- J Expo Sci Environ Epidemiol 2014 Apr 16.
The potential human health effects of bisphenol A (BPA) exposure are a public health concern. In order to design adequately powered epidemiological studies to address potential health effects, data on the reproducibility of BPA concentration in serial urine specimens taken during pregnancy are needed. To provide additional data on the reproducibility of maternal urine specimens, 80 women in the Generation R Study (Rotterdam, The Netherlands) contributed a spot urine specimen at <18, 18-25, and >25 weeks of pregnancy. Reproducibility, estimated by the intraclass correlation coefficient (ICC), was 0.32 (95% confidence interval: 0.18-0.46), and, on a creatinine basis, 0.31 (95% confidence interval: 0.16-0.47). Although the ICC observed in the Generation R Study is slightly higher than previous reproducibility studies of BPA, it nevertheless indicates a high degree of within-person variability that presents challenges for designing well-powered epidemiologic studies.Journal of Exposure Science and Environmental Epidemiology advance online publication, 16 April 2014; doi:10.1038/jes.2014.23.
- Reliability and validity of expert assessment based on airborne and urinary measures of nickel and chromium exposure in the electroplating industry. [JOURNAL ARTICLE]
- J Expo Sci Environ Epidemiol 2014 Apr 16.
The reliability and validity of six experts' exposure ratings were evaluated for 64 nickel-exposed and 72 chromium-exposed workers from six Shanghai electroplating plants based on airborne and urinary nickel and chromium measurements. Three industrial hygienists and three occupational physicians independently ranked the exposure intensity of each metal on an ordinal scale (1-4) for each worker's job in two rounds: the first round was based on responses to an occupational history questionnaire and the second round also included responses to an electroplating industry-specific questionnaire. The Spearman correlation (rs) was used to compare each rating's validity to its corresponding subject-specific arithmetic mean of four airborne or four urinary measurements. Reliability was moderately high (weighted kappa range=0.60-0.64). Validity was poor to moderate (rs=-0.37-0.46) for both airborne and urinary concentrations of both metals. For airborne nickel concentrations, validity differed by plant. For dichotomized metrics, sensitivity and specificity were higher based on urinary measurements (47-78%) than airborne measurements (16-50%). Few patterns were observed by metal, assessment round, or expert type. These results suggest that, for electroplating exposures, experts can achieve moderately high agreement and (reasonably) distinguish between low and high exposures when reviewing responses to in-depth questionnaires used in population-based case-control studies.Journal of Exposure Science and Environmental Epidemiology advance online publication, 16 April 2014; doi:10.1038/jes.2014.22.
- Analysis of Proteus mirabilis distribution in multi-species biofilms on urinary catheters and determination of bacteria resistance to antimicrobial agents. [Journal Article]
- Pol J Microbiol 2013; 62(4):377-84.
The objectives of the investigation presented in this paper were: to examine the frequency of P. mirabilis isolation from catheters and assess the complexity of multi-species biofilms which these bacteria form, as well as to determine the vulnerability of planktonic and sessile P. mirabilis populations to popular antibiotics and compare it to the susceptibility of other Gram-negative bacteria isolated as associated flora from multi-species biofilm. 88 urological catheters, collected from long-term catheterized patients were examined. Uropathogens were recovered from the catheter surface by sonication, and identified on standard diagnostic media. The broth-microdilution method and the MBEC High-throughput Screening assay were used to determine the bacterial resistance to antibiotics. 279 microorganisms were isolated from 88 urinary catheter biofilms. The Enterobacteriaceae family were the most frequently detected bacteria (53.2% of isolates), whereas Proteus spp. isolation accounted for 17.9%, which placed these bacilli on the third position in the Enterobacteraceae family. Among all the tested drugs, amikacin and cephalosporins (ceftriaxone, cefotaxime and cefaclor) exhibited the highest activity against P. mirabilis planktonic cells, 86% and 73% of strains were susceptible to these antibiotics, respectively. 100% of P. mirabilis sessile forms were resistant to cefepime, ciprofloxacin, gatifloxacin, and norfloxacin. Amikacin and ceftriaxone affected only 5% of sessile forms. The planktonic cells of the other studied uropathogens were mostly vulnerable to the all tested drugs (exception P. aeruginosa strains), the most effective of which occurred to be amikacin and cefepime. Obtained MBECs values were 2-512-fold higher than MICs assessed for planktonic forms.
- Neurogenic bladder in patients with traumatic spinal cord injury: treatment and follow-up. [JOURNAL ARTICLE]
- Spinal Cord 2014 Apr 15.
Study design:Multi-center, cross-sectional study.Objectives:Our aim was to evaluate the treatment methods and follow-up of neurogenic bladder in patients with traumatic spinal cord injury retrospectively using a questionnaire.Setting:Turkey.Methods:Three hundred and thirty-seven patients who had spinal cord injury for at least 2 years were enrolled from six centers in the neurogenic bladder study group. They were asked to fill-out a questionnaire about treatments they received and techniques they used for bladder management.Results:The study included 246 male and 91 female patients with a mean age of 42±14 years. Intermittent catheterization (IC) was performed in 77.9% of the patients, 3.8% had indwelling catheters, 13.8% had normal spontaneous micturition, 2.6% performed voiding maneuvers, 1.3% used diapers and 0.6% used condom catheters. No gender difference was found regarding the techniques used in bladder rehabilitation (P>0.05). Overall, 63.2% of patients used anticholinergic drugs; anticholinergic drug use was similar between genders (P>0.05). The most common anticholinergic drug used was oxybutynin (40.3%), followed by trospium (32.6%), tolterodine (19.3%) darifenacin (3.3%), propiverine (3.3%) and solifenacin (1.1%). The specialties of the physicians who first prescribed the anticholinergic drug were physiatrists (76.2%), urologists (22.1%) and neurologists (1.7%). Only four patients had previously received injections of botulinum-toxin-A into the detrusor muscle and three of them stated that their symptoms showed improvement. Most of the patients (77%) had regular follow-up examinations, including urine cultures, urinary system ultrasound and urodynamic tests, when necessary; the reasons for not having regular control visits were living distant from hospital (15.3%) and monetary problems (7.7%). Of the patients, 42.7% did not experience urinary tract infections (UTI), 36.4% had bacteriuria but no UTI episodes with fever, 15.9% had 1-2 clinical UTI episodes per year and 5% had 3 clinical UTIs. The clinical characteristics of patients with and without UTI (at least one symptomatic UTI during 1 year) were similar (P>0.05). The frequency of symptomatic UTI was similar in patients using different bladder management techniques (P>0.05).Conclusion:The most frequently used technique for bladder rehabilitation in patients with SCI was IC (77.9%). In all, 63.2% of patients used anticholinergic drugs, oxybutynin being the most commonly used drug. Also, 77% of patients had regular control visits for neurogenic bladder; 42.7% did not experience any UTIs.Spinal Cord advance online publication, 15 April 2014; doi:10.1038/sc.2014.41.