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urinary retention [keywords]
- Novel presentation of rituximab-induced herpes zoster: urinary retention and acute kidney failure. [LETTER]
- J Eur Acad Dermatol Venereol 2014 Jul 30.
- Rupture of the Left Renal Fornix after Vaginal Repair of Postpartum Vesicovaginal Fistula. [JOURNAL ARTICLE]
- Geburtshilfe Frauenheilkd 2014 Apr; 74(4):376-378.
Surgical repair of vesicovaginal fistulas carries a risk of postoperative obstruction of the upper urinary tract. In the case described here, a postoperative intramural edema led to urinary retention and subsequent rupture of the renal pelvis. This is a rare but typical urological emergency. If patients complain postoperatively of flank pain, ultrasound should be carried out promptly. If the findings are unclear (no urinary retention despite clinical symptoms), additional computed tomography should be performed to determine whether rupture of the fornix has occurred.
- Efficacy of tension-free vaginal tape obturator and single-incision tension-free vaginal tape-Secur, hammock approach, in the treatment of stress urinary incontinence. [Journal Article]
- Minerva Urol Nefrol 2014 Sep; 66(3):167-75.
Aim of the present study was to compare the efficacy of tension-free vaginal tape obturator and single-incision tension-free transvaginal tape Secur, hammock approach, in the treatment of stress urinary incontinence.Clinical data of patients who received anti-incontinence surgery between June 2008 and July 2012 were retrospectively analyzed. Efficacy and early failure rate of the tension-free vaginal tape obturator and tension-free vaginal tape-Secur hammock approach were assessed by cough test and criteria of International Consultation on Incontinence Questionnaire-Short Form. Intraoperative and postoperative complications were also computed.There were 28 patients in the tension-free vaginal tape obturator group while 32 patients in the tension-free vaginal tape-Secur group. The mean operation time, intraoperative blood loss and inpatient days after surgery between the two groups showed no significant difference. The catheter retention time of the tension-free vaginal tape obturator group was longer than in the tension-free vaginal tape-Secur group. The cure rate of the tension-free vaginal tape obturator and tension-free vaginal tape-Secur groups were respectively 84% and 80%, and the recurrence rates were 14.3% and 16.7%, without significant difference. The scores of International Consultation on Incontinence Questionnaire-Short Form in two groups both decreased after surgery, but there was no difference between the two groups. There were no serious complications in the two groups.Our study demonstrated that both tension-free vaginal tape obturator and tension-free vaginal tape-Secur can achieve a cure rate over 80% while with little complications, showing both methods are reliable to treat stress urinary incontinence.
- Spinal epidural hematoma caused by pseudogout: a case report and literature review. [Journal Article]
- Global Spine J 2014 Jun; 4(2):105-8.
Study Design Case report. Objective We present the first reported case of spontaneous spinal epidural hematoma secondary to calcium pyrophosphate crystal deposition disease (pseudogout) in a 75-year-old woman. Methods A retrospective review of the patient's case notes was undertaken and the limited literature on this subject reviewed. Results This patient presented with sudden-onset lower limb paresis, sensory loss, urinary retention, and back pain. Magnetic resonance imaging showed an epidural hematoma, which was evacuated. Histologic specimens of the clot showed calcium pyrophosphate dihydrate crystal deposits (pseudogout). Conclusion The importance of histopathologic review of surgical specimens is highlighted when considering the differential diagnosis of apparently spontaneous spinal epidural hematoma.
- [Subtotal colectomy with cecorectal end-side anastomosis in the treatment of slow transit constipation]. [English Abstract, Journal Article]
- Zhonghua Wei Chang Wai Ke Za Zhi 2014 Jul 25; 17(7):680-2.
To study the feasibility of subtotal colectomy with cecorectal end-side anastomosis for slow transit constipation.Retrospective analysis was performed on 23 patients with colon slow transit constipation treated by subtotal colectomy with cecorectal end-side anastomosis in our department from March 2006 to April 2013. The main measure outcome was the curative effect on constipation by this type of surgery.Twenty-three patients were successfully treated. Anastomotic leakage occurred in one case, and urinary retention in 1 case, while no anastomotic stricture, abdominal bleeding, abdominal hernia, incontinence and other complications occurred. During follow-up of 2 months to 7 years, defecation frequency was 1-4 times a day with no need of antidiarrheal agents. Each time of defecation was less than 5 min. All the patients had no recurrence of constipation.Subtotal colectomy with cecorectal end-side anastomosis can be used to treat colon slow transit constipation, while accurate preoperative evaluation and strict indications for the surgery is the key to success.
- Long-term Safety and Efficacy of Single-tablet Combinations of Solifenacin and Tamsulosin Oral Controlled Absorption System in Men with Storage and Voiding Lower Urinary Tract Symptoms: Results from the NEPTUNE Study and NEPTUNE II Open-label Extension. [JOURNAL ARTICLE]
- Eur Urol 2014 Jul 25.
Short-term trials have demonstrated the efficacy and safety of combination therapy using antimuscarinics and α-blockers in men with lower urinary tract symptoms (LUTS). The Study of Solifenacin Succinate and Tamsulosin Hydrochloride OCAS (oral controlled absorption system) in Males with Lower Urinary Tract Symptoms (NEPTUNE) II is the first long-term study using solifenacin (Soli) and the oral controlled absorption system formulation of tamsulosin (TOCAS).To evaluate long-term (up to 52 wk) safety and efficacy of flexible dosing of two fixed-dose combinations (FDC) of Soli plus TOCAS in men with moderate to severe storage symptoms and voiding symptoms.Patients with both storage and voiding LUTS, maximum urinary flow rate of 4.0-12.0ml/s, prostate size <75ml, and postvoid residuals ≤150ml, who completed the 12-wk, double-blind NEPTUNE study could continue in the 40-wk, open-label NEPTUNE II study.FDC of Soli 6mg plus TOCAS 0.4mg, or Soli 9mg plus TOCAS 0.4mg; patients could switch between doses in NEPTUNE II.Safety and efficacy data from NEPTUNE and NEPTUNE II were combined to cover a 52-wk period. Primary efficacy end points were total International Prostate Symptom Score (IPSS) and total urgency and frequency score (TUFS); secondary end points included IPSS storage and voiding subscores, micturition diary variables, and quality of life parameters.In all, 1066 men completed NEPTUNE and received one dose or more of study medication in NEPTUNE II. Treatment-emergent adverse events were reported in 499 (46.8%) patients who participated in NEPTUNE II; most were mild or moderate. Urinary retention occurred in 13 of 1208 (1.1%) patients receiving one or more FDCs in NEPTUNE and/or NEPTUNE II; 8 (0.7%) required catheterisation (acute urinary retention [AUR]). Reductions in total IPSS and TUFS during NEPTUNE were maintained for up to 52 wk of FDC treatment, with mean reductions of 9.0 (standard deviation [SD]: 5.7) and 10.1 (SD: 9.2), respectively, from baseline to end of treatment. Clinically relevant improvements were also observed for secondary efficacy end points.Long-term treatment with FDC Soli plus TOCAS was well tolerated and efficacious in men with storage and voiding LUTS, with a low incidence of AUR.Treatment with solifenacin plus tamsulosin in a fixed-dose combination tablet was well tolerated by men with lower urinary tract symptoms. Improvements in symptoms were achieved after 4 wk of treatment, with further improvements at week 16 maintained for up to 52 wk throughout the study.
- Urodynamics in the Evaluation of the Patient with Multiple Sclerosis: When Are They Helpful and How Do We Use Them? [REVIEW]
- Urol Clin North Am 2014 Aug; 41(3):439-444.
Multiple sclerosis (MS) is an autoimmune inflammatory disease that results in damage to the myelin sheaths of the nerves in the central nervous system. Urinary urgency, frequency, and urgency incontinence are the most common symptoms, occurring in 37% to 99% of patients. Voiding symptoms (hesitancy, feeling of incomplete bladder emptying, and occasionally urinary retention) are also common in this population, occurring in 34% to 79% of patients. Traditionally, filling cystometry combined with pressure/flow studies has been a cornerstone of the initial evaluation of all patients with neurogenic lower urinary tract dysfunction, although recently that practice has been challenged.
- Conservative management of a delayed neovesicocutaneous fistula. [Journal Article]
- Case Rep Urol 2014.:632917.
A neovesicocutaneous fistula is a rare complication after orthotopic bladder reconstruction, particularly in the late postoperative period. We report the case of a 59-year-old man who had undergone ileal neobladder construction 17 months previously. He presented with urinary retention concomitant with urinary tract infection due to a neovesicourethral anastomotic stricture. After a combination of transurethral catheter drainage and broad-spectrum antibiotic therapy for 3 weeks, the fistulous tract completely closed. Therefore, conservative treatment may be regarded as a valid option for a delayed neovesicocutaneous fistula.
- OnabotulinumtoxinA (Botox(®)): A Review of its Use in the Treatment of Urinary Incontinence in Patients with Multiple Sclerosis or Subcervical Spinal Cord Injury. [JOURNAL ARTICLE]
- Drugs 2014 Jul 25.
OnabotulinumtoxinA (BOTOX(®)) is a type A neurotoxin derived from Clostridium botulinum bacteria that is approved as treatment for urinary incontinence (UI) in patients with neurogenic detrusor overactivity resulting from multiple sclerosis (MS) or subcervical spinal cord injury (SCI) who are not adequately treated by antimuscarinics. This article reviews the pharmacology of intradetrusor onabotulinumtoxinA in this indication. The presumed mode of action of onabotulinumtoxinA in bladder disorders is by interfering with efferent innervation of the detrusor muscle and afferent pathways involved in the micturition reflex. In phase III trials in adult patients with MS or SCI with UI who were not adequately treated with antimuscarinics, intradetrusor onabotulinumtoxinA 200 U produced significantly greater mean changes (reductions) from baseline in UI episodes/week at week 6 than placebo (primary endpoint). Similar significant benefits of intradetrusor onabotulinumtoxinA 200 U over placebo were observed on other UI, urodynamic, health-related quality of life and treatment satisfaction endpoints. Intradetrusor onabotulinumtoxinA 200 U was generally well tolerated, with the most frequent adverse events being urinary tract infections and urinary retention. Few patients discontinued treatment because of adverse events. Based on interim analyses of an extension study of the phase III trials, repeat injections of onabotulinumtoxinA 200 U were similarly efficacious and well tolerated. Intradetrusor onabotulinumtoxinA represents a clinically important advance in the therapy of UI in patients with MS or SCI who have not responded to antimuscarinics or who are unable to tolerate antimuscarinics.
- Multiplexed LC-MS/MS Assay for Urine Albumin. [JOURNAL ARTICLE]
- J Proteome Res 2014 Jul 24.
Urinary excretion of albumin is a major diagnostic and prognostic marker of renal dysfunction and cardiovascular disease; therefore, accurate measurement of urine albumin is vital to clinical diagnosis. Although inter-method differences and analyte heterogeneity have been reported for urine albumin measurements, accuracy assessments of the available methods have been hindered by the lack of a reference system, including reference measurement procedures and reference materials, for this clinical analyte. To address the need for a reference measurement system for urine albumin, we have developed a candidate reference measurement procedure that utilizes isotope dilution-mass spectrometry (ID-MS) and multiple reaction monitoring (MRM) to quantify full-length urine albumin in a targeted mass spectrometric-based approach. The reference measurement procedure incorporates an isotopically-labeled (15N) full-length recombinant human serum albumin (15N-rHSA) material as the internal standard, which permits the absolute quantitation of albumin in urine. A total of 11 peptides with two transitions per peptide were selected from the tryptic digestion of human serum albumin on the basis of retention time reproducibility, peak intensity, and the degree of HSA sequence coverage. In addition to method validation, the generated calibration curves were used to determine the albumin content in pooled human urine samples to access the accuracy of the MS-based urine albumin quantitation method.