Lysis of epidural adhesion has been done in patients with refractory lumbar radiculopathies. Cauda equina syndrome is a rare complication of epidural block. We report a case of cauda equina syndrome following epidural adhesiolysis in a patient with spinal stenosis. She complained of numbness in perineum, weakness of left leg, voiding difficulty, and fecal incontinence. She was finally recovered 1 month after the procedure without any sequelae following treatment with medication, bladder training and physical therapy. We suggest the causative factors are osmotic damage produced by subarachnoid injection of large doses of hypertonic saline and the temporary neural compression due to spinal stenosis.
Fecal Incontinence ; Humans ; Hypesthesia ; Leg ; Perineum ; Polyradiculopathy* ; Radiculopathy ; Spinal Stenosis* ; Urinary Bladder

Leiomyoma of the female urethra is a rare entity. We experienced a case of leiomyoma in the female urethra recently. Forty-one-year-old woman admitted to the hospital with the chief complaint of a painless, protruded large mass outside the vaginal introitus. The mass was excised surgically and confirmed as a leiomyoma pathologically.
Female ; Humans ; Leiomyoma* ; Urethra*

PURPOSE: Spinal cord injuries can lead to varying degrees and patterns of neurologic deficits, which depend on the level of the injury, duration, completeness. So we analyzed the relationship between the types of neurogenic bladder and the level of injury in the spinal cord injury. MATERIALS AND METHODS: From June 1997 to August 2002, one-hundred twenty seven spinal cord injury patients were studied by neurological and urological examination and video-urodynamic evaluation. The neurogenic bladder in spinal cord injury were analyzed into five types according to the injured level. RESULTS: The 94 males and 33 females had a mean age of 45.7+/-15.1 years (range 15 to 92). Mean follow up interval after injury was 33.9+/-48.4 months. Injured level was classified into five levels; cervical, thoracic, lumbar, and sacral. Of the 127 patients 37 (29.1%) was cervical, 18 (14.2%) was thoracic, 33 (26.0%) was lumbar, and 39 (30.7%) was sacral. When all patients were divided suprasacral and infrasacral lesion. Typically, suprasacral lesions show detrusor hyperreflexia, and infrasacral lesions have detrusor areflexia. 30 (37.5%) of 88 suprasacral lesions and 12 (30.8%) of 39 infrasacral lesions were presented to atypical. 35.7% of patients have combine spinal lesion, but 47.6% of patients have no causes for atypical patterns. 3 (27.3%) of 11 patients were followed up, they changed neurogenic pattern. CONCLUSIONS: In our results, video urodynamic findings showed that about 30 percent patients had atypical patterns of neurogenic bladder, and they have underlying disease about 52.4%. And 27% of followed patients changed neurogenic pattern of bladder. So, urodynamic study have an important role in the spinal cord injury for diagnosis of neurogenic pattern and selection proper treatment, catching out the interval change and correction of treatment method, and evaluation of prognosis.
Diagnosis ; Female ; Follow-Up Studies ; Humans ; Male ; Neurologic Manifestations ; Prognosis ; Reflex, Abnormal ; Spinal Cord Injuries* ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urodynamics

PURPOSE: Among complications after the tension-free vaginal tape(TVT) procedure for female stress urinary incontinence, the voiding dysfunction is one of the most common complaints of the patients. The aim of the study was to assess the incidence of objective voiding dysfunction and evaluate the clinical, uroflometric and urodynamic risk factors predisposing to voiding dysfunction following the TVT procedure. MATERIALS AND METHODS: 437 women with stress urinary incontinence underwent the TVT procedure in our institution for recent three years. Among them, 285 patients with post-operative uroflowmetry were evaluated. Objective voiding dysfunction was defined as a peak-flow rate less than 12 ml/sec(voided volume greater than 100 ml), or inability to void at least 75% of bladder capacity, on two or more readings. Clinical and urodynamic parameters and global satisfaction were analyzed and compared between patients(objective voiding dysfunction, n=33, 11.6%) who had uroflowmetric parameters of voiding difficulties after TVT procedure and patients(well- voiding, n=252, 88.4%) who had not. RESULTS: Two hundred sixty-one patients (91.6%) answered satisfied by global satisfaction questionnaire. Subjective and objective cure rates were 93.9% and 90.9% at least 6 months follow-up. Among parameters, patient's age, peak-flow rate, and 1 hour pad test showed significant differences between voiding dysfunction group and well-voiding group(average age: 54.9 vs 50.9 years-old, p=0.024, peak urinary flow rate: 30.9 vs 24.1 ml/sec, p=0.003, 1 hour pad test: 53.8 vs 81.6 gm, p=0.035). There was no statistically significant difference in subjective and objective cure rates and satisfaction rates between the two groups. CONCLUSIONS: Women with the old age, low peak urinary flow rate, and large volume with 1 hour pad test are most likely to have voiding dysfunction after TVT procedure. Patients with these risk factors should be given more counsel regarding post-operative voiding dysfunction before the surgery.
Female ; Follow-Up Studies ; Humans ; Incidence ; Surveys and Questionnaires ; Reading ; Risk Factors* ; Suburethral Slings* ; Urinary Bladder ; Urinary Incontinence ; Urodynamics

PURPOSE: We evaluated the efficacy of the selective alpha1a and alpha1d antagonist (tamsulosin 0.2 mg) once daily in the treatment of patient with lower urinary tract symptom(LUTS), especially irritative symptom. MATERIALS AND METHODS: A total of 170 men with LUTS were treated for 12 weeks with tamsulosin 0.2 mg/day. The primary efficacy parameters are improvements in total, irritative and obstructive International Prostate Symptom Scores(IPSS), quality of life index(QOL index) and peak urinary flow rate(Qmax). Secondary efficacy parameters include percentage of patients with improvement in total, irritative and obstructive IPSS of at least 25%, Qmax of at least 30% and 3 ml/s increase in Qmax. RESULTS: Statistically significant improvements in all efficacy parameters were observed. Tamsulosin produced improvements in Qmax(21.7%), decrease in total, irritative, obstructive symptom score(25%, 19.1%, 29.2%) and QOL index(0.7 points). Seventy two patients(42.4%) had a > or =25% decrease in total symptom score, 71 patients (41.8%) in irritative and 90 patients(52.9%) in obstructive symptom score after 12 weeks(P<0.05). Sixty patients (35.3%) had a > or =30% increase and 67 patients(39.4%) had > or =3 ml/s increase in Qmax. CONCLUSIONS: This study showed beneficial short term results for the efficacy of selective alpha(1a) and alpha(1d) blocker (tamsulosin) in treating patients with LUTS, especially irritative symptom.
Humans ; Male ; Prostate ; Quality of Life ; Urinary Tract*

PURPOSE: The purpose of this study was to evaluate the urodynamic effect of oxybutynin chloride on bladder dysfunction in rats with focal cerebral ischemia. MATERIALS AND METHODS: The cerebral infarction of 8 to 9 week-old male Sprague-Dawley rats was induced by occlusion of the left middle cerebral artery. The control groups received sham operation. At 1, 2 and 4 weeks after operation, cystometrogram (CMG) was performed before and after intravesical instillation of 0.5 ml of oxybutynin chloride (0.005 and 0.05 mg/ml) (n=7). RESULTS: The body weight of cerebral-infarcted (CI) rats was smaller than that of sham-operated rats. Compared to sham-operated rats, CI rats showed a shorter voiding interval, smaller micturition pressure, smaller voiding volume and more residual urine. in CMG. After intravesical instillation of oxybutynin, CMG showed dose-dependent increase of voiding interval and functional bladder volume and decrease of peak micturition pressure. The effects of oxybutynin on CI rats were more prominant than that of sham-operated rats. CONCLUSIONS: CI rats showed urinary frequency and decrease of micturition pressure in CMG. The result of this study will be useful for explanation of the detrusor hyperactivity with impaired contractility (DHIC) in patients with cerebral infarction. These results suggest that treatment with intravesical oxybutynin will be an effective alternative treatment of detrusor hyperactivities with cerebral infarction.
Administration, Intravesical ; Animals ; Body Weight ; Brain Ischemia* ; Cerebral Infarction ; Humans ; Male ; Middle Cerebral Artery ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder* ; Urination ; Urodynamics*

PURPOSE: We performed a pilot survey via internet to assess the prevalence of overactive bladder syndrome (OABs) and urinary incontinence(UI) in young and middle aged women. MATERIALS AND METHODS: From 22 April 2002 to 5 May 2002, a total of 3,372(89.8%) women(mean age: 26.3+/-4.8 years) among 3,757 participants completed a questionnaire via internet web site. They were divided into 3 groups: those who had OABs(group 1), who had UI(group 2), and controls who had neither. The factors related to OABs and UI were analyzed by multiple logistic regression analysis. RESULTS: Of 3,372 respondents, the prevalence of OABs and UI in young women was 429(12.7%) and 707 (21%), respectively. The factors related to OABs were history of urinary tract infection and family history. The factors related to UI were age, occupation, history of urinary tract infection, family history, and parity. CONCLUSIONS: The symptoms suggestive of OABs and UI are highly prevalent in young and middle aged women. So, effective healthcare polices and prompt management about OABs and UI should be concerned.
Surveys and Questionnaires ; Delivery of Health Care ; Female ; Humans ; Internet ; Logistic Models ; Middle Aged* ; Occupations ; Parity ; Prevalence* ; Surveys and Questionnaires ; Urinary Bladder, Overactive* ; Urinary Incontinence* ; Urinary Tract Infections

No abstract available.
Urinary Bladder, Overactive* ; Duloxetine Hydrochloride

Endometriosis represents extrauterine nonneoplastic endometrial tissue. It is most commonly diagnosed in women of childbearing age, with a peak age of 40 to 44 years. The incidence of genitourinary involvement ranges from 1% to 2%. Ureteral endometriosis is a rare entity, and its diagnosis requires a high index of suspicion. We report a case of ureteral endometriosis in a 44-year-old multiparous woman with a brief review of literature.
Adult ; Diagnosis ; Endometriosis* ; Female ; Humans ; Hydronephrosis ; Incidence ; Ureter*

Inflammatory pseudotumors of the urinary bladder are rare, benign and nonepithelial tumors characterized by proliferative myofibroblast, fibroblast, histiocytes, and occasionally by plasma cell and lymphocytes. Microscopically, inflammatory pseudotumors present as either pedunculated intraluminal tumors that can be seen readily during cystourethroscopy or as submucosal mural lesions that may be easily overlooked. Histological features of this benign lesion mimic those of malignant neoplasm but their clinical course is benign. Although inflammatory poseudotumors can occur anywhere in the body, they are rare in the bladder. We report a case in which induced acute urinary retention and describe the clinical presentation, and radiographic and histologic findings.
Fibroblasts ; Granuloma, Plasma Cell* ; Histiocytes ; Lymphocytes ; Myofibroblasts ; Plasma Cells ; Urinary Bladder* ; Urinary Retention*