PURPOSE: Overactive bladder (OAB) is a symptom syndrome and is usually diagnosed by subjective symptoms of urgency with or without urgency incontinence. However, because urgency symptoms are so subjective, it is difficult to objectively grade symptoms of urgency. Although urodynamic study can detect detrusor overactivity (DO) objectively, not all patients with OAB are found to have DO. Therefore, recent research interests have focused on urinary and image biomarkers in the assessment of OAB. MATERIALS AND METHODS: Investigating articles from the literature and recent published works were reviewed. RESULTS: The urinary nerve growth factor (NGF) level is found to increase in patients with OAB-wet, bladder outlet obstruction, mixed urinary incontinence, and urodynamic DO. NGF levels are correlated with OAB symptoms and return to normal after treatment. However, urinary NGF is not increased only in patients with OAB and DO. It also increases in patients with interstitial cystitis/painful bladder syndrome (IC/PBS) and other lower urinary tract diseases such as urinary tract stones, bacterial infection, and urothelial tumor. Thirty percent of OAB patients have a low urinary NGF level. Nevertheless, antimuscarinic or botulinum toxin treatment can decrease the urinary NGF level, and changes in the NGF level are correlated with the urgency severity scale. CONCLUSIONS: It is therefore possible to use urinary NGF levels as a biomarker for assessment of therapeutic outcome in patients with OAB. Further research on combined multiple biomarkers to differentiate OAB and IC/PBS is necessary.
Bacterial Infections ; Biomarkers ; Botulinum Toxins ; Humans ; Nerve Growth Factor ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Bladder, Overactive ; Urinary Calculi ; Urinary Incontinence ; Urodynamics ; Urologic Diseases

Preputial calculi is a very rare disease and a disease of phimosis. A case of preputial calculi associated urethral calculi, bladder-calculi and bladder transitional cell carcinoma was presented.
Calculi* ; Carcinoma, Transitional Cell* ; Female ; Phimosis ; Rare Diseases ; Urinary Bladder Calculi* ; Urinary Bladder Neoplasms ; Urinary Bladder*

Preputial calculi is a very rare disease and a disease of phimosis. A case of preputial calculi associated urethral calculi, bladder-calculi and bladder transitional cell carcinoma was presented.
Calculi* ; Carcinoma, Transitional Cell* ; Female ; Phimosis ; Rare Diseases ; Urinary Bladder Calculi* ; Urinary Bladder Neoplasms ; Urinary Bladder*

There have been some pros and cons about the of routine intravenous pyelography in benign prostatic hyperplasia. Herein we analyzed 196 patients who underwent intravenous pyelography before prostatectomy at Dept. of Urology, Seoul National University Hospital from Jan. 1976. to Dec. 1983. Of 196 patients 140 (72%) showed normal upper tract with cystogram compatible with benign prostatic hyperplasia(Group I), 22(11%) dilated upper tract(Group II), 20(10%) incidental upper tract abnormalities including 9 urolithiasis(Group III), and 14(7%) completely normal findings(Group IV). There was a significant relationship between Group II and serum BUN value. Cystoscopy revealed evidence of prostatic enlargement in 14 cases and other abnormal findings including bladder tumor which were not shown on routine IVPs. We conclude that intravenous pyelography is not always necessary in diagnosis of benign prostatic hyperplasia when urine analysis and serum BUN are normal Instead, we recommend KUB to observe renal outline and calculi, and preoperative routine cystoscopy to evaluate prostatic enlargement and bladder neck obstruction.
Calculi ; Cystoscopy ; Diagnosis ; Humans ; Prostatectomy ; Prostatic Hyperplasia ; Seoul ; Urinary Bladder Neck Obstruction ; Urinary Bladder Neoplasms ; Urography* ; Urologic Diseases* ; Urology

Augmentation ileocystoplasty is the most available method of enlargement of capacity for the contracted bladder by using the intestinal segment. Contracture of bladder is the result of chronic vesical infections such as tuberculosis, interstitial cystitis, radiation cystitis, or neurogenic bladder, among them tuberculosis is the most common cause of bladder contracture in Korea. Contracted bladder usually demands active correction, while it may lead to considerable vesicoureteral reflux and deterioration of renal function. Herein we describe a clinical observation and follow-up study for more than 2 years on the 5 cases of augmentation ileocystoplasty, which we experienced during the periods from December 1978 to November 1980.
Contracture ; Cystitis ; Cystitis, Interstitial ; Follow-Up Studies* ; Korea ; Tuberculosis ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Vesico-Ureteral Reflux

Spinal cord injury (SCI) may lead to urinary system disturbances. Patients with SCI usually have neurogenic bladder, and treatment optionss for this condition include clean intermittent catheterization and a permanent indwelling urethral or suprapubic catheter. Complications of catheterization include urinary tract infection, calculi, urinary tract injury, bladder contraction, bladder spasm, renal dysfunction, bladder cancer, and so forth. To the best of our knowledge, ureteral rupture is an unusual complication of catheterization, and ureteral rupture has been rarely reported in SCI patients. Therefore, here we report a case of ureteral rupture caused by a suprapubic catheter used for the treatment of neurogenic bladder with vesicoureteral reflux in a male patient with SCI. Due to SCI with neurogenic bladder, ureteral size can be reduced and the suprapubic catheter tip can easily migrate to the distal ureteral orifice. Thus, careful attention is required when a catheter is inserted into the bladder in patients with SCI.
Catheterization ; Catheters* ; Humans ; Intermittent Urethral Catheterization ; Male* ; Rupture* ; Spasm ; Spinal Cord Injuries* ; Spinal Cord* ; Ureter* ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Bladder, Neurogenic ; Urinary Calculi ; Urinary Catheterization ; Urinary Tract Infections ; Vesico-Ureteral Reflux

OBJECTIVETo study the etiology, clinical manifestation, diagnosis and treatment of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum.

METHODSWe retrospectively analyzed the clinical data of a case of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum and reviewed the relevant literature. The patient was a 37-year-old man, with urinary incontinence for 22 years and intermittent dysuria with frequent micturition for 9 years, aggravated in the past 3 months. He had received surgery for spina bifida and giant vesico-prostatic calculus. The results of preoperative routine urinary examination were as follows: WBC 17 -20/HPF, RBC 12 - 15/HPF. KUB, IVU and pelvic CT revealed spina bifida occulta, neurogenic bladder and giant prostatic calculus.

RESULTSThe patient underwent TURP and transurethral lithotripsy with holmium-YAG laser. The prostatic calculus was carbonate apatite in composition. Urinary dynamic images at 2 weeks after surgery exhibited significant improvement in the highest urine flow rate and residual urine volume. Seventeen months of postoperative follow-up showed dramatically improved urinary incontinence and thicker urine stream.

CONCLUSIONProstate diverticulum with prostatic giant calculus is very rare, and neurogenic bladder may play a role in its etiology. Cystoscopy is an accurate screening method for its diagnosis. For the young patients and those who wish to retain sexual function, TURP combined with holmium laser lithotripsy can be employed, and intraoperative rectal examination should be taken to ensure complete removal of calculi.

Adult ; Calculi ; complications ; Diverticulum ; complications ; Humans ; Male ; Prostatic Diseases ; complications ; Urinary Bladder, Neurogenic ; complications

We report a rare case of vesico-acetabular fistula due to an improperly treated pelvic fracture with urinary stone formation in the joint cavity. This complication was related to an unrecognized mechanism of bladder wall entrapment in the acetabular floor defect during weight bearing. This situation led to several mistreatment decisions in our case and should be always considered by urologists dealing with patients after major pelvic trauma. In this case report, we analyze the publications related to this problem, discuss the main mechanisms of bladder wall damage after acetabular fracture, and propose tips for diagnosis and treatment.
Fistula ; Floors and Floorcoverings ; Fractures, Malunited ; Hip ; Hip Joint ; Humans ; Joints ; Multiple Trauma ; Urinary Bladder ; Urinary Bladder Diseases ; Urinary Bladder Fistula ; Urinary Calculi ; Urolithiasis ; Weight-Bearing

PURPOSE: Augmentation enterocystoplasty (AE) has been shown to improve clinical symptoms in patients with end-stage bladder disease (ESBD). Herein, we report the long-term outcomes of a series of patients with different etiologies of ESBD who received AE. METHODS: We retrospectively reviewed 102 patients with ESBD who received AE at the Hualien Tzu Chi General Hospital from 1992 to 2014. ESBD in this study was defined as including neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury (SCI) or myelomeningocele, inflammatory bladder disease (IBD), ESBD occurring after pelvic cancer surgery, and other etiologies. Complications including active lower urinary tract problems and urinary tract infection (UTI), as well as patients’ self-reported satisfaction with the procedure, were evaluated. RESULTS: A total of 102 patients were included in the study. A majority of patients received AE for NLUTD (n=43), followed by IBD (n=38), ESBD after pelvic cancer surgery (n=15), and the other etiologies (n=6). Patients had a mean age of 39.4±18.7 years and were followed for a mean of 78 months. All patients had significantly increased cystometric bladder capacity and compliance at the time of follow-up. Fifty-four patients (52.9%) reported moderate to excellent satisfaction with the outcome, and there were no significant differences among the groups (P=0.430). The most common reason for dissatisfaction was the need for clean intermittent catheterization (CIC; 41.7%), followed by urinary incontinence (25.0%) and recurrent UTI (16.7%). CONCLUSIONS: AE is a safe and effective procedure for patients with ESBD. Postoperative urinary incontinence and UTI as well as the need for CIC may affect quality of life and decrease patient satisfaction.
Compliance ; Cystitis ; Follow-Up Studies ; Hospitals, General ; Humans ; Intermittent Urethral Catheterization ; Lower Urinary Tract Symptoms ; Meningomyelocele ; Patient Satisfaction ; Pelvic Neoplasms ; Quality of Life ; Retrospective Studies ; Spinal Cord Injuries ; Urinary Bladder Diseases* ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections

Emphysematous cystitis is an uncommon condition in which pockets of gas are formed in and around the bladder wall by gas-forming organisms. Patients with diabetes, neurogenic bladder and chronic urinary infection are predisposed to the disease. Severity of illness ranges from an asymptomatic condition to life-threatening cystitis. Successful management depends on early diagnosis with correction of underlying causes, administration of appropriate antibiotics, establishment of adequate bladder drainage and surgical excision of involved tissue when required. Early detection and prompt treatment are encouraged. We report one case of emphysematous cystitis complicated with diabetic nephropathy in a 68-year-old woman.
Aged ; Anti-Bacterial Agents ; Asymptomatic Diseases ; Cystitis* ; Diabetic Nephropathies* ; Drainage ; Early Diagnosis ; Female ; Humans ; Urinary Bladder ; Urinary Bladder, Neurogenic