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

This review provides a comprehensive view of translational research aimed at elucidating the pathophysiology of pediatric lower urinary tract dysfunction (LUTD). A web search was conducted according to combinations of keywords, and the significance of each article was defined by the author. The dramatic evolution of the mass analysis method of genomes, transcripts, and proteins has enabled a comprehensive analysis of molecular events underlying diseases, and these methodologies have also been applied to pediatric LUTD. In genetic analyses of syndromes underlying daytime incontinence, urofacial (Ochoa) syndrome may be creating a prototype of a new research approach. Nocturnal enuresis has long been studied genetically, and several candidate loci have been reported. However, the pursuit for enuresis genes has been abandoned partly because genetic association and enuresis phenotype (bladder or renal type) could not be linked. Enuresis associated with diabetes insipidus has provided new insights into the etiology of the diseases. A chronobiological approach may shed new light on this area. Posterior urethral valves and neurogenic bladders have attracted the interest of pediatric urologists to the smooth muscle biology of the bladder. Bladder exstrophy and cloacal anomalies are rare but major anomalies caused by defective urorectal development and have recently been studied from a genetic standpoint. Translational studies for pediatric LUTD may be extended to adult bladder disease, or to application of precision medicine for diseased children.
Adult ; Biology ; Bladder Exstrophy ; Child ; Diabetes Insipidus ; Enuresis ; Genome ; Genomics ; Humans ; Lower Urinary Tract Symptoms ; Methods ; Muscle, Smooth ; Nocturnal Enuresis ; Pediatrics ; Phenotype ; Precision Medicine ; Translational Medical Research* ; Urinary Bladder ; Urinary Bladder Diseases ; Urinary Incontinence ; Urinary Tract*

This review provides a comprehensive view of translational research aimed at elucidating the pathophysiology of pediatric lower urinary tract dysfunction (LUTD). A web search was conducted according to combinations of keywords, and the significance of each article was defined by the author. The dramatic evolution of the mass analysis method of genomes, transcripts, and proteins has enabled a comprehensive analysis of molecular events underlying diseases, and these methodologies have also been applied to pediatric LUTD. In genetic analyses of syndromes underlying daytime incontinence, urofacial (Ochoa) syndrome may be creating a prototype of a new research approach. Nocturnal enuresis has long been studied genetically, and several candidate loci have been reported. However, the pursuit for enuresis genes has been abandoned partly because genetic association and enuresis phenotype (bladder or renal type) could not be linked. Enuresis associated with diabetes insipidus has provided new insights into the etiology of the diseases. A chronobiological approach may shed new light on this area. Posterior urethral valves and neurogenic bladders have attracted the interest of pediatric urologists to the smooth muscle biology of the bladder. Bladder exstrophy and cloacal anomalies are rare but major anomalies caused by defective urorectal development and have recently been studied from a genetic standpoint. Translational studies for pediatric LUTD may be extended to adult bladder disease, or to application of precision medicine for diseased children.
Adult ; Biology ; Bladder Exstrophy ; Child ; Diabetes Insipidus ; Enuresis ; Genome ; Genomics ; Humans ; Lower Urinary Tract Symptoms ; Methods ; Muscle, Smooth ; Nocturnal Enuresis ; Pediatrics ; Phenotype ; Precision Medicine ; Translational Medical Research* ; Urinary Bladder ; Urinary Bladder Diseases ; Urinary Incontinence ; Urinary Tract*

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

BACKGROUND: In recent years the treatment of primary nocturnal enuresis (PNE) with desmopressin (DDAVP) has been promising. The route of administration until now had been intranasal, but because the tablets were introduced for the treatment of diabetes insipidus they have also become available for the treatment of PNE. PURPOSES: To find the efficacy and safety of the treatment with desmopressin tablets in a group of children with monosymptomatic nocturnal enuresis. Materials and METHODS: The efficacy and safety of at least 3 months of treatment with oral desmopressin (1-deamino-8-D-arginine-vasopressin) (DDAVP tablets, Minirin) at doses of 200 to 600 ug. at bedtime were investigated in 50 children (ages 5 to 15 years) with monosymptomatic nocturnal enuresis. The efficacy of the drug was measured in reductions of the number of wet nights per week. RESULTS: The number of wet nights per week decreased from a mean of 6.1 to 2.0 (p<0.01). During the treatment period, 22 (44%) patients could be classified as good responders (0 to 1 wet night per week) and 15 (30%) as responders (over 50% reduction of wet night) and 13 (26%) as nonresponders (less than 50% reduction of wet night). No side effects we.e observed. CONCLUSION: Oral desmopressin has a clinically significant effect on patients with monosymptomatic nocturnal enuresis, and therapy is safe when administered as long-term treatment.
Child ; Deamino Arginine Vasopressin* ; Diabetes Insipidus ; Enuresis ; Humans ; Nocturnal Enuresis* ; Tablets*

Two hundred and sixty-three patients over the age of 50 years who visited our clinic during 6 and a half years from April 1954 to September 1960 were clinically investigated for the initial study of the benign prostatic hypertrophy in Korea. Among these 263 cases 36 were diagnosed as the benign prostatic hypertrophy and 19 of them were hospitalized. Their ages ranged from 51 to 82 years. The average was 68 years. Their chief complaints were reasonable for B. P. H. and urinary symptoms appeared more commonly than those of non B. P. H. group. Eighty-eight and 0.6% of their prostates appeared to be more or less enlarged in size. None of them were considered to stay within normal limits. Residual urine was noted from 3-1,500 cc in 31 checked cases, the average 62cc. Their urethras were intact in 83% of the cases. Their endoscopic findings were corresponding to the signs suggesting prostatic hypertrophy, mainly prostatic compression sign to the bladder, elongation of the prostatic urethra, kissing or almost kissing of the lateral lobes, trabeculation and cellule formations in the bladder and inflammatory signs of the bladder. Treatments given to 19 hospitalized cases included 10 suprapubic prostatectomy, 1 transurethral resection, 1 suprapubic cystostomy, and conservative treatments for the remainders. In all the patients who had received the surgical interventions, smooth and voluntary urination was restored as of discharge. No follow-up study was fulfilled. Weight of the removed prostates were noted from 39.5 gm to 107gm, the average 61.3gm. By a transurethral resection 10.2gm of hypertrophied prostate was resected. Of complications of 19 hospitalized cases. cystitis was found as a top 68.4%. Not only urological diseases, bladder stones, epididymitis and diverticula of the bladder but also systemic diseases, hypertensive heart disease, asthma and arteriosclerosis were found though less frequent.
Arteriosclerosis ; Asthma ; Cystitis ; Cystostomy ; Diverticulum ; Epididymitis ; Heart Diseases ; Humans ; Korea ; Male ; Prostate ; Prostatectomy ; Prostatic Hyperplasia* ; Urethra ; Urinary Bladder ; Urinary Bladder Calculi ; Urination ; Urologic Diseases

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

Desmopressin diacetate arginine vasopressin (DDAVP) is a synthetic analogue of the arginine vasopressin that is widely used in the treatment of diabetes insipidus, nocturnal enuresis, and polyuria. Although it is generally well-tolerated, DDAVP can cause hyponatremia, especially in elderly patients. There are many reports of DDAVP-induced hyponatremia, but there has been only one case report in which sinus node dysfunction was caused by severe hyponatremia. Here we report a case of sick sinus syndrome that occurred during an episode of severe hyponatremia induced by chronic use of desmopressin in a 91-year-old man who had nocturnal enuresis.
Aged ; Arginine Vasopressin ; Deamino Arginine Vasopressin* ; Diabetes Insipidus ; Humans ; Hyponatremia* ; Nocturnal Enuresis ; Polyuria ; Sick Sinus Syndrome*

No abstract available.
Nocturnal Enuresis*

No abstract available.
Nocturnal Enuresis*