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Predictors of Successful Trial without Catheter for Postoperative Urinary Retention Following Non-Urological Surgery.

Kwang Soo LEE ; Ki Hong LIM ; Sung June KIM ; Hyeung Joon CHOI ; Dong Hoon NOH ; Hae Won LEE ; Min Chul CHO

International Neurourology Journal.2011;15(3):158-165.

PURPOSE: To investigate the success rate of trial without catheter (TWOC) for postoperative urinary retention (POUR) after non-urological surgery and to determine predictors of successful TWOC. METHODS: A total of 104 patients who underwent non-urological surgery and were referred to the department of urology for POUR were included in this retrospective study. All eligible patients underwent indwelling catheterization as an initial treatment and then TWOC was performed 3 to 7 days later. POUR was defined as micturition difficulty with greater than 400 mL of postvoid residual (PVR) urine volume measured by catheterization after non-urological surgery. Successful TWOC was defined as voiding with less than 100 mL of PVR urine volume. Predictive factors were identified by multivariate regression analysis. All definitions corresponded to recommendations of the International Continence Society. RESULTS: The mean age of the patients was 65.2 (range, 23 to 92) years. There were 45 male and 59 female patients. Intraoperative indwelling catheterization was performed in 69 (66.3%) patients. Mean duration of indwelling catheterization for POUR was 5.0 (range, 3.0 to 7.0) days and 83 (79.8%) patients received medication with an alpha-blocker. A successful TWOC was observed in 70 (67.4%) patients. The mean age of the patients with failure of TWOC was significantly higher than that of the patients with successful TWOC. The percentages of female patients, spinal surgery, and prone position during surgery in patients with unsuccessful TWOC were higher than in those with successful TWOC. In the multivariate logistic regression analysis, age and location of surgery (spine vs. non-spine) were the independent predictors of successful TWOC for POUR. CONCLUSIONS: Our data suggest that older age and spinal surgery may be important risk factors for failure of TWOC for POUR after non-urological surgery. Thus, adequate prevention measures may be necessary for POUR after non-urological surgery, especially in patients with these risk factors.
Catheterization ; Catheters ; Catheters, Indwelling ; Female ; Humans ; Logistic Models ; Male ; Postoperative Care ; Prone Position ; Retrospective Studies ; Risk Factors ; Urinary Retention ; Urination ; Urology

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Effect of 5-alpha Reductase Inhibitor on Storage Symptoms in Patients with Benign Prostatic Hyperplasia.

Kang Jun CHO ; Se Hee KANG ; Hyo Sin KIM ; Jun Sung KOH ; Joon Chul KIM

International Neurourology Journal.2011;15(3):152-157.

PURPOSE: Many patients with benign prostatic hyperplasia (BPH) have storage symptoms. The aim of this study was to evaluate the effects of treatment with a 5-alpha reductase inhibitor (5ARI) on storage symptoms in patients with BPH. METHODS: This study was conducted in 738 patients with lower urinary tract symptoms secondary to BPH. Patients with a prostate volume of higher than 30 mL on the transrectal ultrasound were classified into two groups: group A, in which an alpha blocker was solely administered for at least 12 months, and group B, in which a combination treatment regimen of an alpha blocker plus 5ARI was used. This was followed by an analysis of the changes in parameters such as the total International Prostate Symptom Score (IPSS), voiding symptom subscore, and storage symptom subscore between the two groups. In addition, we examined whether there was a significant difference between the two groups in the degree of change in storage symptoms between before and after the pharmacological treatment. RESULTS: Of the 738 men, 331 had a prostate volume > or =30 mL, including 150 patients in group A and 181 patients in group B. Total IPSS, the voiding symptom subscore, and the storage symptom subscore were significantly lower after treatment than before treatment in both groups (P<0.05). A comparison of the degree of change between before and after treatment, however, showed no significant differences in the storage symptom subscore between the two groups (P>0.05). CONCLUSIONS: Alpha blocker and 5ARI combination treatment is effective for patients with BPH including storage symptoms. However, 5ARI does not exert a significant effect on storage symptoms in BPH patients.
5-alpha Reductase Inhibitors ; Humans ; Lower Urinary Tract Symptoms ; Male ; Oxidoreductases ; Prostate ; Prostatic Hyperplasia ; Urinary Bladder, Overactive

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The Impact of Overactive Bladder on Health-Related Quality of Life, Sexual Life and Psychological Health in Korea.

Eun Sang YOO ; Bum Soo KIM ; Duk Yoon KIM ; Seung June OH ; Joon Chul KIM

International Neurourology Journal.2011;15(3):143-151.

PURPOSE: We aimed to estimate the prevalence of overactive bladder (OAB) in Korea, to assess the variation in prevalence by sex and age, and to measure the impact of OAB on quality of life. METHODS: A population-based, cross-sectional telephone survey was conducted between April and June 2010 with a questionnaire regarding the prevalence of OAB, demographics, and the impact of OAB on quality of life. A geographically stratified random sample of men and women aged > or =30 years was selected. RESULTS: The overall prevalence of OAB was 22.9% (male, 19%; female, 26.8%). Of a total of 458 participants with OAB, 37.6% and 19.9% reported moderate or severe impact on their daily life and sexual life (5.6% and 3.5%, respectively, in participants without OAB). Anxiety and depression were reported by 22.7% and 39.3% of participants with OAB, respectively (9.7% and 22.8%, respectively, in participants without OAB). Only 19.7% of participants with OAB had consulted a doctor for their voiding symptoms, but 50.7% of respondents with OAB were willing to visit a hospital for the management of their OAB symptoms. CONCLUSIONS: This study confirmed that OAB symptoms are highly prevalent in Korea, and many sufferers appear to have actively sought medical help. OAB has severe effects on daily and sexual life as well as psychological health.
Aged ; Anxiety ; Demography ; Depression ; Female ; Humans ; Korea ; Male ; Prevalence ; Quality of Life ; Surveys and Questionnaires ; Telephone ; Urinary Bladder, Overactive

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Korean Version of the Overactive Bladder Symptom Score Questionnaire: Translation and Linguistic Validation.

Seong Jin JEONG ; Yukio HOMMA ; Seung June OH

International Neurourology Journal.2011;15(3):135-142.

PURPOSE: The overactive bladder symptom score (OABSS) consists of 4 questions regarding OAB symptoms. The aim of this study was to develop Korean version of the OABSS from the original Japanese version, with subsequent linguistic validation. METHODS: Between February and May 2008, the translation and linguistic validation process was performed as follows: a forward translation, reconciliation, backward translation, cognitive debriefing, and final proofreading. RESULTS: A forward translation from the original version of the OABSS to the Korean language was carried out by 2 native Korean speakers, who were also fluent in Japanese. Reconciliation was made after review of both translations by a panel consisting of both translators and one of the authors. Another bilingual translator who had never seen the original version of the OABSS carried out a translation of the reconciled version back into Japanese, and the original and backward-translated versions were subsequently compared. After discussion of all discrepancies between both versions by the panel, a second Korean version was produced. During cognitive debriefing, 5 outpatients with OAB reported that each question of the Korean version was significant and appropriate for their symptoms. However, 2 patients said that some parts of the questions or instructions were not clear or were not easy to understand. According to the cognitive debriefing, some words and phrases were revised into more understandable expressions. CONCLUSIONS: A Korean version of the OABSS was developed and linguistic validation was performed. Further studies are needed to assess the reproducibility and validity of the questionnaire in Korean populations.
Asian Continental Ancestry Group ; Humans ; Linguistics ; Nocturia ; Outpatients ; Translations ; Urinary Bladder, Overactive

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Exploring the Potential of Flunarizine for Cisplatin-Induced Painful Uremic Neuropathy in Rats.

Arunachalam MUTHURAMAN ; Sumeet Kumar SINGLA ; Anil PETERS

International Neurourology Journal.2011;15(3):127-134.

PURPOSE: The present study was designed to explore the potential of flunarizine for cisplatin induced painful uremic neuropathy in rats. METHODS: Cisplatin (2 mg/kg; i.p., for 5 consecutive days) was administered and renal uremic markers i.e., serum creatinine were estimated on days 4 and 25. Behavioral changes were assessed in terms of thermal hyperalgesia (hot plate, plantar, tail immersion, and tail flick tests at different time intervals). Biochemical analysis of total calcium, superoxide anion, DNA, and transketolase, and myeloperoxidase activity in tissue samples was also performed. Furthermore, flunarizine (100, 200, and 300 microM/kg; p.o., for 21 consecutive days) was administered to evaluate its potency on uremic neuropathy, and the results were compared with those for the carbamazepine-treated (30 mg/kg; p.o., for 21 consecutive days) groups. RESULTS: Flunarizine attenuated the cisplatin-induced uremic neuropathy, and the degree of behavioral and biochemical changes in serum and tissue samples in a dose dependent manner. The medium and high doses of flunarizine were shown to produce a significant effect on cisplatin induced painful uremic neuropathy. CONCLUSIONS: Our results indicate the potential of flunarizine for anti-oxidative, anti-inflammatory, and neuroprotective actions. Therefore, it may have use as a novel therapeutic agent for the management of painful uremic neuropathy.
Animals ; Calcium ; Cisplatin ; Creatinine ; DNA ; Flunarizine ; Hyperalgesia ; Immersion ; Neurotoxins ; Peroxidase ; Rats ; Superoxides ; Transketolase ; Uremia

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Long Hu JIN ; Chang Shin PARK ; Hwa Yeon SHIN ; Sang Min YOON ; Tack LEE

International Neurourology Journal.2011;15(3):120-126.

PURPOSE: We investigated bladder function, with a special focus on nonvoiding contractions (NVCs), in awake rats with chronic chemical cystitis and bladder outlet obstruction (BOO) by use of simultaneous registrations of intravesical and intraabdominal pressures. In addition, we tested the effects of tolterodine on the NVCs in these models. METHODS: A total of 20 female Sprague-Dawley rats were used in this study. In eight rats, chemical cystitis was induced by intravesical instillation of HCl. Twelve rats were subjected to sham instillations or partial BOO. Four weeks after intravesical instillation or 2 weeks after partial BOO, cystometrograms were obtained by use of simultaneous recording of intravesical and intraabdominal pressure in all unanesthetized, unrestrained rats in metabolic cages. RESULTS: A total of 17 rats survived. In the rats with acute injury by HCl, 50% showed detrusor overactivity (DO), which was not seen in the sham group. The cystitis group had lower DO pressure without a difference in DO frequency compared with the BOO group. After the administration of tolterodine, the cystitis group showed no difference in DO frequency or pressure, whereas the BOO group showed decreased values for both parameters. CONCLUSIONS: Our study showed that toleterodine produced no effect on DO during the filling phase in rats with chronic chemical cystitisbut decreased the frequency and pressure of DO in rats with BOO. Clinically, studies are needed to improve the treatment effect of anticholinergic drugs ininterstitial cystitis patients with overactive bladder.
Administration, Intravesical ; Animals ; Benzhydryl Compounds ; Contracts ; Cresols ; Cystitis ; Female ; Humans ; Phenylpropanolamine ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Tolterodine Tartrate ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Bladder, Overactive ; Urodynamics

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Regenerative Medicine Strategies for Treating Neurogenic Bladder.

James J YOO ; Jennifer OLSON ; Anthony ATALA ; Bupwan KIM

International Neurourology Journal.2011;15(3):109-119.

Neurogenic bladder is a general term encompassing various neurologic dysfunctions of the bladder and the external urethral sphincter. These can be caused by damage or disease. Therapeutic management options can be conservative, minimally invasive, or surgical. The current standard for surgical management is bladder augmentation using intestinal segments. However, because intestinal tissue possesses different functional characteristics than bladder tissue, numerous complications can ensue, including excess mucus production, urinary stone formation, and malignancy. As a result, investigators have sought after alternative solutions. Tissue engineering is a scientific field that uses combinations of cells and biomaterials to encourage regeneration of new, healthy tissue and offers an alternative approach for the replacement of lost or deficient organs, including the bladder. Promising results using tissue-engineered bladder have already been obtained in children with neurogenic bladder caused by myelomeningocele. Human clinical trials, governed by the Food and Drug Administration, are ongoing in the United States in both children and adults to further evaluate the safety and efficacy of this technology. This review will introduce the principles of tissue engineering and discuss how it can be used to treat refractory cases of neurogenic bladder.
Adult ; Biocompatible Materials ; Child ; Humans ; Meningomyelocele ; Mucus ; Neurologic Manifestations ; Regeneration ; Regenerative Medicine ; Research Personnel ; Tissue Engineering ; United States ; United States Food and Drug Administration ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Calculi

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The Evolution of Urogenital Tissue Engineering.

Khae Hawn KIM

International Neurourology Journal.2011;15(3):107-108.

No abstract available.
Tissue Engineering

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Calculi in a Female Urethral Diverticulum.

Ji Sung SHIM ; Mi Mi OH ; Jae Il KANG ; Sun Tae AHN ; Du Geon MOON ; Jeong Gu LEE

International Neurourology Journal.2011;15(1):55-57.

Urinary stones are rarely seen in the urethra and are usually encountered in men with urethral stricture or diverticulum. The case of a 52-year-old woman presented, who consulted for weak stream associated with repeated urinary infections. The diverticulum was approached via vaginal route and the extraction was successful. The patient has been well, with no dysuria, dyspareunia, incontinence for 3-month follow-ups.
Calculi ; Diverticulum ; Dyspareunia ; Dysuria ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rivers ; Urethra ; Urethral Stricture ; Urinary Calculi

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Urodynamic Detrusor Overactivity in Patients with Overactive Bladder Symptoms.

Mohammed A AL-GHAZO ; Ibrahim Fathi GHALAYINI ; Rami AL-AZAB ; Osama Bani HANI ; Yousef S MATANI ; Yazan HADDAD

International Neurourology Journal.2011;15(1):48-54.

PURPOSE: To evaluate the relationship between urodynamic detrusor overactivity (DO) and overactive bladder (OAB) symptoms in men and women. METHODS: We reviewed the records of adult males and females who attended a tertiary referral center for urodynamic evaluation of OAB syndrome symptoms with the presence or absence of DO. DO was calculated for symptoms alone or in combination. RESULTS: The overall incidence of DO was 76.1% and 58.7% in male and female OAB patients, respectively. Of men 63% and 61% of women with urgency (OAB dry) had DO, while 93% of men and 69.8% of women with urgency and urgency urinary incontinence (OAB wet) had DO. Of women, 58% who were OAB wet had stress urinary incontinence symptoms with 26.4% having urodynamic stress incontinence. 6% of men and 6.5% of women with OAB symptoms had urodynamic diagnosis of voiding difficulties with postvoid residual greater than 100 mL. Combination of symptoms is more accurate in predicting DO in OAB patients. The multivariate disease model for males included urge urinary incontinence (UUI) and urgency while for females it included UUI and nocturia. CONCLUSIONS: There was a better correlation in results between OAB symptoms and the urodynamic diagnosis of DO in men than in women, more so in OAB wet than in OAB dry. Combination of symptoms of the OAB syndrome seems to have a better correlation with objective parameters from the bladder diary, filling cystometry, and with the occurrence of DO.
Adult ; Female ; Humans ; Incidence ; Male ; Tertiary Care Centers ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence ; Urodynamics

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