OBJECTIVE: To explore the impact factors and the clinical significance of the urination intermittences in benign prostatic hyperplasia (BPH) patients. METHODS: A retrospective study was performed in BPH patients who underwent urodynamic studies in Beijing Jishuitan Hospital form January 2016 to June 2021. The patients were aged 45 to 84 years with a median age of 63 years, and all the patients had no previous history of neurological disease and had no positive findings in neurological examinations. All the patients had free uroflometry followed by urethral catheterization and urodynamic tests. The voiding work of bladder was calculated using the detrusor power curve method, and the voiding power of bladder and the voiding energy consumption were also calculated. The frequency of urination intermittences generated in uroflometry was also recorded and the patients were divided into different groups according to it. The detrusor pressure at maximal flow rate (P_detQ_max), the maximal flow rate (Q_max), the bladder contractile index (BCI), the bladder outlet obstruction index (BOOI), the voiding work, the voiding power, and the voiding energy consumption were compared among the different groups. Multiva-riate analyses associated with presence of urination intermittences were performed using step-wise Logistic regressions. RESULTS: There were 272 patients included in this study, of whom, 179 had no urination intermittence (group A), 46 had urination intermittence for only one time (group B), 22 had urination intermittence for two times (group C), and 25 had urination intermittence for three times and more (group D). The BCI were 113.4±28.2, 101.0±30.2, 83.3±30.2, 81.0±30.5 in groups A, B, C, and D, respectively; The voiding power were (29.2±14.8) mW, (16.4±9.6) mW, (14.5±7.1) mW, (8.5±5.0) mW in groups A, B, C, and D, respectively, and the differences were significant (P < 0.05). The BOOI were 41.6±29.3, 46.4±31.0, 41.4±29.0, 42.7±22.8 in groups A, B, C, and D, respectively; The voiding energy consumption were (5.41±2.21) J/L, (4.83±2.31) J/L, (5.02±2.54) J/L, (4.39±2.03) J/L in groups A, B, C, and D, respectively, and the differences were insignificant (P>0.05). Among the patients, 179 cases were negative in presence of urination intermittences and 93 cases were positive. Step-wise Logistic regression analysis showed that bladder power (OR=0.814, 95%CI: 0.765-0.866, P < 0.001), BCI (OR=1.023, 95%CI: 1.008-1.038, P=0.003), and bladder work (OR=2.232, 95%CI: 1.191-4.184, P=0.012) were independent risk factors for urination intermittences in the BPH patients. CONCLUSION The presence of urination intermittences in the BPH patients was mainly influenced by bladder contractile functions, and was irrelevant to the degree of bladder outlet obstruction. The increase of frequency of urination intermittences seemed to be a sign of the decrease of the bladder contractile functions in the BPH patients.
Prostatic Hyperplasia/physiopathology* ; Humans ; Male ; Urodynamics ; Urination ; Retrospective Studies ; Middle Aged ; Aged ; Aged, 80 and over ; Urinary Bladder/physiopathology* ; Urination Disorders/etiology*

PURPOSE: Existing data supports a relationship between pelvic floor dysfunction and lower urinary tract symptoms. We developed a survival model of pelvic floor dysfunction in the rabbit and evaluated cystometric (CMG), electromyographic (EMG) and ambulatory voiding behavior. MATERIALS AND METHODS: Twelve female adult virgin rabbits were housed in metabolic cages to record voiding and defecation. Anesthetized CMG/EMG was performed before and after treatment animals (n=9) received bilateral tetanizing needle stimulation to the pubococcygeous (PC) muscle and controls (n=3) sham needle placement. After 7 days all animals were subjected to tetanizing transvaginal stimulation and CMG/EMG. After 5 days a final CMG/EMG was performed. RESULTS: Of rabbits that underwent needle stimulation 7 of 9 (78%) demonstrated dysfunctional CMG micturition contractions versus 6 of 12 (50%) after transvaginal stimulation. Needle stimulation of the PC musculature resulted in significant changes in: basal CMG pressure, precontraction pressure change, contraction pressure, interval between contractions and postvoid residual; with time to 3rd contraction increased from 38 to 53 minutes (p=0.008 vs. prestimulation). Vaginal noxious stimulation resulted in significant changes in: basal CMG pressure and interval between contractions; with time to 3rd contraction increased from 37 to 46 minutes (p=0.008 vs. prestimulation). Changes in cage parameters were primarily seen after direct needle stimulation. CONCLUSIONS: In a majority of animals, tetanizing electrical stimulation of the rabbit pelvic floor resulted in voiding changes suggestive of pelvic floor dysfunction as characterized by a larger bladder capacity, longer interval between contractions and prolonged contraction duration.
Animals ; Disease Models, Animal ; Dystonia/*etiology ; Electric Stimulation/adverse effects/methods ; Electromyography/methods ; Female ; Muscle Contraction/physiology ; Pelvic Floor/*physiopathology ; Pelvic Floor Disorders/*complications/physiopathology ; Rabbits ; Urinary Bladder/physiopathology ; Urinary Retention/*etiology ; Urination/physiology ; Urine ; Vagina/*physiopathology

BACKGROUNDUrination disorders are common in Parkinson's disease (PD) and respond poorly to medication. This study aimed to analyze the risk factors for urination disorders in PD.

METHODSNinety-one patients with PD (aged 34-83 years old) were recruited. Patients were assessed with the Unified PD Rating Scale (UPDRS), Hoehn and Yahr stage, Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HAMD), and Hamilton Anxiety Scale (HAMA). Micturition number was recorded, and Type B ultrasound was used to evaluate residual urine. Statistics was performed using binary logistic regression, bivariate correlations, and Chi-square and t-tests.

RESULTSOf 91 patients, urinary dysfunction occurred in 55.0%. Among these, 49.5% suffered with nocturia, 47.3% with pollakiuria. Nocturia number had a positive linear relationship with HAMA score (odds ratio [OR] = 0.340, P = 0.001), HAMD score (OR = 0.323, P = 0.002), duration of L-dopa medication (OR = 0.328, P = 0.001), dose of L-dopa (OR = 0.273, P = 0.009), UPDRS-II (OR = 0.402, P = 0.000), UPDRS-III score (OR = 0.291, P = 0.005), and PSQI score (OR = 0.249, P = 0.017). Micturition number over 24 h was positively associated with HAMA (OR = 0.303, P = 0.004) and UPDRS-II scores (OR = 0.306, P = 0.003). Of patients with residual urine, 79.3% had a volume of residual urine <50 ml. Residual urine was present in 44.4% of the patients with nocturia, 46.5% of the patients with pollakiuria, and 80.0% of the patients with dysuria. More men than women had residual urine (35.2% male vs. 13.3% female; P = 0.002).

CONCLUSIONSNocturia and pollakiuria were common micturition symptoms in our participants with PD. Nocturia was associated with depression, anxiety, sleep problems, and severity of PD. Pollakiuria was associated with anxiety and severity of PD. Male patients were more prone to residual urine and pollakiuria.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Nocturia ; etiology ; Parkinson Disease ; complications ; Risk Factors ; Urination Disorders ; etiology

OBJECTIVETo observe the clinical efficacy differences between regular acupuncture combined with acupuncture at trigone of urinary bladder and simple regular acupuncture for treatment of urination dysfunction induced by spinal cord injury.

METHODSSixty patients were randomized into an observation group and a control group, 30 cases in each one. The control group was treated with regular acupuncture at Sanyinjiao (SP 6), Zusanli (ST 36), Zhongwan (CV 12) and Tianshu (ST 25), etc. Based on the treatment of control group, the observation group was additionally treated with intensive needling at trigone of urinary bladder, once a day, 30 min per treatment. Ten treatments were considered as one course, and there was an interval of two days between courses, 4 courses of treatment were given in two groups. The improvement of urination function in two groups was evaluated, and the efficacy of urination function in two groups was compared.

RESULTSAfter treatment, the times of urine leakage, maximum urine output, bladder capacity and residual urine were all improved in two groups (all P<0.05). The improvement of times of urine leakage, bladder capacity and residual urine in the observation group was superior to that in the control group (all P<0.05). The total effective rate was 96.7% (29/30) in the observation group, which was superior to 83.3% (25/30) in the control group (P<0.05).

CONCLUSIONThe efficacy of regular acupuncture combined with intensive needling at trigone of urinary bladder on urination dysfunction induced by spinal cord injury is significantly superior to that of simple regular acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; complications ; Treatment Outcome ; Urination ; Urination Disorders ; etiology ; physiopathology ; therapy ; Young Adult

OBJECTIVETo compare the positive rates and complications of ultrasound-guided transrectal and transperineal prostate biopsies.

METHODSWe retrospectively analyzed 156 cases of ultrasound-guided transrectal (n = 97) and transperineal (n = 59) prostate biopsy, and compared the positive rate and post-biopsy complications between the two approaches.

RESULTSThe positive rates in the transrectal and transperineal groups were 48.4% and 44.1%, respectively, with no significant difference between the two approaches according to different PSA levels (P >0.05). No statistically significant differences were observed between the transrectal and transperineal groups in the post-biopsy incidence rates of such complications as hematuria (54.6% vs 42.4%, P >0.05), lower urinary tract symptoms (17.5% vs 22.0%, P >0.05), dysuria (9.3% vs 6.8%, P >0.05), and acute urinary retention (7.2% vs 6.8%, P >0.05). However, the incidence rates of post-biopsy infection and rectal bleeding were remarkably higher (15.5% vs 3.4%, P<0.05 and 50.5% vs 3.4%, P >0.01) while that of perineal swelling markedly lower in the former than in the latter (3.1% vs 13.6%, P <0.05).

CONCLUSIONTransrectal and transperineal biopsies are both effective for the diagnosis of prostate cancer. Since their complications vary, the choice between the two methods depends on the specific condition of the patient.

Biopsy, Needle ; adverse effects ; methods ; Hematuria ; etiology ; Humans ; Lower Urinary Tract Symptoms ; etiology ; Male ; Prostate ; pathology ; Prostatic Neoplasms ; pathology ; Rectum ; Retrospective Studies ; Ultrasonography, Interventional ; methods ; Urination Disorders ; etiology

OBJECTIVETo study whether anxiety and depression are associated with the development of neurogenic urination in children.

METHODSA total of 136 9 to 12-year-old children with neurogenic urination (case group) and 136 age-matched healthy children (control group) were enrolled. The Screen for Children Anxiety Related Emotion Disorders (SCARED) and Depression Self-rating Scale for Children (DSRSC) were used to evaluate the psychological status. The incidences of anxiety and depression as well as the SCARED and DSRSC scores were compared between two groups. Logistic regression analysis model was used to evaluate the relationship between psychological status and the development of neurogenic urination.

RESULTSThe case group was found to have a higher incidence of anxiety and depression compared with the control group (P<0.01). The SCARED score in the case group (28.1 ± 8.6) increased significantly compared with 14.4 ± 4.9 in the control group (P<0.01). The DSRSC score in the case group was also significantly higher than in the control group (13.5 ± 4.8 vs 9.1 ± 3.2; P<0.01). The logistic regression analysis showed that the children with anxiety (SCARED-score>23) had a 1.224-fold increased risk for the development of neurogenic urination compared with the children with the SCARED-score≤23 and that the children with depression (DSRSC-score≥15) had a 1.148-fold increased risk for the development of this disorder.

CONCLUSIONSAnxiety and depression participate in the development of neurogenic urination in school children.

Anxiety ; complications ; Child ; Depression ; complications ; Female ; Humans ; Logistic Models ; Male ; Urination Disorders ; etiology ; psychology

OBJECTIVETo evaluate the effect of placement of urethral catheter combined with lidocaine on urethral irritation caused by postoperative indwelling catheters.

METHODSA total of 120 male surgical patients requiring postoperative indwelling catheters between June 2011 and January 2012 were divided into two equal groups for placement of painless urethral catheter combined with bladder washing with lidocaine on the first postoperative day, or for routine catheter placement only. The symptoms of urethral irritation such as urethral pain, urinary urgency, and perineal discomforts were observed and compared between the two groups.

RESULTSIn patients with painless urethral catheter placement combined with bladder washing with lidocaine, 11 developed urethral irritation symptoms, as compared to 24 in the patients with routine catheter placement only, showing a significant difference between the two groups (P<0.05).

CONCLUSIONPlacement of painless urethral catheter combined with bladder washing with lidocaine can significantly reduce the incidence of urethral irritation due to postoperative indwelling catheters.

Adult ; Humans ; Lidocaine ; Male ; Middle Aged ; Urinary Catheterization ; methods ; Urinary Catheters ; adverse effects ; Urination Disorders ; etiology ; prevention & control ; Young Adult

OBJECTIVETo study the urodynamic changes in patients with recent non-infective voiding dysfunction following radical hysterectomy and assess its significance.

METHODSNinety-six patients with cervical cancer, who were not found any abnormal representation of urodynamics before the operation, were selected into this study group. Eighty-three patients in the study group without urinary infection were detected by urodynamic examination following radical hysterectomy, in order to analyze the urodynamic reasons for the non-infective voiding dysfunction following the surgery.

RESULTSForty-two patients were found with non-infective voiding dysfunction after the operation. Low compliance bladder, bladder destrusor dysfunction and destrusor overactivity were the three leading types of postoperative bladder dysfunction. Moreover, the incidences of low compliance bladder (50.0% vs. 17.1%), bladder destrusor dysfunction (58.4% vs. 14.6%) and destrusor overactivity (31.0% vs. 4.9%) in the group with voiding dysfunction were significantly higher than the corresponding values in the group without voiding dysfunction (P < 0.01). Secondarily, forty-two patients with recent non-infective voiding dysfunction were divided into simple irritation sign group, simple obstruction sign group and mixed sign group according to their main symptoms. The incidence of bladder destrusor dysfunction in the simple obstruction sign group was significant higher than that in the simple irritation sign group, and the incidence of detrusor overactivity in the simple irritation sign group was significant higher than that in the other two groups (P < 0.05).

CONCLUSIONSThere were many different types of urodynamic disorder in the patients with recent non-infective voiding dysfunction after radical hysterectomy. Low compliance bladder, bladder destrusor dysfunction and detrusor overactivity caused by the damage of the pelvic autonomic nerve during the operation may be the main reasons for the recent non-infective voiding dusfunction after radical hysterectomy. Moreover, bladder destrusor dysfunction and detrusor overactivity may be the key points for the symptoms of bladder irritation and bladder obstruction. Urodynamic study is important for the etiology analysis and clinical treatment of recent non-infective voiding dysfunction postoperation.

Adult ; Female ; Humans ; Hysterectomy ; adverse effects ; methods ; Middle Aged ; Urinary Bladder ; physiopathology ; Urinary Bladder, Overactive ; etiology ; physiopathology ; Urination Disorders ; etiology ; physiopathology ; Urodynamics ; Uterine Cervical Neoplasms ; physiopathology ; surgery

OBJECTIVE: To investigate the timing of reaching maximum improvement of the lower urinary tract symptoms (LUTS) in patients with advanced prostate cancer treated with maximal androgen blockade(MAB), and to provide guidelines for the treatment program. METHODS: We collected the data of 45 advanced prostate cancer patients complicated with lower urinary tract symptoms who were treated by MAB. The international prostate symptom score (IPSS) and maximum urinary flow rate (Qmax) were selected as indicators reflecting the degree of lower urinary tract symptoms and were observed before the MAB, 3, 6, and 9 months after the patients received MAB. We also observed the changes of prostate volume and analyzed the role of MAB in improving LUTS in patients with prostate cancer. RESULTS: The IPSS and Qmax had significant difference between the 3rd month after the patients received MAB and before the MAB (P<0.05). No significant difference was found between the 3rd month and the 6th month after the patients received MAB (P>0.05). The prostate volume had significant difference in the 3rd month and the 6th month (P<0.05), but no significant difference in the 6th month and the 9th month (P>0.05). CONCLUSION MAB for patients with advanced prostate cancer can improve their lower urinary tract symptoms, whose main effect is presented in the 3rd months after the androgen deprivation therapy.
Aged ; Aged, 80 and over ; Androgen Antagonists ; therapeutic use ; Anilides ; therapeutic use ; Flutamide ; therapeutic use ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Nitriles ; therapeutic use ; Prostatic Neoplasms ; complications ; drug therapy ; Tosyl Compounds ; therapeutic use ; Urination Disorders ; drug therapy ; etiology

BACKGROUNDDespite 100 years of research, the continued absence of well-established risk factors impedes the diagnosis and treatment of interstitial cystitis/painful bladder syndrome (IC/PBS). We aimed to identify risk factors in patients with lower urinary tract symptoms (LUTS) without urinary tract infection or benign prostate hyperplasia in China.

METHODSA total of 397 outpatients with LUTS presenting for care to urology clinics in several hospitals throughout China were surveyed using a standardized questionnaire and validated outcome measures. The definitions for painful bladder syndrome based on the O'Leary-Sant interstitial cystitis symptom and problem indices were used. The prevalence of possible risk factors was analyzed using the Fisher's exact test and Pearson chi-square test, and multivariate predictive models were developed using binary Logistic regression methods.

RESULTSOf those multi-centre patients surveyed, including 174 women and 223 men, 41% (162/397) met criteria for painful bladder syndrome. There was a significant difference between women and men (55% (95/174) vs. 30% (67/223), P < 0.001). Women with IC/PBS were more likely than those without IC/PBS to report a history of gynecological infections (odds ratio (OR): 2.85; 95% confidence interval (CI): 1.32 - 6.16, P = 0.007), intake of stimulatory foods (OR: 3.52; 95%CI: 1.50 - 8.30; P = 0.004), irritable bowel (OR: 3.46; 95%CI: 1.22 - 9.80; P = 0.014) and/or anorectal disease (OR: 2.68; 95%CI: 1.12 - 6.40, P = 0.023). After adjusting for confounding factors, bladder pain was significantly associated with stimulatory foods (OR: 3.85; 95%CI: 1.58 - 9.36, P = 0.003) and anorectal disease (OR: 2.76; 95%CI: 1.09 - 7.04, P = 0.03) in women. Caffeine beverage intake (OR: 3.54; 95%CI: 1.54 - 8.12, P = 0.003) was identified the only modifiable association noted in multivariate analysis of men.

CONCLUSIONSWe found that stimulatory foods, anorectal disease and caffeine beverages are potential risk factors for IC/PBS. Further studies are necessary to determine their role in the pathogenesis of this disorder.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; Cystitis, Interstitial ; epidemiology ; etiology ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Prostatic Hyperplasia ; complications ; Risk Factors ; Sex Characteristics ; Surveys and Questionnaires ; Urination Disorders ; complications