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Der Chirurg; Zeitschrift Fur Alle... Jan 2010Functional disorders of micturition after rectal resection were investigated on an in-house patient collective. Because the neuro-anatomy of the small pelvis is very...
AIM
Functional disorders of micturition after rectal resection were investigated on an in-house patient collective. Because the neuro-anatomy of the small pelvis is very complex, the aim of this study was to evaluate the incidence and form of disorders in micturition.
MATERIALS AND METHODS
A total of 536 patients were operated on for a rectal carcinoma during the period 2000 to 2004 at the Surgical University Clinic in Erlangen. Patients with a recurrent tumor and patients who died during the study were excluded (140 patients). All patients were retrospectively questioned on the pre-operative and postoperative bladder function using a standard questionnaire.
RESULTS
The patient collective consisted of 167 males and 111 females with an average age of 63 years and a mean follow-up time of 2.6 years. Age (<65 years versus >65 years) was found not to play a significant role with respect to micturition (p>0.05). Of the patients 20 already had a pollakisuria before the operation and 63 patients after the operation. Also 9 patients already had a nycturia before the operation and 55 after the operation. An imperative urgency to urinate was experienced by 9 patients before and 47 after the operation. Stress incontinence grade I was present in 21 patients before the operation, grade II in 4 patients and grade III in 1 patient. Of the patients 43 complained of stress incontinence grade I after the operation, 20 patients of a grade II and 15 of a grade III. The postoperative quality of life was assessed as very limited by 57 patients and moderately limited by 85.
CONCLUSIONS
Functional disorders of micturition after rectal resection in rectal cancer patients are commonly occurring complications which have received relatively little attention in the literature considering the clinical significance. Only few affected patients have received a urological treatment. Further studies are necessary, also experimental in nature, to understand the neuro-anatomy of the small pelvis in order to avoid intra-operative neurolesions as far as possible.
Topics: Aged; Cross-Sectional Studies; Female; Follow-Up Studies; Germany; Humans; Incidence; Male; Middle Aged; Postoperative Complications; Quality of Life; Rectal Neoplasms; Urination Disorders; Urodynamics
PubMed: 19730796
DOI: 10.1007/s00104-009-1790-0 -
APMIS : Acta Pathologica,... Jun 1989Aerococci are only occasionally isolated from urinary tract specimens. A 4-month' survey revealed 29 patients suspected of urinary tract infection (UTI), from whom an...
Aerococci are only occasionally isolated from urinary tract specimens. A 4-month' survey revealed 29 patients suspected of urinary tract infection (UTI), from whom an Aerococcus-like organism (ALO) was isolated in significant numbers from urinary tract specimens and singly in 11 cases. Approximately 0.8% of all urinary tract specimens examined during the period yielded growth of ALO. The median age of patients was 75 years. Half of the patients were found to have conditions predisposing to UTI. 9 of 11 patients without indwelling catheter, having ALO isolated in pure culture from the urine, showed one or more typical signs of UTI (fever, dysuria and/or pollakisuria and pyuria). A phenotypic comparison was made between 29 strains of ALO and 6 related organisms, including Aerococcus viridans, Streptococcus faecium, Streptococcus sanguis, Streptococcus bovis, Streptococcus Group Q and Streptococcus Group R. ALO and A. viridans showed many similarities, but, owing to characteristic differences with regard to colony morphology, biochemical reactions and antibiotic susceptibility pattern, the strains were easily separated.
Topics: Catheterization; Humans; Streptococcaceae; Urinary Tract Infections
PubMed: 2736106
DOI: 10.1111/j.1699-0463.1989.tb00828.x -
Wiener Medizinische Wochenschrift (1946) 1992In climacteric women stress and urge incontinence often occur as a consequence of estrogen deficiency. Urinary incontinence is defined as involuntary discharge of urine... (Review)
Review
In climacteric women stress and urge incontinence often occur as a consequence of estrogen deficiency. Urinary incontinence is defined as involuntary discharge of urine associated with psychologic and hygienic problems. Of 3,248 women investigated between 1986 and 1990 at our Clinic for Climacteric Dysfunctions, Vienna, 1,039 women (32%) reported symptoms such as vaginal dryness, incontinence and problems with regard to cohabitation. Indications for estrogen replacement therapy in and/or after the climacteric period are urinary stress incontinence degree I, urge incontinence (pollakisuria, nycturia), atrophic urethritis as well as preoperative estrogen replacement. For therapeutic management both conjugated estrogens and estradiol as well as estriol preparations may be employed, taking the contraindications into account. Postmenopausal estrogen replacement is highly indicated with dysfunctions in the area of urethra and urinary bladder.
Topics: Climacteric; Estrogen Replacement Therapy; Female; Humans; Middle Aged; Urethra; Urinary Incontinence; Urodynamics
PubMed: 1615679
DOI: No ID Found -
Hinyokika Kiyo. Acta Urologica Japonica Feb 2006The patient was a 35-year-old woman with complaints of residual sensation and pollakisuria. Excretory urography and magnetic resonance imaging revealed right ureterocele...
The patient was a 35-year-old woman with complaints of residual sensation and pollakisuria. Excretory urography and magnetic resonance imaging revealed right ureterocele with hydronephrosis. Transurethral incision of the ureterocele was carried out. Two months postoperatively, the ureterocele prolapsed through the external urethral meatus, and transurethral resection of ureterocele was performed. Forty-one cases of prolapsed ureterocele reported in the Japanese literature are reviewed.
Topics: Adult; Female; Humans; Hydronephrosis; Magnetic Resonance Imaging; Postoperative Complications; Prolapse; Ureteral Neoplasms; Ureterocele; Urethra; Urography; Urologic Surgical Procedures
PubMed: 16541768
DOI: No ID Found -
Hinyokika Kiyo. Acta Urologica Japonica Apr 1998Clear cell adenocarcinoma of the female urethra is a rare disease. We herein report the 23rd case of clear cell adenocarcinoma of the female urethra in Japan. A... (Review)
Review
Clear cell adenocarcinoma of the female urethra is a rare disease. We herein report the 23rd case of clear cell adenocarcinoma of the female urethra in Japan. A 75-year-old female visited our hospital because of pollakisuria. Pelvic CT revealed a 2.2 cm tumor surrounding the entire circumference of the urethra with pelvic lymph node metastases. Chest CT revealed mediastinal lymph node metastases. She underwent anterior pelvic exenteration and ileal conduit urinary diversion. Pathological diagnosis of the tumor was clear cell adenocarcinoma. She has been alive 11 months after surgery in spite of enlarged mediastinal lymph node metastases.
Topics: Adenocarcinoma, Clear Cell; Aged; Female; Humans; Lymphatic Metastasis; Magnetic Resonance Imaging; Urethral Neoplasms
PubMed: 9617628
DOI: No ID Found -
Estradiol 1 mg and drospirenone 2 mg as hormone replacement therapy in postmenopausal Chinese women.Climacteric : the Journal of the... Aug 2011Drospirenone is a novel progestogen that, combined with 17β-estradiol, reduces the frequency and severity of menopausal vasomotor symptoms (VMS) in different... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Drospirenone is a novel progestogen that, combined with 17β-estradiol, reduces the frequency and severity of menopausal vasomotor symptoms (VMS) in different populations. This double-blind, multicenter study compared the efficacy, safety and tolerability of 2 mg drospirenone/1 mg estradiol (DRSP/E2) vs. placebo in Chinese postmenopausal women with moderate to severe VMS.
METHODS
Women, aged 45-65 years, were randomized to DRSP/E2 (n=183) or placebo (n=61) once daily for four 28-day cycles. Changes in the frequency and severity of hot flushes were analyzed as primary variables, together with other climacteric and urogenital symptoms, clinical global improvement, adverse events and physical/gynecological parameters.
RESULTS
Relative changes in numbers of hot flushes/week were -80.4% for DRSP/E2 vs. -51.9% for placebo (treatment difference -28.5%, p<0.0001). There were trends toward a greater reduction in severity of hot flushes with DRSP/E2 treatment. Patients treated with DRSP/E2 were more often free from sweating episodes (p<0.0001) and vaginal dryness (p=0.0008). Other climacteric symptoms, including nervousness and pollakisuria, followed a trend of greater response with DRSP/E2. Similar to other combination HRT regimens, DRSP/E2 increased occurrences of bleeding, but these decreased over time. Adverse events in patients treated with DRSP/E2 were mostly mild to moderate and withdrawal rates were low.
CONCLUSIONS
Daily treatment of postmenopausal Chinese women with DRSP/E2 for 16 weeks significantly reduced the incidence of hot flushes and demonstrated advantages vs. placebo for other climacteric symptoms. These results indicate that DRSP/E2 is effective, safe and well tolerated in postmenopausal Chinese women.
Topics: Aged; Androstenes; China; Double-Blind Method; Drug Combinations; Estradiol; Estrogen Replacement Therapy; Female; Hot Flashes; Humans; Middle Aged; Mineralocorticoid Receptor Antagonists; Placebos; Postmenopause; Vaginal Diseases
PubMed: 21469973
DOI: 10.3109/13697137.2011.553971 -
Hinyokika Kiyo. Acta Urologica Japonica Jan 1985The clinical effectiveness of PPC, amino acid preparation, on nonspecific chronic prostatitis was evaluated by the double-blind test method. A mixture of two pollen... (Clinical Trial)
Clinical Trial
The clinical effectiveness of PPC, amino acid preparation, on nonspecific chronic prostatitis was evaluated by the double-blind test method. A mixture of two pollen extracts which has been widely employed for the treatment of chronic prostatitis was used as a control. Neither antibiotics nor anti-inflammatory drug was administered during the investigation. A total of 76 cases was reported from six facilities but 14 of them were excluded or dropped out. In 32 cases in the PPC group, subjective symptoms such as discomfort after urination, discomfort in the perineal region, pollakisuria, sense of residual urine and dysuria were improved in 50.0 approximately 61.9% and 70.0 approximately 83.3% after 2- and 4-week administrations, respectively. Similar results regarding each subjective symptom were obtained in 30 cases of the control group and there was no significant difference between the two groups. In the overall clinical effectiveness concerning subjective symptoms, the effective rate including excellently, moderately and slightly effective was 81.3% with PPC and 83.3% with control drug. However when the effective rate was limited to excellently and moderately effective, PPC was slightly superior to the control drug (50.5% versus 36.7%). In regard to prostatic tenderness by the digital examination, both PPC and control drug induced relatively good improvement after 2-week administration. The degree of improvement, however, was not increased in the subsequent 2 weeks. Sclerotic change of the prostate was poorly recovered in both groups even after 4-week treatment. Swelling of the prostate was alleviated in 12.5% of the control group after 2 weeks and in 31.8% after 4 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Alanine; Chronic Disease; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Glutamine; Glycine; Humans; Male; Prostatitis
PubMed: 3887870
DOI: No ID Found -
World Journal of Surgical Oncology Nov 2009Urachal carcinoma is an uncommon neoplasm associated with poor prognosis.
BACKGROUND
Urachal carcinoma is an uncommon neoplasm associated with poor prognosis.
CASE PRESENTATION
A 45-year-old man was admitted with complaints of abdominal pain and pollakisuria. A soft mass was palpable under his navel. TC-scan revealed a 11 x 6 cm tumor, which was composed of a cystic lesion arising from the urachus and a solid mass component at the urinary bladder dome. The tumor was removed surgically. Histological examination detected poor-differentiated adenocarcinoma, which had invaded the urinary bladder. The patient has been followed up without recurrence for 6 months.
CONCLUSION
The urachus is the embryological remnant of urogenital sinus and allantois. Involution usually happens before birth and urachus is present as a median umbilical ligament. The pathogenesis of urachal tumours is not fully understood. Surgery is the treatment of choice and role of adjuvant treatment is not clearly understood.
Topics: Adenocarcinoma; Cystoscopy; Humans; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Urachus; Urinary Bladder Neoplasms
PubMed: 19895702
DOI: 10.1186/1477-7819-7-82 -
Therapeutische Umschau. Revue... Sep 1996Painful micturition is one of the most common symptoms of urological diseases. The term "dysuria" is descriptive for micturition which the patient perceives as...
Painful micturition is one of the most common symptoms of urological diseases. The term "dysuria" is descriptive for micturition which the patient perceives as unpleasant. Usually, dysuria is combined with other symptoms such as pollakisuria (increased frequency of micturition) and urge (non suppressible compulsion of micturition). The symptoms may arise acutely or progress slowly and are often strictly linked to the act of micturition. The patients frequently complain of a burning pain at the beginning or during micturition. Therefore the anamnesis may already give the first clue for localization of the disease. The most common cause of painful micturition is an inflammation of the lower urinary tract. However, tumours, obstructive conditions and other less common urologic diseases must also be considered Basic diagnostics with urine analysis and culture can easily be done by almost all general practitioners. In doubtful cases, however, a special urologic examination is mandatory.
Topics: Female; Humans; Male; Pain; Prostatitis; Ultrasonography; Urinary Bladder Diseases; Urination Disorders; Urine; Urodynamics
PubMed: 8966693
DOI: No ID Found -
Hinyokika Kiyo. Acta Urologica Japonica Oct 1983Two patients with eosinophilic cystitis are presented in this report. The first case was a 39-year-old man who was admitted to our clinic with complaints of...
Two patients with eosinophilic cystitis are presented in this report. The first case was a 39-year-old man who was admitted to our clinic with complaints of pollakisuria, pain on urination and hematuria for a month, which had not been relieved by antibiotic therapy. He had both a family and a personal past history of allergy. Excretory urograms showed a mild bilateral hydroureter and small bladder with irregular filling defects. Cystoscopic examination revealed velvety, ulcerated areas in the bladder mucosa, and we diagnosed these changes as eosinophilic cystitis after bladder biopsy. Steroid and antihistaminic therapy improved these symptoms. The second case was a 67-year-old woman who visited our clinic complaining chiefly of hematuria for 2 months. There was no predisposition to allergy, but she had a past history of uterine cancer which had been treated with irradiation. Cystoscopic examination disclosed a large amount of intravesical coagula, and erythematous and edematous areas with petechiae of the bladder mucosa. Bladder biopsy revealed hemangioma and eosinophilic cystitis. There was no recurrence of cystitis after the removal of the coagula without any other treatment.
Topics: Adult; Aged; Cystitis; Cystoscopy; Eosinophilia; Female; Humans; Male; Radiography; Urinary Bladder
PubMed: 6681507
DOI: No ID Found