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World Journal of Gastroenterology Nov 2014IgG4-related autoimmune pancreatitis is frequently accompanied by relevant lesions in the genitourinary tract and retroperitoneal organs, which cause various clinical... (Review)
Review
IgG4-related autoimmune pancreatitis is frequently accompanied by relevant lesions in the genitourinary tract and retroperitoneal organs, which cause various clinical problems, ranging from non-specific back pain or bladder outlet obstruction to renal failure. The diagnosis of IgG4-related retroperitoneal fibrosis requires a multidisciplinary approach, including serological tests, histological examination, imaging analysis, and susceptibility to steroid therapy. Radiological examinations are helpful to diagnose this condition, but surgical resection is occasionally unavoidable to exclude malignancy, particularly for patients with isolated retroperitoneal involvement. Steroid therapy is the treatment of choice for this condition, the same as for other manifestations of IgG4-related disease. For patients with severe ureteral obstruction, additional ureteral stenting needs to be considered prior to steroid therapy to preserve the renal function. Some papers have suggested that IgG4-related disease can affect male reproductive organs including the prostate and testis. IgG4-related prostatitis usually causes lower urinary tract symptoms, such as dysuria and pollakisuria. Patients sometimes state that corticosteroids given for IgG4-related disease at other sites relieve their lower urinary tract symptoms, which leads us to suspect prostatic involvement in this condition. Because of the limited number of publications available, further studies are warranted to better characterize IgG4-related disease in male reproductive organs.
Topics: Adrenal Cortex Hormones; Animals; Autoimmune Diseases; Biomarkers; Diagnostic Imaging; Female Urogenital Diseases; Humans; Immunoglobulin G; Male; Male Urogenital Diseases; Pancreatitis; Predictive Value of Tests; Retroperitoneal Fibrosis; Risk Factors; Sex Factors; Stents; Treatment Outcome
PubMed: 25469023
DOI: 10.3748/wjg.v20.i44.16550 -
Aktuelle Urologie Nov 2004The integral theory of Petros and Ulmsten has profoundly changed our understanding of the female pelvic floor. Anatomic laxity of the vaginal wall caused by pelvic floor... (Comparative Study)
Comparative Study Review
The integral theory of Petros and Ulmsten has profoundly changed our understanding of the female pelvic floor. Anatomic laxity of the vaginal wall caused by pelvic floor defects induced at different damage zones is frequently not only responsible for stress urinary incontinence but also for pollakisuria, urgency, post-void residual and pelvic pain. A number of minimally invasive techniques have been developed to correct these defects. Applying a tension-free polypropylene tape around the mid-urethra has become an established method to correct the anterior ligaments. The infra-coccygeal sacropexy can achieve dorsal stabilization of the vaginal wall. Currently, polypropylene meshes are increasingly used for repairing supporting pelvic fasciae. The most recommended conservative methods are exercises to strengthen the pelvic floor muscles. Duloxetine increases the rhabdosphincter contractility during the filling phases, but not during voiding, and therefore is a promising drug for clinical use.
Topics: Adrenergic Uptake Inhibitors; Age Factors; Aged; Clinical Trials, Phase III as Topic; Duloxetine Hydrochloride; Exercise Therapy; Female; Humans; Middle Aged; Minimally Invasive Surgical Procedures; Pelvic Floor; Polypropylenes; Selective Serotonin Reuptake Inhibitors; Sex Factors; Surgical Mesh; Thiophenes; Urinary Bladder; Urinary Incontinence, Stress
PubMed: 15526228
DOI: 10.1055/s-2004-830118 -
Acta Medica Croatica : Casopis... 2001A case of a 37-year-old man admitted to our Department of Internal Medicine for medical evaluation of hypertension is reported. The patient had a 4-year history of...
A case of a 37-year-old man admitted to our Department of Internal Medicine for medical evaluation of hypertension is reported. The patient had a 4-year history of oscillating hypertension prior to admission, however, with no major subjective complaints, except for pollakisuria. Clinical and biochemical assessment revealed no damage to target organs. Laboratory parameters showed normal values, except for hyperlipidemia. On routine ultrasonography of the pelvis confirmed a pelvic tumor of uncertain etiology, with no abdominal lymph node enlargement. No signs of metastasis were found. The patient was transferred to the Department of Surgery, where the tumor was removed in toto. Histopathologic analysis of the tumor, 11 x 8 x 8 cm in size, composed of cellular and mixoid areas with traces of collagenous connective tissue, necrosis, and tiny calcifications with scattered palisading nuclei and Verocay bodies, pointed to the diagnosis of a benign tumor, i.e. neurilemmoma. Postoperatively, the patient's subjective state was excellent, with normal blood pressure values, and without pollakisuria. A very large space-occupying lesion was responsible for compression of the neighboring organs, especially urinary bladder, resulting in pollakisuria. To our knowledge, pelvic localization of neurilemmoma, particularly a large one, is rare.
Topics: Adult; Humans; Male; Neurilemmoma; Pelvic Neoplasms; Retroperitoneal Neoplasms; Urination Disorders
PubMed: 11505636
DOI: No ID Found -
Journal of Neural Transmission (Vienna,... Apr 2013Bladder dysfunctions are quite common in Parkinson's disease. They may occur at any stage of the illness and get worse with advancing and aggravating disease. The most... (Review)
Review
Bladder dysfunctions are quite common in Parkinson's disease. They may occur at any stage of the illness and get worse with advancing and aggravating disease. The most prominent dysfunction is the so-called overactive bladder. Control of bladder function is part of a highly complex system subject to the interaction of predominantly the frontal and pontine micturition or continence center and the spinal cord. Besides there are some other anatomic structures involved in the complex control loop of bladder regulation. Regarding central regulation, dopamine is the essential neurotransmitter that inhibits bladder activity. All dopaminergic substances are capable of influencing automatic control systems. This also holds true for many other classes of other medications such as anticholinergics, antidepressants, and beta-blockers. The chief clinical problem of this patient consists in reduced inhibition with consequentially resulting overactivity of the detrusor muscle, meaning the urge to urinate in the absence of adequate bladder filling. The patients mostly complain of an imperative urge to urinate, of pollakisuria, nocturia and even incontinence of urine (urge incontinence). The objectives of diagnosis and therapy focus on controlled bladder evacuation and continence of urine. The most important diagnostic clues are provided by the patient's medical history. Only in rare cases urodynamic studies are indicated as well. For treatment we can avail ourselves of a number of anticholinergic drugs. We must watch out though that the medication ordered is not going to impact on cognition.We recommend tolteradine, not passing the blood brain barrier, or M3-specific antimuscarinics such as solifenacin and darifenacin. Positive therapeutic outcomes are limited. A new alternative at hand, albeit not approved for the time being, is the local injection of botulinum toxin into the detrusor muscle.
Topics: Humans; Parkinson Disease; Urinary Bladder; Urination; Urologic Diseases
PubMed: 23196979
DOI: 10.1007/s00702-012-0914-8 -
Schweizerische Medizinische... Mar 1961
Topics: Dipyrone; Drug Combinations; Muscle Relaxants, Central; Parasympatholytics; Tropanes; Urination Disorders
PubMed: 13744552
DOI: No ID Found -
Maturitas Dec 1981Post-operative symptoms of hysterectomy have received relatively little attention in the literature. In the present study the first author has personally interviewed and... (Comparative Study)
Comparative Study
Post-operative symptoms of hysterectomy have received relatively little attention in the literature. In the present study the first author has personally interviewed and examined 105 abdominal hysterectomy patients and 107 patients with supravaginal uterine amputation pre-operatively and thrice post-operatively. At one year the follow-up percentage was 99.5 (211/212). In the statistical analysis McNemar's test of symmetry and Fisher's exact test were used. Loglinear models were developed where applicable. A number of patients had urinary symptoms pre-operatively: 27.6% of the abdominal hysterectomy and 48.6% of the supra-vaginal amputation patients suffered from pollakisuria; preoperative nocturia and dysuria were present in about 10% of patients in each group. These urinary symptoms disappeared more frequently in patients who underwent supra-vaginal amputation; with regard to pollakisuria the difference is statistically significant. Twelve months post-operatively pollakisuria was present in 10.3% of supra-vaginal amputation and 13.5% of hysterectomy patients. The advantage of supra-vaginal amputation over abdominal hysterectomy with regard to these symptoms may result from the considerably less extensive manipulation of the bladder during supra-vaginal amputation. Possibly the support provided by the remaining stump and the round ligaments fixed to it also help to reduce urinary symptoms in these patients. However, further urodynamic studies are needed.
Topics: Adult; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Middle Aged; Postoperative Complications; Prospective Studies; Time Factors; Urinary Tract Infections; Urination Disorders
PubMed: 7334931
DOI: 10.1016/0378-5122(81)90026-8 -
Deutsches Arzteblatt International Jun 2010Urinary incontinence can arise in a woman of any age. Its prevalence is between 10% and 40%. The main clinical problems in urogynecology are stress urinary incontinence... (Review)
Review
BACKGROUND
Urinary incontinence can arise in a woman of any age. Its prevalence is between 10% and 40%. The main clinical problems in urogynecology are stress urinary incontinence (involuntary leakage of urine on exertion, sneezing, or coughing) and the overactive bladder syndrome (nycturia, pollakisuria, and urinary urgency with or without incontinence).
METHOD
Selective literature search, with special attention to large-scale studies and to the guidelines of the German Society of Obstetrics and Gynecology (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, DGGG) and its Task Force on Urogynecology and Pelvic Floor Reconstruction (Arbeitsgemeinschaft Urogynäkologie und Beckenbodenrekonstruktion).
RESULTS
There are many diagnostic and therapeutic options, whose use should be based on the degree of the patient's suffering and on her motivation to be treated. Anticholinergic drugs are of established value in the treatment of overactive bladder. They are used in combination with possible lifestyle changes and bladder training. In some circum-stances, botulinum toxin injections can be considered as well. Stress incontinence should be treated conservatively (with pelvic floor training) before any surgical treatment is provided. The new tension-free vaginal tapes are just as effective as classic treatments, such as colposuspension, while being less invasive and enabling a more rapid recovery.
CONCLUSION
All women with urinary incontinence should undergo appropriate, specialized diagnostic evaluation and well-founded counseling in order to benefit from individualized treatment.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Middle Aged; Prevalence; Urinary Incontinence; Women's Health; Young Adult
PubMed: 20607084
DOI: 10.3238/arztebl.2010.0420 -
Nihon Hinyokika Gakkai Zasshi. the... May 2000Our purpose of this study was to evaluate the effect of a transdermal estradiol delivery system in postmenopausal women with confirmed pollakisuria and urinary... (Clinical Trial)
Clinical Trial
PURPOSE
Our purpose of this study was to evaluate the effect of a transdermal estradiol delivery system in postmenopausal women with confirmed pollakisuria and urinary incontinence.
PATIENTS AND METHODS
We investigated 10 postmenopausal women, age 54-83 years, with pollakisuria and urinary incontinence but did not show distinct urological and/or neurological abnormalities. In this study, estradiol transdermal therapeutic system (Estraderm TTS 2 mg) alone were administrated for total of 8-week and this is observational, not randomized, blinded or controlled. A clinical evaluation were performed two times at before and after administration.
RESULTS
In seven eligible cases, the severity of urinary incontinence was graded down in almost of them and the therapeutic effect on urinary incontinence was evaluated as "very effective" in 3 cases, "improved" in 2, "slightly improved" in 1 and "no change" in 1, respectively. In three eligible cases, the severity of pollakisuria was no change in all of them.
CONCLUSION
Thus, the estrogen supplement therapy was considered effective for postmenopausal urinary incontinence.
Topics: Administration, Cutaneous; Aged; Aged, 80 and over; Estradiol; Estrogen Replacement Therapy; Female; Humans; Middle Aged; Postmenopause; Urinary Incontinence
PubMed: 10853331
DOI: 10.5980/jpnjurol1989.91.501 -
Hinyokika Kiyo. Acta Urologica Japonica Feb 1987The clinical effect of terodiline hydrochloride (TD-758) was studied in 95 patients with nervous pollakisuria or irritative bladder. TD-758 was given per os randomly at... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
The clinical effect of terodiline hydrochloride (TD-758) was studied in 95 patients with nervous pollakisuria or irritative bladder. TD-758 was given per os randomly at a dose of 24 mg or 12 mg once a day for 4 weeks. The symptoms such as urinary frequency, urinary incontinence and sense of residual urine were improved in 74% of the patients taking 24 mg, and in 51% of the patients taking 12 mg. The difference was statistically significant. Side effects such as dry mouth, constipation and heart burn were observed in 15% of the patients in each group and were not serious. The results of this study indicate that TD-758 is useful for these patients and its optimal dosage is 24 mg once a day.
Topics: Administration, Oral; Adolescent; Adult; Aged; Butylamines; Calcium Channel Blockers; Drug Evaluation; Humans; Middle Aged; Polyuria; Urinary Bladder Diseases; Urinary Incontinence
PubMed: 3591595
DOI: No ID Found -
Nihon Hinyokika Gakkai Zasshi. the... Sep 1991Based on the frequency volume chart, 215 patients who complained of pollakisuria were clinically investigated. The subjects were divided into 2 groups: the elderly group... (Comparative Study)
Comparative Study
Based on the frequency volume chart, 215 patients who complained of pollakisuria were clinically investigated. The subjects were divided into 2 groups: the elderly group was composed of 85 patients more than 65 years of age (mean of 72) and the adult group comprised 130 patients less than 64 years old (mean of 47). The elderly group was characterized by the fact that, during nighttime (after sleep), their urinary volume was larger, each voided volume was smaller and the number of voiding was greater than the other group. Clinical analysis of the causes of pollakisuria enabled us to subdivide them into 6 diagnostic categories. Among the elderly patients polyuria during sleep and unstable bladder were prevalent and among adult patients unstable bladder and over hydration were common. Medication was made in 80 patients (37%), while 108 (50%) needed neither medication nor surgery. It is stressed that the frequency volume chart is one of the important diagnostic tools to evaluate the cause of pollakisuria and to select appropriate treatment.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Urination; Urination Disorders
PubMed: 1942704
DOI: 10.5980/jpnjurol1989.82.1446