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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 -
Hinyokika Kiyo. Acta Urologica Japonica Apr 2010A 64-year-old man was referred to our hospital with chief complaints of gross hematuria and pollakisuria. Cystoscopic examination showed non-papillary broad basis tumor... (Review)
Review
A 64-year-old man was referred to our hospital with chief complaints of gross hematuria and pollakisuria. Cystoscopic examination showed non-papillary broad basis tumor on the left lateral wall involving the left ureteral orifice. Computed tomography (CT) and magnetic resonance imaging revealed left hydronephrosis and urinary bladder tumor which extended outside of the bladder wall. Transurethral biopsy showed grade 3 urothelial carcinoma with glandular differentiation including signet ring cells. Radical cystectomy, left nephrureterectomy and right ureterocutaneostomy were performed. Pathological examination showed urothelial carcinoma; pT3aN0. Lymph node metastasis occurred five months later. Three courses of M-VAC chemotherapy (methotrexate, vinblastine, adriamycin, cisplatin) were done with little effectiveness. Sixteen months after the operation, he complained of anorexia and tenesmus, and CT showed annular thickening of the rectal wall. A fecal diversion was performed, but he died two months later.
Topics: Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Carcinoma, Signet Ring Cell; Cisplatin; Combined Modality Therapy; Constriction, Pathologic; Cystectomy; Doxorubicin; Fatal Outcome; Humans; Male; Methotrexate; Middle Aged; Neoplasm Invasiveness; Neoplasms, Multiple Primary; Rectal Neoplasms; Rectum; Urinary Bladder Neoplasms; Vinblastine
PubMed: 20448448
DOI: No ID Found -
International Journal of Urology :... May 2010Nocturia is a bothersome condition, defined as a complaint whereby the individual has to wake one or more times per night in order to void. Nocturia that occurs twice or...
Nocturia is a bothersome condition, defined as a complaint whereby the individual has to wake one or more times per night in order to void. Nocturia that occurs twice or more per night can have a substantial adverse effect on the patient's quality of life (QOL), and in many cases treatment may be required. These guidelines provide a treatment algorithm for use by primary care physicians. The initial assessment is conducted through a history taking interview. With a clear understanding of symptoms, patients can be classified into three broad categories: (1) nocturia only, (2) nocturia and diurnal pollakisuria without other lower urinary tract symptoms, and (3) nocturia and diurnal pollakisuria accompanying other lower urinary tract symptoms. For treatment, the literature supporting each form of drug therapy was ranked and a recommendation grade was determined for each form of therapy. A grade of 'F (pending)' was applied to any drug not currently approved for use in Japan or for which the efficacy and safety in Japanese patients was unconfirmed at the time of evaluation. We recommend instruction and guidance on water intake that will generally result in 24-h urine volume of 20 to 25 mL/kg. This corresponds to a daily water intake of 2.0% to 2.5% of body weight. In Japan, desmopressin is indicated for central diabetes insipidus and nocturnal enuresis, but not indicated for nocturia. The therapeutic mechanism of the anticholinergic drugs for nocturia may depend on the action of the sensory nerve mediated by the muscarinic receptors.
Topics: Algorithms; Cholinergic Antagonists; Humans; Nocturia
PubMed: 20415705
DOI: 10.1111/j.1442-2042.2010.02527.x -
Acta Chirurgica Belgica 2009In this paper we report a rare case of an incarcerated inguinoscrotal hernia of the urinary bladder in a 64-year-old male patient. He presented with a giant inguinal...
In this paper we report a rare case of an incarcerated inguinoscrotal hernia of the urinary bladder in a 64-year-old male patient. He presented with a giant inguinal hernia and pollakisuria. The bladder was surgically repositioned intra-abdominally and resection of part of the bladder fundus was performed through laparotomy. Closure of the inguinal defect was performed through an inguinal approach. The patient's further recovery was uneventful. Herniation of the bladder is a very infrequent finding in inguinal hernias. We searched the literature and only found a few case reports describing this rare pathology. The literature and treatment options are discussed.
Topics: Cystoscopy; Diverticulum; Hernia; Hernia, Inguinal; Humans; Male; Middle Aged; Urinary Bladder Diseases; Urination Disorders
PubMed: 20184079
DOI: 10.1080/00015458.2009.11680547 -
Hinyokika Kiyo. Acta Urologica Japonica Oct 2009A 79-year-old man was admitted to our hospital with a chief complaint of pollakisuria. He was diagnosed as having bladder tumors and bladder stone by cystoscopy.... (Review)
Review
A 79-year-old man was admitted to our hospital with a chief complaint of pollakisuria. He was diagnosed as having bladder tumors and bladder stone by cystoscopy. Transurethral resection of bladder tumors (TURBT) and transurethral cystolithotripsy were performed and histology revealed non-muscle-invasive hepatoid adenocarcinoma that produced alpha-fetoprotein (AFP) and urothelial carcinoma. The serum AFP level was present at a high level of 39.08 ng/ml. After five months' follow up, recurrent tumor were detected in the bladder. TURBT was performed and the pathologic finding showed non-muscle-invasive (not hepatoid) adenocarcinoma that produced AFP. After eight months' follow up, a recurrent tumor was detected in the bladder again. TURBT was performed and the pathologic finding showed non-muscle-invasive urothelial carcinoma. However, the serum AFP level remained above 35 ng/ml. After the 3rd TURBT, intravesical intillations were performed, which led to a normalization of the serum AFP level. Nineteen months after his final hospitalization, the patient has had no evidence of recurrence.
Topics: Adenocarcinoma; Aged; Humans; Male; Urinary Bladder Neoplasms; alpha-Fetoproteins
PubMed: 19926947
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 -
Hinyokika Kiyo. Acta Urologica Japonica Sep 2009We report a case of a prostatic retention cyst around the bladder neck causing prostatitis-like symptoms. A 34-year-old man was referred to our hospital for treatment of...
We report a case of a prostatic retention cyst around the bladder neck causing prostatitis-like symptoms. A 34-year-old man was referred to our hospital for treatment of a cystic lesion in his prostate and prostatitis-like symptoms such as pollakisuria, dysuria and pain on urination. Blood examination and urinalysis showed neither systemic inflammation nor urinary tract infection. Transrectal ultrasonography (TRUS), magnetic resonance imaging (MRI) and cystoscope revealed a projecting prostatic cyst which occupied the bladder outlet and seemed to cause the prostatitis-like symptoms. Transurethral resection of the cyst was performed and the symptoms were markedly improved. Histopathologically, the cyst was retention cyst of the prostate.
Topics: Adult; Cysts; Humans; Magnetic Resonance Imaging; Male; Prostatic Diseases; Prostatitis; Transurethral Resection of Prostate; Treatment Outcome; Urinary Bladder
PubMed: 19827624
DOI: No ID Found -
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 -
Hinyokika Kiyo. Acta Urologica Japonica May 2009A 82-year-old man was referred to our hospital with a chief complaint of macrohematuria and pollakisuria. Cystoscopy showed an abnormal mucosa on the right wall. We...
A 82-year-old man was referred to our hospital with a chief complaint of macrohematuria and pollakisuria. Cystoscopy showed an abnormal mucosa on the right wall. We suspected carcinoma in situ but two months after cystoscopy showed a non-papillary and sessile tumor with calcification. We performed transurethral resection of the bladder tumor, muscle layer and adipose tissue. Histopathological findings revealed small cell carcinoma of the bladder infiltrating the externaladipose tissue. As postoperative adjuvant therapy, chemotherapy (cisplatin total 150 mg) was performed with 40 Gy of extra beam radiotherapy to the bladder. After chemotherapy and radiotherapy,urinary cytology was negative and cystoscopy showed the scar. Follow up magnetic resonance imaging revealed disappearance of the bladder tumor.
Topics: Aged, 80 and over; Antineoplastic Agents; Carcinoma, Small Cell; Chemotherapy, Adjuvant; Cisplatin; Cystectomy; Humans; Magnetic Resonance Imaging; Male; Radiotherapy Dosage; Radiotherapy, Adjuvant; Treatment Outcome; Urethra; Urinary Bladder Neoplasms
PubMed: 19507545
DOI: No ID Found -
Journal of Pediatric Urology Dec 2009An inflammatory tumour of the prostate is very rare in young boys without genital anomalies. We report a 4.5-year-old boy presenting with pollakisuria, dysuria,...
An inflammatory tumour of the prostate is very rare in young boys without genital anomalies. We report a 4.5-year-old boy presenting with pollakisuria, dysuria, secondary urinary incontinence and decreased urine stream. Ultrasonography, magnetic resonance imaging and transrectal tumour biopsy justified the diagnosis of an inflammatory tumour of the prostate with a size of 5x3x5cm. Under antibiotic therapy the clinical symptoms disappeared within 6weeks. Three months later ultrasonography revealed a normal prostate with a residual midline cyst of 3x4mm. Follow-up examinations for 2years did not show any evidence of relapse. We believe that the inflammatory tumour can be explained by the embryologic development of the prostate and the persistence of an intraprostatic cyst.
Topics: Child, Preschool; Cysts; Humans; Male; Prostatic Diseases; Prostatitis
PubMed: 19482551
DOI: 10.1016/j.jpurol.2009.03.023