Search

The aim of this study is to compare detrusor overactivity (DO) subtypes namely terminal (TDO) and phasic (PDO) in terms of frequency, etiologic reasons, urodynamic findings and relationships with neurological diseases. Patients' characteristics including age, gender, neurological diseases, were noted. Bladder volume on the first desire to voiding (FSD), the strong desire to voiding (SDV), maximum bladder capacity (MBC), bladder compliance (BC), presence and type of DO, and amplitude of DO (Ad) were also noted during the IUDS. Patients with TDO and PDO were compared in terms of patient characteristics, urodynamic parameters, and neurological diseases. 1018 patients were enrolled in the study. Neurological disease was noted in 180 patients; spinal cord trauma (SCT):46, Alzheimer Disease (AD):8, Parkinson's Disease (PD):12, spina bifida (SB):21, epilepsy (ED):18, cerebrovascular disease (CVD):20 and Multiple Sclerosis (MS):55. Urodynamic DO was observed in 882 patients (neurogenic-DO:149 and idiopathic-DO:733), (PDO:837, TDO:45). A significant difference was observed between the groups regarding the FSD, MBC and Ad (p=0.032, p=0.049 and p=0.001 respectively). However, no difference was observed in BC (p=0.510). The incidence of TDO and PDO was 6% and 5% for neurogenic-DO and 94% and 95% for the idiopathic-DO, respectively (p=0.327). Among the neurogenic diseases only patients with SCT had significant differences regarding type of DO (TDO 11.1%, PDO 3.1%) (p= 0.04). Neurogenic diseases are not a significant risk factor for TDO. Spinal cord trauma is associated with higher rates of TDO compared to other neurogenic diseases. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study is to evaluate prediction of postoperative ureteral obstruction needing ureteral stent insertion by evaluating the resistive index (RI) values and the grade of hydronephrosis. Material and Methods: A total of 66 adult patients undergoing stentless endoscopic ureteral stone treatment (URS) between January 2018 and January 2019 were included in this prospective study. Preoperative patient and stone characteristics were noted. All patients were evaluated with renal Doppler ultrasonography study to assess degree of hydronephrosis and RI values. A renal Doppler ultrasonography was repeated at postoperative 1st, 3rd and 7th days. Changes in both RI and hydronephrosis levels before and after the procedures were noted. On the postoperative 7th day, patients were divided into two groups including obstructive and non-obstructive cases according to RI values assessed where a RI value of 0.7 was accepted as the cut-off for obstruction. The preoperative and perioperative characteristics of both groups were evaluated in a comparative manner. Results: The mean patient age was 43.6 ± 1.72 years. Significant improvements were noted in RI and grade of hydronephrosis after the operation. The grade of hydronephrosis and RI values were found to improve more significantly on postoperative 3rd day when compared to the postoperative 7th day (p < 0.01 and p < 0.01). A significant correlation was detected between the grade of hydronephrosis (>grade 2) and obstructive RI values (> 0.7) in each postoperative visits (p: 0.001). RI values (> 0.7) at postoperative seventh days were correlated with larger mean stone size, increased ureteral wall thickness, increased diameter of the ureter proximal to the stone, and longer duration of the operation. Preoperative high-grade hydronephrosis indicated obstructive RI values at postoperative seventh day (p = 0.001) Conclusion: Changes in RI values on Doppler sonography and the grade of hydronephrosis may be a guiding parameter in assessing postoperative ureteral obstruction. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine different variables that may be predictive for prolonged lymporrhoea and duration of lymphatic drainage. Two hundred and three patients who underwent radical cystectomy (RC) and pelvic lymph node dissection (PLND) were enrolled in this study. Lymphorrhoea was defined as the total amount of lymph drained by the drains until their removal. Duration of drainage was defined as the days until the removal of the last drains. Parameters that might be related to lymphorrhoea and duration of drainage including age, body mass index (BMI), removed lymph nodes, hemoglobin level (gr/dl), estimated blood loss (ml) (EBL), platelet count (PLN), hospital stay (HS) and lymph node status were reviewed retrospectively. Statistical analyses were performed to determine the association between lymphorrhoea with probable predictors for these variables. The mean number of removed lymph nodes was 28.52 (16-58). The mean amount of lymphorrhoea and the duration of drainage were 1504 ml (300-5850) and 10.10 days (2-27), respectively. Multivariate analyses revealed that the mean amount of lymphorrhoea rises gradually as EBL, patients age, negative lymph nodes and lymphadenectomy extension increases (P<0.05). Related to the duration of drainage, multivariate analyses showed that BMI and the number of removed lymph nodes were statistically significant predictors of prolonged drainage (p=0.016, p=0.046; respectively). Predictors for lymphorrhoea may help us mainly to foresee the duration of the hospital stay and the eventual complications that may be induced by lymphorrhoea. In patients with a higher risk for lymphorrhoea, preoperative maneuvers could be applied to decrease lymphorrhoea. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study, is to find out the most accurate cut-off level for the detrusor leak point pressure (DLPP) in terms of upper urinary tract (UUT) protection in a cohort of children with myelodysplasia. Materials and Methods One hundred and ninety-three children with myelodysplasia were included in the study based on the availability of urological evaluation at age of 3 years. Children were assigned to one of two groups-those who had UUT damage at age 3 (group 1, n: 70) and those without UUT changes (group 2, n: 123), and compared. Results Urological follow-up data revealed higher incidences of febrile urinary tract infections and secondary tethering of the spinal cord in group 1. No statistically significant difference was determined between group 1 and group 2 in terms of DLPP values (median 42.5 vs. 39.5 cm H2O, respectively, P = 0.087). Analysis of different cut-off values showed that DLPP above 20 cm H2O had a higher sensitivity for UUT damage (91.4%). A normal UUT was found in 56.5% and 62.2% of children with DLPP between 20 and 40 cm H2O, and with DLPP over 40 cm H2O, respectively. Conclusions Present study showed that more than half of the children with myelodysplasia had normal UUT function even with a DLPP of 40 cm H2O and over. Thus, DLPP, is not the sole decision making parameter to rely for more invasive therapies in children with myelodysplasia. On the other hand, a DLPP cut-off value of 20 cm H2O showed a higher sensitivity to predict UUT damage instead of 40 cm H2O. Neurourol. Urodynam. 36:759-763, 2017. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]