Search

Purpose: The purpose of this study was to examine the association between blood lead levels and the prevalence of nocturia in American adults. Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2020, focusing on individuals aged 20 years or older (n = 11,919). Blood lead levels were categorized into two groups (<2 µg/dL and ≥2 µg/dL), and the presence of nocturia was assessed based on questionnaire responses. We used multivariable logistic regression models to explore the association between blood lead levels and nocturia while adjusting for various covariates, including sex, ratio of family income to poverty (RIP), lipid profile, age, body mass index (BMI), race, citizenship, sleep trouble, diabetes, and hypertension. To verify whether certain covariates influence blood lead levels and the risk of nocturia, we conducted subgroup analyses. Results: Of the study participants, 31.70% reported experiencing nocturia. Individuals with higher blood lead levels (≥2 µg/dL) exhibited a higher likelihood of experiencing nocturia compared to those with lower levels (<2 µg/dL) in all three models (Model 1: OR 1.46, 95% CI 1.29–1.66, p < 0.0001; Model 2: OR 1.25, 95% CI 1.09–1.44, p = 0.002; Model 3: OR 1.22, 95%CI 1.06–1.41, p = 0.01). Subgroup analyses revealed that factors such as age, sex, sleep trouble, diabetes, hypertension, BMI, RIP, and race did not affect the association between blood lead levels and the risk of nocturia (P for interaction >0.05). Conclusions: This study reported the correlation between blood lead levels and nocturia. We found that compared to blood lead levels below 2 µg/dL, when lead levels reached or exceeded 2 µg/dL, the risk of nocturia occurrence increased by 22%. Clinical trial registration: This study is based on existing data from a public database and not from a specific clinical trial; hence, clinical registration information is not provided. [ABSTRACT FROM AUTHOR]

Background: The relationship between waist circumference and nocturia has not been previously studied. This study investigated the association between waist circumference and the occurrence of nocturia in adults. Methods: We analyzed data from the National Health and Nutrition Examination Survey covering 2005–2020, encompassing 6287 adults aged ≥20. Nocturia was defined as the need to urinate two or more times during the night. First, we compared baseline characteristics between the nocturia and non‐nocturia groups. Subsequently, we used multivariate logistic regression analysis to investigate the relationship between waist circumference and nocturia prevalence. We also employed restricted cubic spline analysis to study the potential nonlinear correlation between waist circumference and the prevalence of nocturia. Recognizing the baseline data's heterogeneity based on nocturia prevalence, we conducted subgroup analyses according to age, sex, body mass index (BMI), and ethnicity. Results: Our findings indicated that females, individuals aged ≥50, citizens, Non‐Hispanic Black, those with lower education levels (high school or less), higher BMIs, lower family income‐to‐poverty ratios, higher waist circumference, hypertension, and diabetes were more likely to experience nocturia. Compared with individuals in the lowest waist circumference quartile (Q1), those in the higher quartiles (Q4) exhibited an increased risk of nocturia in Model 1 (Q4, OR:2.00, 95% CI:1.64, 2.45, p < 0.0001). These results remained consistent after adjusting for covariates in models 2 and 3. A restricted cubic spline analysis suggested a linear association between waist circumference and nocturia (P for nonlinearity = 0.066). Subgroup analyses based on age, sex, BMI, and ethnicity revealed no significant differences in the interaction tests between waist circumference and nocturia (P for interaction = 0.437, 0.331, 0.121, and 0.889, respectively), indicating that these baseline characteristics did not influence the association. Conclusions: Our findings indicated an association between increased waist circumference and a higher prevalence of nocturia. Knowledge of this association reinforces the importance of lifestyle modifications in maintaining a healthy waist circumference and informs public health strategies to address other potential risk factors for nocturia. [ABSTRACT FROM AUTHOR]

This review contains the results of Polish (Central Europe) ethnomedical studies that describe the treatment of urinary tract diseases with wild and cultivated plants. The study includes only the plants that are used to treat the urinary tract, excluding prostate diseases. A review of the literature was carried out to verify the pharmacological use of the plants mentioned in the interviews. Based on this, the study reviews the pharmacological activities of all the recorded species and indicates their most important chemical compounds. Fifty-three species (belonging to 30 families) were selected for the study. The Compositae (eight species), Rosaceae (six species), and Apiaceae (six species) are the most common families used in the treatment of urinary diseases in Polish folk medicine. Both in vitro and in vivo studies have confirmed that many of these plant species have beneficial properties, such as diuretic, antihyperuricemic, antimicrobial, and anti-inflammatory activity, or the prevention of urinary stone formation. These effects are exerted through different mechanisms, for example, through the activation of bradykinin B2 receptors, inhibition of xanthine oxidase, or inhibition of Na+-K+ pump. Many plants used in folk medicine are rich in phytochemicals with proven effectiveness against urinary tract diseases, such as rutin, arbutin, or triterpene saponins. [ABSTRACT FROM AUTHOR]

Objective: To compare the etiologies and perinatal outcomes of fetal megacystis according to their gestational age at diagnosis. The second aim is to detect the prognostic sonographic criteria in each gestational age group. Methods: Fetal megacystis cases detected over eight years were retrospectively searched on hospital records. They were classified into three groups according to the gestational age at diagnosis: first, second, and third trimester of pregnancy. Pregnancy outcomes, postnatal prognosis, and etiologies were compared between the groups. The sonographic criteria that predicted the adverse outcomes were assessed for each trimester. Results: A total of seventy-eight cases of fetal megacystis were included in the study. Thirty-two, forty, and six of the cases were diagnosed in the first, second, and third trimester respectively. 38.4% of the fetuses were born alive, and 19.2% of the fetuses survived beyond infancy. Gestational age at diagnosis, the presence of signs of renal impairment, and increased bladder diameter were associated with poor outcomes in the first trimester. Oligohydramnios, earlier gestational weeks at diagnosis, and an increased bladder length/biparietal diameter ratio were associated with poor outcomes in the second trimester. Third-trimester cases had better outcomes and were associated with varying pathologies. Conclusion: The underlying etiologies of megacystis vary depending on gestational age at diagnosis. It may have a favorable prognosis when it presents in the later gestational ages and when abnormal amniotic fluid volume does not accompany. LBD: BPD ratio higher than 0.96 can be used as a poor prognostic factor in the second trimester of pregnancy. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to examine the correlation between television (TV) and/or video viewing time and the occurrence of nocturia in adults. Methods: An analysis of data from the National Health and Nutrition Examination Survey for 2011–2016 was conducted, involving 13 294 adults aged 20 and older. The main outcome was specified as nocturia, which refers to the requirement of urinating two or more times during the night. Initially, baseline characteristics were contrasted between individuals with and without nocturia. The effects of TV and/or video viewing time on nocturia were further explored using multivariable logistic regression models. To acknowledge the variation in baseline data regarding the prevalence of nocturia, subgroup analyses were performed. Results: Adjusted multivariate analysis revealed that individuals in the group with the longest TV and/or video viewing time had a significantly 48% higher risk of experiencing nocturia compared to those with the shortest TV and/or video viewing time. The results of subgroup analyses revealed no significant differences in the interaction tests between TV and/or video viewing time and nocturia. Conclusions: Our research showed that individuals who spent 5 or more hours a day watching TV and/or videos were significantly more likely to develop nocturia. [ABSTRACT FROM AUTHOR]

Objective: To establish a normal reference value of postvoid residual (PVR) urine volume in "healthy" adults. Methods: Adults were recruited to undergo uroflowmetry and PVR. Those with neurological disorders, malignancy, diabetes, known lower urinary tract dysfunction, and urinary tract infection within the previous 3 months, were excluded from the study. Constipation was defined as Rome IV ≥ 2. Results: Of the 883 adults enrolled in this study, 194 (22.3%) did not complete the questionnaires or perform the uroflowmetry, 103 (11.7%) met ≥1 exclusion criteria and thus were excluded. In addition, 30 and 38 uroflowmetry were excluded due to artifacts and low bladder volume (BV) (<100 mL), respectively. Finally, 515 uroflowmetry and PVR data from adults aged 36–89 (mean: 59.0 ± 9.5) were examined. There was a significant nonlinear relationship between BV and PVR (p < 0.05), with PVR significantly increased when BV was around 528 mL. Women had lower PVR than men (p < 0.05). PVR also increased as the International Prostatic Symptom Score (IPSS) increased. PVR was unaffected by age and functional constipation. A multivariate analysis revealed that BV (p < 0.05) and IPSS (p < 0.05) had significant influence on PVR, but age, gender, and Rome IV score did not. The 90th and 95th percentiles of PVR for men were 73.2 mL (25% of BV) and 102.6 mL (30% of BV), respectively, while for women they were 60.5 mL (21% of BV) and 93.8 mL (27% of BV), respectively. Conclusion: Women had lower PVR than men. The 90th percentile or 95th percentile of normal adults' PVR may serve as the upper limit of normal PVR, and readings above this level may necessitate additional evaluation and treatment. Further studies are required to substantiate these recommendations. [ABSTRACT FROM AUTHOR]

Introduction: The most common interventions in lower urinary tract obstruction are vesico-amniotic shunting (VAS) and serial amnioinfusions; however, their outcome remains uncertain. The aim of the study was to assess the kidney function as well as clinical complications in boys at the age of 6 months with posterior urethral valves (PUV), who underwent prenatal VAS and survived the neonatal period. Material and methods: The study group consisted of 14 boys and the mean time of the VAS procedure was 22 weeks of gestational age (GA). Children were born in 34 GA (29--39) with average birth weight of 2860 g. Four fetuses needed amnioinfusion. In the study we assessed physical development, prevalence and aetiology of urinary tract infections (UTIs), number of hospitalizations, estimated glomerular filtration rate, presence of hypertension, albuminuria, proteinuria and acidosis. Results: Average body weight at 6 months of life was 7.2 kg. 86% of children had at least one UTI; the same percentage were given antibacterial prophylaxis. 36% underwent urinary diversion. Median number of hospitalizations was 4. One patient required chronic renal replacement therapy, and one needed a short course of peritoneal dialysis. Median serum creatinine level was 0.65 mg/dl with estimated glomerular filtration rate (eGFR) 50.6 ml/min/1.73 m². Average serum cystatin C level was 1.50 mg/l with eGFR 48.5 ml/min/1.73 m². 43% developed acidosis. 71% had elevated albuminuria with a median urine albumin-to-creatinine ratio of 581.64 mg/g. 28.5% had overt proteinuria. Conclusions: Growth at the age of 6 month of infants with PUV after prenatal VAS was barely satisfactory. More than half had impaired kidney function, but the need for renal replacement therapy was uncommon. [ABSTRACT FROM AUTHOR]

Ureteral stents are commonly used in urology but are frequently associated with hematuria, abdominal discomfort, urinary tract infection, stent displacement, and stent encrustation. Surface modification of ureteral stents is beneficial to solve the problem, and these can be divided into coated stents and drug-eluting stents according to the modification method. Coated stents can be divided into hydrophilic coatings, antibacterial coatings, and anti-encrustation coatings. Drug-eluting stents can be divided into antimicrobial drug-eluting, antispasmodic analgesic drug-eluting, anti-ureteral stricture drug-eluting, and anti-tumor drug-eluting. Surface modification of ureteral stents can not only reduce complications related to ureteral stents but also strengthen the treatment of certain urologic diseases, which has a high clinical application value. This review focuses on highlighting and summarizing the latest research progress about surface modification of ureteral stents, ureteral stent development history, classification, functions, and future development prospects. The purpose of this article is to discuss surface modification of ureteral stents to reduce stent-related complications and potential research directions for the treatment of urinary tract tumors are also briefly discussed, to help guide further innovation in ureteral stent coatings, which contribute to the future progress of ureteral stents surface modification. [ABSTRACT FROM AUTHOR]

This review contains the results of Polish (Central Europe) ethnomedical studies that describe the treatment of urinary tract diseases with wild and cultivated plants. The study includes only the plants that are used to treat the urinary tract, excluding prostate diseases. A review of the literature was carried out to verify the pharmacological use of the plants mentioned in the interviews. Based on this, the study reviews the pharmacological activities of all the recorded species and indicates their most important chemical compounds. Fifty-three species (belonging to 30 families) were selected for the study. The Compositae (eight species), Rosaceae (six species), and Apiaceae (six species) are the most common families used in the treatment of urinary diseases in Polish folk medicine. Both in vitro and in vivo studies have confirmed that many of these plant species have beneficial properties, such as diuretic, antihyperuricemic, antimicrobial, and anti-inflammatory activity, or the prevention of urinary stone formation. These effects are exerted through different mechanisms, for example, through the activation of bradykinin B2 receptors, inhibition of xanthine oxidase, or inhibition of Na+-K+ pump. Many plants used in folk medicine are rich in phytochemicals with proven effectiveness against urinary tract diseases, such as rutin, arbutin, or triterpene saponins.

Aims: Describing the urodynamic parameters of children aged 3 to 5 years with microcephaly related to congenital Zika syndrome and verifying the association with clinical, imaging and neurological characteristics. Methods: From October 2018 to March 2020, children with Zika-related microcephaly underwent urological, ultrasonographic and urodynamic evaluation. In selected cases, complementary exams such as urethrocystography and scintigraphy were performed. The children also underwent a complete neurological evaluation. To compare frequency between groups, we used Pearson's chi-squared test or Fisher's exact test. Results: This study evaluated 40 children, of whom 85% were 4 years old, and all had abnormalities on the urodynamic study, with low bladder capacity (92.5%) and detrusor overactivity (77.5%) as the most frequent findings. Only three children had ultrasound abnormalities, but no child had cystographic or scintigraphic abnormalities, and the postvoid residual volume was normal in 80% of cases. In spite of a frequency of 67.5% of intestinal constipation, there was no record of febrile urinary tract infection after the first year of life. All children presented severe microcephaly and at least one neurological abnormality in addition to microcephaly. The homogeneity of the children in relation to microcephaly severity and neurological abnormalities limited the study of the association with the urodynamic parameters. Conclusions: Urodynamic abnormalities in children aged 3 to 5 years with Zika-related microcephaly do not seem to characterize a neurogenic bladder with immediate risks for the upper urinary tract. The satisfactory bladder emptying suggests that the voiding pattern is reflex. [ABSTRACT FROM AUTHOR]

Neonatal nephrology is really complex and still a somewhat incomplete branch of nephrology. There are many questions and dilemmas about the diseases of the urinary tract in newborns that we don’t have an answer to, and even more so when it comes to neonates with low birth weight and extremely low birth weight. As we all know, the fetal kidney is of utmost importance for the normal growth of the fetus, and after birth, the primary function of the kidneys is maintaining the homeostasis of the electrolytes and fluids. The most common diseases of newborns’ urinary tract are congenital malformations of the urinary tract and then many other diseases such as urinary tract infections, nephrocalcinosis, glomerulopathy, hypertension, etc. It’s very important to diagnose these diseases and conditions as soon as possible and apply the corresponding therapy in order to prevent permanent kidney injury which could lead, later in life, to a terminal kidney injury. There has been an increasing number of studies pointing out that there is a connection between prenatal and neonatal events that affect the development of hypertension in adolescents and adults. [ABSTRACT FROM AUTHOR]

KoreaPurpose: We examined the association between thyroid hormone and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH).Materials and Methods: A total of 5,708 middle aged men were included. LUTS/BPH were assessed using the international prostate symptom score (IPSS), total prostate volume (TPV), maximal flow rate (Qmax), and a full metabolic workup. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were measured using chemiluminescence immunoassay. We divided participants into quartiles based on their TSH and FT4 levels: first to fourth quartile (Q1–Q4). Results: There was a significant increase in the percentage of men with IPSS>7, Qmax7 were significantly different between FT4 quartile groups (ORs; [5–95 percentile interval], p; TPV≥30 mL, Q1: 0.000 [references]; Q2: 1.140 [0.911–1.361], p=0.291; Q3: 1.260 [1.030–1.541], p=0.025; Q4: 1.367 [1.122–1.665], p=0.002; IPSS>7: Q1: 0.000 [references]; Q2: 0.969 [0.836–1.123], p=0.677; Q3: 1.123 [0.965–1.308], p=0.133; Q4: 1.221 [1.049–1.420], p=0.010). In men with above median levels of testosterone, the FT4 correlated positively with TPV, even after adjusting for confounders. However, the FT4 was not correlated with TPV in men with below median levels of testosterone. TSH was not related to LUTS/BPH measurements.Conclusions: TPV, IPSS, and Qmax were significantly related to FT4. TPV and IPSS were significantly and independently related to FT4. Additionally, the relationship between FT4 and TPV was distinct when testosterone levels are high.

The results of a study of cats with signs of urocystitis are presented. The general principles of diagnostics based on clinical, laboratory and additional research methods are established. Clinically acute urocystitis was manifested by disorders of urination – pollakiuria, dysuria, stranguria. Some of the animals showed an increase in body temperature, pain in the bladder and tightness of the walls of the abdominal cavity. According to the results of urine study, it was observed that 43.7% of the cats with urocystitis showed an increase in relative density of the urine, a change in urine pH towards higher alkaline levels, urine residue – erythrocytes, leukocytes and microorganisms were indicated. Impurities of salt and sand were found in 58.4% of the cats. In 31.4% of the cats, urocystitis was a complication of urolithiasis. Early diagnosis, especially differential diagnosis of acute and chronic, secondary urocystitis presents difficulties. Therefore, in cases of suspected inflammatory diseases of the urinary tract, a complex examination using ultrasound of the kidneys, bladder, prostate gland (in males) and the uterus (in females) is recommended.With therapeutic purpose, sick cats (two groups of 8 animals/group) were administered: anti-microbial agent (5% solution of Enrofloxacin), spasmolytic medicinal agent – Riabal®. Animals of the second group were additionally administered the drug Cystocure (Candioli Farmaceutici). According to the instructions, the plant basis of the powder Cystocure is presented by extracts of cranberries and orange peels. These substances provide the main properties of the drug – help in resisting the bacterial colonization of the lower urinary tract and change in urine pH to the acid side. The applied therapy positively influenced the clinical condition of the cats. Their general health was improved, painful sensations during the act of urination disappeared, the quantity and frequency of diuresis normalized. On the seventh day of treatment, according to the results of the study, the urine became transparent, no microorganisms were detected. In cats of the second group, which additionally used the drug Cystocure, the amount of salts and sand decreased significantly, the pH of the urine did not exceed the recommended value of 6.4, in contrast to animals of the first group.

Aims: Describing the urodynamic parameters of children aged 3 to 5 years with microcephaly related to congenital Zika syndrome and verifying the association with clinical, imaging and neurological characteristics. Methods: From October 2018 to March 2020, children with Zika-related microcephaly underwent urological, ultrasonographic and urodynamic evaluation. In selected cases, complementary exams such as urethrocystography and scintigraphy were performed. The children also underwent a complete neurological evaluation. To compare frequency between groups, we used Pearson’s chi-squared test or Fisher’s exact test. Results: This study evaluated 40 children, of whom 85% were 4 years old, and all had abnormalities on the urodynamic study, with low bladder capacity (92.5%) and detrusor overactivity (77.5%) as the most frequent findings. Only three children had ultrasound abnormalities, but no child had cystographic or scintigraphic abnormalities, and the postvoid residual volume was normal in 80% of cases. In spite of a frequency of 67.5% of intestinal constipation, there was no record of febrile urinary tract infection after the first year of life. All children presented severe microcephaly and at least one neurological abnormality in addition to microcephaly. The homogeneity of the children in relation to microcephaly severity and neurological abnormalities limited the study of the association with the urodynamic parameters. Conclusions: Urodynamic abnormalities in children aged 3 to 5 years with Zika-related microcephaly do not seem to characterize a neurogenic bladder with immediate risks for the upper urinary tract. The satisfactory bladder emptying suggests that the voiding pattern is reflex.

Children’s bodies are extremely sensitive to the action of various pathogens, toxins, chemicals, as well as mental stresses [1]. In today’s environmental, economic and social conditions, an increased antigenic load has changed the course of many diseases in children. First of all, at the present time such negative moments in children’s health should include an increased incidence of diagnosis of allergic and atopic conditions, prevalence of diseases, which are based on acute or chronic endotoxemia, a high incidence of comorbidity [2]. In this regard, an important pathogenetic moment of therapeutic and preventive efforts of pediatricians is minimizing the adverse effects of endotoxemia on the child’s body and improving the treatment of various diseases [1].The publication provides an overview of the clinical studies de­monstrating the experience of clinical application of Lymphomyosot, a combined bioregulatory drug known in the pediatric practice, in common diseases of childhood [3–5]. Lymphomyosot — a basic drainage combined bioregulatory drug that improves the lymph outflow from the tissues and organs, providing detoxification and immunomodulating effects, which creates conditions for the optimization of the course of inflammation and its completion. Lymphomyosot has a favorable safety profile and was well tole­rated [1, 2, 6–15]. The drug in drops dosage form is approved for use in neonates, solution for injections — from 6 years old.

Uncomplicated infection of lower urinary tract is one of most common reason to visit a doctor among women. Statistically there are about 36 million cases of acute cystitis registered yearly in Russia. The treatment of acute cystitis is usually empirical, that’s why it is very important to know etiology of the disease. There are some criteria for drug choice for the disease treatment: the sensitivity range of uropathogenic microflora, the effectiveness of a preparation based on clinical trials, tolerance of the patient to the antibacterial drug, low risk of collateral damage, availability of the drug and its price. The author has assessed the treatment effectiveness of Urofuragin (Furazidinum) preparation in case of acute cystitis. This drug is high active against main causative agents of the infection diseases of lower urinary tract. Due to the results of the research cupping of dysuria, hematuria and pain syndrome were recorded in all clinical groups on the 2nd-3rd day of treatment. Normalization of urinalysis had place in 98% of cases (51 patient). Only 4 patients (7,6%) had unwanted side effects during the treatment time: nausea, loss of appetite. All the unwanted side effects were poorly expressed and didn’t require to withdraw the treatment. The results of this research show that Urofuragin (Furazidinum) is an effective antibacterial preparation which is easy to use, has affordable price, wide indications and good tolerance to the drug.

OBJECTIVE To study the pattern of general surgery cases and their management in Bacha Khan Medical Complex Shahmansoor Swabi. METHODS This descriptive cases-series study was conducted prospectively in general surgery department Bacha Khan Medical Complex Shahmansoor Swabi form jan, 2013 to Dec, 2015. There were 1200 patients in the series who were managed either conservatively or operated upon. All patients with symptoms suggesting a surgical disease and managed as a surgical case were included, while cases that were referred to other departments and those that left against medical advice were excluded. RESULTS Most of the patients had alimentary tract diseases 361(30%) followed by urinary tract diseases 264 (22%),superficial lumps 142 (11.8%), hernia 140 (11.7%), hepato-biliary-pancreatic diseases 116 (9.7%), breast diseases 55 (4.6%), scrotal diseases 41 (3.4%), thyroid diseases 28 (2.3%),salivary gland diseases 15 (1.3%), vascular diseases 8 (0.7%), thoracic diseases 2 (0.2%) and miscellaneous 28 (2.3%). A total of 604 (64.5%) patients were treated as elective cases and333 (35.5%). were treated as emergency cases. As many as 937 (74.08%) patient were treated by operations and 263 (21.92%) patients by conservative treatment, while 41 (3.41%) patients were referred. Seven patients expired, giving a mortality rate of 0.58%. CONCLUSION The commonest cause of seeking surgical care was alimentary tract diseases, followed by urinary tract diseases, superficial lumps, hernias, hepato-biliary-pancreatic diseases, breast diseases, scrotal diseases and thyroid diseases. Bacha Khan Medical Complex Shahmansoor Swabi is a newly established hospital catering to the needs of population of district Swabi and adjoining districts and areas.

Adipose-derived stem cells (ADSCs) is a kind of adult stem cells separated from the fat ,which have the capacity of self-renewal and multi-differentiation. ADSCs have a high degree of plasticity, and could be induced to differentiate into a variety of cells. Compared with other stem cells, ADSCs have become a hot research topic in basic medical and clinical treatment due to the unique advantages of sufficient source, convenient and easy to accept the donor. The differentiation and transplantation of ADSCs can effectively treat many tissue injury diseases, improve or restore organ function. As perfector seed cells, In recent years, ADSCs for cell therapy and tissue engineering of the new seed cells have made great progress in the treatment of urinary system disease. This paper focuses on the prospect of the biological characteristics of ADSCs and its application in urinary tract diseases. [ABSTRACT FROM AUTHOR]

Aim To investigate clinical and morphometric characteristics of patients with lower urinary tract symptoms (LUTS) due to lumbar spinal stenosis (LSS).Methods This study evaluated LSS patients using clinical assessments of motor, sensory, bladder, and bowel functions, and functional disability scores from the Oswestry Disability Index (ODI) and Swiss Spinal Stenosis Questionnaire (SSSQ). Morphometric analysis included MRI measurements of the anteroposterior diameter of the intervertebral disc and dural sac, and the modified Torg-Pavlov ratio (mTPR), with follow-up re-evaluations at 6 months.Results Of 159 patients, 49 (30.8%) had LUTS and 110 (69.2%) were in the control group. LUTS patients had a significantly higher prevalence of neurogenic claudication (100% vs. 47.3%; p

CONTEXT: Urinary bladder and rectum share a common embryological origin. Their autonomic and somatic innervations have close similarities. Moreover, the close proximity of these two organ systems could suggest that dysfunction in one may influence, also mechanically, the function of the other. Therefore, it is not surprising that defecation problems and lower urinary tract symptoms (LUTS) occur together, as reported in the literature. OBJECTIVE: To study the relationship between constipation and LUTS focusing on what is evidence-based. EVIDENCE ACQUISITION: We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE) database in February 2010 to retrieve English language studies (from 1997 to 2009) and the 2005, 2006 and 2007 abstract volumes of the European Association of Urology (EAU), American Urological Association (AUA) and International Continence Society (ICS). EVIDENCE SYNTHESIS: We present the findings according to the studied population in four groups: (a) children, (b) middle-aged women, (c) elderly and (d) neuropathic patients. Most published studies that correlated rectal and bladder dysfunction were carried out in children or in young women. On the other hand, there are few studies regarding the association between constipation and LUTS in the elderly and in neuropathic patients. CONCLUSIONS: Several studies in children documented that constipation is linked to urinary tract problems, including infections, enuresis, vesicoureteral reflux and upper renal tract dilatation. The underlying pathophysiology of these findings has not yet been clearly defined. Studies in middle-aged women also support a high prevalence of constipation among patients suffering from urinary tract dysfunction. Furthermore, an association between constipation and urinary incontinence, as well as between constipation and pelvic organ prolapse, has been suggested. The only prospective study in constipated elderly with concomitant LUTS demonstrates that the medical relief of constipation also significantly improves LUTS. Finally, the available data on neuropathic patients suggest that stool impaction in the rectum may mechanically impede bladder emptying. However, most of the studies only include a small number of patients, are not prospective and are uncontrolled. Therefore, there is a need for large-scale, controlled studies to further improve evidence and to provide a valid recommendation for all groups, especially for the elderly and neuropathic patients.

Purpose: Rhythmic or random rectal contractions independent of bladder activity are frequently observed during cystometry and usually attributed either to a neurological disease, or to ageing. The aim of our study was to search for an association of rhythmic rectal contractions (RRCs) with a specific lower urinary tract symptom or/and an urodynamic diagnosis. Materials and Methods: The population consisted of 534 consecutive women with lower urinary tract symptoms and without specific gastro-intestinal disease referred for urodynamics; 382 (non-ND) had no history of neurological disease and 152 (ND) a history of neurological disease. Cystometries were performed according to ICS recommendations. Rectal pressure was measured using a punctured balloon filled with 2 mL of saline. RRCs were defined as rhythmic changes in the rectal pressure of at least 3 cm H2O independent of the total vesical pressure. Results: RRCs were observed in 69 patients, with no difference in neurological status or age (non-ND: 12.3% and 65.5y; ND: 14.5% and 62.7y). Patients with RRCs were significantly older than the negative population (p = 0.0002). RRCs had a low frequency: 1 - 4/min; their amplitude was ≤ 15 cm H2O in 67 patients. RRCs were associated with urgency (35 patients) whatever the neurological status and with detrusor overactivity only in the neurological patients. Conclusions: RRCs cannot be considered as artefactual events during cystometry in women, occur in the older population, are frequently associated with urgency but not with detrusor overactivity or neurological disease. Occurrence of RRCs should prompt the physician to look at the possible causes of urgency (colonic or bladder).

Background Childhood cancer has been associated with long-term risk of urinary tract diseases, but risk patterns remain to be comprehensively investigated. We analysed the lifetime risk of urinary tract diseases in survivors of childhood cancer in the Nordic countries. Methods We identified 32,519 one-year survivors of childhood cancer diagnosed since the 1940s and 1950s in the five Nordic cancer registries and selected 211,156 population comparisons of a corresponding age, sex, and country of residence from the national population registries. To obtain information on all first-time hospitalizations for a urinary tract disease, we linked all study subjects to the national hospital registry of each country. Relative risks (RRs) and absolute excess risks (AERs) and associated 95% confidence intervals (CIs) for urinary tract diseases among cancer survivors were calculated with the appropriate morbidity rates among comparisons as reference. Results We observed 1645 childhood cancer survivors ever hospitalized for urinary tract disease yielding an RR of 2.5 (95% CI 2.4–2.7) and an AER of 229 (95% CI 210–248) per 100,000 person-years. The cumulative risk at age 60 was 22% in cancer survivors and 10% in comparisons. Infections of the urinary system and chronic kidney disease showed the highest excess risks, whereas survivors of neuroblastoma, hepatic and renal tumours experienced the highest RRs. Conclusion Survivors of childhood cancer had an excess risk of urinary tract diseases and for most diseases the risk remained elevated throughout life. The highest risks occurred following therapy of childhood abdominal tumours. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Chinese herbal medicine (CHM) has a recorded history of over 2000 years that may be used to authenticate and guide modern treatments for disease, and also identify neglected but potentially useful treatment strategies. However this process is often based on over-simplistic conceptions of tradition and history that fail to take into account the dynamic nature of ‘traditions’ and underestimate the importance of contextual factors in their interpretation. Materials and methods As part of a process of defining good practice for a clinical trial of CHM for recurrent urinary tract infections, a selective review of classical Chinese medical texts was undertaken to investigate the historical treatment of urinary diseases specified by the traditional category of Lin diseases. Results The historical review provided interesting insights into the evolution and meaning of Lin diseases and how pertinent data may be found, precisely, outside the boundaries of the categories on which the original investigation was premised. Although there were interesting parallels and continuities in the classical and modern understandings of the aetiology, pathophysiology and treatment of urinary diseases, there were also important divergences. Conclusions It became apparent that, in the search for ‘traditional’ herbs to treat a particular modern syndrome it is essential to contextualise remedies, including as far as possible the intertextual, social, cultural, and gender context, and conditions of practice. Historical ethnopharmacology adds a level of subtlety and complexity to over-simplistic attempts at bioprospecting. Some insights that emerged from this historical review could inform the proposed clinical trial but these have had to be filtered through the constraints of modern regulatory procedures. Further research is required on how best to integrate the wealth of data that exists in historical texts with the desire to produce effective herbal products for the modern world. [ABSTRACT FROM AUTHOR]

Objective Document the clinical features, short- and long-term outcomes and prognostic factors in New World camelids with acquired urethral obstruction. Design Retrospective case study. Methods Case data from medical records of 34 New World camelids presenting with acquired urethral obstruction were collected and follow-up information on discharged patients was obtained. Associations with short- and long-term survival were evaluated using Wilcoxon rank-sum tests, exact-logistic regressions and Kaplan-Meier survival curves. Results Of the 34 New World camelids 23 were intact males and 11 were castrated; 4 animals were euthanased upon presentation, 7 were treated medically and 23 surgically, including urethrotomy, bladder marsupialisation, tube cystostomy alone or combined with urethrotomy, urethrostomy or penile reefing. Necrosis of the distal penis was found in 4 animals and all were short-term non-survivors. Short-term survival for surgical cases was 65%, and 57% for medical cases. Incomplete urethral obstruction at admission and surgical treatment were associated with increased odds of short-term survival. Of 14 records available for long-term follow-up, 6 animals were alive and 8 were dead (median follow-up 4.5 years, median survival time 2.5 years). Recurrence of urethral obstruction was associated with long-term non-survival. Conclusions Surgically treated New World camelids with incomplete urethral obstruction have the best odds of short-term survival and those with recurrence of urethral obstruction have a poor prognosis for long-term survival. [ABSTRACT FROM AUTHOR]