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Urology
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
Investigations➣ Serum creatinine: Might be raised if acute or chronic obstruction.➣ Urine analysis: to exclude superimposed infection.➣ PSA: to exclude malignancy.➣ Urinary flowmetry and post void residual measurement.➣ Cystoscopy: to exclude bladder disease.➣ Transrectal ultrasound and biopsy: to exclude malignancy.➣ Renal ultrasound to rule out upper tract deterioration/ hydronephrosis.
Health Consequences of the Obesity Epidemic
Published in Roy J. Shephard, Obesity: A Kinesiologist’s Perspective, 2018
Nakeeb et al. [79] found that a BMI >30 kg/m2 was a significant risk factor for symptomatic gallstone disease (the relative risk was 3.7 in a multivariate analysis). Other factors contributing to gall-bladder disease included the female sex, age, and a positive family history. A meta-analysis of 4 studies [39] found that in men risk ratios were 1.20 for those who were overweight and 1.43 for those who were obese, with corresponding figures of 1.27 and 1.78 in women.
Physiotherapy for Urinary Incontinence
Published in Linda Cardozo, Staskin David, Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
Figure 43.4 electromyogrAm (eMG) biofeedbAck. (A) eMG biofeedbAck, here registered by surfAce electrodes, cAn be used to visuAlize on-screen; (b) selective pelvic floor muscle Activity (blue line) together with control of Any synergistic AbdominAl muscle Activity (red line). (From berghmAns b et Al., in: AtlAs of BlAdder DiseAse, stAskin D (ed.), springer, new York, 2009.)
Pharmacological management of interstitial cystitis /bladder pain syndrome and the role cyclosporine and other immunomodulating drugs play
Published in Expert Review of Clinical Pharmacology, 2018
Teruyuki Ogawa, Osamu Ishizuka, Tomohiro Ueda, Pradeep Tyagi, Michael B. Chancellor, Naoki Yoshimura
Interstitial cystitis (IC) was initially reported by Hunner [1] as a rare type of bladder disease with ulcerative changes known as Hunner’s lesions [2]. The symptoms including urinary frequency and suprapelvic pain are often frustrating and difficult to treat. The leaky bladder urothelium has been considered as a pathophysiological basis of IC to impair the barrier function, resulting in bladder pain during filling; however, the mechanism inducing urothelial dysfunction is unclear. The diagnostic criteria have been changed for decades. In 1998, the National Institute of Diabetes and Digestive Kidney Diseases (NIDDK) developed the strict criteria of IC, which was established mainly for clinical trials [3]. In 2011, the American Urological Association published the symptom-based definition and guideline [4], which defined IC/BPS as: the disorder with ‘an unpleasant sensation (pain, pressure and/or discomfort) associated with lower urinary tract symptoms of more than 6 weeks duration, in the absence of infection or other identifiable causes’, and indiscriminates the existence of Hunner’s lesion for the initial diagnosis [4].
Bladder health in patients treated with BCG instillations for T1G2-G3 bladder cancer – a follow-up five years after the start of treatment
Published in Scandinavian Journal of Urology, 2018
Gun Danielsson, Per-Uno Malmström, Staffan Jahnson, Hans Wijkström, Tommy Nyberg, Helena Thulin
This study showed that patients with Bladder Cancer T1G2–G3 had disease-specific symptoms before the start of BCG therapy. Nevertheless, side-effects during BCG treatment can be troublesome and the patients’ tolerance of disturbing symptoms can determine whether full treatment can be given or not. It is important to ascertain whether symptoms are the result of side-effects of the BCG-treatment or by the bladder disease itself. It is, therefore, important to document a baseline status for the patient’s symptoms, in order to be able to compare and evaluate symptoms over time. The patient should have information that the burden of symptoms might be reduced over time, a course that indicates that the bladder will recover.
Revascularized Pyelo-Uretero-Cystoplasty in Patients with Chronic Bladder Outlet Obstruction Due to Ectopic Ureterocele: A Safe Surgical Technique with Superior Continence Outcomes
Published in Journal of Investigative Surgery, 2022
Asal Hojjat, Shabnam Sabetkish, Abdol-Mohammad Kajbafzadeh
Obstructing ureterocele can result in recurrent urinary tract infection (UTI), vesicoureteral reflux (VUR), obstructive bladder dysfunction, and worsening of renal function.1 Prenatal bladder outlet obstruction secondary to ectopic obstructive ureterocele may cause permanent ramifications on the urinary tract system, and therefore put the patients at increased subsequent risk of serious complications and risk of decompensated bladder tissue and function.2 End-stage bladder disease in the subgroup of obstructive bladders caused by duplex systems and ureterocele is a rare phenomenon. This disease is observed in some children with history of ectopic obstructive ureterocele, following unroofing of the ureterocele, and long-term bladder neck obstruction due to ureterocele remnant.3 Irreversible contracted/overactive bladder and reduced bladder compliance as a result of varied diseases can be classified as end-stage bladder disease. These patients generally have noncompliant thick-walled bladder, urinary incontinence, and diminished functional bladder capacity that is related to detrusor overactivity. Clean intermittent catheterization (CIC) and anticholinergic agents are among the mainstay of conservative managements; however, their usage is not recommended due to failure in dryness achievement and not improving bladder compliance sufficiently.4 For many of these patients, augmentation cystoplasty can be considered as a harmless and practical reservoir that permits for urinary continence and avoidance of upper tract weakening as well as protecting the upper urinary tract from damage of high pressure produced by outlet obstruction and high pressure VUR.5