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The renal system
Published in Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella, Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella
Approximately 74,000 new cases of bladder cancer were diagnosed in the United States in 2015. The average age at diagnosis is 74 years. Men are three to four times more likely to develop bladder cancer than women. The vast majority of bladder cancers arise from the transitional epithelial cells that line the bladder. Tumors may be papillary or flat and have varying degrees of invasiveness. Because the bladder stores urine, the bladder epithelium will be bathed in any carcinogens that are excreted and concentrated into the urine. As such, cigarette smoking is an important risk factor for the development of bladder cancer. Individuals who have been exposed to industrial solvents, toxins and carcinogens likewise have a greater risk for the development of bladder cancer. Most cases of bladder cancer are initially asymptomatic. When symptoms do occur they may include hematuria, urinary urgency, and dysuria. Treatment and prognosis of bladder cancer is dependent upon the type of cancer cells that are present and their invasiveness.
Continence
Published in Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson, Health Care Needs Assessment, 2018
Catherine W. McGrother, Madeleine Donaldson
Education emphasises the voluntary control over motor and sensory impulses. Distraction techniques to control urinary urgency are also incorporated. The voiding schedule includes mandatory voiding at specific intervals. These intervals are gradually extended until a reasonable time between voids is established.
Pathophysiology of detrusor underactivity/acontractile detrusor
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
Dae Kyung Kim, Michael B. Chancellor
Lyme disease, caused by the spirochete Borrelia burgdorferi, is associated with a variety of neurologic sequelae. The urologic manifestation of Lyme disease can be the primary or late manifestation of the disease affecting both sexes and all ages. Urinary urgency, nocturia, and urge incontinence are the most common urological symptoms.106
The safety and effectiveness of mirabegron in Parkinson’s disease patients with overactive bladder: a randomized controlled trial
Published in Scandinavian Journal of Urology, 2022
Mohamad Moussa, Mohamad Abou Chakra, Baraa Dabboucy, Youssef Fares, Athanasios Dellis, Athanasios Papatsoris
Parkinson’s disease (PD) is a common movement disorder associated with the degeneration of dopaminergic neurons in the substantia nigra. Bladder dysfunction is one of the most common autonomic disorders in PD [1]. OAB (overactive bladder) symptoms can occur in early and untreated PD patients. Both storage symptoms and voiding symptoms were reported [2]. Nocturia is the most prevalent storage symptom reported by patients with PD (>60%). Patients also complain of urinary urgency (33–54%) and daytime frequency (16–36%) [3]. Pharmacologic interventions, especially anticholinergic medications, are the first-line option for treating OAB in patients with PD [4]. However, it is important to balance the therapeutic benefits of these drugs with their potential adverse effects. Intradetrusor Botulinum toxin injections and electrical stimulation were also used to treat OAB in those patients with variable efficacy [5]. Mirabegron is a β3-agonist that was approved for the treatment of idiopathic OAB. Its efficacy seems comparable to that of anticholinergic drugs, with superior tolerability. Mirabegron improved both the urodynamic and patient-reported outcomes in patients with neurogenic detrusor overactivity arising from spinal cord injury or multiple sclerosis. Treatment with mirabegron was tolerated well in those patients [6].
Understanding and managing autonomic dysfunction in persons with multiple sclerosis
Published in Expert Review of Neurotherapeutics, 2021
Ivan Adamec, Magdalena Krbot Skorić, Mario Habek
Urinary symptoms can manifest either as storage phase dysfunction with incontinence or voiding phase dysfunction with retention and incomplete bladder emptying [52]. These symptoms are one of the most frequent in MS and occur during the course of the disease in up to 97% of pwMS [53]. Incontinence not only has a significant impact on quality of life but can also cause a substantial economic burden due to the cost of medications, incontinence products, and hospital stays [54]. Demyelinating lesions in the spinal cord that interrupt neural connections from the pontine micturition center to the parasympathetic sacral micturition center are thought to cause bladder dysfunction in pwMS [55]. These CNS lesions in turn can lead to detrusor hyperactivity, the most common urinary dysfunction in pwMS [56]. Urodynamic studies have demonstrated that detrusor hyperreflexia is the most common abnormality present, followed by detrusor sphincter dyssynergia and detrusor hyporeflexia [57]. The most common urinary symptom reported in the same study was urinary urgency followed by frequency, urge incontinence, stress incontinence, and dysuria [57].
Emerging patterns of resistance in a cohort of Greek patients with recurrent UTIs: a pilot study
Published in Journal of Chemotherapy, 2019
Ioannis Moustakas, Georgios Dryllis, Avraham Pouliakis, Georgios Petrikos, Georgios Daikos, Theodoros Pittaras, Panagiota Karasante, Konstantinos Karampotsis, Sotirios Tsiodras
Group B patients reported more intense lower abdominal pain (1.7 ± 1.5 vs. 1.1 ± 1.2 on the five point semi-quantitative pain scale, p = 0.02, Table 1). Urinary urgency was more frequent in Group A patients (p = 0.0494, OR: 3.34, 95% CI: 0.95–11.71). The absence of genital symptoms at the time of visit correlated with more than three episodes of UTI in the last year (p = 0.026, OR: 0.26, 95% CI: 0.08–0.90). Patients with diabetes had a higher probability for ≥3 UTIs during the last year of the study (p = 0.0059, OR: 5.5, 95% CI: 1.5–20.2). Group A patients had abnormal (high) glucose levels at the time of visit compared to group B patients (25% vs. 7%, p = 0.016, OR: 4.6, 95% CI: 1.2–17.0, Table 2). No other demographic and clinico-epidemiological characteristic (e.g. age at wedding and first sexual intercourse, smoking and drinking habits, sexual partner characteristics, as well as, dysuria, itching and dyspareunia) was significantly associated with the number of UTIs.