• Title/Summary/Keyword: Lower urinary tract symptoms

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Prevalence of Lower Urinary Tract Symptoms and Association of Hypertension with I-PSS (국제 전립선 증상 점수(I-PSS)를 이용한 하부요로증상의 유병률 및 고혈압과의 관계)

  • Ha, Jee-Young;Cho, Dong-Young;Yang, Sang-Kuk;Chang, Soung-Hoon;Lee, Kun-Sei;Lee, Won-Jin;Yu, Byung-Yeon
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.265-273
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    • 2000
  • Benign prostatic hyperplasia (BPH) is a highly prevalent, age-related disorder in men which place a considerable burden on health care resources worldwide. While BPH and hypertension are apparently diverse disease processes, they have some features in common(e.g. underlying etiology of the sympathetic nervous system). The purpose of this study is to estimate the prevalence of lower urinary tract symptoms using I-PSS(international prostate symptom score) and to investigate the association of hypertension with I-PSS. This study was carried out to 390 men(40~86 year old) at 3 Myun in Chungju City from July to August, 1997. Subjects answered on questionnaire for I-PSS and were checked age, education, marital status, annual income, blood pressure. The mean age of subjects was 59.8 year old. The mean of I-PSS were increased by age decades(40~49, 50~59, 60~69, 70~86) and it's scores were 4.4, 7.0, 8.2, 12.3 respectively. Strong correlations were observed between the I-PSS and the QUL(quality of life)(P=0.0001). I-PSS(mean-value) were 7.85 in hypertensive group and 8.39 in normotensive group but there was no statistically significance between the two groups(P>0.05). The proportion of mean scoring greater than 8 was 42.5%. There have been reports of association between lower urinary tract symptoms and hypertension, but there was no consistent suggestion that such an association could be casual. The need for high-quality epidemiological information and consequent increased prospects for prevention is obvious.

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Overflow Urinary Incontinence with Herniated Lumbar Disc Managed by Korean Medicine Therapy: A Case Report (요추 추간판 탈출증 환자의 일류성 요실금에 대한 한의 진료의 경과: 증례 보고)

  • Koo, Ji-Eun;Lee, Hee-Won;Kwon, Yong-Su;Yu, Jae-Eun;Bae, Jun-Hyo;Park, Ji-Won;Yoon, Joo-Young;Choi, Sung-Won;Kim, Ka-Hyun
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.3
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    • pp.125-131
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    • 2021
  • This study reports the effectiveness of Korean medicine therapy by improving symptoms in patients with herniated lumbar disc (HLD) diagnosed with chronic overflow urinary incontinence (OUI). The patient was treated with two types of herbal medicine and electroacupuncture for 10 days. We used diary of voiding and incontinence, Overactive Bladder Symptom Score (OABSS), Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTS) and numeral rating scale (NRS) to assess the symptoms. After treatment, the number of nocturia decreased from 5 to 2.5. OABSS decreased from 9 to 2 and BFLUTS decreased from 95 to 87. The NRS of back pain decreased from 7 to 3. This study may suggest that Korean medicine therapy can be effective therapy for OUI with HLD.

Different characteristic between Escherichea coli and non-Escherichea coli urinary tract infection (Escherichea coli 요로 감염과 non-Escherichea coli 요로 감염 사이의 차이점)

  • Jung, Hee Jin;Aum, Ji A;Jung, Soo Jin;Hur, Jae Won
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.457-461
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    • 2007
  • Purpose : Urinary tract infection (UTI) is a common bacterial infectious disease in childhood. Especially UTI in infant and young children is associated with urinary tract anomalies such as hydronephrosis, vesicoureteral reflux. The aim of this study was to compare the clinical and laboratory characteristics, and uroradiologic findings of UTI caused by pathogens other than E. coli with UTI caused by E. coli in infant and young children. Methods : We retrospectively reviewed medical records of 170 infants and children, who had been admitted for UTI to Il Sin Christian Hospital from January 2003 to December 2005. All patients were divided into two groups; E. coli and non-E. coli UTI, and they were compared for demographic data, clinical data (degree and duration of fever, time to defervescence, and length of hospital stay), underlying urinary tract anomalies (by history and ultrasonography), recurrent infection (by history and past medical records), and laboratory data [urinalysis, white blood cells (WBC) count in peripheral blood, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum creatinine level]. Results : Of the 170 UTI patients, the number of non-E. coli UTI was 114 (67.1%) and E. coli UTI was 56 (32.9%). As compared to E. coli group, non-E. coli group was younger in age ($0.52{\pm}0.59years$ vs $0.84{\pm}1.39years$, P<0.05), had higher rates of urinary tract anomalies [n=46 (82.1%) vs n=53 (46.5%), P<0.001], higher recurrence rate, shorter time to defervescence, less peripheral blood WBC count, lower level of CRP, lower level of ESR. Conclusion : The characteristics of non-E. coli UTI compared to E. coli UTI was younger age, milder clinical symptoms and signs, higher rates of urinary tract anomalies and higher recurrence rate.

Sequential treatment with transurethral resection and hormonal therapy for bladder endometriosis of vesicoureteric junction

  • Abdulelah AlAdimi;Nabil AlOdaini;Atef M. M. Darwish
    • Journal of Medicine and Life Science
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    • v.19 no.3
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    • pp.116-120
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    • 2022
  • Objective: To estimate the efficacy of sequential treatment of bladder endometriosis (BE) of the vesicoureteric junction using transurethral resection (TUR) and hormonal therapy. Design: Case report. Setting: Private multispecialty hospital. Patient: A multiparous woman presented with perimenstrual lower urinary tract symptoms, cyclic chronic pelvic pain, and left loin pain. Intervention[s]: Ultrasonography revealed marked left renal dilatation. Computed tomography confirmed the presence of a bladder mass. A diagnostic cystoscopy revealed compression of the left vesicoureteral junction. Complete TUR BE with release of chocolate material during resection, followed by ureteric double J stent insertion for 3 months, was performed. Histopathology confirmed the diagnosis of BE, followed by adjuvant hormonal therapy (dienogest) for 3 months. Follow-up for about 2 years revealed complete relief of the symptoms without any recurrence. Main Outcome Measure[s]. Success and recurrence rates of sequential TUR and hormonal therapy of BE of the vesicoureteric junction. Result[s]. TUR BE followed by adjuvant hormonal therapy was very effective in eradicating BE of the vesicoureteric junction in a safe manner without recurrence on follow-up for 2 years. Conclusion[s]. BE of the vesicoureteric junction can be properly treated by sequential TUR and hormonal therapy without recurrence over a 2-year follow-up.

Risk and Protective Factors for Gastrointestinal Symptoms associated with Antibiotic Treatment in Children: A Population Study

  • Bau, Mario;Moretti, Alex;Bertoni, Elisabetta;Vazzoler, Valentino;Luini, Chiara;Agosti, Massimo;Salvatore, Silvia
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.1
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    • pp.35-48
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    • 2020
  • Purpose: Gastrointestinal symptoms are often related to antibiotic treatment. Their incidence, risk and protective conditions in children are not well defined and represent the aims of this study. Methods: We prospectively enrolled inpatient children submitted to antibiotic treatment. Indication, type, dose and duration of treatment, probiotic supplementation and gastrointestinal symptoms were recorded at recruitment, after two and four weeks. Antibiotic-associated diarrhea (AAD) was defined as the presence of at least 3 loose/liquid stools within 14 days from antibiotic onset. Results: AAD occurred in 59/289 (20.4%) of patients, with increased risk in children younger than 3 years (relative risk [RR]=4.25), in lower respiratory (RR=2.11) and urinary infections (RR=3.67), intravenous administration (RR=1.81) and previous AAD episodes (RR=1.87). Abdominal pain occurred in 27/289 (9.3%), particularly in children >6 years (RR=4.15), with previous abdominal pain (RR=7.2) or constipation (RR=4.06). Constipation was recorded in 23/289 (8.0%), with increased risk in children having surgery (RR=2.56) or previous constipation (RR=7.38). Probiotic supplementation significantly reduced AAD (RR=0.30) and abdominal pain (RR=0.36). Lactobacillus rhamnosus GG (LGG) and L. reuteri significantly reduced AAD (RR=0.37 and 0.35) and abdominal pain (RR=0.37 and 0.24). Conclusion: AAD occurred in 20.4% of children, with increased risk at younger age, lower respiratory and urinary tract infections, intravenous treatment and previous AAD. LGG and L. reuteri reduced both AAD and associated abdominal pain.

Clinical Significances of $^{99m}TC-DMSA$ Renal Scan in Patients with Acute Pyelonephritis (급성신우신염에서 $^{99m}TC-DMSA$ 신장스캔의 임상적 의의)

  • Mok, Cha-Soo;Shin, Dong-Jin;Choi, Ho-Cheon;Kim, Gyeong-Wook;Yi, Gang-Wook;Choi, Dae-Seop
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.2
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    • pp.201-207
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    • 1989
  • Patients with acute pyleonephritis may present with a spectrum of clinical symptoms and signs. There are few noninvasive diagnostic studies, however, to confirm or exclude this diagnosis. To evaluate the clinical utility of $^{99m}Tc-DMSA$ renal scan in diagnosis of acute pyelonephritis, we performed $^{99m}Tc-DMSA$ renal scan in 37 patients suspected with urinary tract infection. Simultaneously, kidney ultrasonography was done in 21 patients diagnosed with acute pyelonephritis, clinically. And we performed the followup scan after treatment in two to six weeks. The results were as follows: 1) $^{99m}Tc-DMSA$ renal scan disclosed single or multiple cortical defects and decreased radiouptake ratio of affected kidney in 23 patients among 25 patients diagnosed with acute pyleonephritis. 2) In the 21 patients with acute pyelonephritis, kidney ultrasonography showed abnormal finding in the 7 patients. And $^{99m}Tc-DMSA$ renal scan disclosed abnormal cortical defects in this 7 patients also. 3) Between the patients with acute pyelonephritis and those with lower urinary tract infection, asymptomatic bacteriuria or pyuria. right-to-left radiouptake ratios (R/L ratio) were significantly different (p < 0.001). 4) In two to six weeks after antibiotic therapy, we performed followup $^{99m}Tc-DMSA$ renal scan for 5 patients among 25 acute pyelonephritis patients. And we have found the improvement of cortical defects and the right-to-left radiouptake ratio. In conclusion, we thought that $^{99m}Tc-DMSA$ renal scan should be useful in diagnosis of acute pyelonephritis and follow-up examination.

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Inflammatory Responses in a Benign Prostatic Hyperplasia Epithelial Cell Line (BPH-1) Infected with Trichomonas vaginalis

  • Kim, Sang-Su;Kim, Jung-Hyun;Han, Ik-Hwan;Ahn, Myoung-Hee;Ryu, Jae-Sook
    • Parasites, Hosts and Diseases
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    • v.54 no.2
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    • pp.123-132
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    • 2016
  • Trichomonas vaginalis causes the most prevalent sexually transmitted infection worldwide. Trichomonads have been detected in prostatic tissues from prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. Chronic prostatic inflammation is known as a risk factor for prostate enlargement, benign prostatic hyperplasia symptoms, and acute urinary retention. Our aim was to investigate whether T. vaginalis could induce inflammatory responses in cells of a benign prostatic hyperplasia epithelial cell line (BPH-1). When BPH-1 cells were infected with T. vaginalis, the protein and mRNA of inflammatory cytokines, such as CXCL8, CCL2, IL-$1{\beta}$, and IL-6, were increased. The activities of TLR4, ROS, MAPK, JAK2/STAT3, and NF-${\kappa}B$ were also increased, whereas inhibitors of ROS, MAPK, PI3K, NF-${\kappa}B$, and anti-TLR4 antibody decreased the production of the 4 cytokines although the extent of inhibition differed. However, a JAK2 inhibitor inhibited only IL-6 production. Culture supernatants of the BPH-1 cells that had been incubated with live T. vaginalis (trichomonad-conditioned medium, TCM) contained the 4 cytokines and induced the migration of human monocytes (THP-1 cells) and mast cells (HMC-1 cells). TCM conditioned by BPH-1 cells pretreated with NF-${\kappa}B$ inhibitor showed decreased levels of cytokines and induced less migration. Therefore, it is suggested that these cytokines are involved in migration of inflammatory cells. These results suggest that T. vaginalis infection of BPH patients may cause inflammation, which may induce lower urinary tract symptoms (LUTS).

Patient's Factors Correlated with Prostate Volume Recovery after 5 Alpha Reductase Inhibitor Discontinuation

  • Choi, Kwibok;Kim, Byounghoon;Cho, In-Chang;Min, Seung Ki
    • Urogenital Tract Infection
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    • v.13 no.3
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    • pp.79-83
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    • 2018
  • Purpose: The 5 alpha reductase inhibitor (5ARI) reduces the size of the prostate and alleviates lower urinary tract symptoms. After stopping 5ARI, the prostate quickly recovers to its pre-medication size. The purpose of this study was to investigate the factors affecting the restoration of prostate size after 5ARI discontinuation. Materials and Methods: Between March 2009 and May 2017, patients who visited an outpatient clinic and were diagnosed with benign prostatic hyperplasia were selected and start 5ARI medication. After 6 months of medication, the patients stopped medication for 1 year. Meanwhile, we measured the prostate volumes of patients 3 times (before and after medication, after discontinuation) and divide the patients into 3 groups (maintained, intermediate, and restored) with recovered prostate volume ratio. After classification, we investigated the relationship between the variable factors (age, serum prostate-specific antigen, initial volume, reduced volume after medication) between groups. Results: Among the 147 selected patients, the mean age and plasma PSA level were $61.6{\pm}7.9$ and $0.8{\pm}0.6$, respectively. The mean initial prostate volume was $32.3{\pm}4.2ml$, which reduced to $23.2{\pm}3.2ml$ after medication. After one year of discontinuation, the mean volume was $31.4{\pm}6.4ml$, with restoration to 101.5% of the reduced size. We noticed a tendency that patients with faster prostate volume recovery were generally older than those with slower recovery; however, this was not statistically significant. Other factors showed no relationship with prostate recovery. Conclusions: When using 5ARI in elderly patients, continuous treatment seems better than intermittent treatment. If discontinuation is needed, short term follow-up is recommended.

First-morning urine osmolality changes in children with nocturnal enuresis at the end of treatment

  • Yun Ha Lee;Jae Min Chung;Sang Don Lee
    • Childhood Kidney Diseases
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    • v.28 no.1
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    • pp.27-34
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    • 2024
  • Purpose: The ability to concentrate urine becomes an important index in determining nocturnal enuresis (NE) treatment. The aim of our study was to investigate first-morning urine osmolality (Uosm) changes at the end of treatment compared to before treatment in children with NE. Methods: A total of 71 children with NE were divided into two groups according to the level of first-morning Uosm before treatment: high group (≥800 mOsm/kg) and low group (<800 mOsm/kg). Baseline parameters were obtained from uroflowmetry, frequency volume charts for at least 2 days, and a questionnaire for lower urinary tract symptoms. All patients were basically treated with standard urotherapy and medication. The first-morning Uosm was measured twice, before treatment and at the end of treatment. Results: The response rate was higher in the low group after 3 months of treatment than in the high group (P=0.041). However, there was no difference between the two groups at the end of the treatment. In the high group, the first-morning Uosm at the end of treatment did not show a significant change compared to before treatment. In contrast, the first-morning Uosm increased in the low group at the end of treatment (P<0.001). However, it was still lower than that of the high group (P=0.007). Conclusions: The ability to concentrate nocturnal urine improved at the end of treatment compared to before treatment in the low Uosm NE children. In addition, NE improved faster in the low Uosm group before treatment than in the high group.

Factors Influencing Illness Intrusiveness of the Sexual Life in Women with Overactive Bladder (과민성방광 여성 환자의 성생활에 관한 지각된 질병의거변화의 영향요인)

  • Cho, Jeong Lim;Lee, Eun Nam
    • Journal of muscle and joint health
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    • v.20 no.1
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    • pp.62-71
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    • 2013
  • Purpose: This study was conducted to explore factors that influence illness intrusiveness of the sexual life in women with overactive bladder. Methods: Ninety-two women diagnosed with overactive bladder, from D University Hospital and three private urology hospitals in B region, participated in a survey between April 7 and August 7, 2012. The Overactive Bladder-questionnaire (OAB-q), the Marital Intimacy Tool, the Center for Epidemiologic Studies Depression (CES-D), and 1 question to ask illness intrusiveness of the sexual life were used in the study. Results: The illness intrusiveness score of the sexual life in women with overactive bladder was 2.22 out of 5. There were no significant differences of illness intrusiveness by demographic and disease related characteristics. The predictor were the clinical symptom score and depression, accounting for 13% of the variance of the illness intrusiveness of the sexual life in the women with overactive bladder. Conclusion: Effective nursing intervention to relieve clinical signs of overactive bladder and reduce depression can improve quality of sexual life in women with overactive bladder.