• Asian Spine Journal
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• 제12권6호
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• pp.1100-1105
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• 2018

Study Design: Prospective observational study. Purpose: To determine the incidence of postoperative urinary retention (POUR) in patients undergoing elective posterior lumbar spine surgery and identify the risk factors associated with the development of POUR. Overview of Literature: POUR following surgery can lead to detrusor dysfunction, urinary tract infections, prolonged hospital stay, and a higher treatment cost; however, the risk factors for POUR in spine surgery remain unclear. Methods: A prospective, consecutive analysis was conducted on patients undergoing elective posterior lumbar surgery in the form of lumbar discectomy, lumbar decompression, and single-level lumbar fusions during a 6-month period. Patients with spine trauma, preoperative neurological deficit, previous urinary disturbance/symptoms, multiple-level fusion, and preoperative catheterization were excluded from the study. Potential patient- and surgery-dependent risk factors for the development of POUR were assessed. Univariate analysis and a multiple logistical regression analysis were performed. Results: A total of 687 patients underwent posterior lumbar spine surgery during the study period; among these, 370 patients were included in the final analysis. Sixty-one patients developed POUR, with an incidence of 16.48%. Significant risk factors for POUR were older age, higher body mass index (BMI), surgery duration, intraoperative fluid administration, lumbar fusion versus discectomy/decompression, and higher postoperative pain scores (p<0.05 for all). Sex, diabetes, and the type of inhalational agent used during anesthesia were not significantly associated with POUR. Multiple logistical regression analysis, including age, BMI, surgery duration, intraoperative fluid administration, fusion surgery, and postoperative pain scores demonstrated a predictive value of 92% for the study population and 97% for the POUR group. Conclusions: POUR was associated with older age, higher BMI, longer surgery duration, a larger volume of intraoperative fluid administration, and higher postoperative pain scores. The contribution of postoperative pain scores in the multiple regression analysis was a significant predictor of POUR.

• The Korean Journal of Pain
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• 제11권1호
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• pp.81-85
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• 1998

Background: Continuous caudal epidural block is a useful method in postoperative pain control after perianal surgery. But caudal epidural block has the potential of developing adverse effects such as urinary retention. The goal of this study is to evaluate the analgesic and adverse effect of bupivacaine with fentanyl through continuous caudal epidural block in relation to the concentration of bupivacaine. Methods: We divided the patients randomly into two groups. For group I(n=25) postoperative pain was controlled by continuous caudal epidural infusion at the rate of 4 ml/hr of 0.0625% bupivacaine with 3 ${\mu}g$/ml fentanyl: group II(n=14), 0.125% bupivacaine with 3 ${\mu}g$/ml fentanyl, respectively, for duration of 48 hours via epidural catheter. We evaluated pain scores with visual analogue scales at 30 mins, 6 hrs, 12 hrs, 24 hrs and 48 hrs after the operation and the incidence of adverse effect, especially urinary retention, for each group. Results: There were no significant differences in the pain score between group I and II. Urinary retention developed in 9 patients(36%) of group I, and 11 patients (78.6%) of group II. Other adverse effects such as pruritus, nausea, vomiting and respiratory depression developed in few patients. Conclusions: While performing continuous caudal epidural block with mixture of bupivacaine and fentanyl after the perianal surgery, we conclude 0.0625% bupivacaine solution is preferable to 0.125% bupivacaine solution because 0.0625% solution resulted in satisfactory analgesia with minimal incidence of adverse effect.

• The Korean Journal of Pain
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• 제23권3호
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• pp.190-197
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• 2010

Background: Conventional spinal saddle block is performed with the patient in a sitting position, keeping the patient sitting for between 3 to 10 min after injection of a drug. This amount of time, however, is long enough to cause prolonged postoperative urinary retention. The trend in this block is to lower the dose of local anesthetics, providing a selective segmental block; however, an optimal dose and method are needed for adequate anesthesia in variable situations. Therefore, in this study, we evaluated the question of whether only 1 min of sitting after drug injection would be sufficient and safe for minor anorectal surgery. Methods: Two hundred and sixteen patients undergoing minor anorectal surgery under spinal anesthesia remained sitting for 1 min after completion of subarachnoid administration of 1 ml of a 0.5% hyperbaric bupivacaine solution (5 mg). They were then placed in the jack-knife position. After surgery, analgesia levels were assessed using loss of cold sensation in the supine position. The next day, urination and 11-point numeric rating scale (NRS) for postoperative pain were assessed. Results: None of the patients required additional analgesics during surgical manipulation. Postoperative sensory levels were T10 [T8-T12] in patients, and no significant differences were observed between sex (P = 0.857), height (P = 0.065), obesity (P = 0.873), or age (P = 0.138). Urinary retention developed in only 7 patients (3.2%). In this group, NRS was $5.0{\pm}2.4$ (P = 0.014). Conclusions: The one-minute sitting position for spinal saddle block before the jack-knife position is a safe method for use with minor anorectal surgery and can reduce development of postoperative urinary retention.

• 대한지역사회영양학회지
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• 제4권3호
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• pp.375-381
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• 1999

The purpose of this study was to investigate Na and K balances in healthy adult women. Anthropometric assessments, biochemical analysis of blood, 3-day dietary flood records and collections of 3-day food, 24-hr urine and faces were performed to evaluate intakes and excretions of Na and K in 20 college women living in Seoul. The mean BMI and blood pressure of the subjects were 21.08 and 110.25/67.50mmHg, respectively. Mean daily intake of energy was 1578.84kcal, 79% of Korean RDA. Also, daily intakes of Na and K ware 120.86mEq and 44.20mEq. The urinary and fecal excretions of Na were 99.88 and 4.45mEq/day, and those of K were 30.41 and 8.66mEq/day, respectively. The body retention, retention rate, and apparent absorption of Na were 17.11mEq, 13.23%, and 96.31%, and those of K were 5.82mEq, 8.69%, and 80.12%, respectively. The urinary and fecal Na/K ratio were 3.48 and 0.52. There were significantly positive correlations between 1) urinary Na, K excretions and intakes of Na or K, 2) urinary K and BMI, 3) serum K and serum globulin, and 4) urinary Na excretion and serum haptoglobin level, respectively. The results of this study show that Na intake was higher and K intake was lower than those of other advanced nations. Therefore, nutrition education show instruct people to reduce Na intake and to increase K intake.

• Asian-Australasian Journal of Animal Sciences
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• 제5권2호
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• pp.279-283
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• 1992

Eighteen wether lambs averaging 32 kg were used to determine the effects of dietary silica, added as silicic acid, on mineral metabolism. Lambs were fed 1200 g daily of a coastal Bermuda grass based diet supplemented with either 0, .5 or 1.5% silicic acid. A 7-d total collection of urine and feces was conducted after lambs had adjusted to the dietary treatments for 19 days. Urinary excretion of silica was higher (p<.01) in lambs fed added silicic acid. Ruminal soluble concentrations of manganese tended to be lower (p<.10) and apparent absorption and retention of manganese were lower (p<.05) in lambs supplemented with silicic acid compared to control lambs. Apparent absorption and retention of calcium were slightly lower (p<.10) in silicic acid fed lambs. No differences in urinary between lambs fed .5 and those given 1.5% silicic acid. Phosphorus, magnesium, iron, zinc and copper absorption and retention were not affected by treatment.

• 대한한의학회지
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• 제37권1호
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• pp.1-9
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• 2016

Objectives: Objectives : This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with Post-stroke Urinary Retention; PSUR. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on PSUR compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: 4 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of acupuncture treatment for PSUR. The moderate evidence was presented that over 3 times a week of the acupuncture should be performed over 4 weeks on the acupoints, such as SP6, CV3, CV6, CV4, SP9, BL28, BL23, BL22, KI3 or BL67, for 15-30 minutes. 20-140Hz frequency and 10-20 minutes of treatment is suggested if electro-acupuncture treatment is performed with. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for PSUR.

• The Korean Journal of Physiology and Pharmacology
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• 제13권1호
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• pp.1-7
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• 2009

Sodium retention is a hallmark of nephrotic syndrome. We investigated whether sodium retention is associated with changes of natriuretic peptide system at different stages (i.e., a sodium retaining stage and a compensatory stage) of nephrotic syndrome. At day 7 after PAN(puromycin aminonucleoside) injection, the urinary excretion of sodium was decreased, along with the development of ascites and positive sodium balance. The plasma and urinary ANP(atrial natriuretic peptide) immunoreactivities were increased. ANP mRNA expression was increased in the heart and kidney, whereas that of NPR(natriuretic peptide receptor)-A and NPR-C mRNA was decreased in the kidney. The expression of NEP was decreased in the kidney. At day 14, urinary excretion of sodium did not differ from the control. The plasma ANP level and heart ANP mRNA expression returned to their control values. The expression of ANP mRNA in the kidney was increased in association with increased urinary ANP immunoreactivities. The expression of NPR-A in the kidney became normal, whereas that of NPR-C kept decreased. The expression of NEP(neutral endopeptidase) remained decreased. These findings suggest that the increased renal ANP synthesis in association with decreased metabolism via NEP and NPR-C may play a compensatory role against the development of sodium retention in nephrotic syndrome. The decreased of NPR-A expression in the kidney may contribute to the ANP resistance at day 7. The subsequent recovery of NPR-A expression may play a role in promoting sodium excretion in later stage(at day 14).

• 대한수의학회지
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• 제25권1호
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• pp.41-48
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• 1985

In the present studies, the effects of dietary high-potassium and high-urea on the metabolism of magnesium, calcium and potassium were checked as an aid to clarify the pathogenesis of hypomagnesaemia(so-called grass tetany) in ruminant. A total of 5 Korean native female goats kept in metabolic cage were received high-potassium(Mg: 0.25%, Ca: 0.94%, K: 5.41%), high-urea(Mg: 0.25%, Ca: 0.94%, K: 0.72%) or control(Mg: 0.25%, Ca: 0.94, K: 0.72%) ration for 15 or 21 days. Daily intakes, fecal and urinary excretions and serum concentrations of magnesium, calcium and potassium were measured with an atomic absorption spectrophotometer. The results obtained were summarized as follows: In high-potassium group, absorption, urinary excretion and serum concentration of magnesium were significantly (p<0.01, p<0.01 and p<0.05 respectively) decreased compared with the control group. On the other hand, the body retention was significantly (p<0.01) increased. However, no clinical symptom of hypomagnesaemic tetany was observable throughout the experimental period. No significant effects on the metabolism and seurm content of calcium were detected in the high-potassium group. In the high-potassium group, significant increase in absorption (p<0.01), urinary excretion (p<0.05) and body retention (p<0.01) of potassium were recognized. However, no significant difference in the concentration of serum was observable between the two groups. In high-urea group, no significant difference in the metabolism of magnesium and potassium or in the serum content were recognized compared with the control group. In high-urea group, tthe absorption, urinary excretion, body retention and serum content of calcium were decreased compared with the control group.

• 대한약침학회지
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• 제27권2호
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• pp.123-130
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• 2024

Objectives: Post-operative urinary retention (POUR) is a frequent complication following surgical procedures, characterized by an acute inability to void, leading to additional complications and extended hospitalization. Acupuncture has been shown to be effective in facilitating spontaneous urination and alleviating anxiety in patients experiencing poor urination. The present study aims to evaluate the effectiveness of electroacupuncture in the management of POUR in patients who have undergone lumbar spine surgery. Methods: This retrospective study conducted at the National Hospital of Acupuncture in Vietnam and reviewed the medical records of patients over 18 years old who underwent lumbar spine surgery and were diagnosed with POUR between January to December 2019. Electroacupuncture was administered at five specific acupuncture points: Qugu (CV2), Zhongji (CV3), Zhibian (BL54), Pangguanshu (BL28), and Kunlun (BL60). This study monitored key parameters related to the effectiveness of the acupuncture treatment, including the number of acupuncture treatment sessions required until a patient was successfully treated was recorded, with a maximum of three acupuncture treatment sessions per patient, the time elapsed until urination following the treatment (minutes), and urinary bladder volume before and after treatment (mL). Results: The study demonstrated a 93.3% success rate in treating POUR with electroacupuncture. A significant reduction in post-void residual volume was noted, and patients could void within 30 minutes post-treatment. No significant differences in treatment effectiveness were observed across difference genders and age groups. Conclusion: Electroacupuncture proved to be a highly effective treatment for POUR in patients post-lumbar spine surgery, with a rapid response time and substantial reduction in PVR. However, the retrospective nature of the study and single-center focus limit its generalizability. Future research incorporating randomized controlled trials or multi-center observational studies are recommended to validate these findings and explore the potential of acupuncture in POUR management on a broader scale.

• 혜화의학회지
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• 제14권1호
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• pp.43-49
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• 2005

One case of patient with urinary retention was reported in this clinical study. After the study, the results were as follows: 1. Anulesis belongs to l$\acute{o}$ng-bi(癃閉) in oriental medicine and the patient of this case belongs to chronic anulesis. 2. The patient of this case was thought as broke out anuresis by vesical nerve palsy of diabetic bladder pathy and sequela of stroke, and ischuria of long lie down 3. The patient of this case changeable process is supposed to urinary frequency, 'bi(閉)', 'l$\acute{o}$ong(癃)', urinary incontinence and urinary frequency. 4. First time of drug treatment is GAMIPHALJENG-SAN(ji$\bar{a}$-w$\grave{e}$i-b$\bar{a}$-h$\bar{e}$ng-s$\check{a}$n) by oral administration that action of alleviate a fever, water utilization and metaphase, convalescence time of drug treatment is PHALMIWANGAMI (b$\bar{a}$-w$\grave{e}$i-w$\acute{a}$n-ji$\bar{a}$-w$\grave{e}$i), YIKLUENG-TANG(yi-ling-t$\bar{a}$ng), CHUKYOO-TANG(s$\grave{u}$-ni$\grave{a}$o-t$\bar{a}$ng) that action of recreation. 5. Accupuncture treatment is s$\bar{a}$n-x$\bar{i}$ng-xuw$\acute{e}$, zw$\acute{u}$-s$\bar{a}$n-li, qi-h$\check{a}$i, gu$\bar{a}$n-yu$\acute{a}$n, zh$\bar{o}$ng-ji by mild supplementing and reducing manipulation of needle and heat accupuncture is qi-h$\check{a}$i, gu$\bar{a}$n-yu$\acute{a}$n, zh$\bar{o}$ng-ji-xu$\acute{e}$. 6. The other treatment is a sitz bath that prevent of urinary tract infection, and relieve of initial acute auresis by using of urethral catheterization.