• 제목/요약/키워드: Urinary dysfunction

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Factors Influencing Postoperative Urinary Retention Following Elective Posterior Lumbar Spine Surgery: A Prospective Study

  • Aiyer, Siddharth Narasimhan;Kumar, Ajit;Shetty, Ajoy Prasad;Kanna, Rishi Mugesh;Rajasekaran, Shanmuganath
    • 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.

뇌졸중 후 요저류 환자 치험 1례 (A case study of a Patient with Poststroke Urinary retention treated with Traditional Korean Medicine)

  • 김세원;김경묵;정민호;조기호;문상관;권승원;진철;정우상
    • 대한중풍순환신경학회지
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    • 제19권1호
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    • pp.1-8
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    • 2018
  • ■ Objectives The purpose of this case report is to show the effect of Traditional Korean Medicine(TKM) on a patient with poststroke urinary retention ■ Methods A stroke patient with urinary retention was treated with herbal medication(Paljungsan), acupuncture, electro-acupuncture and moxibustion. To evaluate the effect of TKM on post-stroke urinary retention, we observed voiding pattern and residual urine after voiding. ■ Results Maintenance of regular self voiding and decrease of residual urine after voiding were observed after the TKM treatment. ■ Conclusion This study showed the effect of TKM treatment on Urinary retention of stroke patient.

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Giant Cauda Equina Schwannoma with Dystrophic Calcifications : Case Report and Review of the Literature

  • Hyun, Seung-Jae;Rhim, Seung-Chul
    • Journal of Korean Neurosurgical Society
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    • 제51권2호
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    • pp.105-108
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    • 2012
  • Giant spinal schwannoma of the cauda equine involving many nerve roots is rare, and ossification is usually not observed in the schwannoma. A 21-year-old man presented with a 12-month history of urinary dysfunction and numbness below the buttocks. Plain radiography showed scalloping of the posterior surface of the vertebral bodies from L4 to the sacrum, and magnetic resonance imaging and computed tomography revealed a giant cauda equina tumor with dystrophic calcification. The tumor was completely removed, with intraoperative neurophysiologic monitoring. Histopathologic examination showed that the tumor was a schwannoma. The patient's postoperative course was uneventful, with urinary function and numbness gradually improving. Although a giant schwannoma accompanied by dystrophic calcification is extremely rare, such a tumor can be removed safely and completely by meticulous dissection and careful neuromonitoring of the cauda equina spinal nerves involved in the tumor.

둥굴레의 승홍으로 유도된 흰쥐 신부전에 미치는 영향 (Effects of Polygonatum odoratum on Mercuric Chloride Induced Renal Failure Rats)

  • 김주향;양기숙
    • 생약학회지
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    • 제33권3호통권130호
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    • pp.200-206
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    • 2002
  • The rhizoma of Polygonatum odoratum (Liliaceae) has been used as the treatment of body fluid deficiency, dryness symptoms and hyper glycemia. To study effects on acute renal failure of P. odorati rhizoma, urinary volume, urinary electrolytes and serum factors associated with renal dysfunction were measured in $HgCl_2-induced$ acute renal failure rats. It was revealed that its ether ex. had significant diuretic effects, regulated hypoelectrolytes$(Na^+,\;K^+,\;Cl^-)$ and inhibited the increase of creatinine, BUN in acute renal failure rats. From the ether ex. which was more effective than MeOH ex., three lipophilic compounds were isolated and elucidated hydrocarbon(l), ${\beta}-sitosteryl$ stearate(2), ${\beta}-sitosterol$(3). The ${\beta}-sitosteryl$ stearate(2) were isolated from Polygonatum sp. at first.

항암제 유발 말초신경병증환자와 유기산검사 마커와의 상관성 연구 (Correlation Analysis of Organic Acid Comprehensive Profile Markers with Chemotherapy Induced Peripheral Neuropathy in Cancer Patients)

  • 박지혜;성상엽;이진선;유화승
    • 대한한의학회지
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    • 제38권1호
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    • pp.72-80
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    • 2017
  • Objectives: The purpose of this study is to evaluate the urinary organic acid comprehensive profile for chemotherapy induced peripheral neuropathy (CIPN). Methods: Participants are 66 patients with CIPN who had symptom (Visual analog scale ${\geq}30mm$, Eastern Cooperative Oncology Group ${\leq}2$). Participants were tested with organic acid comprehensive profile markers. Results: Positive Correlation was observed in the neurotransmitter metabolism markers, N-methyl-D-aspartate (NMDA) modulators markers, detoxification markers, energy production markers, amino acid metabolism markers, and intestinal dysbiosis markers. Especially, all the neurotransmitter metabolism markers were showed positive rate of 44%. In addition, neuro-endo-immune was associated with energy metabolism (mitochondrial dysfunction) in CIPN of cancer patient. especially detoxification, intestinal bacterial hyperplasia, vitamin deficiency (folate, complex B group, vitamin C). Conclusions: Significant urinary organic acid comprehensive profile results were obtained in cancer patients who induced peripheral neuropathy by chemotherapy.

In Search for a Common Pathway for Health Issues in Men - the Sign of a Holmesian Deduction

  • Aoun, Fouad;Chemaly, Anthony Kallas;Albisinni, Simone;Zanaty, Marc;Roumeguere, Thierry
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.1-13
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    • 2016
  • The evidence for the existence of a common pathway for health issues in men is presented in this review. Several epidemiological studies have shown that conditions like cardiovascular diseases (CVD), metabolic syndrome, diabetes, lower urinary tract symptom (LUTS), erectile dysfunction (ED), prostate cancer, hypogonadism, depression and suicide can be associated as risk factors for each other. Thus, the risk of CVD is significantly increased in men with metabolic syndrome, ED, hypogonadism, prostate cancer and/or LUTS. In addition, the above mentioned conditions are more prevalent in atherosclerotic patients. In addition, growing evidence indicates that low androgen levels can cause metabolic syndrome. In addition, obesity, dyslipidaemia and diabetes can further reduce androgen levels potentiating their adverse effect. Low testosterone levels are also associated with a higher incidence of aggressive prostate cancer on biopsy and on definitive pathology, and lower probability of abiraterone response in the metastatic setting. Several recent studies point towards diffuse endothelial dysfunction and dysregulated pro-inflammatory state as the biological link between all these disorders. Our current hypothesis is that oxidative stress caused by these dysfunctions explains the pathogenesis of each of these conditions.

Associations Between Thyroid Hormone Levels and Urinary Concentrations of Bisphenol A, F, and S in 6-Year-old Children in Korea

  • Jang, Yoonyoung;Choi, Yoon-Jung;Lim, Youn-Hee;Lee, Kyung-Shin;Kim, Bung-Nyun;Shin, Choong Ho;Lee, Young Ah;Kim, Johanna Inhyang;Hong, Yun-Chul
    • Journal of Preventive Medicine and Public Health
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    • 제54권1호
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    • pp.37-45
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    • 2021
  • Objectives: Bisphenol A (BPA) is used in the electrical, mechanical, medical, and food industries. Previous studies have suggested that BPA is an endocrine disruptor. Regulation of BPA has led to increased use of bisphenol F (BPF) and bisphenol S (BPS). However, few studies have investigated the associations of BPF and BPS with thyroid dysfunction in children. Our study investigated the associations of prenatal BPA and early childhood BPA, BPF, and BPS exposure with thyroid function in 6-year-old children. Methods: Prenatal BPA concentrations were measured during the second trimester of pregnancy in an established prospective birth cohort. We measured urinary BPA, BPF, and BPS concentrations and thyroid hormone levels (thyroid-stimulating hormone, total T3, and free T4) in 6-year-old children (n=574). We examined the associations between urinary bisphenol concentrations and percentage change of thyroid hormone concentrations using multivariate linear regression. We also compared thyroid hormone levels by dividing the cohort according to BPA, BPF, and BPS concentrations. Results: The associations between prenatal BPA and total T3 levels were statistically significant in all models, except for girls when using a crude model. The associations between urinary BPA and BPS concentrations and levels of all thyroid hormones were not statistically significant. However, we observed that lower free T4 levels (-1.94%; 95% confidence interval, -3.82 to -0.03) were associated with higher urinary BPF concentrations in girls only. Conclusions: Our findings identified significant associations between prenatal BPA exposure and total T3 levels in all children and between BPF exposure and free T4 levels in girls only.

Disseminated Tuberculosis of Central Nervous System : Spinal Intramedullary and Intracranial Tuberculomas

  • Lim, Yu Seok;Kim, Sung Bum;Kim, Min Ki;Lim, Young Jin
    • Journal of Korean Neurosurgical Society
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    • 제54권1호
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    • pp.61-64
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    • 2013
  • As a cause of spinal cord compression, intramedullary spinal tuberculoma with central nervous system (CNS) involvement is rare. Aurthors report a 66-year-old female presented with multiple CNS tuberculomas including spinal intramedullary tuberculoma manifesting paraparesis and urinary dysfunction. We review the clinical menifestation and experiences of previous reported literature.

뇌졸중후 요저류에 대한 침치료 임상진료지침 (Clinical Practice Guideline for acupuncture in Post-stroke urinary retention)

  • 이지원;이의주;신병철;이명수;임성민;조충식;문상관
    • 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.

홍의약침 단일요법이 여성 하부요로증상에 미치는 임상적 효과에 대한 후향적 설문조사 연구 (A Retrospective Questionnaire Survey on the Clinical Effects of HongYi Pharmacopuncture Monotherapy on Female Lower Urinary Tract Symptoms)

  • 황윤경;김용수;최승배;김원일
    • 대한한방내과학회지
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    • 제38권6호
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    • pp.930-943
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    • 2017
  • Objectives: The purpose of this study was to investigate the clinical effects of HongYi pharmacopuncture monotherapy on female voiding dysfunction. Methods: Korean medical practitioners who used HongYi pharmacopuncture to treat female patients complaining of dysuria were surveyed. They performed a retrospective chart review of 31 female patients who visited their Korean medical clinic for dysuria. General characteristics, marital status, urologic medical history, International Prostate Symptom Score (IPSS), International Consultation on Incontinence Modular Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), and related adverse events were examined. Results: Of 31 cases received, 29 were selected for analysis. Two cases were excluded because treatment was not continued through four weeks. In all cases, IPSS and ICIQ-FLUTS scores were significantly decreased after treatment. Adverse reactions occurred during treatment in four cases. Conclusions: These results suggest that treatment by HongYi pharmacopuncture is effective in improving lower urinary tract symptoms in women. Further studies will be needed for evaluation of clinical responses, to evaluate the safety and efficacy of HongYi pharmacopuncture treatment for female patients complaining of dysuria.