• Asian Spine Journal
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• 제12권6호
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• pp.981-986
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• 2018

Study Design: Retrospective case series. Purpose: Cauda equina syndrome (CES) is associated with etiologies such as lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). CES has a prevalence of 2% among patients with LDH and exhibits variable outcomes, even with early surgery. Few studies have explored the factors influencing the prognosis in terms of bladder function. Therefore, we aimed to assess the factors contributing to bladder recovery and propose a simplified bladder recovery classification. Overview of Literature: Few reports have described the prognostic clinical factors for bladder recovery following CES. Moreover, limited data are available regarding a meaningful bladder recovery status classification useful in clinical settings. Methods: A single-center retrospective study was conducted (April 2012 to April 2015). Patients with CES secondary to LDH or LCS were included. The retrieved data were evaluated for variables such as demographics, symptom duration, neurological symptoms, bladder symptoms, and surgery duration. The variable bladder function outcome during discharge and at follow-up was recorded. All subjects were followed up for at least 2 years. A simplified bladder recovery classification was proposed. Statistical analyses were performed to study the correlation between patient variables and bladder function outcome. Results: Overall, 39 patients were included in the study. Majority of the subjects were males (79.8%) with an average age of 44.4 years. CES secondary to LDH was most commonly seen (89.7%). Perianal sensation (PAS) showed a significant correlation with neurological recovery. In the absence of PAS, bladder function did not recover. Voluntary anal contraction (VAC) was affected in all study subjects. Conclusions: Intactness of PAS was the only significant prognostic variable. Decreased or absent VAC was the most sensitive diagnostic marker of CES. We also proposed a simplified bladder recovery classification for recovery prognosis.

• Journal of Korean Neurosurgical Society
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• 제63권3호
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• pp.358-365
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• 2020

To describe how to perform urological evaluation in children with tethered cord syndrome (TCS). Although a common manifestation of TCS is the development of neurogenic bladder in developing children, neurosurgeons often face difficulty in detecting urological problems in patients with TCS. From a urological perspective, diagnosis of TCS in developing children is further complicated due to the differentiation between neurogenic bladder dysfunctions and transient bladder dysfunctions owing to developmental problems. Due to the paucity of evidence regarding evaluation prior to and after untethering, I have shown the purpose and tools for evaluation in my own practice. This may be tailored to the types of neurogenic bladder, developmental status, and risks for deterioration. While the urodynamic study (UDS) is the gold standard test for understanding bladder function, it is not a panacea in revealing the nature of bladder dysfunction. In addition, clinicians should consider the influence of developmental processes on bladder function. Before untethering, UDS should reveal synergic urethral movement, which indicates an intact sacral reflex and lack of TCS. Postoperatively, the measurement of post-void residual urine volume is a key factor for the evaluation of spontaneous voiders. In case of elevation, fecal impaction, which is common in spinal dysraphism, should be addressed. In patients with clean intermittent catheterization, the frequency-volume chart should be monitored to assess the storage function of the bladder. Toilet training is an important sign of maturation, and its achievement should be monitored. Signs of bladder deterioration should be acknowledged, and follow-up schedule should be tailored to prevent upper urinary tract damage and also to determine an adequate timing for intervention. Neurosurgeons should be aware of urological problems related to TCS as well as urologists. Cooperation and regular discussion between the two disciplines could enhance the quality of patient care. Accumulation of experience will improve follow-up strategies.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2005년도 학술대회 논문집 정보 및 제어부문
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• pp.379-381
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• 2005

Urodynamics describes a collection of tests designed to evaluate lower urinary tract function and can be performed using retrograde filling of the bladder within a room. In this study, we designed and calibrated the potable urodynamics monitoring system using DSP chip (TMS320VC33, Texas InstrumentTM, U.S.) and obtained signals of bladder(Pves) and bladder neck pressure(Pneck) and EMG using calibration kit (DPT9022K0122, MedtronicsTM, U.s,). This system monitor spontaneous urination during daily life and can make patients more comportable.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10971-10975
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• 2015

Objective: To investigate bladder and intestinal function recovery and quality of sexual life after laparoscopic nerve-sparing radical hysterectomy (LNRH) for treatment of early invasive cervical carcinoma. Methods: Subjects included patients who underwent radical hysterectomy by laparotomy who were randomly assigned to 2 groups: 30 patients who underwent LNRH and 35 classical laparoscopic radical hysterectomy (LRH). We assessed the patients general clinical information, surgical characteristics, pathological findings, and adjuvant therapies. A urodynamic study was used to assess bladder function. Intestinal function recovery and quality of sexual life were evaluated by questionnaire. Results: No significant differences were found in age, surgery characteristics, pathological findings, adjuvant therapies, and main adverse effects between the 2 groups. The mean duration of the postoperative catheterization (DPC) in group LNRH was shorter than that in group LRH (P < 0.001). The maximum flow rate, maximum cystometric capacity, maximum detrusor pressure and urinary complications in group LNRH were better than those in group LRH. The quality of sexual life evaluated according to the female sexual function index (FSFI) was better in group LNRH than in those who underwent LRH. The intestinal function of patients in group LNRH also recovered better compared with patients in group LRH.

• 대한한의학원전학회지
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• 제23권3호
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• pp.103-110
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• 2010

Conceptions about functions of bladder in Oriental Medicine are focused on excretion of urine, such as "Somun(素問)" "Yeong-ranbijeonron(靈蘭秘典論)". However, functions of bladder cannot be in those. In Oriental Medicine, there are sentences in "Naegyeong", the fluid and humor is dispersed to whole body. It means that bladder has a function by reabsorption of the fluid and humor in metabolism with gi transformation, besides excretion of urine. In that reason, I try to find out meanings of bladder's functions in metabolism of the fluid and humor through bibliographic review. As a result, bladder has a 2 types of function. 1st, it is a excretion of urine that we have already mentioned. 2nd, it is a reabsorption of the fluid and humor.

• Korean Journal of Acupuncture
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• 제25권4호
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• pp.17-29
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• 2008

Objectives : This study was carried out to investigate the correlation of meridian system in oriental medicine and muscular system in western medicine. Methods : Muscles were assigned to meridians by their main functions and the acupoints on them. New mutual relationships between meridians in lower limb were studied based on the muscular function. Results : In gluteal & femoral region, iliopsoas & quadratus femoris are assigned to spleen & stomach meridians, gluteus maximus & hamstrings to urinary bladder & kidney meridians, adductor muscle groups to liver meridian, gluteus medius & minimus & iliotibial tract to gall bladder meridian. In crural region, anterior crural muscles are assigned to stomach meridian, lateral crural muscles to gall bladder meridian, suferficial posterior crural muscles to urinary bladder (& kidney) meridian, deep posterior crural muscles to liver, spleen, kidney meridians. In lower limb, urinary bladder meridian and stomach meridian lead the muscular functions and correspond to each other, while spleen meridian assists stomach meridian, and kidney meridian assists urinary bladder meridian. Conclusions : Muscles may be assigned to meridians by their functions and the acupoints on them. From the view of muscular function, Yang meridians lead Yin meridians in lower limb.

• Anatomy and Cell Biology
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• 제56권4호
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• pp.421-427
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• 2023

Bladder exstrophy is a rare congenital condition of the pelvis, bladder, and lower abdomen that opens the bladder against the abdominal wall, produces aberrant growth, short penis, upward curvature during erection, wide penis, and undescended testes. Exstrophy affects 1/30,000 newborns. The bladder opens against the abdominal wall in bladder exstrophy, a rare genitourinary condition. This study is vital to provide appropriate therapy choices as a basis to improve patient outcomes. This study may explain bladder exstrophy and provide treatment. Epispadias, secretory placenta, cloacal exstrophy, and other embryonic abnormalities comprise the exstrophy-spades complex. The mesenchymal layer does not migrate from the ectoderm and endoderm layers in the first trimester, affecting the cloacal membrane. Embryological problems define the exstrophy-aspidistra complex, which resembles epimedium, classic bladder, cloacal exstrophy, and other diseases. Urogenital ventral body wall anomalies expose the bladder mucosa, causing bladder exstrophy. Genetic mutations in the Hedgehog cascade pathway, Wnt signal, FGF, BMP4, Alx4, Gli3, and ISL1 cause ventral body wall closure and urinary bladder failure. External factors such as high maternal age, smoking moms, and high maternal body mass index have also been associated to bladder exstrophy. Valproic acid increases bladder exstrophy risk; chemicals and pollutants during pregnancy may increase bladder exstrophy risk. Bladder exstrophy has no identified cause despite these risk factors. Exstrophy reconstruction seals the bladder, improves bowel function, reconstructs the vaginal region, and restores urination.

• International Neurourology Journal
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• 제22권4호
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• pp.287-294
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• 2018

Purpose: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. Methods: A retrospective analysis was conducted of 42 patients (31 males; mean age, $14.2{\pm}6.2years$) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median $12.0{\pm}1.5years$ of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. Results: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. Conclusions: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.

• The Korean Journal of Physiology and Pharmacology
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• 제25권2호
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• pp.119-129
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• 2021

Bladder cancer is one of the most common types of cancer. Most gene mutations related to bladder cancer are dominantly acquired gene mutations and are not inherited. Previous comparative transcriptome analysis of urinary bladder cancer and control samples has revealed a set of genes that may play a role in tumor progression. Here we set out to investigate further the expression of two candidate genes, centromere protein U (CENPU) and mitochondrial ribosomal protein s28 (MRPS28) to better understand their role in bladder cancer pathogenesis. Our results confirmed that CENPU is up-regulated in human bladder cancer tissues at mRNA and protein levels. Gain-of-function and loss-of-function studies in T24 human urinary bladder cancer cell line revealed a hierarchical relationship between CENPU and MRPS28 in the regulation of cell viability, migration and invasion activity. CENPU expression was also up-regulated in in vivo nude mice xenograft model of bladder cancer and mice overexpressing CENPU had significantly higher tumor volume. In summary, our findings identify CENPU and MRPS28 in the molecular pathogenesis of bladder cancer and suggest that CENPU enhances the progression of bladder cancer by promoting MRPS28 expression.

• 대한한방부인과학회지
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• 제27권2호
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• pp.83-102
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• 2014

Objectives: This study aimed to review Korean medical clinical management of female overactive bladder (OAB). Methods: We reviewed domestic and foreign papers related to Korean Medicine Treatment for OAB and literatures on Korean Medicine added clinical views of authors. Results: OAB is usually diagnosed to Deficiency pattern (Kidney qi deficiency-cold, Spleen-Lung qi deficiency et al.). The primary treatment goals of OAB is improvement of urinary symptom. But a comprehensive treatment approach including improvement of accompanied symptoms such as depression, insomnia, sexual dysfunction and improvement of quality of life is needed. Warming and tonifying herbal medicine, electro-acupuncture and moxibustion using acupoints specially acting bladder function in lower abdomen and lumbar-sacral area and behavioral therapies such as lifestyle modification, bladder training are usually primary treatments. Treatment period is recommended about 3~6 months to recover and stabilize bladder function. Conclusions: OAB is a clinical area that Korean Medicine tend to be more effective. but additional research about Korean Medical Clinical Management of OAB is needed.