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Zhuang X, Chen B. Commentary on ''Risk factors for infection and acute urinary retention following transperineal prostate biopsy''. Int Urol Nephrol 2024:10.1007/s11255-024-04011-x. [PMID: 38430397 DOI: 10.1007/s11255-024-04011-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/28/2024] [Indexed: 03/03/2024]
Affiliation(s)
- Xiaojing Zhuang
- Department of Clinical Laboratory, Tongxiang Hospital of Traditional Chinese Medicine, Jiaxing, China
| | - Bing Chen
- Department of Clinical Laboratory, Wenchang People's Hospital, Wenchang, 571300, Hainan, China.
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Al-Dali Y, Khalil IA, Alkabbani M, Hatem M, Mansour A, Al Rumaihi K. Recurrent urinary retention due to seminal vesicle cyst a report of rare entity. Urol Case Rep 2023; 51:102556. [PMID: 37727281 PMCID: PMC10506083 DOI: 10.1016/j.eucr.2023.102556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023] Open
Abstract
Male pelvic cyst rarely causes symptoms; here, we are presenting a case of a 48-year-old gentleman who presented with acute urinary retention stemming from a pelvic cyst. This presentation has been recurrent despite undergoing repeated TRUS aspiration of the cyst to relieve the symptoms. We performed a robotic pelvic cyst excision with peritoneal window in an attempt to cure the patient. Based on the MRI and histopathology, it was likely a seminal vesicle cyst that is causing these recurrent episodes. On 3 months follow-up, the patient was symptom free without any complaints.
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Affiliation(s)
| | | | - Majd Alkabbani
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Hatem
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
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Baran C. The effect of acute urinary retention on the results of transurethral resection of the prostate. Urologia 2023; 90:642-646. [PMID: 37491943 DOI: 10.1177/03915603231189627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Acute urinary retention (AUR) is one of the most severe symptoms of Benign Prostatic Hyperplasia (BPH). There are some studies in the literature describing the risk factors for the development of AUR in BPH patients. However, the studies that summarize the effect of AUR on Transurethral resection of Prostate (TUR-P) surgery results are limited. The aim of this study is to assess the effect of AUR on TUR-P results. METHODS Between 2018 and 2020, patients who underwent TUR-P for AUR or lower urinary tract symptoms (LUTS) were included in the study. The inclusion criteria were, men over 50 years old with a BPH diagnosis and who underwent monopolar TUR-P by a single surgeon. The exclusion criteria were; patients who had prostate cancer, multiple sclerosis, or neurogenic bladder were diagnosed or had previous lower urinary tract surgeries such as TUR-P, TUR-Bladder, Urethrotomy, had a chronic indwelling catheter, and patients who did not accept immediate TUR-P and preferred trial without catheter (TWOC) protocol. The age, PSA, prostate volume, pre- and post-operative flow rates, duration of hospitalization, and complications were recorded. Two groups were constituted for comparison such as AUR and Elective Group and p values <0.05 were considered significant. RESULTS There were 14 and 46 patients for AUR and Elective Groups respectively. The age, pre-operative prostate volume, free and total PSA values, postoperative complication rate, and re-hospitalization rate were significantly higher in the AUR-Group. However, there were no differences between groups in terms of pre-operative medication, duration of hospitalization, and post-operative uroflow maximum flow rate. DISCUSSION Patients who underwent TUR-P after AUR have a higher risk for complications and re-hospitalization. Care should be taken in these patients and patients should be warned about the risks.
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Affiliation(s)
- Caner Baran
- Çukurova State Hospital, Department of Urology, Adana, Turkey
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Balarabe HS, Jeannot BM, Kibansha HM, Isaac E, Kiswezi A. Urethral calculus with a recurrent acute urinary retention in a male child aged 11 years: A case report. Radiol Case Rep 2023; 18:4191-4194. [PMID: 37753501 PMCID: PMC10518677 DOI: 10.1016/j.radcr.2023.08.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/28/2023] Open
Abstract
Urolithiasis is the presence of a stone anywhere in the urinary tract, it is commonly seen in adult patients and rare in children, especially when it is associated with acute urinary retention. In children, history is not suggestive and not specific; diagnosis is made by exclusion, and imaging studies often get the findings as incidental. In this case, the clinical presentation made early diagnosis quite difficult. The management of urethral calculi varies according to the site, size, associated urethral pathology, and available resources. It becomes an emergency when it causes acute urinary obstruction, urethral bleeding, or pain. We present a case report of an 11-year-old male with a history of 3 episodes of acute urinary retention secondary to urethral obstruction by calculi. The period between 1 episode and the next was observed to be approximately 1 year, with no logical explanation. Urethral calculus in children is less frequent than in adults worldwide. Urethral calculi are either formed in the native urethra or migrate from the upper urinary tract. Urgent urinary diversion and removal of the calculus with minimal urethral trauma is the recommended treatment.
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Affiliation(s)
- Hauwa Shitu Balarabe
- Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka Bushenyi, Uganda
| | - Baanitse Munihire Jeannot
- Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka Bushenyi, Uganda
- Faculty of Medicine, Université Catholique la Sapientia de Goma, Goma, Democratic Republic of the Congo
| | - Hope Matumaini Kibansha
- Faculty of Medicine, Makerere University and Mulago National Referral Hospital, Kampala, Uganda
| | - Edyedu Isaac
- Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka Bushenyi, Uganda
| | - Ahmed Kiswezi
- Faculty of Clinical Medicine and Dentistry, Department of Surgery, Kampala International University Western Campus, Ishaka Bushenyi, Uganda
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Yuan P, Xu P, Li X, Shi L, Song D. Advanced penile cancer with multiple metastases and self-amputation of penis: A rare case report. Urol Case Rep 2023; 50:102528. [PMID: 37681115 PMCID: PMC10480546 DOI: 10.1016/j.eucr.2023.102528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/04/2023] [Accepted: 08/13/2023] [Indexed: 09/09/2023] Open
Abstract
Penile cancer is a rare malignancy with poor prognosis. Advanced penile cancer that invades the penile shaft and causes urinary retention could be rarely seen. We reported a 72-year-old male suffered from advanced penile cancer with penile self-amputation and acute urinary retention. We reckoned the self-amputation of penis as a new sign of advanced penile cancer.
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Affiliation(s)
- Pu Yuan
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, Zhengzhou, Henan, China
| | - Peiyuan Xu
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, Zhengzhou, Henan, China
| | - Xinwei Li
- Department of Clinical Medicine, Medical College of Zhengzhou University, No.40 Daxue Bei Road, Zhengzhou, Henan, China
| | - Lei Shi
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, Zhengzhou, Henan, China
| | - Dongkui Song
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, Zhengzhou, Henan, China
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Viegas Madrid V, Peláez Laderas A, Soriano JB, Girón Moreno R, Marcos MC, Sánchez Ramírez A, Bermúdez JA, Olivier Gómez C, López-Fando Lavalle L. Genitourinary tract symptoms in patients admitted with COVID-19: Exploring changes in frequency by determinants and pandemic waves. Continence (Amst) 2023; 5:100572. [PMID: 36589696 PMCID: PMC9793955 DOI: 10.1016/j.cont.2022.100572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Urothelial cells exhibit increased expression of angiotensin-converting enzyme-2 receptor, which is the binding site of severe acute respiratory syndrome coronavirus 2 to cells. The frequency and distribution of genitourinary tract symptoms in patients diagnosed with coronavirus disease 2019 (COVID-19) is unknown. Objective We explored trends in genitourinary tract symptoms by gender and each of six pandemic waves in patients admitted for COVID-19, and related them with severity, death and length of hospitalization. Design Setting and Participants A retrospective study took place in our institution of COVID-19 admitted patients. Only patients with RT-PCR or antigen test confirmed SARS-CoV-2 infection were included. Demographic, clinical, and genitourinary symptoms were explored. Outcome Measurements and Statistical Analysis COVID-19 patients with genitourinary tract symptoms were compared with those without. Statistical comparisons were conducted by parametric and nonparametric tests for quantitative variables, and χ 2 test for qualitative variables. Results and limitations Out of a total of 4,661 COVID-19 patients, genitourinary symptoms were found in 21,1%. These symptoms were more frequent in patients admitted for longer than 30 days, except for urinary incontinence (UI) and erectile dysfunction (ED). Acute kidney injury (AKI) and urinary tract infections (UTI) had a higher presence in the 5th (16.7%; 12.8% respectively) and 3rd wave (13.3%; 12.6% respectively). Genitourinary symptoms were higher for those patients admitted in critical care units. Frequency of AKI, UI, UTI and acute urinary retention (AUR) were higher for patients who were finally deceased (26.2%; 3.5%; 13.6% and 3.6% respectively). Conclusions A high frequency of genitourinary symptoms in patients admitted for COVID-19 was observed, whose frequency and distribution varied according to pandemic waves. Specific genitourinary conditions were associated with worse outcomes and poorer prognosis.
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Affiliation(s)
| | | | - Joan B. Soriano
- Hospital Universitario La Princesa, Pneumology, Madrid, Spain
| | | | | | | | | | | | - Luis López-Fando Lavalle
- Hospital Universitario La Princesa, Urology, Madrid, Spain,Correspondence to: Servicio de Urología. Hospital La Princesa. Calle Diego de León 62. 28006, Madrid
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Corral R, Boissier R, Depaquit TL, Gondran-Tellier B, Bastide C, Lechevallier E, Baboudjian M. Saline bladder infusion vs standard catheter removal in patients with acute urinary retention related to benign prostatic hyperplasia: The BLAPERF Study. Prog Urol 2023; 33:319-324. [PMID: 36842924 DOI: 10.1016/j.purol.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/19/2022] [Accepted: 02/10/2023] [Indexed: 02/28/2023]
Abstract
PURPOSE Bladder infusion, which involves filling the bladder with saline prior to catheter removal, has been associated with reduced time-to-discharge and increased success rates in trials without catheter (TWOCs) in perioperative setting. The objective of this study was to evaluate the applicability of this protocol in patients with acute urinary retention (AUR) related to benign prostatic hyperplasia (BPH). METHODS We conducted a retrospective single-center study comparing bladder infusion with at least 150mL of warm saline vs. standard catheter removal during TWOC in patients with BPH-related AUR between January and December 2021. The primary outcome was time to discharge. Secondary outcomes included: TWOC success, and early recurrence of urinary retention defined as recurrence within three months of successful TWOC. RESULTS A total of 75 men were included: 35 in the bladder infusion protocol and 40 in the standard protocol. Baseline characteristics were well balanced between groups. Overall, 35 patients (46.7%) had a successful TWOC without statistically significant difference between groups (P=0.10). Bladder infusion protocol was associated with a shorter median time to discharge (200 vs. 240min, P=0.003). However, patients in the bladder infusion group were associated with a higher risk of early recurrence of urinary retention (30% vs. 0%, P=0.02). CONCLUSION In patients with BPH-related AUR, the saline bladder infusion method reduced time-to-discharge with similar TWOC success rates. Larger studies are needed to properly analyze the risk of early recurrence of urinary retention before any clinical application. LEVEL OF EVIDENCE III.
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Affiliation(s)
- R Corral
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - R Boissier
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - T L Depaquit
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - B Gondran-Tellier
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - C Bastide
- Department of Urology, North Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - E Lechevallier
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - M Baboudjian
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Department of Urology, North Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France.
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Marchi A, Pellerin O, Querub C, Ahmar MA, Gaeta AD, Déan C, Meria P, Thiounn N, Sapoval M, Boeken T. Long-term outcomes of prostate artery embolization for acute urinary retention: An analysis of 88 patients. Diagn Interv Imaging 2023:S2211-5684(23)00023-2. [PMID: 36801097 DOI: 10.1016/j.diii.2023.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023]
Abstract
PURPOSE The purpose of this study was to assess long-term outcome of prostate artery embolization (PAE) in patients presenting with acute urinary retention related to benign prostatic hyperplasia. MATERIALS AND METHODS All consecutive patients who underwent PAE for acute urinary retention due to benign prostatic hyperplasia from August 2011 to December 2021 in a single institution were retrospectively included. There were 88 men with a mean age of 72 ± 12 (standard deviation [SD]) years (range: 42-99 years). Patients underwent a first attempt of catheter removal two weeks after PAE. Clinical success was defined as the absence of acute urinary retention recurrence. Correlations between long-term clinical success and patient variables or bilateral PAE were searched for using Spearman correlation test. Catheter-free survival was assessed using Kaplan-Meier analysis. RESULTS Successful catheter removal in the month following PAE was performed in 72 (72/88; 82%) patients and 16 (16/88; 18%) patients had immediate recurrence. Clinical success persisted for 58 (58/88; 66%) patients at long-term follow-up (mean follow-up: 19.5 months ± 16.5 [SD]; range: 2-74 months). Recurrence occurred at a mean of 16.2 months ± 12.2 (SD) (range: 1.5-43 months) post-PAE. Overall, 21 (21/88; 24%) patients of the cohort underwent prostatic surgery, at a mean of 10.4 months ± 12.2 (SD) (range: 1.2-42.4 months) from initial PAE. No correlations between patients variables or bilateral PAE and long-term clinical success were identified. Kaplan-Meier analysis showed a three-year catheter free probability of 60%. CONCLUSION PAE is a valuable technique for acute urinary retention related to benign prostatic hyperplasia, with a long-term success rate of 66%. However acute urinary retention relapse affects 15% of patients.
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Yee CH, Tang SF, Yuen SK, Chan CK, Teoh JYC, Chiu PKF, Ng CF. Technique, outcome and changes in prostate dimensions in patients with urinary retention managed by aquablation. Int Urol Nephrol 2022. [PMID: 35622268 DOI: 10.1007/s11255-022-03244-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/04/2022] [Indexed: 11/12/2022]
Abstract
Purpose This study aimed to investigate the functional and urodynamic outcome of Aquablation in patients with acute urinary retention (AUR) on catheters. Methods Men aged 50–70 who failed medical treatment of BPO with AUR failing to wean off urethral catheter were recruited to undergo Aquablation. Individuals were assessed pre-operatively and at 3 and 6 months after surgery. The primary outcome was defined by the success rate of weaning off catheter. Secondary outcomes were measured by a change in prostate size, symptom scores and urodynamic parameters. Results Twenty patients underwent Aquablation between June 2019 and September 2020. Mean duration of the urethral catheter in-situ was 5.9 ± 4.9 weeks and mean prostate size of the cohort pre-operatively was 60.8 ± 15.8 cc. A second pass Aqaublation treatment was performed in 14 patients. Five patients failed to wean off the catheter on the first attempt after surgery, requiring another attempt 1 week later which were all successful. At 3 months after the operation, a significant reduction in prostate volume was observed (60.8 ± 15.8 cc vs 24.9 ± 10.3 cc, p < 0.001). No change in international index of erectile function (IIEF) was found (baseline: 16.1 ± 5.8; 3-month: 14.9 ± 6.4; p = 0.953). Mean bladder outlet obstruction index was 14.2 ± 23.0 at 6 months upon urodynamic assessment with 75% of patients had a resolution of detrusor overactivity. Reduction in prostate length was found to be more significant than a reduction in width and height after Aquablation (R = 0.693, p = 0.039). Conclusion From the early data of a single centre, Aquablation was shown to provide a consistent improvement in symptoms, uroflowmetry and urodynamic parameters in patient with a urethral catheter. Results from our study suggest that improvement from Aquablation is reproducible in patients with AUR. Supplementary Information The online version contains supplementary material available at 10.1007/s11255-022-03244-y.
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Guzmán-Esquivel J, Farias-Mendoza KE, Ortega-Ortíz JG, Delgado-Enciso I, Murillo-Zamora E, Guzmán-Solórzano JA, Ochoa-Castro MR. Association of acute urinary retention in postoperative patients with a urinary catheter, with and without bladder catheter clamping. ARCH ESP UROL 2021; 74:747-751. [PMID: 34605414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The use of a temporaryor permanent catheter is very common in clinical practice. Between 15.0% and 25.0% of hospitalized patients have in-dwelling bladder catheters, the majority of which are short-term. Bladder catheter clamping before catheter removal was generally regarded as useful in the past. Today, its utility is questionable. OBJECTIVE To determine the association between bladder catheter clamping and spontaneous micturition or acute urinary retention (AUR) in postoperative patients with short-term indwelling bladder catheter. MATERIALS AND METHODS A descriptive, comparative,longitudinal study was conducted at a secondary care hospital center in a western Mexican state .AUR was the outcome variable. Two study groups wereformed: patients with bladder catheter clamping (n=43) and the control patients with no bladder catheter clamping (n=41). Descriptive statistical analyses were performed, and percentage comparisons were made with the chi-squaretest. Significant predictors were subsequently added to the multivariate model. RESULTS Fourteen percent (n=12) of all the study patients, with and without bladder catheter clamping, presented with AUR and 86% (n=72) did not. In the association analysis, there was no statistically significant difference between presenting with AUR and having or not having bladder catheter clamping (p=0.59). The associations of AUR with bladder re-catheterization (p=0.001), age (p=0.01), and the presence of lower urinary symptoms (p= 0.005) were statistically significant. CONCLUSION Postoperative bladder catheter clamping was not associated with the presence of AUR.
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Affiliation(s)
- José Guzmán-Esquivel
- Unidad de Investigación en Epidemiología Clínica. Instituto Mexicano del Seguro Social. Colima. México
| | | | | | - Iván Delgado-Enciso
- Instituto Estatal de Cancerología de los Servicios de Salud del Estado de Colima. Colima. México
| | - Efrén Murillo-Zamora
- Departamento de Epidemiología. Unidad de Medicina Familiar No. 19. Instituto Mexicano del Seguro Social. Colima. México
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Awowole IO, Adenikinju WS, Ubom AE, Fadare OO. Acute Urinary Retention due to Haematometrocolpos from Imperforate Hymen in a Pubescent Nigerian Girl. West Afr J Med 2021; 38:900-902. [PMID: 34677835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Cryptomenorrhoea is an uncommon gynaecological condition in the adolescent age group. While cyclical abdominal pain is the usual clinical symptom, patients with atypical presentation require a high index of suspicion and meticulous evaluation. OBJECTIVE This case report describes atypical presentation of haematometrocolpos in a pubescent Nigerian female. METHODS A case of acute urinary retention in an adolescent girl, due to haematometrocolpos, is presented. A 13-year-old supposedly premenarcheal girl presented at the Children Emergency Unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria with acute urinary retention of twelve hours' duration. There was no preceding history of difficulty with voiding. About 1,200mls of urine was drained from the bladder with a self-retaining catheter. Examination revealed an 18-week-sized cystic abdomino-pelvic mass, and the vagina was closed with a bulging membrane at the introitus. Abdomino-pelvic ultrasonography revealed a distended uterus containing fluid with low level echo, typifying the ground-glass appearance. Trans-hymenal ultrasonography using a 2.5-7.5MHz endocavitary probe confirmed a ballooned-out vagina with similar content, with a 2mm thick hymen at the distal end. RESULTS Hymenectomy was performed with spontaneous drainage of the menstruum. She was discharged after successful trial of voiding without catheter. CONCLUSION Though uncommon, haematometrocolpos from lower genital obstruction should be considered as a differential diagnosis of lower urinary tract obstruction in pubescent girls. Trans-hymenal ultrasonography is accessible and accurate for assessing the level of obstruction and the thickness of the intervening tissue.
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Affiliation(s)
- I O Awowole
- Department of Obstetrics and Gynaecology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
- Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - W S Adenikinju
- Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - A E Ubom
- Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - O O Fadare
- Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
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Kenzaka T, Goda K, Kumabe A. Meningitis retention syndrome caused by varicella zoster virus in a patient without a rash: a case report. BMC Infect Dis 2021; 21:996. [PMID: 34556030 PMCID: PMC8461943 DOI: 10.1186/s12879-021-06692-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/14/2021] [Indexed: 11/23/2022] Open
Abstract
Background Meningitis retention syndrome (MRS) is a rare condition that presents with acute urinary retention as a complication of aseptic meningitis. Cases of MRS due to varicella zoster virus (VZV) infection without a rash are rare. We report the case of a patient who had no signs of meningitis or VZV infection, including a rash. Case presentation A 58-year-old man presented with dysesthesia of the lower limbs and acute urinary retention. He had fever but no rash and no signs of meningitis. He was diagnosed to have VZV infection based on the detection of VZV DNA in the cerebrospinal fluid. He responded satisfactorily to a course of intravenous acyclovir and experienced no sequelae during a 2-year follow-up period. Conclusion MRS due to aseptic meningitis of viral origin should be considered in the differential diagnosis of acute urinary retention even in the absence of specific signs and symptoms of meningitis or a suggestive rash.
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Affiliation(s)
- Tsuneaki Kenzaka
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tanba, Japan. .,Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, 2-1-5, Arata-cho, Hyogo-ku, Kobe, Hyogo, 652-0032, Japan.
| | - Ken Goda
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tanba, Japan.,Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, 2-1-5, Arata-cho, Hyogo-ku, Kobe, Hyogo, 652-0032, Japan
| | - Ayako Kumabe
- Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, 2-1-5, Arata-cho, Hyogo-ku, Kobe, Hyogo, 652-0032, Japan
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Baboudjian M, Savoie PH, Long JA, Boissier R. [Acute urine retention: Epidemiology, optimization of the care pathway and alternative to permanent bladder drainage]. Prog Urol 2021; 31:967-977. [PMID: 34420877 DOI: 10.1016/j.purol.2021.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/10/2021] [Accepted: 07/15/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this narrative review was to report the most relevant data on the contemporary management of Acute Urine Retention (AUR). METHODS A narrative synthesis of the articles in French and English available on the Pubmed database was carried out in June 2021. We explored the registry of Surveillance sanitaire des urgences et des décès (SurSaUD®, Santé Publique France) to rise original data regarding the epidemiology of AUR in France. RESULTS AUR is a therapeutic emergency that requires a rapid bladder drainage. The average age is 71 years, 87 % are men and the stay in the emergency department is >4hours. In France, the hospitalization rate for UAR is steadily decreasing from 42% in 2014 to 32% in 2019. The introduction of an α-blocker increases the chances to get rid of the urinary catheter of 47% to 77% versus placebo. A post-emergency AUR pathway allows lowering the number of people lost with follow-up and shortening the duration of bladder drainage. The first try for catheter removal should be organized within 48-72hours of the AUR. In case of unsuccessful catheter removal, it is recommended to teach self-catheterization to the patient. The placement of a temporary prostatic stent is a promising alternative that is under evaluation. Immediate surgery is associated with increased morbidity/mortality and is not recommended. CONCLUSION AUR is a common disease. The management has been optimized in recent years to improve the prognosis and the quality of life of patients.
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Affiliation(s)
- Michael Baboudjian
- Service d'urologie et de transplantation Rénale, CHU La Conception, AP-HM, Marseille, France
| | - Pierre Henri Savoie
- Service d'urologie, hôpital d'instruction des Armées Sainte Anne, Toulon, France
| | - Jean-Alexandre Long
- Service d'urologie et de la transplantation rénale, CHU Grenoble, France; TIMC-IMAG CNRS 5525, Grenoble, France
| | - Romain Boissier
- Service d'urologie et de transplantation Rénale, CHU La Conception, AP-HM, Marseille, France.
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14
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Abstract
INTRODUCTION To report the epidemiology and the care pathway for urological emergencies in France for the official report of the 115th Congres Francais d'Urologie. METHODS We made a request to the Institut de Veille Sanitaire and its network Surveillance Sanitaire des Urgences et des Décès (SurSaUD®). Within this system, the OSCOUR® network (Organisation de la surveillance coordonnée des urgences) centralizes in real time the data of emergency visits from more than 720 emergency departments throughout the national territory (>93% of the national territory covered by the OSCOUR® network). For each emergency defined by its CIM-10 code, the following data were collected from 2014 to 2019: age, gender, length of stay and post-emergency status (hospitalization vs. return home). RESULTS From 2014 to 2019, urological emergencies represented on average 4.2% of all emergencies, with an average 591,080±66,782 passages/year including 25% that resulted in hospitalization. Infectious disease represented 35% of all urological emergencies. The 3 most common urologic emergencies were: renal colic, acute urine retention and hematuria for men; acute cystitis, pyelonephritis and renal colic for women. CONCLUSION In an analysis of the OSCOUR® (Organisation de la surveillance coordonnée des urgences) registry, we determined the epidemiological profiles of the main urological emergencies with contemporary data.
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Affiliation(s)
- R Boissier
- Université Aix-Marseille, Service d'Urologie et de transplantation Rénale, CHU La Conception, AP-HM, Marseille, France.
| | - P H Savoie
- Service d'urologie, Hôpital d'Instruction des Armées Sainte Anne, BP 600, 83800 Toulon cedex 09, France
| | - J-A Long
- Service d'urologie et de la transplantation rénale, CHU Grenoble, France; TIMC-IMAG CNRS 5525, France
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15
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Noh TI, Shim JS, Kang SG, Kang SH, Cheon J, Lee JG. Effects of β3-adrenoceptor agonist on acute urinary retention in a rat model. World J Urol 2021. [PMID: 34304275 DOI: 10.1007/s00345-021-03774-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/21/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To investigate the protective effect of mirabegron on bladder dysfunction in an acute urinary retention rat model. MATERIALS AND METHODS Thirty-six 16-week Sprague-Dawley rats were assigned to the mirabegron and normal saline (N/S) groups. Each group of eighteen was divided into sub-groups of 6 for 30 min, 2 h, and 24 h. They were administered mirabegron (10 mg/kg) and N/S daily for 4 weeks, respectively. Mirabegron and N/S groups were divided into sub-groups of 6 rats for 30 min, 2 h, and 24 h. The changes in bladder blood flow were measured using laser Doppler (moorVMS-LDF2). Histopathological examination of the bladder and nitric oxide (NO) measurement were performed. RESULT During the urinary retention phase in the mirabegron group, it showed higher and rapider recovery of blood flow; the lowest at 19.5% ± 3.68% at 3 min, a significant recovery from the lowest value as 23.7 ± 3.4% at 10 min, than that in the N/S group; 15.1 ± 1.84% at 5 min, 23.7 ± 3.4% at 20 min, respectively (P < 0.05). At 30 min, 120 min, and 24 h after reperfusion, the recovery of blood flow in the mirabegron group was significantly higher than that in the N/S group (mirabegron: 41.1 ± 1.7%, 59.9 ± 7.2%, and 89.7 ± 4.4%, N/S: 31.3 ± 2.1%, 47.3 ± 4.5%, 83.9 ± 3.6%, respectively (P < 0.05)). NO levels tended to be higher in the mirabegron group; however, the difference was not statistically significant. Histological examination revealed that the mirabegron group showed recovery close to normal tissue after 24 h. CONCLUSIONS In an acute urinary retention rat model, mirabegron maintained and restored higher bladder blood flow, resulting in protective and recovery effect after acute urinary retention.
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Baboudjian M, Alegorides C, Fourmarier M, Atamian A, Gondran-Tellier B, Andre M, Arroua F, Boissier R, Eghazarian C, Vidal V, Chevrot A, Droupy S, Lechevallier E. Comparison of water vapor thermal therapy and prostate artery embolization for fragile patients with indwelling urinary catheters: Preliminary results from a multi-institutional study. Prog Urol 2021; 32:115-120. [PMID: 34148768 DOI: 10.1016/j.purol.2021.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/05/2021] [Accepted: 03/08/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To report our preliminary experience with water vapor thermal therapy with the Rezūm™ System and Prostate Artery Embolization (PAE) for treatment of medically refractory, complete urinary retention to achieve successful cessation of catheter dependency in frail-patients. PATIENTS AND METHODS A multi-institutional study was conducted including all patients who underwent Rezūm™ procedure and PAE between October 2017 and June 2020. The included population focused on frail-patients unsuitable for conventional surgery with complete urinary retention. Rezūm™ patients were identified and matched (1:1) with patients who underwent PAE. The matching criteria were age, Charlson score, prostate volume and duration of follow-up. The primary outcome was catheter-free survival, defined as spontaneous voiding and release from catheter dependence. RESULTS Eleven patients from the Rezūm™ group were matched to 11 embolized patients. PAE and Rezūm™ patients were comparable in age (median: 77 vs. 75 years), Charlson score (median: 6 vs. 6) and prostate volume (74 vs. 60 cc). Procedures were significantly longer in the PAE group compared to the Rezūm™ procedures (median: 148 vs. 8min, P<0.001). After a median follow-up of 12 months, spontaneous voiding was conserved in all cases (100%) after the Rezūm™ procedure and in 5 cases (45.4%) after PAE (P=0.01). In catheter-free patients, the rate of benign prostatic hyperplasia medication use after procedure was 40% for PAE and 18.2% for Rezūm™ patients (P=0.54). CONCLUSIONS Our preliminary experience for treatment of complete urinary retention in frail-patients shows the feasibility of PAE and Rezūm™ to restore spontaneous urination without being associated with the occurrence of major complications. Early data suggests that Rezūm™ may provide superior results in terms of cessation of catheter dependence. Future studies are needed to definitively assess which treatment would be best suited for each patient. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- M Baboudjian
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, AP-HM, Marseille, France; Department of Urology, Hospital of Aix en Provence, Aix en Provence, France.
| | - C Alegorides
- Department of Urology, Hospital of Aix en Provence, Aix en Provence, France
| | - M Fourmarier
- Department of Urology, Hospital of Aix en Provence, Aix en Provence, France
| | - A Atamian
- Department of Urology, Hospital of Aix en Provence, Aix en Provence, France
| | - B Gondran-Tellier
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - M Andre
- Department of Radiology and Medical imaging, La Timone Academic Hospital, Aix-Marseille University, AP-HM, Marseille, France; European Center for Medical Imaging Research CERIMED/LIIE, Marseille, France
| | - F Arroua
- Department of Urology, Hospital of Aix en Provence, Aix en Provence, France
| | - R Boissier
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - C Eghazarian
- Department of Urology, Hospital of Aix en Provence, Aix en Provence, France
| | - V Vidal
- Department of Radiology and Medical imaging, La Timone Academic Hospital, Aix-Marseille University, AP-HM, Marseille, France; European Center for Medical Imaging Research CERIMED/LIIE, Marseille, France
| | - A Chevrot
- Department of Urology, Hospital Universitaire Carémeau de Nimes, Nimes, France
| | - S Droupy
- Department of Urology, Hospital Universitaire Carémeau de Nimes, Nimes, France
| | - E Lechevallier
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, AP-HM, Marseille, France
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Abstract
Acute urinary retention (AUR) is the sudden inability to pass urine. AUR is more common in men and older men are at highest risk. The most common causes are obstructive in nature-prostatic hyperplasia is responsible for more than half the cases of AUR in men. AUR can also be caused by infection, inflammation, and by iatrogenic and neurological problems. This article outlines how AUR is diagnosed and treated.
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Houcem H, Yassine O, Aziz K, Zied M, Beya C, Yassine N. A rare case of acute urinary retention in a woman caused by primary retro vesical hydatid cyst. Urol Case Rep 2021; 36:101589. [PMID: 33643849 PMCID: PMC7889818 DOI: 10.1016/j.eucr.2021.101589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/24/2021] [Accepted: 01/27/2021] [Indexed: 11/22/2022] Open
Abstract
Hydatid disease is a parasitic infestation that is endemic in many sheep and cattle-raising geographic areas including Mediterranean countries. Primary retro vesical hydatid cyst is a very rare entity. It can be revealed by urinary and gynecological signs. We reported a case of a retro vesical hydatid cyst in a 67-years old woman revealed by an acute urinary retention.
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D'Agate S, Chavan C, Manyak M, Palacios-Moreno JM, Oelke M, Michel MC, Roehrborn CG, Della Pasqua O. Impact of early vs. delayed initiation of dutasteride/tamsulosin combination therapy on the risk of acute urinary retention or BPH-related surgery in LUTS/BPH patients with moderate-to-severe symptoms at risk of disease progression. World J Urol 2021; 39:2635-43. [PMID: 33337513 DOI: 10.1007/s00345-020-03517-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/30/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose To evaluate the effect of delayed start of combination therapy (CT) with dutasteride 0.5 mg and tamsulosin 0.4 mg on the risk of acute urinary retention or benign prostatic hyperplasia (BPH)-related surgery (AUR/S) in patients with moderate-to-severe lower urinary tract symptoms (LUTS) at risk of disease progression. Methods Using a time-to-event model based on pooled data from 10,238 patients from Phase III/IV dutasteride trials, clinical trial simulations (CTS) were performed to assess the risk of AUR/S up to 48 months in moderate-to-severe LUTS/BPH patients following immediate and delayed start of CT for those not responding to tamsulosin monotherapy. Simulation scenarios (1300 subjects/arm) were investigated, including immediate start (reference) and alternative delayed start (six scenarios 1–24 months). AUR/S incidence was described by Kaplan–Meier survival curves and analysed using log-rank test. The cumulative incidence of events as well as the relative and attributable risks were summarised stratified by treatment. Results Survival curves for patients starting CT at month 1 and 3 did not differ from those who initiated CT immediately. By contrast, significant differences (p < 0.001) were observed when switch to CT occurs ≥ 6 months from the initial treatment. At month 48, AUR/S incidence was 4.6% vs 9.5%, 11.0% and 11.3% in patients receiving immediate CT vs. switchers after 6, 12 and 24 months, respectively. Conclusions Start of CT before month 6 appears to significantly reduce the risk of AUR/S compared with delayed start by ≥ 6 months. This has implications for the treatment algorithm for men with LUTS/BPH at risk of disease progression. Electronic supplementary material The online version of this article (10.1007/s00345-020-03517-0) contains supplementary material, which is available to authorized users.
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20
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Au VH, Kazi A, Bruha M, Weiss J. Herpes-zoster associated urinary retention in a 57-year-old immunocompromised male. Urol Case Rep 2021; 34:101498. [PMID: 33294380 DOI: 10.1016/j.eucr.2020.101498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 11/21/2022] Open
Abstract
Herpes zoster-associated urinary retention is a rare but acknowledged phenomenon. It is usually a bladder areflexia resulting from a viral infection in the sacral dermatomes. We describe a 57-year-old immunosuppressed male patient with delayed urinary retention, following an outbreak of shingles in the setting of supratherapeutic immunosuppressive medications and poorly-controlled diabetes mellitus. The patient received a foley catheter, failed a trial of void in the acute treatment setting, completed zoster treatment with antivirals and corticosteroids, and fully recovered bladder function 6 weeks later.
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21
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Schmidt AM, Hirsch K, Schroth M, Stehr M, Schäfer FM. Acute urinary retention in children. J Pediatr Urol 2020; 16:842.e1-842.e6. [PMID: 32900634 DOI: 10.1016/j.jpurol.2020.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/15/2020] [Accepted: 08/15/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Acute urinary retention is a common emergency in adult patients, foremost in older men. In childhood urinary retention is a rare entity with only sparse literature on the etiology. OBJECTIVE To assess the etiology and treatment of acute urinary retention in the pediatric population and assess age and sex distribution. STUDY DESIGN A retrospective analysis of all patients admitted to our emergency department with acute urinary retention between 2005 and 2019 was performed. Exclusion criteria were newborns (because of physiologic postnatal oliguria) and postoperative urinary retention during the same hospital stay. RESULTS 113 children with acute urinary retention (ICD: R33) meeting the above criteria were identified. 16 Patients were excluded because of incomplete medical charts. 97 children were included into the study (age 0.5-18.3 years, mean age 5.3 years). 89 patients had one episode, 8 patients two episodes. A peak around the third year of age was observed. Sex ratio showed a 2:1 male to female distribution. Most common etiology was balanoposthitis (15.5%) and acute constipation/fecal impaction (15.5%). Traumatic urinary retention was found in 11.4% of the cases. Urinary tract infection were found 7.2%. No underlying reason could be found in 12.4% (idiopathic urinary retention). Other causes included febrile non-urinary infection (8.2%), subvesical obstruction (4.1%), vulvovaginitis (3.1%) and urethritis (2.1%). In 50% of the cases of urinary retention under 1 year of age (2 out of 4) an underlying tumor (rhabdomyosarcoma, sacral teratoma) was identified. DISCUSSION Age and sex distribution were similar to previously published series; however, this study shows a marked difference concerning the etiology: e. g. we identified a significantly higher proportion of functional disorders as a reason for acute urinary retention in childhood. It is hypothesized that this is partly because previously published studies originate from areas (USA, Israel, Iran) with different socio-demographic and cultural background. CONCLUSION AUR in children is a rare condition with very heterogeneous causes. Although the majority of cases exhibit mild underlying conditions, serious reasons, such as malignant diseases especially in the first year of life, must be excluded. AUR relief without catheterization is a child-friendly approach in cases of mild inflammatory or functional disorders and can help to minimize traumatization.
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Affiliation(s)
- Ana-Marija Schmidt
- Department of Pediatric Surgery and Pediatric Urology, Cnopfsche Kinderklinik, St. Johannis-Mühlgasse 19, 90419, Nürnberg, Germany
| | - Karin Hirsch
- Department of Urology and Pediatric Urology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany
| | - Michael Schroth
- Department of Pediatrics and Pediatric Emergency Care, Cnopfsche Kinderklinik, St. Johannis-Mühlgasse 19, 90419, Nürnberg, Germany
| | - Maximilian Stehr
- Department of Pediatric Surgery and Pediatric Urology, Cnopfsche Kinderklinik, St. Johannis-Mühlgasse 19, 90419, Nürnberg, Germany
| | - Frank-Mattias Schäfer
- Department of Pediatric Surgery and Pediatric Urology, Cnopfsche Kinderklinik, St. Johannis-Mühlgasse 19, 90419, Nürnberg, Germany.
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22
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Sini I, Birowo P, Hapsari K, Handayani N, Indra BD. Robotic myomectomy for a non-pregnant reproductive age woman with severe acute urinary retention: A case report. Urol Case Rep 2020; 33:101423. [PMID: 33102120 PMCID: PMC7574287 DOI: 10.1016/j.eucr.2020.101423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 11/20/2022] Open
Abstract
Urinary retention in non-pregnant reproductive age women is a very rare condition. Hereby, we reported a rare case of acute urinary retention in a non-pregnant reproductive-age woman with hydronephrosis and hydroureter due to a large fibroid. The fibroid had resulted in constant pressure to the urethral sphincter, which causes urinary retention. Robotic myomectomy was performed after insertion of ureteric catheters. To our knowledge, this is the first case report of a robotic surgery being utilised to manage acute urinary retention in a non-pregnant individual due to large fibroid. We reported a rare case of acute urinary retention in a non-pregnant reproductive-age woman due to a large fibroid. Robotic surgery is an effective tool in management of acute cases.
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Affiliation(s)
- Ivan Sini
- IRSI Research and Training Centre, Jakarta, Indonesia.,Bunda General Hospital, Jakarta, Indonesia
| | - Ponco Birowo
- Department of Urology, Faculty of Medicine, University of Indonesia, Depok, Indonesia.,Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Kartika Hapsari
- Radboud Institute for Molecular Life Sciences, Radboudumc, Radboud University, the Netherlands.,Department of Obstetrics and Gynecology, Harapan Kita National Women and Children Hospital, Jakarta, Indonesia
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Roulet M, Delbarre B, Vénara A, Hamy A, Barbieux J. Urine drainage management in colorectal surgery. J Visc Surg 2020; 157:309-316. [PMID: 32446914 DOI: 10.1016/j.jviscsurg.2020.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Enhanced recovery programs (ERP) is aimed at reducing a patient's surgical stress response, specifically by reducing the duration of catheterization. In cases of colorectal surgery, there is pronounced heterogeneity in urinary catheterization, which is largely explained by fear of acute urinary retention (AUR). OBJECTIVE The objective of the work is to report on the current literature on postoperative urinary catheterization following colorectal surgery, particularly with regard to the risk of AUR, and thereby contribute to the standardization of perioperative practices. RESULTS In colon surgery without preoperative urinary disorders, catheterization must not exceed 24h. In rectal surgery, catheter removal starting on postoperative D2 seems reasonable in the absence of AUR risk factor (RF). Male sex, past history of lower urinary tract obstruction, abdomino-perineal amputation (APA) and low rectal anastomosis are AUR risk factors that must be taken into account when deciding to withdraw the urinary catheter. While the role of a suprapubic catheter is not clearly defined, it may be of use following APA. The epidural catheter is another AUR risk factor, but it seems possible to withdraw the urinary catheter on postoperative D1, before the epidural catheter, provided that the other risk factors have been taken into full account. Lastly, up until now no satisfactorily conducted study has assessed the prophylactic value of systematic perioperative alpha-blocker treatment in colorectal surgery.
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Affiliation(s)
- M Roulet
- Service de chirurgie viscérale et endocrinienne, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
| | - B Delbarre
- Service de chirurgie urologique, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - A Vénara
- Service de chirurgie viscérale et endocrinienne, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - A Hamy
- Service de chirurgie viscérale et endocrinienne, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - J Barbieux
- Service de chirurgie viscérale et endocrinienne, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
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Lee Y, McKechnie T, Springer JE, Doumouras AG, Hong D, Eskicioglu C. Optimal timing of urinary catheter removal following pelvic colorectal surgery: a systematic review and meta-analysis. Int J Colorectal Dis 2019; 34:2011-2021. [PMID: 31707560 DOI: 10.1007/s00384-019-03404-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2019] [Indexed: 02/04/2023]
Abstract
PURPOSE Acute urinary retention (AUR) is a common postoperative complication in colorectal surgery. In pelvic colorectal operations, the optimal duration for postoperative urinary catheter use is controversial. This systematic review and meta-analysis aims to compare early (POD 1), intermediate (POD 3), and late (POD 5) urinary catheter removal. METHODS Medline, EMBASE, CENTRAL, and PubMed databases were searched. Articles were eligible for inclusion if they compared patients with urinary catheter removal on POD 1 or earlier to patients with urinary catheter removal on POD 2 or later in major pelvic colorectal surgeries. The primary outcome was rate of postoperative AUR. The secondary outcome was rates of postoperative urinary tract infection (UTI). RESULTS From 691 relevant citations, five studies with 928 patients were included. Comparison of urinary catheter removal on POD 1 versus POD 3 demonstrated no significant difference in rate of urinary retention (RR 1.36, 95%CI 0.83-2.21, P = 0.22); however, compared to POD 5, rates of AUR were significantly higher (RR 2.58, 95%CI 1.51-4.40, P = 0.0005). Rates of UTI were not significantly different between POD 1 and POD 3 urinary catheter removal (RR 0.40, 95%CI 0.05-3.71, P = 0.45), but removal on POD 5 significantly increased risk of UTI compared to POD 1 (RR 0.50, 95%CI 0.31-0.81, P = 0.005). CONCLUSION Risk of AUR can be minimized with late postoperative urinary catheter removal compared to early removal, but at the cost of increased risk of UTI. Patient-specific factors should be taken into consideration when deciding upon optimal duration of postoperative urinary catheterization.
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Affiliation(s)
- Yung Lee
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Tyler McKechnie
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Jeremy E Springer
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Aristithes G Doumouras
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Division of General Surgery, Department of Surgery, St. Joseph Healthcare, Hamilton, Ontario, Canada
| | - Dennis Hong
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Division of General Surgery, Department of Surgery, St. Joseph Healthcare, Hamilton, Ontario, Canada
| | - Cagla Eskicioglu
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
- Division of General Surgery, Department of Surgery, St. Joseph Healthcare, Hamilton, Ontario, Canada.
- Division of General Surgery Department of Surgery, St. Joseph's Healthcare, McMaster University, 50 Charlton Avenue East, Hamilton, Ontario, L8N 4A6, Canada.
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25
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Kenny AG, Pellerin O, Amouyal G, Desgranchamps F, Méria P, De Gouvello A, Dariane C, Déan C, Pereira H, Thiounn N, Sapoval M. Prostate Artery Embolization in Patients With Acute Urinary Retention. Am J Med 2019; 132:e786-90. [PMID: 31103644 DOI: 10.1016/j.amjmed.2019.04.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/09/2019] [Accepted: 04/16/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND This prospective study assessed the efficacy of prostate artery embolization after failure of a trial without catheter in patients suffering a first episode of acute urinary retention as a result of benign prostatic hyperplasia (BPH). METHODS Patients with failure of a trial without catheter despite alpha-blocker therapy were invited to participate in this protocol. Twenty patients were included in the study, and all underwent prostate artery embolization with calibrated polyvinyl alcohol (PVA) microspheres (Bead Block, BTG Ltd., Farnham, UK). RESULTS Successful removal of the indwelling bladder catheter and spontaneous voiding was achieved in 15 of 20 (75%) patients, and the overall clinical success at 6 months after prostate embolization was 14 of 20 (70%). No patient experienced severe adverse events. CONCLUSIONS Prostate artery embolization might be a valuable treatment after a failure of a trial without catheter. Further studies are needed to better define its place in this setting.
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26
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Xu L, Tao ZY, Lu JY, Zhang GN, Qiu HZ, Wu B, Lin GL, Xu T, Xiao Y. A single-center, prospective, randomized clinical trial to investigate the optimal removal time of the urinary catheter after laparoscopic anterior resection of the rectum: study protocol for a randomized controlled trial. Trials 2019; 20:133. [PMID: 30770766 PMCID: PMC6377729 DOI: 10.1186/s13063-019-3210-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 01/18/2019] [Indexed: 01/28/2023] Open
Abstract
Background Urinary catheter placement is essential before laparoscopic anterior resection for rectal cancer. Whether early removal of the catheter increases the incidence of urinary retention and urinary tract infection (UTI) is not clear. This study aims to determine the optimal time for removal of the urinary catheter after laparoscopic anterior resection of the rectum. Methods/design A total of 220 participants meeting the inclusion criteria will be randomly assigned to an experimental group or a control group. The experimental group will have their urethral catheters removed on postoperative day 2 and the control group will have their urethral catheters removed on postoperative day 7. In both groups, catheter removal will be performed when the bladder is full. The incidence of urinary retention and UTI in the two groups will be compared to determine the optimal catheter removal time. Discussion This is a prospective, single-center, randomized controlled trial to determine whether early removal of the urinary catheter after laparoscopic anterior resection of the rectum will help to decrease the incidence of postoperative acute urinary retention and UTI. Trial registration ClinicalTrials.gov, NCT03065855. Registered on 23 February 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3210-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lai Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Zhi-Yan Tao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Jun-Yang Lu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Guan-Nan Zhang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Hui-Zhong Qiu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Bin Wu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Guo-Le Lin
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Tao Xu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, #5 Dongdan San Tiao, Beijing, 100005, People's Republic of China
| | - Yi Xiao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, People's Republic of China.
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Shields LB, Peppas DS, Rosenberg E. Pelvic neuroblastoma presenting with acute urinary retention and acute kidney injury. Urol Case Rep 2019; 23:82-84. [PMID: 30719406 PMCID: PMC6350374 DOI: 10.1016/j.eucr.2019.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/21/2018] [Accepted: 01/08/2019] [Indexed: 11/27/2022] Open
Abstract
Neuroblastomas are tumors that arise from primitive sympathetic ganglion cells and are rarely seen in the pelvic region. Neuroblastomas are the most common extracerebral solid tumors in children under the age of five years. Acute urinary retention due to extrinsic compression from a pelvic mass is a rare phenomenon in infants. Pelvic neuroblastoma may cause acute urinary retention and acute kidney injury.
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Affiliation(s)
- Lisa B.E. Shields
- Norton Neuroscience Institute, Norton Healthcare, Louisville, KY, 40202, USA
| | - Dennis S. Peppas
- Norton Children's Urology, Norton Healthcare, Louisville, KY, 40207, USA
| | - Eran Rosenberg
- Norton Children's Urology, Norton Healthcare, Louisville, KY, 40207, USA
- Corresponding author. Norton Children's Urology, Norton Healthcare, Norton Medical Plaza 3 – St. Matthews, 4123 Dutchmans Lane, Suite 102, Louisville, KY, 40207, USA.
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Shokrpour M, Shakiba E, Sirous A, Kamali A. Evaluation the efficacy of prophylactic tamsulosin in preventing acute urinary retention and other obstructive urinary symptoms following colporrhaphy surgery. J Family Med Prim Care 2019; 8:722-727. [PMID: 30984702 PMCID: PMC6436324 DOI: 10.4103/jfmpc.jfmpc_18_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and Aim: Postoperative urinary retention (POUR) is defined as a disability in urinary excision after surgery. There are several strategies to prevent POUR, such as tamsulosin, which is a selective antagonist at alpha-1A and alpha-1B-adrenoceptors which reduces the bladder outlet resistance. The aim of this study was to investigate the efficacy of prophylactic tamsulosin in preventing acute urinary retention and other obstructive urinary symptoms following colporrhaphy surgery. Materials and Methods: This study was a randomized, double-blind clinical trial. A total of 130 patients who were candidates for colporrhaphy were divided into two groups: the intervention group (65 subjects received 0.4 mg tamsulosin in a single dose at the time of sleeping) and the control group (65 subjects received placebo at the same time as the intervention group). The incidence of acute urinary retention and other obstructive urethral symptoms and the mean urination volume after catheterization were recorded 24 h after operation. Patients’ demographic and clinical data were analyzed using SPSS version 20 software using Chi-square and Fisher's tests. Results: There was a significant difference in the incidence of acute urinary retention, decrease in urine flow diameter, and the mean residual urine volume Post Void Residual (PVR) in the bladder, and the incidence of these symptoms decreased in the tamsulosin recipient group. The incidence of other symptoms of acute urinary retention was not significantly different when compared between both the groups. Conclusion: It seems that the use of prophylactic tamsulosin is more effective in decreasing the incidence of acute urinary retention, decreasing the PVR in the bladder, and decreasing the diameter of the urine flow in patients after colporrhaphy.
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Affiliation(s)
- Maryam Shokrpour
- Department of Gynecology, Arak University of Medical Sciences, Arak, Iran
| | - Elmira Shakiba
- Department of Gynecology, Arak University of Medical Sciences, Arak, Iran
| | - Ali Sirous
- Department of Orology, Arak University of Medical Sciences, Arak, Iran
| | - Alireza Kamali
- Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran
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Villa L, Capogrosso P, Capitanio U, Martini A, Briganti A, Salonia A, Montorsi F. Silodosin: An Update on Efficacy, Safety and Clinical Indications in Urology. Adv Ther 2019; 36:1-18. [PMID: 30523608 DOI: 10.1007/s12325-018-0854-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Silodosin determines smooth muscle relaxation in bladder and prostate tissues, increases bladder blood flow in conditions of chronic bladder ischemia and regulates the activity of transcriptional factors responsible for stromal growth and prostate hyperplasia. Phase III trials have already demonstrated the efficacy and safety of silodosin in the treatment of patients bothered by lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). OBJECTIVE We aimed to describe the rationality for the use of silodosin and to summarize the current literature on the use of Silodosin for the treatment of LUTS. METHODS PubMed and Web of Science were queried with the terms: 'silodosin' in combination (AND) with the terms 'lower urinary tract symptoms', 'LUTS', 'pathophysiology', 'symptoms' OR 'therapy'. Studies published in the last 10 years (2007-2017) in adults and core clinical journals in English were included. RESULTS Silodosin 8 mg once-daily was superior to placebo in improving IPSS total score, voiding subscore, storage subscore and QoL score, and at least as effective as tamsulosin 0.4 mg once-daily in all the efficacy analyses. In addition, studies assessing the effect on urodynamic parameters showed that silodosin determined a higher improvement in the bladder outlet obstruction index compared to other alpha1 adrenergic receptor antagonists. Concerning the safety profile, long-term data (after 9 months of treatment) confirmed the limited effect of silodosin on the cardiovascular and gastrointestinal systems. Although ejaculatory disorders represented the main complaint of patients taking silodosin, the discontinuation rate due to this condition remained low even in a long-term follow-up study (7.5%). Encouraging findings showed that silodosin may be administered as a medical expulsive therapy for promoting spontaneous stone passage of distal ureteral stones < 10 mm, to relieve LUTS in patients who underwent prostate cancer brachytherapy and to increase the likelihood of successful trials without a catheter in patients experiencing acute urinary retention. CONCLUSION Silodosin is one of the drugs approved for the treatment of BPH, being highly effective in improving not only LUTS but also urodynamic parameter impairments secondary to BPH. Moreover, it has shown efficacy as medical expulsive therapy for distal ureteral stones in previous prospective randomized trials. FUNDING Sponsorship for this study and article processing charges were funded by Recordati.
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Baghani Aval H, Ameli Z, Ameli M. Effectiveness of the addition of tadalafil to tamsulosin in the treatment of acute urinary retention in patients with benign prostatic hyperplasia: A randomized clinical trial. Urologia 2018; 85:51-54. [PMID: 30043714 DOI: 10.1177/0391560317749427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Acute urinary retention is one of the most significant complications of benign prostatic hyperplasia. Until now, standard treatments include catheterization and use of α-blockers. Tadalafil has been recently seen to also play a role in the treatment of urinary symptoms caused by benign prostatic hyperplasia. The aim of this study was to survey the addition of tadalafil to tamsulosin in the treatment of acute urinary retention in patients with benign prostatic hyperplasia. MATERIALS AND METHODS This is a randomized, double-blind placebo-controlled clinical trial. In all, 80 patients with benign prostatic hyperplasia-related acute urinary retention referred to the emergency department of the hospital were divided into two groups of 40 each and randomly assigned to receive either 0.4 mg tamsulosin plus placebo or 0.4 mg tamsulosin plus 10 mg tadalafil daily for 7 days. At the same first visit, the catheter was removed and the ability to void in 24 h and 1 week later was assessed in each group. RESULTS The differences in age, urine retention volume, history of drug use, lower urinary tract symptoms, and previous acute urinary retention were not significant between the two groups ( p = 0.619, 0.149, 0.501, 0.284, and 0.371, respectively). After catheter removal, 23 (57.5%) patients in the placebo group and 26 (65%) in the tadalafil group voided successfully at 24 h ( p = 0.491). After 1 week, 29 (72.5%) patients taking placebo and 26 (65%) taking tadalafil could void, yet indicating no significant difference ( p = 0.469). CONCLUSION Addition of tadalafil to α-blockers has no significant advantage in improving benign prostatic hyperplasia-related acute urinary retention versus tamsulosin alone.
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Affiliation(s)
| | - Zeinab Ameli
- 1 Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mojtaba Ameli
- 2 Gonabad University of Medical Sciences, Gonabad, Iran
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Collado A, Domínguez-Escrig J, Ortiz Rodríguez IM, Ramirez-Backhaus M, Rodríguez Torreblanca C, Rubio-Briones J. Functional follow-up after Advance ® and Advance XP ® male sling surgery: assessment of predictive factors. World J Urol 2019; 37:195-200. [PMID: 29948042 DOI: 10.1007/s00345-018-2357-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/26/2018] [Indexed: 10/14/2022] Open
Abstract
PURPOSE To evaluate the efficacy of the Advance® and AdvanceXP® slings in men with stress urinary incontinence (SUI) post-radical prostatectomy and to identify predictive factors for outcome. METHODS Included were male patients with SUI following radical prostatectomy who had a positive "repositioning test", 24 h-pad weight (PW) test < 400 g and who were continent at night and at rest. Urgency was defined as a sudden compelling desire to pass urine, which was difficult to defer. The cure rate was defined as no pad use. RESULTS From February 2008 to October 2014, 24 AdVance® and 70 AdVance XP® were implanted. The median (range) follow-up was 49 (12-102) months. The overall cure rate was 77%. The preoperative 24 h PW was significantly related to the continence outcome (p = 0.044). A total of 12 patients (13%) presented with postoperative AUR, which was significantly related to abnormal voiding detrusor activity (p = 0.036). Twenty-two patients (23%) had postoperative urgency (16% "de novo"), which was significantly related to preoperative urgency (p = 0.003). During follow-up, a degree of deterioration of continence was observed in five patients who were classed as cured initially. To date, no reports of urethral sling erosion have been made. CONCLUSIONS The AdVance® and AdVanceXP® slings are safe and effective in relieving SUI following post-radical prostatectomy. There were no differences between the two slings in terms of efficacy, urgency or postoperative AUR. There was a moderate rate of "de novo "urgency and low rate of loss of continence during follow-up.
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Abstract
We report two uncommon cases of acute urinary retention in Chinese patients caused by reactivation of sacral herpes zoster and requiring bladder drainage. Indwelling urinary catheterization, antiviral medication (ganciclovir), and physiotherapy with infrared light (830 nm) led to successful recovery of the micturition reflex in both cases.
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Affiliation(s)
- H He
- Department of Urology, Jinling Hospital, Nanjing, China
| | - C Tang
- Department of Urology, Jinling Hospital, Nanjing, China
| | - X Yi
- Department of Urology, Jinling Hospital, Nanjing, China
| | - W Zhou
- Department of Urology, Jinling Hospital, Nanjing, China
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Abstract
Urologic emergencies can involve the kidneys, ureters, bladder, urethra, penis, scrotum, or testicles. History and physical examination are essential to diagnosis, whereas imaging is increasingly used to confirm diagnoses. Acute urinary retention should be relieved with Foley placement. Penile emergencies include paraphimosis, which can be treated by foreskin reduction, whereas penile fracture and priapism require urologic intervention. Fournier gangrene and testicular torsion are scrotal emergencies requiring emergent surgery. Nephrolithiasis, although painful, is not an emergency unless there is concern for concomitant urinary tract infection, both ureters are obstructed by stones, or there is an obstructing stone in a solitary kidney.
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Affiliation(s)
- Adarsh S Manjunath
- Department of Urology, Northwestern University Feinberg School of Medicine, 303 East Chicago Avenue 16-703, Chicago, IL 60611, USA
| | - Matthias D Hofer
- Department of Urology, Northwestern University Feinberg School of Medicine, 303 East Chicago Avenue 16-703, Chicago, IL 60611, USA.
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Abstract
Lower urinary tract symptoms (LUTS) consist of a common set of urologic symptoms that can affect the elderly. The prevalence of LUTS is expected to rise owing to the continued increase of numbers of the elderly. Although benign prostatic hyperplasia is considered a common cause of LUTS, the broader potential causes of LUTS are myriad. A wide range of diagnostic modalities and treatments are available to manage patients with LUTS and their utilization should not be limited to the urologist.
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Affiliation(s)
- Omar Al Hussein Alawamlh
- Department of Urology, Weill Medical College of Cornell University, James Buchanan Brady Foundation, New York, NY, USA
| | - Ramy Goueli
- Department of Urology, Weill Medical College of Cornell University, James Buchanan Brady Foundation, New York, NY, USA
| | - Richard K Lee
- Department of Urology, Weill Medical College of Cornell University, James Buchanan Brady Foundation, New York, NY, USA.
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Gas J, Liaigre-Ramos A, Beauval JB, Roumiguié M, Tostivint V, Patard PM, Huyghe E, Soulié M, Charpentier S, Gamé X. [Epidemiology of emergency consultations for acute urine retention]. Prog Urol 2018; 28:107-113. [PMID: 29337127 DOI: 10.1016/j.purol.2017.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 11/16/2017] [Accepted: 12/01/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Acute urinary retention (AUR) is a common reason for emergency consultation. It may be spontaneous or precipitated and affects both men and women. The purpose of this study was to determine the profile of men visiting emergency departments for an AUR. MATERIEL AND METHODS A retrospective monocentric study including all men who consulted the emergency department between January 2014 and December 2016 for AUR was conducted. RESULTS In 3 years, 731 patients were admitted for AUR (611 men and 120 women). The mean age was 71.6±14 years with a mean retention volume of 948±668mL drained for 96% of patients (n=584) through a bladder catheter and 4% (n=27) with a suprapubic catheter. Most patients had an urological (66%, n=104) or neurologic (40%, n=242) history and 23% (n=136) already had an episode of AUR. In 28% of cases (n=173), the globe was not painful. A majority of AUR were spontaneous, 53% (n=326) versus 46% (n=279) who were precipitated, secondary to a recent surgical procedure (<1 month) (15%, n=89), hematuria (9%, n=54), or male urinary tract infections (7%, n=42). Patients were treated externally in 71% (n=436), 25% (n=153) were hospitalized with significantly more comorbidities. CONCLUSION Men consulting emergency for AUR are 72 years old, with a globe volume of 942mL. Thirty-three percent have a history of BPH, with a prostate treatment like alpha-blockers type. Almost all patients were treated with a bladder catheter and the majority was treated externally. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- J Gas
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France.
| | - A Liaigre-Ramos
- Service d'accueil des urgences, CHU de Toulouse, 31059 Toulouse, France
| | - J B Beauval
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - M Roumiguié
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - V Tostivint
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - P-M Patard
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - E Huyghe
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - M Soulié
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
| | - S Charpentier
- Service d'accueil des urgences, CHU de Toulouse, 31059 Toulouse, France
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU de Toulouse, 31059 Toulouse, France
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Savaria F, Beauchesne MF, Forget A, Blais L. Polypharmacy, chronic kidney disease, and benign prostatic hyperplasia in patients with chronic obstructive pulmonary disease newly treated with long-acting anticholinergics. Respir Med 2017; 132:195-202. [PMID: 29229097 DOI: 10.1016/j.rmed.2017.10.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/27/2017] [Accepted: 10/28/2017] [Indexed: 11/20/2022]
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Masson E, Scemama UA, Lignères MA, Benyamine A, Rossi P, Chaumoitre K, Granel B. [A left peri-renal infiltration]. Rev Med Interne 2017; 39:968-969. [PMID: 28734579 DOI: 10.1016/j.revmed.2017.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 06/20/2017] [Indexed: 11/29/2022]
Affiliation(s)
- E Masson
- Service de médecine interne, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - U-A Scemama
- Service d'imagerie médicale, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - M-A Lignères
- Service d'imagerie médicale, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - A Benyamine
- Service de médecine interne, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - P Rossi
- Service de médecine interne, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - K Chaumoitre
- Service d'imagerie médicale, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France
| | - B Granel
- Service de médecine interne, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
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Rampoldi A, Barbosa F, Secco S, Migliorisi C, Galfano A, Prestini G, Harward SH, Di Trapani D, Brambillasca PM, Ruggero V, Solcia M, Carnevale FC, Bocciardi AM. Prostatic Artery Embolization as an Alternative to Indwelling Bladder Catheterization to Manage Benign Prostatic Hyperplasia in Poor Surgical Candidates. Cardiovasc Intervent Radiol 2017; 40:530-536. [PMID: 28130568 DOI: 10.1007/s00270-017-1582-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/17/2017] [Indexed: 01/21/2023]
Abstract
PURPOSE To prospectively assess discontinuation of indwelling bladder catheterization (IBC) and relief of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) following prostate artery embolization (PAE) in poor surgical candidates. METHODS Patients ineligible for surgical intervention were offered PAE after at least 1 month of IBC for management of urinary retention secondary to BPH; exclusion criteria for PAE included eligibility for surgery, active bladder cancer or known prostate cancer. Embolization technical and clinical success were defined as bilateral prostate embolization and removal of IBC, respectively. Patients were followed for at least 6 months and evaluated for International Prostate Symptom Score, quality of life, prostate size and uroflowmetric parameters. RESULTS A total of 43 patients were enrolled; bilateral embolization was performed in 33 (76.7%), unilateral embolization was performed in 8 (18.6%), and two patients could not be embolized due to tortuous and atherosclerotic pelvic vasculature (4.7%). Among the patients who were embolized, mean prostate size decreased from 75.6 ± 33.2 to 63.0 ± 23.2 g (sign rank p = 0.0001, mean reduction of 19.6 ± 17.3%), and IBC removal was achieved in 33 patients (80.5%). Clavien II complications were reported in nine patients (21.9%) and included urinary tract infection (three patients, 7.3%) and recurrent acute urinary retention (six patients, 14.6%). Nine patients (22.0%) experienced post-embolization syndrome. CONCLUSIONS PAE is a safe and feasible for the relief of LUTS and IBC in highly comorbid patients without surgical treatment options.
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Affiliation(s)
- Antonio Rampoldi
- Department of Interventional Radiology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20100, Milan, Italy
| | - Fabiane Barbosa
- Department of Interventional Radiology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20100, Milan, Italy.
| | - Silvia Secco
- Department of Urology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20100, Milan, Italy
| | - Carmelo Migliorisi
- Department of Interventional Radiology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20100, Milan, Italy
| | - Antonio Galfano
- Department of Urology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20100, Milan, Italy
| | - Giovanni Prestini
- Department of Urology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20100, Milan, Italy
| | - Sardis Honoria Harward
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Dario Di Trapani
- Department of Urology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20100, Milan, Italy
| | - Pietro Maria Brambillasca
- Department of Interventional Radiology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20100, Milan, Italy
| | - Vercelli Ruggero
- Department of Interventional Radiology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20100, Milan, Italy
| | - Marco Solcia
- Department of Interventional Radiology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20100, Milan, Italy
| | - Francisco Cesar Carnevale
- Department of Interventional Radiology, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-001, Brazil
| | - Aldo Massimo Bocciardi
- Department of Urology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20100, Milan, Italy
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Grabbert M, Apfelbeck M, Schulz G, Beck V, Stief CG, Tritschler S. [Emergency checklist - acute urinary retention]. MMW Fortschr Med 2016; 158:47-49. [PMID: 27704422 DOI: 10.1007/s15006-016-8778-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Markus Grabbert
- Urologische Klinik und Poliklinik Klinikum der Universität München (LMU), Campus Großhadern, Marchioninistr. 15, D-81377, München, Deutschland.
| | - Maria Apfelbeck
- Urologische Klinik und Poliklinik Klinikum der Universität München (LMU), Campus Großhadern, Marchioninistr. 15, D-81377, München, Deutschland
| | - Gerald Schulz
- Urologische Klinik und Poliklinik Klinikum der Universität München (LMU), Campus Großhadern, Marchioninistr. 15, D-81377, München, Deutschland
| | - Vincent Beck
- Urologische Klinik und Poliklinik Klinikum der Universität München (LMU), Campus Großhadern, Marchioninistr. 15, D-81377, München, Deutschland
| | - Christian G Stief
- Urologische Klinik und Poliklinik Klinikum der Universität München (LMU), Campus Großhadern, Marchioninistr. 15, D-81377, München, Deutschland
| | - Stefan Tritschler
- Urologische Klinik und Poliklinik Klinikum der Universität München (LMU), Campus Großhadern, Marchioninistr. 15, D-81377, München, Deutschland
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Kuiper JG, Bezemer ID, Driessen MT, Vasylyev A, Roehrborn CG, Penning-van Beest FJA, Herings RMC. Rates of prostate surgery and acute urinary retention for benign prostatic hyperplasia in men treated with dutasteride or finasteride. BMC Urol 2016; 16:53. [PMID: 27580700 PMCID: PMC5006364 DOI: 10.1186/s12894-016-0170-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022] Open
Abstract
Background Previous studies have suggested a greater benefit for various outcomes in men diagnosed with benign prostatic hyperplasia (BPH) who are treated with dutasteride than for men treated with finasteride. This study investigates whether the rates of BPH-related prostate surgery and acute urinary retention (AUR) differ between dutasteride and finasteride users in the Netherlands. Methods From the PHARMO Database Network, men aged ≥50 years with a dispensing of dutasteride or finasteride with or without concomitant alpha-blocker treatment between March 1, 2003 and December 31, 2011 were selected. The incidence of BPH-related prostate surgery and AUR was determined during dutasteride or finasteride treatment and stratified by type of initial BPH-treatment (5-ARI monotherapy or combination with alpha-blocker) and prescriber (general practitioner (GP) or urologist). Comparison of the incidence of BPH-related prostate surgery and AUR between the treatment groups was done by Cox proportional hazard regression. Results 11,822 dutasteride users and 5,781 finasteride users were identified. Most users started treatment in combination with an alpha-blocker. Overall, dutasteride users had a lower risk of BPH-related prostate surgery was lower among dutasteride users than finasteride users (HR: 0.75; 95 % CI: 0.56–0.99). This lower risk among dutasteride users was also seen when stratifying by monotherapy or combination therapy (HR: 0.73; 95 % CI: 0.54–0.98 for monotherapy and HR: 0.85; 95 % CI: 0.74–0.97 for combination therapy). However, the association was only present among men treated by urologists. For AUR the rates were low and no statistical significant difference was observed between dutasteride and finasteride users. Conclusions The risk of undergoing BPH-related prostate surgery was lower among men using dutasteride compared to men using finasteride. The association was observed for monotherapy as well as combination therapy, however, only among men who received their prescription from a urologist.
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Affiliation(s)
- Josephina G Kuiper
- PHARMO Institute for Drug Outcomes Research, van Deventerlaan 30-40, 3528 AE, Utrecht, Netherlands.
| | - Irene D Bezemer
- PHARMO Institute for Drug Outcomes Research, van Deventerlaan 30-40, 3528 AE, Utrecht, Netherlands
| | | | | | - Claus G Roehrborn
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Bldv, TX 75390, Dallas, TX, USA
| | | | - Ron M C Herings
- PHARMO Institute for Drug Outcomes Research, van Deventerlaan 30-40, 3528 AE, Utrecht, Netherlands
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41
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Abstract
The diagnosis and management of urologic emergencies are incorporated into the basic training of all urology residents. In institutions without access to urologic services, it is usually left to the General Surgeon or Emergency Medicine physician to provide timely care. This article discusses diagnoses that are important to recognize and treatment that is practically meaningful for the non-Urologist to identify and treat. The non-Urology provider, after reading this article, will have a better understanding and a higher comfort level with treating patients with urologic emergencies.
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Affiliation(s)
- Adam E Ludvigson
- Division of Urology, Maine Medical Center, 100 Brickhill Ave., South Portland, Maine 04106, USA
| | - Lisa T Beaule
- Division of Urology, Maine Medical Center, Tufts University School of Medicine, 100 Brickhill Ave., South Portland, Maine 04106, USA.
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42
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Cinar O, Suat Bolat M, Akdeniz E, Sahinkaya N. A rare cause of acute urinary retention in women: meatal condyloma accuminata, a case report. Pan Afr Med J 2016; 24:87. [PMID: 27642426 PMCID: PMC5012721 DOI: 10.11604/pamj.2016.24.87.9751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 05/12/2016] [Indexed: 11/11/2022] Open
Abstract
Acute urinary retention in women is a rarely seen phenomenon due to pharmacological, neuromuscular, anatomical, functional and infectious causes. Human papillomaviruses causing condyloma acuminata is one of the rarely reported viral infectious cause of acute urinary retention in case reports. A 45-year-old woman with acute urinary retention was found to have a round solid lesion on external urethral meatus. Histopathological examination revealed as condyloma acuminata. Urethral condyloma can be treated by local excision as an effective method for early improvement of voiding function. Even if the genital condyloma can be locally excised, patients should be referred to the gynecologists for cervical cancer screening.
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Affiliation(s)
- Onder Cinar
- Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Mustafa Suat Bolat
- Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ekrem Akdeniz
- Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Necmettin Sahinkaya
- Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey
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43
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Abstract
We report a case of meningitis-retention syndrome followed by urodynamic tests. A 48-year-old man was admitted to the hospital for an undiagnosed fever with headache and urinary retention. Aseptic meningitis was suspected according to cerebrospinal fluid analyses, and urodynamic test showed an underactive detrusor, leading to inadequate contraction of the bladder on voiding in spite of a normal sensation during bladder filling. Clean intermittent self-catheterization was required temporarily, but normal urinary voiding without the need for medication was restored in 2 weeks after discharge from the hospital, when urodynamic tests showed normal contractility of the bladder during voiding.
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Affiliation(s)
- Gen Ishii
- Atsugi City Hospital, 1-16-36 Mizuhiki, Atsugi City, Kanagawa 243-8588, Japan
| | - Kenichi Hata
- Atsugi City Hospital, 1-16-36 Mizuhiki, Atsugi City, Kanagawa 243-8588, Japan
| | - Soichiro Aoki
- Atsugi City Hospital, 1-16-36 Mizuhiki, Atsugi City, Kanagawa 243-8588, Japan
| | - Masayasu Suzuki
- Atsugi City Hospital, 1-16-36 Mizuhiki, Atsugi City, Kanagawa 243-8588, Japan
| | - Takahiro Kimura
- Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Shin Egawa
- Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo 105-8461, Japan
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44
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Dagur G, Suh Y, Warren K, Singh N, Fitzgerald J, Khan SA. Urological complications of uterine leiomyoma: a review of literature. Int Urol Nephrol 2016; 48:941-8. [PMID: 26922066 DOI: 10.1007/s11255-016-1248-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 02/13/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Uterine leiomyomas are common gynecologic tumor in reproductive-aged women, by age 50, diagnosis shared by urologist, gynecologists and radiologists. OBJECTIVE The goal of this article is to review the current literature, study the impact of leiomyoma on female lower urinary tract, examine the cause female sexual dysfunction and provide a comprehensive review of current diagnostic, imaging studies, and current treatment of leiomyoma. METHODS Clinical leiomyoma studies published from 1956 through 2015 were identified using the PubMed search engines and the key words leiomyoma, fibroid in the current literature. Impact of leiomyoma on the lower urinary tract including female sexual dysfunction was reviewed with terms of "urinary retention", "bladder", "urethra", "dyspareunia", "incontinence", "incomplete bladder emptying", "female sexual dysfunction", and "lower urinary tract" to study the urological and sexual effects of leiomyoma. Literature related to leiomyoma was reviewed from 1965 to present. RESULTS Women with uterine leiomyomata complained of pelvic pain, menstrual irregularities, infertility, lower urinary tract symptoms and sexual dysfunction. CONCLUSION Leiomyoma is a common tumor of the uterus that often clinically impacts on the lower urinary tract and results in urological and sexual symptoms. Leiomyoma can compress and grow into and become adherent to the bladder and surrounding pelvic organs or metastasize into peritoneal organs. Leiomyoma can enlarge and compress the urinary bladder, urethra, and lower end of the ureters. Leiomyoma can cause embarrassing sexual dysfunction in females. Current literature of non-surgical and surgical therapy of leiomyoma is described.
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45
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Abstract
OBJECTIVES Acute urinary retention (AUR) in females is a poorly defined condition with undetermined epidemiology. This study aimed to evaluate female AUR in an outpatient population. PATIENTS AND METHODS One hundred and thirty-eight adult female outpatients who presented to the emergency room with symptoms of urinary retention were retrospectively analyzed. The women who were ultimately diagnosed with true, complete AUR were systematically reviewed for clinical characteristics and management. RESULTS In this outpatient cohort with urinary retention complaints, only 23% of the patients were diagnosed with objective AUR. Detailed medical and urological history in addition to urogenital, neurological, and pelvic examinations was essential; urine analysis and pelvic ultrasonography were necessary as baseline investigations. Further radiological and urodynamic tests were required in a minority. Specific etiology was established in 77% of the patients, whereas there was more than one probable cause in 16% of the patients, and no specific cause was found in 6.5% of the patients. Bladder decompression and correction of the underlying cause helped 92.6% of the reviewed patients to eventually achieve spontaneous micturition. CONCLUSIONS The proportion of true, complete AUR among female outpatients presenting to the emergency department was 23% following urological evaluation. Acute condition was resolved by urgent catheterization in all, and the majority of women had eventually resumed spontaneous voiding.
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Affiliation(s)
- Bora Özveren
- Department of Urology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Selçuk Keskin
- Department of Urology, Acibadem University School of Medicine, Istanbul, Turkey
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46
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Cahn DB, Ross CP, Dubowitch EP, Persun ML, Ginsberg PC, Harkaway RC. Predicting Acute Urinary Retention in Patients with Elevated Post-Void Residuals. Curr Urol 2015; 8:79-83. [PMID: 26889122 DOI: 10.1159/000365694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 06/19/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To perform a retrospective analysis evaluating factors that may predict which men with elevated post-void residuals (PVRs) that were at increased risk to develop acute urinary retention (AUR). METHODS We retrospectively analyzed the records of 44 male patients who had 2 consecutive PVRs greater than 100 ml over a 6-month period. Using regression analysis, we evaluated patient's age, PVR volume, prostate specific antigen (PSA) and transrectal ultrasound prostate volume with respect to development of AUR over 24 months. RESULTS Of the 44 patients, 4 developed AUR. When all factors were considered, prostate volume was determined to be the only that was statistically significant (p = 0.003). A 1-SD increase in prostate volume (12 ml) led to a 19.6% increased risk of developing AUR. There was a strong correlation between PSA and prostate volume (0.787). A regression analysis was then repeated excluding prostate volume. PSA then became a statistically significant predictor of AUR (p = 0.007). A 1-SD increase in PSA (1.377 ng/ml) increased the patients' risk of developing AUR by 12.3%. CONCLUSION In men with an elevated PVR, increased transrectal ultrasound prostate volume or PSA may help predict which patients have an elevated risk of developing AUR within the next 24 months. This information may influence which patients need early surgical intervention versus medical therapy.
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Affiliation(s)
- David B Cahn
- Department of Urology, Einstein Healthcare Network, Philadelphia, Pa., USA
| | - Curtis P Ross
- Department of Urology, Einstein Healthcare Network, Philadelphia, Pa., USA
| | | | - Michelle L Persun
- Department of Urology, Einstein Healthcare Network, Philadelphia, Pa., USA
| | - Philip C Ginsberg
- Department of Urology, Einstein Healthcare Network, Philadelphia, Pa., USA
| | - Richard C Harkaway
- Department of Urology, Einstein Healthcare Network, Philadelphia, Pa., USA
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47
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Oh JJ, Kim SH, Shin JS, Shin SJ. Risk factors for acute postpartum urinary retention after vaginal delivery: focus on episiotomy direction. J Matern Fetal Neonatal Med 2015; 29:408-11. [PMID: 25731655 DOI: 10.3109/14767058.2014.1002395] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study aimed to investigate the independent factors for acute postpartum urinary retention (APUR) after vaginal delivery. METHODS From January 2008 to December 2013, 98 patients with APUR after vaginal delivery without instrument use were compared with 108 control patients matched by age and medical history. Multivariate logistic regression analysis was performed to identify independent risk factors for APUR. Predictive accuracy for the multivariate model was assessed using the derived area under a receiver operating characteristics curve. RESULTS Among maternal previous partial history, mean live birth history was lower in the APUR group (0.12 versus 0.31, p = 0.017). Regional anesthesia use (76.5% versus 60.2%, p = 0.036), mediolateral episiotomy (63.3% versus 31.5%, p < 0.001) and labor time were significantly higher in the APUR group. Multivariate logistic regression analysis showed that mediolateral episiotomy, labor time and the presence of regional anesthesia were independent contributing factors for the development of APUR. This model's predictive accuracy for APUR was 73.1%. CONCLUSION Prolonged labor time, regional anesthesia and mediolateral episiotomy were independent factors for APUR. Therefore, we considered median episiotomy to be the best approach during vaginal delivery avoiding APUR.
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Affiliation(s)
- Jong Jin Oh
- a Department of Urology , Seoul National University Bundang Hospital , Seongnam , Korea and
| | - Soo Hyun Kim
- b Department of Obstetrics and Gynecology , Gangnam CHA Medical Center, CHA University , Seongnam , Korea
| | - Joong Sik Shin
- b Department of Obstetrics and Gynecology , Gangnam CHA Medical Center, CHA University , Seongnam , Korea
| | - Seung Ju Shin
- b Department of Obstetrics and Gynecology , Gangnam CHA Medical Center, CHA University , Seongnam , Korea
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48
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Abstract
Pelvic organ prolapse can affect urinary tract function by reducing flow rates and increasing post void residual urine volumes secondary to outlet obstruction. If the diagnosis is missed or left untreated, pelvic organ prolapse can lead to acute renal injury, chronic renal failure or even end stage renal disease. Herein, we present a case of a patient who presented to Albert Einstein Medical Center in Philadelphia, PA with urinary retention and acute kidney injury secondary to complete uterine prolapse, also referred to as procidentia.
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Affiliation(s)
- Elliot Dubowitch
- Hahnemann University Hospital, Einstein Healthcare Network, Philadelphia, Pa., USA
| | - David Cahn
- Department of Urology, Einstein Healthcare Network, Philadelphia, Pa., USA
| | - Curtis Ross
- Department of Urology, Einstein Healthcare Network, Philadelphia, Pa., USA
| | - Ali Husain
- Department of Urology, Einstein Healthcare Network, Philadelphia, Pa., USA
| | - Richard Harkaway
- Department of Urology, Einstein Healthcare Network, Philadelphia, Pa., USA
| | - Michael Metro
- Department of Urology, Einstein Healthcare Network, Philadelphia, Pa., USA
| | - Philip Ginsberg
- Department of Urology, Einstein Healthcare Network, Philadelphia, Pa., USA
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49
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Bailly V, Le Ray I, Bardonnaud N, Pillot P, Martin L, Pastori J, Balssa L, Guichard G, Bittard H, Kleinclauss F. [Meteo-U-rology: climate impact on urological emergencies]. Prog Urol 2014; 24:535-9. [PMID: 24975786 DOI: 10.1016/j.purol.2014.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 02/10/2014] [Accepted: 02/13/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES The aim of this study was to analyze the weather influence on the onset of renal colic (RC), acute urinary retention (AUR) and testicular torsion (TT). MATERIALS AND METHODS We correlated the daily number of RC, AUR and TT cases admitted to our urology department and weather conditions between 2005 and 2009 on day-to-day basis. Eight hundred and seventy-six RC, 453 AUR and 50 TT were analyzed. Information on temperature, atmospheric pressure, relative humidity, vapor pressure, wind force, evapotranspiration and sunshine level were collected from the national meteorological office (Meteo-France) in Besançon, France. We performed a univariate and a multivariate Stepwise method in linear regression using Akaike Information Criterion. RESULTS We reported a statistically significant increased risk of renal colic at higher vapor pressure. Likewise, temperature seemed to be a risk factor for occurrence of renal colics. We determined an increased daily rate when maximal daily temperature rises above 20 Celsius degrees (P = 0.05). Furthermore, we observed a positive link between mean (P = 0.05) and minimal (P = 0.08) daily temperature and urolithiasis. Contrarywise AUR was more frequent when the mean temperature falls below zero Celsius degree. We also demonstrated a non-significant influence of temperature on TT, with 3 fold higher events during cold period. Much more mystic, we noted a higher AUR rate on new moon days, and fewer renal colic on full moon. CONCLUSIONS Further investigations are necessary to understand the mechanisms underlying the relationship between urologic diseases and climate. But our findings could help us justify healthy living messages.
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Affiliation(s)
- V Bailly
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - I Le Ray
- Inserm 803, centre d'investigation, clinique plurithématique, CHU de Dijon, 21000 Dijon, France
| | - N Bardonnaud
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - P Pillot
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - L Martin
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - J Pastori
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - L Balssa
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - G Guichard
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - H Bittard
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - F Kleinclauss
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France; Inserm UMR 1098, 25000 Besançon, France.
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50
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Abstract
New-onset urinary retention can typically be explained by the use of the routine normally suspected medications (e.g., anticholinergics, antihistamines). However, selective serotonin-reuptake inhibitors are not typically presumed as the cause of acute urinary retention (AUR). The following case describes the introduction of escitalopram in a patient and the subsequent development of AUR. Medical causes of urinary retention had been ruled out, and ipratropium was initially suspected to be the cause of urinary difficulties and was discontinued. However, the retention persisted four days after suspending the ipratropium. Normal micturition resumed only after stopping the escitalopram without further need for catheterization. Escitalopram may cause rare cases of AUR and may often times be overlooked possibly because of the paucity of reporting.
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Affiliation(s)
- Dominick Trombetta
- Department of Pharmacy Practice, Wilkes University Nesbitt School of Pharmacy College of Pharmacy and Nursing, Wilkes-Barre, Pennsylvania
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