1
|
Pattou M, Neuzillet Y, Lebret T, Yonneau L, Madec FX. [Penile necrosis, a specific complication of prostatic artery embolization]. Prog Urol 2023; 33:407-411. [PMID: 37156687 DOI: 10.1016/j.purol.2023.04.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Endoscopic surgery is the standard treatment for benign prostatic hyperplasia (BPH) refractory to pharmacological treatments. In order to reduce invasiveness and preserve sexual function, prostatic artery embolization (PAE) has been developed. However, the technical difficulties of carrying out this procedure and the results, which have yet to be confirmed, mean that it is not currently recommended. The seriousness of the complications generated should lead to a reflection on the benefit-risk balance. The objective is to report a case of penile ischemia after embolization of the prostatic arteries. MATERIAL AND METHOD A severe complication following prostatic artery embolization (PAE) is reported with its clinical and paraclinical evaluation before and after the procedure as well as the therapeutic management. RESULTS Penile necrosis following prostatic artery embolization was reported in a 75-year-old patient despite an attempt of deobstruction. Lower urinary tract symptoms worsened postoperatively, associated with glans necrosis and refractory erectile dysfunction. CONCLUSION The place of PAE in the therapeutic arsenal of BPH needs to be confirmed. This innovative technique exposes the patient to potentially severe risks such as penile ischemia, not encountered in conventional endoscopic surgical treatment. PAE should not be included in the therapeutic armamentarium for BPH outside of clinical trials.
Collapse
|
2
|
Viallard L, Voiry C, Maze S, Fontaine S, Kerdraon J, Bonan I, Peyronnet B. [Uroflowmetry: A follow-up tool for neurogenic bladder patients treated by transcutaneous tibial posterior stimulation?]. Prog Urol 2023; 33:421-426. [PMID: 36922295 DOI: 10.1016/j.purol.2023.02.001] [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] [Received: 08/22/2022] [Revised: 12/21/2022] [Accepted: 02/10/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE Neurogenic bladders can suffer from overactivity, underactivity or dyssynergia depending on the level of the initial lesion. These symptoms can lead to severe alterations of the upper urinary tract. One of the first-line treatments is the transcutaneous tibial posterior stimulation (TTNS), which was demonstrated to be efficient on urodynamics. But it is an invasive, expensive and sometimes not patient-accepted examination, contrary to the uroflowmetry. The aim of this study is to assess the feasibility of a follow-up with a uroflowmetry when treated by TTNS and show that the maximum flow rate increased after treatment, displaying a better detrusor contraction. METHODS In total, 38 patients with neurogenic bladder undergoing a 12-weeks TTNS treatment and with 2 uroflowmetries interpretable before and after treatment were included. The maximum flow rate (Qmax), the urinated volume and the post-void residual (PVR) were retrieved from the uroflowmetry, and the USP-score and the urinary discomfort were asked at each appointment. RESULTS Qmax is increased from 17,53ml/s to 18,26ml/s, as well as the PVR (from 76,97ml to 79,16ml). Urinated volume is decreased from 241,4ml to 193,66ml. Patients feel enhanced after TTNS according to the decrease in the USP-score and the urinary discomfort scale. CONCLUSION The increase of the cystomanometric capacity and the delay of the detrusor overactivity due to TTNS explains the reduction of the urinated volume and the increase of PVR. Increased Qmax might show a better voluntary bladder contraction, with a restraint due to the lack of abdominal pressure measurement during voiding.
Collapse
Affiliation(s)
- Lisa Viallard
- Service de médecine physique et rééducation, CHU de Rennes, 35000 Rennes, France; Université Rennes 1, 35000 Rennes, France.
| | - Caroline Voiry
- Service de médecine physique et rééducation, CHU de Rennes, 35000 Rennes, France
| | - Stéphanie Maze
- Service de médecine physique et rééducation, CHU de Rennes, 35000 Rennes, France
| | - Sylvie Fontaine
- Service de médecine physique et rééducation, CHU de Rennes, 35000 Rennes, France
| | - Jacques Kerdraon
- Service de médecine physique et rééducation, CHU de Rennes, 35000 Rennes, France; Centre de rééducation de Kerpape, 56270 Ploemeur, France
| | - Isabelle Bonan
- Service de médecine physique et rééducation, CHU de Rennes, 35000 Rennes, France; Université Rennes 1, 35000 Rennes, France
| | - Benoît Peyronnet
- Université Rennes 1, 35000 Rennes, France; Service d'urologie, CHU de Rennes, 35000 Rennes, France; Équipe thématique INPHY CIC 1414, Inserm UMR 991, CHU de Rennes, 35000 Rennes, France
| |
Collapse
|
3
|
Long Depaquit T, Michel F, Gaillet S, Savoie PH, Karsenty G. [Home uroflowmetry technics and clinical relevance: A narrative review]. Prog Urol 2022; 32:1531-1542. [PMID: 35961806 DOI: 10.1016/j.purol.2022.07.142] [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] [Received: 04/19/2022] [Revised: 06/12/2022] [Accepted: 07/10/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Urine flowmetry (UF) is a key non-invasive urodynamic test for the evaluation of the voiding phase in patients with lower urinary tract symptoms (LUTS). Traditional free urodynamic testing (FUT) performed on a one-time basis in the office is limited by difficulty in capturing normal voiding and high intrapatient variability in urine flow parameters. Home measurement of urine flow by the patient could be a way to obtain multiple data in real-life conditions, addressing its limitations. The objective of this article was to review the literature on the different techniques of home uroflowmetry (HUF) and their clinical interest in comparison with FUT. MATERIAL AND METHODS A search on the PubMed database using the key words "Urodynamics, Uroflowmetry, non-invasive urodynamics, Ambulatory urodynamics, bladder outlet obstruction, male LUTS" was performed to find articles in English or French that had been published with no time limit and March 2022. The sorting by reading the abstract allowed the selection of all articles describing and/or evaluating a HUF technique that were read entirely according to the same collection grid to propose a narrative synthesis. RESULTS Thirty-one articles were identified, selected, and analyzed. Simple and inexpensive techniques by timing or use of funnels reliably and reproducibly estimate the average and maximum urine flow in relation to the FUT, without providing a complete flow curve. More sophisticated electronic or sonometric methods, some using connected mobile applications, present results that are more consistent with ICS recommendations for flow measurement. With the possibility of studying the average of several values of the maximum urinary flow (Qmax) captured during micturition in physiological conditions, some studies suggest a gain in diagnostic value in the evaluation of the emptying phase and lower urinary tract symptoms in men. However, the literature is sparse, old and the clinical benefits are not yet proven. CONCLUSION There is a wide range of techniques for measuring urine flow in the patient's home, all of which aim to fill the gaps in conventional urine flow measurement. Further studies are needed to demonstrate the acceptability of this type of measurement by patients, the existence of a real clinical benefit, to assess the cost/benefit balance and finally to define a possible place for home uroflowmetry in daily practice, compared with traditional free flowmetry and invasive urodynamics (pressure-flow test).
Collapse
Affiliation(s)
- T Long Depaquit
- Service d'urologie, HIA Sainte-Anne, 2 boulevard Sainte-Anne BP600, 83000 Toulon, France; Service d'urologie et de transplantation rénale, hôpital de La Conception, AP-HM, Marseille, France; Aix-Marseille université, Marseille, France.
| | - F Michel
- Service d'urologie et de transplantation rénale, hôpital de La Conception, AP-HM, Marseille, France; Aix-Marseille université, Marseille, France
| | - S Gaillet
- Service d'urologie et de transplantation rénale, hôpital de La Conception, AP-HM, Marseille, France
| | - P-H Savoie
- Service d'urologie, HIA Sainte-Anne, 2 boulevard Sainte-Anne BP600, 83000 Toulon, France
| | - G Karsenty
- Service d'urologie et de transplantation rénale, hôpital de La Conception, AP-HM, Marseille, France; Aix-Marseille université, Marseille, France
| |
Collapse
|
4
|
Boulma R, Charfi M, Trigui M, Daoud MF, Sahnoun M, Bouhaouala MH, Chouchen A. [Correlation between detrusor thickness, intravesical prostatic protrusion and maximum urinary flow in the monitoring of benign prostatic hyperplasia]. Prog Urol 2021; 32:291-297. [PMID: 34801388 DOI: 10.1016/j.purol.2021.10.004] [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: 02/02/2021] [Revised: 09/08/2021] [Accepted: 10/08/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Detrusor thickness (DT) and intravesical prostatic protrusion (IPP) are closely related to bladder outlet obstruction. The aim of our study was to look for correlation between DT, IPP and maximum urinary flow (Qmax). METHODS It is a prospective, observational study including men over fifty managed for benign prostatic hyperplasia. Low urinary tract symptoms were assessed with the International Prostatic Symptom Score (IPSS). Pelvic ultrasound was performed for all patients measuring prostatic volume, bladder volume, post- void residual, DT and IPP. Uroflowmetry was performed for all patients, Qmax was noted. Qmax equal or less than 15ml/s was considered pathologic. RESULTS Sixty patients were included for our study. Strong negative correlation was noted between DT, IPP and Qmax (r=-0.59, r=-0.61 respectively). Patients with pathologic Qmax had higher DT and IPP than those with normal Qmax, the difference was significant (P<0.01). Threshold values predicting pathologic Qmax were 3mm for DT and 7mm for IPP. ROC analysis reveals for DT an AUC of 0.84 (95% CI 0.76-0.92) and for IPP an AUC of 0.88 (95% CI 0.80-0.97). CONCLUSION Detrusor thickness and intravesical prostatic protrusion have strong negative correlation with Qmax. These parameters could be an alternative to Qmax measurement if uroflowmetry is unavailable. LEVEL OF EVIDENCE Grade B.
Collapse
Affiliation(s)
- Rami Boulma
- Service d'urologie, hôpital FSI La Marsa, Tunis, Tunisie.
| | - Mehdi Charfi
- Service de radiologie, hôpital FSI La Marsa, Tunis, Tunisie.
| | - Mohamed Trigui
- Service d'urologie, hôpital FSI La Marsa, Tunis, Tunisie.
| | | | - Moez Sahnoun
- Service de chirurgie générale, hôpital FSI La Marsa, Tunis, Tunisie.
| | | | - Adnen Chouchen
- Service de chirurgie générale, hôpital FSI La Marsa, Tunis, Tunisie.
| |
Collapse
|
5
|
Coindreau V, Chesnel C, Babany F, Declemy A, Savard E, Charlanes A, Lebreton F, Amarenco G. [Urinary tract symptoms in Lewy body dementia: About 19 cases]. Prog Urol 2020; 30:267-272. [PMID: 32224094 DOI: 10.1016/j.purol.2020.02.007] [Citation(s) in RCA: 1] [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: 06/13/2018] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Lewy Body Dementia (LBD) is a Parkinsonian disorder which often leads to Lower Urinary Tract Symptoms (LUTS), especially an Overactive Bladder (OAB). There have been few LBD related LUTS depictions in the literature, which is why we did this retrospective study. METHODS Retrospective single institution study. RESULTS Nineteen patients with confirmed LBD diagnosis were found, (63% of men, mean age 74 years old). The main symptom was OAB (100% of patients) with frequent stress urinary incontinence (94%) associated with detrusor overactivity (93%) with pressure elevation (79%). Voiding difficulties were found in 16% of medical interviews, and in 53% of urodynamics. In total, 92% of patients complained of constipation, with 44% suffering from fecal incontinence. DISCUSSION LBD is characterized by alpha-synuclein aggregates in the cerebral cortex, thus explaining associated cognitive impairment. The most commonly found LUTS is stress incontinence. We also found voiding difficulties in smaller proportion, sometimes associated with prostatism. Topographically, these symptoms could be explained by alpha-synuclein aggregates in the frontal and temporal cortex and the pons. Anorectal disorder and sexual dysfunction were frequently associated. Urological complications are scarce in this population, screening is focused in increasing quality of life, and the possibility to discriminate the different types of Parkinsonisms. CONCLUSION OAB is the most common lower urinary tract symptom in LBD often associated with detrusor overactivity, and less frequently voiding difficulties sometimes associated to prostatism. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- V Coindreau
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - C Chesnel
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Babany
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - A Declemy
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - E Savard
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - A Charlanes
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Lebreton
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - G Amarenco
- Groupe de recherche clinique en neuro-urologie (GREEN GRC-01 UPMC), Sorbonne universités, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| |
Collapse
|
6
|
Godmer M, Guinet-Lacoste A, Charvier K, Luauté J, Rode G, Soler JM, Hadiji N. [Is there any obstruction other than prostatic obstruction in Idiopathic Parkinson's Disease?]. Prog Urol 2019; 29:579-585. [PMID: 31302008 DOI: 10.1016/j.purol.2019.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Received: 03/25/2019] [Revised: 06/10/2019] [Accepted: 06/12/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To highlight the existence of pseudo-dyssynergia in Idiopathic Parkinson's Disease (IPD) constituting a functional bladder outlet obstruction. MATERIALS AND METHODS A retrospective study was conducted by including men with a confirmed diagnose of IPD who participated in the SIROCCO rehabilitation program. Patients included clinically exhibited overactive bladder and voiding dysfunction without prostatic hypertrophy ultrasounded. They have been clinically assessed by the Urinary Symptoms Profile (USP) urinary symptom score. Bladder outlet obstruction was assessed by the pressure-flow study. Urodynamic obstruction has been quantified by the bladder obstruction index which depends on detrusor pressure at maximum flow rate and maximum flow rate. It has been defined by a BOOI>40. RESULTS The pressure-flow profile was analyzed in 5 patients who met the inclusion criteria. In this group of 5 patients with IPD, the diagnosis was made on average 10.6 years (7-14) before the pressure-flow studies were performed. Our results objectified 4 patients obstructive among 5 and one equivocal patient. A striated pseudo-dyssynergia was found in the 3 obstructive patients and associated with a smooth pseudodyssynergia in one patient. CONCLUSION We have observed, in this short series, a pseudo-dyssynergia by subjects suffering from IPD. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- M Godmer
- Service de médecine physique et de réadaptation, rééducation neurologique, hôpital Henry-Gabrielle, CHU de Lyon, 69230 Saint-Genis-Laval, France; Service de MPR pédiatrique neurologique, Centre Médical Romans Ferrari, rue de la Chanal-Miribel, 01700 Miribel, France.
| | - A Guinet-Lacoste
- Hôpital Henry Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France.
| | - K Charvier
- Hôpital Henry Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France; Service d'urologie Pr-Alain-Ruffion, centre hospitalier Lyon Sud, Hospices Civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
| | - J Luauté
- Service de médecine physique et de réadaptation, rééducation neurologique, hôpital Henry-Gabrielle, CHU de Lyon, 69230 Saint-Genis-Laval, France; Université de Lyon, université Lyon 1, 69100 Villeurbanne, France; Centre de recherche en neuroscience de Lyon (CRNL), équipe IMPACT, Inserm, U1028, CNRS, UMR5292, 69675 Bron, France.
| | - G Rode
- Service de médecine physique et de réadaptation, rééducation neurologique, hôpital Henry-Gabrielle, CHU de Lyon, 69230 Saint-Genis-Laval, France; Centre de Recherche en Neurosciences de Lyon, ImpAct Team, Institut National de la Santé et de la Recherche Médicale U1028, Centre National de la Recherche Scientifique UMR5292, Université Claude Bernard Lyon 1, Lyon, France.
| | - J M Soler
- Laboratoire de neuro-urologie et de sexologie, Centre Bouffard, Vercelli, 66290 Cerbère, France.
| | - N Hadiji
- Hôpital Henry Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France; Service de neuro-urologie, Centre Médical Germaine-Revel, 69440 Saint-Maurice-sur-Dargoire, France.
| |
Collapse
|
7
|
Jeanson G, Lebreton F. [Neuroanatomical correlates between stroke lesions and urinary disorders: A narrative review]. Prog Urol 2018; 29:226-234. [PMID: 30527571 DOI: 10.1016/j.purol.2018.10.004] [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: 05/27/2018] [Revised: 10/15/2018] [Accepted: 10/29/2018] [Indexed: 10/27/2022]
Abstract
CONTEXT Stroke generates diverse urinary disorders, frequent but often under-diagnosed and thus untreated. Even though advances in the comprehension of the physiological voiding control and involved brain areas, the precise correspondence between lesion sites and observed urinary symptoms is not clearly established. OBJECTIVE This review aimed to update on this neuroanatomical correlates. DOCUMENTARY SOURCES The search focused on articles written in French or English, on PubMed, studying human beings or animals, published between the 1st of January 2000 and the 31st of August 2018 using the following keywords (stroke or hemiplegia) and (urinary incontinence or low urinary tract symptom or retention or overactive bladder or dysuria) and (anatomy or location or localization or area or lesion). STUDIES SELECTION The main author selected the most pertinent articles on abstracts and then on full text. RESULTS Twelve studies were included in our review. We could not fully confirm the neuroanatomical correlates based on the animal model. Frontoparietal lesions in urinary incontinence, role of the insula in the urinary retention, and systematic but different urinary symptoms in the brain stem lesions are the main findings. LIMITS Few studies were included, with varying methodologies and types of population. CONCLUSION A few cerebral areas damaged by stroke seem to be linked to certain urinary troubles, but new studies with a higher methodological quality are required to confirm this result.
Collapse
Affiliation(s)
- G Jeanson
- Service de MPR Neurologie, CHU Grenoble-Alpes, 38700 La Tronche, France.
| | - F Lebreton
- Service de neuro-urologie, hôpital Tenon, AP-HP, Paris 75020, France.
| |
Collapse
|
8
|
Abstract
Zusammenfassung. Das Urethralsyndrom bei Frauen mit Schmerzen in der Harnröhre und Blasenentleerungsstörungen ist eine Ausschlussdiagnose. Zu den möglichen Ursachen zählen unter anderem Infektionen, Entzündungen der paraurethralen Drüsen, Verspannungen der Sphinkteren und/oder der Beckenbodenmuskulatur, Östrogenmangelerscheinungen, Traumata, Neuropathien, Allergien und psychosomatische Störungen. Patientinnen mit Urethralsyndrom müssen ganzheitlich betrachtet, abgeklärt und behandelt werden. Während der Abklärung und Behandlung benötigen diese Patientinnen viel Zeit und Aufmerksamkeit. Heute gilt als sicher, dass bei vielen somatischen Leiden psychosoziale Faktoren mitspielen, die den Verlauf der Erkrankung entscheidend beeinflussen können und im Behandlungsprozess berücksichtigt werden müssen.
Collapse
|
9
|
Mazeron R, Bosq J, Rivin del Campo E, Arfi-Rouche J, Boros A, Ghez D. An uncommon cause of dysuria solved by "boom-boom" radiotherapy. Cancer Radiother 2016; 20:115-8. [PMID: 26971221 DOI: 10.1016/j.canrad.2015.12.001] [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: 10/26/2015] [Revised: 12/19/2015] [Accepted: 12/24/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chronic lymphocytic leukaemia is a common disease affecting the hematopoietic organs. The disease remains classically indolent for years preceding a blast crisis. However, the disease can affect all parts of the body. We report here an unusual localization. CASE PRESENTATION A 72-year-old man was followed for 2 years for an indolent chronic lymphocytic leukaemia while he presented a rapidly progressive dysuria. Prostate biopsies were performed concluding to a prostate involvement by the chronic lymphocytic leukaemia. In the absence of progression according to RAI staging system and Binet's classification, he was treated with local low-dose radiotherapy, twice 2 Gy, allowing for a rapid resolution of the symptoms. No systemic treatment was introduced, and 1 year after the completion of his treatment, he is still under watchful waiting strategy for his chronic lymphocytic leukaemia. CONCLUSION Low-dose radiotherapy is an underused effective strategy in indolent lymphoma. In this case, urinary symptoms from a prostate involvement were relieved non-invasively at low cost.
Collapse
Affiliation(s)
- R Mazeron
- Department of radiation oncology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
| | - J Bosq
- Department of biopathology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - E Rivin del Campo
- Department of radiation oncology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - J Arfi-Rouche
- Department of radiology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - A Boros
- Department of radiation oncology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - D Ghez
- Department of hematology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| |
Collapse
|
10
|
Falcou L, Mauruc E, Guinet-Lacoste A, Jousse M, Le Breton F, Vérollet D, Amarenco G. [Lazy bladder syndrome: review of 126 cases]. Prog Urol 2014; 24:651-7. [PMID: 25214295 DOI: 10.1016/j.purol.2014.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 03/31/2014] [Accepted: 04/02/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The lazy bladder syndrome (LBS) is characterized by an infrequent voiding, a large bladder capacity without neurological or urological disorders. In spite of being relatively common, there is little literature about it. The aim of our study was to compare the clinical features and urodynamic findings in asymptomatic or symptomatic patients with lazy bladder syndrome. PATIENTS AND METHODS We reviewed the charts of 126 adult patients diagnosed with lazy bladder syndrome. Clinical and radiological features, urodynamic findings and therapeutic management were evaluated. With these data, we divided patients into 2 groups: asymptomatic and symptomatic patients. After, we performed a comparative analysis of the data. RESULTS The incident of LBS was significantly higher in women (81%). Twenty-one patients were asymptomatic (17%), 105 patients were symptomatic (83%). The patients with symptomatic LBS were significantly older (54.3 years ± 14.7). Voiding dysfunction (53%) and urinary retention (27%) were the most common symptoms in symptomatic group. In the uroflowmetry test, maximum and mean uroflow were significantly higher in asymptomatic group (P=0.0074). Reduced bladder sensation revealed no difference in the 2 groups, but in the symptomatic group, detrusor has also a poor contractility (P=0.0001). Nineteen patients (18%) had uro-nephrological complications. CONCLUSION LBS is certainly underestimated. Voiding dysfunction, urinary retention in infrequent voiders or uro-nephrological complication (urinary tract infection with fever, ureteral reflux…) should recall LBS diagnosis. The hypothesis of bladder structural failure or autonomic nervous system dysfunction may be discussed (suggested). LEVEL OF EVIDENCE 5.
Collapse
|