AimsThe aims of this study were to determine the prevalence, risk factors, and impact upon health related quality of life (HRQL) of urinary incontinence in Saudi women.MethodsWe performed a clinic‐based cross‐sectional survey. 6,600 women aged 20 years and older were selected. The bother of urinary incontinence symptoms was assessed using the Arabic version of the short form of Urogenital Distress Inventory (UDI‐6) questionnaire. We measured the impact of urinary incontinence on HRQL using the Incontinence Impact Questionnaire (IIQ‐7).ResultsThe overall prevalence of urinary incontinence in our study was 29%. The prevalence of urinary incontinence according to its type was 50% stress urinary incontinence, 28% urgency urinary incontinence, and 22% mixed urinary incontinence. Older age, obesity, large baby birth weight, high parity, caesarean delivery, vaginal delivery, and diabetes were significant risk factors. Less than 10% of the women in this study reported a significant effect of urinary incontinence on their HRQL. In our study population, 9% sought medical care.ConclusionsTwenty‐nine percent of the women in Riyadh suffered from urinary incontinence. Diabetes is the most significant factor. Urinary incontinence affects women's HRQL. Most of the women did not seek medical care. We consider our study as an important step to start the plans for early detection, and treating urinary incontinence in Saudi Arabia. Neurourol. Urodynam. 31:642–645, 2012. © 2012 Wiley Periodicals, Inc.
Renal angiomyolipoma (RAML), though a rare benign tumor, may impose a significant morbidity or even mortality due to its unique characteristics and the complications subsequent to its treatment. The classic tumor variant is composed of smooth muscular, vascular, and fatty components. The most straightforward diagnosis is when the fat component is abundant and gives a characteristic appearance on different imaging studies. In fat-poor lesions, however, the diagnosis is difficult and presumed a renal cell carcinoma. Yet, some variants of RAML, though rare, express an aggressive behavior leading to metastasis and mortality. The challenge lies in the early detection of benign variants and identifying aggressive lesions for proper management. Another challenge is when the vascular tissue component predominates and poses a risk of hemorrhage that may extend to the retroperitoneum in a massive life-threatening condition. The predicament here is to identify the characteristics of tumors at risk of bleeding and provide a prophylactic treatment. According to the clinical presentation, different treatment modalities, prophylactic or therapeutic, are available that span the spectrum of observation, embolization, or surgery. Renal impairment may result from extensive tumor burden or as a complication of the management itself. Improvement of diagnostic techniques, super-selective embolization, nephron-sparing surgery, and late treatment with the mammalian target of rapamycin inhibitors have provided more effective and safe management strategies. In this review, we examine the evidence pertaining to the risks imposed by RAML to the patients and identify merits and hazards associated with different treatment modalities.
Different types of dementia cause different LUTS at varying time points during the disease process and need singular therapeutic approaches. Treatment of LUTS should be tailored to individual patient needs and disease status, considering factors like mobility, cognitive function, and general medical condition. Neurourol. Urodynam. 36:245-252, 2017. © 2015 Wiley Periodicals, Inc.
Aim:To evaluate the clinical outcomes of two different doses of BTX-A in patients with refractory idiopathic overactive bladder.Patients and Methods:Thirty nine patients with refractory idiopathic overactive bladder from 1/1/2008 till 30/3/2009 were evaluated in a tertiary care hospital. Patients were evaluated using urodynamic studies, voiding diary, UDI-6 and IIQ-7 questionnaires prior to being prospectively randomized (alternate randomization) to the BTX-A applications and three months after treatment. Voiding diary and residual volume were followed two weeks later. All patients received intradetrusorial injections of BTX-A (Botox, Allergan, Irvine, CA) of 100u or 200u under cystoscopic control on an outpatient basis. The primary endpoint was assessed for the improvement of urodynamic parameters and adverse events at three months after the initial treatment. Secondary end points included urinary frequency, urgency and UUI episodes as assessed by voiding diary and QoL.Results:Eleven patients were enrolled to each arm of the study. There were no significant differences in demographic characteristics between the two groups. Urodynamic assessment at the end of the third month showed significant improvement in urodynamic variables in both groups. There was no statistically significant difference in urodynamic parameters and in the voiding diary between the two groups. QOL was significantly improved in both groups with no statistically significant difference between the different doses. Only three patients developed acute urinary retention.Conclusion:BTX-A at 100u and 200u appears to improve symptoms, urodynamic parameters and QoL with no statistical significance between the two groups.
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