Minimally invasive measurement of vesical pressure for diagnosis of infravesical obstruction

Almeida, João Carlos Martins de; D’Ancona, Carlos Arturo Levi; Bassani, José Wilson Magalhães

doi:10.1002/nau.23366

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…Чоловіки молодого віку із СНСШ відрізняються від літніх чоловіків із такими ж симптомами через епідеміологічну картину. У чоловіків похилого віку основною патологією, що викликає інфравезікальну обструкцію найчастіше, є доброякісна гіперплазія передміхурової залози, отже, найімовірніший діагноз у них може бути встановлений із високим ступенем впевненості та без необхідності проведення зайвих досліджень [5,6].…”

Section: лікування захворювань що супроводжуються інфравезикальною об...unclassified

Treatment of Diseases Accompanied by Infravesical Obstruction in Young Men

Nikitin¹,

Reznikovov²

2022

Ukr. ž. med. bìol. sportu

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The purpose of the work was to study the possibilities of conservative and surgical treatment of infravesical obstruction in young patients with lower urinary tract symptoms. Materials and methods. Urodynamic diagnosis of infravesical obstruction due to increased resistance of the prostatic part of the urethra was established in 36 patients, whose age was 32.76 ± 1.13 years on average. The volume of the prostate gland according to transrectal ultrasound examination varied from 18 to 32 cm3 (on average 24.05 ± 1.28 cm3). Based on the results of a complex urodynamic study, 3 groups were identified: group 1 – 12 (33.3%) patients with infravesical obstruction with low-amplitude detrusor hyperactivity in the filling phase; group 2 – 13 (36.1%) patients with infravesical obstruction without an abdominal component during urination; group 3 – 11 (30.6%) men with infravesical obstruction in the presence of an abdominal component during urination. The control group included 16 men aged 21–48 years (on average 36.32 ± 2.34 years), who had no lower urinary tract symptoms. The effectiveness of drug therapy was assessed by comparing the initial indicators and quality of life indicators after 1 month, the IPSS index, the maximum volumetric rate of urination, and the residual urine volume. Results and discussion. To select the first line of therapy, the data of a complex urodynamic study and other examination methods (tamsulosin 0.4 mg, tamsulosin 0.4 mg + solifenacin 5 mg or tamsulosin 0.4 mg + mirabegron 25 mg) were taken into account. 16 patients who felt improvement after 1 month of drug treatment continued to experience it for 12–18 months. 17 (47.2%) persons out of 36 examined patients underwent surgical intervention due to symptoms of infravesical obstruction: 14 (70.0%) out of 20 – in whom drug therapy did not achieve the expected effect and 3 patients who refused conservative therapy despite its effectiveness. The patients underwent transurethral resection of the prostate gland. 12–18 months after observation, the patients determined a significant improvement in their condition, namely, in all parameters there was no significant difference from the control indicators. Conclusion. The effectiveness of conservative therapy in young men with infravesical obstruction reaches only 44.4%. But in case of improvement from treatment after 1 month, the stable positive effect of this type of treatment remains for 12–18 months. We believe that the main cause of infravesical obstruction in this contingent of patients may be benign prostatic hyperplasia, which debuted at earlier terms. Observation and treatment of this group of patients should be carried out according to the same principles as in patients with a similar pathology of an older age. If conservative therapy is ineffective within 1 month in this contingent of patients, transurethral resection of the prostate gland is indicated. After 12–18 months of observation, the operated patients determined a significant improvement in their condition, namely – in all parameters there was no significant difference from the control indicators. Thus, in case of absence of effectiveness of drug therapy in young male patients with infravesical obstruction, minimally invasive surgical intervention can significantly improve the quality of life, normalize urodynamic indicators, and reduce the IPSS score

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Section: лікування захворювань що супроводжуються інфравезикальною об...unclassified

Treatment of Diseases Accompanied by Infravesical Obstruction in Young Men

Nikitin¹,

Reznikovov²

2022

Ukr. ž. med. bìol. sportu

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“…З іншого боку, симптоми спорожнення виникають під час сечовипускання, а саме: повільний або слабкий струмінь сечі, переривчастий струмінь, нерішучість на початку сечовипускання і напряг при сечовипусканні. Симптоми спорожнення можуть бути пов'язані з обструкцією відтоку сечі із сечового міхура або зниженням здатності сечового міхура генерувати достатню силу для спорожнення [16,17].…”

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Diagnosis and Treatment of Overactive Bladder in Young Men

Oleh

Hennadii

2022

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The objective: to analyze the diagnostic capabilities and various methods of treatment of overactive bladder in young patients with lower urinary tract symptoms (LUTS). Materials and methods. The study involved 40 men who were divided into two groups. The main group included 24 patients with urodynamic diagnosis of overactive bladder (OAB) who were treated for LUTS. The age of patients ranged from 21-37 years old (mean age – 28.5±2.4 years). The control group included 16 men 21-48 years old (mean age – 36.32±2.34 years) without LUTS. The patients had complex urodynamic testing (UDT) for the diagnosis, the treatment management, and to determine the degree of functional disorders of the urination. The clinical task of treatment of OAB was to control the involuntary contractions of the bladder to normalize the quality of patient’s life. In 14 (58.3 %) patients of the main group solifenacin at a dose of 10 mg was used, in 10 (41.7 %) men – mirabegron at a dose of 50 mg. Results. The results of the first line therapy were studied in 1 month and then a decision was made to continue treatment or to change the medical approach. During the evaluation of the effectiveness of therapy, it was determined that the first line therapy was effective in 11 (45.8 %) patients, and in 13 (54.2 %) patients there was effect. In the absence of the results of medication treatment of OAB in 1 month in 8 out of 13 patients the treatment with the second line drug was prescribed – intradetruce injections of Botox. During the analysis of complex UDT after 12-18 months of the first injection of Botox, positive dynamics of therapy was estabslihed. Conclusions. Complex urodynamic testing is a reliable method of diagnosis and control of therapy. It is performed in the presence of overactive bladder (OAB). It is proved that if initially first-line drug therapy in young men is effective, it remained efficacy in longer period. If the first line therapy by botulotoxin injection in young men with OAB is not effective this led to some reduction in the tone of the detrusor. However, clinically this type of therapy has contributed to a significant improvement in the patient’s quality of life and the normalization of urodynamic.

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Design of a rapid diagnostic model for bladder compliance based on real-time intravesical pressure monitoring system

Tang

Peng

et al. 2022

Computers in Biology and Medicine

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Minimally invasive measurement of vesical pressure for diagnosis of infravesical obstruction

Cited by 3 publications

References 17 publications

Treatment of Diseases Accompanied by Infravesical Obstruction in Young Men

Treatment of Diseases Accompanied by Infravesical Obstruction in Young Men

Diagnosis and Treatment of Overactive Bladder in Young Men

Design of a rapid diagnostic model for bladder compliance based on real-time intravesical pressure monitoring system

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