Newborn infants who had neurogenic bladder dysfunction(NBD)have a normal upper urinary tract at birth.Most of them will develop deterioration of renal function and chronic kidney disease if they do not receive proper ...Newborn infants who had neurogenic bladder dysfunction(NBD)have a normal upper urinary tract at birth.Most of them will develop deterioration of renal function and chronic kidney disease if they do not receive proper management.Children with NBD can develop renal damage at adolescence or earlier,which is due to high detrusor pressures resulted from poor compliance of the bladder,detrusor overactivity against a closed sphincter or detrusor sphincter dyssynergia.To preserve renal function and prevent deterioration of the kidneys,NBD must be treated immediately after being diagnosed.Over the last few years there was great progress in the treatment of children with the NBD.We searched PubMed and the Cochrane Library for peer-reviewed articles published in any language up to March 10,2021,using the search term“neurogenic bladder children.”Our search excluded diagnosis,pathophysiology,surgical treatment of spinal cord injury and spina bifida.The research identified the effectiveness of treatment regimens targeting prevention of chronic kidney disease and the indications of kidney transplantation.The results of the research showed that NBD in children should be diagnosed early in life,and the child should receive the proper management.The literature search concluded that the management of NBD in children would be personalized for every case and could be changed according to response to treatment,side effects,child compliance,availability of treatment modality and costs of treatment.The objectives of the study are to present the different options of management of NBD in children and the selection of the proper method in a personalized manner.展开更多
The International Consultation on Urological Disease have recently published comprehensive conclusions, based on evidence reviewed by eight committees, on aspects of male lower urinary tract symptoms(LUTS). In this re...The International Consultation on Urological Disease have recently published comprehensive conclusions, based on evidence reviewed by eight committees, on aspects of male lower urinary tract symptoms(LUTS). In this review, we summarise the conclusions from fourof the committees, namely, the evidence regarding the epidemiology of male LUTS, patient assessment, nocturia and medical management. It is indisputable that with an expanding and ageing global population the prevalence of male LUTS is likely to increase. Therefore symptom prevention and preservation of quality of life(Qo L) feature highly in the guidelines. There are now a number of different medical options, proven to lead to significant improvements in symptom scores, flow rate and Qo L available to men with LUTS. Metaanalyses have shown the benefits for alpha blockers, antimuscarinics, 5-α reductase and phosphodiesterase-5 inhibitors. High level evidence also exists for combinations of all of the above with alpha blockers and so men with concomitant storage symptoms, prostate volume > 30 mL, PSA > 1.4 or erectile dysfunction may be considered for combination treatment of an alpha blocker with an antimuscarinic, 5-α reductase inhibitor or phosphodiesterase-5 inhibitor respectively. In an era of personalised medicine, appropriate patient selection is likely to provide the key to the most effective clinical management strategy.展开更多
文摘Newborn infants who had neurogenic bladder dysfunction(NBD)have a normal upper urinary tract at birth.Most of them will develop deterioration of renal function and chronic kidney disease if they do not receive proper management.Children with NBD can develop renal damage at adolescence or earlier,which is due to high detrusor pressures resulted from poor compliance of the bladder,detrusor overactivity against a closed sphincter or detrusor sphincter dyssynergia.To preserve renal function and prevent deterioration of the kidneys,NBD must be treated immediately after being diagnosed.Over the last few years there was great progress in the treatment of children with the NBD.We searched PubMed and the Cochrane Library for peer-reviewed articles published in any language up to March 10,2021,using the search term“neurogenic bladder children.”Our search excluded diagnosis,pathophysiology,surgical treatment of spinal cord injury and spina bifida.The research identified the effectiveness of treatment regimens targeting prevention of chronic kidney disease and the indications of kidney transplantation.The results of the research showed that NBD in children should be diagnosed early in life,and the child should receive the proper management.The literature search concluded that the management of NBD in children would be personalized for every case and could be changed according to response to treatment,side effects,child compliance,availability of treatment modality and costs of treatment.The objectives of the study are to present the different options of management of NBD in children and the selection of the proper method in a personalized manner.
文摘The International Consultation on Urological Disease have recently published comprehensive conclusions, based on evidence reviewed by eight committees, on aspects of male lower urinary tract symptoms(LUTS). In this review, we summarise the conclusions from fourof the committees, namely, the evidence regarding the epidemiology of male LUTS, patient assessment, nocturia and medical management. It is indisputable that with an expanding and ageing global population the prevalence of male LUTS is likely to increase. Therefore symptom prevention and preservation of quality of life(Qo L) feature highly in the guidelines. There are now a number of different medical options, proven to lead to significant improvements in symptom scores, flow rate and Qo L available to men with LUTS. Metaanalyses have shown the benefits for alpha blockers, antimuscarinics, 5-α reductase and phosphodiesterase-5 inhibitors. High level evidence also exists for combinations of all of the above with alpha blockers and so men with concomitant storage symptoms, prostate volume > 30 mL, PSA > 1.4 or erectile dysfunction may be considered for combination treatment of an alpha blocker with an antimuscarinic, 5-α reductase inhibitor or phosphodiesterase-5 inhibitor respectively. In an era of personalised medicine, appropriate patient selection is likely to provide the key to the most effective clinical management strategy.
