Objective:Bladder neck contracture and vesicourethral anastomotic stenosis are difficult to manage endoscopically,and open repair is associated with high rates of incontinence.In recent years,there have been increasin...Objective:Bladder neck contracture and vesicourethral anastomotic stenosis are difficult to manage endoscopically,and open repair is associated with high rates of incontinence.In recent years,there have been increasing reports of robotic-assisted bladder neck reconstruction in the literature.However,existing studies are small,heterogeneous case series.The objective of this study was to perform a systematic review of robotic-assisted bladder neck reconstruction to better evaluate patency and incontinence outcomes.Methods:We performed a systematic review of PubMed from first available date to May 2023 for all studies evaluating robotic-assisted reconstructive surgery of the bladder neck in adult men.Articles in non-English,author replies,editorials,pediatric-based studies,and reviews were excluded.Outcomes of interest were patency and incontinence rates,which were pooled when appropriate.Results:After identifying 158 articles on initial search,we included only ten studies that fit all aforementioned criteria for robotic-assisted bladder neck reconstruction.All were case series published from March 2018 to March 2022 ranging from six to 32 men,with the median follow-up of 5e23 months.A total of 119 patients were included in our analysis.A variety of etiologies and surgical techniques were described.Patency rates ranged from 50%to 100%,and pooled patency was 80%(95/119).De novo incontinence rates ranged from 0%to 33%,and pooled incontinence was 17%(8/47).Our findings were limited by small sample sizes,relatively short follow-ups,and heterogeneity between studies.展开更多
Introduction: To investigate if potty training from infancy can affect bladder dysfunction in boys with posterior urethral valves (PUV). Subjects and Methods: The voiding pattern and emptying ability were followed usi...Introduction: To investigate if potty training from infancy can affect bladder dysfunction in boys with posterior urethral valves (PUV). Subjects and Methods: The voiding pattern and emptying ability were followed using the 4-hour voiding observation method in 17 Vietnamese boys with PUV aged 3 months to 4 years who had been potty-trained from infancy. This group was compared with a group of healthy Vietnamese boys. Results: In the boys with PUV, the bladder volume increased according to age, and interrupted voiding was rare. However, when comparing boys with PUV with healthy boys, a significant difference was noted with more frequent voidings and lower voided volumes in the age group 0 - 1 year (P < 0.001). Despite the minimum amount of residual urine, average 8 ml or less in the boys with PUV, the age groups 1 - 2 and 2 - 4 years had significantly higher residual volumes compared with those of the healthy boys (P The findings from the 4-hour voiding observation showed few signs of dysfunctional bladder in the Vietnamese boys with PUV, including residual urine, even if there were signs of dysfunction compared with the healthy Vietnamese boys. Potty training from infancy could favor early bladder rehabilitation in boys with PUV.展开更多
Penetrating wound of the anal canal is relatively rare, which is often complicated with injuries of the rectum, urinary bladder or posterior urethra. Misdiagnosis and improper treatments of the disease may lead to pel...Penetrating wound of the anal canal is relatively rare, which is often complicated with injuries of the rectum, urinary bladder or posterior urethra. Misdiagnosis and improper treatments of the disease may lead to pelvic abscess, anal stenosis, fecal incontinence, or rectovesical fistula. From 1985 to 2004, 16 patients with penetrating wounds through the anorectum and urinary bladder or posterior urethra were treated in our hospital.展开更多
文摘Objective:Bladder neck contracture and vesicourethral anastomotic stenosis are difficult to manage endoscopically,and open repair is associated with high rates of incontinence.In recent years,there have been increasing reports of robotic-assisted bladder neck reconstruction in the literature.However,existing studies are small,heterogeneous case series.The objective of this study was to perform a systematic review of robotic-assisted bladder neck reconstruction to better evaluate patency and incontinence outcomes.Methods:We performed a systematic review of PubMed from first available date to May 2023 for all studies evaluating robotic-assisted reconstructive surgery of the bladder neck in adult men.Articles in non-English,author replies,editorials,pediatric-based studies,and reviews were excluded.Outcomes of interest were patency and incontinence rates,which were pooled when appropriate.Results:After identifying 158 articles on initial search,we included only ten studies that fit all aforementioned criteria for robotic-assisted bladder neck reconstruction.All were case series published from March 2018 to March 2022 ranging from six to 32 men,with the median follow-up of 5e23 months.A total of 119 patients were included in our analysis.A variety of etiologies and surgical techniques were described.Patency rates ranged from 50%to 100%,and pooled patency was 80%(95/119).De novo incontinence rates ranged from 0%to 33%,and pooled incontinence was 17%(8/47).Our findings were limited by small sample sizes,relatively short follow-ups,and heterogeneity between studies.
文摘Introduction: To investigate if potty training from infancy can affect bladder dysfunction in boys with posterior urethral valves (PUV). Subjects and Methods: The voiding pattern and emptying ability were followed using the 4-hour voiding observation method in 17 Vietnamese boys with PUV aged 3 months to 4 years who had been potty-trained from infancy. This group was compared with a group of healthy Vietnamese boys. Results: In the boys with PUV, the bladder volume increased according to age, and interrupted voiding was rare. However, when comparing boys with PUV with healthy boys, a significant difference was noted with more frequent voidings and lower voided volumes in the age group 0 - 1 year (P < 0.001). Despite the minimum amount of residual urine, average 8 ml or less in the boys with PUV, the age groups 1 - 2 and 2 - 4 years had significantly higher residual volumes compared with those of the healthy boys (P The findings from the 4-hour voiding observation showed few signs of dysfunctional bladder in the Vietnamese boys with PUV, including residual urine, even if there were signs of dysfunction compared with the healthy Vietnamese boys. Potty training from infancy could favor early bladder rehabilitation in boys with PUV.
文摘Penetrating wound of the anal canal is relatively rare, which is often complicated with injuries of the rectum, urinary bladder or posterior urethra. Misdiagnosis and improper treatments of the disease may lead to pelvic abscess, anal stenosis, fecal incontinence, or rectovesical fistula. From 1985 to 2004, 16 patients with penetrating wounds through the anorectum and urinary bladder or posterior urethra were treated in our hospital.
文摘目的:探究经会阴三维盆底超声在女性压力性尿失禁(stress urinary incontinence,SUI)诊断及病情程度评估的应用。方法:选取2020年7月至2021年12月于武汉市中医医院诊疗的120例SUI患者为SUI组,再按病情分级分为轻度组(n=28)、中度组(n=56)、重度组(n=36);另选取同期行体检的健康女性40例为对照组。收集所有受试者一般资料及Valsalva状态超声检查参数膀胱颈移动度(bladder neck descent,BND)、尿道旋转角、膀胱后角。采用单因素、Pearson相关系数法分析相关指标与SUI的关系,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析经会阴三维盆底超声对SUI诊断及病情评估的效能。结果:SUI组超声检查参数BND、尿道旋转角、膀胱后角均明显大于对照组(均P<0.05)。轻度组、中度组、重度组的BND、尿道旋转角、膀胱后角均依次增大,组间比较差异均有统计学意义(均P<0.05)。ROC曲线分析显示,BND、尿道旋转角、膀胱后角对女性SUI诊断及病情评估均具一定价值,且以三者联合的应用价值最大。诊断SUI:曲线下面积(area under the curve,AUC)为0.991,敏感度为94.17%,特异度为100.00%。评估中度SUI:AUC为0.914,敏感度为92.86%,特异度为71.43%。评估重度SUI:AUC为0.937,敏感度为94.44%,特异度为87.50%。结论:经会阴三维盆底超声对女性SUI具有较高诊断价值,且可用于评估SUI病情程度,为临床诊疗提供客观、科学的依据。
