Introduction: According to the most recent AUA/SUFU guidelines, intradetrusor onabotulinumtoxinA (BTN/A) is a standard, evidence strength grade B, third line treatment option for refractory non-neurogenic overactive b...Introduction: According to the most recent AUA/SUFU guidelines, intradetrusor onabotulinumtoxinA (BTN/A) is a standard, evidence strength grade B, third line treatment option for refractory non-neurogenic overactive bladder (OAB). Urinary retention is the most common clinically significant reported side effect ranging from 5.4% to 43% in previous studies. The aim of this study was to investigate the real-time rate of urinary retention in patients treated with BTN/A for refractory non-neurogenic OAB in a multi-institutional study. Methods: Retrospective chart review identified 71 patients who were treated with 100U BTN/A for refractory non-neurogenic OAB from August 2011 to July 2015 at two institutions. Using a flexible cystoscope, 100U Botox® reconstituted with 10 ml normal saline was administered. Injections of 1 ml (10 units/ mL) were administered in 10 evenly distributed sites sparing the trigone. Pre and post BTN/A post-void residuals (PVR) were reviewed. Urinary retention was defined as PVR > 200 mL requiring clean intermittent catheterization (CIC). Results: After exclusion, the study group consisted of 66 patients with a mean age of 67 years and 30% were men. Mean pre and post-procedural PVR were 14.06 mL and 69.21 mL. Eight patients (12.12%) were noted to have elevated PVR > 200 mL post injection however only one patient (female) required initiation of CIC. The rate of urinary retention was 1.5% (N = 1). There was no correlation with age, history of previous radiation, diabetes or prior use of a neuromodulator device. Conclusions: To the best of our knowledge, this is the first study to demonstrate a very low risk of real-time urinary retention rates in appropriately selected patients treated with BTN/A for refractory non-neurogenic OAB outside of a clinical trial setting.展开更多
OBJECTIVE：To identify global trends in research on spinal cord injury-induced neurogenic bladder, through a bibliometric analysis using the Web of Science. DATA RETRIEVAL：We performed a bibliometric analysis of stud...OBJECTIVE：To identify global trends in research on spinal cord injury-induced neurogenic bladder, through a bibliometric analysis using the Web of Science. DATA RETRIEVAL：We performed a bibliometric analysis of studies on spinal cord injury-induced neurogenic bladder using the Web of Science.Data retrieval was performed using key words＂spinal cord injury＂,＂spinal injury＂,＂neurogenic bladder＂,＂neuropathic bladder＂,＂neurogenic lower urinary tract dysfunction＂,＂neurogenic voiding dysfunction＂,＂neurogenic urination disorder＂and ＂neurogenic vesicourethral dysfunction＂. SELECTION CRITERIA：Inclusion criteria：（a）published peer-reviewed articles on spinal cord injury-induced neurogenic bladder indexed in the Web of Science;（b）type of articles：original research articles and reviews;（c）year of publication：no limitation.Exclusion criteria：（a）articles that required manual searching or telephone access;（b）Corrected papers and book chapters. MAIN OUTCOME MEASURES：（1）Annual publication output;（2）distribution according to journals; （3）distribution according to subject areas;（4）distribution according to country;（5）distribution according to institution;and（6）top cited publications. RESULTS：There were 646 research articles addressing spinal cord injury-induced neurogenic bladder in the Web of Science.Research on spinal cord injury-induced neurogenic bladder was found in the Science Citation Index-Expanded as of 1946.The United States,Ireland and Switzerland were the three major countries contributing to studies in spinal cord injury-induced neurogenic bladder in the 1970s.However,in the 1990s,the United States,the United Kingdom,the Netherlands,Germany and Japan published more papers on spinal cord injury-induced neurogenic bladder than Switzerland,and Ireland fell off the top ten countries list.In this century,the United States ranks first in spinal cord injury-induced neurogenic bladder studies,followed by France,the United Kingdom,Germany,Switzerland and Japan.Subject categories including urology, nephrology and clinical neurology,as well as rehabilitation,are represented in spinal cord injury-induced neurogenic bladder studies. CONCLUSION：From our analysis of the literature and research trends,we conclude that spinal cord injury-induced neurogenic bladder is a hot topic that will continue to generate considerable research interest in the future.展开更多
Purpose: To clarify which patients need careful neurourological management after abdominal radical hysterectomy (RH) by investigating the effects of adjuvant radiotherapy and reversibility of neurogenic bladder (NB) o...Purpose: To clarify which patients need careful neurourological management after abdominal radical hysterectomy (RH) by investigating the effects of adjuvant radiotherapy and reversibility of neurogenic bladder (NB) on the storage function as well as the effects of urethral resistance on the emptying function. Methods: Data from sixty-two patients referred to our NB clinic after RH were retrospectively reviewed. Findings of urodynamic studies performed at 3 (UDS-1) and 12 (UDS-2) months after treatment were compared, and logistic analysis was used to calculate the odds ratio (OR) of the effects of radiotherapy and irreversible NB on decreased bladder capacity and decreased compliance. Irreversible NB was defined as the need for clean intermittent catheterization at the last follow-up. Results: At the median follow-up period of 41 months, 60% of the patients continued to require clean intermittent catheterization. Of patients with irreversible NB and radiotherapy, 80% had decreased bladder capacity and decreased compliance at UDS-2. For decreased bladder capacity and decreased compliance, ORs of adjuvant radiotherapy at UDS-2 were 38.42 (p Conclusions: Careful neurourological follow-up after RH is mandatory for patients who undergo adjuvant radiotherapy and have irreversible NB with impaired urethral relaxation.展开更多
BACKGROUND Intestinal seromuscular bladder augmentation(SMBA)surgery has produced no mucosal-related complications,but its outcomes need to be studied.AIM To evaluate the safety and effectiveness of SMBA in the treatm...BACKGROUND Intestinal seromuscular bladder augmentation(SMBA)surgery has produced no mucosal-related complications,but its outcomes need to be studied.AIM To evaluate the safety and effectiveness of SMBA in the treatment of children with neurogenic bladder.METHODS A retrospective analysis of the clinical data of children with SMBA was performed from March 2008 to February 2018,and the data were compared with those of children receiving standard cystoplasty(SC).RESULTS In a cohort of 67 children who underwent bladder augmentation,the 46 children in the SC group had an average age of 10.6 years and a follow-up time of 36 mo,and the 21 children in the SMBA group had an average age of 7.6 years and a follow-up time of 29.7 mo.The preoperative and postoperative bladder volumes in the SMBA group were 151.7 mL and 200.4 mL,respectively,and those in the SC group were 173.9 mL and 387.0 mL,respectively.No significant difference in preoperative urinary dynamic parameters was found between the two groups,but the difference after operation was statistically significant.The main complications after SMBA were residual ureteral reflux and failed bladder augmentation,with incidences of 33.3%and 28.6%,respectively.In all 6 patients with failed augmentation in the SMBA group,ileum seromuscular patches were used for augmentation,and SC was chosen for reaugmentation.During reoperation,patch contracture and fibrosis were observed.CONCLUSION The improvement of urinary dynamic parameters in the SMBA group was significantly lower than that in the SC group.Children with SMBA had a higher probability of patch contracture and reaugmentation,which might be related to impaired blood supply and urine stimulation,and the sigmoid colon patch should be the priority.展开更多
目的观察电针对骶上脊髓损伤后尿潴留型神经源性膀胱大鼠排尿功能的影响,并探讨电针调节嘌呤能离子通道型受体7(purinergic ligand-gated ion channel 7 receptor,P2X7R)介导的细胞焦亡途径在其中的潜在效应机制。方法从48只雌性SD大鼠...目的观察电针对骶上脊髓损伤后尿潴留型神经源性膀胱大鼠排尿功能的影响,并探讨电针调节嘌呤能离子通道型受体7(purinergic ligand-gated ion channel 7 receptor,P2X7R)介导的细胞焦亡途径在其中的潜在效应机制。方法从48只雌性SD大鼠中随机抽取12只纳入假手术组,剩余大鼠以T8完全性脊髓横断法建立尿潴留型神经源性膀胱大鼠模型,将已成模的27只大鼠二次随机分为模型组与电针组,每组12只,剩余3只模型大鼠用于实验候补。电针组于术后第19天开始干预,连续10 d,其余两组仅予以捆绑。干预结束后,各组大鼠先行尿流动力学检测,随后快速分离膀胱组织待检,应用HE染色观察膀胱组织形态学变化,透射电镜观察膀胱组织超微结构变化,TUNEL染色检测膀胱组织中细胞损伤情况,ELISA检测膀胱组织中三磷酸腺苷(adenosine triphosphate,ATP)水平,免疫组织化学法和Western blot法检测膀胱组织中P2X7R、NOD样受体热蛋白结构域相关蛋白3(NODlike receptor thermal protein domain associated protein 3,NLRP3)、半胱氨酸天冬氨酸蛋白酶-1(cysteinyl aspartate specific proteinase-1,Caspase-1)、白细胞介素-1β(interleukin-1β,IL-1β)蛋白表达情况。结果与假手术组比较,模型组大鼠膀胱漏尿点压力、膀胱最大压力、膀胱最大容量显著升高(P<0.01),以膀胱体积增大伴尿潴留为主要表现;模型组大鼠膀胱组织存在明显的炎性反应且病理改变显著,膀胱组织超微结构可见明显肿胀、变形等细胞损伤,膀胱组织细胞损伤率显著增加(P<0.01),膀胱组织中ATP含量、P2X7R、NLRP3、Caspase-1、IL-1β的阳性表达及蛋白表达水平均显著升高(P<0.01)。与模型组比较,电针组大鼠膀胱漏尿点压力、膀胱最大压力、膀胱最大容量降低(P<0.05),尿潴留症状较轻,膀胱排尿功能改善;电针组大鼠膀胱组织的炎性反应及病理损伤减轻,膀胱组织超微结构变化明显改善,膀胱组织细胞损伤率显著减少(P<0.01),膀胱组织中ATP含量、P2X7R、NLRP3、Caspase-1、IL-1β的阳性表达及蛋白表达水平均显著降低(P<0.01)。结论电针可有效改善骶上脊髓损伤后尿潴留型神经源性膀胱大鼠的膀胱排尿功能,缓解尿潴留症状,减轻膀胱组织病理损伤程度及其炎症反应,其机制与抑制膀胱组织中P2X7R/NLRP3信号通路焦亡蛋白的表达有关。展开更多
AIM To analyses the current literature regarding the urogenital functional outcomes of patients receiving robotic rectal cancer surgery. METHODS A comprehensive literature search of electronic databases was performed ...AIM To analyses the current literature regarding the urogenital functional outcomes of patients receiving robotic rectal cancer surgery. METHODS A comprehensive literature search of electronic databases was performed in October 2015. The following search terms were applied: "rectal cancer" or "colorectal cancer" and robot* or "da Vinci" and sexual or urolog* or urinary or erect* or ejaculat* or impot* or incontinence. All original studies examining the urological and/or sexual outcomes of male and/or female patients receiving robotic rectal cancer surgery were included. Reference lists of all retrieved articles were manually searched for further relevant articles. Abstracts were independently searched by two authors. RESULTS Fifteen original studies fulfilled the inclusion criteria. A total of 1338 patients were included; 818 received robotic, 498 laparoscopic and 22 open rectal cancer surgery. Only 726(54%) patients had their urogenital function assessed via means of validated functional questionnaires. From the included studies, three found that robotic rectal cancer surgery leads to quicker recovery of male urological function and five of male sexual function as compared to laparoscopic surgery. It is unclear whether robotic surgery offers favourable urogenital outcomes in the long run for males. In female patients only two studies assessed urological and threesexual function independently to that of males. In these studies there was no difference identified between patients receiving robotic and laparoscopic rectal cancer surgery. However, in females the presented evidence was very limited making it impossible to draw any substantial conclusions. CONCLUSION There seems to be a trend towards earlier recovery of male urogenital function following robotic surgery. To evaluate this further, larger well designed studies are required.展开更多
Tanshinone ⅡA, extracted from Salvia miltiorrhiza Bunge, exerts neuroprotective effects through its anti-inflammatory, anti-oxidative and anti-apoptotic properties. This study intravenously injected tanshinone ⅡA 20...Tanshinone ⅡA, extracted from Salvia miltiorrhiza Bunge, exerts neuroprotective effects through its anti-inflammatory, anti-oxidative and anti-apoptotic properties. This study intravenously injected tanshinone ⅡA 20 mg/kg into rat models of spinal cord injury for 7 consecutive days. Results showed that tanshinone ⅡA could reduce the inflammation, edema as well as compensatory thickening of the bladder tissue, improve urodynamic parameters, attenuate secondary injury, and promote spinal cord regeneration. The number of hypertrophic and apoptotic dorsal root ganglion（L6–S1） cells was less after treatment with tanshinone ⅡA. The effects of tanshinone ⅡA were similar to intravenous injection of 30 mg/kg methylprednisolone. These findings suggested that tanshinone ⅡA improved functional recovery after spinal cord injury-induced lower urinary tract dysfunction by remodeling the spinal pathway involved in lower urinary tract control.展开更多
Aim: To determine whether bladder functions deteriorate with age. Methods: Data contained in electronic medical record (INFOMED?) were used in this institutional retrospective review. Analysis was done on the urodynam...Aim: To determine whether bladder functions deteriorate with age. Methods: Data contained in electronic medical record (INFOMED?) were used in this institutional retrospective review. Analysis was done on the urodynamic studies in women over 18 years old conducted between May 2011 and November 2015. Patients with previous history of pelvic surgery or radiotherapy, neurological disease, vaginal prolapse greater than grade I, congenital urogenital malformations, urinary obstructive disease, diabetes, or the use of any medication that could interfere with bladder function were excluded from the analysis. The urodynamic parameters analyzed were the Maximum Cystometric Capacity (MCC), Voiding Volume (VV), Maximum Flow (Qmax), Bladder Compliance (BC), Detrusor Pressure at Maximum Flow (PdetQmax), Bladder Contractility Index (BCI), Bladder Voiding Efficiency (BVE) and Post-Void Residual Urine Volume (PVR). Patients were further stratified in five groups according to age (A—18 to 40;B—41 to 50;C—51 to 60;D—61 to 70;E—over 70 years old). Results: Out of 3103 urodynamic studies analyzed, 719 were eligible for the study. The average age of patients was 49.3 (+13.2) years old and in all evaluated parameters, statistically significant correlation between age and decline of bladder function was obtained (p Conclusions: This study showed a decline in bladder storage function (reduction in MCC and BC) and in bladder emptying function (reduction in Qmax, PdetQmax, VV, BCI and BVE with an increase in PVR) with age.展开更多
Overactive bladder(OAB) syndrome is a condition which affects 16.9% of women and 16.2% of men with a significant negative impact on quality of life. It is a condition characterized by urgency, with or without urge inc...Overactive bladder(OAB) syndrome is a condition which affects 16.9% of women and 16.2% of men with a significant negative impact on quality of life. It is a condition characterized by urgency, with or without urge incontinence, frequency and nocturia. Behavioral modifications and oral anti-muscurinic medications are first and second-line therapies for OAB but are frequently ineffective or poorly tolerated. For refractory cases of OAB, onabotulinum toxin can be offered and this therapy was approved by the Food and Drug Administration in January of 2013. In this editorial, we will review the indications, usage, efficacy and safety data for intradetrusor injection of onabotulinum toxin A.展开更多
文摘Introduction: According to the most recent AUA/SUFU guidelines, intradetrusor onabotulinumtoxinA (BTN/A) is a standard, evidence strength grade B, third line treatment option for refractory non-neurogenic overactive bladder (OAB). Urinary retention is the most common clinically significant reported side effect ranging from 5.4% to 43% in previous studies. The aim of this study was to investigate the real-time rate of urinary retention in patients treated with BTN/A for refractory non-neurogenic OAB in a multi-institutional study. Methods: Retrospective chart review identified 71 patients who were treated with 100U BTN/A for refractory non-neurogenic OAB from August 2011 to July 2015 at two institutions. Using a flexible cystoscope, 100U Botox® reconstituted with 10 ml normal saline was administered. Injections of 1 ml (10 units/ mL) were administered in 10 evenly distributed sites sparing the trigone. Pre and post BTN/A post-void residuals (PVR) were reviewed. Urinary retention was defined as PVR > 200 mL requiring clean intermittent catheterization (CIC). Results: After exclusion, the study group consisted of 66 patients with a mean age of 67 years and 30% were men. Mean pre and post-procedural PVR were 14.06 mL and 69.21 mL. Eight patients (12.12%) were noted to have elevated PVR > 200 mL post injection however only one patient (female) required initiation of CIC. The rate of urinary retention was 1.5% (N = 1). There was no correlation with age, history of previous radiation, diabetes or prior use of a neuromodulator device. Conclusions: To the best of our knowledge, this is the first study to demonstrate a very low risk of real-time urinary retention rates in appropriately selected patients treated with BTN/A for refractory non-neurogenic OAB outside of a clinical trial setting.
文摘OBJECTIVE：To identify global trends in research on spinal cord injury-induced neurogenic bladder, through a bibliometric analysis using the Web of Science. DATA RETRIEVAL：We performed a bibliometric analysis of studies on spinal cord injury-induced neurogenic bladder using the Web of Science.Data retrieval was performed using key words＂spinal cord injury＂,＂spinal injury＂,＂neurogenic bladder＂,＂neuropathic bladder＂,＂neurogenic lower urinary tract dysfunction＂,＂neurogenic voiding dysfunction＂,＂neurogenic urination disorder＂and ＂neurogenic vesicourethral dysfunction＂. SELECTION CRITERIA：Inclusion criteria：（a）published peer-reviewed articles on spinal cord injury-induced neurogenic bladder indexed in the Web of Science;（b）type of articles：original research articles and reviews;（c）year of publication：no limitation.Exclusion criteria：（a）articles that required manual searching or telephone access;（b）Corrected papers and book chapters. MAIN OUTCOME MEASURES：（1）Annual publication output;（2）distribution according to journals; （3）distribution according to subject areas;（4）distribution according to country;（5）distribution according to institution;and（6）top cited publications. RESULTS：There were 646 research articles addressing spinal cord injury-induced neurogenic bladder in the Web of Science.Research on spinal cord injury-induced neurogenic bladder was found in the Science Citation Index-Expanded as of 1946.The United States,Ireland and Switzerland were the three major countries contributing to studies in spinal cord injury-induced neurogenic bladder in the 1970s.However,in the 1990s,the United States,the United Kingdom,the Netherlands,Germany and Japan published more papers on spinal cord injury-induced neurogenic bladder than Switzerland,and Ireland fell off the top ten countries list.In this century,the United States ranks first in spinal cord injury-induced neurogenic bladder studies,followed by France,the United Kingdom,Germany,Switzerland and Japan.Subject categories including urology, nephrology and clinical neurology,as well as rehabilitation,are represented in spinal cord injury-induced neurogenic bladder studies. CONCLUSION：From our analysis of the literature and research trends,we conclude that spinal cord injury-induced neurogenic bladder is a hot topic that will continue to generate considerable research interest in the future.
文摘Purpose: To clarify which patients need careful neurourological management after abdominal radical hysterectomy (RH) by investigating the effects of adjuvant radiotherapy and reversibility of neurogenic bladder (NB) on the storage function as well as the effects of urethral resistance on the emptying function. Methods: Data from sixty-two patients referred to our NB clinic after RH were retrospectively reviewed. Findings of urodynamic studies performed at 3 (UDS-1) and 12 (UDS-2) months after treatment were compared, and logistic analysis was used to calculate the odds ratio (OR) of the effects of radiotherapy and irreversible NB on decreased bladder capacity and decreased compliance. Irreversible NB was defined as the need for clean intermittent catheterization at the last follow-up. Results: At the median follow-up period of 41 months, 60% of the patients continued to require clean intermittent catheterization. Of patients with irreversible NB and radiotherapy, 80% had decreased bladder capacity and decreased compliance at UDS-2. For decreased bladder capacity and decreased compliance, ORs of adjuvant radiotherapy at UDS-2 were 38.42 (p Conclusions: Careful neurourological follow-up after RH is mandatory for patients who undergo adjuvant radiotherapy and have irreversible NB with impaired urethral relaxation.
文摘BACKGROUND Intestinal seromuscular bladder augmentation(SMBA)surgery has produced no mucosal-related complications,but its outcomes need to be studied.AIM To evaluate the safety and effectiveness of SMBA in the treatment of children with neurogenic bladder.METHODS A retrospective analysis of the clinical data of children with SMBA was performed from March 2008 to February 2018,and the data were compared with those of children receiving standard cystoplasty(SC).RESULTS In a cohort of 67 children who underwent bladder augmentation,the 46 children in the SC group had an average age of 10.6 years and a follow-up time of 36 mo,and the 21 children in the SMBA group had an average age of 7.6 years and a follow-up time of 29.7 mo.The preoperative and postoperative bladder volumes in the SMBA group were 151.7 mL and 200.4 mL,respectively,and those in the SC group were 173.9 mL and 387.0 mL,respectively.No significant difference in preoperative urinary dynamic parameters was found between the two groups,but the difference after operation was statistically significant.The main complications after SMBA were residual ureteral reflux and failed bladder augmentation,with incidences of 33.3%and 28.6%,respectively.In all 6 patients with failed augmentation in the SMBA group,ileum seromuscular patches were used for augmentation,and SC was chosen for reaugmentation.During reoperation,patch contracture and fibrosis were observed.CONCLUSION The improvement of urinary dynamic parameters in the SMBA group was significantly lower than that in the SC group.Children with SMBA had a higher probability of patch contracture and reaugmentation,which might be related to impaired blood supply and urine stimulation,and the sigmoid colon patch should be the priority.
文摘目的观察电针对骶上脊髓损伤后尿潴留型神经源性膀胱大鼠排尿功能的影响,并探讨电针调节嘌呤能离子通道型受体7(purinergic ligand-gated ion channel 7 receptor,P2X7R)介导的细胞焦亡途径在其中的潜在效应机制。方法从48只雌性SD大鼠中随机抽取12只纳入假手术组,剩余大鼠以T8完全性脊髓横断法建立尿潴留型神经源性膀胱大鼠模型,将已成模的27只大鼠二次随机分为模型组与电针组,每组12只,剩余3只模型大鼠用于实验候补。电针组于术后第19天开始干预,连续10 d,其余两组仅予以捆绑。干预结束后,各组大鼠先行尿流动力学检测,随后快速分离膀胱组织待检,应用HE染色观察膀胱组织形态学变化,透射电镜观察膀胱组织超微结构变化,TUNEL染色检测膀胱组织中细胞损伤情况,ELISA检测膀胱组织中三磷酸腺苷(adenosine triphosphate,ATP)水平,免疫组织化学法和Western blot法检测膀胱组织中P2X7R、NOD样受体热蛋白结构域相关蛋白3(NODlike receptor thermal protein domain associated protein 3,NLRP3)、半胱氨酸天冬氨酸蛋白酶-1(cysteinyl aspartate specific proteinase-1,Caspase-1)、白细胞介素-1β(interleukin-1β,IL-1β)蛋白表达情况。结果与假手术组比较,模型组大鼠膀胱漏尿点压力、膀胱最大压力、膀胱最大容量显著升高(P<0.01),以膀胱体积增大伴尿潴留为主要表现;模型组大鼠膀胱组织存在明显的炎性反应且病理改变显著,膀胱组织超微结构可见明显肿胀、变形等细胞损伤,膀胱组织细胞损伤率显著增加(P<0.01),膀胱组织中ATP含量、P2X7R、NLRP3、Caspase-1、IL-1β的阳性表达及蛋白表达水平均显著升高(P<0.01)。与模型组比较,电针组大鼠膀胱漏尿点压力、膀胱最大压力、膀胱最大容量降低(P<0.05),尿潴留症状较轻,膀胱排尿功能改善;电针组大鼠膀胱组织的炎性反应及病理损伤减轻,膀胱组织超微结构变化明显改善,膀胱组织细胞损伤率显著减少(P<0.01),膀胱组织中ATP含量、P2X7R、NLRP3、Caspase-1、IL-1β的阳性表达及蛋白表达水平均显著降低(P<0.01)。结论电针可有效改善骶上脊髓损伤后尿潴留型神经源性膀胱大鼠的膀胱排尿功能,缓解尿潴留症状,减轻膀胱组织病理损伤程度及其炎症反应,其机制与抑制膀胱组织中P2X7R/NLRP3信号通路焦亡蛋白的表达有关。
文摘AIM To analyses the current literature regarding the urogenital functional outcomes of patients receiving robotic rectal cancer surgery. METHODS A comprehensive literature search of electronic databases was performed in October 2015. The following search terms were applied: "rectal cancer" or "colorectal cancer" and robot* or "da Vinci" and sexual or urolog* or urinary or erect* or ejaculat* or impot* or incontinence. All original studies examining the urological and/or sexual outcomes of male and/or female patients receiving robotic rectal cancer surgery were included. Reference lists of all retrieved articles were manually searched for further relevant articles. Abstracts were independently searched by two authors. RESULTS Fifteen original studies fulfilled the inclusion criteria. A total of 1338 patients were included; 818 received robotic, 498 laparoscopic and 22 open rectal cancer surgery. Only 726(54%) patients had their urogenital function assessed via means of validated functional questionnaires. From the included studies, three found that robotic rectal cancer surgery leads to quicker recovery of male urological function and five of male sexual function as compared to laparoscopic surgery. It is unclear whether robotic surgery offers favourable urogenital outcomes in the long run for males. In female patients only two studies assessed urological and threesexual function independently to that of males. In these studies there was no difference identified between patients receiving robotic and laparoscopic rectal cancer surgery. However, in females the presented evidence was very limited making it impossible to draw any substantial conclusions. CONCLUSION There seems to be a trend towards earlier recovery of male urogenital function following robotic surgery. To evaluate this further, larger well designed studies are required.
基金supported by the China Postdoctoral Science Foundation,No.2015M581120
文摘Tanshinone ⅡA, extracted from Salvia miltiorrhiza Bunge, exerts neuroprotective effects through its anti-inflammatory, anti-oxidative and anti-apoptotic properties. This study intravenously injected tanshinone ⅡA 20 mg/kg into rat models of spinal cord injury for 7 consecutive days. Results showed that tanshinone ⅡA could reduce the inflammation, edema as well as compensatory thickening of the bladder tissue, improve urodynamic parameters, attenuate secondary injury, and promote spinal cord regeneration. The number of hypertrophic and apoptotic dorsal root ganglion（L6–S1） cells was less after treatment with tanshinone ⅡA. The effects of tanshinone ⅡA were similar to intravenous injection of 30 mg/kg methylprednisolone. These findings suggested that tanshinone ⅡA improved functional recovery after spinal cord injury-induced lower urinary tract dysfunction by remodeling the spinal pathway involved in lower urinary tract control.
文摘Aim: To determine whether bladder functions deteriorate with age. Methods: Data contained in electronic medical record (INFOMED?) were used in this institutional retrospective review. Analysis was done on the urodynamic studies in women over 18 years old conducted between May 2011 and November 2015. Patients with previous history of pelvic surgery or radiotherapy, neurological disease, vaginal prolapse greater than grade I, congenital urogenital malformations, urinary obstructive disease, diabetes, or the use of any medication that could interfere with bladder function were excluded from the analysis. The urodynamic parameters analyzed were the Maximum Cystometric Capacity (MCC), Voiding Volume (VV), Maximum Flow (Qmax), Bladder Compliance (BC), Detrusor Pressure at Maximum Flow (PdetQmax), Bladder Contractility Index (BCI), Bladder Voiding Efficiency (BVE) and Post-Void Residual Urine Volume (PVR). Patients were further stratified in five groups according to age (A—18 to 40;B—41 to 50;C—51 to 60;D—61 to 70;E—over 70 years old). Results: Out of 3103 urodynamic studies analyzed, 719 were eligible for the study. The average age of patients was 49.3 (+13.2) years old and in all evaluated parameters, statistically significant correlation between age and decline of bladder function was obtained (p Conclusions: This study showed a decline in bladder storage function (reduction in MCC and BC) and in bladder emptying function (reduction in Qmax, PdetQmax, VV, BCI and BVE with an increase in PVR) with age.
文摘Overactive bladder(OAB) syndrome is a condition which affects 16.9% of women and 16.2% of men with a significant negative impact on quality of life. It is a condition characterized by urgency, with or without urge incontinence, frequency and nocturia. Behavioral modifications and oral anti-muscurinic medications are first and second-line therapies for OAB but are frequently ineffective or poorly tolerated. For refractory cases of OAB, onabotulinum toxin can be offered and this therapy was approved by the Food and Drug Administration in January of 2013. In this editorial, we will review the indications, usage, efficacy and safety data for intradetrusor injection of onabotulinum toxin A.
