Reduced bladder capacity without daytime voiding symptoms with nocturnal enuresis

Background: This study aimed to evaluate the prevalence of monosymotomatic nocturnal enuresis (MSNE) with reduced bladder capacity in children with primary nocturnal enuresis (NE) and to suggest treatment outcomes. Methods: This study retrospectively evaluated 54 children (30 males, 24 females; median age: 8; range: 5?14) who were newly diagnosed with primary NE from November 2017 to October 2019. Reduced bladder capacity in MSNE was defined when a patient’s maximal voided volume (MVV) from his or her voiding diary was 75% or less than estimated functional bladder capacity ([age + 1] x 30 mL) for his or her age and there were no daytime lower urinary tract symptoms (LUTS) as assessed using history taking and questionnaires. Results: Nineteen (35.2%) of 54 children with newly diagnosed primary NE did not report daytime LUTS. Fifteen children (27.8%) had a reduced bladder capacity and were prescribed anticholinergic or beta-3 agonist. After three months of medication, MVV significantly increased from 117.5 mL to 183.3 mL (P = 0.010), but frequency showed no significant change from 5.7 to 4.9 times a day. Improvement in enuresis occurred completely and partially in 41.7% and 25% of participants, respectively. Conclusions: The prevalence of reduced bladder capacity without daytime voiding symptoms was relatively high as 27.8% in children newly diagnosed with primary NE. In primary MSNE, reduced bladder capacity should be investigated using a frequency-volume chart in addition to thorough history taking or questionnaires. Anticholinergics or beta-3 agonists for MSNE with reduced bladder capacity are effective at increasing the bladder capacity of these patients

Outcomes of extracoporeal shock wave lithotripsy for ureteral stones according to ESWL intensity

Baekground: We evaluated the treatment outcomes of ureteral stones according to energy intensity generated by ESWL. Conclusions: Stone size and HU affected the ESWL success rate. ESWL intensity was not significantly relate to the success rate, so it should be adjusted accordig ton patient pain and the degree of stone fragmentation

Varying Outcomes among Patients with Large Angiomyolipomas according to the Treatment Method

Purpose: This study aimed to evaluate the outcomes of large angiomyolipoma (AML) treatment by selective arterial embolization (SAE) versus nephron-sparing surgery (NSS) using a robotic surgical system. Materials and Methods: Between January 2011 and June 2018, we retrospectively reviewed 25 patients who underwent robot-assisted partial nephrectomy (RAPN) or SAE for large AMLs. Ten patients underwent RAPN, and 15 underwent SAE. Patient demographics, AML characteristics, and operative and postoperative clinical outcomes were recorded and analyzed. Outcomes were compared between patients who underwent RAPN and patients who underwent SAE. Specifically, changes in renal function and size were evaluated after the treatment. Results: The mean age of the patients was 52.9 years, and 22 of 25 patients were female. The mean maximum AML diameter on computed tomography was 8.9 cm, and 8 patients had multiple masses. Twenty-two of 25 patients had moderate to high RENAL complexity. Patients who underwent SAE had more symptoms (p = 0.018) and higher RENAL complexity scores (p = 0.013) on average. On average, tumor size decreased by 99% among RAPN patients and by 58% among SAE patients (p = 0.001). Although the mean pretreatment estimated glomerular filtration rate (eGFR) was higher among RAPN patients (99.8 vs. 80.0 mL/min/1.73 m(2), p = 0.043), there were no significant changes in eGFR in either group after the treatment. One patient in the RAPN group experienced complications, but the postoperative ileus resolved without intervention. Conclusions: Both RAPN and SAE were effective and feasible treatment options for large AMLs. The AML characteristics and the condition of the patient might be important in determining the appropriate treatment method

Efficacy and tolerability of mirabegron compared with solifenacin for children with idiopathic overactive bladder: A preliminary study

Purpose: To compare the efficacy and tolerability of mirabegron and solifenacin in pediatric patients with idiopathic overactive bladder (OAB) and to identify factors affecting OAB symptom improvement after treatment. Materials and Methods: We retrospectively reviewed 103 patients (5-15 years old) who visited our hospital with OAB symptoms between July 2017 and March 2019. All participants had received solifenacin or mirabegron. Those who had secondary OAB or who did not complete the frequency-volume chart either before or after treatment were excluded. The age-adjusted bladder capacity ratio was used to evaluate bladder capacity. Efficacy was assessed on the basis of patient reports and changes in the frequency-volume chart, and >= 90% reduction was regarded as "responding to medication." Tolerability was assessed by obtaining reports from patients about the adverse effects of the drug. Results: After the exclusion of 58 patients, 45 patients (29 in solifenacin-group and 16 in mirabegron-group) were included in the primary analysis. The age-adjusted bladder capacity ratio increased from 0.71 to 0.96 (p<0.001) and from 0.57 to 0.97 (p=0.002) after solifenacin and mirabegron use, respectively. Decreased bladder capacity before medication was associated with responding to medication (odds ratio, 7.41; p=0.044). There was no significant difference in efficacy between the two drugs. Drug-induced adverse effects were reported in only 3 (10.3%) of the solifenacin-treated patients. Conclusions: Mirabegron showed comparable efficacy to solifenacin in pediatric patients with idiopathic OAB. Additionally, only few adverse effects were reported, suggesting that mirabegron can be a safe alternative for the treatment of idiopathic pediatric OAB

Developmentally regulated GTP-binding protein 2 levels in prostate cancer cell lines impact docetaxel-induced apoptosis

Purpose: This study aimed to confirm the association between developmentally regulated GTP-binding protein 2 (DRG2) expression and docetaxel-induced apoptosis and to determine whether prostate cancer responses to docetaxel treatment differ with DRG2 expression. Materials and methods: PC3, DU145, and LNCaP prostate cancer cell lines were used. The MTT assay was used to determine cell viability. Western blotting analysis was performed using anti-DRG2 antibodies. Cells were transfected with 50 nmol DRG2 siRNA using an siRNA transfection reagent for DRG2 knockdown. The cell cycle was analyzed by using flow cytometry, and apoptosis was detected by using the Annexin V cell death assay. Results: DRG2 expression differed in each prostate cancer cell line. Docetaxel reduced DRG2 expression in a dose-dependent manner. Upon DRG2 knockdown in prostate cancer cells, an increase in the sub-G1 phase was observed without a change in the G1 or G2/M phases. When 4 nM docetaxel was administered to DRG2 knockdown prostate cancer cell lines, an increase in the sub-G1 phase was observed without increasing the G2/M phase, which was similar to that in DU145 cells before DRG2 knockdown. In PC3 and DU145 cell lines, DRG2 knockdown increased docetaxel-induced Annexin V (+) apoptosis by 8.7 and 2.7 times, respectively. Conclusions: In prostate cancer cells, DRG2 regulates G2/M arrest after docetaxel treatment. In prostate cancer cells with DRG2 knockdown, apoptosis increases without G2/M arrest in response to docetaxel treatment. These results show that inhibition of DRG2 expression can be useful to enhance docetaxel-induced apoptosis despite low-dose administration in castration-resistant prostate cancer