A rare cause of acute abdomen: radiotherapy-induced bladder rupture

Introduction: Spontaneous intraperitoneal rupture of the bladder, which is rare, is a life-threatening condition. In emergency services, when patients present with lower quadrant abdominal pain and acute renal failure in the patient's laboratory findings consistent with curriculum vitae should be suspected if there is a history of radiotherapy. A cystography is the most accurate and precise method to make a diagnosis. The definitive solution is surgery, which depends on the condition of the patient.Case Report: A 52-years-old female patient with diffuse abdominal pain applied to our emergency department with complaints of high fever and hematuria. The fact that operated from cervical cancer medical history and undergone radiotherapy was learned. A physical examination of the abdomen and midline defects detected a urine-like liquid coming from the defect. Cystography was also performed because of being macroscopic hematuria to patient, and bladder rupture was detected.Conclusion: The aim of this phenomenon in our presentation. If patients who present to the emergency department with acute renal failure and peritonitis with a medical history of radiotherapy have a history of pelvic radiotherapy in the curriculum vitae with acute renal failure and peritonitis emergency signs, spontaneous rupture of the bladder is to emphasize that occur years after radiation therapy should be considered

The renoprotective effects of mannitol and udenafil in renal ischemia-reperfusion injury model

Purpose: The aim of this study was to investigate and compare the effects of udenafil and mannitol in an experimental renal ischemia-reperfusion (I/R) injury model.Materials and Methods: A total of 64 female Wister Albino rats were used. Right nephrectomy was performed in all groups. In the control group; I/R injury was not performed. In the I/R group; left renal pedicle was clamped for 45 minutes and then underwent 60 minutes and 24 hours of reperfusion. In the mannitol group; 1 mL 20% mannitol was given intravenously 15 minutes before clamping. In the udenafil group; 10-mg/kg udenafil was given orally 1 hour before clamping. Creatinine (Cr), blood urea nitrogen (BUN), Cr clearance, malondialdehyde, neutrophil gelatinase associated lipocalin (NGAL), histological examination and DNA damage (Comet Assay method) levels were compared in tissue, serum and urine samples.Results: Udenafil had a better protective effect than mannitol according to biochemical parameters (Cr, BUN, Cr clearance, and NGAL levels) and histopathological findings when compared with the I/R group. In the Comet sampling analysis no significant difference was detected.Conclusions: Udenafil has a better renoprotective effect than mannitol against I/R injury and this effect supports more functional improvements. Further clinical trials are needed to demonstrate those effects and clinical utility of udenafil for that purpose in humans

Optimizing individual treatment outcomes in men with lower urinary tract symptoms using storage subscale score/total International Prostate Symptom Score (IPSS) as a new IPSS lratio

Background/aim: To evaluate the effects of the storage/total International Prostate Symptom Score (s/T) ratio on the selection and success of medical therapy in men with lower urinary tract symptoms (LUTS).Materials and methods: A total of 54 men (>45 years of age) with moderate or severe LUTS were divided into 2 groups according to the s/T ratio: Group 1 at 0.43. Tamsulosin (0.4 mg to Group 1) and tolterodine ER (4 mg to Group 2) were administered. Patients were evaluated during the 1st and 3rd months of follow-up treatment.Results: Thirty-seven (68.5%) and 17 (31.5%) patients were in Groups 1 and 2, respectively. The mean s/T ratios in Groups 1 and 2 increased to 0.38 ± 0.19 from 0.33 ± 0.08 (P = 0.03) and decreased to 0.54 ± 0.18 from 0.59 ± 0.1 (P = 0.17) during the 3rd month of follow-up, respectively. The treatment success rates of Groups 1 and 2 were 88.4% and 75.7%, respectively. Nine unsuccessful cases were treated with combination therapy and the treatment success was 86.6% at follow-up.Conclusion: The s/T ratio is effective to determine symptom dominance in men with LUTS and can guide medical treatment selection through better identification of symptoms. © TÜBİTAK

Assessment of proportion of hidden patients having symptoms of overactive bladder and why has it been hidden in female outpatients admitted to hospital

Purpose: To determine the proportion of patients with undetected symptoms of overactive bladder by using the overactive bladder-validated 8 (OAB-V8) screening questionnaire and investigate these symptoms were undetected in female patients who were hospitalized. Methods: We invited 2,250 female patients hospitalized in the Aegean region of Turkey to answer a self-administered questionnaire. The questionnaire included questions on evidence of lower urinary tract symptoms (OAB-V8), relevant medical history, and demographic data. Patients with a total OAB-V8 score ≥ 8 were defined as having OAB symptoms. Results: The proportion of patients with OAB symptoms in this study was 40.6%. Nearly 57% of the patients with OAB symptoms had not been previously admitted to any hospital for lower urinary tract symptoms (LUTS). The two most common reasons why women with OAB symptoms did not admit themselves to a hospital because of LUTS were as follows: "I did not think I had a disease" and "The symptoms did not bother me," with a response rate of 74.7%. The mean OAB-V8 scores of the patients with these two responses were significantly lower than those of the other patients (P < 0.001). Conclusions: This is the first study to demonstrate a significant proportion of women with undetected OAB symptoms. The main reasons the women did not admit themselves to a hospital were their unawareness of the disease and because the LUTS were not bothersome. Public awareness programs on this disease may resolve this problem. © 2016 Korean Continence Society