A hólyagkontraktilitási index meghatározásának fontossága a csökkent hólyagműködés kezelésében | The importance of Bladder Contractility Index in the management of underactive bladder

Absztrakt: Célkitűzés: A hólyagkontraktilitási index (BCI) fontosságának felmérése a csökkent hólyagműködés kezelésében. Betegek és módszer: Retrospektív tanulmányunkban 2013. január és 2016. szeptember közötti, detrusor-alulműködéssel (BCI<100) kórismézett beteg adatait dolgoztuk fel (BCI = PdetQmax+5Qmax). Eredmények: A tanulmányozott betegek (férfi 38, nő 53) esetében a BCI átlagértéke 55 volt (17–110), urodinámiás vonatkozásban: átlag-Qmax 7 ml/s, átlag-Pdet 14 H2O-cm. A BCI csökkenő tendenciát mutat az életkor előrehaladtával, valamint összefüggés mutatható ki a BCI, a diabetes (p = 0,003), illetve a neurológiai betegségek (p = 0,015) között. Következtetések: A csökkent hólyagműködés kórismézése igazi kihívás az urológus számára, az urodinámiás vizsgálatok (a residuum értéke, Qmax, PdetQmax) és a BCI értéke nagyban elősegítik a megfelelő kezelési terv felállítását. Orv Hetil. 2017; 158(31): 1222–1227. | Abstract: Aim: To evaluate the importance of BCI in the management of underactive bladder (UB). Material and method: A retrospective study over a period of 3 years and 9 months (January 2013–September 2016) in Mureş County Hospital, Clinic of Urology, including 91 patients. Detrusor underactivity was defined by BCI less than 100 using the formula: PdetQmax+5Qmax. Results: The median of Qmax value was 7 ml/s and the median value of Pdet was 14 cm H2O. The median value of BCI was 55 with extremities between 17 and 110. BCI tends to decrease with age and there is a relation between value of BCI and diabetes (p = 0,003) and neurological diseases (p = 0,015). Conclusions: The UB diagnosis represents a real challenge for the urologist, so that, urodynamical findings such as absence of bladder obstruction, post-void residual urine, Qmax, together with BCI value, helps in setting the proper management. Orv Hetil. 2017; 158(31): 1222–1227

Renal Denervation – a Modern Option for Treating Resistant Hypertension

Hypertension is one of the main cardiovascular risk factors, and it remains an important health problem, demonstrating an increasing incidence despite new treatment methods. Numerous risk factors that can lead to the development of difficult-to-treat or resistant hypertension have been described in the literature in recent years. In this type of hypertension, an important role is played by the sympathetic nervous system. Especially in these cases, with a sympathetic overactivation, renal denervation has proven its efficacy and safety in lowering blood pressure. In this brief clinical update, we present the results of the main studies regarding the efficacy and safety of the renal denervation technique used in the treatment of resistant hypertension

Zinner’s Syndrome – The Value of Clinical Imaging and Morphopathological Findings for Diagnosis

Introduction: Cystic congenital malformations of the seminal vesicle are unusual. More than half of them are associated with ipsilateral renal agenesis. This disease was first described by Zinner in 1914, and since then, more than 200 cases have been reported. Most of the patients with this congenital disease present few symptoms until the middle-age

Easily Available Blood Test Neutrophil-To-Lymphocyte Ratio Predicts Progression in High-Risk Non-Muscle Invasive Bladder Cancer

Introduction: The inflammatory response surrounding the tumour has a major importance in the oncologic outcome of bladder cancers. One marker proved to be useful and accessible is NLR (neutrophil-to-lymphocyte ratio). The objective of the study was the analysis of NLR as a prognostic factor for recurrence and progression in pT1a and pT1b bladder cancers

Bacteriological evaluation of the non-struvite nephrolithiasis and its association with urinary tract infections

Objective: To evaluate the bacteriological features in non-struvite nephrolithiasis and in its associated urinary tract infection, and to establish the relationship between the two pathologies

The role of neutrophil to lymphocyte ratio in patients with pTa non-muscle invasive bladder cancer

Introduction: The peritumoral inflammatory reaction has a substantial importance in the oncologic outcome of bladder cancer (BC). One biomarker proven to be practical and accessible is the NLR (neutrophil-to-lymphocyte ratio) for high risk non-muscle invasive bladder cancer (NMIBC). The aim of the study was to investigate the role of NLR as a prognostic biomarker for disease recurrence, progression and survival of p Ta (pathological assesment of the primary tumor) NMIBC

Severe Acute Ischemia of Glans Penis after Achieving Treatment with Only Hyperbaric Oxygen Therapy: A Rare Case Report and Systematic Literature Review

Acute ischemia of the glands is a severe complication after circumcision. We outline the challenging case of a seventeen-year-old boy with glandular ischemia (GI) that appeared shortly after circumcision. Methods: We present a case report and literature review related to glans ischemia, and the complications of circumcision are reviewed. We note that there are very few cases described in the literature. Our patient was successfully treated with hyperbaric oxygen therapy (HBOT) after four days of no positive effect after all medical and surgical treatments written in the literature: Subcutaneous enoxaparin, local application of a glyceryl trinitrate, continuous epidural perfusion, intravenous pentoxifylline, alprostadil, intraoperative drainage, and aspiration with saline solution and epinephrine. Clinical improvement was noted at the first session of HBOT. A number of days after the operation, the penis looked normal and was healing. Complete healing of the penile glans was successfully realized one month after surgery. Conclusion: Based on the review and the case presented, we conclude that HBOT is the treatment of choice for acute ischemia of the penile glans, especially when other treatments do not work