Adult posterior urethral valve: a case report

Introduction: Posterior urethral valve (PUV) is a congenital obstructive defect of the male urethra with an incidence of 1/8,000 to 1/25,000 live births. PUV is the most common cause of lower urinary tract obstruction in neonates. The diagnosis of PUV is usually made early, and PUV cases have rarely been detected in adults

The role of prostaglandin E2 in children with lower urinary tract dysfunction

Objectives: The objective of the study is to examine the effect of prostaglandin E2 (PGE2) in the etiology of children with lower urinary tract dysfunction (LUTD), we formed this prospective study. The role of PGE2 in children with LUTD has not been reported yet. Materials and Methods: Between October 2010 and April 2012, a total of 91 children between 5 and 15 years age enrolled in this study. A total of 11 children were excluded from the study for active urinary tract infection. About 48 children from a nursery and a primary school were chosen as a control group. Nearly 32 of the children had LUTD. Results: The median PGE2 was not statistically significant different between LUTD and control group (P = 0.93), but the PGE2 level was higher in control group. Although there was no statistically significant difference between genders and between the patients with overactive bladder (OAB) symptoms, postvoid residual (PVR), enuresis, and opposites, or according to voiding patterns; the PGE2 level was higher in the patients with OAB symptoms, enuresis, and tower voiding pattern. On the other hand, the PGE2 level was lower in the patients with PVR. Conclusions: PGE2 may not be an etiological factor in children with LUTD. Higher PGE2 levels in control group and lower PGE2 levels in patients with PVR offers further examinations to understand the PGE2 effect.&nbsp

The effects of pelvic floor muscle therapy on symptoms, voiding, and pelvic floor muscle activity parameters in children with overactive bladder

Introduction Refractory overactive bladder (OAB) in children can be treated with second line modalities such as as biofeedback, transcutaneous electrical stimulation (TENS), and botulinum toxin. In this study, we aimed to investigate the efficacy of biofeedback-assisted pelvic floor muscle therapy (PFMT) on symptoms, bladder capacity, uroflowmetry, and pelvic floor muscle activity (PFMA) in children with resistant OAB or dysfunctional voiding (DV) with associated seconder bladder overactivity (DV/SBO). Materials and Methods A total of 24 children with resistant OAB were included in the study. Patients were divided into two groups as: group-1 pure OAB and group-2 DV/SBO. Children were evaluated with voiding diary, uroflowmetry-EMG, PFMA before and after treatment. All patients were treated with PFMT. Results Urgency cured or improved in 12 of 17 (71%) of children in group-1 and in six of seven (86%) children in group-2 (P < 0.0001 and 0.031, respectively). Other symptoms cured or improved with 64%-100% recovery rates in group-1 and 50%-80% in group-2. Maximum voided volume (maxVV) in voiding diary increased from 81.6 to 150.9 mL in group-1 and from 115.6 to 175.7 mL in group-2 (P < 0.0001 and 0.063, respectively). Mean work value of PFMA increased and mean rest value of PFMA decreased significantly (P < 0.0001, 0.018 and P = 0.002 and 0.018, respectively). Conclusion The measurement of PFMA in children with refractory OAB or DV/SBO gives information on the strength and endurance of PFMs. In children with refractory OAB or DV/SBO, biofeedback-assisted PFMT provides symptomatic improvement and increases functional bladder capacity

Comparison of the inguinal and scrotal approaches for the treatment of communicating hydrocele in children

PubMed: 24656161The inguinal approach is used for the treatment of hydrocele in the pediatric population. Although studies on scrotal orchiopexy have mentioned hernia or hydrocele repair through the same scrotal incision as a part of an orchiopexy procedure, there are a few studies reporting the treatment of isolated communicating hydrocele through a scrotal incision. We retrospectively evaluated and compared the outcomes of inguinal and scrotal approaches for the treatment of communicating hydrocele in boys. The classical inguinal and scrotal approaches to the treatment of communicating hydrocele were performed on 46 and 30 testicular units (in 43 boys and 27 boys, respectively). The patients' charts were reviewed to assess the operative times as well as the immediate and long-term complications during follow-up periods. The patients' ages ranged from 1 year to 8 years (3.6 ± 2.0 years) in the inguinal group and from 1 year to 10 years (mean 4.6 ± 2.8 years) in the scrotal group. Operative time was significantly lower in the scrotal group (p < 0.0001). The early minor complication rate did not differ between the two groups. Furthermore, there were no major complications noted. None of the patients had hydrocele recurrence after a mean follow-up of 6 months. The advantages of the scrotal approach for the treatment of communicating hydrocele are as follows: it is well tolerated, simple, and cosmetically appealing, and it has a short operative time in comparison with the standard inguinal approach. The scrotal incision technique is an effective alternative in communicating hydrocele treatment. © 2013, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved

Does Structured Withdrawal of Desmopressin Improve Relapse Rates in Patients with Monosymptomatic Enuresis?

Purpose: Relapse after cessation of desmopressin is an important problem in treating patients with enuresis. Structured withdrawal of desmopressin tablets has been shown to decrease relapse rates. However, scientific data are lacking on the structured withdrawal of the fast melting oral formulation of desmopressin. We compared relapse rates of structured withdrawal using placebo and direct cessation in a population of patients with enuresis who were desmopressin responders

Does Structured Withdrawal of Desmopressin Improve Relapse Rates in Patients with Monosymptomatic Enuresis?

Purpose: Relapse after cessation of desmopressin is an important problem in treating patients with enuresis. Structured withdrawal of desmopressin tablets has been shown to decrease relapse rates. However, scientific data are lacking on the structured withdrawal of the fast melting oral formulation of desmopressin. We compared relapse rates of structured withdrawal using placebo and direct cessation in a population of patients with enuresis who were desmopressin responders