• Title/Summary/Keyword: Urinary tract function

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Urinary incontinence - Anatomy and physiology of bladder and bowel - (요실금 - 방광과 장의 해부학적, 생리학적 연관성 -)

  • Lee, Jung Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1136-1139
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    • 2008
  • The genitourinary tract and gastrointestinal system are interdependent but share the same embryological origin, pelvic region, and sacral innervation. Although children with voiding disturbances often present with bowel dysfunction, this coexistence was considered coincidental until recently. However, it is now accepted that dysfunction in emptying of both systems is interrelated. Afferent impulses carrying sensory information are transmitted through the spinal cord and brainstem toward several cortical and subcortical areas, resulting in conscious control of the bladder and bowel. Alteration in these afferent pathways can result in dysfunction, including urinary and fecal incontinence. Distal gastrointestinal tract problems such as constipation might induce an inhibitory rectovesical reflex that interferes with normal voiding. Therefore, lower urinary tract function seems to be closely associated with distal gastrointestinal tract function.

Implementation and estimation of the noninvasive vesical pressure measurement system for diagnosis of lower urinary tract symptom (하부요로 폐색진단을 위한 비침습적 방광내압 계측 시스템의 구현 및 평가)

  • Jeong, Do-Un;Jeon, Gye-Rok
    • Journal of Sensor Science and Technology
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    • v.15 no.2
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    • pp.139-147
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    • 2006
  • Lower urinary tract symptoms (LUTS) affect self-assessed quality of life. The prevalence of LUTS is commonly high in the elderly. The purpose of urodynamic investigation is to obtain information on the function of the urinary system. One of the most frequently used measurement procedures in urodynamics is filling and voiding cystometry. But in this system transurethral catheter is used and it makes patients uncomfortable. The aim of this study is to implement the system that could evaluate noninvasively the function of urinary tract. A new system has been developed to analyze urine flow rate and vesical pressure during voiding. These signals were recorded simultaneously and transmitted to a PC. For system evaluation, a model for the lower urinary system of men was constructed. From the evaluation of the model, vesical pressure was correlated with the occlusion degree. In a pilot study with five male subjects, maximum of standard deviation was 1.26, error rate was 3.49 and coefficient of variation was 3.48.

Estimation of compensatory hypertrophy in lower urinary system using void force measurement (배뇨력 측정을 통한 하부요로계의 보상성기능항진 평가)

  • Jeong, Do-Un;Jeon, Gye-Rok
    • Journal of Sensor Science and Technology
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    • v.15 no.6
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    • pp.449-456
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    • 2006
  • The purpose of urodynamic investigation is to obtain the information on the function of the urinary system. The aim of this study is to acquire the useful information of lower urinary tract symptom (LUTS) diagnosis through void force signal as noninvasive method. The system which could evaluate the function of compensatory hypertrophy with noninvasive and comfortable method was implemented to measure uroflow and void force during urination. The implemented system composes of the sensor parts, signal conditioning parts and PC monitoring program. For the evaluation of the implemented system, the simulation of control part of the system was performed and the model system for the lower urinary system was designed. The superiority of a measuring characteristic of the implemented system was verified using the model system. From the evaluation of the model system, we have found out that the void force was dependent on the occlusion degree and compensatory hypertrophy significantly.

The Evaluation of 10 week urinary Tract Function Promotion Program for the Elderly Women in the Community (노인 여성의 요로기능증진 10주 프로그램 개발 및 평가)

  • Kim, Jeung-Im
    • Women's Health Nursing
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    • v.9 no.4
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    • pp.439-448
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    • 2003
  • Purpose: This study was accomplished to apply and to evaluate the 10-week Urinary tract Function Promotion for the Elderly Women (UFPE), and to suggest guideline and to be utilized on the community level. Method: Subjects were 30 persons of 16 healthy elderly and 14 hemiplegic elderly. This UFPE was composed of diagnosis of incontinence & evaluation of physical condition, understanding of urogenital system & urinary incontinence management. UFPE was evaluated by subjective urinary condition, intra-vaginal contraction power, continence self-efficacy (CSE), incontinence stress, geriatric depression. The collected data was analyzed using Wilcoxon Matched Signed-Ranks test by SPSS/WIN program. Result: 5 subjects (31.2%) in healthy group and 2 subjects(14.3%) in hemiplegic group have a daytime frequency, 14 subjects(87.5%) in healthy- group and 14 subjects(100%) have a nocturia. After program, subjective urinary condition was increased just only healthy elderly (Z=-2.545, p<0.05), while intra-vaginal contraction power and CSE were increased significantly only in the hemiplegic elderly (Z=-2.57, P<0.05: Z=-2.29, p<0.05). There were barriers not to comply program guidance such as inadequate perception of pelvic floor muscle, forget to do exercise, fatigue. Conclusion: UFPE was effective in increasing subjective urinary condition for healthy elderly and in increasing intra-vaginal contraction power and continence self-efficacy for the hemiplegic elderly women. I suggest that this UFPE be utilized at the health center and elderly center, and public health nurse counsel and guide the elderly's work through phone service.

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Hypogonadal men with moderate-to-severe lower urinary tract symptoms have a more severe cardiometabolic risk profile and benefit more from testosterone therapy than men with mild lower urinary tract symptoms

  • Saad, Farid;Doros, Gheorghe;Haider, Karim Sultan;Haider, Ahmad
    • Investigative and Clinical Urology
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    • v.59 no.6
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    • pp.399-409
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    • 2018
  • Purpose: To analyze data from an observational, prospective, cumulative registry study in 805 hypogonadal men stratified by mild or moderate-to-severe lower urinary tract symptoms (LUTS) according to International Prostate Symptom Score. Materials and Methods: A total of 412 men underwent testosterone therapy (TTh) with injectable testosterone undecanoate, 393 men served as untreated controls. Measures of urinary function, anthropometric and metabolic parameters were performed at least twice per year. Results: Data from 615 men with mild LUTS (253 treated, 362 untreated) and 190 with moderate-to-severe LUTS (159 treated, 31 untreated) were available. During a follow-up period of 8 years a significant improvement of LUTS was noted for all TTh-patients whereas the control-groups showed deterioration or fluctuation around initial values. Despite advancing age, TTh fully prevented worsening of symptoms. In parallel, a considerable improvement of anthropometric parameters, lipids and glycemic control, blood pressure, C-reactive protein, and quality of life was found. Moderate-to-severe LUTS was associated with worse cardiometabolic risk profile at baseline as well as worse cardiovascular outcomes during follow-up in comparison to mild LUTS. Effect size of TTh was more pronounced in men with moderate-to-severe than with mild LUTS. Conclusions: Correcting hypogonadism by TTh is highly effective and safe for improving LUTS in hypogonadal men. TTh may also improve cardiometabolic risk and major adverse cardiovascular events.

Congenital Anomaly of Urinary Tract in Children (소아 선천성 요로계 기형에 관한 고찰)

  • Shin Weon Hye;Ko Cheol Woo;Koo Ja Hoon;Chung Sung Kwang
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.88-94
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    • 1999
  • Purpose : Malformation of urinary tract is among the most common of all congenital anomalies and can progress to irreversible renal damage before diagnosis due to difficulty of early diagnosis. Present study was undertaken to determine the clinical characteristics of urinary tract anomaly and to find out the most appropriate diagnostic and therapeutic measures for children with these anomalies. Methods : During the past 10 years from 1987 to 1998, review of medical records revealed 65 children with congenital anomaly of urinary tract and the following results were obtained. Results : The most common anomalies were ureteropelvic junction obstruction occuring in 26 cases ($36\%$), followed by ureteral duplication in 11 cases, renal agenesis in 10 cases and ureterovesical function obstruction in 7 cases. Complex anomaly of urinary tract was found in 8 cases and anomaly of other systems such as congenital heart disease was detected in 11 cases. The most frequent age group at the time of diagnosis was below 1 year of age constituting 39 cases ($60\%$) and male preponderance was noted as male to female ratio being 2.25:1. Presenting symptoms were urinary tract infection in 25 cases, followed by hematuria, abdominal mass, abdominal pain and voiding difficulty, etc, and in 11 cases, the anomaly was picked up by routine prenatal ultrasonography. Azotemia was noted in 9 cases and the underlying anomaly was obstructive uropathy in 4 out of these 9 cases. Surgical correction was undertaken in 38 cases (most frequently in cases of obstructive uropathy) and in 2 out off cases with obstructive uropathy in whom surgical correction was done, azotemia disappeared during follow up period of 1-5years. No new cases of deteriorating renal function appeared during follow-up period. Conclusion : In spite of high incidence of congenital malformation of urinary tract, early diagnosis is still hampered by nonspecific symptoms and signs. Therefore, in patients with symptoms such as urinary tract infection, abdominal pain and voiding problems, etc, it Is advisable to take various diagnostic tests promptly to pick up any urinary tract anomaly and to apply proper therapy in order to avoid progression to irreversible renal damage. In this regard, prenatal ultrasonography should be utilized more widely as a routine procedure to detect any urinary tract anomalies before birth.

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The Relationship of Quality of Sleep, Depression, Late-life Function and Disability (LLFDI) in Community-Dwelling Older Women with Urinary Incontinence (노년기 요실금 여성의 수면의 질, 일상생활 수행능력과 우울)

  • Shin, Kyung-Rim;Kang, Youn-Hee;Oak, Ji-Won
    • Journal of Korean Academy of Nursing
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    • v.38 no.4
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    • pp.573-581
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    • 2008
  • Purpose: The purpose of this study was to investigate the relationships among quality of sleep, depression, late-life function and disability in community-dwelling older women with urinary incontinence. Methods: A stratified random sampling method was conducted to recruit participants from May 10 to August 17, 2007. Data were collected by questionnaires, which were constructed to include lower urinary tract symptoms, quality of sleep, depression, and late-life function and disability in 128 community-dwelling older women. Results: The major findings of this study were as follow: 1) 56.3% of participants belonged to urinary incontinence group. 2) There were significant relationships between depression and sleep latency, sleep duration, daytime dysfunction, quality of sleep, function component, frequency dimension, and limitation dimension. 3) Depression was significantly associated with frequency dimension, limitation dimension in capability which explained 44% of variance in depression. Conclusion: These results may contribute to a better understanding of sleep quality, depression, late-life function and disability in the community-dwelling older women with urinary incontinence. Therefore, health programs for prompting older women's health should be planned based on results of the study.

Frequency domain analysis of the urophonography for LUTS diagnosis (하부요로 폐색 진단을 위한 요류음 주파수 분석)

  • Jeong, Do-Un;Jeon, Gye-Rok
    • Journal of Sensor Science and Technology
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    • v.16 no.3
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    • pp.202-210
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    • 2007
  • The aim of this study is to acquire useful information of lower urinary tract symptom (LUTS) diagnosis through urophonography signal as a noninvasive method. The hardware and software which could evaluate the function of compensatory hypertrophy with noninvasive and comfortable method was implemented to measure uroflow and urophonography signal during urination. The PSD (power spectrum density) and the log-log plot gradient analysis were accomplished in frequency domain. For evaluation of the system and analysis method, a model system for the lower urinary system of men was used. From the evaluation of the model system, the PDS and the log-log plot gradient were dependent on the occlusion degree significantly. In a pilot study on normal and abnormal male subjects, the PSD and the log-log plot gradient were highly correlated with the artificial urethral obstruction.

Routine double-J stenting for live related donor kidney transplant recipients: It doesn't serve the purpose, but does it serve a better purpose?

  • Kumar, Vikash;Punatar, Chirag B;Jadhav, Kunal K;Kothari, Jatin;Joshi, Vinod S;Sagade, Sharad N;Kamat, Madhav H
    • Investigative and Clinical Urology
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    • v.59 no.6
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    • pp.410-415
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    • 2018
  • Purpose: Despite meticulous techniques, surgical complications continue to be problematic in kidney transplant recipients. Role of routine stenting to reduce complications is controversial. In this study, we compare incidence of early urological complications, lymphoceles, urinary tract infections (UTI) and graft function; with or without double-J stenting. Materials and Methods: All patients who underwent live related donor renal transplantation from February 2014 to February 2016 were included. Transplants prior to February 2015 were without routine stenting; subsequent transplants were with routine stenting. Patients with neurogenic bladder, previously operated bladder and delayed or low urinary output were excluded. Followup was for at least three months. Descriptive statistics was performed for all parameters. Chi square test and Fisher's Exact test were used for qualitative variables. For quantitative variables, Mann-Whitney test was used to test median difference and independent samples t-test for mean difference. The p-value ${\leq}0.05$ was considered significant. Results: We analysed 74 patients (34 stented and 40 non-stented). There was no difference in the incidence of urinary leak, anastomotic obstruction, lymphoceles or UTI (p>0.4 for all comparisons). However, mean estimated glomerular filtration rate at sixth day, 14th day, one month and two months were 76.1 vs. 61.5 (p=0.025), 72.1 vs. 56.6 (p=0.005), 79.4 vs. 63.1 (p=0.002) and 82.0 vs. 63.3 (p=0.001) in the stented versus non-stented groups. Conclusions: Placement of ureteral stent in renal transplant does not significantly affect the incidence of early urinary complications or UTI. However, graft function is significantly better in stented recipients, at least in the short term.

Implementation of Uroflow and Urophonography Analysis System for LUTS Diagnosis (하부요로증상 진단을 위한 요속 및 요류음 분석 시스템 구현)

  • Jeon, Gye-Rok;Jeong, Do-Un
    • Journal of Biomedical Engineering Research
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    • v.31 no.4
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    • pp.302-309
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    • 2010
  • The present study proposed a method of measuring uroflow and urophonography at the same time for more accurate diagnosis in case uroflow looks normal due to compensatory function hypertrophy in the expression of early obstruction. In case of early obstruction, there happens turbulent uroflow by the obstruction even if the uroflow looks normal and thus obstruction can be detected by measuring and analyzing signal caused by turbulent flow. We implemented a system that can measure both uroflow and urophonography, and evaluated its performance. In the experiment, we observed changes in uroflow and urophonography according to artificial pressure and the degree of obstruction, and confirmed that it is possible to determine the effect of compensatory function hypertrophy by analyzing urophonographyic parameter under the same uroflow. The results of our experiment show that the effect of compensatory function hypertrophy in the early-stage obstruction of lower urinary tract, which is not detectible with uroflowmetry alone, can be assessed through urophonographic analysis.