• Clinical and Experimental Pediatrics
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• v.48 no.6
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• pp.575-579
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• 2005

Urinary incontinence is the most common urinary symptom in children and causes considerable anxiety in children and parents. In most cases, there is no underlying organic pathology and the longterm prognosis is excellent. Despite these reassuring facts, children with wetting problems can be a challenge for primary pediatrician. This is probably because the problem is poorly understood, there is no readily identifiable medical pathology, and because treatment is usually time consuming and arduous. There is a great demand for treatment because wetting is an unpleasant symptom that can cause a stress and anxiety in the family. There may also be other coexisting problems such as urinary tract infection, constipation, soiling, and behavioral or emotional difficulties. Despite the frequency and vexing nature of voiding dysfunction, physicians may not always obtain a careful history to identify and to treat children properly with this condition. This article addresses the comprehensive diagnostic and therapeutic approach to such children.

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.182-187
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• 2001

Purpose : To evaluate the clinical significance of antenatally detected mild fetal pelviectasia and the role of voiding cystourethrography (VCUG) Methods : From January 1999 to September 1999, 28 neonates (44 pelviectatic kidneys) with mild fetal pelviectasia (anteroposterial diameter <10 mm) were evaluated by postnatal renal sonography and voiding cystourethrography. Results : Among 44 mild pelviectatic kidneys, 29 ($65.9\%$) kidneys had no pelviectasia and 15 ($34.1\%$) kidneys had persistent mild pelviectasia on postnatal renal sonography. Four ($9.1\%$) kidneys of 3 males ($10.7\%$) without pelviectasia on postnatal renal sonography had vesicoureteral reflux (VUR) on voiding cystourethrography. Vesicoureteral reflux was not correlated with prenatal progression or regression of pelviectasia and was not correlated with postnatal pelviectasia. Conclusion : All neonate with mild fetal pelviectasia need to undergo voiding cystourethrography for early diagnosis of vesicoureteral reflux even though postnatal renal sonography shows no pelviectasia. (J Korean Soc Pediatr Nephrol 2001 ;5 : 182-87)

• The Korean Journal of Nuclear Medicine
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• v.34 no.2
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• pp.135-143
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• 2000

Purpose: As vesicoureteral reflux (VUR) could lead to renal functional deterioration when combined with urinary tract infection, we need to decide whether operative anti-reflux treatment should be performed at the time of diagnosis of VUR. Predictive value of radioisotope voiding cystography (RIVCG) for renal outcome was tested. Materials and Methods: In 35 children (18 males, 17 females), radiologic voiding cystoure-thrography (VCU), RIVCG and DMSA scan were performed. Change in renal function was evaluated using the follow-up DMSA scan, ultrasonography, and clinical information. Discriminant analysis was performed using individual or integrated variables such as reflux amount and extent at each phase of voiding on RIVCG, in addition to age, gender and cortical defect on DMSA scan at the time of diagnosis. Discriminant function was composed and its performance was examined. Results: Reflux extent at the filling phase and reflux amount and extent at postvoiding phase had a significant prognostic value. Total reflux amount was a composite variable to predict prognosis. Discriminant function composed of reflux extent at the filling phase and reflux amount and extent at postvoiding phase showed better positive predictive value and specificity than conventional reflux grading. Conclusion: RIVCG could predict renal outcome by disclosing characteristic reflux pattern during various voiding phases.

• Journal of Korean Neurosurgical Society
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• v.37 no.1
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• pp.76-78
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• 2005

We report a rare case of cauda equina syndrome due to bilateral lumbar facet cyst. A 62-year-old woman has developed both legs sciatica 3 months prior to her visit, but recently motor weakness and voiding difficulty occurred. Lumbar magnetic resonance image showed bilateral lumbar facet cyst compressing and surrounding both L5 nerve root and accompanying spinal stenosis. Urgent decompressive laminectomy and cyst removal was performed. Although sciatica was relieved and motor weakness was recovered usefully. Voiding difficulty and dysesthesia were not improved.

• Journal of Acupuncture Research
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• v.23 no.3
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• pp.155-163
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• 2006

Objectives : This study was designed to evaluated the effect of electro acupuncture on Heart Rate Variability of Patients with functional voiding disease. Methods: Subjects were voluntarily recruited by newspapers and internet. Electro acupuncture was performed three times a week for 3 weeks. Acupuncture point for EA group was B32, Electrical stimulation frequency was 2Hz, duration 20min, and intensity was up to pain threshold according to patients. The patients' Heart Rate Variability was measured before, after 3 weeks of treatment for 5 minutes. Results : In time domain analysis, There were significant increase of SDNN and RMSSD(p<0.05) after 3 weeks treatment. In frequency domain analysis, There were significant increase of LF and LF /HF ratio(p<0.05) after 3 weeks treatment. There were no significant changes in other components of heart rate variability. Conclusion : This study suggests that electroacupuncture treatments can be applicable to improve autonomic nervous system in patients with functional voiding disease.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.376-379
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• 1999

We report our experience with a case of urethrolysis using a transvaginal suprameatal approach without lateral perforation of the urethropelvic ligament. A 43-year-old woman suffered from voiding difficulties such as hesitancy, frequency, urgency, decreased urinary flow, residual urine sensation after Marshall-Marchetti-Krantz operation concurrent with hysterectomy. The results of multidisciplinary work-ups of urethral obstruction such as history, vaginal examination, voiding cystourethrography, urodynamic study, showed that she had urethral obstruction due to a previous operation. Since clean intermittent catheterization and alpha-blocker therapy did not improve her symptoms, suprameatal transvaginal urethrolysis was performed to resolve the symptoms. Postoperative follow-up for 5 months showed that the patient remained free from voiding difficulty in their life. We believe that suprameatal transvaginal urethrolysis is worth attempting for urethral obstruction associated with anti-incontinence surgery.

• Korean Journal of Adult Nursing
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• v.17 no.4
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• pp.622-634
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• 2005

Purpose: The purpose of this study was to evaluate the applicability of the evidence based guideline for prompted voiding by Lyons & Specht (2001) in National Guideline $Clearinghouse^{TM}$ for use in Korea based on the experts' opinions. Method: The target expert group consisted of 8 registered nurses, 6 physicians, and 5 nursing professors who are experts in urinary incontinence. This study used a questionnaire survey. The appropriateness, applicability, and the present application of each recommendation in the guideline were analyzed with descriptive statistics using the SPSS program, with content analysis based on the experts' opinions. Result: The scores on each recommendation's appropriateness showed the high degree of agreement among nurses, physicians, and nursing professors. However, the recommendation for 'use of oxybutinin' showed the lowest score as 5.89. It was notable that the most recommendations scored lower for applicability compared with appropriateness. The reasons for lower scores for applicability were the lack of clinicians' knowledge of assessment and management, and the lack of resources in clinical settings in Korea. Conclusion: This study will augment the understanding of the actual urinary incontinence management in Korean clinical settings and can be used as the baseline data for further study of tailoring international guidelines into local and national clinical settings.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.97-100
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• 1997

Rupture or contrast extravasation of urinary bladder after voiding cystourethrography(VCUG) was a very rare complication which occurred in neurogenic or unused bladder. Only one case of bladder extravasation was reported in a girl with normal bladder function. Case: A 18 month-old boy presented with recurrent E. Coli urinary tract infection and was evaluated with isotope VCUG, which was failed to catheter insertion. Two days later, isotope VCUG was repeated with difficult catheter insertion. Two hours after isotope VCUG, gross hematuria and anuria developed, and abdominal distension was followed. Bladder rupture was diagnosed by abdominal sonography and computerized tomography. He was treated with simple closure and suprapubic catheter drainage.

• International Neurourology Journal
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• v.22 no.4
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• pp.228-236
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• 2018

Neuromodulation was introduced for patients with poor outcomes from the existing traditional treatment approaches. It is well-established as an alternative, novel treatment option for voiding dysfunction. The current system of neuromodulation uses an open-loop system that only delivers continuous stimulation without considering the patient's state changes. Though the conventional open-loop system has shown positive clinical results, it can cause problems such as decreased efficacy over time due to neural habituation, higher risk of tissue damage, and lower battery life. Therefore, there is a need for a closed-loop system to overcome the disadvantages of existing systems. The closed-loop neuromodulation includes a system to monitor and stimulate micturition reflex pathways from the lower urinary tract, as well as the central nervous system. In this paper, we reviewed the current technological status to measure biomarker for closed-loop neuromodulation systems for voiding dysfunction.

• Journal of the Korean Society of Radiology
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• v.14 no.7
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• pp.965-973
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• 2020

The purpose of this study was to quantitatively correlate the change of flow velocity and signal voiding in TOF-MRA. We made our phantom to control the flow velocity, and changed the flow velocity in 16 steps from 8.0 to 127.3 mc/s. The TOF-MRA test was performed using a 3.0T MRI system and the signal intensity was measured by classifying the signal voiding length and image into the In flow, Mid flow, and Out flow. The length of signal voiding was the longest when the flow velocity was 127.3 cm/s and the signal intensity decreased with increasing flow velocity(p<0.05). In flow(-.547) and Mid flow(-.643) were negatively correlated with flow velocitys(p<0.05). In conclusion, it was confirmed that the increase in flow velocity was a major factor causing signal voiding in TOF-MRA. In the future, this study will provide basic data when studying sequences and parameters to reduce signal voiding in models with a high flow velocity.