• 동의생리병리학회지
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• 제26권2호
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• pp.241-247
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• 2012

The purpose of this case study is to report the effect of electroacupuncture at acupoints Baliao (BL31 Shangliao, BL32 Ciliao, BL33 Zhongliao, BL34 Xialiao) on patients with voiding problem. Neurogenic Bladder can be classified according to whether impairment of urinary reservoir or emptying. The first case was a patient with urinary emptying impairment. He was diagnosed with areflexic neurogenic bladder, and was managed with suprapubic cystostomy. After starting of electroacupuncture on Baliao, residual urine volume was gradually decreased, at last cystostomy could be removed. The second case was a patient with urinary reservoir impairment. She complained symptoms of urinary frequency, nocturia due to overactive bladder. After starting of electroacupuncture on Baliao, urination frequency was significantly decreased. We consider electroacupuncture on Baliao may have a useful effect on voiding problem, both urinary reservoir and emptying impairment.

• 대한한방내과학회지
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• 제43권1호
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• pp.90-103
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• 2022

Objective: The purpose of this case study is to report the effectiveness of Baliao acupoints electro-acupuncture treatment on a neurogenic overactive bladder induced by stroke. Method: A patient suffering from middle cerebral artery infarction was diagnosed with a neurogenic overactive bladder and treated by Korean medicine, including electro-acupuncture on Baliao acupoints six times per week. The evaluation was performed by monitoring urinary frequency and using the Korean versions of the Overactive Bladder Symptom Score (OABSS) and Urinary Incontinence Quality of Life (I-QoL). Results: After 27 days of electro-acupuncture treatment, the OABSS score improved from 6 to 3. The I-QoL total score improved from 60 to 87. The patient also showed a decrease in nocturia frequency. Conclusion: This case suggests that electro-acupuncture on Baliao acupoints can be effective for overactive bladders due to supra-pontine lesions.

• Childhood Kidney Diseases
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• 제2권1호
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• pp.90-94
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• 1998

Hinman syndrome is a condition representing urinary voiding dysfunction in the neurologically intact child. The syndrome is probably caused by acquired behavioral and psychosocial disorders manifested by bladder and/or bowel dysfunction mimicking neurologic disease. Clinically, the symptom complex may include day and night time enuresis, encopresis, constipation, and recurrent urinary tract infections. Cystoscopy frequently demonstrates normal vesicourethral anatomy. Voiding films usually demonstarate a carrot-shaped proximal urethra with a persistent narrowing at the external sphincter. The bladder is large and often appears trabeculated with a thickened wall and significant postvoid residual. A 13-year-old male child was admitted due to fever, urinary tract infection, enuresis and flank pain. His neurologic examination was normal. Renal sonograms showed moderate hydronephrosis. Voiding cystourethrograms showed a huge, trabeculated bladder without vesicourethral reflux and urethral valves. No abnormal findings was found in spinal MRI.

• Childhood Kidney Diseases
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• 제1권1호
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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.

• Asian Spine Journal
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• 제12권6호
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• pp.981-986
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• 2018

Study Design: Retrospective case series. Purpose: Cauda equina syndrome (CES) is associated with etiologies such as lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). CES has a prevalence of 2% among patients with LDH and exhibits variable outcomes, even with early surgery. Few studies have explored the factors influencing the prognosis in terms of bladder function. Therefore, we aimed to assess the factors contributing to bladder recovery and propose a simplified bladder recovery classification. Overview of Literature: Few reports have described the prognostic clinical factors for bladder recovery following CES. Moreover, limited data are available regarding a meaningful bladder recovery status classification useful in clinical settings. Methods: A single-center retrospective study was conducted (April 2012 to April 2015). Patients with CES secondary to LDH or LCS were included. The retrieved data were evaluated for variables such as demographics, symptom duration, neurological symptoms, bladder symptoms, and surgery duration. The variable bladder function outcome during discharge and at follow-up was recorded. All subjects were followed up for at least 2 years. A simplified bladder recovery classification was proposed. Statistical analyses were performed to study the correlation between patient variables and bladder function outcome. Results: Overall, 39 patients were included in the study. Majority of the subjects were males (79.8%) with an average age of 44.4 years. CES secondary to LDH was most commonly seen (89.7%). Perianal sensation (PAS) showed a significant correlation with neurological recovery. In the absence of PAS, bladder function did not recover. Voluntary anal contraction (VAC) was affected in all study subjects. Conclusions: Intactness of PAS was the only significant prognostic variable. Decreased or absent VAC was the most sensitive diagnostic marker of CES. We also proposed a simplified bladder recovery classification for recovery prognosis.

• Childhood Kidney Diseases
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• 제6권1호
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• pp.109-113
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• 2002

저자들은 야뇨증을 주소로 내원한 12살 남아에서 천추 부위의 피부 보조개를 발견하여 정밀 검사를 통한 계류 척수 증후군을 확인하였고 이에 따른 신경원성 방광과 만성 신부전을 경험하였기에 문헌 고찰을 통한 증례 보고를 하는 바이다.

• Archives of Plastic Surgery
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• 제48권5호
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• pp.528-533
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• 2021

Bladder acontractility affects several thousand patients in the United States, but the available therapies are limited. Latissimus dorsi detrusor myoplasty (LDDM) is a therapeutic option that allows patients with bladder acontractility to void voluntarily. Our goal was to conduct a systematic review of the literature to determine whether LDDM is a better option than clean intermittent catheterization (CIC) (standard treatment) in patients with bladder acontractility. On January 17, 2020, we conducted a systematic review of the PubMed/MEDLINE, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov databases, without time frame limitations, to identify articles on the use of LDDM for bladder acontractility. Of 75 potential articles, 4 fulfilled the eligibility criteria. The use of LDDM to treat patients with bladder acontractility was reported in four case series by the same group in Europe. Fifty-eight patients were included, and no comparison groups were included. The most common cause of bladder acontractility was spinal cord injury (n=36). The mean (±standard deviation) operative time was 536 (±22) minutes, postoperative length of hospital stay ranged from 10 to 13 days, and follow-up ranged from 9 to 68 months. Most patients had complete response, were able to void voluntarily, and had post-void residual volume less than 100 mL. Although promising outcomes have been obtained, evidence is still weak regarding whether LDDM is better than CIC to avoid impairment of the urinary tract among patients with bladder acontractility. Further prospective studies with control groups are necessary.

• 대한임상검사과학회지
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• 제52권2호
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• pp.112-118
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• 2020

이 연구의 목표는 엔지니어링 중간엽 줄기세포에 의해 발현된 SDF-1의 효과를 규명하고 신경인성방광 랫 모델에서 관련 메커니즘을 조사하는 것이다. Sprague-Dawley 랫(N=48)을 대조군, 신경인성방광군, 신경인성방광군+imMSC군 및 신경 인성방광군+SDF-1 eMSC 군으로 무작위 선정하였다. 신경인성방광 랫 모델은 양측 골반 신경 손상으로 유도하였으며 골수 유래 중간엽 줄기세포를 immortalized한 MSC (empty vector)와 upregulated SDF-1한 MSC ( immortalized+SDF-1 치료유전차 발현)로 엔지니어링 하였다. 엔지니어링 중간엽줄기세포를 양측 골반 신경 손상부위와 방광에 주사하여 생착시켰다. 주사 4주 후 치료 효과를 양측골반신경 및 방광 조직을 마손 삼색 염색 및 면역 염색으로 분석하였다. 신경인성방광군+SDF-1 eMSC 군에서 방광 평활근이 유의하게 증가하였다(P<0.05). 신경마커 베타-III 튜불린 및 SDF-1 발현 또한 유의하게 증가하였으며(P<0.05), 이를 통해 손상된 신경을 복구하고, 신경인성 방광 랫 모델의 방광조직을 회복시켰다.

• International Neurourology Journal
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• 제22권4호
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• pp.287-294
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• 2018

Purpose: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. Methods: A retrospective analysis was conducted of 42 patients (31 males; mean age, $14.2{\pm}6.2years$) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median $12.0{\pm}1.5years$ of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. Results: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. Conclusions: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.142-146
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• 2017

Purpose: To evaluate changes in quality of life (QoL) in patients with neurogenic bladder treated with clean intermittent catheterization (CIC), who changed from a multiple use catheter (MUC) to single use catheter (SUC). Methods: The Modified Intermittent Self-Catheterization Questionnaire (mISC-Q) was used to determine potential changes in patients' QoL as a result of switching from MUC to SUC. The mISC-Q consists of questions within four categories: ease of use, convenience, discreetness, and symptomatic benefit. Answers were graded as Strongly agree (+2), Agree (+1), Not sure (0), Disagree (-1), and Strongly disagree (-2). Overall patient QoL, as well as by sex, disease (presence of augmentation cystoplasty), and catheterization route (via urethra or urinary diversion), were analyzed. Results: Thirty-eight patients (21M:17F; mean age: $21.7{\pm}5.3y$) submitted questionnaires. For ease of use, SUC was significantly better than MUC (score: 0.364, P=0.002) in all patients. Patients with catheterization via the urethra showed significant favor for SUC in ease of use (score: 0.512, P<0.001) and convenience (score: 0.714, P=0.011), but patients with catheterization via the abdominal stoma of urinary diversion gave negative scores in all categories, though no categories were significant. Conclusion: This study suggested that changing from MUC to SUC may lead to improvements in QoL, especially regarding ease of use. This benefit was clearly found in patients with catheterization via urethra rather than abdominal stoma of urinary diversion.