1/8. Falsely elevated postvoid residual urine in pregnant women.Portable ultrasound assessment of postmicturition bladder for residual urine volume is rapid, accurate, and precise. However, other cystic pelvic pathologic conditions may present as a false-positive finding on the ultrasound. We describe two cases in which the residual urine was falsely detected as being elevated due to unsuspected pregnancy.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
2/8. Psychogenic urinary retention in women.There appears to be a spectrum of psychogenic urinary retention that is seen mostly in women. The degrees of psychiatric disorder and bladder disorder do not necessarily coincide. Some patients with psychogenic retention may have one acute episode temporally related to psychologic trauma. Others may present with problems related to large residual volumes such as recurrent urinary tract infection or incontinence. All patients require complete neurologic, urologic, and psychiatric evaluation. Permanent urethral catheterization is avoided if possible. Intermittent self-catheterization should be used during periods of psychotherapy and bladder training. patients with neurogenic bladder, as determined by urodynamic studies, should be managed by bladder training and the use of pharmacologic agents when indicated.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
3/8. Successful treatment of partial nephrogenic diabetes insipidus with thiazide and desmopressin.OBJECTIVE: To clarify whether combination treatment with desmopressin (DDAVP) and thiazide was clinically effective in a patient with congenital nephrogenic diabetes insipidus (CNDI), we evaluated the treatment in a 7-year-old boy with CNDI who had demonstrated a partial response to DDAVP. METHOD: Both volume of urine and the presence of nocturia were determined during treatment. RESULT: Neither the usual therapy of a low-salt diet and a thiazide nor intranasal therapy with a large dose of DDAVP was effective. However, combination treatment resulted in a decrease in urinary volume and the disappearance of nocturia. CONCLUSION: DDAVP coupled with thiazide may be useful for CNDI in patients who have shown a partial response to DDAVP.- - - - - - - - - - ranking = 2keywords = volume (Clic here for more details about this article) |
4/8. risperidone-associated ejaculatory and urinary dysfunction in male adolescents.We report two male adolescents who developed partial or complete retrograde ejaculation during risperidone treatment. Additionally, one patient complained of bladder outflow obstruction, and the other reported a reduced ejaculatory volume and decreased viscosity of semen. On rechallenge with risperidone, patient A showed a prompt recurrence of the ejaculatory dysfunction. The side effects were highly disturbing and led to reduced treatment compliance in both patients. The impact of risperidone, a strong alpha(1)-receptor antagonist, on the adrenergic system might induce retrograde ejaculation by altering the sympathetic tonus, allowing semen to pass retrogradely into the bladder during ejaculation. The reduced ejaculatory volume may be caused by risperidone-induced hyperprolactinemia. Clinicians should regularly inquire about sexual dysfunction and symptoms suggestive of hyperprolactinemia before starting risperidone treatment and regularly thereafter.- - - - - - - - - - ranking = 2keywords = volume (Clic here for more details about this article) |
5/8. Sonographic findings in a case of voiding dysfunction secondary to the tension-free vaginal tape (TVT) procedure.The tension-free vaginal tape (TVT) procedure was introduced as a minimally invasive surgical technique for treating female stress urinary incontinence. This procedure is supposed to be associated with less postoperative voiding dysfunction because the vaginal tape, theoretically, remains tension-free. Nevertheless, significant voiding dysfunction or complete urinary retention has been reported to complicate 2.8% to 7.6% of TVT procedures. We report a case of voiding dysfunction following a TVT procedure. Two-dimensional sonography revealed the tape situated beneath the mid-urethra. The spatial orientation between the vaginal tape and the urethral structure was clearly demonstrated on three-dimensional scanning. The urethra was indented from the posterior by the vaginal tape, resulting in acute constriction of the hypoechogenic region of the urethra. Urethral dilation was performed using Hegar dilators. Thereafter, the patient's voiding difficulty improved dramatically and the residual urine volume decreased. One week later, repeat sonography showed the hypoechogenic region of the urethra to have a normal configuration with a lesser degree of urethral indentation.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
6/8. hematoma into peritoneum following transrectal echo-guide prostate biopsy inducing lower abdominal and urinary tract symptoms.A 58 years man was submitted to a sextant echo-guided transrectal prostate biopsy. Three weeks later he started complaining of lower abdominal and urinary tract symptoms. Abdominal ultrasound and 3D contrast enhanced CT detected an ovular shaped and capsulated 140 cc volume mass into the peritoneum compressing the bladder. Cytology evaluation showed only haemorrhagic content. After the mass evacuation all the symptoms referred, disappeared. Anyway a hematoma into the peritoneum following a transrectal echo-guided prostate biopsy should represent a unique entity. In fact, this is considered a safe procedure in which generally mild complications occur and they stop spontaneously.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
7/8. Effect of a GnRH analogue (leuprolide) on benign prostatic hypertrophy.To determine the effects of reversible medical castration on prostatic size in patients with benign prostatic hypertrophy (BPH), 3 patients with BPH were treated with a GnRH analogue, leuprolide, for six months at a dosage of .2ml (1 mg) s.c. daily. serum testosterone, dihydrotestosterone and estradiol fell to castration levels 4-6 weeks after the initiation of treatment and remained low throughout the study period. Transrectal ultrasonography of the prostate demonstrated an average decrease in prostatic volume of 58% at 6 months, with the greatest rate of decrease occurring during the 2nd to 5th months of treatment. One man who had acute urinary retention before treatment was subsequently able to void extremely well. In a second man the symptoms of prostatism diminished but in the third urinary frequency and nocturia persisted in spite of a reduction in prostatic size, presumably because his symptoms were due to renal insufficiency.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
8/8. Micturitional disturbance in a patient with adrenomyeloneuropathy (AMN).We report a case of adrenomyeloneuropathy (AMN) in which serial urodynamic studies showed neurogenic bladder dysfunction. The patient was in good health until the age of 12, when he began to lose his hair. At age 25 he started to have urinary urgency, difficulty in voiding, occasional fecal incontinence, erectile impotence, and progressive gait disturbance. In his first admission to our hospital age 31, he was intelligent but childish. He showed diffuse baldness, spastic paraparesis, and disturbed vibratory sensation. serum cortisol response to corticotropin (ACTH) was low and serum levels of very long chain fatty acids were increased. Nerve conduction studies and sural nerve biopsy showed the presence of peripheral neuropathy. These findings confirmed the diagnosis of AMN. The first urodynamic study showed residual urine volume of 50 ml, impaired bladder sensation, and detrusor hyperreflexia. At age 38 he needed diapers because he became apathetic and demented, and could no longer stand by himself. MRI disclosed high signal intensities in the bilateral cerebral white matter. The second urodynamic study showed residual urine volume of 200 ml and decreased bladder capacity with marked detrusor hyperreflexia. Demyelinating lesions of the peripheral nerve and white matter of the spinal cord and the cerebrum may be mainly responsible for the micturitional disturbance in our patient with AMN.- - - - - - - - - - ranking = 2keywords = volume (Clic here for more details about this article) |