Continence Reports最新文献

Background:

Leiomyoma is a benign fibromuscular neoplasm originating from smooth muscle cells. Paraurethral leiomyoma is an extremely rare, benign, hormone-dependent​ growth from the mesenchymal cells in paraurethral space of female urethra. They usually appear in the reproductive age group women, mean age of presentation being approximately 41 years.

Case presentation:

A 22-year-old woman presented with palpable mass at vagina and weak urinary stream. She underwent clinical examination and MRI imaging followed by transvaginal excision of the mass. Histopathological examination confirmed paraurethral leiomyoma.

Conclusion:

Paraurethral leiomyoma make up approximately five percent of urethral tumors. This case depicts the presentation and treatment of a paraurethral leiomyoma in one of the youngest women reported in the literature.

Introduction:

Intermittent catheterization (IC), considered the gold standard for bladder management for individuals with spinal cord injury (SCI) with sufficient dexterity, is usually performed using hydrophilic (HPC) or non-hydrophilic catheters (non-HPC). Currently, there is little evidence on the temporal burden associated with IC in general. Our objective was to compare both catheters regarding their time requirement for IC and participant satisfaction.

Materials and Methods:

Twenty individuals with chronic (>1-year) SCI were randomized to undergo two cross-over assessments within 10 days (i.e., either starting with HPC or non-HPC). We measured the time taken to perform IC using a 13 step pre-determined protocol. Furthermore, we assessed user satisfaction of both catheters using a Likert scale. Time to perform IC and participant satisfaction were compared using non-parametric statistics. Results are presented as median with lower and upper quartiles.

Results:

Participants using an HPC spent significantly less time overall to perform IC [283 s (242; 352) vs. 373 s (249; 441), $p=0.01$] and to prepare a catheter [15 s (10; 20) vs. 41 (20; 69), $p=0.002$, i.e. adjusted for multiple comparisons] compared to non-HPC. No significant differences between both catheters were found with respect to participant satisfaction.

Conclusions:

This crossover RCT revealed that the overall time to perform IC appears to be a significant temporal burden for individuals with SCI independent of the catheter type. Further, we found that the preparation and usage of HPC for IC is faster compared to non-HPC. These findings warrant a larger trial to further assess the temporal burden of IC in this cohort.

Aims:

An unpleasant, inappropriate, and persistent need to urinate (PNU) is a sensory symptom reported by some patients with lower urinary tract symptoms (LUTS). However, no detailed definition of this symptom exists. This study aimed to describe the characteristics of patients reporting PNU and to discuss the pathophysiology and therapeutic approach.

Methods:

The clinical and urodynamic findings of patients presenting with PNU without chronic bladder pain syndrome or neurological or urological conditions between October 2019 and December 2020 were retrospectively reviewed. The treatment efficacy was self-reported at follow-up as “total cure”, “significant improvement” or “no modification”.

Results:

Seventy-nine patients were included (51 women (65%), mean age 49 years (Standard Deviation (SD) 18)). The mean duration of symptoms was 7 years (SD 11). Frequency was commonly associated with PNU (mean interval between voids 103 min (SD 69)) and 50 patients (63%) reported nocturia. Voiding difficulties were described in 33 cases (40%). The mean first desire to void was 112mL (SD 93) with normal maximum cystometric capacity of 397mL (SD 135), and 5 patients had detrusor overactivity. Proposed treatments were tibial nerve stimulation (n=25) with a total cure or significant improvement in 17 cases, alpha-blockers (n=8) with an improvement in 4 patients, antimuscarinics (n=29) with an improvement in only 3 patients, and antidepressant or antiepileptic (n=8) with an improvement in 5 patients.

Conclusion:

PNU is poorly described but could be responsible for LUTS. Further studies to understand the underlying mechanisms and to assess the therapeutic efficacy of the different options are required.

We present a case of a man who developed a neurogenic detrusor acontractility because of too much Vitamin B6 or pyridoxine intake. He developed voiding dysfunction and sensory neuropathy in both legs (numbness). The analysis gave no other explanation for the development of his complaints than the intake of excessive multivitamins, resulting in a supraphysiologic vitamin B6 level associated with neurotoxicity. Multivitamins are not only regarded as healthy but may also cause severe physical complaints, including voiding LUTS. Caretakers should bear that in mind when they encounter patients with voiding difficulties.

Vaccine-related adverse events have been increasingly reported as the COVID-19 vaccination campaign progresses worldwide. Urological symptoms after COVID-19 vaccination are reported rarely. Herein, we report a case of urinary retention following the second dose of Oxford/AstraZeneca COVID-19 vaccine injection.