Pub Date : 2019-01-01DOI: 10.24105/2168-9857.8.225
K. Koshiba, H. Mizoguchi, R. Suzuki, Yutaka Jujo, M. Aihara, H. Nakajo, S. Shimura
Background: Transurethral Microwave Thermotherapy (TUMT) has shown limited efficacy as a treatment for prostate cancer, mainly because of the inability of microwaves to reach the peripheral region of the prostate. Pretreatment with Androgen Deprivation Therapy (ADT) may increase TUMT efficacy by reducing the prostate size. Objective: To examine the clinical outcomes of patients undergoing TUMT after at least 3 months of ADT. Design, setting, and participants: One hundred twenty-three men with early, non-metastatic prostate cancer and Prostate-Specific Antigen (PSA) levels of 4.0 ng/mL or higher were enrolled between 2001 and 2011 and followed up until 2017. TUMT was performed after at least 3 months of ADT and the efficacy of this treatment was confirmed by radical Transurethral Resection of the Prostate (TURP) performed at least 3 months after TUMT. Intervention: ADT and TUMT, Outcome Measurements and Statistical Analysis, Post-intervention prostate volume, presence of remnant cancer cells, and clinical outcomes. Results and limitations: Prostate volume was significantly reduced (mean, 35.2%) after 3 months of ADT. Histopathological examination of TURP chips revealed no cancer cells in 102 of 123 patients. Twenty-one patients demonstrated remnant cancer cells; in 13 patients these were non-viable, and in 8 they were degraded. During the 17- year follow-up period, 28 patients received regular or intermittent anti-androgen therapy to maintain PSA levels below 4.0 ng/mL. No patients died of prostate cancer. Conclusion: Combination ADT and TUMT therapy in 123 patients suggests that early prostate cancer is easily destroyed by heat. A significant reduction of prostate volume after ADT increased TUMT efficacy in the peripheral zone and apex. Patient summary: In this study, ADT reduced the volume of the prostate gland by around 35%, enhancing the ability of TUMT to kill cancer cells. This approach should be further evaluated as a less-invasive alternative to current, conventional therapies.
{"title":"Definitive Therapy of Early Prostate Cancer with Transurethral MicrowaveThermotherapy after Prostate Volume Reduction by Androgen Deprivation: A17-Year Experience of a Potential Alternative to Radical Surgery","authors":"K. Koshiba, H. Mizoguchi, R. Suzuki, Yutaka Jujo, M. Aihara, H. Nakajo, S. Shimura","doi":"10.24105/2168-9857.8.225","DOIUrl":"https://doi.org/10.24105/2168-9857.8.225","url":null,"abstract":"Background: Transurethral Microwave Thermotherapy (TUMT) has shown limited efficacy as a treatment for prostate cancer, mainly because of the inability of microwaves to reach the peripheral region of the prostate. Pretreatment with Androgen Deprivation Therapy (ADT) may increase TUMT efficacy by reducing the prostate size. Objective: To examine the clinical outcomes of patients undergoing TUMT after at least 3 months of ADT. Design, setting, and participants: One hundred twenty-three men with early, non-metastatic prostate cancer and Prostate-Specific Antigen (PSA) levels of 4.0 ng/mL or higher were enrolled between 2001 and 2011 and followed up until 2017. TUMT was performed after at least 3 months of ADT and the efficacy of this treatment was confirmed by radical Transurethral Resection of the Prostate (TURP) performed at least 3 months after TUMT. Intervention: ADT and TUMT, Outcome Measurements and Statistical Analysis, Post-intervention prostate volume, presence of remnant cancer cells, and clinical outcomes. Results and limitations: Prostate volume was significantly reduced (mean, 35.2%) after 3 months of ADT. Histopathological examination of TURP chips revealed no cancer cells in 102 of 123 patients. Twenty-one patients demonstrated remnant cancer cells; in 13 patients these were non-viable, and in 8 they were degraded. During the 17- year follow-up period, 28 patients received regular or intermittent anti-androgen therapy to maintain PSA levels below 4.0 ng/mL. No patients died of prostate cancer. Conclusion: Combination ADT and TUMT therapy in 123 patients suggests that early prostate cancer is easily destroyed by heat. A significant reduction of prostate volume after ADT increased TUMT efficacy in the peripheral zone and apex. Patient summary: In this study, ADT reduced the volume of the prostate gland by around 35%, enhancing the ability of TUMT to kill cancer cells. This approach should be further evaluated as a less-invasive alternative to current, conventional therapies.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"536 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77150571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.35248/2168-9857.19.8.215
M. Rafie, Ziad Alnaib, Zeyad Aljuboori, Elsawi Osman
Objective: To assess the efficacy of Amikacin as the anti-biotic of least recorded resistance locally in preventing urinary infective episodes following ESWL (Extracorporeal Shock Wave Lithotripsy) in patients with DJ stents in-situ. Materials and methods: A retrospective review of a cohort of 60 adult patients with upper urinary tract calculi and DJ stent in-situ, who received one dose of Amikacin intravenously immediately before ESWL was carried out. All patients had a documented negative urine culture prior to ESWL. The incidence rate of post ESWL bacteriuria was calculated and compared to the published incidence rates of bacteruria patients who did not receive any prophylaxis. Results: A total number of 60 adult patients with DJ stent in-situ, who received Amikacin prophylaxis, underwent ESWL between the 1st of January 2017 and the 31st of December 2017. All of the 60 patients had a documented negative urine culture pre-ESL. Two patients were found to have positive urine culture post ESWL with an incidence rate of 3.33. This was not statistically different to the published percentage of patients who received no prophylaxis in the compared studies that showed incidence rates of 3.08 and 2.17 respectively (Chi-square=0.704, p=0.703). Conclusion: Intravenous Amikacin prophylaxis was not efficacious in reducing UTI and urinary sepsis following ESWL in patients with DJ stents in-situ, despite being the antibiotic of least resistance locally.
{"title":"Amikacin as the Most Potent Antibiotic Locally, is it Required Prior to Extracorporeal Shock Wave Lithotripsy (ESWL) in Patients with Double J Stents?","authors":"M. Rafie, Ziad Alnaib, Zeyad Aljuboori, Elsawi Osman","doi":"10.35248/2168-9857.19.8.215","DOIUrl":"https://doi.org/10.35248/2168-9857.19.8.215","url":null,"abstract":"Objective: To assess the efficacy of Amikacin as the anti-biotic of least recorded resistance locally in preventing urinary infective episodes following ESWL (Extracorporeal Shock Wave Lithotripsy) in patients with DJ stents in-situ. Materials and methods: A retrospective review of a cohort of 60 adult patients with upper urinary tract calculi and DJ stent in-situ, who received one dose of Amikacin intravenously immediately before ESWL was carried out. All patients had a documented negative urine culture prior to ESWL. The incidence rate of post ESWL bacteriuria was calculated and compared to the published incidence rates of bacteruria patients who did not receive any prophylaxis. Results: A total number of 60 adult patients with DJ stent in-situ, who received Amikacin prophylaxis, underwent ESWL between the 1st of January 2017 and the 31st of December 2017. All of the 60 patients had a documented negative urine culture pre-ESL. Two patients were found to have positive urine culture post ESWL with an incidence rate of 3.33. This was not statistically different to the published percentage of patients who received no prophylaxis in the compared studies that showed incidence rates of 3.08 and 2.17 respectively (Chi-square=0.704, p=0.703). Conclusion: Intravenous Amikacin prophylaxis was not efficacious in reducing UTI and urinary sepsis following ESWL in patients with DJ stents in-situ, despite being the antibiotic of least resistance locally.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"115 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78287446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.24105/2168-9857.8.220
Ashurmetov Azizbek Mirsagatovich
Modern literature data related to the erectile dysfunction was stated in this article. The issues of systemic and local endothelial dysfunction are discussed in this Research Work. Also the issues of the interaction of terahertz infrared radiation with biological objects of varying complexity of implementation are discussed. The implementation of the effect of infrared waves of the terahertz range in bio system is possible at the molecular, cellular and systemic levels of regulation.
{"title":"The Disturbance of Energy and Material Exchange in Pathogenesis of Erectile Dysfunction","authors":"Ashurmetov Azizbek Mirsagatovich","doi":"10.24105/2168-9857.8.220","DOIUrl":"https://doi.org/10.24105/2168-9857.8.220","url":null,"abstract":"Modern literature data related to the erectile dysfunction was stated in this article. The issues of systemic and local endothelial dysfunction are discussed in this Research Work. Also the issues of the interaction of terahertz infrared radiation with biological objects of varying complexity of implementation are discussed. The implementation of the effect of infrared waves of the terahertz range in bio system is possible at the molecular, cellular and systemic levels of regulation.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"74 6 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89205264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bilateral duplicated system with ectopic ureter is a rare entity. Duplication and its associated anomalies are more common in females. Anomalies of the renal collecting system should be considered by clinicians and surgeons in patients presenting with urinary incontinence. We present a 32-year-old female with a Bilateral Ureteral Duplication with Right Ectopic Ureter presenting with low volume Incontinence. We emphasized the importance of imaging in the diagnosis of anomalies of the renal collecting system presenting with incontinence. In the absence of a dysplastic renal moiety, an ureteroneocystostomy is an ideal procedure of choice to correct incontinence from ectopic ureters in females.
Pub Date : 2019-01-01DOI: 10.24105/2168-9857.8.221
A. E. Hemaly, L. Mousa, K. IbrahimM., Il, M. Morad, Mervat M. Ibrhaim, Fatma S. Al Sokkary, Ahmad M. Erfan
The urinary bladder and the urethra; the rectum and the anal canal have the same embryologic anatomical source, from the cloaca. They share the same nerve supply and have systemic sensory and proprioceptors (mechanoreceptors) in the muscle responsive to mechanical changes. Toilet training switches the toilet control, supervised by the CNS, from para-sympathetic to mainly sympathetic control. Acquired high sympathetic tone at the Internal Urethral Sphincter (IUS) and the Internal Anal Sphincter (IAS) keeps both sphincters contacted and the urethra and anal canal empty and closed all the time. Voluntarily or in need with proper social circumstances, controlled by intact healthy CNS, the IUS and/or the IAS relax and the urethra and the anal canal will open to allow pass of urine, flatus and/or feces. The neurotransmitter at the sympathetic nerve endings is nor-epinephrine, which can be deficient in cases of nocturnal enuresis. The IUS and the IAS are collagen-muscle tissue cylinders. In women both sphincters are closely related to the vagina, and are subject to lacerations from vaginal delivery. Lacerated sphincters as a result of Child-Birth Trauma (CBT) become weak and cannot stand against sudden rise of abdominal pressure resulting in Urinary Incontinence (UI) and/or Fecal Incontince (FI).
{"title":"Micturition and Defecation, Neuro-Chemical Control","authors":"A. E. Hemaly, L. Mousa, K. IbrahimM., Il, M. Morad, Mervat M. Ibrhaim, Fatma S. Al Sokkary, Ahmad M. Erfan","doi":"10.24105/2168-9857.8.221","DOIUrl":"https://doi.org/10.24105/2168-9857.8.221","url":null,"abstract":"The urinary bladder and the urethra; the rectum and the anal canal have the same embryologic anatomical source, from the cloaca. They share the same nerve supply and have systemic sensory and proprioceptors (mechanoreceptors) in the muscle responsive to mechanical changes. Toilet training switches the toilet control, supervised by the CNS, from para-sympathetic to mainly sympathetic control. Acquired high sympathetic tone at the Internal Urethral Sphincter (IUS) and the Internal Anal Sphincter (IAS) keeps both sphincters contacted and the urethra and anal canal empty and closed all the time. Voluntarily or in need with proper social circumstances, controlled by intact healthy CNS, the IUS and/or the IAS relax and the urethra and the anal canal will open to allow pass of urine, flatus and/or feces. The neurotransmitter at the sympathetic nerve endings is nor-epinephrine, which can be deficient in cases of nocturnal enuresis. The IUS and the IAS are collagen-muscle tissue cylinders. In women both sphincters are closely related to the vagina, and are subject to lacerations from vaginal delivery. Lacerated sphincters as a result of Child-Birth Trauma (CBT) become weak and cannot stand against sudden rise of abdominal pressure resulting in Urinary Incontinence (UI) and/or Fecal Incontince (FI).","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"520 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77805401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2168-9857.1000207
S. Allen
Introduction: Type-III chronic prostatitis (CP) is characterized by pelvic pain, sexual dysfunction and urinary symptoms in the absence of infection. It is also known as chronic pelvic pain syndrome (CPPS) This study discusses the cause of CP/CPPS, the understanding of which can help to find effective therapy. Materials: An observational clinical trial, before and 6 months after treatment with Thermobalancing therapy (TT) and Dr Allen’s therapeutic device (DATD), which uses natural body energy, has been used. The treatment group-45 patients with CP/CPPS, who received DATD, and the control group-45 men with CP/CPPS, who not. Methods: The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) include examination of pain score and quality of life (QoL), ultrasound-prostate volume (PVmL), uroflowmetry-maximum urine flow rate (Qmax). Results: Compared to control, significant improvements from baseline to endpoint were seen: pain score, 10.38 to 3.58 against 10.49 to 9.71, (P<0.001); QoL index 8.11 to 2.98; against 8.47 to 8.33 (P<0.001); PVmL 31.75 ± 7.01 to 27.07 ± 4.52 against 30.77 ± 6.44 to 31.58 ± 7.14 (P<0.001); QmaxmL/sec, 11.93 ± 4.34 to 16.45 ± 3.50 against 12.59 ± 3.57 to 12.20 ± 2.54 (P<0.001). Conclusions: Vascular changes, namely pathological activity of capillaries, in the prostate tissue cause CP/ CPPS. The focus of hypothermia combined with spontaneous expansion of capillaries create the pressure in the prostate tissue and, consequently, the CP/CPPS symptoms. DATD, by accumulation of emitted body heat and spreading this safe energy to the prostate in men with CP/CPPS, relieves pain and other symptoms effectively.
{"title":"The Cause, Aetiology and Physiopathology of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) and its Effective Treatment with Thermobalancing Therapy","authors":"S. Allen","doi":"10.4172/2168-9857.1000207","DOIUrl":"https://doi.org/10.4172/2168-9857.1000207","url":null,"abstract":"Introduction: Type-III chronic prostatitis (CP) is characterized by pelvic pain, sexual dysfunction and urinary symptoms in the absence of infection. It is also known as chronic pelvic pain syndrome (CPPS) This study discusses the cause of CP/CPPS, the understanding of which can help to find effective therapy. Materials: An observational clinical trial, before and 6 months after treatment with Thermobalancing therapy (TT) and Dr Allen’s therapeutic device (DATD), which uses natural body energy, has been used. The treatment group-45 patients with CP/CPPS, who received DATD, and the control group-45 men with CP/CPPS, who not. Methods: The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) include examination of pain score and quality of life (QoL), ultrasound-prostate volume (PVmL), uroflowmetry-maximum urine flow rate (Qmax). Results: Compared to control, significant improvements from baseline to endpoint were seen: pain score, 10.38 to 3.58 against 10.49 to 9.71, (P<0.001); QoL index 8.11 to 2.98; against 8.47 to 8.33 (P<0.001); PVmL 31.75 ± 7.01 to 27.07 ± 4.52 against 30.77 ± 6.44 to 31.58 ± 7.14 (P<0.001); QmaxmL/sec, 11.93 ± 4.34 to 16.45 ± 3.50 against 12.59 ± 3.57 to 12.20 ± 2.54 (P<0.001). Conclusions: Vascular changes, namely pathological activity of capillaries, in the prostate tissue cause CP/ CPPS. The focus of hypothermia combined with spontaneous expansion of capillaries create the pressure in the prostate tissue and, consequently, the CP/CPPS symptoms. DATD, by accumulation of emitted body heat and spreading this safe energy to the prostate in men with CP/CPPS, relieves pain and other symptoms effectively.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"07 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87146321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2168-9857.1000210
S. Markowitz, J. Rosenblum, M. Goldstein, H. Gadagkar, L. Litman
The authors evaluate a novel Surface Acoustic Wave Actuator and its effect on preventing CAUTI. This is a double blinded randomized control trial, of the Uroshield⢠device. 55 patients in a skilled nursing facility chain being treated with long term indwelling catheters were evaluated. There was a significant difference between the treated group and the placebo group in the number of Colony Forming Units present upon evaluation, as well as on the number of treated UTIâs. The effect lasted beyond the time of active treatment.
{"title":"The Effect of Surface Acoustic Waves on Bacterial Load and Preventing Catheter- associated Urinary Tract Infections (CAUTI) in Long Term Indwelling Catheters","authors":"S. Markowitz, J. Rosenblum, M. Goldstein, H. Gadagkar, L. Litman","doi":"10.4172/2168-9857.1000210","DOIUrl":"https://doi.org/10.4172/2168-9857.1000210","url":null,"abstract":"The authors evaluate a novel Surface Acoustic Wave Actuator and its effect on preventing CAUTI. This is a double blinded randomized control trial, of the Uroshield⢠device. 55 patients in a skilled nursing facility chain being treated with long term indwelling catheters were evaluated. There was a significant difference between the treated group and the placebo group in the number of Colony Forming Units present upon evaluation, as well as on the number of treated UTIâs. The effect lasted beyond the time of active treatment.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"28 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80998864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2168-9857.1000E121
M. Matrana
After years of attempts to find an adjuvant therapy to reduce the risk of renal cell carcinoma recurrence after nephrectomy, we now have an FDA-approved targeted therapy for this indication. There have been numerous negative studies previously, and some felt that VEGF targeted therapy would never gain regulatory approval in the adjuvant setting, however, results of phase III S-TRAC trial have changed all of that.
{"title":"FDA Approves an Adjuvant Targeted Therapy for Post-Surgery RCC Patients, but Questions and Clinical Challenges Remain","authors":"M. Matrana","doi":"10.4172/2168-9857.1000E121","DOIUrl":"https://doi.org/10.4172/2168-9857.1000E121","url":null,"abstract":"After years of attempts to find an adjuvant therapy to reduce the risk of renal cell carcinoma recurrence after nephrectomy, we now have an FDA-approved targeted therapy for this indication. There have been numerous negative studies previously, and some felt that VEGF targeted therapy would never gain regulatory approval in the adjuvant setting, however, results of phase III S-TRAC trial have changed all of that.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"14 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78901059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2168-9857.1000198
M. AbdelKarimElHemaly, A. LailaMousa, M. Ibrahim, M. IbrahimKandil, M. Morad, Fatma El Sokary
Introduction: Body excreta (urine, feces and flatus) are expelled through the urethra in front and the anal canal posterior. Both the urethra and the anal canal are derived embryological from the cloaca and have the same neurovascular bundle, thoraco-lumbar sympathetic nerves (T10-L2) through the inferior hypogastric nerve plexus as exciter, and sacral sensory nerves (S 2, 3 &4). Everybody organ has a strong collagen chassis, this include the internal urethral sphincter (IUS) and the internal anal sphincter (IAS). Toilet training in early childhood leads to acquiring and keeping high sympathetic tone at the IUS and the IAS causing their contraction and the urethra and the anal canal are kept empty and closed all the time until there is a need/or a desire to expel at proper social circumstances. Clinical Study: Function of the IUS is proved by urodynamic studies, while structural damage of both the IUS and the IAS is demonstrated by medical imaging. Results: We proved that there is high sympathetic tone at the IUS, recording the UPP at rest, and then we gave alpha-sympathetic drug, the UPP dropped markedly. We gave sympathomimetic drug the UPP raised immediately. Medical imaging proved lacerated IUS in cases of stress urinary incontinence (SUI) and lacerated IAS in cases of fecal incontinence (FI). Conclusion: Urinary continence depends on a closed and empty urethra. Fecal continence depends on a closed and empty anal canal. Healthy reactive CNS, intact sensory nerves, intact sympathetic nerves producing normal neuro-transmitter are essential for continence.
{"title":"Body Excreta Control and Incontinence","authors":"M. AbdelKarimElHemaly, A. LailaMousa, M. Ibrahim, M. IbrahimKandil, M. Morad, Fatma El Sokary","doi":"10.4172/2168-9857.1000198","DOIUrl":"https://doi.org/10.4172/2168-9857.1000198","url":null,"abstract":"Introduction: Body excreta (urine, feces and flatus) are expelled through the urethra in front and the anal canal posterior. Both the urethra and the anal canal are derived embryological from the cloaca and have the same neurovascular bundle, thoraco-lumbar sympathetic nerves (T10-L2) through the inferior hypogastric nerve plexus as exciter, and sacral sensory nerves (S 2, 3 &4). Everybody organ has a strong collagen chassis, this include the internal urethral sphincter (IUS) and the internal anal sphincter (IAS). Toilet training in early childhood leads to acquiring and keeping high sympathetic tone at the IUS and the IAS causing their contraction and the urethra and the anal canal are kept empty and closed all the time until there is a need/or a desire to expel at proper social circumstances. Clinical Study: Function of the IUS is proved by urodynamic studies, while structural damage of both the IUS and the IAS is demonstrated by medical imaging. Results: We proved that there is high sympathetic tone at the IUS, recording the UPP at rest, and then we gave alpha-sympathetic drug, the UPP dropped markedly. We gave sympathomimetic drug the UPP raised immediately. Medical imaging proved lacerated IUS in cases of stress urinary incontinence (SUI) and lacerated IAS in cases of fecal incontinence (FI). Conclusion: Urinary continence depends on a closed and empty urethra. Fecal continence depends on a closed and empty anal canal. Healthy reactive CNS, intact sensory nerves, intact sympathetic nerves producing normal neuro-transmitter are essential for continence.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"148 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80631020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2168-9857.1000205
Mohamed Fi, Ibrahim Yf, Ibrahim Sf
A great variety of self-inflicted foreign bodies have been removed from the lower urinary tract and male external genitalia. These foreign bodies were inserted or applied for autoerotic, psychiatric, therapeutic, or no definite reasons by the patient. Most patients present when complications had occurred from the foreign body such as difficulty in passing urine, haematuria, extravasations, pain or swelling of the external genitalia and abscess formation. Three young patients who applied metallic foreign bodies around their genitals will be presented. The symptoms, findings and surgical management will be presented.
{"title":"Self-Inflicted Foreign Bodies around the Male Genitalia","authors":"Mohamed Fi, Ibrahim Yf, Ibrahim Sf","doi":"10.4172/2168-9857.1000205","DOIUrl":"https://doi.org/10.4172/2168-9857.1000205","url":null,"abstract":"A great variety of self-inflicted foreign bodies have been removed from the lower urinary tract and male external genitalia. These foreign bodies were inserted or applied for autoerotic, psychiatric, therapeutic, or no definite reasons by the patient. Most patients present when complications had occurred from the foreign body such as difficulty in passing urine, haematuria, extravasations, pain or swelling of the external genitalia and abscess formation. Three young patients who applied metallic foreign bodies around their genitals will be presented. The symptoms, findings and surgical management will be presented.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"2 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80902740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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