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Purpose: We tried to discover the voiding patterns, which was diurnal & nocturnal urinary volume and voiding frequencies in women with overactive bladder (OAB). Materials and Methods: All voided volumes, times and frequencies were recorded in 249 women with overactive bladder. The subjects age related changes in bladder capacity, urinary volume and frequency were evaluated. The causes of nocturnal urinary frequency and its increase with age in older women with OAB were evaluated using 3 days of voiding diaries. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. Results: Total voided volume, daytime urine volume, functional bladder capacity were decreased with the age. Nocturnal urine volume and nocturnal urinary frequency were increased with age. Nocturnal polyuria was the major cause for nocturia, and mixed type was increased with age. Conclusions: Voiding symptoms as well as storage symptoms were increased with age in OAB female. In most cases, nocturia was caused by nocturnal polyuria. (J Korean Continence Soc 2009;13:37-44) Purpose: We tried to discover the voiding patterns, which was diurnal & nocturnal urinary volume and voiding frequencies in women with overactive bladder (OAB). Materials and Methods: All voided volumes, times and frequencies were recorded in 249 women with overactive bladder. The subjects age related changes in bladder capacity, urinary volume and frequency were evaluated. The causes of nocturnal urinary frequency and its increase with age in older women with OAB were evaluated using 3 days of voiding diaries. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. Results: Total voided volume, daytime urine volume, functional bladder capacity were decreased with the age. Nocturnal urine volume and nocturnal urinary frequency were increased with age. Nocturnal polyuria was the major cause for nocturia, and mixed type was increased with age. Conclusions: Voiding symptoms as well as storage symptoms were increased with age in OAB female. In most cases, nocturia was caused by nocturnal polyuria. (J Korean Continence Soc 2009;13:37-44)
Purpose: The aim of this study is to determine whether the outcome of the mid-urethral sling procedures may be influenced by the body-mass index in Korean women with stress urinary incontinence (SUI). Materials and Methods: A total of 285 women 28 to 80 years old with a minimum follow-up of 6 months were included in the study. Patients were stratified as follows: normal weight, 18.5∼23 kg/m2; overweight, 23∼ 27.5 kg/m2; obesity, 27.5 kg/m2 or higher. Results: There was no significant complication. Bladder perforations were noted in 11 cases (4.9%, 3.8% and 2.2% in the normal weight, overweight and obesity group, p=0.449). There was no significant difference between the three groups for cure rate (p=0.173). The rates of postoperative urinary retention were 9.9%, 10.1% and 15.6% in the normal weight, overweight and obesity group (p=0.396). No significant difference was found between the three groups in the persistence of urgency (p=0.312). Seventy-nine patients (27.7%) had symptoms suggestive of voiding disorder, postoperatively. The incidence of these symptoms was not significant difference in the three groups (p=0.106). Conclusion: Our results demonstrate the feasibility and safety of the mid-urethral sling procedures for obese Korean women with SUI. Additional studies, including prospective randomized trials with longer follow-up, are needed to verify these findings. (J. Korean Continence Society 2005;9:28-33)
Purpose: To compare IRIS procedure with TVT and SPARC in the treatment of female stress urinary incontinence (SUI). Materials and Methods: Among 96 patients with SUI who underwent sling procedure, we retrospectively compared IRIS procedure (n=34) to TVT (n=32) and SPARC (n=30). All patients were evaluated preoperatively with a detailed history, pelvic examination, voiding cystourethrography, urodynamic study and incontinence staging with SEAPI classification. Parameters of comparison included presence of stress incontinence, length of hospital stay, duration of catheterization, operation time, complication, success rate and satisfaction rate. Results: The success rates were 97%, 96.9% and 96.7% in the IRIS, TVT and SPARC group, respectively. The satisfaction rates were 94.1%, 96.9% and 96.6% in the IRIS, TVT and SPARC group. The complication rates were 23.5%, 21.8% and 23.3% in the IRIS, TVT and SPARC group. There was no statistically significant difference among the 3 groups in terms of success rates, satisfaction rates, complication rates, and postoperative subjective SEAPI scores. Conclusion: IRIS procedure was equally effective compared to conventional mid urethral sling procedure such as TVT and SPARC in the management of female SUI with high cure rates and acceptably low complication rates. (J. Korean Continence Society 2006;10:126-131)
Purpose: We administered doxazosin gastrointestinal therapeutic system (GITS) to women with non-neurogenic voiding dysfunction to evaluate its therapeutic effects. Materials and Methods: Women who had voiding dysfunctions for at least 3 mo were included. Inclusion criteria were age ≥18yr, an International Prostate Symptom Score (IPSS) ≥15, and a maximum flow rate (Qmax) <15mL/sec and/or postvoid residual (PVR) ≥150mL. Patients with neurogenic voiding dysfunction or anatomical bladder outlet obstruction were excluded. All patients were classified according to the Blaivas-Groutz nomogram. After 4 weeks, treatment outcomes were evaluated. Results: Sixty-two patients were evaluated of mean age 53.8 (32-78)yr. According to the Blaivas-Groutz nomogram, 24 patients had no or mild obstruction (group A) and 38 had moderate or severe obstruction (group B). After treatment, mean IPSS decreased significantly and by more than 5 points in 42 (67.7%). Mean bother scores, Qmax, and PVR also changed significantly. Thirty-seven (59.7%) showed Qmax increases of more than 50%. No significant difference were observed between the groups in terms of IPSS, bother score, Qmax, PVR, micturition frequencies, or functional bladder capacity changes. Adverse effects related to medication were de novo stress urinary incontinence (SUI) (1 case) and underlying SUI aggravation (1 case). By satisfaction assessments, 16 patients (25.8%) were 'mainly satisfied', 31 (50%) were 'slightly satisfied', and 15 (24.2%) were 'dissatisfied'. Conclusion: Doxazosin GITS was found to be effective in female patients with voiding dysfunction regardless of obstruction grade. The α-adrenoceptor antagonists should be viewed as initial treatment option for women with a non-neurogenic voiding dysfunction. (J Korean Continence Soc 2008;12:19-26)
Purpose: The aim of this study was to analyze the influence on voiding symptoms when performing sling operation on patients with stress urinary incontinence with detrusor underactivity. Materials and Methods: We analyzed medical records of 100 patients who received the sling operation. Based on their preoperative urodynamic study, we defined "stress urinary incontinence with detrusor underactivity (SUI with DU)" group as these findings; peak flow less than 11 ml/s or void with abdominal pressure instead of detrusor contraction or residual urine volume more than 100 ml. And the others were defined as the "stress urinary incontinence only (SUI)"group. We compared two groups and analyzed the changes of pre- and postoperative uroflowmetry. Results: The number of patients with the "SUI with DU" group was 30 and that with the "SUI" group was 70. In the "SUI with DU" group, there were no changes in peak flow rate and residual urine volume between postoperative uroflowmetry and preoperative urodynamic study (15.1 ± 7.9 vs. 14.7 ± 7.1 ml/s, 123.1 ± 79.2 vs. 127.3 ± 91.9 ml) (p>0.05). Twenty four patients underwent urinary drainage with nelatone catheter either on postoperative first or second day. However, 22 patients did not need to continue self catheterization. Conclusion: Sling operation could be performed on patients who are diagnosed as stress urinary incontinence with detrusor underactivity without aggravating their voiding symptoms. (J Korean Continence Soc 2009;13:73-79)
Purpose: To assess the efficacy and safety of a IRIS (innovative replacement of incontinence surgery) procedure for surgical treatment of stress urinary incontinence in women during the follow-up of 2 years. Materials and Methods: From March 2003 to March 2004, 48 women with stress urinary incontinence underwent a IRIS procedure under local, spinal or general anesthesia. Post-operative evaluation was carried out after 1 month, 12 months and 24 months. The mean age was 51.1±11.0 years and mean follow-up period was 32.1±3.8 months. Operation time, success rate and patient's satisfaction, perioperative and postoperative complications were evaluated. Results: The mean operation time was 24.46±1.95 minutes and mean hospital stay was 1.77±0.75 days. The success rates were 95.8% (cured 79.2%, improved 16.7%) and 93.8% (cured 75.0%, improved 18.8%), at the 1 and 2-year follow-up, respectively. The satisfaction rates were 91.7% at 1-year follow-up and persisted at 2-year follow-up. There were no serious or long-term complications related to the procedure, and no significant changes in the postoperative outcome over time. Conclusion: Our results demonstrate that the IRIS procedure is as safe and effective as TVT procedure for the treatment of female stress urinary incontinence, although longer follow-up is necessary to determine long-term effect. (J. Korean Continence Society 2006;10:44-48) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ Key Words: Stress urinary incontinence, IRIS
Purpose: The aim of this study was to investigate the effects of testosterone deprivation on urinary bladder in male rabbits by proteomic analysis. Materials and Methods: New Zealand white male rabbits (2.5-3 kg) were divided into 2 group; control group with 5 rabbits and bilateral orchiectomized group, bilateral orchiectomized group was divided into post-operative 4 weeks group (group 1), and 8 weeks group (group 2) with 5 rabbits respectively. Bladder wall was excised partly at 4 or 8 weeks from the beginning of the experiment. Conventional proteomics was performed with high resolution 2-D gel electrophoresis followed by computational image analysis and protein identification using mass spectrometry. We decided to consider ‘significant' if protein had 50% decreasing or 200% increasing expression rate. Results: Six proteins were significantly changed in orchiectomy group, compared to control group; serum albumin precursor, GABA transaminase, dimethylarginine dimethylaminohydrolase 2, serum/glucocorticoid regulated kinase and LOC304923 protein were over-expressed in both group 1 and group 2. Annexin A1 was significantly over-expressed in the group 2 only. Conclusion: An overexpression of Annexin A1 and GABA transaminase mean a processing of neuronal reactions to injury in orchiectomized rabbit bladder. Also an overexpression of dimethylarginine dimethylaminohydrolase 2 would increase NO synthesis and thereby promote re-endothelialization in the rabbit bladder after orchiectomy. Serum/glucocorticoid regulated kinase would relate to Na+ transport. Albumin precursor and LOC304923 protein are remained to further research. These data suggested that bilateral orchiectomy would make the urinary bladder unstable. However more information is needed in human bladder tissue. (J Korean Continence Soc 2008;12:121-6)
Purpose: International guidelines and national laws have been formulated to protect human subjects in research. Recently, many efforts have been tried to contribute to better awareness and knowledge about the link between quality systems and protection to develop better quality procedures in health research. In this study, to improve the understandings about health research, awareness about health research was evaluated with questionnaires for patients and care-givers in our institute. Materials and Methods: 339 persons responded to the questionnaires. 128 persons were patients with mild symptoms and 69 were caregivers. 123 were male and 179 were female. Dominant educational level was college graduates and were 166 and economic status was middle-class (247). Questionnaires was composed of 18 items; 7 demographical characteristics items, 7 understanding of clinical trials items, 4 understandings of IRB (Institutional Review Board) concepts items. Results: 71.7% of responder have informations about clinical trials by TV and 23.9% by newspapers. 22.3% have never heard about clinical trials. Knowledge level about clinical trials was thought to be a middle level and subjects of clinical trials were animals (62.5%), patients (54.9%), normal persons (25.4%), plants (11.8%). Objects to be included in clinical trials were pharmaceuticals (62.2%), cell therapy (58.7%), medical device (30.4%), health promotion foods (14.5%). Answer about 'Intention to be the participant" were no in 56% and yes in 34.5%. Conclusions: Although mass media contributed to the spread of understandings about clinical trials, 22.3% did not know about health research. To improve the awareness and understandings about health research, television (TV) can be the most effective method and the safety about human subject protection should be certified. (J Korean Continence Soc 2008;12:48-57)
Purpose: Tension-free vaginal tape (TVT) procedure is widely used as an initial operative method in stress urinary incontinence because of high success rate and low morbidity. However, some patients have complained of voiding difficulties after TVT. We evaluated 14 patients who underwent mesh cutting because of obstructive symptoms after TVT. Materials and Methods: 14 patients who underwent mesh cutting because of prolonged obstructive symptoms after TVT were included for the study. Their voiding symptoms were evaluated by Qmax, voiding time and postvoid residual urine. These parameters which were done before TVT, post-TVT and post-mesh cutting were compared. Results: 4 out of 14 patients were intrinsic sphincter deficiency (valsalva leak point pressure <60 cmH2O) and no patient had detrusor overactivity before TVT. After TVT, Qmax was decreased from 25.4±3.5 ml/sec to 9.4±2.4 ml/sec, and voiding time was prolonged from 26.7±6.6 sec to 65.5±24.8 sec. However, the volume of postvoid residual urine was unchanged. After mesh cutting, Qmax was increased to 21.7±7.7 ml/sec and voiding time was decreased to 27.2±7.6 sec. Subjective voiding symptoms were improved immediately in 13 out of 14 patients (92.9%), although 1 patient showed small amount of urine leakage when coughing. And also, in 1 out of 2 patients, detrusor overactivity which was shown after TVT was disappeared. Conclusion: We believe that we do not need to hesitate to cut the mesh in patients who are suffering from severe obstructive symptoms after TVT. (J. Korean Continence Society 2005;9:13-16)