전립선비대증 환자에서 전립선용적의 예측인자로서의 전립선특이항원

류동수,오태희,김병한,박우진,권준오 대한배뇨장애요실금학회 2006 International Neurourology Journal Vol.10 No.2

전립선비대증 환자의 원격관리에 대한 선호도 조사

박문선,김원재,이형래,조인창,김태환 대한배뇨장애요실금학회 2006 International Neurourology Journal Vol.10 No.1

대상포진에 의한 배뇨장애에서 치료 방법에 따른회복기간의 비교

박범수,김진일,이선주 대한배뇨장애요실금학회 2007 International Neurourology Journal Vol.11 No.1

Purpose: We compared the recovery periods in zoster-associated voiding dysfunction according to the treatment modality to establish the best treatment policy. Materials and Methods: From January 2004 to August 2006, medical records of 250 patients admitted for zoster infection were reviewed. Of 250 patients, patients complaining of lower urinary tract symptoms (LUTS) were selected. The clinical and urodynamic features, and treatment outcomes were analyzed. Results: Thirty eight (15.2%) of 250 patients had zoster-associated LUTS. Urinary retention was the most common symptom. Urodynamically, detrusor underactivity was the most common finding (71.8%). Twenty were followed, of which 5 received oral medication, 10 received clean intermittent catheterization (CIC), 4 received indwelling catheterization (IC) and remained 1 was observed without treatment. All patients regained normal voiding function. Mean recovery period was 12 days. According to the treatment modality, mean recovery period was 21 days in medication group, 10 days in CIC group, and 6 days in IC group. The mean recovery period was significantly shorter in CIC or IC group than medication group (p=0.013, 0.005). Conclusion: Zoster-associated voiding dysfunction is a reversible condition. Thus, patients with mild symptoms can be observed. However, if symptoms are severe or retention develops, catheterization is recommended rather than medication alone. (J. Korean Continence Society 2007;11:36-40)

여성 복압성 요실금 환자에서 TVT 술식 후 발생한 배뇨곤란의 Hegar 확장기를 이용한 치료경험

문형윤,노준,김철성,장대수,조원진,임동훈,백승 대한배뇨장애요실금학회 2005 International Neurourology Journal Vol.9 No.1

The tension-free vaginal tape procedure (TVT) has become a state of the art operation for female stress urinary incontinence. The most common problems after the TVT seen are voiding difficulties. Although the incidence of urinary retention appears to be low after the TVT procedure, it is recommended that patients be counseled about the risk and carefully monitored for voiding symptoms during the first 3 weeks postoperatively. When obstruction after the TVT is clinically evident, immediate tape adjustment in the operating room by open vaginal incision, may be indicated. We report of voiding difficulty 8 weeks after the TVT who was successfully managed with urethral dilation. (J. Korean Continence Society 2005;9:46-48)

하부요로증상을 가진 여성 환자에서 Tamsulosin 0.2mg 단독요법의 유효성

장혁수,정세일,권태균,김덕윤,오태희,정재일,박철희 대한배뇨장애요실금학회 2006 International Neurourology Journal Vol.10 No.2

Purpose: The study of lower urinary tact symptoms (LUTS) in women is rare except urinary incontinence, and there were even no diagnostic or therapeutic guidelines for female bladder outlet obstruction. The objective of this study was to determine the efficacy of tamsulosin 0.2 mg/day single therapy for the female patients with LUTS. Materials and Methods: A total 71 patients were evaluable. Tamsulosin 0.2 mg/day was administered orally in a nonblind design for 8 weeks. The efficacy parameters were International Prostate Symptom Score (IPSS), quality of life (QOL) score, frequency in daytime and night, maximal flow rate (Qmax), post-void residual urine volume (PVR), and changes in blood pressure and pulse rates. Changes in parameters between baseline and 8 weeks were assessed using Student’s paired t-test. Results: Statistically significant changes in the total, obstructive and irritative IPSS, QOL score, daytime and night time frequency, Qmax and PVR were observed at week 8. Adverse events included dizziness in 2 patients and increased nocturia in 1 patient. There were no withdrawals resulting from adverse events. There were significant differences in systolic blood pressure, but did not cause significant hypotension events. Conclusion: Treatment with tamsulosin 0.2 mg/day in female patients with LUTS was effective and well tolerated in improving LUTS and QOL. (J. Korean Continence Society 2006;10:140-146)

여성 복압성요실금 환자에서 수술적 치료 후 발생한 배뇨장애의 치료

한동석,나용길,김홍식,설종구,길건,신주현,소성민,육승모,김용웅,임재성 대한배뇨장애요실금학회 2005 International Neurourology Journal Vol.9 No.1

Purpose: We studied the voiding dysfunction after surgical treatment of female stress urinary incontinence and diagnosis and treatment. Materials and Methods: Three hundred women with stress urinary incontinence underwent surgical procedure between January 1998 and December 2004. Ninety two patients (30.6%) experienced the postoperative voiding dysfunction. As the primary procedure for the management of postoperative voiding dysfunction alpha-blockers medication and clean intermittent catheterization (CIC) were performed. Then, hegar dilation and urethral pull-down procedure were performed as a secondary measure. For the patients who showed persistent obstructed symptoms, cutting of mesh or sling materials were performed. Results: In 57 patients, symptoms improved by alpha-blockers medication and CIC. The others were received hegar dilation and urethral pull-down procedure, and 29 patients were improved. 6 patients were not controlled by conservative treatment, of which 3 patients underwent cutting of mesh or sling. De novo urgency was developed in 12 patients. Anticholinergics were taken, symptoms were diminished in 10 patients after 5 months of medication. Conclusion: Most voiding dysfunction after surgery may be effectively managed by conservative treatment. In cases of failure, hegar dilation and urethral pull-down procedure may be useful within postoperative first weak. Finally, cutting of mesh or sling must be considered in patient whose the secondary measure is failed. (J. Korean Continence Society 2005;9:40-45)

배뇨근 저활동성의 복압성 요실금 환자에서 중부 요도 슬링이 배뇨에 미치는 영향

이상협,김진일,이선주 대한배뇨장애요실금학회 2009 International Neurourology Journal Vol.13 No.1

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)

치매와 배뇨장애

최종보 대한배뇨장애요실금학회 2008 International Neurourology Journal Vol.12 No.1

Voiding dysfunction is very common in Alzheimer's disease, especially urinary incontinence with reported frequencies of 11-90%. Urinary incontinence occurs secondarily from dementia, can result in medical morbidity, impaired self-esteem of the patents, caregiver's stress, early institutionalization of the patients, and considerable financial cost. Many studies have found that the frequency and severity of incontinence is positively correlated with the severity of dementia and the inability to walk or transfer. Research on the management of urinary incontinence in demented patients has focused almost exclusively on toileting programs and drug treatments for detrusor overactivity. To date, anticholinergic and antispasmodic medications have not been shown to be effective in treating incontinence in demented persons. Therefore we have to study about the etiology and treatment of Alzheimer's disease. (J Korean Continence Soc 2008;12:10-17)

복합성요실금 환자에서 Modified Ingelman-Sundberg 탈신경화 수술의 단기 추적 결과

박봉희,박영경,김명기,정영범 대한배뇨장애요실금학회 2006 International Neurourology Journal Vol.10 No.2

과민성 방광모델로서 자연발생 고혈압 쥐에서 비마취하 요역동학 검사로 관찰한 항콜린성 제제인 tolterodine의 배뇨 압력 및 용적에 대한 경구 및 주사 효과

이소영,권용현,윤상민,진롱후,장진혁,강용진,이택 대한배뇨장애요실금학회 2009 International Neurourology Journal Vol.13 No.2

Purpose: We investigated the effect of oral or intravenous tolterodine on cystometric parameters in awake spontaneously hypertensive rats (SHRs) as a model of overactive bladder (OAB). The aim of our study was to observe the experimental conditions required to reproduce the clinical pharmacological effects of tolterodine, as seen in humans, to decrease bladder pressure or increase bladder capacity. Materials and methods: We studied the effects of the most widely used antimuscarinic drug, tolterodine, on cystometric parameters via two different administrations (oral and intravenous) in awake SHRs. Results: Oral administration of tolterodine 10 mg/kg-1 body weight in awake rats did not change any cystometric parameters significantly. Intravenous administration of tolterodine 0.3 mg/kg-1 body weight significantly decreased basal pressure (BP) and micturition pressure (MP), but showed no effect on micturition interval (MI) or bladder capacity (BC). Conclusion: Despite a high dose of tolterodine via an oral or an intravenous route, a decrease in BP or MP was the only effect on cystometrographic parameters in awake rats, whereas MI and BC were not significantly affected. Therefore, it is difficult to reproduce in awake rats as an acute response the cystometric increase in the MI that is observed in humans after chronic administration of antimuscarinic agents.