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Quality control and the effect of technique in urodynamicsSullivan, Jonathan Gerald January 2009 (has links)
No description available.
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The lower urinary tract in pregnancyCutner, Alfred January 1993 (has links)
No description available.
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Some studies in renal functionRamsay, David J. January 1964 (has links)
No description available.
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Core and bladder temperature gradient in critically ill adults : urine flow rate as a factor /Fallis, Wendy M. January 2002 (has links)
Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 111-120).
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Η διερεύνηση της σχέσης της, [sic] υπερηχογραφικά υπολογιζόμενης, μάζας του εξωστήρα της ουροδόχου κύστης με τα ουροδυναμικά και κλινικά ευρήματα σε ασθενείς με δυσλειτουργική ούρησηΔεϊρμεντζόγλου, Σταύρος Χ. 07 June 2013 (has links)
ΣΚΟΠΟΣ: Η διερεύνηση της πιθανής συσχέτισης του υπερηχογραφικά υπολογιζόμενου βάρους της ουροδόχου κύστης (UEBW) με τα ουροδυναμικά ευρήματα, σε γυναίκες με συμπτώματα από το κατώτερο ουροποιητικό σύστημα (ΣΚΟ), ειδικά με την υποσυσταλτικότητα του εξωστήρα (DU) και την απόφραξη (BOO).
ΥΛΙΚΟ-ΜΕΘΟΔΟΣ: Στη μελέτη εντάχθηκαν ενήλικες γυναίκες που απευθύνθηκαν στο ουροδυναμικό εργαστήριο για διερεύνηση ΣΚΟ. Μετά από την ουροδυναμική εξέταση, χρησιμοποιήθηκε η φορητή συσκευή Bladderscan® BVM 6500 προκειμένου να υπολογιστεί το πάχος του εξωστήρα της κύστης (DWT) αλλά και το βάρος της κύστης (UEBW), σύμφωνα με συγκεκριμένο πρωτόκολλο.
Οι ασθενείς κατανεμήθηκαν σε ομάδες με βάση τα ουροδυναμικά ευρήματα. Σαν ομάδα ελέγχου χρησιμοποιήθηκαν οι γυναίκες με φυσιολογικά ουροδυναμικά ευρήματα, παρά τα συμπτώματά για τα οποία προσήλθαν.
Έγινε στατιστική σύγκριση πρωτίστως των μετρήσεων UEBW και DWT και στη συνέχεια και των υπολοίπων παραμέτρων, τόσο μεταξύ των διαφόρων ομάδων και της ομάδας ελέγχου, όσο και μεταξύ τους.
ΑΠΟΤΕΛΕΣΜΑΤΑ: Συνολικά 178 γυναίκες συμπεριλήφθηκαν στην στατιστική ανάλυση. Το UEBW ήταν σημαντικά μικρότερο σε ασθενείς με υποσυσταλτικότητα του εξωστήρα σε σύγκριση με την ομάδα ελέγχου (39,32±2,95g vs 45,67±3.11g, p<0,001). Σημαντικές διαφορές παρατηρήθηκαν στο UEBW και μεταξύ της ομάδας ελέγχου και των ασθενών με απόφραξη είτε με είτε χωρίς υπερδραστηριότητα (45,67±3,11g vs 52,14±3,90g και 52,58±5,99g, αντίστοιχα, p<0,001 και στις δύο περιπτώσεις). Αντιθέτως, δεν υπήρχε στατιστικά σημαντική διαφορά στο UEBW μεταξύ της ομάδας ελέγχου και των ασθενών με αμιγή υπερδραστηριότητα εξωστήρα, ακράτεια από προσπάθεια και ακράτεια από προσπάθεια με συνοδό υπερδραστηριότητα (45,67±3,11g vs 45,39±2,92g, vs 45,24±3,79g και vs 46,88±5,68g, αντίστοιχα, με p>0,05 σε όλες τις συγκρίσεις).
Το DWT επίσης παρουσίασε την ίδια συμπεριφορά, με στατιστική σημαντικότητα όσον αφορά την απόφραξη είτε με είτε χωρίς υπερδραστηριότητα και μη σημαντική διαφορά όσον αφορά τις υπόλοιπες ομάδες. Το UEBW παίζει το σημαντικότερο ρόλο σε σύγκριση με τις άλλες μη επεμβατικές παραμέτρους στην προσπάθεια πρόβλεψης του ουροδυναμικού πορίσματος. Επίσης, αποτελεί σχετιά ακριβή μέθοδο για τη διαφοροδιάγνωση μεταξύ των γυναικών με υποδραστηριότητα ή απόφραξη (με ή χωρίς υπερδραστηριότητα) και των «φυσιολογικών».
ΣΥΜΠΕΡΑΣΜΑΤΑ: Το UEBW όπως και το DWT ήταν στατιστικώς σημαντικά μεγαλύτερο στα άτομα με απόφραξη, σε σύγκριση με την ομάδα ελέγχου. Επίσης, το UEBW ήταν στατιστικά σημαντικά μικρότερο στα άτομα με υποσυσταλτικότητα εξωστήρα. Αντιθέτως, δεν επιβεβαιώθηκε στατιστικά σημαντική διαφορά του UEBW αλλά και του DWT μεταξύ ασθενών με αμιγή υπερδραστηριότητα εξωστήρα, ακράτεια από προσπάθεια και ακράτεια από προσπάθεια με συνοδό υπερδραστηριότητα και της ομάδας ελέγχου, ούτε και του DWT μεταξύ των ασθενών με υποδραστηριότητα και της ομάδας ελέγχου. Το UEBW είναι σημαντικός παράγοντας για την πρόβλεψη του ουροδυναμικού ευρήματος, κυρίως όταν αφορά την υποδραστηριότητα και την απόφραξη. / OBJECTIVES: To test the hypothesis that ultrasound estimated bladder weight (UEBW) correlates to urodynamic diagnoses in women with lower urinary tract symptoms (LUTS), especially detrusor underactivity (DU) and bladder outflow obstruction (BOO).
METHODS: Adult women referred to the urodynamics suite for investigation of LUTS, were enrolled. After urodynamics, the portable BladderScan® BVM 6500 device was used to calculate detrusor wall thickness (DWT) and UEBW according to a standardized protocol. Patients were categorized according to urodynamic findings. Women with normal investigations, despite symptoms for which they were referred, were used as controls. UEBW and DWT measurements were compared between groups and controls, using the Dunnett t-test. P value <0.05 was considered statistically significant. Certain other comparisons were performed on the other parameters between the same groups.
RESULTS: 187 women were enrolled but only 178 were included in the statistical analysis. UEBW was significantly lower in patients with DU compared to controls (39,32 ±2,95g vs 45,67±3,11g, p<0.001). Significant differences were also noted between controls and patients with bladder outlet obstruction with (BOO-DO) or without detrusor overactivity (BOO) (45,67±3,11g vs 52,14±3,90g and 52,58±5,99g respectively, p<0.001 for both comparisons). The difference, in terms of UEBW, between controls and patients with detrusor overactivity (DO), stress urinary incontinence (SUI) and stress urinary incontinence with overactivity (SUI-DO) was not statistically significant (45,67±3,11g vs 45,39±2,92g, vs 45,24±3,79g vs 46,88±5,68, respectively, with p>0.05 for all comparisons). Regarding DWT the comparisons had the same results, with no statistical difference between patients with DU, DO, SUI and SUI-DO and controls. Among the others non-invasive parameters, UEBW was the most useful one, in predicting the urodynamic findings. UEBW is, also, a relatively accurate method to distinguish women with hypocontractility or bladder outlet obstruction from women with normal urodynamic findings.
CONCLUSIONS: Significantly reduced UEBW in female patients with DU and significantly increased UEBW in cases of bladder outlet obstruction were shown. The finding of significantly increased bladder weight in DO or significantly different bladder weight in SUI and SUI-DO was not confirmed in this study. The same results were present regarding the DWT, although there was no significant difference between patients with DU and controls. UEBW was a significant factor in predicting the urodynamic findings, especially in women with hypocontractility or bladder outlet obstruction.
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Efeitos vesicais da inibição crônica da produção de óxido nítrico em camundongos com obstrução parcial uretral / The effects of chronic nitric oxide synthesis on bladder function in partial outlet obstructed micePereira, Marcy Lancia, 1981- 25 August 2018 (has links)
Orientadores: Carlos Arturo Levi D'Ancona, Edson Antunes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T05:49:51Z (GMT). No. of bitstreams: 1
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Previous issue date: 2014 / Resumo: A hiperplasia prostática benigna (HPB) ou aumento benigno da próstata (ABP) leva a disfunção do trato urinário, que pode ser mimetizada outras espécies animais, como roedores, por meio de obstrução parcial da uretra (OPU). O óxido nítrico (NO), sintetizado a partir da L-arginina por meio de três isoenzimas (iNOS, eNOS e nNOS) vem sendo estudado por ser apontado como responsável por alterações morfológicas e funcionais decorrentes do processo obstrutivo uretral. Este trabalho teve como objetivo caracterizar as alterações vesicais crônicas em camundongos com OPU e tratados cronicamente com L-NAME (inibidor competitivo não seletivo da NOS) e aminoguanidina (inibidor competitivo seletivo para iNOS). Os animais foram divididos em 6 grupos experimentais: Sham, Sham + L-NAME, Sham + aminoguanidina, OPU, OPU + L-NAME e OPU + aminoguanidina. A realização da OPU foi feita por meio de laparotomia e ligadura parcial ao nível do colo vesical utilizando-se cateter como guia externo. Após 5 semanas do procedimento cirúrgico, os animais foram avaliados quanto a cistometria, estudos farmacológicos em banho para órgão isolado e peso vesical. Os animais OPU apresentaram disfunção vesical observada por meio de aumento de contrações não miccionais (CNM) e da capacidade vesical, além de menor resposta contrátil muscarínica e elétrica. A inibição das três isoformas de NOS levou a diminuição da capacidade vesical em animais OPU. O tratamento com L-NAME levou a aumento de CNM, prevenção ao ganho de peso vesical e aumento das respostas contráteis a estimulação muscarínica e elétrica em animais OPU. A aminoguanidina diminuiu as CNM, mas não evitou o aumento do peso da bexiga em animais OPU e não aumentou as respostas contráteis vesicais. Tais achados sugerem que as NOS constitutivas (eNOS e nNOS) parecem ter papel mais relevante na fisiopatologia da OPU crônica do que a iNOS / Abstract: Benign prostatic hyperplasia (BPH) or Benign prostatic enlargement (BPE) leads to urinary tract dysfunction, which can be seen in experimental models, like rodents, by causing bladder outlet obstruction (BOO). Nitric oxide (NO), synthetized from L-arginine by three isoforms (iNOS, eNOS and nNOS) has been studied because it can be responsible for the urinary morphofunctional alterations. This study aimed to evaluate chronic bladder function in mice with BOO and treated chronically with L-NAME (non-selective NOS inhibitor) and aminoguanidine (iNOS selective inhibitor). Animals were divided into 6 experimental groups: Sham, Sham + L-NAME, Sham + aminoguanidine, BOO, BOO + L-NAME e BOO + aminoguanidine. BOO induction was made by laparotomy and partial ligature of bladder neck with a catheter as external guide. After 5 weeks of surgical procedure, animals were evaluated and filling cystometry, tissue bath contractile studies and bladder weight. BOO animals showed increase of non voiding contractions (NVC) and bladder capacity, and also less contractile response to Carbachol and Electric Field Stimulation. Inhibition of NOS isoforms diminished bladder capacity in BOO animals. L-NAME caused more NVC, prevented bladder weight gain and leaded to augmented contractile responses at muscarinic and electric stimulation. Aminoguanidine diminished NVC, but did not avoid bladder weight gain in BOO animals and did not cause increase in contractile responses. These results suggest that constitutive NOS (eNOS and nNOS) seem to be more important in chronic BOO pathophysiology than iNOS / Doutorado / Fisiopatologia Cirúrgica / Doutora em Ciências
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Estudo da associação entre o escore do International Consultation on Incontinence Questionnaire - Urinary Incontinence / Short Form e a avaliação urodinâmica em mulheres com incontinência urinária = Correlation of the International Consultation on Incontinence Questionnaire - Urinary Incontinence / Short Form to urodynamic diagnosis in women with urinary incontinence / Correlation of the International Consultation on Incontinence Questionnaire - Urinary Incontinence / Short Form to urodynamic diagnosis in women with urinary incontinenceDi Sessa, Renata Gebara de Grande, 1981- 21 August 2018 (has links)
Orientador: Viviane Herrmann Rodrigues / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T08:30:53Z (GMT). No. of bitstreams: 1
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Previous issue date: 2012 / Resumo: Introdução: A Incontinência Urinária (IU) tem impacto na qualidade de vida da mulher, física, psicológica e socialmente. A Avaliação Urodinâmica (AU) pode ser considerada o padrão ouro no diagnóstico da etiologia da IU. Entretanto, trata-se de exame invasivo, que provoca desconforto e constrangimento à paciente e cujo resultado nem sempre reproduz a sintomatologia clínica. Objetivo: Avaliar a associação entre o "International Consultation on Incontinence Questionnaire - Urinary Incontinence/Short Form" (ICIQ-UI/SF) e a Avaliação Urodinâmica, em mulheres com incontinência urinária. Métodos: Foi realizada análise retrospectiva dos dados clínicos e AU de 358 mulheres com IU atendidas em clínica privada. Utilizou-se a curva ROC com os valores de sensibilidade e especificidade dos escores do ICIQ-UI/SF apresentados pelas pacientes, a fim de estabelecer o escore capaz de discriminar o diagnóstico urodinâmico nos grupos estudados. Para o cálculo do p valor foi utilizado o teste de qui-quadrado ou exato de Fisher. O teste de Spearman avaliou a correlação entre o ICIQ-UI/SF e os parâmetros urodinâmicos. O nível de significância foi de 5% e o software utilizado para a análise foi o SAS versão 9.2. Resultados: A média de idade entre as pacientes foi de 51,1 anos, a raça predominante foi branca e 86,5% das pacientes tiveram ao menos duas gestações. As pacientes com Incontinência Urinária de Esforço segundo a AU (grupo 1) representaram 67.3% das pacientes estudadas. As pacientes com IUE na AU e Hiperatividade Detrusora (HD) - grupo 2 - representaram 16,2% da amostra e as pacientes com HD isolada (grupo 3) representaram 7,3% do total. Em 9.2% a Avaliação Urodinâmica foi considerada normal. Pacientes dos grupos 1 e 2 apresentaram escore ? 14 no ICIQ-UI/SF, sendo esta associação significativa (p=0,01 e p=0,001, respectivamente). Foi observada significativa associação entre a PPE ? 90 cmH2O e escore ICIQ-UI/SF ? 15 (p=0,0037). O teste de Spearman mostrou significativa correlação inversa entre o escore do ICIQ-UI/SF e a PPE, porém não mostrou correlação entre este escore e a Capacidade Cistométrica Máxima (CCM) ou com o volume vesical no primeiro desejo miccional (PDM). Conclusão: Mulheres com PPE ? 90 cmH2O apresentaram escores mais altos ao ICIQ-UI/SF, porém não há correlação com a CCM ou o PDM. Foi observada associação significativa entre a IUE e a PPE ? 90 cmH2O e escores mais altos no ICIQ-UI/SF / Abstract: Introduction: Urinary incontinence (UI) compromises women's quality of life, either in physical, psychological or sexual aspects. Urodynamics is considered the gold standard in the diagnosis of urinary symptoms. However it is invasive, expensive, provokes constraints to patients and is not always related to clinical complains. Objective: To evaluate the association between the "International Consultation on Incontinence Questionnaire - Urinary Incontinence/Short Form" (ICIQ-UI/SF) and urodynamics in women with urinary incontinence. Methods: It was a retrospective analysis of the data of 358 women with urinary incontinence attending a private clinic. A ROC curve was applied for sensitivity and specificity of ICIQ-UI/SF, to identify the score that would discriminate urodynamic diagnosis for the groups considered. P-value was obtained by Q-square and Fishers Exact Test. Spearman's test was used to correlate the ICIQ-UI/SF score to urodinamic parameters. Significance was 5% and the software SAS version 9.2. Results: Mean age was 51.1 years-old, the majority was white and 86.5% has been pregnant at least twice. Two hundred forty one patients (67.3%) presented stress urinary incontinence (SUI) on urodynamics (group 1), 16.2% presented SUI and Detrusor Overactivity (DO) (group 2) and 7.3% only DO. In 9.2% of the cases, urodynamics was considered normal. Women in groups 1 and 2 presented a significant association with ICIQ-UI/SF scores ? 14 (p=0.01 and p=0.001, respectively). A significant association was observed between Leak-point Pressure (LPP) ? 90 cmH2O and an ICIQ-UI/SF ? 15 (p=0.0037). Spearman's test showed a significant inverse correlation between ICIQ-UI/SF and LPP, but not to Maximum Cistometric Capacity (MCC) or First Desire to Void (FDV). Conclusions: Women with LPP ? 90cmH2O presented higher ICIQ-UI/SF scores, but no correlation was observed with MCC or FDV. Higher scores of the ICIQ-UI/SF were significantly associated with SUI and LPP ? 90cmH2O / Mestrado / Fisiopatologia Ginecológica / Mestra em Ciências da Saúde
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Urodinaminių ir kitų klinikinių požymių prognozinė vertė vaikų šlapimo organų infekcijos kartojimuisi / Prognostic value of urodynamic and other clinical signs for recurrent urinary tract infection in childrenRudaitis, Šarūnas 15 April 2008 (has links)
Šlapimo organų infekcija (ŠOI) vaikams yra antra pagal dažnį po kvėpavimo organų infekcijų. Tai dažniausia vaikų nefrologinė liga. ŠOI iki 3–6 mėn. amžiaus dažniau serga berniukai, vyresniame amžiuje – mergaitės. Priešmokykliniame amžiuje mergaitės simptomine šlapimo organų infekcija serga 6–20 kartų dažniau nei berniukai. Beveik kas trečia moteris iki 24 metų ŠOI yra sirgusi bent vieną kartą, o per gyvenimą ŠOI yra sirgusi beveik kas antra moteris. ŠOI linkusi pasikartoti. Kartojantis ŠOI, liga gali įgauti lėtinę eigą, sukelti inkstų randėjimą, lėtinį inkstų funkcijos nepakankamumą (IFN), nulemti hipertenzijos atsiradimą, o moterims – nėštumo komplikacijas. 29 % vaikų, kuriems buvo atliktos inkstų transplantacijos, inkstų pažeidimas buvo sąlygotas pielonefrito ar intersticinio nefrito. Lietuvoje vaikų lėtinio IFN priežastis 31,7 proc. obstrukcinė nefropatija ir lėtinis pielonefritas. Kol nebuvo taikomas profilaktinis gydymas, 60 proc. mergaičių ir 20 proc. berniukų ŠOI pasikartodavo jau pirmaisiais metais po pirmos ŠOI. Taikant profilaktinį gydymą, 1 m. laikotarpyje po persirgtos ŠOI. infekcijos pasikartojimas sumažėjo iki 15 proc. Mažo amžiaus vaikams ŠOI pasikartojimą dažniausiai lemia įgimtos šlapimo organų anomalijos. Dauguma jaunesnio mokyklinio amžiaus vaikų, kuriems yra pasikartojanti ŠOI, turi organiškai nepakitusius šlapimo organus. Pastaruoju metu atliekamos studijos, kurių tikslas nustatyti elgesio ir funkcinių sutrikimų vertę ŠOI pasikartojimui, tačiau duomenys... [toliau žr. visą tekstą] / Urinary tract infection (UTI) is one of the most common bacterial diseases in childhood. Recurrent UTI occurs in 20 – 86% of children. Recurrent UTI is relatively frequent in girls. At the age of 7, the prevalence of recurrent UTI in boys population is 1%, in girls population – 5%. Nearly one of three women will have at least one episode of UTI requiring antimicrobial therapy by the age of 24 years. Almost half of all women will experience one UTI during their lifetime.
It is known, that in the group of young children the most common reason of recurrent UTI is anatomic abnormalities, such as vesicoureteral reflux (VUR), hydronephrosis. However, not all recurrent UTI can be explained by anatomic abnormalities. The vast majority of school age children with recurrent UTI have anatomically normal urinary tract. We found changes in urodynamic investigation for 91.4% of children with recurrent urinary tract infection at the age of 5–18. Having a history of previous recurrent UTI is a strong risk factor for having subsequent UTI. Antibacterial characteristics of urine and other host defence mechanisms may be important signs associated with UTI risk, but have not been clearly shown to be associated with UTI in healthy persons. Recent studies discuss about the role of behavioural and functional abnormalities (inadequate fluid intake, stool retention, infrequent voiding, etc.) that can predispose recurrent urinary tract infections. Influence of some these abnormalities for recurrent... [to full text]
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Alterações da função vesical devido ao envelhecimento em mulheres avaliadas através do estudo urodinâmicoALBUQUERQUE NETO, Moacir Cavalcante de 22 January 2016 (has links)
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Previous issue date: 2016-01-22 / Objetivos: O declínio da função vesical com a idade pode levar a comprometimento da
qualidade de vida além de sérios problemas de saúde aos idosos. Assim, avaliaremos as
alterações da função vesical com o envelhecimento em mulheres através do estudo urodinâmico
e tentaremos desenvolver fórmulas que possam estimar os valores esperados dos parâmetros
urodinâmicos avaliados de acordo com a idade.
Materiais e métodos: Foi realizada uma análise retrospectiva dos estudos urodinâmicos
realizados no Serviço de Urologia do Departamento de Cirurgia do Hospital das Clínicas da
UFPE, cadastrados no prontuário eletrônico www.infomed.net.br entre maio de 2011 e
novembro de 2015, a fim de obter e calcular os parâmetros necessários para avaliar a função
vesical em diferentes faixas etárias (18-30, 31-40, 41-50, 51-60, 61-70, 71-80 e maior que 80
anos). Além disso, excluímos pacientes com qualquer fator conhecido que tenha o potencial de
afetar a função vesical que não a idade.
Resultados: De um total de 3103 exames analisados, foram selecionadas 719 pacientes do sexo
feminino para serem incluídas no estudo. A média de idade das pacientes foi de 49,3 anos e em
todos os parâmetros avaliados (fluxo máximo, volume urinado, complacência vesical,
capacidade cistométrica máxima, pressão detrusora no fluxo máximo, resíduo pós-miccional,
índice de contratilidade vesical e índice de eficiência vesical) obtivemos correlação
estatisticamente significante entre o declínio da função vesical e a idade. Ainda, conseguimos
expressar por equações matemáticas a relação de causa-efeito por regressão linear.
Conclusão: O presente estudo observou que há uma diminuição da função vesical tanto de
armazenamento (diminuição da capacidade cistométrica máxima e complacência vesical)
quanto de esvaziamento (diminuição do fluxo máximo, da pressão detrusora no fluxo máximo,
do volume urinado, do índice de contratilidade vesical e do índice de eficiência vesical, assim
como o aumento do resíduo pós-miccional) com o envelhecimento. Paralelamente, estamos
propondo fórmulas que podem estimar os valores esperados dos parâmetros urodinâmicos
avaliados de acordo com a idade, na população estudada. / Purposes: The bladder function declines with age and can lead to impaired quality of life and
serious health problems in the elderly. The aim of the study is to evaluate changes in bladder
function with aging in women by urodynamic study and try to develop equations that can
estimate the expected values of the urodynamic parameters evaluated according to the age.
Methods: A retrospective analysis of urodynamic studies in the Urology Service of the
Department of Surgery - Hospital das Clínicas, Federal University of Pernambuco, recorded in
the electronic medical database www.infomed.net.br among May 2011 and November 2015
was performed in order to obtain and calculate the parameters necessary to evaluate bladder
function in different age groups (18-30, 31-40, 41-50, 51-60, 61-70, 71-80 and above 80 years).
Patients with any factor that had the potential to affect bladder function were excluded.
Results: 3103 urodynamics studies were analyzed and 719 female patients were selected. The
average age of patients was 49.3 years and in all evaluated parameters (maximum flow, volume
of urination, bladder compliance, maximum cystometric capacity, detrusor pressure at
maximum flow, post-void residual urine volume, bladder contractility index and bladder
voiding efficiency) statistically significant correlation between the decline of bladder function
and age were obtained. Also we presented mathematical equations with cause-effect
relationship by linear regression.
Conclusion: The present study showed that there is a decrease in the bladder storage function
(reduction in maximum cystometric capacity and bladder compliance) and in the bladder
emptying function (reduction of the maximum flow, detrusor pressure at maximum flow,
volume of the urination, contractility index urinary bladder and bladder voiding efficiency , as
well increased post-void residual urine volume) with aging. Analyzing data let us to propose
equations that can estimate the expected values of the urodynamic parameters evaluated
according to the age in the studied population.
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Avaliação da função vesical antes e após transplante renal em pacientes sem doença urológica = Evaluation of bladder function pre and post renal transplantation in patients without urological cause / Evaluation of bladder function pre and post renal transplantation in patients without urological causeSilva, Daniel Carlos Uliano Moser da, 1980- 21 August 2018 (has links)
Orientador: Carlos Arturo Levi D'Ancona / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T07:14:10Z (GMT). No. of bitstreams: 1
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Previous issue date: 2012 / Resumo: Objetvos: Avaliar com realização do estudo urodinâmico, a recuperação da função vesical em pacientes com doença renal crônica sem causa urológica de base com longos períodos de oligúria / anúria, submetidos a transplante renal. Pacientes e Métodos: De abril de 2009 a junho de 2010, 30 pacientes apresentando oligúria / anúria, foram prospectivamente avaliados com estudo urodinâmico. Este foi realizado imediatamente antes e seis meses após o transplante renal. Os critérios de inclusão foram: idade > 18 anos, doença renal crônica sem causa urológica envolvida na sua etiologia, tempo de diálise superior a 12 meses, nome em lista de transplante com doador falecido. Foram excluídos pacientes com alteração no ultrassom de vias urinárias, uretrocistografia miccional e urianálise e com diurese residual de 24 horas superior a 1000ml. Resultados: Observou-se completa recuperação da função vesical após o retorno da diurese, no sexto mês pós-transplante, independente de haver ou não disfuncionalização vesical. As variações nos parâmetros urodinâmicos foram: primeira sensação de enchimento vesical: 88,8 para 168,7ml (p = 0,0005); primeiro desejo miccional: 137,2 para 251,1ml (p <0,0001); capacidade cistométrica máxima: 221,2 para 428,7ml (p<0,0001); complacência vesical: 73,9 para 138,6ml/cm H2O (p =0,03) e fluxo máximo: 8,1 para 15,8ml/s (p <0,0001). O número de Abrams-Griffths nos homens reduziu de 31,8 para 15,2 (p =0,002). Não se observou mudanças significativas na pressão detrusora no fluxo máximo e resíduo pós-miccional. Pacientes com diurese residual de 24 horas menor que 200ml apresentaram alterações urodinâmicas significativamente maiores antes do transplante. Conclusão: Completa recuperação da função vesical foi observada nos pacientes sem doença urológica, seis meses após o transplante renal e retorno do débito urinário / Abstract: Purpose: To evaluate by urodynamic assessment, recovery of bladder function in patients with end stage renal disease without urological causes with long term oliguria, submitted to renal transplant. Patients and Methods: From April 2009 to June 2010, 30 patients presenting defunctionalized bladders were prospectively evaluated with urodynamics. The studies were performed immediately before and six months after renal transplantation. Inclusion criteria were age >18 years-old, end-stage renal disease secondary to non-urological disease, renal substitutive therapy longer than 12 months, waiting for deceased donor organ. Exclusion criteria was: abnormal urinary tract ultrasound, voiding cystourethrography or urinalyses and 24 hours residual diuresis higher than 1000ml. Results: Complete recovery of bladder function was observed after return of diuresis, on the sixth month post transplantation, independently of the presence of bladder defunctionalization. Urodynamics parameters changes from baseline to six months were: first sensation of bladder filling: 88.8 to 168.7ml (p = 0.0005); first desire to void: 137.2 to 251.1ml (p <0.0001); maximum cystometric capacity: 221.2 to 428.7ml (p <0.0001); bladder compliance: 73.9 to 138.6 ml/cm H2O (p = 0.03) and maximum flow rate: 8.1 to 15.8 ml/s (p <0.0001). The Abrams-Griffths number in men reduced from 31.8 to 15.2 (p = 0.002). No significant chances were observed in detrusor pressure at maximum flow rate and post void residual volume. Patients with 24 hours diuresis volume lower than 200ml tended to have more significant abnormalities in urodynamics parameters before transplantation. Conclusions: A complete recovery of bladder function was observed in patients with end stage renal disease, without urological disease, six months after transplant, associated with recovery of urine output by the renal graft / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências
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