Background: Bethanechol chloride, a cholinergic agonist, is often prescribed in suspected underactive bladders to improve detrusor contractility, despite its limited clinical efficacy. We investigated the usage patter...Background: Bethanechol chloride, a cholinergic agonist, is often prescribed in suspected underactive bladders to improve detrusor contractility, despite its limited clinical efficacy. We investigated the usage pattern of bethanechol in actual practice with the understanding that it would enable the physicians to make an informed decision on the coherent use of bethanechol. Methods: A nation-wide survey was carried out to obtain the responses of the urologists. Out of the 755 urologists approached, 630 survey responses were considered for analysis. Results: Usage of bethanechol was advocated as very common [318 (50.48%)], common [200 (31.75%)], not so common [107 (16.98%)], and rare [5 (0.79%)] in postoperative urinary retention, where it was preferred either exclusively [255 (40.48%)] or along with alpha blockers [247 (39.21%)]. Predilection to use alpha-blocker [247 (39.21%)], alpha-blocker plus naloxone [4 (0.64%)], naloxone [1 (0.16%)], alpha-blocker plus bethanechol plus naloxone [1 (0.16%)] was also observed. It was also preferred individually in pathologies causing urinary retention such as benign prostatic hyperplasia [125 (19.84%)], diabetic neuropathy [82 (13.02%)], neurological diseases [69 (10.95%)], senile bladder [14 (2.22%)], drugs [13 (2.06%)], and infective/inflammatory conditions [6 (0.95%)]. Other [321 (50.95%)] physicians opted to prescribe bethanechol in two or more of the enumerated indications. Bethanechol was prescribed orally as 25 mg thrice daily [441 (70.00%)], 50 mg thrice daily [86 (13.65%)], 25 mg four times daily [59 (9.37%)], and many “strongly agree” and “agree” that its sustained release formulation may offer better treatment compliance [565 (89.68%)], safety [548 (86.99%)], and efficacy [544 (86.35%)]. Conclusion: Bethanechol was the most prescribed drug for the management of postoperative urinary retention and other pathologies suspected to cause underactive bladder.展开更多
Purpose: To investigate the association between the maximum cystometric capacity (MCC) and other cystometric parameters in lumbar canal stenosis (LCS) rats. Material and Methods: One small hole was drilled at the fift...Purpose: To investigate the association between the maximum cystometric capacity (MCC) and other cystometric parameters in lumbar canal stenosis (LCS) rats. Material and Methods: One small hole was drilled at the fifth lumbar vertebral arch (Sham), and a rectangular piece of silicone rubber was then placed in the epidural space (LCS) of Wister rats. Two weeks after surgery, awake cystometry was performed. LCS rats were divided into three groups: Group A (n = 5, MCC < 0.87 mL), Group B (n = 13, MCC 0.87 - 1.81 mL), and Group C (n = 14, MCC > 1.81 mL). Cystometric parameters were investigated in sham and LCS groups. Results: MCC did not significantly correlate to the frequency of non-voiding contractions (NVCs), voided volume (VV), or maximum intravesical pressure during voiding (Pmax), but significantly positively correlated to postvoid residual urine volume (PVR) and residual urine rate (RUR) (Spearman’s correlation coefficients (ρ) = 0.8973 (p < 0.0001) and 0.4915 (p = 0.0068), respectively). Compared with the sham rats, LCS rats in each group revealed significantly smaller VV, larger RUR, and lower Pmax. On the other hand, among LCS rats, VV, RUR, and Pmax were not significantly different. The frequency of NVCs in each LCS group was not significantly different from that in sham-operated rats (Tukey-Kramer’s HSD test). However, a Jonckheere-Terpstra trend test revealed a significant trend toward higher NVCs in the order of sham, Groups C, B, and A (p = 0.036). Conclusions: LCS rats showed the same degree of detrusor underactivity regardless of MCC. NVCs did not significantly increase in LCS rats with decreased MCC, but the trend toward higher NVCs with smaller MCC was significant.展开更多
目的抗氧化剂对糖尿病性膀胱病的排尿功能影响尚不清楚。文中探讨抗氧化剂莱菔硫烷(SF)对糖尿病性膀胱活动低下小鼠膀胱排尿功能的影响。方法采用腹腔注射单剂量的链脲佐菌素(STZ,65 mg/kg)制备糖尿病小鼠模型。将造模成功的小鼠随机数...目的抗氧化剂对糖尿病性膀胱病的排尿功能影响尚不清楚。文中探讨抗氧化剂莱菔硫烷(SF)对糖尿病性膀胱活动低下小鼠膀胱排尿功能的影响。方法采用腹腔注射单剂量的链脲佐菌素(STZ,65 mg/kg)制备糖尿病小鼠模型。将造模成功的小鼠随机数字表法分为3组:SF处理组(SF处理)、阴性对照组(赋形剂处理)、糖尿病模型组,另设同龄小鼠为空白对照组。实验第24周进行小鼠体重、空腹血糖(FBG)、24 h尿量(24 h UV)、膀胱湿重(BWW)及膀胱测压检测,膀胱测压参数包括排尿间隔(ICI)、排尿时最大膀胱压(Pmax)、最大膀胱容量(MCC)、排尿量、排尿后残余尿量(PVR)及残尿率。结果实验第24周,与空白对照组比较,其余3组小鼠体重均下降,FBG、24 h UV、BWW均升高(P<0.05);与糖尿病模型组比较,SF处理组24 h UV[(22.47±1.93)m L/24 h vs(16.27±1.51)m L/24 h]及BWW[(67.96±2.35)mg vs(57.69±2.41)mg]均降低(P<0.05);与阴性对照组比较,SF处理组24 h UV及BWW均降低(P<0.05)。与空白对照组比较,其余3组小鼠ICI明显延长及Pmax明显降低;与糖尿病模型组比较,阴性对照组ICI和Pmax无明显差异,而SF处理组ICI明显缩短及Pmax轻度升高;与阴性对照组比较,SF处理组ICI明显缩短及Pmax轻度升高。与空白对照组比较,各组小鼠MCC、排尿量、PVR及残尿率均明显增加(P<0.05);与糖尿病模型组比较,SF处理组小鼠MCC[(0.70±0.03)m L vs(0.54±0.03)m L]、PVR[(0.49±0.02)m L vs(0.34±0.02)m L]及残尿率[(70.10±0.80)%vs(62.71±1.26)%]明显减少(P<0.05);与阴性对照组比较,SF处理组MCC、PVR及残尿率明显减少(P<0.05)。结论 SF可以改善STZ诱导的糖尿病小鼠膀胱排尿功能障碍,可能与SF的抗氧化应激损伤作用机制有关。展开更多
Objective: Exploring the clinical efficacy of transurethral plasma enucleation of the prostate in the treatment of benign prostatic hyperplasia with underactive bladder detrusor contractility. Methods: Retrospective a...Objective: Exploring the clinical efficacy of transurethral plasma enucleation of the prostate in the treatment of benign prostatic hyperplasia with underactive bladder detrusor contractility. Methods: Retrospective analysis of the clinical data of 68 patients with benign prostatic hyperplasia and underactive detrusor muscle contractility treated by our department from July 2021 to July 2022. The above patients all met the diagnosis of benign prostatic hyperplasia, excluding prostate cancer and urethral stricture. Urodynamics showed a decrease in the contractile force of the bladder detrusor muscle, and the surgical equipment used Olympus bipolar plasma resection equipment method. Divide the above patients into two groups: the experimental group of 34 patients who underwent transurethral plasma enucleation of the prostate and the control group of 34 patients who underwent transurethral plasma resection of the prostate. Evaluate the preoperative clinical baseline level and postoperative observation indicators of the two groups of patients, and compare the statistical differences between the two groups. Results: Both groups of patients successfully completed the surgery, and there were no serious complications such as rectal or bladder perforation during the surgery, with less bleeding. The postoperative QOL, IPSS, Qmax, and residual urine volume of patients undergoing transurethral plasma enucleation and resection of the prostate were significantly improved compared to those before surgery (P 0.05). Conclusion: Transurethral enucleation of the prostate has good efficacy and safety in the treatment of benign prostatic hyperplasia combined with weakened detrusor muscle contractility. Compared with traditional electric resection surgery, the efficacy is more significant. In terms of the main complications of the surgery, although there are slightly more patients with temporary urinary incontinence after prostate enucleation, there is no statistically significant difference compared to after electric resection, and th展开更多
文摘Background: Bethanechol chloride, a cholinergic agonist, is often prescribed in suspected underactive bladders to improve detrusor contractility, despite its limited clinical efficacy. We investigated the usage pattern of bethanechol in actual practice with the understanding that it would enable the physicians to make an informed decision on the coherent use of bethanechol. Methods: A nation-wide survey was carried out to obtain the responses of the urologists. Out of the 755 urologists approached, 630 survey responses were considered for analysis. Results: Usage of bethanechol was advocated as very common [318 (50.48%)], common [200 (31.75%)], not so common [107 (16.98%)], and rare [5 (0.79%)] in postoperative urinary retention, where it was preferred either exclusively [255 (40.48%)] or along with alpha blockers [247 (39.21%)]. Predilection to use alpha-blocker [247 (39.21%)], alpha-blocker plus naloxone [4 (0.64%)], naloxone [1 (0.16%)], alpha-blocker plus bethanechol plus naloxone [1 (0.16%)] was also observed. It was also preferred individually in pathologies causing urinary retention such as benign prostatic hyperplasia [125 (19.84%)], diabetic neuropathy [82 (13.02%)], neurological diseases [69 (10.95%)], senile bladder [14 (2.22%)], drugs [13 (2.06%)], and infective/inflammatory conditions [6 (0.95%)]. Other [321 (50.95%)] physicians opted to prescribe bethanechol in two or more of the enumerated indications. Bethanechol was prescribed orally as 25 mg thrice daily [441 (70.00%)], 50 mg thrice daily [86 (13.65%)], 25 mg four times daily [59 (9.37%)], and many “strongly agree” and “agree” that its sustained release formulation may offer better treatment compliance [565 (89.68%)], safety [548 (86.99%)], and efficacy [544 (86.35%)]. Conclusion: Bethanechol was the most prescribed drug for the management of postoperative urinary retention and other pathologies suspected to cause underactive bladder.
文摘Purpose: To investigate the association between the maximum cystometric capacity (MCC) and other cystometric parameters in lumbar canal stenosis (LCS) rats. Material and Methods: One small hole was drilled at the fifth lumbar vertebral arch (Sham), and a rectangular piece of silicone rubber was then placed in the epidural space (LCS) of Wister rats. Two weeks after surgery, awake cystometry was performed. LCS rats were divided into three groups: Group A (n = 5, MCC < 0.87 mL), Group B (n = 13, MCC 0.87 - 1.81 mL), and Group C (n = 14, MCC > 1.81 mL). Cystometric parameters were investigated in sham and LCS groups. Results: MCC did not significantly correlate to the frequency of non-voiding contractions (NVCs), voided volume (VV), or maximum intravesical pressure during voiding (Pmax), but significantly positively correlated to postvoid residual urine volume (PVR) and residual urine rate (RUR) (Spearman’s correlation coefficients (ρ) = 0.8973 (p < 0.0001) and 0.4915 (p = 0.0068), respectively). Compared with the sham rats, LCS rats in each group revealed significantly smaller VV, larger RUR, and lower Pmax. On the other hand, among LCS rats, VV, RUR, and Pmax were not significantly different. The frequency of NVCs in each LCS group was not significantly different from that in sham-operated rats (Tukey-Kramer’s HSD test). However, a Jonckheere-Terpstra trend test revealed a significant trend toward higher NVCs in the order of sham, Groups C, B, and A (p = 0.036). Conclusions: LCS rats showed the same degree of detrusor underactivity regardless of MCC. NVCs did not significantly increase in LCS rats with decreased MCC, but the trend toward higher NVCs with smaller MCC was significant.
文摘目的抗氧化剂对糖尿病性膀胱病的排尿功能影响尚不清楚。文中探讨抗氧化剂莱菔硫烷(SF)对糖尿病性膀胱活动低下小鼠膀胱排尿功能的影响。方法采用腹腔注射单剂量的链脲佐菌素(STZ,65 mg/kg)制备糖尿病小鼠模型。将造模成功的小鼠随机数字表法分为3组:SF处理组(SF处理)、阴性对照组(赋形剂处理)、糖尿病模型组,另设同龄小鼠为空白对照组。实验第24周进行小鼠体重、空腹血糖(FBG)、24 h尿量(24 h UV)、膀胱湿重(BWW)及膀胱测压检测,膀胱测压参数包括排尿间隔(ICI)、排尿时最大膀胱压(Pmax)、最大膀胱容量(MCC)、排尿量、排尿后残余尿量(PVR)及残尿率。结果实验第24周,与空白对照组比较,其余3组小鼠体重均下降,FBG、24 h UV、BWW均升高(P<0.05);与糖尿病模型组比较,SF处理组24 h UV[(22.47±1.93)m L/24 h vs(16.27±1.51)m L/24 h]及BWW[(67.96±2.35)mg vs(57.69±2.41)mg]均降低(P<0.05);与阴性对照组比较,SF处理组24 h UV及BWW均降低(P<0.05)。与空白对照组比较,其余3组小鼠ICI明显延长及Pmax明显降低;与糖尿病模型组比较,阴性对照组ICI和Pmax无明显差异,而SF处理组ICI明显缩短及Pmax轻度升高;与阴性对照组比较,SF处理组ICI明显缩短及Pmax轻度升高。与空白对照组比较,各组小鼠MCC、排尿量、PVR及残尿率均明显增加(P<0.05);与糖尿病模型组比较,SF处理组小鼠MCC[(0.70±0.03)m L vs(0.54±0.03)m L]、PVR[(0.49±0.02)m L vs(0.34±0.02)m L]及残尿率[(70.10±0.80)%vs(62.71±1.26)%]明显减少(P<0.05);与阴性对照组比较,SF处理组MCC、PVR及残尿率明显减少(P<0.05)。结论 SF可以改善STZ诱导的糖尿病小鼠膀胱排尿功能障碍,可能与SF的抗氧化应激损伤作用机制有关。
文摘Objective: Exploring the clinical efficacy of transurethral plasma enucleation of the prostate in the treatment of benign prostatic hyperplasia with underactive bladder detrusor contractility. Methods: Retrospective analysis of the clinical data of 68 patients with benign prostatic hyperplasia and underactive detrusor muscle contractility treated by our department from July 2021 to July 2022. The above patients all met the diagnosis of benign prostatic hyperplasia, excluding prostate cancer and urethral stricture. Urodynamics showed a decrease in the contractile force of the bladder detrusor muscle, and the surgical equipment used Olympus bipolar plasma resection equipment method. Divide the above patients into two groups: the experimental group of 34 patients who underwent transurethral plasma enucleation of the prostate and the control group of 34 patients who underwent transurethral plasma resection of the prostate. Evaluate the preoperative clinical baseline level and postoperative observation indicators of the two groups of patients, and compare the statistical differences between the two groups. Results: Both groups of patients successfully completed the surgery, and there were no serious complications such as rectal or bladder perforation during the surgery, with less bleeding. The postoperative QOL, IPSS, Qmax, and residual urine volume of patients undergoing transurethral plasma enucleation and resection of the prostate were significantly improved compared to those before surgery (P 0.05). Conclusion: Transurethral enucleation of the prostate has good efficacy and safety in the treatment of benign prostatic hyperplasia combined with weakened detrusor muscle contractility. Compared with traditional electric resection surgery, the efficacy is more significant. In terms of the main complications of the surgery, although there are slightly more patients with temporary urinary incontinence after prostate enucleation, there is no statistically significant difference compared to after electric resection, and th
