The effect of moxisylyte hydrochloride in the symptomatic treatment of benign prostatic hyperplasia

The clinical effectiveness of moxisylyte hydrochloride (Moxyl, Fuji Rebio), a selective alpha 1-adrenoceptor blocking agent, was investigated in patients with symptomatic benign prostatic hyperplasia. Moxisylyte hydrochloride was administered at the dose of 90 mg per day orally for four weeks. Residual urine sensation was improved in 9 out of 17 cases (53%), retarded urination in 14 out of 19 (74%), prolonged urination in 12 out of 19 (63%), weak stream in 14 out of 21 (67%) and strained voiding in 11 out of 19 cases (58%). Residual urine volume and residual urine ratio were decreased in 14 out of 21 cases (67%), maximum urine flow rate was increased in 14 out of 21 (67%) and mean flow rate was increased in 15 out of 21 cases (71%). There was, however, no statistical significance between pre- and post drug administration in objective parameters. Our open trial showed that the subjective efficacy of moxisylyte hydrochloride was 82% (18/22 cases), the objective one was 59% (13/22 cases) and overall efficacy was 77%. Side effects were observed in four of all subjects (18.2%), and drug administration had to be ceased in only one of these patients due to mild dizziness. Other side effects were mild nausea, headache and chest discomfort. Decrease in blood pressure was not seen in all but one case.     

Clinical effectiveness of KL 007 (oxybutynin hydrochloride) in urinary disorders

The clinical effectiveness of KL 007 (oxybutynin hydrochloride) was studied on patients with urinary disturbance, mostly complaints of urinary frequency, who were suffering from nervous pollakisuria, irritable bladder or neurogenic bladder. Fifty two patients were administered KL 007 three times daily at the dose of 6 mg, 9 mg, or 12 mg per day for one or two weeks. An overall clinical effectiveness of KL 007 was seen in the cases of hypertonic bladder. As to the clinical effectiveness of subjective symptoms, KL 007 improved the symptoms of urinary frequency, urinary incontinence, discomfort upon micturition, urinary urgency and sense of residual urine. Transient side effects were observed in 23 cases (41.4%), and dry mouth was most observed. No severe side effects were noticed.     

Additional effect of propiverine for naftopidil-resistant nocturia in the patient with benign prostate hypertrophy

The efficacy and safety of additional administration of propiverine were prospectively studied for naftopidil-resistant nocturia in patients with benign prostatic hypertrophy (BPH). Patients of 50 years and over with BPH who experienced nocturia twice a night or more and an overall International Prostate Symptom Score (IPSS) of 8 or more were first administered naftopidil (50 or 75 mg/day) for 4 weeks. Thirty subjects who did not show improvement in nocturia and requested further treatment were enrolled in the present study. Propiverine was then administered concomitantly 10 mg/day for 8 weeks. Significant improvement was observed with additional propiverine in the frequency of nocturia on voiding diary, total IPSS, voiding symptom, storage symptom and nocturnal voiding scores. No significant change was observed in the peak urinary flow rate (Qmax), mean urinary flow rate (Qave), voided urine volume, or residual urine volume. Adverse events were dysuria (2 cases), increased residual urine (6 cases), weak urine flow (1 case), thirsty (2 cases), angular cheilitis (1 case). Administration of propiverine was suspended in 7 subjects, 1 following dysuria and 6 following increased residual urine volume. The suspension of propiverine following increased residual urine volume was significantly more prevalent in subjects with pretreatment Qmax values of less than 10 ml/second or in subjects whose prostate specific antigen (PSA) levels were 2 ng/ml or more. In conclusion, the results indicate that additional administration of propiverine may be useful for the patients with BPH who have naftopidil-resistant nocturia. However, caution must be exercised regarding Qmax and PSA levels.     

Clinical effect of terodiline hydrochloride on pollakisuria and urinary incontinence

Efficacy and safety of terodiline hydrochloride were studied by treating 38 patients who complained of pollakiuria and incontinence with this drug. Terodiline hydrochloride in a dose of 24 mg once or 12 mg twice a day was administered to these patients for 4 weeks and the conditions of the patients before and after the treatment were evaluated. According to the subjective symptoms, pollakisuria during the daytime and at night, incontinence, anischuria at night and frequency of urination were all reduced significantly. Objective symptoms detected after the treatment a tendency of increase (p less than 0.1) in the bladder volume at the time of maximum micturition. However, no change in the urination volume and the maximum urine flow was observed before and after the administration. A significant decrease (p less than 0.05) in residual urine was noted after the treatment. The results were favorable with overall improvement of 78.4% and efficacy of 75.7%. Side effects were observed in 3 of the 38 cases (7.9%), but all the symptoms were slight.     

Therapeutic effect of Robaveron tablet (KN-7) on urinary disturbance by benign prostatic hypertrophy

Therapeutic effect of Robaveron tablet (KN-7) was studied on 101 patients with urinary disturbance accompanied by benign prostatic hypertrophy. Robaveron tablet, which contains 20 mg of a swine prostatic extract per tablet, was administered 6 tablets daily for 3 weeks in principle. Evaluation of drug efficacy was based on residual urine, cystometric findings, urethral pressure profile, uroflowmetry and subjective symptoms. Remarkable decrease of residual urine was observed at all stages of Guyon classification, in parallel with increases of cystometric pressure amplitude and average flow rate. Rate of residual urine reduction rose in proportion to the higher stage or bulkier volume of residual urine. Improvements of subjective symptoms were also obtained. The overall effectiveness, rated slightly improved or better was 76.8%. Side effects were seen at a low rate of 3.9%, and there were no abnormal changes directly due to the drug in clinical laboratory tests. These results indicate that Robaveron tablets act on the detrusor muscle and contribute to improve the depressed voiding efficiency and incidental symptoms of the subjects.     

Clinical effect of oxybutynin hydrochloride (1 mg/tablet)

The clinical efficacy of oxybutynin hydrochloride was studied on 21 patients with neurogenic bladder or unstable bladder complaining of urinary frequency, urgency and urgent incontinence. Oxybutynin hydrochloride (1 mg/tablet) was administered orally for 26.7 days, on average, 3 mg per day in 3 and 6 mg per day in 18 patients and the usefulness of this drug was assessed subjectively and objectively. Of 21 patients treated, 9 had neurogenic bladder and 10 had unstable bladder. Urinary frequency was normalized in 6 out of 16 (37.5%), urgency ceased in 6 out of 17 (35.7%) and urgent incontinence disappeared in 9 out of 14 (50%) patients. The mean volume at the first desire to void and the maximum cystometric capacity increased significantly on the cystometrogram after the administration of oxybutynin hydrochloride (p less than 0.01). Furthermore, the maximum vesical pressure decreased significantly (p less than 0.05). The maximum urinary flow rate increased slightly (p less than 0.1) and the residual urine volume significantly increased (p less than 0.05) after medication, although no changes were observed in tidal voiding volume or mean urinary flow rate. Of 20 patients, 9 showed improvement globally (45%), although no subjective or objective improvement was observed in 4 (20%) patients. Marked side effects were observed in 5 cases (two of acute urinary retention, each of increased urgency, residual urine and liver dysfunction), and side effects were seen in 10 of the 21 (47.6%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

Using Flavoxate as Primary Medication for Patients Suffering from Urge Symptomatology

A drug utilization observation study collected data on a total of 1800 patients given flavoxate (Spasuret^? 200) over 2 weeks for urge incontinence. Efficacy and tolerance parameters were determined. A subgroup of 618 patients without urinary tract infections or benign prostatic hyperplasia were treated with flavoxate only. The subgroup (n= 618) showed a reduction of dysuria (37%), nocturia (53%), and both daytime (61%) and nighttime urge (69%). Bladder volume at first urge sensation increased by 55.1 ± 58.8 ml (36%), which was comparable to data from the entire group (1800 patients). In 89.2% of all patients the residual urine volume was stable or decreased. Undesirable side effects occurred in 1.8% of cases. Both groups showed better results with flavoxate four times daily (800 mg), compared to three times daily (600 mg). Flavoxate is effective and well tolerated and causes no additional problems due to residual urine or side effects.     

Genetic analysis of Tp53 from urine sediment as a tool for diagnosing recurrence and residual of bladder carcinoma

OBJECTIVES: Longitudinal study of Tp53 mutation in urine sediments of 26 patients with mutated primary transitional cell carcinoma (TCC) of the urinary bladder at different time periods after transurethral resection of the bladder (TURB), i.e. before and after the first TURB, prior to the control resection and before treatment of a recurrence. METHODS: DNA of the critical Tp53 exons 5-8 was anaylzed by temperature gradients (TGGE) and sequence. RESULTS: (1) In 11 of 12 patients (91.7%) mutation reoccurred with the detection of recurrence of the disease. The mutation frequency in patients without any recurrence was 1 in 8 (12.5%) after a follow-up period of 4-16 months. (2) In 7 of 10 patients, the mutation was no longer detectable in the urine sediment after TURB. (3) The mutation frequency at the control resection 6 weeks after the first TURB was 5 in 7 (71.4%) in patients found to have residual and 1 in 7 (14.2%) in the tumor-free patients. (4) In 9 of 10 samples identical mutations were found by sequence in the recurrent tumor. These results show a significant correlation between the detection of a Tp53 mutation in the urine sediments and tumor recurrence or residual. CONCLUSIONS: (1) Tp53 mutations in the urine sediment could be a useful indicator of tumor recurrence or tumor residual in patients ( approximately 40%) with primary mutated bladder cancer tissue. (2) These results support the monoclonal seeding theory. (3) The finding of identical mutations at different times indicate that the tumor was never totally removed.     

Vesicourethral dysfunction of diabetic patients

In order to evaluate vesicourethral dysfunction in diabetic patients, urodynamic studies, IVP and urinalysis were performed on 173 diabetic patients (male 78, female 95) and 17 nondiabetic control cases. In addition to the classical findings as increased volume at the first desire to void and decreased maximum vesical pressure, diabetic patients showed varieties of vesicourethral dysfunctions such as overactive bladder (14.5%), low compliance bladder (11.0%) and loss of detrusor-external sphincter coordination (31.7%). Vesicourethral function of diabetics was classified in following 5 types by analysing the volume at first desire to void, volume at maximum desire to void, maximum vesical pressure, residual urine volume and bladder compliance. 1. Type 1, normal vesical function, 13 cases. 2. Type 2, vesical dysfunction with minimal residual urine, 49 cases. 3. Type 3, vesical dysfunction with residual urine, 66 cases. 4. Type 4, low compliance bladder, 20 cases. 5. Type 5, overactive bladder, 25 cases. Pyuria was observed in 59.8%, hydronephrosis was found in 10.9% and ectasia of lower ureter was found in 17.8% of diabetic patients. The highest incidence of pyuria and abnormality of the upper urinary tract were noted in Type 4 and followed by Type 3 and by Type 2 in decreasing order. Extent of pyuria and ectasis of the upper urinary tract showed statistically significant correlation with residual urine volume and detrusor-external sphincter coordination. When vesicourethral function was compensated by abdominal strain, the volume of residual urine is not elevated, but when the mechanism of compensation is lost or in the absence of detrusor-external sphincter coordination results in gradual accumulation of residual urine. In cases with long standing chronic urinary tract infection may results in fibrosis of the bladder wall with low compliance bladder. Fibrotic obstruction of uretero-vesical junction can cause hydroureteronephrosis and followed by renal function impairment. As vesical damage become irreversible at this end stage, proper management during early stage is crucial for management of diabetic patients. Cholinergic agent were effective to reduce residual urine volume in Type 3. alpha-blocking agent were effective to reduce residual urine volume in Type 3 and some cases of Type 4. In cases in which medication therapy failed to reduce residual urine, the clean intermittent catheterization was successful in control of urinary tract infection and upper urinary tract ectasis. Transurethral resection of the prostate and the bladder neck is indicated in the male patients with a large amount of residual urine in Type 3 and 4.     

Evaluation of residual urine volume by ultrasound for detection of urinary bladder dysfunction after surgical therapy of rectal cancer]

INTRODUCTION: Despite total mesorectal excision and protection of the pelvic autonomous nerve system, dysfunctions of the urinary bladder are often observed after surgical therapy for rectal cancer. In this prospective study, the frequency of urinary bladder malfunctions was assessed by measuring residual urine volume using transcutaneous ultrasound before and after surgery. PATIENTS AND METHODS: Seventy-five patients with rectal cancer were analyzed for urine volume retained before and after surgical therapy. The tumors were localized in the lower third of the rectum for 31 patients, in the middle for 30, and in the upper third for 14. RESULTS: An increase in retained urine of more than 100 ml was found in 12 patients (15%), and neurogenic bladder was diagnosed in two (3%). In female patients, urinary bladder malfunctions were significantly less frequent and severe. CONCLUSIONS: The percutaneous assessment of urine volume retained in the bladder is suited for determining urinary bladder malfunctions after surgery. This method can serve to assess the quality of surgical treatment for rectal cancer. A standardized definition of relevant urinary bladder malfunctions is required.     

Comparisons of factors affecting voiding disorders between patients with benign prostate hyperplasia and volunteers

PURPOSE: The prostate size and motivation to visit clinics were investigated in patients with prostate hyperplasia. OBJECTS AND METHODS: One hundred ninety-five patients who had urinary symptoms and visited our outpatient clinic between September 1994 and October 1999 and 268 age-matched volunteers in Mitaka City who underwent a medical examination of the prostate in June 1997 were compared. International Prostate Symptom Score (IPSS), Quality Of Life Score (QOL score), residual urine volume, prostate volume and urinary flow rate were measured. RESULTS: The prostate volume of the volunteers was 20-25 cm3 irrespective of the age. The prostate size of the outpatients was larger than that of the volunteers for every age group. IPSS and QOL score were significantly higher in the outpatients than in the volunteers. Diurnal urinary frequency and sense of residual urine contributed to the discrimination index of the two groups more significantly than the other scores. There was a significant correlation between prostate volume and residual urine volume. The score of weak urinary steam was inversely and significantly correlated with peak urinary flow rate. CONCLUSIONS: There was no age-related enlargement of the prostate gland. The prostate gland was significantly larger in the patients than in the volunteers even in those in their fifties. Urinary frequency and sense of residual urine are important factors for men to seek and receive medical care.     

Plasma kinetic vaporization of the prostate: clinical evaluation of a new technique

PURPOSE: We evaluated our results with bipolar plasma kinetic electrovaporization in the treatment of benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Twenty-one patients with infravesical obstruction by BPH have been treated with bipolar plasma kinetic electrovaporization. International Prostate Symptom Score (IPSS) with a quality of life (QOL) scoring questionnaire, uroflowmetry (maximum flow rate; Qmax), transrectal ultrasonography (TRUS), and residual urine volume and prostate specific antigen (PSA) measurements had been performed before surgery. The IPSS scores, prostate volumes, and residual urine volumes were reevaluated during the third postoperative month. Uroflowmetry was repeated on postoperative days 7, 15, 30, and 90. Total PSA and free PSA measurements were repeated on postoperative days 3, 5, 7, 15, 30, and 90. RESULTS: The results of 20 patients could be evaluated. The median age of these patients was 61 years. The median volume of the prostates was 42 cc (95% CI 56-53). The median operation time and postoperative hospitalization were 55 minutes (95% CI 40-65) and 3 days (95% CI 3-5), respectively. The mean period of time needed for vaporizing 1 g of tissue was calculated as 2.8 +/- 1.3 minutes. Postoperative day 90 values of IPSS, QOL, prostate volume, residual urine volume, and Qmax showed significant improvement compared with preoperative values (p < 0.05). The median preoperative PSA value was 1.64 mg/mL (95% CI 1-3.6). The value showed a statistically significant increase 24 hours after the intervention (p < 0.0001), but the PSA values on the 30th (p = 0.041) and 90th (p = 0.025) days were below preoperative values. CONCLUSION: The IPSS with QOL scores, prostate volumes, and residual urine volumes showed significant decreases and Qmax values showed a significant increase after bipolar plasma kinetic electrovaporization. This treatment modality causes a temporary increase in the PSA concentration, as do other interventional treatment methods, but the measurements on the 30th and 90th days were below preoperative values.     

Effects of the selective acetylcholinesterase inhibitor TAK-802 on the voiding behavior and bladder mass increase in rats with partial bladder outlet obstruction

PURPOSE: We examined the effects of the selective acetylcholinesterase (AChE) inhibitor TAK-802 on voiding behavior and residual urine volume in rats with partial bladder outlet obstruction (BOO) vs rats treated with the nonselective AChE inhibitor distigmine and the muscarinic agonist bethanechol. In addition, the effect of repeat doses of TAK-802 on the bladder mass increase associated with BOO was also examined. MATERIALS AND METHODS: Male rats with BOO were used. Six to 8 days after obstruction voiding behavior was observed in a metabolic cage. The animals were then treated orally with 1 drug, and voiding frequency and urine volume at each void were measured for 3 hours. Subsequently the volume of urine retained in the bladder (residual urine) was measured. In another experiment bladder weight in rats with BOO was measured after early repeat doses of TAK-802. RESULTS: BOO increased voiding frequency and decreased average voided volume. TAK-802 and distigmine increased average voided volume, while not causing any change in voiding frequency. On the other hand, bethanechol increased voiding frequency without affecting average voided volume. While all 3 drugs significantly decreased residual urine volume, TAK-802 was most efficacious. In addition, bladder weight in the control BOO group was greater (approximately 2.2-fold) than that in the sham operated group and early repeat administration of TAK-802 prevented the bladder mass increase. CONCLUSIONS: AChE inhibitors decreased residual urine volume by restoring voiding function in rats with BOO, although only the effect of TAK-802 was dose dependent. Bethanechol also decreased residual urine volume in a dose dependent manner but by increasing voiding frequency. The prevention of a bladder mass increase by TAK-802 treatment may be attributable to its effect on restoring voiding.     

Transurethral incision of bladder neck for voiding dysfunction after radical hysterectomy: A report of 24 cases

Twenty-four women who had radical abdominal hysterectomy, and subsequently developed persistent high post-void residual urine underwent transurethral bladder neck incision. Persistent high post-void residual urine is defined as a residual urine volume 20% greater than the amount just voided. This was determined during a 24-hour period, 3 months or more after the radical hysterectomy. Our results indicated that the bladder outlet resistance before and after the procedure was 0.96±1.01 and 0.19±0.07 respectively (P<0.05). The mean ratios between residual urine and total bladder volume in 24 cases were reduced from 93.45±42.93% to 33.47±22.79% after the procedure (P<0.001). In addition, there was a significant decrease of functional urethral length, maximal urethral closure pressure and bladder outlet resistance. Based on the ratios of residual urine and total bladder volume, 7 patients were markedly improved, 10 were partially improved, 7 remained unchanged and none worsened. The overall improvement rate was 71% (17/24). Urinary incontinence was a rare complication which occurred in only one woman (4%).     

Experience with the memotherm stent in high-risk urinary retention patients

PURPOSE: We report on our experience with the Memotherm stent implanted in high-risk patients who had an indwelling catheter. PATIENTS AND METHODS: Seventeen patients (mean age 80.6 years, range 55 to 93) who had an indwelling catheter were treated by placement of the Memotherm stent. The mean duration time of indwelling catheter were 12.7 months (range 1 to 60). The methods of implantation was used the special delivery system and treatment can be done with the patient under local anesthesia with non-steroidal anti-inflammatory drug. To assess the efficacy of the treatment we measured urinary peak flow rate (ml/sec), residual urine volume (ml) and residual urine rate (residual urine volume/total urine volume: %). Subjective symptoms were evaluated using the International Prostate Symptom Score (I-PSS). The mean follow-up time was 3.3 months (range 1 week to 8 months). RESULTS: There were no severe medical problems associated with stent placement. Sixteen patients were able to void immediately after insertion of the stent. The remaining 1 required an indwelling catheter to 2 months, however, eventually able to void. Only 7 of the 17 patients can be evaluation for urinary flow and residual urine, nevertheless the mean urinary peak flow rate showed 9.7 ml/sec, the mean residual urine volume was 77.4 ml, and the mean residual urine rate was 27.5%. Also, average I-PSS showed 13.4 in these patients. CONCLUSIONS: As a results of this study, the Memotherm stent is good conservative therapy for high-risk urinary retention patients.     

Ultrasonographic assessment of intravesical urine volume

The assessment of intravesical urine volume is very important in the management of the patients with lower urinary tract obstruction or incontinence. As the non-invasive method for measuring residual urine volume, accuracy and usefulness of ultrasonographic measurement was evaluated in a total of 116 occasions in comparison with the conventional catheter technique. The values of the maximum transverse (W), cranio-caudal (H) and antero-posterior distance (D) of the inflated bladder were obtained by trans-abdominal scanning. These parameters were used for the ellipsoid formula (pi/6 x W x H x D). The ultrasonographic measurement of urine volume showed a high coefficiency against the conventional catheterized volume (r = 0.9543). Although a mean standard error was 56.3% of the actual volume, the amount of residual urine at the target of 50 ml and 100 ml could be accurately assessed by ultrasound with an accuracy of 90.5%. The method was also valid in follow-up study to monitor the changes of residual urine volume. The ultrasonographic assessment of intravesical urine volume is, thus, a non-invasive, useful tool in the management of the patients with voiding disturbance.     

前列腺增生症病人的逼尿肌收缩力减弱与剩余尿

应用压力流率测定技术，经Ｓｃｈ¨ａｆｅｒ列线图和直线被动尿道阻力关系（ＬｉｎＰＵＲＲ）定量分析９５例前列腺增生症病人的逼尿肌收缩强度。逼尿肌收缩强度分为四级：很弱（ＶＷ）、弱（Ｗ）、正常（Ｎ）和强（ＳＴ）。导管法结合压力流率测定时膀胱灌注量与排出量之差确定剩余尿。结果表明，逼尿肌收缩力很弱和弱与收缩力正常和强的病人之间存在显著性差异（Ｐ＜０．００１）。剩余尿量随逼尿肌收缩力减弱而增加。逼尿肌收缩力很弱的病人术后剩余尿量未改善；逼尿肌收缩力弱的病人术后逼尿肌收缩力可能改善，剩余尿减少；逼尿肌收缩力正常或强的病人术后剩余尿明显减少。     

前列腺增生症患者剩余尿与膀胱出口梗阻逼尿肌收缩力的相关性研究

目的 :探讨前列腺增生症 (BPH)患者剩余尿 (RUV )与膀胱出口梗阻 (BOO)、逼尿肌收缩力相关性。方法 :对 42例 BPH患者进行尿动力学检查。结果 :RUV与 BOO呈正相关 (r =0 .716 0 ,P <0 .0 1) ,与逼尿肌等容收缩压 (Piso)呈负相关 (r =- 0 .5 718,P <0 .0 1)。术前和术后的 RU V、尿道阻力因子 (URA )的差异有显著性意义 (P<0 .0 5 ) ,而术前和术后的 Piso差异无显著性意义 (P>0 .0 5 )。结论 :BPH患者 RUV的产生及增多是由于 BOO的加重和逼尿肌功能受损的共同结果 ,在病程的不同阶段 ,BOO和逼尿肌收缩力对 RUV的产生、增多及减少具有不同的作用和意义。     

Intra-individual variability in nighttime urine production and functional bladder capacity estimated by home recordings in patients with nocturnal enuresis.

PURPOSE: We evaluated the intra-individual variability and reproducibility of nighttime urine production on wet nights and functional bladder capacity estimated by long-term home recordings of monosymptomatic nocturnal enuresis. In particular, the intention was to evaluate the validity of 1 versus 2 weeks of recording when estimating urine volume on wet nights and 1 versus 2 weekends of recording when estimating functional bladder capacity. MATERIALS AND METHODS: We analyzed 120, 2-week home recordings of nighttime urine volume from patients with monosymptomatic nocturnal enuresis 6 to 16 years old (mean age 9.1) with at least 3 wet nights per week. Most patients were nonresponders or partial responders to desmopressin. Nighttime urine volume was estimated by weighing diapers before and after sleep, and measuring morning urine volume. Of the home recordings 62 included frequency volume charts for 2 weekends, which were evaluated for functional bladder capacity defined as the largest voided volume observed. RESULTS: No significant overall week-to-week differences were observed in average urine volume on wet nights and functional bladder capacity. There was a large intra-individual variability in all measured variables, which was most pronounced for functional bladder capacity and least pronounced for urine volume on wet nights. With regard to repeatability, the limits of agreement of urine volume on wet nights were -32% and 36% (95% confidence interval) as opposed to -54% and 48% for functional bladder capacity. CONCLUSIONS: In this study intra-individual week-to-week estimates of average urine volume on wet nights demonstrated acceptable variability and repeatability in contrast to functional bladder capacity. A reliable estimate of urine volume on wet nights could be obtained by 7 nights of home recording, whereas 4 days of daytime recording were necessary when estimating functional bladder capacity. Similar studies of patients who respond to desmopressin are needed.     

Sonographische Restharnbestimmung

Introduction

Despite total mesorectal excision and protection of the pelvic autonomous nerve system, dysfunctions of the urinary bladder are often observed after surgical therapy for rectal cancer. In this prospective study, the frequency of urinary bladder malfunctions was assessed by measuring residual urine volume using transcutaneous ultrasound before and after surgery.

Patients and methods

Seventy-five patients with rectal cancer were analyzed for urine volume retained before and after surgical therapy. The tumors were localized in the lower third of the rectum for 31 patients, in the middle for 30, and in the upper third for 14.

Results

An increase in retained urine of more than 100 ml was found in 12 patients (15%), and neurogenic bladder was diagnosed in two (3%). In female patients, urinary bladder malfunctions were significantly less frequent and severe.

Conclusions

The percutaneous assessment of urine volume retained in the bladder is suited for determining urinary bladder malfunctions after surgery. This method can serve to assess the quality of surgical treatment for rectal cancer. A standardized definition of relevant urinary bladder malfunctions is required.