RESUMO
AIMS: To describe the voiding pattern (VP) of women with urinary incontinence but without voiding symptoms and compare their clinical and urodynamic features between those voiding with and without a measurable detrusor contraction (DET-cont). METHODS: Retrospective analysis of a prospectively built database of female urodynamic studies (UDS). Women with voiding symptoms and having medical history of different factors that could alter the lower urinary tract function were excluded. All UDS were performed following the ICS guidelines. DET-cont and abdominal straining (ABD-strain) were defined as an increase ≥10 cm H2 O over the baseline for pdet and pabd at Qmax , respectively. RESULTS: A total of 186 women were included in the analysis. Mean age was 58 ± 10.7 years (24-83). Most women showed a VP with DET-cont (77.4%), with or without ABD-strain. When compared to women voiding without DET-cont, those with DET-cont were younger (P = .004), more likely to have detrusor overactivity (P = .035) and better urinary sphincter competency in the UDS (P = .018). On multivariate analysis, the presence of DET-cont was associated with age ≤50 years (P = .004) and the absence of urodynamic stress urinary incontinence (SUI) or SUI with abdominal leak point pressure ≥100 cm H2 O (P = .008). CONCLUSIONS: Most women without voiding symptoms show a VP characterized by a measurable detrusor contraction, with or without ABD-strain. The results suggest that the VP may vary independently with aging and with changes in the state of the urinary sphincter, emphasizing that for the interpretation of micturition in women different aspects must be considered.
Assuntos
Bexiga Urinária/fisiopatologia , Incontinência Urinária/fisiopatologia , Micção/fisiologia , Urodinâmica/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
OBJECTIVES: To compare the initial resting intravesical pressure (pves ) and abdominal pressure (pabd ) in the sitting position with the typical range of values, to assess the correlation between such pressures and patient xipho-pubic distance, body weight, height and body mass index (BMI), and to estimate if xipho-pubic distance can be a guide to interpret initial resting pressures in urodynamic testing. METHODS: Women with lower urinary tract symptomatology referred for urodynamic testing were consecutively enrolled in a prospective study. Conventional cystometry was done following "good urodynamic practices". The correlation between initial resting pves and pabd and xipho-pubic distance, body weight, height and BMI were studied using simple and multiple linear regression analysis. Statistical significance was defined as P < 0.05. RESULTS: One hundred women aged (mean ± SD) 59.2 ± 13.3 were studied. There was a significant correlation between both pves and pabd , and xipho-pubic distance, body weight and BMI and no correlation with height. Over the multiple analysis, xipho-pubic distance and body weight correlated independently with pves ; body weight correlated independently with pabd . Three patients had pves and/or pabd out of typical range, with BMIs values of 18.48, 18.72 and 35.81 kg/m2 . There was a wide range of difference between xipho-pubic distance and initial resting pressures. CONCLUSIONS: Out of range initial resting pressures occur in underweight (or close to) or severely obese patients. Xipho-pubic distance and body weight correlated independently with pves . Body weight correlated independently with pabd . Xipho-pubic distance cannot be a guide to interpret the initial resting pressures.
Assuntos
Abdome/fisiologia , Pesos e Medidas Corporais , Pressão , Bexiga Urinária/fisiologia , Urodinâmica , Adulto , Idoso , Estatura/fisiologia , Índice de Massa Corporal , Peso Corporal/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Sínfise Pubiana/anatomia & histologia , Postura Sentada , Processo Xifoide/anatomia & histologiaRESUMO
OBJECTIVES: To compare several risk factors in the testicular biopsy of patients with pure seminoma with and without clinical metastasis at diagnosis. METHODS: We performed a retrospective study of patients with pure seminoma. The retroperitoneum was staged with computed tomography and the thorax with simple radiography and/or computed tomography, taking into account the original reports and clinical stage. The previous reports and original pathology plates were reviewed by pathologists who were unaware of the clinical stage of the patients. Patients with beta-human chorionic gonadotropin greater than 800 mUI/mL were excluded. RESULTS: A total of 86 patients had sufficient data and comprised the study cohort. Of the 86 patients, 62 had clinical Stage I (72%), 20 had Stage II (23%), and 4 had Stage III (5%). On univariate analysis, tumor size greater than 4 cm (P = 0.0135), testicular vascular invasion (P = 0.0042), rete testis invasion (P = 0.0002), tunica albuginea penetration (P = 0.00001), base of the spermatic cord invasion (P = 0.0002), epididymis invasion (P = 0.001), and vascular invasion of the cord (P = 0.024) were predictive of metastasis. On multivariate analysis, tumor size greater than 6 cm (odds ratio 6.9, 95% confidence interval 1.3 to 35, P = 0.02) and rete testis invasion (odds ratio 6.1, confidence interval 1.2 to 30, P = 0.025) remained as important predictors of metastasis (tumor size less than 6 cm was not significant on multivariate analysis). CONCLUSIONS: The results of this study have demonstrated that rete testis invasion and tumor size correlate independently with the presence of clinical metastasis at diagnosis of testicular seminoma.