Average Urine Volume Research Articles

Adsorption of ciprofloxacin from aqueous solution and fresh synthetic urine by graphene oxide: Conventional and statistical physics modeling approaches

This work uses conventional and statistical physics modeling approaches to address ciprofloxacin (CIP) adsorption by graphene oxide (GO) from aqueous solution and fresh synthetic urine. Instrumental techniques such as FTIR, XRD, SEM, TGA, BET, and EDS were employed to characterize the adsorbent material. The adsorption experiments were performed in a typical batch using different initial concentrations of CIP, adsorbent dosage, pH, and temperatures. Besides, the statistical physics approach was employed to investigate the CIP adsorption onto GO. Five models based on mono, double, and multilayers were used to describe the equilibrium isotherms. Steric and energetic parameters such as the number of adsorbed molecules per site, receptor site density, and half-saturation were considered. The kinetic data were adjusted using three conventional models (pseudo 1st order, pseudo 2nd order, and general order). The pH effect and influence of adsorbent dosage on adsorption performance were also investigated and discussed. In addition, adsorption mechanisms hypotheses were proposed based on experimental data and adsorption modeling using a statistical physics approach. Furthermore, the current work reports the removal of CIP at concentrations commonly found in urine considering factors such as fraction excreted in unmetabolized form, daily defined dose, and average daily urine volume excreted. The adsorption capacity values in aqueous medium and fresh synthetic urine were were 354.24 and 291.39 mg g−1, respectively.

Development of a clinical risk score system for peritoneal dialysis-associated peritonitis treatment failure

ObjectiveThis study aimed to construct a clinical risk score system for peritoneal dialysis-associated peritonitis (PDAP) treatment failure to provide a theoretical basis for clinical workers.MethodsA total of 161 PDAP individuals admitted to our hospital were included, among whom 70 cases were in the treatment-improved group and 87 cases were in the treatment failure group. We compared the general condition, clinical manifestations, and laboratory examination indicators of the two groups of individuals, used multivariate logistic regression analysis to identify the factors influencing PDAP treatment failure, and developed a clinical risk score system. The diagnostic performance of the risk score system was evaluated utilizing the receiver operating characteristic (ROC) curve.ResultsSignificant differences (P < 0.05) were observed between the two groups in terms of contamination, peritoneal fluid culture results, blood urea nitrogen (BUN) level, C-reactive protein (CRP) level, B-type natriuretic peptide (BNP) level, average residual urine (RU) volume, and urea clearance rate (UCR). Multivariate logistic regression analysis showed that BUN level, CRP level, BNP level, average RU volume, and UCR were independent risk factors affecting PDAP patient treatment outcomes (P < 0.05). The ROC curve analysis of the risk score system for predicting treatment failure in PDAP individuals showed an area under the curve of 0.895 [95% confidence interval (0.847–0.943)]. The optimal cut-off point was 2.5 points, with corresponding sensitivity and specificity of 88.5% and 74.3%, separately.ConclusionBUN level, CRP level, BNP level, average RU volume, and UCR are independent risk factors for PDAP treatment failure. The clinical risk score system based on these five independent risk factors can accurately predict the risk of treatment failure in PDAP individuals.

Feasibility of Mini sipIT Behavioral Intervention to Increase Urine Volume in Patients With Kidney Stones

To determine the feasibility and acceptability of mini sipIT, a context-sensitive reminder system that incorporates a connected water bottle and mobile app with text messaging, for kidney stone patients who have poor adherence to increasing fluid intake for prevention. Patients with a history of kidney stones and urine volume <2L/d participated in a 1-month single-group feasibility trial. Patients used a connected water bottle and received text message reminders when fluid intake goals weren't met. Perceptions of drinking behavior, intervention acceptability, and 24-hour urine volumes were obtained at baseline and 1-month. Patients with a history of kidney stones were enrolled (n = 26, 77% female, age=50.4 ± 14.2years). Over 90% of patients used the bottle or app daily. Most patients perceived that mini sipIT intervention helped them to increase their fluid intake (85%) and reach their fluid intake goals (65%). There was a significant increase in average 24-hour urine volume after the 1-month intervention compared to baseline (2006.5 ± 980.8 mL vs 1352.7 ± 449.9 mL, t (25)= 3.66, P = .001, g= 0.78), with 73% of patients having higher 24-hour urine volumes at the end of the trial. Mini sipIT behavioral intervention and outcome assessments are feasible for patients and may lead to significant increases in 24-hour urine volume. Digital tools in combination with behavioral science may improve adherence to fluid intake recommendations for kidney stone prevention, however, rigorous efficacy trials are necessary.

Results of kidney transplant and monitoring of complications in the patients after kidney transplantation from living donors in Thai Nguyen National Hospital

This study aims to evaluate the results of kidney transplant surgery from living donors at Thai Nguyen National Hospital and investigate complications immediately after transplantation and the results of management of complications after kidney transplantation. The study used descriptive observation and whole sampling methods, on 29 patients with a kidney transplant were eligible for selection, with indications for a kidney transplant. Results showed that 24/29 (82.8%) of surgery cases are left kidney transplants, only 5/29 (17.2%) cases are right kidney transplants. End-to-end anastomosis was 24 cases, the remaining 5 cases are en to side. 100% of kidney transplants are placed in the right iliac fossa. There are 5 cases of gun barrel angioplasty; 29/29 cases of external iliac vein anastomosis. 100% of ureteral transplants to the bladder follow the Lich - Gregoir technique. All kidney transplant patients had urine on the operating table, the average urine volume after 24 hours was 6,327±2,479 ml. After 4 weeks, the urine volume was 2,983±1,784 ml. After 5 days, kidney function nearly returned to normal, average urea concentration: 8.2±6.0 mmol/l; creatinine: 118.3±27.52 μmol/l, kali: 4.1±0.6 mmol/l. timely treatment of surgical complications: perirenal fluid block (5/29); hematoma (1/29); treatment: re-operation, aspiration of fluid around the kidney; 3 cases supported hemodialysis. Infectious complications: infection at the surgical site (1/29); have urinary tract infections caused by E. coli and vaginal yeast (1/29). Treatment with antibiotics, urine culture, antibiotic susceptibility testing. In conclusions, 29/29 (100%) patients with a kidney transplant from living donors had successful surgery, the left kidney surgery was the main one. The majority of the surgical method was end-to-end anastomosis. Complications after transplantation are perirenal fluid mass, hematoma, infection with a low rate, the results of the management of complications are stable.

A meta-analysis on the characteristics of placebo effects on urinary function in placebo-controlled clinical trials among Japanese patients.

This study aimed to assess the effect sizes, changes over time, and ethnic differences in placebo effects on urinary function among Japanese patients participating in clinical trials. A meta-analysis of 30 Japanese placebo-controlled clinical trials was conducted to determine the placebo effects on three functions: daily urinary frequency, nocturnal urinary frequency, and average urine volume per void. The I-square heterogeneity values for the basic values of the three functions ranged from 84.5% to 97.9%, with differences among trials. Longitudinal analysis (1 to 12 weeks) indicated an enhanced placebo effect for up to 8 weeks and no consistency among trials on nocturnal urinary frequency (p < 0.01), unlike those on daily urinary frequency and average urine volume per void (p=1.0). Based on the random-effects model, the mean differences in urinary frequency at 4, 8, and 12 weeks were -0.70 (-0.80; -0.60), -1.06 (-1.16; -0.96), and -1.18 (-1.34; -1.01), respectively. Furthermore, the mean difference (95% confidence interval) in nocturnal urinary frequency and volume of urination per void at 12 weeks was -0.63 (-0.94; -0.31) and 9.67 (7.25; 12.1), respectively. My findings suggest an increase in the strength of placebo effects over time (up to 8 weeks). A comparison of my results to those published in previous global reports showed no meaningful differences in placebo effects among ethnic groups. The consistent placebo effect size on urinary function could be an external indicator in clinical trials.

PD16-07 REASSESSMENT OF THE EFFECT OF LOWER URINARY TRACT OBSTRUCTION ON UROTHELIAL TISSUE: EVALUATION VIA HOLEP AND ANIMAL STUDY

You have accessJournal of UrologyCME1 May 2022PD16-07 REASSESSMENT OF THE EFFECT OF LOWER URINARY TRACT OBSTRUCTION ON UROTHELIAL TISSUE: EVALUATION VIA HOLEP AND ANIMAL STUDY Young-Min Yang, Katsumi Shigemura, Koki Maeda, Yuzo Nakano, and Masato Fujisawa Young-Min YangYoung-Min Yang More articles by this author , Katsumi ShigemuraKatsumi Shigemura More articles by this author , Koki MaedaKoki Maeda More articles by this author , Yuzo NakanoYuzo Nakano More articles by this author , and Masato FujisawaMasato Fujisawa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002548.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is a debate that the volume and morphology of the prostate do not completely correlate with the micturition status. That is, Schafer nomogram, asessing lower urinary tract obstruction and the severity, may not be directly lead to good outcome of urination status after Holmium-Laser Enucleation of the Prostate (HoLEP). So, we re-assessed Schafer nomogram in HoLEP. And we created a benign prostatic hyperplasia model mouse, and evaluated how the increase in prostate volume affects inflammtion and function in prostate and bladder, and searched for new marker to evaluate bladder function. METHODS: We collected 320 patients who underwent HoLEP from April 2005 to March 2021 in Kobe university hospital. We retrospectively assess the relationship between Schafer nomogram and surgical outcome such as change of maximum flow rate (MFR, ml/s), average flow rate (AFR, ml/s) and residual urine volume (RUV, ml) from pre- to post-operation, and prostate volume (ml) and resected prostate weight (g). Next, we made a mouse prostatic hyperplasia model by testosterone propionate after castration, we evaluated to correlation between prostate volume, and the expressions of α1 -adrenoreceptor and TGF-β in prostate glands and those of β-3 receptor and Rho in bladder membrane. RESULTS: As to the HoLEP data, there was no significant difference of change of MFR (p=0.1044), AFR (p=0.2186) and RUV (p=0.5978) from pre- to post-HoLEP. However, there was significant difference of prostate volume and resected prostate weight among Schafer nomogram: prostate volume (p=0.009) and resected prostate weight (p=0.0007). In animal study, there was no difference in body weight among the individuals. The mean prostate weight was 75 ± 27 mg in the control group, 101.9 ± 1.7 mg in the castration group, and 130 ± 19 mg in the testosterone propionate group. There was no significant prostate volume difference between the castration group and the control group (p = 0.5) but was between the testosterone propionate group and the control group (p<0.05). Immunostaining showed a significant correlation between prostate volumes, and α1-adrenoreceptor expression in prostate gland, and expressions of β3 receptor and Rho in bladder. CONCLUSIONS: Our study demonstarted that he Schafer classification has not completely evaluated the degree of obstruction, so a new index for evaluating the degree of obstruction is required. And animal study showed that Rho expression in baldder membrane may reflects the degree of obstruction. Further evaluation needs to be performed for a definitive conclusion. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e271 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Young-Min Yang More articles by this author Katsumi Shigemura More articles by this author Koki Maeda More articles by this author Yuzo Nakano More articles by this author Masato Fujisawa More articles by this author Expand All Advertisement PDF DownloadLoading ...

Freeflow: The novel portable uroflowmeter can help to realize practical urinary conditions at home.

To evaluate the effectiveness of a novel portable urine flowmeter, Freeflow, for examining the actual state of urination at home. Forty-three patients with benign prostatic hyperplasia used the Freeflow uroflowmeter in the hospital and at home without accumulating urine. We created a nomogram for each patient's urine volume and maximal urinary flow rate (Qmax). Furthermore, we investigated the actual state of each patient's urination. We also investigated the differences in the micturition status between daytime and nighttime. Of the 43 patients, 40 were able to provide the necessary data in the hospital, and all patients provided data measured at home. The trial period of the home assessment was 2-7 days. Regarding the average urine volume, no significant difference was observed between in-hospital and at-home patients; however, Qmax and mean flow rate (Qave) were significantly higher at home. The average coefficient of variation was very large. The relationship between daytime and nighttime was observed in 30 patients; urine volume increased significantly at nighttime; however, no significant difference was observed in Qmax and Qave. The nomogram for several days and a completed urinary diary helped to display daytime and nighttime urination characteristics. Freeflow, the newly developed uroflowmeter, enabled us to determine the fluctuations in the measurements recorded at home and the differences between daytime and nighttime. Thus, creating a nomogram for objectively examining nighttime urination status and utilizing a urination diary was found to be effective for providing correct diagnosis and treatment of lower urinary tract symptoms.

UJI DIURETIK INFUSA DAUN TEH HIJAU (Camellia sinensis L.,)PADA TIKUS PUTIH JANTAN GALUR WISTAR ( Rattus norvegicus )

ABSTRACT&#x0D; Green tea leaves are natural materials, contains flavonoids can increase the volume of urine, This study aims to determine the diuretic effect of ethanol extract of green tea leaves in male Swiss mice.&#x0D; This study is an experimental post control group design using in male swiss mice were divided into 5 groups: group I negative control with CMC Na 0,5%, group II positive control with furosemide dose of 3,6mg/KgBB, and group III ethanol extract of green tea leaves dose of 250 mg/gBB, group IV ethanol extract of green tea leaves dose of 500 mg/gBB, group V ethanol extract of green tea leaves dose of 750 mg/gBB. Before treatment all mice were given warm water orally, then give it according to the group. Tests on the diuretic effect is done by measuring the urine volume, the measurements of to be conducted every 60 minutes for 6 hours. Data analysis was performed using SPSS 23 with One-way ANOVA test and continue LSD.&#x0D; Results of the average cumulative urine volume group I of 7,01 ml, group II of 12,98 ml, group III of 9, 13 ml, gruop IV of 12, 57 ml, and gruop V of 12, 81 ml . Furthermore, analysis of data using SPSS. LSD test results showed that the group V differ significantly with group II, ie with significant value 0,850 (p&gt; 0.05). Based on the average volume and SPSS can be concluded that the ethanol extract of green tea leaves have a diuretic.&#x0D; &#x0D; Keywords: Diuretics, Infusa Green Tea Leaves, Green Tea Leave

Clinical efficacy of bevacizumab combined with cisplatin in the treatment of malignant pleural effusion and ascites caused by lung cancer: a randomized trial.

To analyze the clinical effect of bevacizumab combined with cisplatin in the treatment of malignant pleural effusion and ascites. A total of 86 patients with malignant pleural effusion and ascites admitted from June 2018 to September 2020 were selected as the research participants and randomly divided into a control group and observation group, with 43 cases in each group. The control group was given cisplatin intracavitary perfusion scheme, and the observation group was given bevacizumab combined with cisplatin intracavitary perfusion scheme. The Symptom Checklist 90 (SCL-90), Hamilton Depression Scale (HAM-D), and Hamilton Anxiety Scale (HAM-A) were used to evaluate participants' self-perceived negative symptoms, depression, and anxiety. The therapeutic effect and adverse reactions of the 2 groups were compared. The t-test was used for measurement data, and c2 test was used for enumeration data. Statistical significance was considered at P<0.05. After treatment, the serum levels of hypoxia inducible factor-1 (HIF-1α) and vascular endothelial growth factor (VEGF) in the observation group were significantly decreased and statistically lower than those in the control group (both P<0.05); the malignant pleural and abdominal water volume, average urine volume, and average chest circumference of the observation group were improved, and the difference was statistically significant compared with the control group (all P<0.05). The scores of each factor of SCL-90 in the observation group were decreased, among which the scores of somatization, interpersonal sensitivity, depression, anxiety, hostility, and terror in the observation group were significantly lower than those in the control group (all P<0.05); after treatment, the HAMD and HAMA scores of the observation group decreased, and the scores of HAMD (13.71±5.98) and HAMA (17.62±3.98) of the observation group were significantly lower than the score of (16.52±5.75) and (21.54±4.77) of the control group (both P<0.05). In the clinical treatment of malignant pleural effusion and ascites, bevacizumab combined with cisplatin intracavitary perfusion can improve the clinical treatment effect, reduce the depression and anxiety of patients, optimize patient quality of life, and improve the safety of treatment. Chinese Clinical Trial Registry ChiCTR2100048959.

Exploratory pilot study of exogenous sustained-release melatonin on nocturia in Parkinson's disease.

Nocturia is one of the commonest non-motor symptoms in Parkinson's disease (PD). Nocturia has evolved from being understood as a symptom of urological disorders or neurogenic bladder dysfunction to being considered as a form of circadian dysregulation. Exogenous melatonin is known to help circadian function and can be an effective strategy for nocturia in PD. In this open-label, single-site, exploratory, phase 2 pilot study, adults with PD and nocturia underwent assessments using standardized questionnaires, urodynamics studies and a bladder scan. This was followed by completion of a frequency volume chart (FVC) and 2-week sleep diary. Sustained-release melatonin 2mg was then administered once-nightly for 6weeks. A repeat assessment using questionnaires, the FVC and sleep diary was performed whilst on treatment with melatonin. Companion or bed partners filled in sleep questionnaires to assess their sleep during the intervention. Twenty patients (12 males; mean age 68.2 [SD=7.8] years; mean PD duration 8.0 [±5.5] years) with PD reporting nocturia were included. Administration of melatonin was associated with a significant reduction in the primary outcome bother related to nocturia measured using the International Consultation on Incontinence Questionnaire Nocturia (ICIQ-N) (p=0.01), number of episodes of nocturia per night (p=0.013) and average urine volume voided at night (p=0.013). No serious adverse events were reported. No significant improvement was noted in bed partner sleep scores. In this preliminary open-label study, administration of sustained-release melatonin 2mg was found to be safe for clinical use and was associated with significant improvements in night-time frequency and nocturnal voided volumes in PD patients.

Therapeutic effects of Low intensity extracorporeal low energy shock wave therapy (LiESWT) on stress urinary incontinence

This study aimed to evaluate the therapeutic effects of Low intensity extracorporeal low energy shock wave therapy (LiESWT) on stress urinary incontinence (SUI). The investigation was a single-arm, open-label, multicentre study conducted in Taiwan. 50 female patients with SUI received LiESWT-treated with 0.25 mJ/mm2 intensity, 3000 pulses, and 3 pulses/second, once weekly for 4-weeks (W4) and 8-weeks (W8). The pad test, uroflowmetry, life quality questionnaires, and 3-day urinary diary measurement were performed before and after LiESWT intervention. The results revealed that 8-week of LiESWT treatment meaningfully improved urine leakage (pad test), maximum flow rate, post-voided residual urine, average urine volume, functional bladder capacity, urinary frequency, urgency symptom, and nocturia, which also persisted to show significant improvements at 1-month follow up (F1). Moreover, bothersome questionnaires scores were significantly improved at W4, W8, and F1 as compared to the baseline (W0). These results indicated that 8 weeks of LiESWT attenuated SUI symptoms on physical activity, reduced bladder leaks and overactive bladder (OAB), implying that LiESWT brought significant improvement in the quality of life. (ClinicalTrials.gov number, NCT04059133).

Iodine status of breastfed infants and their mothers' breast milk iodine concentration.

Iodine is an essential nutrient for growth and development during infancy. Data on iodine status of exclusively (EBF) and partially breastfed (PBF) infants as well as breast milk iodine concentration (BMIC) are scarce. We aimed to assess (a) infant iodine nutrition at the age of 5.5 months by measuring urinary iodine concentration (UIC) in EBF (n = 32) and PBF (n = 28) infants and (b) mothers' breast milk iodine concentration (n = 57). Sixty mother–infant pairs from three primary health care centres in Reykjavik and vicinities provided urine and breast milk samples for iodine analysis and information on mothers' habitual diet. The mother–infant pairs were participants of the IceAge2 study, which focuses on factors contributing to infant growth and development, including body composition and breast‐milk energy content. The median (25th–75th percentiles) UIC was 152 (79–239) μg/L, with no significant difference between EBF and PBF infants. The estimated median iodine intake ranged from 52 to 86 μg/day, based on urinary data (assuming an average urine volume of 300–500 ml/day and UIC from the present study). The median (25th–75th percentiles) BMIC was 84 (48–114) μg/L. It is difficult to conclude whether iodine status is adequate in the present study, as no ranges for median UIC reflecting optimal iodine nutrition exist for infants. However, the results add important information to the relatively sparse literature on UIC, BMIC, and iodine intake of breastfed infants.

Randomized controlled trial for the efficacy of electroacupuncture in the treatment of urge urinary incontinence: A clinical study protocol.

Background:Despite that the urge urinary incontinence (UUI) is a nonfatal disease, it can lead to anxiety, embarrassment and depression to the patient. UUI is a common public health problem that can significantly affect the quality of life of the patient. Several conservative treatments have been recommended for the treatment of UUI; however, their efficiency remains unclear, leaving the disease without a real effective treatment. The clinical application of acupuncture to treat UUI is currently considered an effective approach despite the limited evidence that support its efficiency. The aim of this study is to assess the efficacy and safety of electroacupuncture therapy in the treatment of UUI.Methods and analysis:A randomized, parallel, controlled study will be performed. Patients with UUI treated with electroacupuncture group (EA) will compare with the sham-treated sham EA (SA) patients. A total of 100 participants with UUI will be randomly allocated to either the EA or the SA group with a 1:1 ratio. The treatment of UUI patients will performed 3 times per week, for 8 weeks in 30-minute sessions. At the end of the treatment the patients will be followed-up until week 32. The primary outcomes include scores of incontinence questionnaire-short form, the average 24-hour urgency incontinence episodes, and the average 24-hour urge episodes responses from baseline until the 4th, 8th , 24th, and 32nd week. The secondary outcomes included the average 24-hour urine volume and the average 24-hour micturition frequency responses from baseline until the 8th and 32nd week, as well as the change in incontinence quality of life scores from baseline at the 8th and 32nd week. In addition, the degree of satisfaction of the participants undergoing acupuncture treatment will be measured at the 4th and 8th week. The participants’ clinical acupuncture expectations were evaluated at baseline, and the questionnaire for urinary incontinence diagnosis was used to identify stress incontinence, mixed urinary incontinence, and urge incontinence at baseline.Discussion:This is a randomized, controlled, observer-blinded trial of electroacupuncture treatment for UUI. The results of this trial will provide more evidence on whether electroacupuncture is efficacious for treating UUI.

The Relationship between Overweight and Overactive Bladder Symptoms

Background: Several authors have investigated the relationship between obesity – assessed only by body mass index (BMI) – and overactive bladder (OAB) symptoms. Objectives: The objective of this study was to determine the relationship between body fat percentage (BFP) and the severity of OAB symptoms with an impact on quality of life. Design: Cross-sectional study. The sample consisted of 206 overweight women; they were university students (BMI = 25.8 ± 3.0) with an average age of 30.6 ± 2.4 years. Body composition analysis was used, including assessment of BFP, visceral fat area (cm²/level), and other parameters. OAB symptoms were evaluated with an OAB questionnaire (OAB-q), voiding diary, and quality of life scale (I-QoL). Results: Ninety women had a BFP >32% and 116 had a BFP <32%. The voiding diary and OAB-q confirmed significant differences in 24-h daytime and nighttime frequency of voiding and average urine volume during the day. The OAB-q symptom score was lower in the group with BFP <32%. I-QoL recorded significantly worse parameters in the group with BFP >32% (p < 0.01). The Patient Perception of Intensity of Urgency Scale significantly correlated with BFP (r = 0.466, p < 0.001). Women with a BFP above 32% had a 1.95 times greater chance of developing OAB (odds ratio = 1.95, 95% CI = 1.09–3.52, p < 0.02). Conclusion: Young women with a BFP >32% were 95% more likely to have OAB than other young women with a BPF <32%.

A systematic review and meta-analysis of 24-h urinary output of children and adolescents: impact on the assessment of iodine status using urinary biomarkers

PurposeUrinary iodine concentration (UIC (μg/ml) from spot urine samples collected from school-aged children is used to determine the iodine status of populations. Some studies further extrapolate UIC to represent daily iodine intake, based on the assumption that children pass approximately 1 L urine over 24-h, but this has never been assessed in population studies. Therefore, the present review aimed to collate and produce an estimate of the average 24-h urine volume of children and adolescents (> 1 year and < 19 years) from published studies.MethodsEBSCOHOST and EMBASE databases were searched to identify studies which reported the mean 24-h urinary volume of healthy children (> 1 year and < 19 years). The overall mean (95% CI) estimate of 24-h urine volume was determined using a random effects model, broken down by age group.ResultsOf the 44 studies identified, a meta-analysis of 27 studies, with at least one criterion for assessing the completeness of urine collections, indicated that the mean urine volume of 2–19 year olds was 773 (654, 893) (95% CI) mL/24-h. When broken down by age group, mean (95% CI) 24-h urine volume was 531 mL/day (454, 607) for 2–5 year olds, 771 mL/day (734, 808) for 6–12 year olds, and 1067 mL/day (855, 1279) for 13–19 year olds.ConclusionsThese results demonstrate that the average urine volume of children aged 2–12 years is less than 1 L, therefore, misclassification of iodine intakes may occur when urine volumes fall below or above 1 L. Future studies utilizing spot urine samples to assess iodine status should consider this when extrapolating UIC to represent iodine intakes of a population.

Robot-assisted training can improve the bladder and intestinal functions of paraplegic patients

Objective To explore the clinical effect of training assisted by a lower limb rehabilitation robot on the bladder and intestinal function of paraplegic spinal cord injury survivors. Methods Thirty-eight paraplegic patients with spinal cord injury were divided according to their admission order into an experimental group (n=19) and a control group (n=19). Both groups were given conventional rehabilitation training, while the experimental group was additionally provided with robot-assisted lower limb training in three stages: adaptation, training and consolidation. It lasted 30 minutes daily, 5 days per week for 12 weeks. Before and after the training, an urodynamics examination system was used to evaluate the maximum urine flow, bladder capacity, residual urine volume, bladder pressure and detrusor pressure. Colon transit time, mean rectal pressure and intestinal function were measured using the colon transit test, a mean rectal pressure test, and the Functional Independence Measure (FIM) scale respectively. Results The average bladder volume, maximum urine flow rate, average urine flow rate, detrusor pressure, bladder compliance, average rectal pressure and intestinal FIM score of the robot training group after training were all significantly better than before the training, as were the average residual urine volume and colon transit time. After the training, the average bladder volume, maximum urine flow rate, average urine flow rate, detrusor pressure, bladder compliance and average rectal pressure of the robot training group were all significantly higher than those of the control group, while the average residual urine volume and colon transit time were significantly smaller. Then, 32% of the patients in the experimental group achieved no less than 6 points for their average FIM score, significantly higher than in the control group. Conclusion Robot-assisted lower limb training combined with comprehensive rehabilitation training can effectively improve the bladder and intestinal function of paraplegic patients after a spinal cord injury. Key words: Spinal cord injury; Paraplegia; Rehabilitation robots; Bladder function; Intestinal function

Quantified water intake in laboratory cats from still, free-falling and circulating water bowls, and its effects on selected urinary parameters.

The study objectives were to determine if the method of water presentation (still [S], circulating [C] or free-falling [FF] bowl systems) influences daily water consumption in cats in a controlled environment, and whether differences in water intake affect urine relative super saturation (RSS) for calcium oxalate and struvite, urine specific gravity (USG), urine osmolality (Uosmol) and urine volume. Sixteen healthy laboratory cats fed a dry diet were individually housed with urine collection systems. Each cat underwent a randomized 2 week crossover period with all bowl systems, allowing a 1 week acclimation period between each crossover. Water intake was measured daily by bowl weight, accounting for spillage and evaporation. USG and urine volume were measured daily, whereas other urinary parameters were measured at various time points throughout each 14 day crossover period. Fourteen cats completed the study. Average daily water intake (ml/kg/day), urine volume, USG and urine RSS for struvite and calcium oxalate were not significantly different between water bowls. Uosmol was significantly higher in C compared with S and FF bowl systems (P = 0.009 for both). Three individual cats demonstrated a significant water bowl preference (Cat 4: C >S, P = 0.039; Cat 10: FF >C, P = 0.005; Cat 11: S >C, P = 0.037). Overall, water bowl type had no appreciable effect on water intake. Uosmol was the only urinary parameter found to be significantly different, and was higher for the C bowl. The implication of this is unknown, considering water intake did not differ significantly between bowls. Alternative methods to increase water intake should be implemented beyond providing unique water bowls in patients where augmented water intake would be beneficial for disease management.

Nerve-sparing Mid-urethral Obstruction (NeMO) in Female Small Rodents.

Partial bladder outlet obstruction (pBOO) has a high prevalence, causes significant patient burden, and immense health care costs. The most common animal model to investigate bladder remodeling in pBOO are female rodents undergoing partial obstruction at the proximal urethra. Variability in the degree of obstruction and animal mortality are major concerns with proximal obstruction. Furthermore, dissecting around the proximal urethra and bladder neck jeopardizes bladder innervation. We developed a nerve-sparing mid-urethral obstruction (NeMO) model for pBOO avoiding the disadvantages of the traditional model. We approached the urethra just inferior to the pubic symphysis, which obviated the need for laparotomy as well as for dissection in this area; also, the striated urethral sphincter remained untouched. We performed NeMO in female Sprague-Dawley rats (12 obstructions, 6 sham animals) as well as in female C57/bl6 mice (20 obstructions, 18 sham animals). After two weeks, we evaluated bladder function, bladder mass, and body mass. We had no mortalities among obstructed- or sham-operated female rats; as described for the traditional proximal pBOO-method, we tied the suture around the proximal urethra and a temporarily placed 0.9 mm metal rod. NeMO induced an 85% increase in bladder mass after two weeks, average residual urine volume was 0.4 mL in partially obstructed rats while only 0.03 mL in sham animals. In mice, we tested 3 sizes of cannulas that we placed along the urethra when tying the suture. We found that using a 27-gauge cannula resulted in over 50% animal mortality; placing the 25-gauge cannula did not yield the desired response in increasing bladder mass; utilizing a 26-gauge cannula yielded favorable results with minimal animal mortality (1/8) yet a significant 2-fold increase in bladder mass.

Urodynamic effects of electrical stimulation of the detrusor spastic bladder after spinal cord injury

Objective To observe the clinical effect of surface electrical stimulation on bladder spasm among patients with spinal cord injury, and compare it with that of therapy combining electrical stimulation with bladder function training. Methods Forty-two patients with bladder spasm after spinal cord injury were randomly divided into an experimental group (n=21) and a control group (n=21). Patients in the experimental group were further divided into three subgroups: patients with cervical spinal injury (n=7), thoracic spinal injury (n=9) and lumbar spinal injury (n=5). Both the experimental group and control group were given normal bladder function recovery exercise, while the experimental group was given the extra electrical stimulation on the surface of the sacral nerve. Urodynamic tests including the maximum detrusor pressure, bladder capacity, residual urine volume and bladder compliance were conducted for both groups before the treatment, after the first and the second 18-days of treatment and during a follow-up visit 2 months after the intervention. Results After the first course of treatment, significant differences were found in all measurements in the experimental group and most measurements of the control group except for the residual urine volume. Significant differences were found in all measurements after the second course of treatment compared to those after the first course in both groups. After the two courses of treatment and during the follow-up visit the average residual urine volume of the experiment group was significantly better than that of the control group. After the second course of treatment the average maximum detrusor pressure and bladder compliance of the experimental group were significantly better than those of the control group. Conclusion Surface electrical stimulation significantly improves the urodynamics and bladder function of patients with bladder spasm after spinal cord injury and its therapeutic effect is greater for patients with cervical and thoracic spinal injury than for those with lumber spinal injury. Key words: Spinal cord injury; Detrusor contraction; Surface electrical stimulation; Urodynamics

Obesity-initiated metabolic syndrome promotes urinary voiding dysfunction in a mouse model.

Accumulating evidences suggests that obesity and metabolic syndrome (MetS) contribute towards lower urinary tract symptoms (LUTS) through alterations in the phenotype of bladder and prostate gland. Clinical studies indicate a link between MetS and LUTS. Nevertheless, there is lack of suitable animal model(s) which could illustrate an association linking obesity to LUTS. We examined the lower urinary tract function in an obesity-initiated MetS mouse model. Male C57BL/6N wild-type and obese B6.V-Lepob/J maintained on regular diet for 28 weeks were subjected to the assessment of body weight (BW), body length (BL), waist circumference (WC), body mass index (BMI), blood glucose (BG), plasma insulin (INS), plasma leptin (LEP), total cholesterol (CHO), free fatty acid (FFA), and measurement of urinary functions. Whole animal peritoneal and subcutaneous adipose tissue measurements as well as prostate and bladder volumes were analyzed by MRI followed by histological evaluation. These parameters were used to draw correlations between MetS and LUTS. Obesity parameters such as BW, WC, and BMI were significantly higher in B6.V-Lepob/J mice compared to C57BL/6N mice (P < 0.01). Higher levels of total CHO and FFA were noted in B6.V-Lepob/J mice than C57BL/6N mice (P < 0.05). These results were concurrent with frequency, lower average urine volume and other urinary voiding dysfunctions in B6.V-Lepob/J mice. MRI assessments demonstrate marked increase in body fat and prostate volume in these mice. Compared to C57BL/6N mice, histological analysis of the prostate from B6.V-Lepob/J mice showed increased proliferation, gland crowding, and infiltration of immune cells in the stroma; whereas the bladder urothelium was slightly thicker and appears more proliferative in these mice. The regression and correlation analysis indicate that peritoneal fat (R = 0.853; P < 0.02), CHO (R = 0.729; P < 0.001), BG (R = 0.712; P < 0.001) and prostate volume (R = 0.706; P < 0.023) strongly correlate with LUTS whereas BMI, WC, INS, and FFA moderately correlate with the prevalence of bladder dysfunction. Our results suggest that LUTS may be attributable in part to obesity and MetS. Validation of an in vivo model may lead to understand the underlying pathophysiological mechanisms of obesity-related LUTS in humans. Prostate 76:964-976, 2016. © 2016 Wiley Periodicals, Inc.