Nocturnal Urinary Incontinence Research Articles

Desmopressine is and remains the drug of first choice for clozapine-induced nocturnal enuresis or urinary incontinence.

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Effect of M-cholinoblockers on the Clinical Course of Urinary Incontinence in Patients with an Artifical Bladder

The objective: to study the M-cholinoblockers effect by urinary incontinence after the formation of an artificial bladder and to analyze the effectiveness of pharmacological correction on survival and quality of life. Materials and methods. 114 patients after radical cystectomy with the formation of a neobladder at various stages of the postoperative period involved in the study. The significant urinary incontinence of different degrees, which affected the patient’s quality of life, was determined in 27 (23.7%) persons who were included in solifenacin effect study group. To identify the degree of severity and the dynamics of recovery of the continence function, a questionnaire was conducted among patients who had urinary incontinence during the day and at night. With the help of a comprehensive study on the Delphis KT urodynamic unit, an analysis of urodynamic parameters in urinary incontinence was carried out. Results. After the formation of an artificial bladder, the patients had more stable daytime continence due to mental control over urination and understanding the need to urinate according to time. The situation was more complicated in patients with nocturnal urinary incontinence after radical cystectomy and the formation of an artificial bladder. However, after 2 weeks of treatment with solifenacin, patients had a significant improvement in the function of nocturnal urinary retention. After treatment with solifenacin patients had an improvement in daytime urinary retention by 37.2 % and nighttime urinary retention by 48.9 %. Two-week treatment with solifenacin significantly improved the patient’s quality of life and the dynamics of enterocystomanometry indicators, as evidenced by the results of control studies. The indicator of the subjective sensitivity level increased statistically significantly by 35.24 % compared to the group before treatment and amounted to 304.2±62.1 cm of water column (p≤0.05). The level of the first urge to urinate also increased reliably by 20.4 % – 458.2±81.0 cm of water column (p≤0.05). The level of urge to urinate was 636.1±92.8 ml (p≤0.05), which was statistically significantly higher by 17.5 % compared to patients who did not take solifenacin. Conclusions. The use of M-cholinoblockers in the correction of urinary incontinence in patients with an artificial urinary bladder due to the action on the smooth muscles of the intestines through parasympathetic innervation improves urodynamic indicators and the quality of life of the patients.

Treatment strategies for clozapine-induced nocturnal enuresis and urinary incontinence: a systematic review.

Clozapine is the most effective medication for treatment-refractory schizophrenia but is associated with significant adverse drug reactions, including nocturnal enuresis and urinary incontinence. This side effect can be burdensome and lead to medication nonadherence and psychotic relapse. Evidence to guide treatment of clozapine-induced nocturnal enuresis and urinary incontinence is sparse. We therefore aimed to synthesize the evidence base to guide management for clinicians, patients, and their carers. We systematically searched PubMed, Embase, PsycInfo, CINAHL, and the Cochrane Trial Registry databases from inception to May 2021 for publications on management of clozapine-induced nocturnal enuresis and urinary incontinence using a PROSPERO preregistered search strategy. We identified 22 case reports and case series describing 74 patients. Interventions included clozapine dose reduction, nonpharmacological treatment, and pharmacological treatments. Among pharmacological treatments, desmopressin, oxybutynin, trihexyphenidyl, tolterodine, imipramine, amitriptyline, ephedrine, pseudoephedrine, aripiprazole, and verapamil were associated with complete resolution of nocturnal enuresis and urinary incontinence. Balancing evidence for effectiveness against risk of adverse effects, we developed a management framework for clozapine-induced nocturnal enuresis and urinary incontinence. Following assessment of urological, psychiatric, pharmacological, and common comorbid medical issues, first-line treatments should be nonpharmacological, including bathroom alarms, voiding before bedtime, and nocturnal fluid restriction. If these interventions do not provide adequate relief, aripiprazole should be trialed. Desmopressin may be considered for severe refractory cases, but monitoring for hyponatremia is essential.

Treatment of diabetes insipidus with extracts from the pituitary gland

Prof. D. M. Rossiyskiy (Nauchi. Izv. NKP, 1923, No. 5) observed a case of diabetes insipidus, which developed after a skull injury and was accompanied by stuttering, nocturnal urinary incontinence and testicular atrophy, where pituitary therapy gave a brilliant and persistent therapeutic the effect.

Analysis of the patients' quality of life after radical cystectomy with the orthotopic neobladder or ileal conduit formation

Introduction. Orthotopic neobladder or ileal conduit are the most optimal and common methods of intestinal urine diversion. Nevertheless, there is no consensus in the current literature as to which of these urine diversion techniques provides a better quality of life. Purpose of the study. To conduct a comparative study of the quality of life of patients who underwent radical cystectomy with the formation of an orthotopic neobladder or ileoconduit. Materials and methods. The study included 60 patients (46 men (76.6%) and 14 (23.4%) women) who underwent radical cystectomy (RCE) with intestinal urine diversion. The mean age of the patients was 66 (47 - 85) years. The exclusionary criteria for the study were: neoadjuvant chemotherapy for bladder cancer; preoperative ASA IV - V degree; RCE with intestinal urine diversion not for bladder cancer; the inability to fill out questionnaires assessing the postoperative aspects of the quality of life (QoL) for certain reasons. All patients were divided into 2 groups to allow comparative analysis: Group I — 26 patients (43.3%) underwent RCE with the formation of an orthotopic neobladder according to the Studer method; Group II — 34 patients (56.7%) underwent RCE with the formation of an ileal conduit according to Bricker. The median follow-up period for patients from the completed surgical procedure to the survey was 7 months (4.5 - 9.5 months). The monitoring of the postoperative patients' QoL after RCE was carried out based on the questionnaires: EORTC QLQ-C30, EORTC QLQ-BLM. Also, we carried out a retrospective comparative analysis of early postoperative complications and mortality after RCE in both groups due to Clavien-Dindo classification. Results. The mean time of surgery in Groups I was 280 ± 56.3 min, in Group II — 230 ± 60.8 minutes, (p = 0.117), median blood loss was 350 ml (283 - 380) in Group 1 with 270 (245 - 310) ml in Group 2 (p = 0.213). The frequency of complications according to Clavien-Dindo I - II in the Group 1 was observed in 11 (42.3%) patients, in the Group 2 in 12 (35.2%) patients (p = 0.579), complications according to Clavien-Dindo III - IV in the Group 1 were found in 5 (19.2%) patients while in the Group 2 in 7 (20.5%) patients (p = 0.896). The mortality rate was 8.3% (5 people) and there is no statistically significant difference in the mortality rate in both groups of patients (p = 0.241). Based on the analysis of the QLQ-C30 and QLQ-BLM questionnaire data, we noted that a total of «good» quality of life in the Group 1 was noted by up to 18 (69.2%) patients compared with the Group 2 in up to 15 (44.1%) patients (p < 0.05). At the same time, the predominance of the QoL was observed on all the main scales of the QLQ-C30 questionnaire: the scale of physical condition, cognitive functions, emotional state and social adaptation. According to the results of the QLQ-C30 questionnaire, there were more financial in the group of patients with an ileal conduit. In the postoperative period, the following symptoms prevailed in both groups of patients: nausea, vomiting, weakness and pain. During the analysis of the functional results, we noted that in Group I,4 (15.3%) patients had nocturnal and daytime urinary incontinence, 2 (7.6%) patients required self-catheterization of the intestinal reservoir periodically, in Group II — 8 (23.5%) patients report urine leakage from the urostomy and skin dermatitis periodically. Conclusion. Despite the fact of worldwide recognition as a result of the preferences of surgeons in favour of the ileal conduit formation by the Bricker technique during RCE, urine diversion using orthotopic neobladder demonstrates better results with analysis of QoL in our patients. Obviously, long-term studies with a large sample of patients are required to obtain more reliable results of a QoL evaluation after RCE with intestinal urine diversion.

Function of the orthotopic urinary reservoir formed from the ileocecal angle in the long term after radical cystectomy in women

Objective: to study the long-term functional results of creating an orthotopic urinary reservoir from the ileocecal angle in comparison with the Studer technique of creating a urinary reservoir after radical cystectomy in women. Materials and methods. From 2004 to 2018 radical cystectomy for bladder cancer was performed in 120 women. In 71 (59.2 %) patients, an orthotopic urinary reservoir was formed: 48 (67.6 %) from the ileum, 23 (32.4 %) from segments of the colon. This study included 11 patients who had a reservoir formed from the ileocecal angle, including by their own modification, and 13 patients who had a reservoir forme by Studer. The average age of the patients was 62.6 ± 2.6 (29—82) years. The average follow-up time was 77.1 ± 10.5 (19—184) months. The presence and degree of urinary incontinence was assessed using a questionnaire and a Pad test. 12 months or more after the operation, a complex urodynamic study was performed. Results. The overall 5-year survival rate was 92.3 %: in the Studergroup it was 90.9 %, in the ileocecal angle group it was 100 % (p = 0.317). In the general population of patients, 37.5 % were completely continent. Women after plastic surgery by Studer retained urine better than after plastic surgery by ileocecal angle (46.2 % vs 27.3 %), the difference was only for mild urinary incontinence, which was more common in the ileocecal angle group. The frequency of severe urinary incontinence in both groups was the same. Nocturnal urinary incontinence was more common in patients in the Studer group (46.2 %). In the group of patients with ileocecal angle plastic surgery, there was no chronic urinary retention requiring intermittent catheterization, and in the group of Studer plastic surgery — in 1 (7.7 %) case. Analysis of urodynamic parameters revealed the presence of a greater physiological capacity of the urinary reservoir in the group of patients after plastic surgery according to Studer (p = 0.043). In the group of patients with ileocecal angle plastic surgery, higher values of the maximum pressure of the reservoir wall, “leakage pressure” and maximum expulsion pressure are observed, possibly associated with a more pronounced muscle layer of the intestinal segment used. Conclusion . The functional results of the orthotopic reservoir formedfrom the ileocecal angle are comparable to the results of urine derivation using the classical Studer method. Complex urodynamic study showed a direct influence of various characteristics of the reservoir on the nature and degree of urination disorders in patients.

Man With Nocturnal Urinary Incontinence

Man With Nocturnal Urinary Incontinence

Validation of the effectiveness of a modified Studer orthotopic neobladder in a single center after 3 years of its application.

In this study, we reported the 2 years outcomes of orthotopic neobladder diversion according to the Studer modified technique described by Bianchi G. et al. This technique improves the stability of the reservoir and the urine-storage capacity. After radical cystectomy, urinary diversion is created with a spheroidal-shaped reservoir with a conic distal-part, obtained with 40 cm detubulized ileal segment, and a 15 cm of tubular afferent limb, where a Wallace ureteral anastomoses is made. The conic distal part of the neobladder that is anastomized to the urethral stump. After the reconstructive part, the neobladder and the afferent limb are attached to the elevator ani and psoas muscles, respectively. In all, 18 patients underwent radical cystectomy with the reconstruction of urinary diversion with the Modified-Studer Orthotopic technique, at S. Giuseppe Hospital. We studied the post-operative years of follow-up, especially with anamnesis of lower urinary tract, axial computerized tomography, and blood tests, according to the EAU guidelines. We discover with TC 2 cases of low-grade bilateral hydronephrosis, associated with a slight increase in creatinine levels (1.4-1.8 mg/dL). No stricture at the neobladder-urethral anastomosis was detected. Three patients complain daytime urinary incontinence; only two patients report nocturnal urinary incontinence. One patient underwent ureteroscopy for lithiasis and 1 patient died for non-onco-urological disease. The modifications we applied to the Studer-Neobladder seems to improve urinary tract restoration, potentially decreasing long-term complications like hydronephrosis connected to ureteral anastomotic stenosis (11.1% vs 16.9% reported in literature) and urinary retention (0% vs 12% reported in literature). However, we discovered the same risk of diurnal and nocturnal incontinence reported in literature for the classic Studer Neobladder.

КОМПЛЕКСНАЯ ДИАГНОСТИКА И ЛЕЧЕНИЕ НЕДЕРЖАНИЯ МОЧИ У ДЕТЕЙ

The article discusses the diagnosis and treatment of urinary incontinence in children. The etiological factors of urinary incontinence in children are considered in detail. Practical recommendations are given to doctors on the choice of approaches to diagnosis and effective medications for treatment and pharmacological methods of therapy. As one of the effective medications for the treatment of monosymptomatic nocturnal urinary incontinence, the drug Driptan (oxybutynin hydrochloride) is recommended.

Comparative response of Desmopressin versus Combination Therapy (Desmopressin + Oxybutynin) in Children with Nocturnal Enuresis.

Objective:To assess the safety as well as efficacy of desmopressin monotherapy alone and in combination (desmopressin + oxybutynin) in treating nocturnal urinary incontinence among children with 7 to 13 years.Methods:This randomized controlled trial has been carried out in National Institute of Child Health from September 2018 to March 2019 with the utilization of convenient sampling technique. Data has been collected after taking ethical approval and informed consent of the Parents with complete confidentiality. The sample size was 84 and equal number of patients was divided in two groups. Group-I was given desmopressin at monotherapy at a dose of 0.2 mg and Group-II was given desmopressin and oxybutynin at the dose of 0.2 mg desmopressin and 5 mg oxybutynin patients were diagnosed on the basis of history. Routine lab investigation included Urine DR and ultrasound abdomen.Results:In this study significant differences between two groups were found with respect to socio economic status, lack of education of parents (P Less than 0.05). The frequency, urgency and incontinence of this ailment was significantly controlled by combination therapy (desmopressin + oxybutynin) as compared to desmopressin as monotherapy (P Less than 0.05) as patient was followed after one, two and three monthly basis.Conclusion:Desmopressin combination with oxybutynin is more effective as compared to monotherapy treatment. The affectivity of the combination therapy was very high with least side effects and all the children recovered from the condition at third month of treatment. Furthermore, headache was observed to be common with monotherapy and loss of appetite was observed with combination therapy.

The short-term effects of tolterodine on nocturnal incontinence after ileal orthotopic neobladder: a randomised crossover placebo-controlled study.

To assess the effect of tolterodine in the treatment of nocturnal urinary incontinence (NUI) after ileal orthotopic neobladder (ONB). This is a prospective randomised placebo-controlled crossover study (clinicaltrials.gov: NCT02877901). Patients with NUI after ONB were randomly allocated into two equal groups. Group T received 4mg extended-release tolterodine at bed-time and Group P received placebo for 4weeks followed by 2weeks of washout, then crossed over to the alternate therapy for 4weeks. Patients were assessed by the number of pads used per night (PPN) and with the Arabic version of the International Consultation on Incontinence Modular Questionnaire-Short Form (ICIQ-SF) at both phases of the study. The outcomes were the rate of NUI improvement and medication adverse events. Out of 172 patients, 150 and 122 patients were evaluated at both phases of the study. The mean ICIQ-SF scores and PPN were significantly decreased in Group T compared to Group P in both study phases (P<0.001). In Group T, 15 (10%) and 11 (9%) patients became dry after the first allocation and crossover, respectively. In Group T, 60 (77.9%) patients reported improvement vs four (5.5%) in Group P (P<0.001) after the first allocation. Similarly, 46 (73%) and seven (11.9%) patients showed improvement in groups T and P after the crossover, respectively (P<0.001). Dry mouth occurred in 31 (20.8%) patients. Tolterodine seems to be a good choice for treatment ofNUI after radical cystectomy and ONB. However,furtherstudies are needed to delineate the long-term effects and the associated urodynamic characteristics.

Use of Body Sensors to Examine Nocturnal Agitation, Sleep, and Urinary Incontinence in Individuals With Alzheimer's Disease.

Nighttime agitation, sleep disturbances, and urinary incontinence (UI) occur frequently in individuals with dementia and can add additional burden to family caregivers, although the co-occurrence of these symptoms is not well understood. The purpose of the current study was to determine the feasibility and acceptability of using passive body sensors in community-dwelling individuals with Alzheimer's disease (AD) by family caregivers and the correlates among these distressing symptoms. A single-group, descriptive design with convenience sampling of participants with AD and their family caregivers was undertaken to address the study aims. Results showed that using body sensors was feasible and acceptable and that patterns of nocturnal agitation, sleep, and UI could be determined and were correlated in study participants. Using data from body sensors may be useful to develop and implement targeted, individualized interventions to lessen these distressing symptoms and decrease caregiver burden. Further study in this field is warranted. [Journal of Gerontological Nursing, 44(8), 19-26.].

Clinical study of effectiveness and safety of CELcomplex® containing Cucurbita Pepo Seed extract and Flax and Casuarina on stress urinary incontinence in women

AimThe safety and effectiveness of a preparation containing a mix of Cucurbita Pepo Seed extract, Equisetum arvense and Linum usitatissimum - Flax A (CELcomplex®) on stress urinary incontinence (SUI) was evaluated in female patients recruited from 20 urological and gynaecological outpatient clinics in Slovakia. MethodsA total of 86 women aged from 32 to 88 with SUI (grade 1 = 44, grade 2 = 42) were enrolled in the study and followed-up for six weeks (point 1) and twelve weeks (point 2). The primary outcome of the study was evaluated by changes in day-time and nocturnal urinary frequency (bathroom visits) and urinary incontinence episodes (leaks). Also, adverse events were quantified as well as the self-perceived effectiveness of the treatment. Research Ethics Board approval was obtained for this study. ResultsAfter 12 weeks of treatment there was a 30% (grade 1 SUI, p < 0.01), and 35% (grade 2 SUI, p < 0.01) improvement in urinary incontinence episodes, a 40% (grade 1 SUI, p < 0.01) and 26% (grade 2 SUI, p < 0.01) improvement in day-time urination frequency and 64% (grade 1 SUI, p < 0.01) and 54% (grade 2 SUI, p < 0.01) improvement in nocturnal urinary frequency. Reported side effects were: headache (3.5%), flatulence (4.1%) and gastrointestinal discomfort (3%). A total of 89.4 % of women in the study reported no side effects from this therapy and 97% acknowledged improvement of symptoms. ConclusionThis clinical study demonstrated that a 12 week treatment with a mix of Cucurbita Pepo Seed extract, Equisetum arvense and Linum usitatissimum - Flax A (CELcomplex®) is highly effective on stress urinary incontinence (SUI) with minimum adverse events. Further studies may be needed in order to determine the effectiveness and efficacy of this phytotherapy in other populations.

Pathophysiology of nocturnal lower urinary tract symptoms in older patients with urinary incontinence.

To explore the mismatch between functional bladder capacity and nocturnal urine production, and to study the pathophysiology of an increased nocturnal urine production in older patients with urinary incontinence. The present prospective observational study included adults aged ≥65years with urinary incontinence. Participants completed questionnaires, frequency volume charts and renal function profiles. The nocturnal lower urinary tract symptom index was defined as nocturnal urine output/maximum voided volume; the nocturnal polyuria index as nocturnal/24h urine output. The median age (n=95) was 74years (69-79), 87% were women and 73% had nocturnal lower urinary tract symptoms (nocturnal urinary incontinence or nocturia ≥2). Participants with nocturnal lower urinary tract symptoms had a significantly higher nocturnal urine output (809mL vs 650mL; P=0.001) and no significant difference in maximum voided volume (350mL vs 437mL; P=0.079) compared with participants without nocturnal lower urinary tract symptoms. Participants (nocturnal polyuria index >33% [n=56], nocturnal polyuria index >40% [n=42], nocturnal lower urinary tract symptom index >1.87 [n=51]) showed higher night-time diuresis rates, free water and sodium clearance compared with during the daytime. Controls (nocturnal polyuria index ≤33% [n=26], nocturnal polyuria index ≤40% [n=40], nocturnal lower urinary tract symptom index ≤1.87 [n=44]) had no circadian rhythm in their diuresis rate or sodium clearance, but more nocturnal free water clearance compared with during the daytime. The majority of older adults with urinary incontinence present nocturnal lower urinary tract symptoms. An increased nocturnal sodium diuresis seems to be the only mechanism differentiating patients with nocturnal lower urinary tract symptoms from controls.

Comparison of Development Indicators, According to Ages and Stages Questionnaires in Children with Pollakiuria Compared to Healthy Children

Background: Children with pollakiuria have extraordinary daytime urinary frequency, which means urination every 15 to 20 minutes per day, without nocturnal enuresis, urinary incontinence, dysuria, and UTIs. This can be associated with developmental disorders. Therefore, this study aimed at evaluating the effect of Pollakiuria on developmental disorders. Methods: A total of 224 individuals were included in this study. The age range was 5 to 7 years old and 70 patients with Pollakiuria were allocated to the case group and 154 healthy individuals were included in the control group. Height, weight, and Body Mass Index (BMI) were measured and were compatible with gender and age. The following information was also recorded, personal and social development, problem solving, fine motor, gross motor, communication, defining words, understanding of contradictory words, counting numbers, names of colors, copying forms of □ and Δ, and walking on toes, which were obtained by the ages and stages questionnaires (ASQ) and nelson development table. Results: From a total of 224 children, factor expressing growth and development condition in the case group was significantly less than the control group (P = 0.001). Conclusions: Development indicators, according to ages and stages questionnaires, in healthy children had a better status compared to children with Pollakiuria.

Urinary tract infections in children

Urinary tract infections (UTI) are the most common bacterial infections in children. The symptoms are not very specific and range from abdominal pain, poor feeding to nocturnal urinary incontinence. The technique of collecting urine plays an important role for securing the diagnosis. The best way to obtain urine in non-toilet-trained children is catheterization or suprapubic bladder aspiration. In toilet-trained children midstream urine is an acceptable alternative after cleaning the foreskin or labia. In the case of an infection aprompt empirical antibiotic therapy is necessary to reduce the risk of parenchymal scarring of the kidneys. There are different approaches to diagnose vesicoureteral reflux in different countries. The commonly used standard approach in Germany is voiding cystourethrography. In the case of reflux dimercaptosuccinic acid (DMSA) scintigraphy should beperformed additionally to exclude renal scarring (bottom-up approach).

Nocturnal Urinary Disorders and Multiple Sclerosis: Clinical and Urodynamic Study of 309 Patients

The aim of this study was to describe nocturia with or without leakage in a population of patients with multiple sclerosis. This is a retrospective, single center study of 309 patients with multiple sclerosis who were followed at an experienced neurourology center between 2011 and 2013. All patients had daytime urinary symptoms associated with this disorder. Among the patients with nocturia 2groups were defined, including those with isolated nocturia but without nocturnal urinary incontinence and patients with nocturia associated with nocturnal urinary incontinence. The control group comprised patients without nocturia. The clinical variables and urodynamic data studied were gender, age, EDSS (Expanded Disability Status Scale), the USP (Urinary Symptoms Profile) questionnaire overactive bladder score, bladder capacity, detrusor activity and volume at the first detrusor contraction. Of our patients 53.3% had nocturia, including 35.7% with nocturnal urinary incontinence. The average ± SD USP overactive bladder score was statistically greater in patients with nocturia than in controls (9.14 ± 4.3 vs 5.1 ± 3.5, p = 8.21E-17). Mean maximum cystometric capacity was statistically higher in the control group than in patients with nocturia (380.17 ± 113.79 vs 313 ± 128.4 ml, p = 5.60E-6). A similar outcome was found for the first contraction (mean 232.58 ± 146.05 vs 181.14 ± 100.11 ml, p = 0.041). Isolated nocturia or nocturnal urinary incontinence is a frequent problem encountered with multiple sclerosis. Our results suggest that an overactive detrusor is the main mechanism. Further studies are needed to verify the complications arising from nocturia.

Postoperative urinary incontinence exacerbates nocturia-specific quality of life after robot-assisted radical prostatectomy.

To elucidate the effect of postoperative urinary incontinence on nocturia-related quality of life after robot-assisted radical prostatectomy. A total of 100 consecutive patients who underwent robot-assisted radical prostatectomy completed a nocturia quality of life questionnaire score and a frequency-volume chart before and after surgery. These patients were divided into two groups by continence status (continent and incontinent) according to the number of pad exchanges per day and the 1-h pad test after surgery. Assessment was carried out before surgery, and then at 3 and 12 months after surgery. The Nocturia Quality of Life questionnaire total score and the Bother/Concern subscore were significantly lower in incontinent patients at 3 and 12 months after surgery (Nocturia Quality of Life questionnaire total score: Bother/Concern subscores P = 0.006: P = 0.04 at 3 months after surgery; and P = 0.04: P = 0.02 at 12 months). Both nocturnal maximum voided volume and nocturnal frequency were not significantly different between continent and incontinent patients. On multivariate analysis, nocturnal urinary frequency (P = 0.01) and urinary incontinence (P = 0.005) were significantly associated with nocturia-specific quality of life. Although the number of nocturia episodes was not significantly different between the continent and incontinent patients after surgery, the Nocturia Quality of Life questionnaire score was significantly worse in incontinent patients. In these patients, other than the number of nocturia episodes, psychological stress might worsen the Nocturia Quality of Life questionnaire score. Therefore, prevention of post-prostatectomy incontinence might be important to avoid aggravating the Nocturia Quality of Life questionnaire score.

A Rare Case of Nocturnal Urinary Incontinence and Menuria after Lower Segment Cesarean Section

ABSTRACT Misgav Ladach technique for lower segment cesarean section (LSCS) is considered advantageous universally, but debate still continues about nonclosure in layers and further consequences; hence, careful selection of cases and intraoperative decision of closure in layers is important. The classical Youssef's syndrome comprises cyclic hematuria, amenorrhea, menuria, and complete urinary continence in a patient who had LSCS. Hereby, we present a case report of a woman who suffered with chronic pelvic pain, menuria, and nocturnal eneuresis after her LSCS for obstructed labor, although not exactly the same as Youssef syndrome but rare in occurrence and relieved after adhesiolysis and gonadotropin-releasing hormone (GnRH) analog therapy. How to cite this article Chaudhry P, Shrivastava DS, Bhute S, Jajoo S. A Rare Case of Nocturnal Urinary Incontinence and Menuria after Lower Segment Cesarean Section. J Med Sci 2016;2(1):23-25.

A Rare Case of Nocturnal Urinary Incontinence and Menouria after Lower Segment Cesarean Section

A Rare Case of Nocturnal Urinary Incontinence and Menouria after Lower Segment Cesarean Section