Treatment Of Urinary Disorders Research Articles

Ongenital Medullary Malformations and Urinary Disorders: The Contribution of Urodynamic Assessment in the Diagnostic, Prognostic and Theurapeutic Approach in the Light of Recommendations and The Literature

Congenital medullary malformations or spinal dysraphisms are anomalies in the closure of the neural tube affecting the spinal column and the spinal cord. The cause is usually multifactorial. The main cause of morbidity and mortality in these children is renal deterioration. This is the main cause of neurological bladder in children. Urinary management must begin early, from the neonatal period, with the aim of preserving the urinary tract and renal function, as vesico-sphincter imbalance is the cause of renal deterioration and may therefore be life-threatening for these children. Urodynamic investigation is the key examination for analysing the functioning of the lower urinary tract and proposing a course of treatment based on the mechanisms of vesicosphincter dysfunction. There are still very few publications on urodynamics in children. Although urodynamic exploration techniques differ little from those used in adults, the pathophysiology of bladder and bowel function in infants is specific to this age group. This article reviews the literature to demonstrate the value of urodynamic testing in the diagnosis and treatment of urinary disorders in congenital medullary malformations.

PREPARATION AND QUALITY EVALUATION OF A POLYHERBAL FORMULATION: KARKATI BEEJ CHURNA.

Herbal medicines, made up of different plants materials are used world wide to treat various disorders and are widely accepted by large number of population. But due to climatic changes and lack of knowledge w.r.t identification and preparation of the drugs, it is essential that quality evaluation of herbal medicines must be carried out to manifest the drug as potent and safe. Karkatibeej churna is an ayurvedic herbal formulation which is used in the treatment of urinary disorders. The present study focusses on the quality evaluation of Karkati beej churna w.r.t. parameters like organoleptic chracteristics, physicochemical parameters, microscopic evaluation, phytochemical screening and chromatographic profiling. A Thin layer chromatographic profile was obtained for saponins as saponins are considered as one of the plant diuretics. The results thus obtained for all the above mentioned parameters can be used for future references.

Anti-nociceptive and Anti-inflammatory Activities of Crotalaria pallida Aiton (Fam: Fabaceae) Leaves

The present study was designed to evaluate the anti-nociceptive and anti-inflammatory properties of the ethanolic extract of Crotalaria pallida Aiton (Family: Fabaceae) leaves based on its traditional uses in the treatment of urinary disorders, external application as a poultice to treat painful swelling of joints and to reduce fever. The anti-nociceptive effect was assessed in mice using acetic acidinduced writhing, formalin-induced paw licking and tail immersion assays. Anti-inflammatory activity was evaluated by carrageenan induced paw oedema in rats. In acetic acid-induced writhing test, the extract at different doses (50 mg/kg and 100 mg/kg bw) significantly (p<0.001) and dose-dependently reduced pain by 37.50% and 47.70%, respectively. The extract also significantly inhibited formalininduced paw licking in mice at both the early and late phases. In the tail immersion test, the extract caused a significant inhibition of pain (64.91% inhibition after 4 hrs) at a dose of 100 mg/kg. C. pallida exhibited a considerable inhibition of paw oedema development in the carrageenan-induced oedema test. The findings of the study suggested that C. pallida leaves have significant anti-nociceptive and antiinflammatory effects, confirming the traditional uses of this plant in the treatment of various diseases associated with pain and inflammation.Bangladesh Pharmaceutical Journal 20(2): 165-171, 2017

Recommendations for the management of urinary disorders in multiple sclerosis: a consensus of the Italian Multiple Sclerosis Study Group

Urinary disorders are uncommon in the initial phases of multiple sclerosis, but increase in frequency as the disease progresses, with a negative impact on quality of life. The goal of this study was to propose a protocol for the diagnosis and treatment of urinary disorders in multiple sclerosis, based on data from the scientific literature and the experience of Italian clinical centres. In particular, the following clinical aspects were considered: what to do with patients with asymptomatic multiple sclerosis; what to do with symptomatic patients; how and when to perform a second-level diagnostic evaluation; and how to treat urinary disorders. A diagnostic-therapeutic algorithm is proposed, that can be applied in Italian clinical centres.

Crataeva nurvala: A Valuable Medicinal Plant

Crataeva nurvala Buch. Ham. (Capparaceae) is a high-value medicinal tree that grows almost all over India, especially in the semiarid regions. Medicinal usage has been reported in traditional systems of medicine, such as Ayurveda and Unani, wherein the plant is frequently preferred in the treatment of urinary disorders that reoccur owing to development of antibiotic resistance by the infecting organism. C. nurvala has also been used in the treatment of prostate enlargement and bladder sensitivity. The plant is known to relieve, prevent, and promote the discharge of kidney stones. Lupeol, a pentacyclic triterpene isolated from the root bark, has been shown to significantly minimize the deposition of stone-forming constituents in kidneys. Investigations have also indicated the plant has anti-arthritic, hepatoprotective, and cardio-protective actions. These multiple uses of C. nurvala along with erratic seed germination, destructive harvesting, and habitat loss from deforestation have endangered survival of the plant. As a result of this endangerment, in India the plant has been categorized as rare or vulnerable in the natural environment, making conservation of this plant crucial. This review briefly examines the biological activities, pharmacological actions, clinical studies, and medicinal applications of C. nurvala to provide direction for further research.

Diabetes influences the effect of 17β-estradiol on mechanical responses of rat urethra and detrusor strips

Estrogen deficiency is one of the factors involved in the stress incontinence in postmenopausal women, and estrogens have been used clinically in the treatment of urinary disorders during menopause. Sex hormones seem to be also involved in the diabetic changes of urinary bladder and urethra, because ovariectomy causes an increase in the micturition of streptozotocin-diabetic rats. In the present study diabetic and healthy female rats were used to investigate the effect of 17beta-estradiol on mechanical contractions to norepinephrine and to KCI and relaxations to ATP on isolated proximal urethral preparations as well as on contractions to ACh, ATP and KCl on detrusor smooth muscle strips. The data were compared with those obtained in OVX animals, with or without estradiol replacement. The present study showed that ovariectomy decreased the responses to ATP, NE and KCl in urethral preparations, and responses to ATP, ACh and KCl in bladder strips from both healthy and diabetic rats. Diabetes appeared to potentiate the effect of ovariectomy in both tissues. Estrogen replacement was able to recover functional responses in urethras of healthy rats. In diabetic rats, this treatment partially restored ATP-induced responses in both tissues, almost completely restored those to NE in urethra and those to ACh in bladder. This study clearly indicated that abnormalities of urethra and bladder function caused by ovariectomy can be restored by estrogen treatment also in diabetic animals, at least at an early stage of disease.

Effect of cromakalim on the purinergic and cholinergic transmission in the rat detrusor muscle

Contraction of the rat detrusor muscle is mediated by cholinergic and purinergic mechanisms. The present study was carried out to look at the influence of cromakalim, compared with atropine, suramin and nifedipine on the contractile response evoked by single shock and exogenous agonists (carbachol and ATP) in rat urinary bladder. Cromakalim was able to inhibit only partially the response to carbachol and profoundly affected the response to exogenous ATP. Atropine suppressed the response to carbachol and was inactive versus ATP. Suramin was inactive versus carbachol and was able to antagonize the response to ATP. Nifedipine proved to be a non-competitive antagonist versus carbachol (p D 2=7.66±0.05) and deeply affected the response to ATP. Cromakalim inhibited only partially the first, purinergic, phase of the electrically evoked response but was able to inhibit in a concentration-dependent manner the second, cholinergic, phase (log IC 50=6.87±0.05). Nifedipine blocked both the phases. Atropine blocked partially only the second phase. Suramin inhibited the first phase but, at least partially, also the second one. The combination of atropine and suramin enhanced the inhibition of the second phase. The antagonistic effect of suramin on the second phase could indicate an overlap of the purinergic and cholinergic components. The comparison between pre- and postjunctional effects indicates that cromakalim acts on purinergic transmission predominantly postjunctionally. On the contrary, the action on cholinergic transmission seems to occur mainly at prejunctional level. This conclusion can be relevant in view of the claimed importance of K + channel openers in the treatment of urinary disorders.