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Pediatric Neurogenic Bladder Dysfunction by Ciro Esposito,Jean Michel Guys,David Gough,Antonio Savanelli Pdf
This book provides a leading international reference on the diagnostic and therapeutic approach to the pediatric patient with urinary problems due to spinal cord pathologies. It represents a unique guide for specialists involved in the management of this pathology. The text is well illustrated with figures.
Neurogenic bladder and bowel dysfunction by Peter Wide Pdf
Spinal dysraphism (SD) is a congenital malformation that to a varying extent, often severely, affects the life of the child and the family. Most individuals with SD suffer from neurogenic bladder and bowel dysfunction—with the risk of urinary tract infections, renal deterioration, urinary and fecal incontinence—that affects social participation and quality of life negatively. In newborns with SD, early detection of neurogenic bladder dysfunction and determination of post-void residual urine are required to determine the need of clean intermittent catheterization (CIC) and follow-up. The non-invasive method of four-hour voiding observation with provocation test (VOP) was used to evaluate bladder function in 50 newborn children with SD. Voiding patterns for the children were described and compared with those of 50 healthy newborns evaluated with VOP in an earlier study. Comparison revealed significant differences among several variables. In particular, leakage at provocation test and not voiding with a stream were common in newborns with SD but did not occur in healthy newborns. VOP is a non-invasive standardized method to determine residual urine in newborns with SD. It also adds information on voiding pattern, frequency, voiding with a stream and leakage at provocation. Findings in neonatal VOP of the same cohort of newborns with SD were then related to radiology, presence of urinary tract infections during the first year, and urodynamic findings and use of CIC at the age of one year. It was found that, in children with SD, not voiding with a stream may have a predictive value for the need of CIC at the age of one year, followed probably by lifelong CIC. Despite this, the presence of an open SD per se has stronger predictive value, and each child needs to be evaluated individually while considering a number of factors. The main value of VOP may be as a structured non-invasive screening method to uncover neurogenic bladder-sphincter dysfunction in the newborn. Studies with a larger number of subjects than the present are needed to evaluate the potential of VOP in newborns with closed spinal dysraphism in whom the neurological consequences vary. A retrospective analysis detected renal damage on DMSA scintigraphy in 5 of 41 children with SD who were followed according to a proactive national program with minimal use of surgery. Median follow-up time was 10 years. High baseline pressure was confirmed as a risk factor for renal damage. Compliance with treatment and follow-up is likely to be an important factor for renal health. Therefore, efforts to support children and their families are crucial. A questionnaire-based study of 107 children with SD (age 6–16y) in Sweden and Norway examined aspects of treatment for neurogenic bowel dysfunction focusing on incontinence, independence, general satisfaction and quality of life. It was found that transanal irrigation (TAI) and antegrade colonic enemas (ACE) are effective treatments, but are time-consuming and difficult to perform independently. The majority of children using TAI (72%) and ACE (63%) never went to the toilet alone to empty their bowels. As children achieving independence on the toilet reported higher quality of life, efforts to support independence are beneficial. Continent, self-managing children with healthy kidneys enjoy high quality of life and contribute more fully to society. Therefore, further research is required to investigate and develop existing and new technologies and methods that mitigate the problems related to SD, and to make them accessible to all children with spinal dysraphism. Under de senaste 50 åren har det skett en enastående utveckling av möjligheterna för barn som föds med ryggmärgsbråck. Tidigare har majoriteten av barn med ryggmärgsbråck avlidit redan som spädbarn men idag överlever de flesta till vuxen ålder. Utan aktiva insatser och uppföljning är dock risken för medicinska problem och allvarlig påverkan på livet mycket stor. Nu när nästan alla barn överlever ligger fokus på att också nå okad livskvalitet och självständighet för personer med ryggmärgsbråck. Nästan alla med ryggmärgsbråck måste hantera en allvarlig påverkan på blåsan och tarmen med risk för njurskador, inkontinens och förstoppning. I avhandlingens två första studier värderade vi en metod att, med minimalt obehag för barnet, bedöma blåsfunktionen. Detta för att kunna skilja ut de barn som behöver genomgå mer avancerade undersökningar och få hjälp med blåstömningen genom täta tappningar med kateter, sa kallad ren intermittent kateterisering, RIK. När vi jämförde resultatet av testet för 50 nyfödda med ryggmärgsbråck med samma undersökning av 50 friska nyfödda fann vi stora skillnader. Mest tydligt var att de flesta nyfödda med ryggmärgsbråck (69%) men inga friska nyfödda läckte urin när man tryckte över blåsan. Av nyfödda med ryggmärgsbråck kissade de flesta (74%) inte med stråle vilket alla friska nyfödda gjorde. Att inte kissa med stråle talade också starkt för att barnet skulle komma att behöva hjälp med RIK för att tomma blåsan vid ett ars ålder, och då sannolikt livet ut. Sammantaget visade avhandlingens två första arbeten att den metod för bedömning av blåsfunktion vi undersökt kan användas för att styra uppföljning och behandling av nyfödda med ryggmärgsbråck. Avhandlingens tredje studie visade att aktiv uppföljning av barnen enligt ett nationellt vårdprogram lyckades förhindra njurskador hos de flesta, men att höga tryck i urinblåsan och återkommande urinvägsinfektioner ökade risken för skador. Även familjernas förmåga att i en pressad vardag klara av att genomföra de ofta krävande behandlingar och undersökningar som rekommenderas verkade vara viktig för att förhindra njurskador. Stöttning av familjerna är därför viktig. Avhandlingens fjärde arbete berörde tarmen som nästan alltid är påverkad vid ryggmärgsbråck, med risk för svår förstoppning och avföringsläckage. Detta har påtaglig påverkan på barnen och deras familjer. En tredjedel av de 107 familjerna i vår enkätundersökning i Sverige och Norge (barn 6-16 år) beskrev att man fått avstå från aktiviteter såsom resor på grund av barnets tarmproblem och de barn som hade avföringsläckage rapporterade tydligt lägre livskvalitet än andra. Trots denna allvarliga påverkan finns det hittills inga studier som jämför de olika behandlingar som barnet kan använda. I vår enkät kartlade vi därför vilka metoder som användes och hur bra de fungerade. Vi ställde frågor till både barn och föräldrar, särskilt om avföringsläckage, hur nöjd man var med metoden, barnens livskvalitet och självständighet på toaletten. Det var utifrån svaren tydligt att båda de vanligaste typerna av tarmsköljning var effektiva men tidskrävande och svara för barn och ungdomar att klara att utföra på egen hand. Ingen metod visade sig överlägsen den andra men de barn som klarade att skota tarmtomningen själva skattade sin livskvalitet klart högre än övriga. Vi drar därför slutsatsen att det är viktigt att vårdpersonal diskuterar de olika behandlingsalternativen med barn och föräldrar, och tillsammans med dem väljer den metod som passar det enskilda barnet bäst. Då skapas bästa förutsättningar för att gemensamt arbeta vidare för att uppnå största möjliga självständighet. Självständiga individer, med friska njurar och utan urin- och avföringsinkontinens upplever högre livskvalitet och behöver mindre sjukvård och andra samhällsinsatser. Det behövs mer forskning för att utveckla existerande och nya metoder att hantera de allvarliga komplikationer som riskerar att drabba barn och vuxna med ryggmärgsbråck.
Pediatric Incontinence by Israel Franco,Paul Austin,Stuart Bauer,Alexander von Gontard,Yves Homsy Pdf
Pediatric incontinence: evaluation and clinical management offers urologists practical, 'how-to' clinical guidance to what is a very common problem affecting up to 15% of children aged 6 years old. Introductory chapters cover the neurophysiology, psychological and genetic aspects, as well as the urodynamics of incontinence, before it moves on to its core focus, namely the evaluation and management of the problem. All types of management methods will be covered, including behavioural, psychological, medical and surgical, thus providing the reader with a solution to every patient's specific problem. The outstanding editor team led by Professor Israel Franco, one of the world’s leading gurus of pediatric urology, have recruited a truly stellar team of contributors each of whom have provided first-rate, high-quality contributions on their specific areas of expertise. Clear management algorithms for each form of treatment support the text, topics of controversy are covered openly, and the latest guidelines from the ICCS, AUA and EAU are included throughout. Perfect to refer to prior to seeing patients on the wards and in the clinics, this is the ideal guide to the topic and an essential purchase for all urologists, pediatric urologists and paediatricians managing children suffering from incontinence.
Neuropathic Bladder in Childhood by M. Borzyskowski,A. R. Mundy Pdf
This is the first book to cover comprehensively all aspects of the management of the neuropathic bladder in the pediatric age group. The most recent advances in the assessment and management of these children are fully discussed. The reader is taken logically through the neurology and diagnosis of neuropathic bladder, investigations, and indications for surgical and nonsurgical intervention. There are sections on the management of infection, renal problems, constipation, and sexual problems, and there is a review of the psychological problems encountered by these children and their families.
Neuro-Urology by Roger Dmochowski,John Heesakkers Pdf
This volume is a useful handbook for medical doctors involved in the diagnosis and treatment of neuro-urological problems. The first section reviews the relevant neuro-anatomy and neuro-physiology and provides a practical overview of specific neuro-urological pathologic conditions. The second section discusses the various clinical entities that can be encountered and focuses on the clinical entities neuro-urological consquences. The third section is devoted to the different diagnostic possibilities. Internationally accepted algorithms are presented and put into perspective. Section 4 deals with the triad of major clinical problems in this area: urinary (incontinence, retention and voiding dysfunction as well as upper urinary tract problems), anorectal (faecal incontinence and constipation) and sexual (erectile dysfunction and ejaculatory failure) dysfunctions. The final section covers the specific management of patients with neuro-urological problems and describes conservative and surgical treatments, providing the most recent information. Throughout, the text is accompanied by numerous illustrated case reports and discussions as well as tips and tricks based on the personal experience of the different authors.
Cerebral Palsy by Freeman Miller,Steven J. Bachrach Pdf
When a child has a health problem, parents want answers. But when a child has cerebral palsy, the answers don't come quickly. A diagnosis of this complex group of chronic conditions affecting movement and coordination is difficult to make and is typically delayed until the child is eighteen months old. Although the condition may be mild or severe, even general predictions about long-term prognosis seldom come before the child's second birthday. Written by a team of experts associated with the Cerebral Palsy Program at the Alfred I. duPont Hospital for Children, this authoritative resource provides parents and families with vital information that can help them cope with uncertainty. Thoroughly updated and revised to incorporate the latest medical advances, the second edition is a comprehensive guide to cerebral palsy. The book is organized into three parts. In the first, the authors describe specific patterns of involvement (hemiplegia, diplegia, quadriplegia), explain the medical and psychosocial implications of these conditions, and tell parents how to be effective advocates for their child. In the second part, the authors provide a wealth of practical advice about caregiving from nutrition to mobility. Part three features an extensive alphabetically arranged encyclopedia that defines and describes medical terms and diagnoses, medical and surgical procedures, and orthopedic and other assistive devices. Also included are lists of resources and recommended reading.
Evidence-based Urology by Philipp Dahm,Roger Dmochowski Pdf
An updated and revised resource to evidence-based urology information and a guide for clinical practice The revised and updated second edition of Evidence-Based Urology offers the most current information on the suitability of both medical and surgical treatment options for a broad spectrum of urological conditions based on the best evidence available. The text covers each of the main urologic areas in specific sections such as general urology, oncology, female urology, trauma/reconstruction, pediatric urology, etc. All the evidence presented is rated for quality using the respected GRADE framework. Throughout the text, the authors highlight the most patient-important, clinical questions likely to be encountered by urologists in day-to-day practice. A key title in the “Evidence-Based” series, this revised and expanded edition of Evidence-Based Urology contains new chapters on a variety of topics including: quality improvement, seminoma, nonseminomatous germ cell tumor, penile cancer, medical prophylaxis, vesicoureteral reflux disease, cryptorchidism, prenatal hydronephrosis, and myelodysplasia. This updated resource: Offers a guide that centers on 100% evidence approach to medical and surgical approaches Provides practical recommendations for the care of individual patients Includes nine new chapters on the most recently trending topics Contains information for effective patient management regimes that are supported by evidence Puts the focus on the most important patient and clinical questions that are commonly encountered in day-to-day practice Written for urologists of all levels of practice, Evidence-Based Urology offers an invaluable treasure-trove of evidence-based information that is distilled into guidance for clinical practice.
Clinical Urodynamics in Childhood and Adolescence by Giovanni Mosiello,Giulio Del Popolo,Jian Guo Wen,Mario De Gennaro Pdf
This book aims to impart all the practical knowledge required in order to evaluate and treat children with anatomical, neurological, and functional incontinence. It explains how appropriate choice of management in childhood depends first of all on a correct diagnosis, then on thorough urodynamic evaluation, and finally on sound assessment of the condition of the individual patient. The full range of relevant pathologies are considered and all of the treatment options are extensively discussed, including behavioral therapy, rehabilitation, physiotherapy, pharmacotherapy, neuromodulation, endoscopic procedures, and surgical reconstruction. Careful attention is paid to the impacts that treatments performed during childhood may have on later adult life, including on fertility and pregnancy, with a view to ensuring that the reader will be in a position to time treatments correctly, thereby avoiding adverse effects, and possess all the information needed to address the concerns of patients and their families. The book will be of value to pediatricians, urologists, nurses, physiotherapist, students, and all others with an interest in the field.
Evaluation and Treatment of the Neurogenic Bladder by Jacques Corcos,Eric Schick Pdf
Excerpted from the Textbook of the Neurogenic Bladder, Essential Guide to the Neurogenic Bladder provides information on two topics essential to the practicing clinician: evaluation and treatment. Giving the reader easy access to the diagnostic armamentarium, this well-illustrated text provides the examining physician with excellent guidelines for
Textbook of the Neurogenic Bladder by Jacques Corcos,Erik Schick Pdf
All patients with vesico-urethral dysfunction, regardless of the nature of the neurological process causing it, are investigated with the same diagnostic tools. Textbook of the Neurogenic Bladder provides physicians—whether qualified or in training—with excellent instruction for conducting thorough, efficient, and beneficial examinations of both adults and children using a variety of instruments and tests. Features: Clarifies the differing states of neurogenic bladder dysfunction Describes the pathophysiology of neurogenic bladder dysfunction and the ways it alters vesico-urethral function Provides an overview of quality of life instruments that help determine the main outcome of interventions Covers imaging, electrophysiology, and extensive urodynamic studies in adults and children Discusses new non-surgical options and new ways to administer traditional treatments Includes a full chapter on a new classification system by its developer, Professor Anders Mattiasson This well-illustrated text includes both surgical and non-surgical treatment options from international experts. The book will enable practitioners to choose the best treatments for optimal results.
Abrams' Urodynamics by Marcus Drake,Hashim Hashim,Andrew Gammie Pdf
Abrams’ Urodynamics A complete guide to urodynamic investigation in modern health care Urodynamic testing is an ever-advancing field with applications in the management of patients from across a wide range of clinical areas. Bringing together fundamental principles and cutting-edge innovations, Abrams’ Urodynamics has been designed as an all-in-one guide to Functional Urology and Urogynecology, offering direct, up-to-date instruction on how to best perform and understand urodynamic tests within the overall treatment pathway. Its chapters cover everything from everyday basic practice to advanced complex cases, and are enhanced with more than 450 helpful illustrations. Including numerous revisions and new features, this fourth edition of the book boasts: Coverage of all investigative approaches, including uroflowmetry, cystometry, video-urodynamics, and non-invasive techniques Details on the successful running of a urodynamic unit, with information on organizational issues, equipment set-up, and common problems and pitfalls Sections addressing children, women, men, the elderly, and neuropaths Extensive description of International Continence Society (ICS) Standards throughout Appendices that include ICS Standards and Fundamentals documents, ICIQ modules, and Patient Information Leaflets With its wealth of clinical tips, illustrations, new innovations, and hands-on advice, Abrams’ Urodynamics is essential reading for all those wishing to better integrate urodynamic testing into their daily practice.
Neurogenic Bladder by Jacques Corcos,Erik Schick Pdf
Textbook of the Neurogenic Bladder, Second Edition covers all aspects of the neurogenic bladder from aetiology and pathophysiology to diagnosis and treatment of all associated problems. This evidence-based text is an essential reference source for residents, physicians, and healthcare professionals involved in the diagnosis and management of neurogenic bladder patients. With over 300 superbly illustrated images that clarify the differing states of neurogenic bladder dysfunction, this one-stop resource expands on the strong reputation of the first edition to highlight the new diagnostic techniques that have emerged to complement traditional management. These major advances range from non-surgical, electrical, and surgical treatments to neurostimulation and tissue engineering. Topics include: the pathophysiology of neurogenic bladder dysfunction and the ways it alters vesico-urethral function an overview of quality of life instruments that help determine the main outcome of interventions imaging, electrophysiology, and extensive urodynamic studies in adults and children new non-surgical options and new ways to administer traditional treatments a full chapter on a new classification system by its developer, Professor Anders Mattiasson
The purpose of this book is to present a focused approach to the pathophysiology, diagnosis, and management of the most common autonomic disorders that may present to the clinical neurologist. Autonomic Neurology is divided into 3 sections. The first section includes 5 chapters reviewing the anatomical and biochemical mechanisms of central and peripheral nervous system control of autonomic function, principles of autonomic pharmacology, and a clinical and laboratory approach to the diagnosis of autonomic disorders. The second section focuses on the pathophysiology and management of orthostatic hypotension, postural tachycardia, baroreflex failure; syncope, disorders of sweating, neurogenic bladder and sexual dysfunction, gastrointestinal dysmotility, and autonomic hyperactivity. The final section is devoted to specific autonomic disorders, including central neurodegenerative disorders; common peripheral neuropathies with prominent autonomic failure; painful small fiber neuropathies; autoimmune autonomic ganglionopathies and neuropathies; focal brain disorders; focal spinal cord disorders; and chronic pain disorders with autonomic manifestations. This book is the product of the extensive experience of its contributors in the evaluation and management of the many patients with autonomic symptoms who are referred for neurologic consultation at Mayo Clinic in Rochester, Minnesota. Autonomic Neurology focuses on clinical scenarios and presentation of clinical cases and includes several figures showing the results of normal and abnormal autonomic testing in typical conditions. Its abundance of tables summarizing the differential diagnosis, testing, and management of autonomic disorders also help set this book apart from other books focused on the autonomic nervous system.
