The preventive treatment of recurrent stone-formation: how can we improve compliance in the treatment of patients with recurrent stone disease?

Whether prevention of Urolithiasis is worthwhile is the outcome of the balance between efficacy of prevention and costs and efforts related of respectively prevention and treatment of a new stone. Well controlled trials demonstrate that effective prevention of new stone formation is possible using medical treatment and lifestyle interventions. In long-term general practice the results obtained with preventive interventions is disappointing.

Influence of sildenafil on blood oxygen saturation of the obstructed bladder.

Background: Blood oxygen saturation (BOS) is decreased in a low-compliant, overactive obstructed bladder. The objective of this study is to determine the effect of Sildenafil (SC) on bladder function and BOS) in an in vivo animal model of bladder outlet obstruction.

Methods: Thirty-two guinea pigs; sham operated (n = 8), sham operated + SC (n = 8), urethrally obstructed (n = 8) and urethrally obstructed + SC (n = 8) were studied during an 8 week period.

Academic development for urologists in the Kurdistan region of Iraq.

Objectives: Continuous education is mandatory for all urologists, and undertaking cooperative research is a very effective means for this. We describe the experience and possibilities for continuing education for urologists in the Kurdistan region of Iraq. We hope to provide a framework for stimulating urological education and research in other countries where urologists face the same obstacles.

Metaphylaxis, diet and lifestyle in stone disease.

Objective: The most common urinary stones (calcium salts, uric acid) form due to genetic factors and lifestyle. This review describes why, if and how medication and lifestyle changes can reduce the risk of formation.

Methods: Previous reports were reviewed to obtain information on three aspects of urolithiasis, i.

In vivo measurement of bladder wall oxygen saturation using optical spectroscopy.

Current diagnosis, follow-up and treatment of patients suffering from bladder dysfunction are mainly symptom-targeted. A recently recognized cause of continuing bladder function loss is a deteriorated bladder microvasculature. Incorporating this aspect into the clinical diagnostic toolbox may improve treatment results.

Changes in bladder wall blood oxygen saturation in the overactive obstructed bladder.

Purpose: Several studies suggest that hypoxia of the bladder wall contributes to bladder dysfunction but the exact relation between bladder function and blood oxygen saturation, a surrogate marker for hypoxia, is not known. We determined bladder wall blood oxygen saturation in vivo in an animal model of bladder outlet obstruction to establish the exact relation between blood oxygen saturation and bladder function.

Materials And Methods: In 8 sham operated and 8 urethrally obstructed guinea pigs we measured blood oxygen saturation of the bladder wall by differential path length spectroscopy before surgery and 8 weeks postoperatively.

The detrusor glycogen content of a de-obstructed bladder reflects the functional history of that bladder during PBOO.

Aims: To determine if detrusor glycogen content in a bladder after removal of a urethral obstruction reflects the situation of bladder dysfunction as it existed during the period of obstruction.

Methods: The glycogen content of the detrusor was scored using a Periodic Acid Schiff's (PAS) staining. It was related to the functional history of the bladder.

The effect of oxybutynin on structural changes of the obstructed guinea pig bladder.

Purpose: Oxybutynin is used clinically to lower intravesical pressure and detrusor overactivity. In vitro it inhibits stretch induced bladder smooth muscle cell proliferation. We tested whether oxybutynin also prevents hypertrophic bladder changes in vivo in a model of partial bladder obstruction.

Modulators of urinary stone formation.

Urine contains compounds that modulate the nucleation, growth and aggregation of crystals as well as their attachment to renal epithelial cells. These compounds may function to protect the kidneys against: 1, the possibility of crystallization in tubular fluid and urine, which are generally metastable with respect to calcium salts, 2, crystal retention within the kidneys thereby preventing stone formation and 3, possibly against plaque formation at the nephron basement membrane. Since oxalate is the most common stone type, the effect of various modulators on calcium oxalate (CaOx) crystallization has been examined in greater details.

Clinical implications of physicochemistry of stone formation.

Measuring crystallization processes for assessing the risk of stone formation or the effect of treatment on that risk. In summary, crystallization processes are involved in the risk for stone formation at several levels. Several tests are available for assessing if crystalization is disturbed.

Estrogen replacement increased the citrate and calcium excretion rates in postmenopausal women with recurrent urolithiasis.

Purpose: Epidemiological data indicate a sharp increase in urinary calcium stone formation after menopause. We investigated the role of menopausal estrogen replacement therapy on the urinary constituents and characteristics that may influence recurrent calcium oxalate stone disease.

Materials And Methods: Urinary constituents in 28 postmenopausal women on estrogen replacement therapy for more than 6 months were compared with those in 41 women who had never been exposed to estrogen after menopause.