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Hideo Nakai - One of the best experts on this subject based on the ideXlab platform.
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aggressive diagnosis and treatment for Posterior Urethral Valve as an etiology for vesicoureteral reflux or urge incontinence in children
Investigative and Clinical Urology, 2017Co-Authors: Hideo Nakai, Taiju Hyuga, Shina Kawai, Taro Kubo, Shigeru NakamuraAbstract:Vesicoureteral reflux (VUR) is one of the most common diseases in pediatric urology and classified into primary and secondary VUR. Although Posterior Urethral Valve (PUV) is well known as a cause of the secondary VUR, it is controversial that minor Urethral deformity recognized in voiding cystourethrography represents mild end of PUV spectrum and contributes to the secondary VUR. We have been studying for these ten years congenital Urethral obstructive lesions with special attention to its urethrographic and endoscopic morphology as well as therapeutic response with transUrethral incision. Our conclusion to date is that congenital obstructive lesion in the postero-membranous urethra is exclusively PUV (types 1 and 3) and that severity of obstruction depends on broad spectrum of morphological features recognized in PUV. Endoscopic diagnostic criteria for PUV are being consolidated.
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the changes of Urethral morphology recognized in voiding cystourethrography after endoscopic transUrethral incision for Posterior Urethral Valve in boys with intractable daytime urinary incontinence and nocturnal enuresis
World Journal of Urology, 2017Co-Authors: Taiju Hyuga, Shigeru Nakamura, Shina Kawai, Taro Kubo, Rieko Furukawa, Toshinori Aihara, Makiko Mieno, Hideo NakaiAbstract:Purpose Endoscopic transUrethral incision (TUI) of Posterior Urethral Valve (PUV) can improve daytime urinary incontinence (DUI) and nocturnal enuresis (NE). However, the underlying mechanism has not been elucidated. In this study, we retrospectively examined the mobility of the urethra before and after TUI by measuring the Urethral angle with voiding cystourethrography (VCUG), to clarify the effects of TUI on the morphology of the urethra during voiding.
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the changes of Urethral morphology recognized in voiding cystourethrography after endoscopic transUrethral incision for Posterior Urethral Valve in boys with intractable daytime urinary incontinence and nocturnal enuresis
World Journal of Urology, 2017Co-Authors: Taiju Hyuga, Shigeru Nakamura, Shina Kawai, Taro Kubo, Rieko Furukawa, Toshinori Aihara, Makiko Mieno, Hideo NakaiAbstract:Endoscopic transUrethral incision (TUI) of Posterior Urethral Valve (PUV) can improve daytime urinary incontinence (DUI) and nocturnal enuresis (NE). However, the underlying mechanism has not been elucidated. In this study, we retrospectively examined the mobility of the urethra before and after TUI by measuring the Urethral angle with voiding cystourethrography (VCUG), to clarify the effects of TUI on the morphology of the urethra during voiding. Between July 2010 and December 2014, 29 boys with intractable DUI and/or NE were diagnosed as PUV and underwent endoscopic TUI. VCUG during voiding phase was performed at sequential radiographic spot images (1 image per second) at a 45° angle in oblique standing position. The point at which the angle of the urethra was the smallest during urination was regarded as the minimum Urethral angle. The maximum Urethral angle during early voiding phase was compared with the minimum Urethral angle, and the percentage by which this angle changed was calculated as the flexion rate. Then changes in minimum Urethral angle and flexion rate were analyzed before and 3–4 months after TUI. After TUI, the minimum Urethral angle on VCUG became more obtuse (before vs. after TUI, respectively: 112.7 vs. 124.5°, p < 0.001), the flexion rate decreased (before vs. after TUI, respectively: 11.8 vs. 4.1%, p < 0.001). This study demonstrated a significant difference in the degree of change. The findings may contribute to understanding of the mechanism of improvement in symptoms after TUI in patients with PUV.
Taiju Hyuga - One of the best experts on this subject based on the ideXlab platform.
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aggressive diagnosis and treatment for Posterior Urethral Valve as an etiology for vesicoureteral reflux or urge incontinence in children
Investigative and Clinical Urology, 2017Co-Authors: Hideo Nakai, Taiju Hyuga, Shina Kawai, Taro Kubo, Shigeru NakamuraAbstract:Vesicoureteral reflux (VUR) is one of the most common diseases in pediatric urology and classified into primary and secondary VUR. Although Posterior Urethral Valve (PUV) is well known as a cause of the secondary VUR, it is controversial that minor Urethral deformity recognized in voiding cystourethrography represents mild end of PUV spectrum and contributes to the secondary VUR. We have been studying for these ten years congenital Urethral obstructive lesions with special attention to its urethrographic and endoscopic morphology as well as therapeutic response with transUrethral incision. Our conclusion to date is that congenital obstructive lesion in the postero-membranous urethra is exclusively PUV (types 1 and 3) and that severity of obstruction depends on broad spectrum of morphological features recognized in PUV. Endoscopic diagnostic criteria for PUV are being consolidated.
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the changes of Urethral morphology recognized in voiding cystourethrography after endoscopic transUrethral incision for Posterior Urethral Valve in boys with intractable daytime urinary incontinence and nocturnal enuresis
World Journal of Urology, 2017Co-Authors: Taiju Hyuga, Shigeru Nakamura, Shina Kawai, Taro Kubo, Rieko Furukawa, Toshinori Aihara, Makiko Mieno, Hideo NakaiAbstract:Purpose Endoscopic transUrethral incision (TUI) of Posterior Urethral Valve (PUV) can improve daytime urinary incontinence (DUI) and nocturnal enuresis (NE). However, the underlying mechanism has not been elucidated. In this study, we retrospectively examined the mobility of the urethra before and after TUI by measuring the Urethral angle with voiding cystourethrography (VCUG), to clarify the effects of TUI on the morphology of the urethra during voiding.
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the changes of Urethral morphology recognized in voiding cystourethrography after endoscopic transUrethral incision for Posterior Urethral Valve in boys with intractable daytime urinary incontinence and nocturnal enuresis
World Journal of Urology, 2017Co-Authors: Taiju Hyuga, Shigeru Nakamura, Shina Kawai, Taro Kubo, Rieko Furukawa, Toshinori Aihara, Makiko Mieno, Hideo NakaiAbstract:Endoscopic transUrethral incision (TUI) of Posterior Urethral Valve (PUV) can improve daytime urinary incontinence (DUI) and nocturnal enuresis (NE). However, the underlying mechanism has not been elucidated. In this study, we retrospectively examined the mobility of the urethra before and after TUI by measuring the Urethral angle with voiding cystourethrography (VCUG), to clarify the effects of TUI on the morphology of the urethra during voiding. Between July 2010 and December 2014, 29 boys with intractable DUI and/or NE were diagnosed as PUV and underwent endoscopic TUI. VCUG during voiding phase was performed at sequential radiographic spot images (1 image per second) at a 45° angle in oblique standing position. The point at which the angle of the urethra was the smallest during urination was regarded as the minimum Urethral angle. The maximum Urethral angle during early voiding phase was compared with the minimum Urethral angle, and the percentage by which this angle changed was calculated as the flexion rate. Then changes in minimum Urethral angle and flexion rate were analyzed before and 3–4 months after TUI. After TUI, the minimum Urethral angle on VCUG became more obtuse (before vs. after TUI, respectively: 112.7 vs. 124.5°, p < 0.001), the flexion rate decreased (before vs. after TUI, respectively: 11.8 vs. 4.1%, p < 0.001). This study demonstrated a significant difference in the degree of change. The findings may contribute to understanding of the mechanism of improvement in symptoms after TUI in patients with PUV.
Abdol-mohammad Kajbafzadeh - One of the best experts on this subject based on the ideXlab platform.
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prognostic significance of maternal urinary carbohydrate antigen 19 9 for antenatal diagnosis of Posterior Urethral Valve associated with fetal hydronephrosis
International Urology and Nephrology, 2019Co-Authors: Abdol-mohammad Kajbafzadeh, Shabnam Sabetkish, Nastaran SabetkishAbstract:PURPOSE To evaluate the predictive role of maternal urinary CA 19-9 as a non-invasive marker for diagnosing antenatal Posterior Urethral Valve (PUV). METHODS A total of 40 women in the third pregnancy trimester were enrolled. Case group (group A) consisted of 20 women with a diagnosis of antenatal PUV. Twenty women with similar gestational age, fetal sex, normal US, and no history of congenital anomalies were chosen as a control group (group B). Maternal urine samples were collected and urinary CA 19-9 was measured in both groups. The correlations between maternal urinary CA 19-9 and APD (measured during pregnancy and the initial evaluation of the newborn) were assessed. CA 19-9 level in first urine of neonates was also evaluated. RESULTS The mean ± SD of maternal urine CA 19-9 was higher in PUV group compared to the control group (131.6 ± 23.8 vs. 13 ± 2.7 U/mL). In addition, there was a significant correlation between maternal urinary CA 19-9 and the APD measured at the third trimester (p < 0.001) and the initial evaluation of fetus after birth according to SFU grading system (p < 0.001). However, no significant difference was found between gestational age and urinary CA 19-9 level (p = 0.34). There was also a significant correlation between the CA 19-9 level in first urine of neonates and CA 19-9 level of maternal urine (p < 0.001). CONCLUSIONS This is the first time that maternal urinary CA 19-9 has been applied as a noninvasive and practical diagnostic marker in antenatal PUV.
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long term impacts of concurrent Posterior Urethral Valve ablation and bladder neck incision on urinary continence and ejaculation
Urology, 2017Co-Authors: Sorena Keihani, Abdol-mohammad Kajbafzadeh, Seyedeh Maryam Kameli, Reza AbbasiounAbstract:Objective To assess the long-term impacts of bladder neck incision (BNI) on continence and ejaculatory function of adults who underwent concurrent Posterior Urethral Valve (PUV) ablation and BNI during childhood. Materials and Methods A retrospective chart review was performed to find all adult patients with relevant history. All patients had undergone BNI at 6 o'clock proximal to the verumontanum with caution to leave the adventitia and verumontanum untouched. Charts were reviewed and attempts were made to contact those ≥18 years old for follow-up. Patients were specifically evaluated for lower urinary tract symptoms and ejaculatory condition. Results Among patients treated for PUV between 1998 and 2015 in our center, 21 were ≥18 years old at the time of assessment. Until February 2016, we were able to contact 18 patients, all of whom agreed to participate. Mean age was 21.1 ± 2.9 years with a mean follow-up of 12.5 ± 4.8 years. None of those contacted had incontinence or dry ejaculations. All considered their ejaculations normal and only one complained of weak ejaculations. Four of 5 patients who consented to perform a semen analysis had normal tests and 1 had low sperm count with abnormal motility. Conclusion BNI is not associated with additional risk of incontinence and dry ejaculation in early adulthood and preserves antegrade ejaculation. Concomitant Valve ablation with BNI may provide additional benefits in care of PUV children, especially those with prominent bladder neck and poor bladder function at presentation.
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solitary crossed renal ectopia concurrence of Posterior Urethral Valve and hypospadias
Case reports in nephrology, 2015Co-Authors: Amin Bagheri, Reza Khorramirouz, Sorena Keihani, Mehdi Fareghi, Abdol-mohammad KajbafzadehAbstract:Solitary crossed renal ectopia (SCRE) represents an exceedingly rare congenital disorder. Although skeletal and genitourinary abnormalities most commonly accompany this condition, vesicoureteral reflux (VUR) has been described in only a few cases. Here, we present two unique cases of SCRE complicated by high-grade VUR concomitant with Posterior Urethral Valve in one case and hypospadias in the other one. We also provide a brief review of the literature on this subject.
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Case Report Solitary Crossed Renal Ectopia: Concurrence of Posterior Urethral Valve and Hypospadias
2015Co-Authors: Amin Bagheri, Reza Khorramirouz, Sorena Keihani, Mehdi Fareghi, Abdol-mohammad KajbafzadehAbstract:Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Solitary crossed renal ectopia (SCRE) represents an exceedingly rare congenital disorder. Although skeletal and genitourinary abnormalities most commonly accompany this condition, vesicoureteral reflux (VUR) has been described in only a few cases. Here, we present two unique cases of SCRE complicated by high-grade VUR concomitant with Posterior Urethral Valve in one case and hypospadias in the other one. We also provide a brief review of the literature on this subject. 1
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the management of vesicoureteral reflux in the setting of Posterior Urethral Valve with emphasis on bladder function and renal outcome a single center cohort study
Urology, 2014Co-Authors: Ali Tourchi, Abdol-mohammad Kajbafzadeh, Zahra Aryan, Maryam EbadiAbstract:Objective To represent our experience in the management of Posterior Urethral Valves and concomitant vesicoureteral reflux (VUR). Methods A total of 326 children with Posterior Urethral Valve who had underwent Valve ablation/bladder neck incision were studied, and those who had persistent VUR and were categorized under 3 main groups were followed up. Group 1 (n = 71) received prophylactic antibiotic, group 2 (n = 50) underwent Deflux injection (2 a ) (n = 28): Deflux injection alone, group 2 b (n = 22) Deflux with concomitant autologous blood injection (HABIT), and group 3 (n = 19) underwent ureteroneocystostomy before referral and was followed up conservatively. VUR resolution, incidence of urinary tract infections (UTI), and bladder function were assessed. Results Mean duration of follow-up was 3.8 years; VUR resolution occurred in 66.1%, 86.0%, and 94.0% of groups 1-3, respectively ( P = .013). Resolution rate in group 2 b was significantly higher than group 2 a (90.9% vs 78.5%). Patients in group 2 experienced a longer UTI-free period compared with others ( P P P P = .027). Myogenic failure developed only in 3 boys in group 3. Conclusion Ablation/bladder neck incision leads to significant improvement in VUR status in part because of improvement in bladder function. After successful Valve removal, conservative therapy can be regarded as the mainstay of reflux treatment, whereas HABIT is recommended for high grade VUR associated with febrile UTI or deterioration in renal function.
Shigeru Nakamura - One of the best experts on this subject based on the ideXlab platform.
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aggressive diagnosis and treatment for Posterior Urethral Valve as an etiology for vesicoureteral reflux or urge incontinence in children
Investigative and Clinical Urology, 2017Co-Authors: Hideo Nakai, Taiju Hyuga, Shina Kawai, Taro Kubo, Shigeru NakamuraAbstract:Vesicoureteral reflux (VUR) is one of the most common diseases in pediatric urology and classified into primary and secondary VUR. Although Posterior Urethral Valve (PUV) is well known as a cause of the secondary VUR, it is controversial that minor Urethral deformity recognized in voiding cystourethrography represents mild end of PUV spectrum and contributes to the secondary VUR. We have been studying for these ten years congenital Urethral obstructive lesions with special attention to its urethrographic and endoscopic morphology as well as therapeutic response with transUrethral incision. Our conclusion to date is that congenital obstructive lesion in the postero-membranous urethra is exclusively PUV (types 1 and 3) and that severity of obstruction depends on broad spectrum of morphological features recognized in PUV. Endoscopic diagnostic criteria for PUV are being consolidated.
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the changes of Urethral morphology recognized in voiding cystourethrography after endoscopic transUrethral incision for Posterior Urethral Valve in boys with intractable daytime urinary incontinence and nocturnal enuresis
World Journal of Urology, 2017Co-Authors: Taiju Hyuga, Shigeru Nakamura, Shina Kawai, Taro Kubo, Rieko Furukawa, Toshinori Aihara, Makiko Mieno, Hideo NakaiAbstract:Purpose Endoscopic transUrethral incision (TUI) of Posterior Urethral Valve (PUV) can improve daytime urinary incontinence (DUI) and nocturnal enuresis (NE). However, the underlying mechanism has not been elucidated. In this study, we retrospectively examined the mobility of the urethra before and after TUI by measuring the Urethral angle with voiding cystourethrography (VCUG), to clarify the effects of TUI on the morphology of the urethra during voiding.
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the changes of Urethral morphology recognized in voiding cystourethrography after endoscopic transUrethral incision for Posterior Urethral Valve in boys with intractable daytime urinary incontinence and nocturnal enuresis
World Journal of Urology, 2017Co-Authors: Taiju Hyuga, Shigeru Nakamura, Shina Kawai, Taro Kubo, Rieko Furukawa, Toshinori Aihara, Makiko Mieno, Hideo NakaiAbstract:Endoscopic transUrethral incision (TUI) of Posterior Urethral Valve (PUV) can improve daytime urinary incontinence (DUI) and nocturnal enuresis (NE). However, the underlying mechanism has not been elucidated. In this study, we retrospectively examined the mobility of the urethra before and after TUI by measuring the Urethral angle with voiding cystourethrography (VCUG), to clarify the effects of TUI on the morphology of the urethra during voiding. Between July 2010 and December 2014, 29 boys with intractable DUI and/or NE were diagnosed as PUV and underwent endoscopic TUI. VCUG during voiding phase was performed at sequential radiographic spot images (1 image per second) at a 45° angle in oblique standing position. The point at which the angle of the urethra was the smallest during urination was regarded as the minimum Urethral angle. The maximum Urethral angle during early voiding phase was compared with the minimum Urethral angle, and the percentage by which this angle changed was calculated as the flexion rate. Then changes in minimum Urethral angle and flexion rate were analyzed before and 3–4 months after TUI. After TUI, the minimum Urethral angle on VCUG became more obtuse (before vs. after TUI, respectively: 112.7 vs. 124.5°, p < 0.001), the flexion rate decreased (before vs. after TUI, respectively: 11.8 vs. 4.1%, p < 0.001). This study demonstrated a significant difference in the degree of change. The findings may contribute to understanding of the mechanism of improvement in symptoms after TUI in patients with PUV.
Taro Kubo - One of the best experts on this subject based on the ideXlab platform.
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aggressive diagnosis and treatment for Posterior Urethral Valve as an etiology for vesicoureteral reflux or urge incontinence in children
Investigative and Clinical Urology, 2017Co-Authors: Hideo Nakai, Taiju Hyuga, Shina Kawai, Taro Kubo, Shigeru NakamuraAbstract:Vesicoureteral reflux (VUR) is one of the most common diseases in pediatric urology and classified into primary and secondary VUR. Although Posterior Urethral Valve (PUV) is well known as a cause of the secondary VUR, it is controversial that minor Urethral deformity recognized in voiding cystourethrography represents mild end of PUV spectrum and contributes to the secondary VUR. We have been studying for these ten years congenital Urethral obstructive lesions with special attention to its urethrographic and endoscopic morphology as well as therapeutic response with transUrethral incision. Our conclusion to date is that congenital obstructive lesion in the postero-membranous urethra is exclusively PUV (types 1 and 3) and that severity of obstruction depends on broad spectrum of morphological features recognized in PUV. Endoscopic diagnostic criteria for PUV are being consolidated.
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the changes of Urethral morphology recognized in voiding cystourethrography after endoscopic transUrethral incision for Posterior Urethral Valve in boys with intractable daytime urinary incontinence and nocturnal enuresis
World Journal of Urology, 2017Co-Authors: Taiju Hyuga, Shigeru Nakamura, Shina Kawai, Taro Kubo, Rieko Furukawa, Toshinori Aihara, Makiko Mieno, Hideo NakaiAbstract:Purpose Endoscopic transUrethral incision (TUI) of Posterior Urethral Valve (PUV) can improve daytime urinary incontinence (DUI) and nocturnal enuresis (NE). However, the underlying mechanism has not been elucidated. In this study, we retrospectively examined the mobility of the urethra before and after TUI by measuring the Urethral angle with voiding cystourethrography (VCUG), to clarify the effects of TUI on the morphology of the urethra during voiding.
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the changes of Urethral morphology recognized in voiding cystourethrography after endoscopic transUrethral incision for Posterior Urethral Valve in boys with intractable daytime urinary incontinence and nocturnal enuresis
World Journal of Urology, 2017Co-Authors: Taiju Hyuga, Shigeru Nakamura, Shina Kawai, Taro Kubo, Rieko Furukawa, Toshinori Aihara, Makiko Mieno, Hideo NakaiAbstract:Endoscopic transUrethral incision (TUI) of Posterior Urethral Valve (PUV) can improve daytime urinary incontinence (DUI) and nocturnal enuresis (NE). However, the underlying mechanism has not been elucidated. In this study, we retrospectively examined the mobility of the urethra before and after TUI by measuring the Urethral angle with voiding cystourethrography (VCUG), to clarify the effects of TUI on the morphology of the urethra during voiding. Between July 2010 and December 2014, 29 boys with intractable DUI and/or NE were diagnosed as PUV and underwent endoscopic TUI. VCUG during voiding phase was performed at sequential radiographic spot images (1 image per second) at a 45° angle in oblique standing position. The point at which the angle of the urethra was the smallest during urination was regarded as the minimum Urethral angle. The maximum Urethral angle during early voiding phase was compared with the minimum Urethral angle, and the percentage by which this angle changed was calculated as the flexion rate. Then changes in minimum Urethral angle and flexion rate were analyzed before and 3–4 months after TUI. After TUI, the minimum Urethral angle on VCUG became more obtuse (before vs. after TUI, respectively: 112.7 vs. 124.5°, p < 0.001), the flexion rate decreased (before vs. after TUI, respectively: 11.8 vs. 4.1%, p < 0.001). This study demonstrated a significant difference in the degree of change. The findings may contribute to understanding of the mechanism of improvement in symptoms after TUI in patients with PUV.