Chia-Da Lin

Age- and gender-specific nomograms for single and dual post-void residual urine in healthy children†‡

To establish the first age‐ and gender‐specific nomograms for single and two consecutive tests for post‐void residual urine (PVR).

Obese children at higher risk for having overactive bladder symptoms: A community‐based study

To investigate the association between obesity and lower urinary tract symptoms (LUTS) in healthy children.

Prostate Volume Did Not Affect Voiding Function Improvements in Diode Laser Enucleation of the Prostate

PURPOSE We compared safety and surgical outcomes in patients with different prostate sizes treated with diode laser enucleation of the prostate. MATERIALS AND METHODS From 2008 to 2012 consecutive patients with benign prostatic obstruction undergoing diode laser prostate enucleation at our institution were enrolled for analysis. A single surgeon performed diode laser prostate enucleation with an end firing, continuous wave diode laser (980 nm). Based on preoperative prostate volume on transrectal ultrasound, patients were stratified into 2 groups, including group 1-65 with less than 60 ml and group 2-55 with 60 ml or greater. Baseline and perioperative characteristics, and postoperative surgical outcomes were compared between the 2 groups. RESULTS A total of 120 men with a mean ± SD age of 70.2 ± 9.0 years were enrolled for analysis. Compared with group 1 patients, those in group 2 had larger mean total prostate volume (85.0 ± 24.6 vs 40.9 ± 10.8 ml), longer mean operative time (117.7 ± 48.2 vs 60.7 ± 25.0 minutes), higher mean retrieved prostate weight (37.3 ± 16.1 vs 12.5 ± 7.3 gm) and a higher mean tissue retrieval ratio (74.4% ± 22.2% vs 58.8% ± 23.2%, p <0.01). There was no significant difference in the postoperative hemoglobin decrease in the 2 groups (median 0.5 vs 0.9 mg/dl, p = 0.11). The rate of temporary postoperative urinary retention after Foley catheter removal was significantly lower in group 2 (15.4% vs 3.6%, p = 0.04). Postoperative improvements in the peak flow rate, post-void residual urine volume and International Prostate Symptom Score were comparable in the 2 groups. CONCLUSIONS Although patients with a larger prostate required significantly longer operative time and laser energy, voiding function improvements and surgical complication rates of diode laser prostate enucleation were comparable in patients with a larger vs smaller prostate.

Advances in non-surgical treatments for urinary tract infections in children.

ObjectiveWith growing antibiotics failure due to emerging resistance of bacteria, non-surgical management of pediatric UTI plays a more important role because of its non-invasive characteristics and little adverse effects.MethodsWe searched the Pubmed for management of UTI in children other than surgical correction and antibiotics using terms: risk factor, prepuce/phimosis, steroid cream/steroid, behavioral therapy, urotherapy, biofeedback/pelvic floor exercise, adrenergic antagonist, anticholinergics, diet/dietary, dysfunctional voiding/dysfunctional elimination syndrome, constipation, dietary, clean intermittent catheterization, probiotics/lactobacillus, cranberry, vitamin supplement, breastfeeding, breast milk, with infant/child/children/pediatrics/pediatrics and urinary tract infection.ResultsThe proposed non-surgical management of pediatric UTI included behavioral modification (timed voiding and adequate fluids intake), topical steroid for phimosis, nutrient supplements (breast milk, cranberry, probiotics, and vitamin A), biofeedback training for dysfunctional voiding, anticholinergics for reducing intravesical pressure, alpha-blockers in dysfunctional voiding and neurogenic bladder, and intermittent catheterization for children with large PVR.ConclusionThe published reports usually included small number of patients and were lacking of randomization and controlled group. Further well-designed studies are warranted to support the concepts of non-operative management for pediatric UTI.

Are prophylactic antibiotics necessary in patients with preoperative sterile urine undergoing ureterorenoscopic lithotripsy

To compare the efficacy of prophylactic antibiotics in reducing post‐surgical infections in patients undergoing ureterorenoscopic lithotripsy (URSL).

Diagnosis and Management of Bladder Outlet Obstruction in Women.

Bladder outlet obstruction (BOO) should be considered when a woman complains of voiding difficulty, abdominal straining to void, or refractory storage symptoms. Diagnosis of female BOO is not straightforward and usually requires invasive (video)urodyanmic study. A diagnostic algorithm is recommended for making optimal diagnosis. Female BOO can be classified as having anatomical and functional origins, and each contains several sub‐classifications. Literatures published between 1988 and 2013 were reviewed and summarized for the diagnosis and therapy in each subtype of female BOO.

Reliability and Validity of a Chinese Version of Urinary Tract Infection Symptom Assessment Questionnaire

ABSTRACT Objectives: Our study evaluates the reliability and validity of a Chinese version of the Urinary Tract Infection Symptom Assessment questionnaire (UTISA). Material and Methods: Our study enrolled women who were diagnosed with uncomplicated urinary tract infection (uUTI) at clinics. The Chinese version of UTISA was completed upon first visit to the clinic for uUTI and at 1-week follow-up. We enrolled 124 age-matched women without uUTI from the community as the control group. The UTISA consists of 14 items (seven symptom items and seven related to quality of life), with each item scoring 0 to 3. The internal consistency was assessed with Chronbachs alpha test. Factor analysis was used to classify symptoms into latent factors. The predictive validity was analyzed by using logistic regression and Receiver Operating Characteristic (ROC) curve analysis. Results: Mean total symptom scores of the UTISA in the 169 cases and 124 controls were 8.9±4.6 and 1.4±2.4, respectively (p<0.01). The alpha coefficient was 0.77, showing a homogeneous composition of symptoms. At a cut-off value of greater than 3, the UTISA symptom score had good predictive value for uUTI (sensitivity of 87.0%, and specificity of 93.1%). Factor analysis revealed two latent variables: 1) lower urinary tract symptoms and 2) physical symptoms. Among the seven items, we found that urinary frequency (OR=2.6), dysuria (OR=5.0), sense of incomplete emptying (OR=2.0), and hematuria (OR=7.6) were significant predictors for uUTI. Conclusions: The Chinese version of UTISA is reliable to predict uncomplicated UTI in women with an optimal cut-off point at >3.

Inter‐Observer, Intra‐Observer and Intra‐Individual Reliability of Uroflowmetry Tests in Aged Men: A Generalizability Theory Approach

To evaluate the inter‐observer, intra‐observer and intra‐individual reliability of uroflowmetry and post‐void residual urine (PVR) tests in adult men.

Surgical Outcomes of Mini Laparoscopic Herniorrhaphy in Infants

PURPOSE We compared surgical outcomes of mini laparoscopic and open herniorrhaphy in infants. MATERIALS AND METHODS We enrolled 55 infants undergoing herniorrhaphy, of whom 24 underwent mini laparoscopic herniorrhaphy (bilateral in 17, unilateral in 7) and 31 open herniorrhaphy (bilateral in 9, unilateral in 22). Mean±SD patient age was 7.17±4.21 months in the mini laparoscopic and 5.39±4.11 months in the open groups (p=0.37). During laparoscopy a contralateral patent processus vaginalis of 2 cm or greater was noted and repaired simultaneously in 13 of 20 infants (65%) initially diagnosed with unilateral hernia. RESULTS Mean±SD followup was 22.9±10.5 months in the mini laparoscopic group and 20.2±10.5 months in the open group (p=0.20). Contralateral metachronous inguinal hernia manifested in 4 of 22 patients (18%) initially presenting with unilateral hernia in the open group and in no patient in the mini laparoscopic group (p<0.05). Recurrence was noted in 1 of the 40 open herniorrhaphy sites and in none of the 41 mini laparoscopic herniorrhaphy sites (p=0.49). For unilateral repair mean±SD operative time was significantly longer in the mini laparoscopic group (80.00±18.97 minutes) compared to the open group (51.15±23.27 minutes, p<0.05). For bilateral repair mean±SD operative time was comparable between the 2 groups (82.52±14.74 minutes for mini laparoscopy and 95.62±20.62 minutes for open repair, p=0.35). CONCLUSIONS Mini laparoscopic herniorrhaphy in infants may prevent contralateral metachronous inguinal hernia, and is as safe and effective as open herniorrhaphy. The drawback of mini laparoscopic repair is the longer operative time for unilateral herniorrhaphy, which may be overcome by increased experience.