Materials and Methods: We performed an observational, descriptive study to elucidate the differential diagnosis in men with overactive
bladder symptoms using a previously validated overactive bladder symptom questionnaire. All patients provided an extensive history, completed the self-administered questionnaire and a 24-hour voiding diary, and underwent physical examination, 24-hour pad test, uroflowmetry, post-void residual urine measurement, cystoscopy and urodynamics. Selection criteria were developed to assign cases to a category, including idiopathic overactive bladder, benign prostatic enlargement, Bindarit benign prostatic obstruction, neurogenic bladder, bladder cancer, prostate cancer treatment complications, urethral stricture, bladder stones and bladder diverticulum.
Results: Of 122 men who met selection criteria for overactive bladder detrusor overactivity was identified
in 99 (79%) on urodynamics. The differential diagnosis was benign prostatic enlargement in 40 men (32%), TNF-alpha inhibitor benign prostatic obstruction in 27 (22%), complications of prostate cancer treatment in 25 (20%), neurogenic bladder in 13 (11%), urethral stricture in 7 (6%), idiopathic overactive bladder in 6 (5%), bladder stone in 2 (2%), bladder cancer in 1 (1%) and bladder diverticulum in 1 (1%).
Conclusions: Overactive bladder is a complex diagnosis with many underlying, contributing urological pathologies. It should be considered a symptom complex and not a syndrome. Knowledge of the differential diagnosis in men with overactive bladder symptoms would hopefully provide clinicians with a diagnostic rubric to more specifically treat such patients with improved success.”
“Functional cerebral asymmetries (FCAs), which constitute a basic principle of human brain organization, are supposedly generated
by interhemispheric inhibition of the dominant on the nondominant hemisphere. It has repeatedly been shown that FCAs are sex specific: While they are relatively stable in men, they change during the menstrual cycle in women, indicating that sex hormones might play an important role in modulating functional brain organization and brain asymmetries in particular. Modern brain imaging techniques like functional magnetic resonance www.selleck.cn/products/SRT1720.html imaging (fMRI) allow for the noninvasive study of the mechanisms underlying changing FCAs. Imaging data show that in women the inhibitory influence of the dominant on the nondominant hemisphere is reduced with rising levels of sex hormones in the course of the menstrual cycle. Apart from modulating interhemispheric inhibition, sex hormones also seem to change functional organization within hemispheres. These results reveal a powerful neuromodulatory action of sex hormones on the dynamics of functional brain organization in the female brain.