Annual Scientific Meeting |
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16 October 2004 (Saturday), 2:00pm ¡V 5:30pm |
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(Please note that you can assume your registration is confirmed once registered unless you are informed that it is not the case. No confirmation letter will be sent.) | |||||||||||||||||||||||||||||||||||||||||||||||||
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Childhood Elimination Symptoms are Carried into Adulthood | |||||||||||||||||||||||||||||||||||||||||||||||||
CHILDHOOD ELIMINATION SYNDROME (ES) SYMPTOMS DO NOT RESOLVE SPONTANEOUSLY. WF Bower1, SK Yip2, CK Yeung1 Aims: Materials and methods: Results: Table 1: Significant associations between key ES symptoms and adult dysfunctions. (Blank cells indicate non significant association).
Conclusions: |
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Recent Advances in Management of Overactive Bladder | |||||||||||||||||||||||||||||||||||||||||||||||||
Recent Advances in Management of Overactive Bladder
Dr. Francis Lee, Tung Wah Hospital Overactive bladder (OAB) is a chronic condition in which the bladder contracts too early during filling phase. The International Continence Society defined it as a symptom complex consists of urinary frequency, nocturia, urgency and/or urge incontinence. Use of antimuscarinic drugs, such as oxybutynin, has been the mainstay of treatment of OAB for many years. However, these drugs have high incidence of side effects and long term compliance is poor. The use of the more bladder-selective antimuscarinic drug tolteradine and changing the bioavailability of oxybutynin has significantly decreased the incidence of side effects. Recent reports on the use of extravesical neuromodulation and intravesical therapies blocking the afferent and efferent pathways of bladder contraction have opened up new horizons for the management of OAB. |
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Acupuncture as a Mode of Neuromodulation for Overactive Bladder | |||||||||||||||||||||||||||||||||||||||||||||||||
ACUPUNCTURE AS A MODE OF NEUROMODULATION FOR OVERACTIVE BLADDER QUE BWM, LEUNG B UNITED CHRISTIAN HOSPITAL, HONG KONG BACKGROUND: Neuromodulation(NM) in the form of sacral nerve stimulation(SNS) has been widely accepted. Incidentally, the S3 foramina used in SNS were also acupoints used in Traditional Chinese Medicine (TCM) for various pelvic pathology.We conducted a pilot study to assess the usefulness of electroacupuncture as a form of neuromodulation. METHOD: From August 2001 to August 2003, 40 male patients (mean age 62.8, range 38-79) who suffered from overactive symptoms but were either shown to have normal maximum flow rate or have been treated with TURP were studied. Electroacupuncture on S3 bilaterally and on RN 4 were performed for a consecutive period of 8 days. Uroflometry, Voiding diary, mid-stream urine culture, IIEF-5, NIH-CPSI and SF-36 questionaires were completed before treatment, 6 weeks, 12 weeks, 18 weeks and 24 weeks post-treatment.Subjective assessment of results of the treatment were also recorded. RESULTS: At the end of acupuncture course,50% of all patients found the treatment beneficial and would recommend to friends with similar symptoms. At 6-week, 55% found this treatment useful. This ratio dropped to 42.5% at 12-week, and further down to 30% at 18-week. At 24-week, only 20% still recommend the treatment. CONCLUSION: Electroacupuncture may be beneficial in patients with overactive bladder symptom, but the effects were not sustained after 12 weeks.It may have a role as intermittent therapy, or as temporary nerve testing before SNS. |
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Prevalence of Incomplete Bladder Emptying in Elderly Wards | |||||||||||||||||||||||||||||||||||||||||||||||||
Prevalence of Incomplete Bladder Emptying in Elderly Wards Dr. C.K. Tam Introduction: Recurrent urinary retention and urinary tract infections (UTI) are commonly encountered problems in elderly patients admitted into hospitals.Incomplete bladder emptying (IBE) is a closely related problem and in fact post-voided residual volume (PVR) >150ml or 200ml has also been defined as chronic urinary retention. Purpose of the Project: To determine the prevalence of various degrees of IBE in elderly patients admitted into a convalescent hospital and to determine a reasonable cut-off value of PVR required for further investigations & interventions based on the relationship between PVR and the risk of UTI. Methods: 119 consecutive patients admitted into 2 convalescent wards from August 1 to 31, 2004 were included in the study. Patients without urinary catheter were screened within 48 hours of admission with an ultrasonic bladder scanner to measure PVR immediately after micturition. A urine sample was sent for routine microscopy & culture within 48 hours of admission.Medical records were traced to determine any documented UTI before admission and up to 4 weeks after admission. Results: 12.6% patients were already on urinary catheter on admission and another 21.8% patients were found to have PVR >100ml.9.2% patients had PVR >400ml requiring immediate catheterization. There was increased risk of UTI when PVR was above 100ml. Conclusion: There was a high prevalence of IBE in elderly patients and screening of all patients on admission for raised PVR is advisable to identify the problems early and to prevent subsequent complications.PVR of 100ml appeared to be a reasonable and practical cut-off value for elderly patients indicated for further investigations and interventions and also be the minimum goal of any interventions. |
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