In patients with BND and

In patients with BND and low detrusor voiding pressure, detrusor contractility could be inhibited by a poorly relaxed EZ Cap Reagent GG (3\' OMe) neck, due to sympathetic hyperactivity. We observed increased detrusor pressure after TUI-BN in high-level spinal cord injury patients with low voiding pressure at baseline. Increased sympathetic tone was speculated as a possible cause to inhibit the detrusor contractility in these neuropathic patients. TUI-BN might disrupt the afferent limb of sympathetic innervation, reduce sympathetic hyperactivity of the bladder neck, and decrease the inhibitory effect on the detrusor nucleus, and finally, detrusor contractility probably recovered after TUI-BN surgery. TUI-BN is a safe procedure for treating BND, although some minor complications have been reported. In 2006, Navalon et al reported that retrograde ejaculation after TUI-BN was a concern, especially when operating on young men. Yang et al reported that preserving a portion of the supramontanal prostatic tissue during TUI-BN preserved the function of antegrade ejaculation. Urinary incontinence is found in 8.3% of women after TUI-BN, and inadvertent injury to the urethral sphincter is likely to be responsible for this complication. In this study, we performed TUI-BN only targeting the bladder neck, without extension of the incision to the urethral sphincter, and probably on this account, no such adverse event was reported among our patients. An accurate diagnosis of BND is important because medical treatment failure can be successfully treated by TUI-BN. Turner-Warwick advocated the use of urodynamic studies and voiding cystourethrography to diagnose BND in men aged ≤50 years with long histories of LUTS. Patients with BND may present with low urinary flow rate and non-specific findings on cystoscopy, such as small prostates, tight bladder necks, and trabeculated bladder walls. VUDS provides data for a more accurate diagnosis of BND. Bladder neck incision without prior urodynamic evaluation is useless in managing neurogenic bladder dysfunction. Male LUTS can result from a complex interplay of pathophysiologic features which include bladder dysfunction and bladder outlet dysfunction such as benign prostatic obstruction, BND, or poor relaxation of the urethral sphincter. VUDS is routinely performed in our department for differential diagnosis of male LUTS refractory to initial medical therapy. Although VUDS is an accurate diagnostic tool to find patients with BND by high voiding detrusor pressure and narrow bladder necks, it is difficult to diagnose patients with BND combined with detrusor underactivity. In this study, low voiding pressure and large PVR persisted after TUI-BN in six patients. In these patients with detrusor underactivity, the detrusor function could take a longer time to recover, or the main cause for their voiding dysfunction was detrusor failure. However, some of these patients voided more efficiently with the aid of abdominal straining because TUI-BN decreased the resistance of the bladder neck.
Conclusion
Introduction Neck lymph node metastasis is the most significant prognostic and survival factor in patients with oral squamous cell carcinoma (OSCC). Patients with pathologically negative cervical lymph nodes are believed to have a relatively good prognosis. In contrast, the outcome of patients with lymph node metastasis occurring after excision or radiotherapy of the primary tumor is poor. Factors that predict contralateral lymph node metastasis in OSCC patients remain controversial. Predicting contralateral neck metastasis may improve the prognosis of these patients. This study was aimed to examine possible predictive clinicopathologic factors for contralateral neck metastasis in surgically-treated primary OSCC.
Setting and ethics
Patients and methods
Statistical analysis Multivariate and univariate logistic regression analysis combined with stepwise selection techniques was used to examine the predictive clinicopathologic factors for contralateral neck metastasis. A p<0.05 was considered statistically significant. Age, sex, tumor site, primary tumor laterality, TNM status, clinical N status, pathologic T status, ipsilateral pathologic N status, tumor stage, status of residual disease, histopathologic differentiation, adjuvant therapy, local relapse, extra-capsular spread by lymph node metastasis, perineural/lympho-vascular invasion, and type of adjuvant therapy were evaluated for association with contralateral neck metastasis. Survival curves were calculated by the Kaplan-Meier method with log rank analysis.