14 results on '"Nevéus, T"'
Search Results
2. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children's Continence Society.
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Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, Rittig S, Vande Walle J, von Gontard A, Wright A, Yang SS, and Nevéus T
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- Adolescent, Child, Humans, Reference Standards, Lower Urinary Tract Symptoms physiopathology, Societies, Medical, Terminology as Topic, Urinary Tract physiopathology, Urinary Tract Physiological Phenomena, Urology
- Abstract
Purpose: The impact of the original International Children's Continence Society terminology document on lower urinary tract function resulted in the global establishment of uniformity and clarity in the characterization of lower urinary tract function and dysfunction in children across multiple health care disciplines. The present document serves as a stand-alone terminology update reflecting refinement and current advancement of knowledge on pediatric lower urinary tract function., Materials and Methods: A variety of worldwide experts from multiple disciplines in the ICCS leadership who care for children with lower urinary tract dysfunction were assembled as part of the standardization committee. A critical review of the previous ICCS terminology document and the current literature was performed. In addition, contributions and feedback from the multidisciplinary ICCS membership were solicited., Results: Following a review of the literature during the last 7 years the ICCS experts assembled a new terminology document reflecting the current understanding of bladder function and lower urinary tract dysfunction in children using resources from the literature review, expert opinion and ICCS member feedback., Conclusions: The present ICCS terminology document provides a current and consensus update to the evolving terminology and understanding of lower urinary tract function in children. For the complete document visit http://jurology.com/., (Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
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3. Editorial comment.
- Author
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Nevéus T
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- Child, Humans, Acupuncture Therapy methods, Laser Therapy methods, Nocturnal Enuresis therapy
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- 2011
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4. Editorial comment.
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Nevéus T
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- 2010
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5. The Swedish reflux trial in children: I. Study design and study population characteristics.
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Brandström P, Esbjörner E, Herthelius M, Holmdahl G, Läckgren G, Nevéus T, Sillén U, Sixt R, Sjöberg I, Stokland E, Jodal U, and Hansson S
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- Antibiotic Prophylaxis, Endoscopy, Female, Humans, Infant, Male, Population Surveillance, Prospective Studies, Sweden, Technetium Tc 99m Dimercaptosuccinic Acid, Ultrasonography methods, Urinary Tract Infections complications, Urinary Tract Infections diagnosis, Urinary Tract Infections drug therapy, Urography, Vesico-Ureteral Reflux etiology, Research Design, Vesico-Ureteral Reflux diagnosis, Vesico-Ureteral Reflux therapy
- Abstract
Purpose: We compared the rates of febrile urinary tract infection, kidney damage and reflux resolution in children with vesicoureteral reflux treated in 3 ways, including antibiotic prophylaxis, endoscopic therapy and surveillance with antibiotics only for symptomatic urinary tract infection., Materials and Methods: Children 1 to younger than 2 years with grade III-IV reflux were recruited into this prospective, open, randomized, controlled, multicenter study and followed for 2 years after randomization. The main study end points were recurrent febrile urinary tract infection, renal status on dimercapto-succinic acid scintigraphy and reflux status. Outcomes were analyzed by the intent to treat principle., Results: During a 6-year period 128 girls and 75 boys entered the study. In 96% of cases reflux was detected after urinary tract infection. The randomization procedure was successful and resulted in 3 groups matched for relevant factors. Recruitment was slower than anticipated but after patients were entered adherence to the protocol was good. Of the children 93% were followed for the intended 2 years without a treatment arm change. All except 2 patients completed 2-year followup scintigraphy., Conclusions: Recruitment was difficult but a substantial number of children were entered and randomly assigned to 3 groups with similar basic characteristics. Good adherence to the protocol made it possible to address the central study questions., (Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)
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- 2010
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6. The Swedish reflux trial in children: IV. Renal damage.
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Brandström P, Nevéus T, Sixt R, Stokland E, Jodal U, and Hansson S
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- Antibiotic Prophylaxis, Endoscopy, Female, Fever diagnosis, Fever epidemiology, Fever etiology, Fever therapy, Humans, Infant, Kidney Diseases diagnosis, Kidney Diseases physiopathology, Kidney Function Tests, Male, Population Surveillance, Prospective Studies, Recurrence, Sex Factors, Sweden epidemiology, Technetium Tc 99m Dimercaptosuccinic Acid, Urinary Tract Infections diagnosis, Urinary Tract Infections epidemiology, Urinary Tract Infections etiology, Urinary Tract Infections therapy, Urography, Vesico-Ureteral Reflux diagnosis, Vesico-Ureteral Reflux epidemiology, Vesico-Ureteral Reflux therapy, Kidney Diseases epidemiology, Kidney Diseases etiology, Vesico-Ureteral Reflux complications
- Abstract
Purpose: We compared the development of new renal damage in small children with dilating vesicoureteral reflux randomly allocated to antibiotic prophylaxis, endoscopic treatment or surveillance as the control group., Materials and Methods: Included in the study were 128 girls and 75 boys 1 to younger than 2 years with grade III-IV reflux. Voiding cystourethrography and dimercapto-succinic acid scintigraphy were done before randomization and after 2 years. Febrile urinary tract infections were recorded during followup. Data analysis was done by the intent to treat principle., Results: New renal damage in a previously unscarred area was seen in 13 girls and 2 boys. Eight of the 13 girls were on surveillance, 5 received endoscopic therapy and none were on prophylaxis (p = 0.0155). New damage was more common in children with than without febrile recurrence (11 of 49 or 22% vs 4 of 152 or 3%, p <0.0001)., Conclusions: In boys the rate of new renal damage was low. It was significantly higher in girls and most common in the control surveillance group. There was also a strong association between recurrent febrile UTIs and new renal damage in girls., (Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)
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- 2010
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7. The dilemmas of refractory nocturnal enuresis.
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Nevéus T
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- Antidepressive Agents therapeutic use, Antidiuretic Agents therapeutic use, Child, Cholinergic Antagonists therapeutic use, Combined Modality Therapy, Deamino Arginine Vasopressin therapeutic use, Diet Therapy, Humans, Prostaglandin Antagonists therapeutic use, Treatment Failure, Nocturnal Enuresis therapy
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- 2008
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8. The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children's Continence Society.
- Author
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Nevéus T, von Gontard A, Hoebeke P, Hjälmås K, Bauer S, Bower W, Jørgensen TM, Rittig S, Walle JV, Yeung CK, and Djurhuus JC
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- Adolescent, Child, Humans, Urethra physiology, Urinary Bladder physiology, Urodynamics, Terminology as Topic, Urination Disorders classification
- Abstract
Purpose: We updated the terminology in the field of pediatric lower urinary tract function., Materials and Methods: Discussions were held of the board of the International Children's Continence Society and an extensive reviewing process was done involving all members of the International Children's Continence Society as well as other experts in the field., Results and Conclusions: New definitions and a standardized terminology are provided, taking into account changes in the adult sphere and new research results.
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- 2006
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9. Diuretic treatment of nocturnal enuresis: preliminary results of an open pilot study.
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Nevéus T, Johansson E, and Hansson S
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- Adolescent, Child, Child, Preschool, Female, Humans, Male, Pilot Projects, Time Factors, Deamino Arginine Vasopressin therapeutic use, Diuretics therapeutic use, Enuresis drug therapy, Furosemide therapeutic use, Renal Agents therapeutic use
- Abstract
Purpose: Since antidiuretic treatment with desmopressin in the evening has proven effective against enuresis, it would not be surprising if diuretic treatment in the afternoon would have similar effects. We are currently testing this in an open pilot investigation., Materials and Methods: A total of 33 children including 12 girls with a mean age +/-SD of 7.6 +/- 2.3 years with monosymptomatic enuresis were recruited from an outpatient primary care setting. Wet and dry nights were recorded for 2 weeks without medication, 2 weeks with 0.4 mg desmopressin orally at night and 2 weeks with 1 mg/kg furosemide 4 to 5 hours before bedtime., Results: The mean number of wet nights +/-SD during the 3 periods was 10.2 +/- 3.0, 6.7 +/- 4.7 and 7.8 +/- 4.5, respectively. The effects of desmopressin and of furosemide were statistically significant (p <0.0001 and p = 0.001), although the 2 treatments did not differ (p = 0.08). Only 6 children had a complete response (ie greater than 90% reduction in wet nights) to desmopressin and 5 responded to furosemide. Interestingly, 2 children had a clearly better response on furosemide than on desmopressin., Conclusions: The treatment of enuresis with diuretic medication in the afternoon may be beneficial but needs to be tested in randomized controlled trials.
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- 2004
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10. Imipramine for therapy resistant enuresis: a retrospective evaluation.
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Gepertz S and Nevéus T
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- Adolescent, Child, Child, Preschool, Drug Resistance, Female, Humans, Male, Prognosis, Retrospective Studies, Adrenergic Uptake Inhibitors therapeutic use, Enuresis drug therapy, Imipramine therapeutic use
- Abstract
Purpose: Imipramine has a proven effect in enuresis but is now seldom used. We reviewed the records of children who had been treated with imipramine to determine prognostic indicators., Materials and Methods: The records of all enuretic children treated with imipramine at our clinic were retrospectively evaluated, with special emphasis on history, and for most children bladder volume, renal concentrating capacity and urine production., Results: All 49 children included in the study had previously received desmopressin, alarm and anticholinergic treatment without success. Of the children 31 (64.6%) were responders (R), with at least 50% reduction in enuresis frequency (22 became completely dry) and 17 (35.4%) were nonresponders (NR). Older age (R 11.4 +/- 3.4, NR 8.7 +/-1.8 years, p = 0.004) and low spontaneous bladder capacity (R 2.6 +/- 0.9, NR 3.4 +/- 0.9 ml/kg body weight, p = 0.03) were prognostically favorable, whereas constipation (p = 0.02) and a history of daytime incontinence (p = 0.04) indicated poor prognosis. Ten children experienced nausea or other minor problems. Seven children with attention deficit and hyperactivity became more focused during treatment., Conclusions: Imipramine is a useful treatment for enuresis when everything else has failed, especially among older children. Factors related to detrusor function provide prognostic information.
- Published
- 2004
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11. Endoscopic treatment of vesicoureteral reflux with dextranomer/hyaluronic acid copolymer is effective in either double ureters or a small kidney.
- Author
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Läckgren G, Wåhlin N, Sköldenberg E, Nevéus T, and Stenberg A
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- Administration, Intravesical, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Male, Retrospective Studies, Treatment Outcome, Vesico-Ureteral Reflux congenital, Vesico-Ureteral Reflux physiopathology, Dextrans administration & dosage, Hyaluronic Acid administration & dosage, Kidney abnormalities, Prosthesis Implantation, Ureter abnormalities, Vesico-Ureteral Reflux therapy
- Abstract
Purpose: Endoscopic injection of dextranomer/hyaluronic acid (Dx/HA) copolymer is an increasingly established treatment for primary vesicoureteral reflux (VUR) in children. We performed a retrospective analysis to assess this treatment for VUR associated with either double ureters or a small kidney., Materials and Methods: The study included 68 children with duplex ureters and 40 with a small kidney (1 kidney contributing 10% to 35% of total renal function) who underwent endoscopic treatment with Dx/HA copolymer for VUR. Followup consisted of voiding cystourethrography 3 and 12 months after injection. Positive response was defined as reflux grade 0 or I. As many as 2 repeat injections were offered to nonresponders, and those with persistent reflux were referred for open surgery. Long-term clinical followup with renal function testing was continued for 4 to 9 years., Results: A positive response was observed in 63% of children with duplex ureters, with only 17 (25%) patients requiring open surgery. Among children with a small kidney the response rate was 70%, and open surgery was performed in 9 (23%). In both treatment groups a positive response to treatment was sustained throughout the followup period in all cases. The treatment was well tolerated, with no complications associated with the procedure., Conclusions: Endoscopic treatment with Dx/HA copolymer appears to be an effective and well tolerated alternative to open surgery for first line treatment of VUR associated with double ureters or a small kidney.
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- 2003
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12. Oxybutynin, desmopressin and enuresis.
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Nevéus T
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- Child, Female, Humans, Male, Cholinergic Antagonists therapeutic use, Deamino Arginine Vasopressin therapeutic use, Enuresis drug therapy, Mandelic Acids therapeutic use, Renal Agents therapeutic use
- Abstract
Purpose: A review of the scarce literature concerning oxybutynin treatment for nocturnal enuresis reveals that its success is greatest when enuresis is combined with daytime incontinence. The renal and bladder related characteristics of children with monosymptomatic enuresis responsive to oxybutynin were evaluated., Materials and Methods: Renal concentrating capacity and functional bladder capacity were compared between 55 dry children who served as controls, and children with monosymptomatic enuresis who responded to desmopressin only (group 1, 27), oxybutynin only (group 2, 11), combination desmopressin and oxybutynin (group 3, 7) or were resistant to all treatment alternatives (group 4, 23)., Results: Renal concentrating capacity was lowest in groups 1 and 3 (939 +/- 147 mOsm./kg. controls, 856 +/- 158 group 1, 1,073 +/- 71 group 2, 762 +/- 119 group 3 and 970 +/- 146 group 4; p <0.01), whereas they had high urinary output (15.4 +/- 73.4 ml./kg. per hour controls, 22.2 +/- 10.2 group 1, 13.5 +/- 4.3 group 2, 21.5 +/- 11.2 group 3 and 15.0 +/- 6.9 group 4; p <0.01). Forced functional bladder capacity of that expected for age was lowest in groups 2 to 4 (107 +/- 43% controls, 88 +/- 43 group 1, 71 +/- 25 group 2, 68 +/- 22 group 3 and 59 +/- 22 group 4; p <0.01)., Conclusions: Children responding to oxybutynin have small bladders and probably hyperactive detrusors, whereas those responding to desmopressin or who need both drugs to achieve dryness have polyuria.
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- 2001
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13. Bladder capacity and renal concentrating ability in enuresis: pathogenic implications.
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Nevéus T, Tuvemo T, Läckgren G, and Stenberg A
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- Child, Deamino Arginine Vasopressin therapeutic use, Female, Humans, Male, Osmolar Concentration, Renal Agents therapeutic use, Enuresis physiopathology, Kidney Concentrating Ability, Urinary Bladder physiopathology
- Abstract
Purpose: We compared bladder volume and renal concentrating capacity in dry children and 2 distinct groups of children with enuresis to hypothesize about the pathogenesis of various types of enuresis., Materials and Methods: A total of 55 dry children and 100 with enuresis underwent an overnight thirst provocation test to assess renal concentrating capacity and completed a 2-day voiding chart to assess functional bladder capacity. The enuretic children were subdivided into 27 desmopressin responders and 73 desmopressin nonresponders before study inclusion., Results: The desmopressin responder group had lower average renal concentrating capacity +/-1 standard deviation than dry children and desmopressin responders (856 +/- 158 mOsm./kg. versus 939 +/- 147 and 962 +/- 151, respectively, p <0.05). Analogously average daytime urine production in the desmopressin responder group was greater than in dry children and desmopressin responders (22.2 +/- 10.2 ml./kg. body weight versus 15.4 +/- 7.3 and 15.3 +/- 7.2, respectively, p <0.01). Average functional bladder capacity expected for age was less in desmopressin nonresponders than in dry children and responders (52.2% +/- 19.9% versus 79.2% +/- 30.4% and 69.5% +/- 25.7%, respectively, p <0.001)., Conclusions: Desmopressin responders produced larger amounts of less concentrated urine than the other children, while desmopressin nonresponders had smaller bladder capacity than the other groups. These results support the idea that enuretic children who respond favorably to desmopressin treatment have polyuria, whereas children with therapy resistant enuresis have detrusor hyperactivity.
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- 2001
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14. Desmopressin resistant enuresis: pathogenetic and therapeutic considerations.
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Nevéus T, Läckgren G, Tuvemo T, Olsson U, and Stenberg A
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- Adolescent, Child, Cross-Over Studies, Double-Blind Method, Drug Resistance, Female, Humans, Male, Deamino Arginine Vasopressin therapeutic use, Enuresis drug therapy, Renal Agents therapeutic use
- Abstract
Purpose: We tested the role of the bladder in the pathogenesis of desmopressin resistant enuresis by evaluating the influence of urine production on the timing of the enuretic event and the response to anticholinergic medication., Materials and Methods: We gave 33 children with monosymptomatic nocturnal enuresis resistant to the standard 0.4 mg. oral dose of desmopressin 0.4 and 0.8 mg. desmopressin and placebo tablets for 5 nights each in a double-blind crossover fashion. The time of enuresis or nocturia was documented. All 9 children who had at least 1 dry treatment period during the randomized portion of the study then received open label treatment with 0.8 mg. desmopressin. Nonresponders to this regimen and the remainder of the children were offered anticholinergic treatment., Results: Average time between bedtime and voiding was 5.0, 5.6 and 5.0 hours during the nights with placebo, and 0.4 and 0.8 mg. desmopressin, respectively (p = 0.12). Of the 9 children subsequently treated with 0.8 mg. desmopressin 5 became completely dry. Of the remaining 28 children given anticholinergic treatment 20 responded., Conclusions: Antidiuresis does not delay the enuretic event in children with desmopressin resistant enuresis. This finding and the favorable response to anticholinergic medication favor the hypothesis that these children have nocturnal bladder instability. A subgroup of enuretic children responds to high but not normal doses of desmopressin.
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- 1999
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