Materials and Methods:

A total of 14 children with idiopathic overactive bladder, 14 with dysfunctional voiding, 5 with underactive bladder, 4 with underactive valve bladder and 7 with neurogenic bladder resistant to conventional therapy underwent percutaneous tibial nerve stimulation weekly for 12 weeks. The stimulation effect was evaluated by comparing bladder diary, flowmetry and urinalysis before and after treatment. Improved patients were followed by bladder diary and urinalysis. Followup data at 1 and 2 years were compared with those obtained after stimulation. Data were analyzed using Fisher’s exact test.

Results: Symptom improvement was significantly greater in nonneurogenic than in neurogenic cases (78% vs 14%, p < 0.002). Selleckchem Romidepsin Of patients 18% with underactive Selleckchem U0126 bladder and 50% with underactive valve bladder were unresponsive. Of 14 overactive bladder cases 12 and all 14 of dysfunctional voiding were improved (p not significant). Of improved patients 5 of 12 with overactive bladder and 12 of 14 with dysfunctional voiding were cured (p < 0.01). On uroflowmetry voided volume and post-void residual urine became normal

in a greater number of dysfunctional voiding than overactive bladder cases (57% vs 20% and 57% vs 25%, each p not significant). At 1 year of followup the cure rate was greater in dysfunctional voiding than in overactive bladder cases (71% vs 41%) and it remained the same at the 2-year evaluation. Chronic stimulation was necessary

to maintain results in 29% of dysfunctional voiding and 50% of overactive bladder Diflunisal cases.

Conclusions: Percutaneous tibial nerve stimulation is reliable and effective for nonneurogenic, refractory lower urinary tract dysfunction in children. Efficacy seems better in dysfunctional voiding than in overactive bladder cases. There is evidence that percutaneous tibial nerve stimulation should be part of the pediatric urology armamentarium when treating functional incontinence.”
“The posterodorsal medial amygdaloid nucleus (MePD) is a sexually dimorphic area in the rat brain and dendritic spines are specialized postsynaptic sites involved with local neural plasticity. Previous electrophysiological data showed that prepubertal males have more excitatory synapses than females in the left MePD. Besides, dorsal and ventral MePD neurons have a heterogeneous expression of estrogen receptors alpha or beta in mating-responsive neurons in females. Based on these findings, the “”single-section”" Golgi method was employed in adult rats (n = 6 in each group) to reveal: (1) the effect of hemispheric laterality in the density of dendritic spines in the MePD of males and diestrus females, and (2) the density of dendritic spines in the MePD dorsal and ventral subregions in proestrus females (mean values from n = 48 neurons for each experimental variable).