Ubirajara Barroso

Federal University of Bahia · Urology

Urinary incontinence in children with neurogenic disorders and congenital malformations of the lower urinary tract is a challenging condition that significantly impacts their quality of life. The use of the artificial urinary sphincter (AUS) has been explored as a relevant therapeutic approach in pediatric urology, aiming to achieve urinary contine...

Background: Although parasacral TENS (pTENS) has been employed in various centers, there is a lack of studies on how children with overactive bladder (OAB) respond after failing to complete pTENS sessions. This study aimed to describe and assess treatments for OAB in children who did not respond to pTENS. Material and methods: This retrospective...

Purpouse: One of the many artificial intelligence based tools that has gained popularity is the Chat-Generative Pre-Trained Transformer (ChatGPT). Due to its popularity, incorrect information provided by ChatGPT will have an impact on patient misinformation. Furthermore, it may cause misconduct as ChatGPT can mislead physicians on the decision-mak...

Purpose: Parasacral Transcutaneous Electrical Stimulation (TENS) is one of the treatments for children with Bladder and Bowel Dysfunction (BBD). Some studies showed that children with increased Rectal Diameter (RD) have more Functional Constipation (FC). However, RD prediction in maintenance of BBD after treatment was never evaluated. Our aim is t...

Introduction: Artificial intelligence (AI) can be described as the combination of computer sciences and linguistics, objective building machines capable of performing various tasks that otherwise would need Human Intelligence. One of the many AI based tools that has gained popularity is the Chat–Generative Pre–Trained Transformer (ChatGPT). Due to...

A bexiga neurogênica (BN) é caracterizada por qualquer alteração da função da bexiga secundária a uma lesão neurológica. A principal causa de BN em crianças é a Espinha Bífida (EB), sendo a malformação mais frequente a Mielomeningocele (MMC) a nível lombossacral. A BN tem uma apresentação heterogênea que reflete o complexo sistema de controle cereb...

Purpose Total corpora mobilization (TCM) is a novel technique that is used for penile reconstruction in cases of micropenis and penile amputation. Its principle is based on Kelly’s procedure for bladder exstrophy (¹1 Kelly JH: Vesical exstrophy: repair using radical mobilisation of soft tissues. Pediatr Surg Int. 1995; 10(5–6):298–304.). In contras...

Objective To assess the impact of parasacral transcutaneous electrical nerve stimulation (parasacral TENS) on quality of life (QoL) and psychological aspects in children treated for overactive bladder (OAB). Methods This international, multicenter, prospective cohort study involved individuals of 6 to 16 years of age under TENS treatment for OAB....

Introduction Clitoroplasty constitutes an important step in feminizing surgery for congenital adrenal hyperplasia (CAH) ( ¹1. J. M. Hutson, R. W. Voigt, Meera Luthra, J. H. Kelly, R. Fowler. Girth-reduction clitoroplasty — a new technique: experience with 37 patients. Pediatric Surgery International 1991, 6:336-340. ). In this video we present a te...

Introduction Electrical nerve stimulation is one of the most commonly used and well-tolerated treatments for overactive bladder (OAB); however, different studies have used different instruments to assess patients’ response to treatment. Objective To analyze agreement between use of the visual analogue scale (VAS) and the Dysfunctional Voiding Scor...

Aims: To evaluate autonomic activity in children/adolescents with isolated overactive bladder. Materials and methods: Descriptive, analytical, non-interventional, cross-sectional study conducted between February 2017 and January 2018 with individuals aged between 5 and 17 years old, with overactive bladder (OAB group) or asymptomatic (control)....

The management of complex urethral stenosis may involve different surgical techniques. As retraction of the graft may account for surgical failure, this risk increases in patients with more extensive stenosis requiring a graft of greater diameter. Although double grafts have already been used to maximize success in these cases, we propose a modifie...

Purpose: This study compares the results achieved following parasacral TENS administered using two different weekly schedules. Materials and methods: Children of at least four years of age with a diagnosis of pure overactive bladder were included in this randomized clinical trial and treated with parasacral TENS (2 versus 3 sessions per week). A...

Aim To analyze uroflowmetry as a predictor of the outcome of treatment with parasacral transcutaneous electrical nerve stimulation (TENS) in patients with pure overactive bladder. Methods Thirty-eight patients of 5 to 16 years of age were included in this prospective cohort study. All the patients had been seen at a referral clinic between 2006 an...

Introduction: Defective closure of the neural tube affects different systems and generates sequelae, such as neurogenic bladder (NB). Myelomeningocele (MMC) represents the most frequent and most severe cause of NB in children. Damage of the renal parenchyma in children with NB acquired in postnatal stages is preventable given adequate evaluation,...

Los defectos del cierre del tubo neural (DCTN), al nacimiento son anormalidades comunes, que conllevan como secuela principal disfunción vesical neurogénica. La prevalencia de espina bífida (EB) es variable entre regiones, pero se estima que en sudamérica puede alcanzar hasta 19 casos por 10.000 nacidos vivos. En la etiopatogenia están involucrados...

BACKGROUND: Recently it was shown an association between lower urinary tract symptoms in mothers and their children. However, the role of functional constipation in this binomial is unclear. OBJECTIVE: To evaluate bladder and bowel dysfunction between mothers and children. METHODS: A population-based cross-sectional study. Mothers and their child...

Introduction: Vesicoureteral Reflux (VUR) is characterized by a retrograde flow of urine from the bladder into the ureters and kidneys. It is one of the most common urinary tract anomalies and the major cause of urinary tract infection (UTI) in the first years of life. If not properly diagnosed and treated can lead to recurrent UTI, renal scar and...

ABSTRACT Introduction: Lower urinary tract dysfunction (LUTD) is a common clinical condition. Emotional and behavioral issues are increasing among children and adolescents, with stress indicating difficulties in personal and social functioning. This study evaluated whether urinary tract symptoms (LUTS) is associated with stress. Materials and Metho...

Normal bladder and urethral sphincter development as well as neural/volitional control over bladder-sphincter function are essential steps for regular lower urinary tract function. These maturational sequences are clinically evident by the age of 5 years. However, in 17–22% of children, symptoms persist beyond that age, characterizing lower urinary...

In individuals with congenital adrenal hyperplasia (CAH) and 46,XX karyotype, androgens produced by the adrenal glands during the intrauterine development promote virilization of the genitals, which may even result in the development of a well-formed penis. Some of these children with late diagnosis are registered as males after birth. After obtain...

Purpose: The purpose of this was to evaluate the efficacy (tolerance and safety) of once-a-week parasacral percutaneous electrical nerve stimulation (PENS) to treat overactive bladder (OAB) in children. Materials and methods: This is a prospective case series of children aged 4-14 years who underwent PENS for OAB. Acupuncture needles were used b...

Background and objective: 5-Alpha reductase type 2 deficiency (5-ARD) is a rare disorder of sex development. The lack of 5-alpha reductase, an enzyme that converts testosterone into dihydrotestosterone, results in external genitalia that may appear female, or predominantly male, albeit undervirilized, or, more often, ambiguous. Methods: This stu...

Background: Congenital adrenal hyperplasia (CAH) consists of a group of diseases characterized by an enzyme deficiency, particularly 21-hydroxylase deficiency. The condition may present in the simple virilizing form or in the salt-wasting form, with varying degrees of genital ambiguity. The non-heterosexual orientation is used in gender studies fi...

Rationale, aims, and objectives: Prostate cancer (PC) presents with a high prevalence, but a low mortality. The evaluation of the risk-benefit ratio of current screening methods has led to conflicting results, which are reflected in some contradictory recommendations proposed by scientific and governmental entities. In this context of uncertainty,...

The aim of this study is identify potential factors associated with child sexual abuse confirmation at forensic examinations. The forensic files of children under 12 years of age reporting sexual abuse at the Nina Rodrigues Institute of Forensic Medicine in Salvador, Bahia, Brazil between January 2008 and December 2009 were reviewed. A multivariate...

Aim: To evaluate the efficacy of the onabotulinum toxin type A in the treatment of HTLV-1 associated overactive bladder and its impact on QoL. Methods: Case series with 10 patients with overactive bladder refractory to conservative treatment with anticholinergic or physical therapy. They received 200Ui of onabotulinumtoxin type A intravesically...

Purpose: To identify which independent variable would be strong predictor of febrile urinary tract infection (UTI) in children and adolescents with overactive bladder. Materials and methods: A search was made of the institute's database for all patients diagnosed with overactive bladder over the preceding four years. Children and adolescents und...

Background: Parasacral transcutaneous electrical nerve stimulation (TENS) has emerged as an effective treatment for overactive bladder (OAB) in view of its high success rates in improving lower urinary tract symptoms and constipation, with no direct side effects. However, the clinical characteristics associated with the outcomes remain to be estab...

Introduction Genital ambiguity is a very common phenomenon in disorders of sex development (DSD). According to the Chicago Consensus 2006, feminizing genitoplasty, when indicated, should be performed in the most virilized cases (Prader III to V). Advances in the knowledge of genital anatomy in DSD have enabled the development and improvement of var...

Introduction: Lower urinary tract dysfunction (LUTD) involves faults in the filling and emptying phases of bladder function in toilet-trained children with no previous infection or any other obvious pathology. Lower urinary tract dysfunction is associated with conditions such as vesicoureteral reflux, recurrent urinary infection, behavioral altera...

Background The association between parents who suffered daytime incontinence as children and children who are incontinence has been reported. However, the association of lower urinary tract (LUT) dysfunction in children and urinary symptoms in mothers has not been studied. Objective To test the hypothesis that the children of mothers with lower ur...

Child sexual abuse is a worldwide public health issue. The objective of this study was to describe the demographic and clinical characteristics of children in cases of sexual abuse confirmed by material evidence at forensic examination. Cases of children younger than 12 years examined for suspected sexual abuse at the Institute of Forensic Medicine...

Objective To evaluate the correlation between constipation and lower urinary tract dysfunction (LUTD) and nocturnal enuresis in a population-based study. Material and methods This is a cross-sectional study. The criteria for inclusion were children and adolescents of between 5 and 17 years and who agreed to sign the informed consent form. The stud...

Objective To describe the demographic and clinical characteristics of a population of children under 12 years submitted to forensic sexual examination and the proportion of confirmed cases of sex abuse by material evidence. Material and methods A retrospective descriptive study was conducted by reviewing all examination reports of forensic sexolog...

Background: Parasacral transcutaneous electrical nerve stimulation (TENS) is an effective method for the treatment of overactive bladder (OAB), and, additionally, it accelerates bowel transit time. Therefore, not only does parasacral transcutaneous electrical nerve stimulation (TENS) improve lower urinary tract symptoms (LUTS), but it also resolve...

Objective: Evaluate clinical aspects associated with the presence of nocturnal enuresis (NE) in children with a diagnosis of overactive bladder (OAB). Material and methods: A data base of 200 children who were evaluated by a structured questionnaire was analysed retrospectively . OAB was defined as the presence of urinary urgency (n=183 cases) a...

Objective: Neuromodulation has emerged as an effective therapeutic option for treatment of OAB in children. However, to our knowledge, no study has yet evaluated the results of neuromodulation on a session-by-session basis. The aim of this study was to evaluate the rate of complete response of overactive bladder (OAB) symptoms for each session of...

The dysfunction of the lower urinary tract (DTUI) is an abnormal pattern of the urinary control with loss of coordinated capacity storage, stocking and elimination of urine. In order to assess the impact of lower urinary tract dysfunction in their child’s caregivers, this series was performed to evaluate 30 cases of caregivers of children with void...

The term DSD refers to disorders that affect the normal process of sexual development causing disagreement between chromosomal, gonadal and phenotypic sex, and this study aimed to describe the clinical profile of a group with DSD 46, XY joined on DSD Clinic of Hospital of Salvador, Bahia Clinics. It was a retrospective study of medical records of s...

Transcutaneous electric nerve stimulation (TENS) has emerged as a good alternative in the treatment of overactive bladder in children. There are two randomized clinical trials that show that this method is superior to sham treatment and to standard urotherapy. It has the additional advantage of treating the symptoms of lower urinary tract as well a...

Introduction: A bladder diary (BD) is a simple and non-invasive method of evaluating people with lower urinary tract symptoms (LUTS). Recently, the ICCS recommended a 48-h daytime frequency and volume chart (which does not need to be recorded on 2 consecutive days) to evaluate lower urinary tract (LUT) dysfunction. However, some studies on adults...

Describir las características demográficas y clínicas de la población de menores de 12 años sometidos a pericia de sexología forense y la proporción de los casos confirmados de abuso sexual por prueba material.

Objective: To evaluate the urodynamic changes immediately after the first session (acute effect) and after the last session of parasacral TENS in children with idiopathic OAB. Materials and methods: We performed urodynamic evaluation immediately before and after the first session of parasacral TENS and immediately after the last session (7 weeks l...

We determined the effectiveness of 2 methods to treat overactive bladder in children using intragroup and intergroup comparisons in a randomized clinical trial. Nine boys and 19 girls with a mean ± SD age of 6.4 ± 2.18 years were randomly divided into group 1-parasacral transcutaneous electrical stimulation with placebo drug and group 2-oxybutynin...

An enuresis electroconditioner pertains to the field of medical appliances and includes a humidity sensor (2) connected to an electric circuit which is activated in the presence of a liquid. When the liquid is detected, an electric current with a frequency of 50 Hz is generated. A qualified person must calibrate the amperage of the apparatus (1), a...

Objective This new device for nocturnal enuresis (NE) consists of a humidity sensor, which beyond activating the sound also triggers an electrical stimulus, contracts the pelvic floor muscles and closes the urethra, thereby interrupting the void. The aim of this study is to test if the theoretical principle described above is true and if the device...

Purpose: We conducted a cross-sectional study to evaluate whether the different positions during urination influence the electrical activity of the abdominal and perineal musculature, as well as the uroflowmetric parameters of children with lower urinary tract dysfunction (LUTD). Materials and methods: Ninety-four children between the ages of 3...

Objetivo: Rever os estudos que utilizaram eletroestimulação no tratamento da hiperatividade vesical na infância. Metodologia: Trata-se de uma revisão sistemática. Os artigos foram pesquisados na base de dados Medline e na biblioteca de busca Cochrane (janeiro de 1990 a março de 2010), seguindo os critérios: 1) participantes com idades entre 0-17 an...

Purpose: To assess the prevalence of LUTS, urinary tract and urodynamics changes in patients with Friedreich's Ataxia (FA), the most common form of hereditary ataxia. Materials and methods: This study evaluated 258 patients with genetically confirmed diagnoses of FA. Of the patients, 158 responded to a questionnaire which assessed their urinary...

Micturitional alterations are described in women living with HTLV-1. We have determined the prevalence of urinary incontinence types (UI) and evaluated the impact on the quality of life of these women. A cross-sectional study was carried out in Salvador, Brazil from 2009 to 2011. After reviewing the medical records 190 HTLV-1+ women with urinary co...

Objective: To conduct a systematic review on single scrotal incision orchiopexy. Materials and methods: A search was performed using Pubmed, through which 16 articles were selected out of a total of 133. The following conditions were considered exclusion criteria: other surgical methods such as an inguinal procedure or a laparoscopic approach, r...

Surgical correction of hypospadias is proposed to improve the aesthetic and functional quality of the penis. Hormone therapy preceding surgical correction is indicated to obtain better surgical conditions. However, there is divergence in the literature regarding the hormone therapy of choice, time of its use before surgery, appropriate dose, and ro...

Introduction In some occasions, correlations between human structures can help planning surgical intra-abdominal interventions. The previous determination of ureteral length helps pre-operatory planning of surgeries, reduces costs of auxiliary exams, the correct choice of double-J catheter with low morbidity and fewer symptoms, and an adequate adhe...

Objective: To evaluate the urodynamic changes immediately after the first session (acute effect) and after the last session of parasacral TENS in children with idiopathic OAB. Materials and methods: We performed urodynamic evaluation immediately before and after the first session of parasacral TENS and immediately after the last session (7 weeks...

Objective: During the follow-up of children who had been diagnosed with arthrogryposis multiplex congenita (AMC), it was noted that some were experiencing dysfunctional voiding. Further investigation into these cases led to a diagnosis of neurogenic bladder. Few studies have investigated the relationship between AMC and neurogenic bladder, this be...

Objective: To evaluate the prevalence of constipation in children with isolated overactive bladder (IOAB) and no micturition complaints. Materials and methods: A questionnaire was used to evaluate constipation in 51 children with IOAB, as well as in a control group of 74 children between the ages of 4 and 14 years. The Rome III criteria for chil...

Purpose: Parasacral transcutaneous electrical nerve stimulation and posterior tibial nerve stimulation have emerged as effective methods to treat overactive bladder in children. However, to our knowledge no study has compared the 2 methods. We evaluated the results of parasacral transcutaneous electrical nerve stimulation and posterior tibial nerv...

Objective: New concepts in ambiguous genitalia have questioned the strategy of female gender reassignment in cases of penile agenesis. Hence, we present a video of the construction of a phallus according to the De Castro technique as an alternative approach for this devastating condition. Methods: A 12-year-old boy with congenital penile agenesi...

Objective: To histologically evaluate, in an experimental study in rabbits, the integration process of the buccal mucosa fenestrated graft applied in the corpora cavernosa for Bracka first stage urethroplasty. Materials and methods: A urethral defect was surgically created in 16 male rabbits of the New Zealand breed through the excision of the p...

Disorders of sex development (DSDs) are estimated to be prevalent in 0.1-2% of the global population, although these figures are unlikely to adequately represent non-white patients as they are largely based on studies performed in Europe and the USA. Possible causes of DSDs include disruptions to gene expression and regulation-processes that are co...

Purpose: Recurrent priapism is prevalent in children. Different medications have been used to avoid new episodes, however, there is no consensus regarding the best option. The use of finasteride to treat priapism in adults has already been tested. The aim of the present study was to test the hypothesis that a low dose of finasteride would be effec...

Objective: To evaluate the efficacy of parasacral transcutaneous electrical nerve stimulation (TENS) for the treatment of constipation in children with lower urinary tract dysfunction (LUTD). Materials and methods: We treated 9 boys and 5 girls with a mean age of 8.07 ± 2.72 years. 10 (71.4%) had overactive bladder and 4 (28.6%) had voiding dysf...

Purpose: To review our experience with prenatal diagnosis of bladder exstrophy by fetal magnetic resonance imaging (MRI). Bladder exstrophy can be diagnosed by ultrasonography (US) evaluation of the fetus based on absence of bladder filling, low-set umbilicus, small genitalia and lower abdominal mass, although in some instances more accurate anato...

To evaluate priapism rates in individuals <18 years of age with sickle cell disease (SCD) at a referral center. An evaluation was made of 599 consecutive male patients with SCD, separated according to type of hemoglobinopathy (HbSS, HbSC and HbS-β-thalassemia). Age at first episode and number of episodes were recorded. Cases of sickle cell trait we...

There is a known association between sickle cell disease and enuresis. However, the cause of this association is unclear. We tested the hypothesis that children with sickle cell disease would have more symptoms of overactive bladder than a control group. Questionnaires were distributed to 155 legal guardians of children and adolescents 5 to 17 year...

To review studies using electrical neural stimulation (ENS), to treat children with non-neurogenic lower urinary tract dysfunctions (LUTD), and to establish the efficacy of this treatment. This review was based on an electronic search of the MEDLINE database and the Cochrane Central Search library, from January 1990 to March 2010. Inclusion criteri...

Purpose: To estimate the prevalence of asymptomatic bacteriuria among pregnant women attended at our university prenatal care clinic and to identify probable clinical predictors. Methods: Across-sectional study was carried out from August 2008 to October 2009 at the Bahiana School of Medicine involving 260 pregnant women without symptoms of urin...

Overactive bladder (OAB) is a urological condition that is frequently observed in children and requires treatment. Standard urotherapy is usually the first line of treatment; however, children with severe OAB do not respond to this therapy. Antimuscarinic drugs may be used, but complete resolution of symptoms with this medication is low. Studies, i...