Continence Reports最新文献

{"title":"The change in urodynamic parameters in young men with bladder neck obstruction following surveillance periods","authors":"Ross Stephens,&nbsp;Sachin Malde,&nbsp;Arun Sahai,&nbsp;Eskinder Solomon","doi":"10.1016/j.contre.2025.100091","DOIUrl":"10.1016/j.contre.2025.100091","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the change in bladder dysfunction in men diagnosed with bladder neck obstruction (BNO) &lt; 50 years of age following surveillance periods.</div></div><div><h3>Methods</h3><div>We retrospectively analysed changes in urodynamic parameters in men &lt;50 years of age diagnosed with BNO during video urodynamics (VUDS) from initial presentation to subsequent investigations following a minimum surveillance period of 2 years.</div></div><div><h3>Results</h3><div>Ten men (mean age 33 ± 14 years) with a mean surveillance period of 4.8 ± 1.9 years were recruited. 5/10 men were taking alpha blockers during this period. 7/10 demonstrated detrusor overactivity (DO) during initial urodynamics. There was a mean (±SD) increase in DO peak pressure of 11.9(±75.1) <span><math><mrow><mi>c</mi><mi>m</mi><msub><mi>H</mi><mn>2</mn></msub><mi>O</mi></mrow></math></span> (p = 0.648). There was a mean (±SD) reduction in bladder compliance of 23.84 <span><math><mrow><mi>m</mi><mi>l</mi><mo>/</mo><mi>c</mi><mi>m</mi><msub><mi>H</mi><mn>2</mn></msub><mi>O</mi></mrow></math></span> (±31.1 <span><math><mrow><mrow><mspace></mspace><mi>m</mi><mi>l</mi><mo>/</mo><mi>c</mi><mi>m</mi><msub><mi>H</mi><mn>2</mn></msub><mi>O</mi></mrow><mo>)</mo></mrow></math></span> (p = 0.067). There was no change in cystometric capacity (p = .998), detrusor pressure at maximum flow <span><math><mrow><mo>(</mo><msub><mi>P</mi><mrow><mi>det</mi><mo>.</mo><mi>Q</mi><mi>m</mi><mi>a</mi><mi>x</mi></mrow></msub><mo>)</mo></mrow></math></span> (p = .211), bladder outlet obstruction index (BOOI) (p = .227) or post void residual (PVR) (p = .707). There was a moderate correlation between BOOI and <span><math><mrow><msub><mi>P</mi><mrow><mi>det</mi><mo>.</mo><mi>Q</mi><mi>m</mi><mi>a</mi><mi>x</mi></mrow></msub></mrow></math></span> at initial urodynamics with the change in compliance over the surveillance period (0.56 and 0.49 respectively). The peak DO pressure at baseline correlates most with the reduction in <span><math><mrow><msub><mi>Q</mi><mi>max</mi></msub></mrow></math></span> during surveillance period (−0.6).</div></div><div><h3>Conclusion</h3><div>The rate of change of bladder dysfunction appears variable in men with BNO. However, our study indicates a trend of worsening loss of compliance and Qmax over a mean period of ∼5 years which appears moderately correlated with the BOOI and DO peak pressures measured at initial urodynamics.</div></div>","PeriodicalId":100330,"journal":{"name":"Continence Reports","volume":"16 ","pages":"Article 100091"},"PeriodicalIF":0.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacral nerve stimulation in sacral agenesis using 3D printing and intraoperative navigation: report of two cases and narrative review","authors":"Sara Nunes-Sequeira ,&nbsp;Filipe Abadesso Lopes ,&nbsp;Mafalda Franco Carneiro ,&nbsp;Lia Lucas-Neto ,&nbsp;Ricardo Pereira E Silva ,&nbsp;Alexandre Rainha Campos","doi":"10.1016/j.contre.2025.100093","DOIUrl":"10.1016/j.contre.2025.100093","url":null,"abstract":"<div><h3>Introduction</h3><div>Caudal Regression Syndrome (CRS) is a rare malformation characterized by lumbosacral deformities and gastrointestinal/genitourinary and/or lower limb abnormalities. Sacral neuromodulation (SNM) is an effective therapy for refractory gastrointestinal/genitourinary symptoms but lead implantation near the S3 roots is challenging in patients with sacral deformities due to the absence of standard fluoroscopic landmarks.</div></div><div><h3>Research question and case description</h3><div>We describe a method for percutaneous lead implantation in patients with sacral deformities, using preoperative 3D-printed anatomical replicas combined with intraoperative navigation. Our first two cases are reported.</div></div><div><h3>Case report</h3><div>Two CRS patients with sacral agenesis and refractory neurogenic lower urinary tract dysfunction underwent this procedure. Preoperative imaging was processed to create a 3D-printed sacrum, and the sacral roots were replicated using silicone threads. These models enabled anatomical analysis, target identification, and planning of the foramen entry point and introducer angle. The plan was integrated into the NN system, and awake surgery was performed with neurophysiological monitoring.</div></div><div><h3>Results</h3><div>Intraoperatively, navigation allowed real-time visualization of the introducer's position and placement of the electrode at the desired location and depth. Correct positioning was confirmed by stimulation with a typical S3 response (hallux flexion and bellows reflex) and fluoroscopy. Both patients proceeded to permanent generator implantation with clinical improvement.</div></div><div><h3>Discussion and conclusion</h3><div>The presence of a 3D replica improves the spatial understanding of sacral anatomy. Together with navigation, it can be used to overcome the technical challenge of placing SNM electrodes in patients with bony deformities.</div></div>","PeriodicalId":100330,"journal":{"name":"Continence Reports","volume":"16 ","pages":"Article 100093"},"PeriodicalIF":0.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The safety and patients satisfaction of the urinary automatic catheter valve, Mirovalve® in patients with urinary catheter: A randomized clinical trial study","authors":"Hadi Mostafaei ,&nbsp;Sepideh Kiani ,&nbsp;Zahra Sheikhalipour ,&nbsp;Hamidreza Ashayeri ,&nbsp;Hanieh Salehi-Pourmehr ,&nbsp;Sakineh Hajebrahimi","doi":"10.1016/j.contre.2025.100092","DOIUrl":"10.1016/j.contre.2025.100092","url":null,"abstract":"<div><h3>Background</h3><div>Urinary tract infections (UTIs) are a significant concern for catheterized patients. Catheter valves have been explored as an alternative to traditional drainage bags, with some studies suggesting improved comfort and a potential reduction in UTIs. This study investigated the Mirovalve®, an automatic catheter valve, in a randomized controlled trial. Our objective was to compare the safety, patient satisfaction, and UTI incidence between the Mirovalve® and standard drainage bags.</div></div><div><h3>Methods</h3><div>This randomized clinical trial involved 65 patients with urinary retention requiring catheterization, who were also using diapers due to their underlying condition. The study was conducted in the urology clinics of Tabriz University of Medical Sciences after obtaining informed consent from eligible participants. Patients were randomly assigned to either the control group (urinary catheter connected to a drainage bag) or the therapy group (urinary catheter connected to the Mirovalve® automatic catheter valve). The primary outcomes were safety, assessed by urine culture results at the end of the three-week intervention, and patient satisfaction. Secondary outcomes included the incidence and nature of adverse events. A negative urine culture was confirmed before the study commenced.</div></div><div><h3>Results</h3><div>All 65 participants completed the three-week follow-up. Patient satisfaction was significantly higher in the Mirovalve® group compared to the drainage bag group (P &lt; 0.001). A large majority of Mirovalve® users (73.6 %) reported being \"very\" or \"extremely\" satisfied, versus only 9.7 % of the drainage bag users. The overall incidence of adverse events was similar between the groups, although two patients in the Mirovalve® group experienced temporary acute urinary retention. The incidence of symptomatic UTIs was significantly lower in the Mirovalve® group (12.9 %) compared to the drainage bag group (46.2 %) (P = 0.025).</div></div><div><h3>Conclusion</h3><div>Our findings indicate that the Mirovalve® automatic catheter valve is associated with significantly higher patient satisfaction and a lower incidence of UTIs compared to standard drainage bags. While both methods showed similar short-term safety profiles, the improved satisfaction with the Mirovalve® highlights its potential to enhance patient quality of life. These results suggest that the Mirovalve® is a valuable option for catheter-dependent patients, though further research is needed to confirm these findings over a longer duration and in more diverse populations.</div></div>","PeriodicalId":100330,"journal":{"name":"Continence Reports","volume":"16 ","pages":"Article 100092"},"PeriodicalIF":0.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted sacrocolpopexy (RASC) in a renal transplant patient with Ehlers-Danlos syndrome (EDS), case report and literature review of perioperative considerations","authors":"Dina El-Hamamsy ,&nbsp;Bénedicte Persyn ,&nbsp;Steven E. Schraffordt Koops","doi":"10.1016/j.contre.2025.100090","DOIUrl":"10.1016/j.contre.2025.100090","url":null,"abstract":"<div><div>With aging populations and advances of healthcare, patients with complex medical histories are more likely to present to our Urogynaecological practices. Similarly, with surgical advances, robotic-assisted surgery is currently gaining momentum with a view to improving surgical precision and potentially patient outcomes. Here, we present the first robotic-assisted sacrocolpopexy in a renal transplant patient with Ehlers-Danlos syndrome, and review the literature for perioperative considerations in these patients.</div><div>Our 51 year old patient presented with obstructive micturition due to advanced pelvic organ prolapse (POP). A pre-operative diagnostic laparoscopy was performed to evaluate abdominal accessibility and aid decision regarding surgical approach for prolapse repair. An uncomplicated robotic assisted sacrocolpopexy was performed with uneventful postoperative recovery, no prolapse recurrence and improved quality of life at 1 year follow-up.</div><div>When surgical repair is indicated in patients with POP after renal transplantation, in most cases vaginal approach will be chosen for primary surgery. Patients at high risk of recurrence of POP, such as the case described here, may benefit from abdominal approach. However, there is limited evidence on safety, feasibility and long-term outcomes following minimally-invasive abdominal POP repair in these cases. We conclude that robotic-assisted approach is feasible and could improve patient outcomes. However, more evidence needs to be generated to support such practice in high-risk patients. We call upon specialist societies to utilize surgical databases to support such cause.</div></div>","PeriodicalId":100330,"journal":{"name":"Continence Reports","volume":"15 ","pages":"Article 100090"},"PeriodicalIF":0.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary conferences to enhance care for pelvic floor dysfunction: A descriptive study at a tertiary center","authors":"Nouf Yahya Akeel ,&nbsp;Leila Neshatian ,&nbsp;Vipul Sheth ,&nbsp;Ekene Enemchukwu ,&nbsp;Sydni Au Hoy ,&nbsp;Brooke H. Gurland ,&nbsp;Stanford Pelvic Health Center Workgroup,&nbsp;Diana Atashroo ,&nbsp;Yosef Chodakiewitz ,&nbsp;Jimmy Dinh ,&nbsp;Haddas Elisha ,&nbsp;Patricia A. Garcia ,&nbsp;Jennifer M. Hah ,&nbsp;Ruth Hicks ,&nbsp;Negaur Iranpour ,&nbsp;Karen Jazmin ,&nbsp;Zaineh Khalil ,&nbsp;Michelle J. Khan ,&nbsp;Natalie N. Kirilcuk ,&nbsp;Kavita Mishra ,&nbsp;Molly O'Brien-Horn","doi":"10.1016/j.contre.2025.100089","DOIUrl":"10.1016/j.contre.2025.100089","url":null,"abstract":"<div><h3>Purpose/background</h3><div>The multidisciplinary approach to pelvic floor disorders has been shown to improve patient care outcomes but remains underutilized. This study aims to assess the utility of multidisciplinary meetings for pelvic floor patients by prospectively evaluating their impact on diagnosis, management, and treatment planning. The specific objectives are to improve diagnostic accuracy, optimize treatment plans, and facilitate efficient resource allocation.</div></div><div><h3>Methods/interventions</h3><div>This is a descriptive study conducted at a tertiary referral academic center. Multidisciplinary conferences were held monthly by a collaborative clinical team. The meetings aimed to: 1. Comprehensively review radiological findings. 2. Develop individualized care plans. 3. Optimize surgical plans and combined surgery. The patients were identified from the pelvic floor multidisciplinary database. \"Utility\" will be measured by metrics including: 1) Rate of amendment to radiology reports, indicating improved diagnostic accuracy; 2) Frequency of recommended further assessment or workup, reflecting enhanced care pathway definition; and 3) Documentation of changes to the initial treatment plan based on multidisciplinary discussion, showing impact on management.</div></div><div><h3>Results/outcomes</h3><div>Nineteen multidisciplinary meetings were conducted between August 2021 and May 2023, discussing 101 cases. The patients were categorized into prolapse (n = 41), functional disorders (n = 38), and miscellaneous (n = 22) groups. The prolapse group was classified into combined rectal and pelvic organ prolapse (n = 22), and isolated rectal prolapse (n = 19). After each case discussion, a comprehensive review note was created and incorporated into the patient's chart, facilitating the initiation of follow-up plans and the coordination of services. Radiology reports were amended in 18 cases (18 %), with the majority of revisions related to rectal prolapse (n = 15, 83 %). Further assessment and workup were recommended in 17 cases (17 %): prolapse (n = 5), miscellaneous (n = 9), and motility (n = 3).</div></div><div><h3>Conclusion/discussion</h3><div>This study suggests that multidisciplinary meetings are beneficial in complex pelvic health conditions. They correlate clinical assessment with radiological findings and inform individualized treatment plans, as evidenced by the rates of amended radiology reports and recommended further assessment/workup. Further research is needed to quantitatively assess the long-term clinical outcomes and cost-effectiveness of this approach.</div></div>","PeriodicalId":100330,"journal":{"name":"Continence Reports","volume":"16 ","pages":"Article 100089"},"PeriodicalIF":0.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trifecta outcomes in surgical treatment of male stress urinary incontinence","authors":"Andrey Tomilov ,&nbsp;Bagrat Grigoryan ,&nbsp;George Kasyan ,&nbsp;Evgeniy Veliev ,&nbsp;Dmitry Pushkar","doi":"10.1016/j.contre.2025.100088","DOIUrl":"10.1016/j.contre.2025.100088","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Stress urinary incontinence (SUI) remains a significant challenge in male patients, particularly following prostate surgery. Despite advancements in surgical techniques and technologies, a standardized method for evaluating treatment success remains under discussion. This study aims to propose a conceptual and comprehensive model that incorporates three key outcomes: quality of life, urinary leakage control, and safety, to provide a structured approach to the assessment of surgical interventions for SUI.</div></div><div><h3>Evidence acquisition</h3><div>A literature review was conducted, focusing on clinical guidelines and outcome measures used in studies of SUI treatment. Key parameters were selected based on their relevance to patient satisfaction, clinical practice, and international standards, including the International Continence Society (ICS) and patient-reported outcomes (PROs).</div></div><div><h3>Results</h3><div>The proposed trifecta model includes three essential criteria: (1) Quality of life, assessed by the Visual Numeric Scale (VNS) with scores of 0–2 indicating significant improvement; (2) Urinary leakage control, defined as “social continence” (use of 0–1 pad per day), reflecting practical success; and (3) Safety, evaluated by the absence of complications within 90 days postoperatively, aligning with standard follow-up timelines. This model addresses both objective and subjective outcomes. While it does not encompass long-term results, the trifecta is adaptable for extended evaluations at 1, 5, and 10 years and serves as a conceptual framework requiring future clinical validation.</div></div><div><h3>Conclusion</h3><div>The proposed trifecta model suggests a patient-centered framework to evaluate the outcomes of surgical interventions for SUI. By addressing critical domains, it offers a structured method for clinical and research assessment. However, its clinical applicability requires confirmation through prospective validation in diverse patient cohorts.</div></div>","PeriodicalId":100330,"journal":{"name":"Continence Reports","volume":"15 ","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of intra-vaginal diazepam for pelvic floor hypertonic disorder: A systematic review and meta-analysis","authors":"Dana Sawan ,&nbsp;Mersal Almanasif ,&nbsp;Sarah Alharshan ,&nbsp;Rasha Alanazi ,&nbsp;Sadeen Fallatah ,&nbsp;Wasan Alanazi ,&nbsp;Nora Aloufi","doi":"10.1016/j.contre.2025.100087","DOIUrl":"10.1016/j.contre.2025.100087","url":null,"abstract":"<div><h3>Background</h3><div>High-tone pelvic floor dysfunction (HTPFD) is a neuromuscular disorder characterized by involuntary spasms of the levator ani muscles, often resulting in pelvic pain, dyspareunia, and bladder or bowel dysfunction. It is frequently associated with syndromes such as vulvodynia, interstitial cystitis, and pelvic myofascial pain. Current treatment options, including pelvic floor physical therapy and pharmacologic interventions, have limited evidence supporting their efficacy.</div></div><div><h3>Objective</h3><div>To assess the effectiveness of intra-vaginal diazepam suppositories in reducing pelvic floor muscle tone and alleviating associated symptoms in women with HTPFD.</div></div><div><h3>Methods</h3><div>A triple-blinded, randomized, placebo-controlled trial was conducted per PRISMA guidelines and registered in PROSPERO. Women aged ≥18 years with EMG-confirmed HTPFD were randomized to receive either 10 mg of diazepam or placebo vaginal suppositories nightly for 28 days. Primary outcomes included changes in resting pelvic floor electromyography (EMG). Secondary outcomes evaluated sexual function, pain levels, and quality of life via validated questionnaires.</div></div><div><h3>Results</h3><div>Twenty-one women were enrolled; 14 completed the trial (7 per arm). No statistically significant differences were observed between groups in resting EMG readings or subjective symptom scores. Both groups reported minor, non-significant improvements in pain and quality of life.</div></div><div><h3>Conclusion</h3><div>Current evidence is insufficient to determine the efficacy of intra vaginal diazepam for high tone pelvic floor dysfunction. Further large, well powered randomized controlled trials are needed to clarify its therapeutic role.</div></div>","PeriodicalId":100330,"journal":{"name":"Continence Reports","volume":"15 ","pages":"Article 100087"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parameters which predict detrusor overactivity after adjustable trans obturator male system (ATOMS) implant.","authors":"Miguel Vírseda-Chamorrro ,&nbsp;Sonia Ruiz-Graña ,&nbsp;Jesús Salinas-Casado ,&nbsp;Javier Angulo Cuesta","doi":"10.1016/j.contre.2025.100084","DOIUrl":"10.1016/j.contre.2025.100084","url":null,"abstract":"<div><h3>Aims:</h3><div>To evaluate which parameters predicted the presence of detrusor overactivity after ATOMS implant in patients who had post prostatectomy urinary incontinence (PPI).</div></div><div><h3>Method:</h3><div>We carried out a prospective study in 56 patients submitted to ATOMS implant for PPI. The study consisted of a clinical and urodynamic record before and after ATOMS implantation. We built a multivariate model to find out which variables independently influenced postoperative DO and a ROC curve to decide the best cut-off value.</div></div><div><h3>Results:</h3><div>We found that the preoperative variables were age, detrusor pressure at maximum flow rate (PQmax) the urethral resistance parameter URA and the bladder contractility index (BCI) and the postoperative variables were, the number of ATOMS adjustments, cystometric bladder capacity, bladder compliance, maximum detrusor pressure, PQmax, bladder outflow obstruction index, URA and the presence of acontractile detrusor. The multivariate model showed that the only independent variables were age (inversely related with the presence of postoperative DO), and URA (directly related). The cut-off point of URA was established at 10. 5 cm H2O.</div></div><div><h3>Conclusions:</h3><div>the degree of postoperative resistance measured by the URA parameter and age were the two factors that independently influenced the presence of postoperative DO. It is possible that these parameters are related to the reaction of detrusor muscle to the increase in postoperative urethral resistance.</div></div>","PeriodicalId":100330,"journal":{"name":"Continence Reports","volume":"14 ","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detrusor underactivity is the main reason for persistent symptoms after transurethral resection of the prostate","authors":"Esther Martinez-Cuenca,&nbsp;Miguel Á. Bonillo,&nbsp;Eduardo Morán,&nbsp;Salvador Arlandis","doi":"10.1016/j.contre.2025.100085","DOIUrl":"10.1016/j.contre.2025.100085","url":null,"abstract":"<div><h3>Introduction:</h3><div>Transurethral resection of the prostate has been considered the gold standard for surgical management of benign prostatic enlargement. Despite its high success rate, a percentage of patients (20%–40%) do not improve afterward. Our purpose is to determine the underlying lower urinary tract dysfunction of patients with persistent symptoms after transurethral resection of the prostate (TURP).</div></div><div><h3>Material and methods:</h3><div>We queried our prospectively maintained database to identify male patients with lack of symptoms improvement after TURP for benign condition. Patients with neurological condition and prostate cancer were excluded.</div><div>Evaluation included symptoms assessment, prostate volume, uroflowmetry, maximum cystometric capacity, bladder compliance, detrusor overactivity and urodynamic stress urinary incontinence. We considered obstruction if <em>Bladder Outlet Obstruction Index</em> (BOOI) <span><math><mo>≥</mo></math></span> 40, no obstruction if BOOI &lt; 20. We considered detrusor underactivity if <em>Bladder Contractility Index</em> (BCI) &lt; 100.</div></div><div><h3>Results:</h3><div>219 patients had complete urodynamic study. Complete data were obtained from 107 patients, the mean (SD) age was 65.6 (8.2) years. Median (IQR) prostatic volume was 40 (31)cc. After surgery, storage symptoms were the most prevalent (73.8% of the patients). Urodynamic findings were: detrusor underactivity in 75 of 107 patients (70.1%), detrusor overactivity in 54 (50.5%), obstruction in 26 (24.3%).</div><div>The only correlation found was between the pre-surgery voided volume in uroflowmetry and detrusor overactivity in the urodynamic study (rho: −0.28, p <span><math><mo>=</mo></math></span> 0.033). No difference regarding Qmax before and after TURP was observed in the detrusor underactivity group (p <span><math><mo>=</mo></math></span> 0.481). Unfavorable outcome after previous prostate surgery might be explained by detrusor underactivity rather than obstruction.</div></div><div><h3>Conclusions:</h3><div>The most common persistent symptoms after TURP are storage, and the most common urodynamic finding is detrusor underactivity. In this scenario urodynamic study is advisable.</div></div>","PeriodicalId":100330,"journal":{"name":"Continence Reports","volume":"14 ","pages":"Article 100085"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Glucagon like Peptide-1 agonists on patients with overactive bladder: A pilot study","authors":"Max D. Sandler ,&nbsp;Adam D. Williams ,&nbsp;Alan Wein ,&nbsp;Katherine Amin ,&nbsp;Raveen Syan","doi":"10.1016/j.contre.2025.100083","DOIUrl":"10.1016/j.contre.2025.100083","url":null,"abstract":"<div><h3>Purpose:</h3><div>To explore preliminary data on the subjective impact of Glucagon-Like Peptide-1 (GLP-1) agonists, commonly used for diabetes and obesity, on symptoms of overactive bladder (OAB), in order to guide future, larger-scale investigations.</div></div><div><h3>Methods:</h3><div>We distributed an anonymous survey on an online forum. Participants aged 18 or older who had used GLP-1 agonists and experienced OAB symptoms were eligible. We collected data on participants’ OAB symptoms, body weight changes, reasons for GLP-1 prescription, and demographics. Data was analyzed using SAS® software, with significance set at p &lt; 0.05.</div></div><div><h3>Results:</h3><div>Of 33 respondents, 27 identified as female and 6 male. All used semaglutide, primarily for weight loss (96.9%). Four had a urinary condition besides OAB. Eleven (33.3%) reported OAB symptom improvement after starting GLP-1 agonists with mean weight loss of 12.2%, but this was not significantly different from those with no change or worsening symptoms (8.4% and 10% mean weight loss, respectively; p = 0.24). Half of those with OAB episodes at least once daily experienced symptom improvement, compared to 7.7% with less frequent symptoms (p = 0.01). Of participants reporting symptom improvement, 90.91% experienced OAB daily (p = 0.01).</div></div><div><h3>Conclusion:</h3><div>While weight loss can improve OAB symptoms, the impact of GLP-1 agonists remains unclear. Our findings may suggest that those with more frequent OAB symptoms at baseline may derive greater benefit from GLP-1 agonists, offering a potential hypothesis for future investigation. Further studies are needed to explore how these medications impact management of OAB.</div></div>","PeriodicalId":100330,"journal":{"name":"Continence Reports","volume":"14 ","pages":"Article 100083"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}