International Neurourology Journal最新文献

{"title":"The Comparative Effectiveness of Botulinum Toxin-A Injection Therapy Versus Augmentation Uretero-Enterocystoplasty for the Treatment of Lower Urinary Tract Dysfunction.","authors":"Xuesheng Wang,&nbsp;Zhonghan Zhou,&nbsp;Limin Liao","doi":"10.5213/inj.2244220.110","DOIUrl":"https://doi.org/10.5213/inj.2244220.110","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated the effectiveness of intravesical botulinum toxin-A (BTX-A) injection therapy in patients with lower urinary tract dysfunction (LUTD) and upper urinary tract (UUT) deterioration and evaluated whether BTX-A injection therapy could substitute for augmentation uretero-enterocystoplasty (AUEC).</p><p><strong>Methods: </strong>Data from a prospective, single-center cohort from 2017-2021 were analyzed. Patients were divided into 2 treatment groups: AUEC and BTX-A (i.e., patients who declined AUEC). Bladder and UUT functions were assessed by comparing clinical information, urodynamic data, laboratory results, and imaging records.</p><p><strong>Results: </strong>In total, 121 patients were enrolled (BTX-A group: 41 patients; AUEC group: 80 patients). The BTX-A group showed a reduced maximum detrusor pressure and increases in the maximum bladder volume and bladder compliance (P<0.05). However, in follow-up evaluations, significantly smaller improvements (all P<0.05) in urodynamic parameters were found in the BTX-A group than in the AUEC group. Notably, there was no significant improvement in vesicoureteral reflux (VUR; P=0.66) or upper urinary tract dilatation (UUTD; P=0.75) in the BTX-A group, and no statistically significant difference in serum creatinine (Scr) levels or the estimated glomerular filtration rate (eGFR) was observed in the follow-up evaluations (all P>0.05). Both VUR and UUTD improved significantly in the AUEC group, and the Scr and eGFR levels significantly improved after AUEC relative to baseline levels (P<0.05). The reduction in the Scr level was significantly lower in the BTX-A group than in the AUEC group during 0-15 months of follow-up (Scr reduction differences, -1.36; P<0.01).</p><p><strong>Conclusion: </strong>Although BTX-A injection therapy was effective for improving bladder function, BTX-A injections did not alleviate UUT deterioration in this study, particularly in patients with advanced-stage LUTD. Conversely, AUEC for LUTD has a well-established role in improving UUT function. Hence, BTX-A injection therapy should not replace AUEC to ameliorate UUT impairment and protect UUT function.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"27 1","pages":"36-46"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/cf/inj-2244220-110.PMC10073004.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9257266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of Urolithiasis Detection Technology Based on a Multimethod Algorithm.","authors":"Jong Mok Park,&nbsp;Sung-Jong Eun,&nbsp;Yong Gil Na","doi":"10.5213/inj.2346070.035","DOIUrl":"https://doi.org/10.5213/inj.2346070.035","url":null,"abstract":"<p><strong>Purpose: </strong>In this paper, we propose an optimal ureter stone detection model utilizing multiple artificial intelligence technologies. Specifically, the proposed model of urinary tract stone detection merges an artificial intelligence model and an image processing model, resulting in a multimethod approach.</p><p><strong>Methods: </strong>We propose an optimal urinary tract stone detection algorithm based on artificial intelligence technology. This method was intended to increase the accuracy of urinary tract stone detection by combining deep learning technology (Fast R-CNN) and image processing technology (Watershed).</p><p><strong>Results: </strong>As a result of deriving the confusion matrix, the sensitivity and specificity of urinary tract stone detection were calculated to be 0.90 and 0.91, and the accuracy for their position was 0.84. This value was higher than 0.8, which is the standard for accuracy. This finding confirmed that accurate guidance to the stones area was possible when the developed platform was used to support actual surgery.</p><p><strong>Conclusion: </strong>The performance evaluation of the method proposed herein indicated that it can effectively play an auxiliary role in diagnostic decision-making with a clinically acceptable range of safety. In particular, in the case of ambush stones or urinary stones accompanying ureter polyps, the value that could be obtained through combination therapy based on diagnostic assistance could be evaluated.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"27 1","pages":"70-76"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/3a/inj-2346070-035.PMC10073001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9257267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased Expression of Urethral Caveolin-1, -2, and -3 in the Rat Model of Overactive Bladder: Potential Mediator of Functional Interaction of Urethra and Urinary Bladder.","authors":"Hyun Jin Cho,&nbsp;Han-Yi Jiao,&nbsp;Sun-Ouck Kim","doi":"10.5213/inj.2244236.118","DOIUrl":"https://doi.org/10.5213/inj.2244236.118","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of detrusor overactivity (DO) on the urethral expression of caveolin (CAV)-1, -2, and -3 of urethra in an animal model of cyclophosphamide (CYP)-induced cystitis rat.</p><p><strong>Methods: </strong>Female Sprague-Dawley rats were divided into the control group (n=20) and the cystitis group (n=20). Cystitis was induced by intraperitoneal injection of CYP (200 mg/kg). An urodynamic study was done 3 days after the CYP injection to measure functional change of the urinary bladder and urethra. Cellular localization and expression of CAV-1, -2, and -3 in the rat urethra were determined by immunohistochemistry (IHC) and Western blot.</p><p><strong>Results: </strong>Urodynamic experiments demonstrated a decreased contraction interval in the cystitis group compared to the control (3.9±1.0 minutes vs. 6.6±1.2 minutes, P<0.05). Conversely, contraction pressure increased significantly in the cystitis group compared to the control (22.4±0.7 mmHg vs. 11.5±0.4 mmHg, P<0.05). The urethral pressure was decreased in the cystitis group compared to the control (4.05 ±2.5 mmHg vs. 5.8 ±2.8 mmHg, P <0.05). The IHC and Western blot data showed that CAV-1, -2, and -3 expression decreased significantly in the cystitis group compared control group (P<0.05).</p><p><strong>Conclusion: </strong>The decreased urethral CAV-1, -2, and -3 in the DO rats suggests that CAVs might be related with the functional change of urethra in association with DO of urinay bladder.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"27 1","pages":"47-54"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/8a/inj-2244236-118.PMC10073002.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9624891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Fluid and Caffeine Modifications on Symptoms in Adults With Overactive Bladder: A Systematic Review.","authors":"Jeongok Park,&nbsp;Hyojin Lee,&nbsp;Youngkyung Kim,&nbsp;Christine Norton,&nbsp;Sue Woodward,&nbsp;Sejeong Lee","doi":"10.5213/inj.2346014.007","DOIUrl":"https://doi.org/10.5213/inj.2346014.007","url":null,"abstract":"<p><p>Overactive bladder (OAB) is prevalent in men and women and negatively impacts physical and psychological health. Fluid and caffeine intake modifications, which are lifestyle modification interventions, are simple methods to manage OAB. However, studies that synthesized both interventions and found scientific evidence are scarce. This review aimed to synthesize scientific evidence on whether fluid and caffeine intake modifications are effective for OAB symptoms. PubMed, CINAHL (Cumulative Index for Nursing and Allied Health Literature), Embase, Scopus, the Cochrane Library, KoreaMed, and RISS (Research Information Sharing Service) were used to search for studies and 8 studies were included. The Cochrane risk of bias tool (RoB 2.0) and ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions) were used to assess the quality of selected studies. Due to the heterogeneous outcome variables, a meta-analysis was not conducted. Among the 8 included, 7 studies were randomized controlled trials and one was a quasi-experimental study. Four studies assessed urgency. Caffeine reduction was statistically effective for urgency symptoms, but increasing fluid intake was not. Frequency was assessed in 5 studies, which showed decreasing caffeine and fluid intake was effective in treating the symptoms. Urinary incontinence episodes were assessed in 6 studies, and nocturia in 2. Restricting caffeine intake was effective in treating these 2 symptoms, but restricting both caffeine and fluid intake was not. Quality of life (QoL) was examined in 5 studies, and modifying fluid and caffeine intake significantly improved QoL in 2. Although there were limited studies, our review provides scientific evidence that fluid and caffeine intake modification effectively manages OAB symptoms. Further research should examine acceptability and sustainability of interventions in the long-term and enable meta-analysis.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"27 1","pages":"23-35"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/45/inj-2346014-007.PMC10073005.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9624889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video Urodynamics in the Digital Age: What Have We Overlooked?","authors":"Tack Lee,&nbsp;Eunmi Kang,&nbsp;Hae Young Lee","doi":"10.5213/inj.2323edi01","DOIUrl":"https://doi.org/10.5213/inj.2323edi01","url":null,"abstract":"Copyright © 2023 Korean Continence Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. A urodynamic study is an important test that helps clinicians objectively evaluate a patient’s subjective voiding symptoms and decide on the optimal treatment. Additionally, video urodynamic studies enable a more in-depth investigation of the causes of voiding dysfunction by observing structural changes and motions of the bladder and urethra. Several studies have reported evidence questioning the role of urodynamics in some diseases [1,2]; this is an important issue that medical professionals responsible for treating voiding dysfunction should address. As a clinician who has been caring for patients with voiding dysfunction and performing urodynamic tests for 30 years, I (the first author of this editorial) believe that one of the most important functions of urodynamic studies is to train clinicians to be experts in the field of voiding dysfunction, even though this is difficult to objectively demonstrate. In any case, this is a suitable time to discuss the history of urodynamics, how it has evolved over time, and the challenges we are currently facing. Video urodynamic studies are the most technologically advanced clinical method for diagnosing voiding dysfunction, and it serves as a prototypical illustration of the successful transition from analog to digital machine technology that has accompanied rapid industrial development in recent years. However, as a clinician who has performed urodynamic tests in both eras, I would like to point out one critical disadvantage of modern digital machines. The most significant advantage of video urodynamic studies in the analog era was that the functionsynchronized bladder and urethral movements were recorded on videotape and could be viewed and analyzed at any time following the test. Modern digital machines lack this advantage of older analog machines. The original definition of “video” refers to a recording of an image or moving images [3]. The majority of medical professionals who carry out urodynamic tests agree that these tests involve moving images. For the human eye to be able to detect motion, a frame rate of greater than 15 per second is required [4]. Storing large numbers of images to show motion was not a problem with videotape, but it appears to be an issue in the digital era. Therefore, it is presumed that this technical limitation with computers was handled by limiting the number of images that could be saved. For this reason, I think that the term “cystographic urodynamic study,” rather than “video urodynamic study,” would better describe what is done with modern digital urodynamic study devices, because the images do not appear to be in motion. Ou","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"27 1","pages":"1-2"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/df/09/inj-2323edi01.PMC10073003.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9257265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Age and Multiple Vaginal Births on Lower Urinary Tract Structure and Function in Nonhuman Primates.","authors":"J Koudy Williams,&nbsp;Karl-Erik Andersson,&nbsp;Shannon Lankford,&nbsp;Gopal Badlani","doi":"10.5213/inj.2244250.125","DOIUrl":"https://doi.org/10.5213/inj.2244250.125","url":null,"abstract":"<p><strong>Purpose: </strong>The relative roles of urinary sphincter damage, aging, and childbirth in stress urinary incontinence (SUI), have not been established. This study was performed to elucidate the roles of these factors.</p><p><strong>Methods: </strong>The study included: (1) 8 female cynomolgus monkeys (17-19 years of age and 7-8 vaginal births each); (2) six 5-yearold nulliparous monkeys with surgically created chronic urinary sphincter dysfunction; and (3) six 5-year-old, nulliparous, nosurgery controls. Sedated abdominal leak point pressure (ALPP) and maximum urethral sphincter pressures (MUP) were measured. Sphincters, bladders, and pelvic support muscles were quantified for collagen content. Additionally, bladders were analyzed for collagen fiber thickness, length, and angle using CT-FIRE analysis of Picrosirius red-stained tissues.</p><p><strong>Results: </strong>Resting MUP values were similar in the controls and older multiparous monkeys (P>0.05). However, aging and multiple births reduced pudendal nerve-stimulated increases in MUP (P<0.05 vs. controls). ALPP values were lower in the older multiparous versus younger groups of monkeys (P<0.05). Sphincter collagen content was greater, and muscle content less, in the injury model (P<0.05 vs. controls). However, these measures were not affected by age and childbirth (P>0.05 vs. young groups). Bladder collagen content was greater, and muscle content less, in the old multiparous monkeys (P<0.05 vs. younger groups). Additionally, collagen fibers were thicker and more angular in the bladders of the older multiparous monkeys than in the other nonhuman primate groups (P<0.05). Pelvic support muscles had higher collagen and lower muscle content in the older multiparous monkeys than in the younger groups of monkeys (P<0.05).</p><p><strong>Conclusion: </strong>SUI, associated with aging and multiple childbirths, appeared to be more strongly associated with bladder dysfunction, reduced pelvic muscle support, and the compensatory response to neural stimulation than with selective urinary sphincter dysfunction.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"27 1","pages":"55-62"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8e/b7/inj-2244250-125.PMC10072999.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9624893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Velocity-Based Approach to Noninvasive Methodology for Urodynamic Analysis.","authors":"Lorenzo Lotti,&nbsp;Pietro Spatafora,&nbsp;Vincenzo Li Marzi,&nbsp;Giulio Nicita,&nbsp;Enio Paris,&nbsp;Sergio Serni","doi":"10.5213/inj.2244274.137","DOIUrl":"https://doi.org/10.5213/inj.2244274.137","url":null,"abstract":"<p><strong>Purpose: </strong>To date, invasive urodynamic investigations have been used to define most terms and conditions relating to lower urinary tract symptoms. This invasiveness is almost totally due to the urethral catheter. In order to remove this source of discomfort for patients, the present study investigated a noninvasive methodology able to provide diagnostic information on bladder outlet obstruction or detrusor underactivity without any contact with the human body.</p><p><strong>Methods: </strong>The proposed approach is based on simultaneous measurements of flow rate and jet exit velocity. In particular, the jet exit kinetic energy appears to be strongly related to bladder pressure, providing useful information on the lower urinary tract functionality. We developed a new experimental apparatus to simulate the male lower urinary tract, thus allowing extensive laboratory activities. A large amount of data was collected regarding different functional statuses.</p><p><strong>Results: </strong>Experimental results were compared successfully with data in the literature in terms of peak flow rate and jet exit velocity. A new diagram based on the kinetic energy of the exit jet is proposed herein. Using the same notation as a Schäfer diagram, it is possible to perform noninvasive urodynamic studies.</p><p><strong>Conclusion: </strong>A new noninvasive approach based on the measurement of jet exit kinetic energy has been proposed to replace current invasive urodynamic studies. A preliminary assessment of this approach was carried out in healthy men, with a specificity of 91.5%. An additional comparison using a small sample of available pressure-flow studies also confirmed the validity of the proposed approach.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"27 1","pages":"63-69"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/6e/inj-2244274-137.PMC10072997.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9404157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Innovative Approach in Functional Bladder Disorders: The Communication Between Bladder and Brain-Gut Axis.","authors":"Jiwon Jung,&nbsp;Aram Kim,&nbsp;Seung-Hoon Yang","doi":"10.5213/inj.2346036.018","DOIUrl":"https://doi.org/10.5213/inj.2346036.018","url":null,"abstract":"<p><p>Functional bladder disorders including overactive bladder and interstitial cystitis may induce problems in many other parts of our body such as brain and gut. In fact, diagnosis is often less accurate owing to their complex symptoms. To have correct diagnosis of these diseases, we need to understand the pathophysiology behind overlapped clinical presentation. First, we focused on reviewing literatures that have reported the link between bladder and brain, as the patients with bladder disorders frequently accompanied mood disorders such as depression and anxiety. Second, we reviewed literatures that have described the relationship between bladder and gut. There exist many evidences of patients who suffered from both bladder and intestinal diseases, such as irritable bowel syndrome and inflammatory bowel disease, at the same time. Furthermore, the interaction between brain and gut, well-known as brain-gut axis, might be a key factor that could change the activity of bladder and vice versa. For example, the affective disorders could alter the activity of efferent nerves or autonomic nervous system that modulate the gut itself and its microbiota, which might cause the destruction of homeostasis in bladder eventually. In this way, the communication between bladder and brain-gut axis might affect permeability, inflammation, as well as infectious etiology and dysbiosis in bladder diseases. In this review, we aimed to find an innovative insight of the pathophysiology in the functional bladder disorders, and we could provide a new understanding of the overlapped clinical presentation by elucidating the pathophysiology of functional bladder disorders.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"27 1","pages":"15-22"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/6f/inj-2346036-018.PMC10072998.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9624890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"Interstitial Cystitis - A Consequence of Weakened Uterosacral Ligaments Failing to Support Visceral Plexuses and Bladder Stretch Receptors and Therefore Potentially Curable?\"","authors":"Tomohiro Ueda","doi":"10.5213/inj.2142204.102","DOIUrl":"https://doi.org/10.5213/inj.2142204.102","url":null,"abstract":"Copyright © 2022 Korean Continence Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Corresponding author: Tomohiro Ueda https://orcid.org/0000-0002-9611-5691 Department of Urology, Ueda Clinic, 6F CUBEOIKE, 599 Bano-cho, Anekojisagaru, Karasuma-dori, Nakagyo-ku, Kyoto 604-8172, Japan Email: tom328177@gmail.com Submitted: November 29, 2021 / Accepted after revision: June 9, 2022 To the editor, Interstitial cystitis/bladder pain syndrome (IC/BPS) is a heterogeneous disease consisting of distinct subgroups of patients who have different underlying pathophysiology. Thus, the proposal by Prof. Petros that loose or damaged uterosacral ligaments (USLs) may be an important etiology outside the bladder to induce or worsen the symptoms of IC/BPS due to altered urothelial receptor sensitivity is interesting. However, for the proper diagnosis and treatment of IC/BPS, it is necessary to first identify bladder-centric pathophysiology including Hunner lesions by using cystoscopy and also prove that identified bladder mucosal abnormalities are the causes of bladder pain, for example, as shown by pain reduction following intravesical lidocaine instillation in the recent dimethyl sulfoxide clinical trial in IC/BPS patients [1,2]. Then, in the case that bladdercentric pathophysiology is less likely to be involved in IC/BPS symptoms, outside-bladder etiology such as the lax USL discussed here should be considered as a cause of bladder symptoms in IC/BPS patients. There will be no bright future for IC/ BPS without the following 3 steps: (1) understanding the symptoms, (2) detecting abnormal findings in or outside the bladder, and (3) verifying that the abnormality is the cause of the symptoms. • Conflict of Interest: No potential conflict of interest relevant to this article was reported.","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"26 4","pages":"352"},"PeriodicalIF":2.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/8e/inj-2142204-102.PMC9816451.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9083248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Intravesical Electrical Stimulation on Urinary Adenosine Triphosphate and Nitric Oxide in Rats With Detrusor Underactivity Induced By Bilateral Pelvic Nerve Crush Injury: The Possible Underlying Mechanism.","authors":"Han Deng,&nbsp;Limin Liao,&nbsp;Xing Li,&nbsp;Qinggang Liu,&nbsp;Xuesheng Wang,&nbsp;Zhonghan Zhou","doi":"10.5213/inj.2244162.081","DOIUrl":"https://doi.org/10.5213/inj.2244162.081","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the effect of intravesical electrical stimulation (IVES) on urinary adenosine triphosphate (ATP) and nitric oxide (NO) in rats with detrusor underactivity (DU) induced by bilateral pelvic nerve crush (bPNC), and to determine the underlying peripheral mechanism.</p><p><strong>Methods: </strong>Twenty-four female Sprague-Dawley rats were equally divided into 3 groups: sham; bPNC; and IVES. Rats in the IVES group began to receive IVES treatment 10 days after bPNC (20 minutes per day for 14 consecutive days). After the 14th IVES, rat urine was collected and cystometry was performed. The serum creatinine, blood urea nitrogen, and urinary ATP and NO levels were measured, and a routine urinalysis was performed.</p><p><strong>Results: </strong>The maximum cystometric capacity (MCC), maximum changes in bladder pressure during filling (∆FP), and postvoid residual urine (PVR) in the IVES group were significantly lower than the bPNC group, and the maximum changes in bladder pressure during voiding (∆VP) was significantly higher than the bPNC group. Compared with the sham group, the MCC, ∆FP and PVR were significantly increased, and the maximum voiding pressure (MVP) and ∆VP were significantly decreased in the bPNC group. After bPNC, urinary ATP was significantly decreased, and urinary NO was significantly increased. In IVES-treated rats, urinary ATP was significantly higher than the bPNC group, and NO was significantly lower than the bPNC group. In addition, the ATP-to-NO ratio of the rats in the bPNC group was significantly lower than the sham and IVES groups. Correlation analysis showed that the ATP and NO were not correlated with the MCC, ∆FP, MVP, ∆VP, and PVR.</p><p><strong>Conclusion: </strong>Promoting the release of urothelial ATP and inhibiting the release of urothelial NO may be one of the peripheral mechanisms underlying IVES in the treatment of DU. Specifically, IVES may shift the balance between excitation and inhibition toward excitation.</p>","PeriodicalId":14466,"journal":{"name":"International Neurourology Journal","volume":"26 4","pages":"288-298"},"PeriodicalIF":2.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/21/inj-2244162-081.PMC9816450.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10520018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}