Neurourology and Urodynamics最新文献

{"title":"Management of Urinary Symptoms in Multiple Sclerosis: An Umbrella Review.","authors":"Sina Hamzehzadeh, Donyasadat Hashemian, Saman Baharomid, Fateme Tahmasebi, Seyedemad Seyedgholami Sharabiani, Sakineh Hajebrahimi, Mahnaz Talebi, Hanieh Salehi-Pourmehr, Amirreza Naseri","doi":"10.1002/nau.70492","DOIUrl":"https://doi.org/10.1002/nau.70492","url":null,"abstract":"<p><strong>Background: </strong>Lower urinary tract dysfunctions (LUTDs) are prevalent among patients with multiple sclerosis (MS), which is the most common immune-mediated neurologic disease among the juvenile population. This study aims to evaluate the efficacy and safety of different methods in the management of MS-related LUTD.</p><p><strong>Methods: </strong>This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Joanna Briggs Institute (JBI) methods. Systematic review studies that reported the efficacy of any management method for LUTD in MS are considered for inclusion. A systematic search was conducted in PubMed, Scopus, Embase, and Web of Science and risk of bias was assessed using the JBI critical appraisal checklist for systematic reviews.</p><p><strong>Results: </strong>Out of 342 screened records, 34 systematic reviews were included. Preliminary efficacy and safety of pelvic floor muscle training (PFMT) and tibial nerve stimulation (TNS), as well as the potential of alpha-blockers, cannabinoids, mirabegron, spinal cord stimulation, sacral neuromodulation, transcranial neuromodulations, vaginal/rectal and clitoral/penile stimulation, foot reflexology, craniosacral therapy, and stem cell therapy were suggested. Despite the appropriate efficacy, anticholinergics, desmopressin, intradetrusor injections of botulinum toxin A, vanilloids, and catheterization were found to cause considerable side effects.</p><p><strong>Discussion: </strong>Despite a high prevalence of LUTDs in MS patients, evidence basis of the management methods is still poor and there is lack of well-designed randomized controlled trials, which makes evidence inconclusive. Future research is needed to refine treatment algorithms, investigate the potential of combination therapies, and develop individualized treatment paradigms.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor on: Noninvasive Triage of Bladder Outlet Obstruction and Detrusor Underactivity in Men With Lower Urinary Tract Symptoms: A Narrative Review and Conceptual Framework for Depth-Aware Multimodal Transcutaneous Testing.","authors":"Sehwan Kim, Bryan K Kim, John T Stoffel, Aram Kim","doi":"10.1002/nau.70454","DOIUrl":"https://doi.org/10.1002/nau.70454","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Letter to Editor on \"One Size Does Not Fit All: Establishing Anticipated Baseline Intravesical Pressures Adjusted for Position and Body Mass Index\".","authors":"Jacqueline Zillioux, Mikel Gray","doi":"10.1002/nau.70488","DOIUrl":"https://doi.org/10.1002/nau.70488","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"Pediatric Patients Undergoing Enterocystoplasty and Risk of Metabolic Disease: A Single Center Retrospective Study\".","authors":"Nitin Jain","doi":"10.1002/nau.70467","DOIUrl":"https://doi.org/10.1002/nau.70467","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Examination of Mitrofanoff Channel Findings and Subsequent Surgical Change of Management-Observations From a 2-Year Patient Cohort.","authors":"Keith Pace, Vishali Sharma, Julia Ali, Tamsin J Greenwell, Jeremy L Ockrim, Mahreen Pakzad, Richard P Nobrega, Helena Gresty, Rachel Barratt, Anthony O Noah","doi":"10.1002/nau.70482","DOIUrl":"https://doi.org/10.1002/nau.70482","url":null,"abstract":"<p><strong>Introduction: </strong>A Mitrofanoff channel is a continent catheterisable channel, most commonly constructed from the appendix or small bowel (Monti channel) to provide an alternative to the urethra for intermittent catheterization. It is imperative for patients to be counselled on the risks of channel complications, including stomal stenosis, recurrent urinary tract infections (rUTI), and, less commonly, incontinence. Endoscopy of the Mitrofanoff (Mitrofanoscopy), is a diagnostic tool employed in these scenarios to visualize the channel and bladder. Herein, we aim to characterize the findings of Mitrofanoscopy and establish whether this leads to a change in surgical management.</p><p><strong>Methods: </strong>A single centre, retrospective review of diagnostic Mitrofanoscopy performed to assess for channel complications between January 2023 and January 2025.</p><p><strong>Results: </strong>Of 140 procedures, 83 diagnostic procedures were analyzed. The overall diagnostic yield (defined as the presence of one or more positive findings) was 55.4%. This was highest when performed for difficulty with catheterizing the channel (74.3%), and lowest for channel leak (22.2%). 34.9% (N = 29) of patients required a change in surgical management, including channel dilatation (32.5%), superficial revision (13.8%), complete revision of the Mitrofanoff channel (27.6%), fistula repair (3.4%) and/or repeat Mitrofanoscopy for lithotripsy (3.4%), biopsy, bladder washout or surveillance of benign lesions (13.8%).</p><p><strong>Conclusion: </strong>The findings can be used to better inform patients during the consenting process by providing more accurate expectations regarding diagnostic yield and downstream management. Mitrofanoscopy is most useful when investigating patients having difficulty catheterizing and may have limited value in those with isolated channel leak.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standing or Sitting to Void? Comparative Uroflowmetry in Healthy Male Volunteers: A Randomized Crossover Study with Equivalence Analysis.","authors":"Juan Iregui-Parra, Santiago Millán-Serna, Mónica G Delgado-Caicedo, Isabella Morales García, Paula Andrea Salas Espinosa, Claudia Marcela Arias, Leydi Tatiana Chávez Pérez, Luis Alfredo Wadskier Gutiérrez, Roberto José Zambrano Guerra, Daniel Mauricio Colmenares Leal","doi":"10.1002/nau.70485","DOIUrl":"https://doi.org/10.1002/nau.70485","url":null,"abstract":"<p><strong>Introduction: </strong>The posture adopted during voiding may influence uroflowmetric parameters, such as maximum urinary flow rate (Qmax), voided volume, and time to maximum flow (tQmax). Published studies have shown inconsistent results, and uncertainty persists regarding the clinical relevance of these differences in healthy men.</p><p><strong>Objective: </strong>To compare uroflowmetric parameters during standing and sitting voiding in healthy male volunteers using a randomized crossover design, incorporating a formal equivalence analysis (Two One-Sided Tests, TOST) for the primary outcome (Qmax).</p><p><strong>Material and methods: </strong>This prospective, randomized, 2 × 2 crossover study included 52 healthy male volunteers allocated to the sitting → standing (n = 24) or standing → sitting (n = 28) sequence, with a minimum washout period of 24 h. The primary outcome was Qmax and the secondary outcomes were the total voided volume and tQmax. Paired tests, correction for multiple comparisons (Bonferroni and Benjamini-Hochberg), linear mixed-effects models, Bayesian analysis, and TOST equivalence analysis for Qmax (margin ±2.5 mL/s) were used.</p><p><strong>Results: </strong>Baseline characteristics were comparable between sequences. No significant differences between postures were observed for Qmax (Δ = -1.47 mL/s; 95% CI -3.55 to 0.62; p = 0.164) or for total volume (Δ = -14.7 mL; 95% CI -43.9 to 14.6; p = 0.318). The tQmax was longer while standing (Δ = +3.32 s; 95% CI 0.94 to 5.69; p = 0.011), remaining significant after Bonferroni correction (p = 0.031) and FDR correction (q = 0.031). The mixed models did not identify either sequence or period effects. Bayesian analysis showed moderate evidence in favor of a difference in tQmax (BF₁₀ = 4.99) and in favor of no difference in volume (BF₀₁ = 4.10). The equivalence analysis (TOST) for Qmax was not significant (p-TOST ≈ 0.16); therefore, the equivalence of the maximum flow between postures could not be formally claimed with the present sample size.</p><p><strong>Conclusions: </strong>In healthy men, voiding posture did not significantly modify the maximum urinary flow rate or voided volume; however, formal equivalence of Qmax was not demonstrated. The sitting position was associated with a shorter time to maximum flow, a small difference that is unlikely to be clinically meaningful and was partly dependent on a single outlier. Larger, pre-registered studies with pre-specified equivalence analyses and symptomatic populations are required.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bladder Contractility Classification Before Bladder Outlet Surgery: Do BCI, Wmax and the Maastricht-Hannover Nomogram Agree and Does It Matter for Outcome?","authors":"Selma Palthe, Nadine A M van Merode, Jeroen Kolenburg, Tom Marcelissen, Martijn G Steffens, Gommert A van Koeveringe, John P Heesakkers, Lambertus P W Witte","doi":"10.1002/nau.70489","DOIUrl":"https://doi.org/10.1002/nau.70489","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to assess the concordance between three classification systems (bladder contractility index, Maximum Watt's factor and Maastricht-Hannover nomogram) in allocating men to bladder contractility subgroups. Secondary aim was to explore whether preoperative contractility classification was associated with short-term flowmetry outcomes after BOP.</p><p><strong>Materials and methods: </strong>This multicenter retrospective cohort study included men who underwent BOP (2010-2016) for lower urinary tract symptoms with available baseline urodynamic study and 6-week postoperative flowmetry. Patients were classified according to BCI, Wmax and MH-nomogram into very weak (BCI < 50, Wmax < 5, MH-nomogram < 10th percentile), weak (BCI: 50-100, Wmax: 5-10, MH-nomogram 10-25th percentile) and normal detrusor contractility (BCI > 100, Wmax > 10, MH-nomogram > 25th percentile) subgroups. Concordance was quantified using percentage agreement and Cohen's linear weighted kappa (κ). Postoperative flowmetry outcomes were compared between subgroups within each classification and pre-postoperative differences were determined for each subgroup.</p><p><strong>Results: </strong>One hundred and thirty three patients were included (median age 69 years). Agreement was highest between BCI and Wmax (78.9%, κ = 0.61, substantial), while agreement was weak between Wmax and MH-nomogram (48.9%, κ = 0.31) and negligible between BCI and MH-nomogram (37.6%, κ = 0.05). All subgroups showed improvement Qmax and PVR parameters after BOP, with no significant association found between preoperative contractility grade and postoperative outcomes.</p><p><strong>Conclusions: </strong>BCI, Wmax and the MH-nomogram show only limited concordance, particularly involving the MH-nomogram, and cannot be regarded as interchangeable. Contractility classification was not associated with postoperative outcomes, and all subgroups improved after BOP. These findings underscore the need for a clinically relevant urodynamic consensus definition of DU and support shared decision-making over classification-based patient selection alone.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"Sensing in Sacral Neuromodulation: Objective, Individualized Stimulation Response Thresholds Directly From the Lead\".","authors":"Abdulkadir Ozmez, Mehmet Ozay Ozgur","doi":"10.1002/nau.70486","DOIUrl":"https://doi.org/10.1002/nau.70486","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"Association Between Toilet Training Timing and Prognosis of Nocturnal Enuresis in Children: A Retrospective Study\".","authors":"Abdulkadir Ozmez, Mehmet Ozay Ozgur","doi":"10.1002/nau.70487","DOIUrl":"https://doi.org/10.1002/nau.70487","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to Editor on Determinants of Estrogen Prescriptions for Recurrent Urinary Tract Infection.","authors":"Khizra Faisal, Bushra Ajmal","doi":"10.1002/nau.70474","DOIUrl":"https://doi.org/10.1002/nau.70474","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}