Neurourology and Urodynamics最新文献

{"title":"Impact of Antibiotic Choice at the Time of Sacral Neuromodulation Implantation on Rates of Surgical Site Infection.","authors":"Hope H Bauer, Peyton S Johnston, Stephen P Rhodes, Adonis K Hijaz, David Sheyn","doi":"10.1002/nau.25595","DOIUrl":"https://doi.org/10.1002/nau.25595","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of specific antibiotic regimens in preventing infection following sacral neuromodulation.</p><p><strong>Materials and methods: </strong>This is a retrospective cohort study utilizing the Premier Healthcare Database. Patients who underwent sacral neuromodulation placement between January 2016 and March 2020. The patients were grouped by those who received dual antibiotic therapy per 2019 AUA guidelines (Gram positive + broad Gram negative coverage), first- or second-generation cephalosporins or any other regimen. Comparison between groups was performed using Kruskal-Wallis and χ² tests for continuous and categorical variables, respectively. Inverse probability of treatment weighted (IPTW) analysis was used to estimate the average treatment effect of AUA guidelines regimens versus the use the first- or second-generation cephalosporins alone.</p><p><strong>Results: </strong>The sample included 14 179 patients, with 2211 patients receiving prophylaxis that followed the AUA guideline recommendations. There was no significant difference in surgical site infection rates within 3 months (p = 0.28) or within 12 months (p = 0.53) between the groups. On IPTW, the probability of an infection at 3 months was lower with the AUA guideline regimens compared to those who received first- or second-generation cephalosporins alone, but this difference was not statistically significant (OR = 0.73, 95% CI: [0.43, 1.24]).</p><p><strong>Conclusions: </strong>In the absence of allergies to cephalosporins or penicillin, first- or second-generation cephalosporins alone may be a sufficient preoperative antibiotic regimen for prevention of infection at the time of sacral neuromodulation.</p><p><strong>Trial registration: </strong>Not applicable due to being a database study.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372394","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":"Comparison of Surgical Outcomes of Autologous Mid-Urethral Fascia Slings and Retropubic Mid-Urethral Slings for Women Undergoing a Primary Surgery for Stress Urinary Incontinence: A Systematic Review and Meta-Analysis.","authors":"Naşide Mangir, Hayrullah Güler, Hakan Keskin","doi":"10.1002/nau.25593","DOIUrl":"https://doi.org/10.1002/nau.25593","url":null,"abstract":"<p><strong>Aim: </strong>Current guidelines on surgical treatment of stress urinary incontinence (SUI) recommend an informed decision making process between the physicians and patients reviewing all available surgical options with and without mesh. However, there is a lack of synthesized clinical evidence on some of the comparisons that can feed into patient counseling processes. The aim of this study was to review the available studies comparing clinical outcomes of an autologous fascial sling (AFS) and a retropubic (RP) synthetic sling for women undergoing a primary surgery for SUI.</p><p><strong>Methods: </strong>We conducted a literature search from 1990 to 2024 following international guidelines. We have included studies reporting on comparative outcomes of AFS and RP synthetic sling surgeries as a primary procedure.</p><p><strong>Results: </strong>Three randomized studies were included with follow-up durations ranging from 24 months to 10 years. The mean percentage change in symptom scores ranged from 27.7% to 44.9%, with no significant difference between the two sling types. There was no difference between groups with regard to objective cure rates, subjective cure rates and length of hospital stay between AFS and RP slings. AFS surgeries had longer operative times. There were concerns about bias, particularly related to allocation, blinding, and missing outcome data.</p><p><strong>Conclusion: </strong>Overall, both types of slings had similar cure rates but AFSs were associated with longer operative times. The study highlights the need for more research on the comparative effectiveness of AFS and synthetic slings for SUI surgery to guide decision-making for SUI surgical treatments.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350905","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":"Preventive Effects of Gonadotropin-Releasing Hormone Treatment on Urinary Bladder and Kidney Damage in Spinal Cord Injured Rats.","authors":"Denisse Calderón-Vallejo, Irma Hernández-Jasso, Carlos Guillermo Martínez-Moreno, Carlos Arámburo, Alvaro Munoz, Ma Consolación Martínez-Saldaña, Ernesto Marmolejo-Esparza, Luis Felipe García-Santana, J Luis Quintanar","doi":"10.1002/nau.25591","DOIUrl":"10.1002/nau.25591","url":null,"abstract":"<p><strong>Introduction: </strong>One of the main causes of a neurogenic bladder is spinal cord injury (SCI),(SCI), which induces little or no bladder reflex activity. Because of this alteration, there is an increased risk of developing urinary tract infections and kidney damage. Gonadotropin-releasing hormone (GnRH) treatment has been shown to improve micturition in a rat model of SCI.</p><p><strong>Aim: </strong>The present study was aimed at determining whether GnRH administration is capable to reduce bladder and kidney damage in rats with SCI.</p><p><strong>Methods: </strong>Ovariectomized female Wistar rats were divided into three groups: sham, SCI with saline solution (SCI), and SCI treated with GnRH (SCI+GnRH) for 6 weeks. SCI was induced by compression at the T10 spinal level. At the end of the experiment, bladders and kidneys were processed for morphological and immunofluorescence analysis. For morphometric analysis, the thickness of the urothelium and the muscular layer of the bladder was measured, as well as the intensity of staining related to collagen in the kidney.</p><p><strong>Results: </strong>At the end of the experiment, all animals in the sham group showed normal urination (100%), in contrast, the percentage of untreated injured rats (SCI) that did not require manual stimulation for micturition was 19%, while the treated group (SCI+GnRH) was 68%. A significative increase in bladder weight, urothelial and muscle thickness, and collagen-related coloration in the kidney was observed in SCI when compared to sham rats.</p><p><strong>Conclusion: </strong>GnRH administration decreased damage to the urinary bladder and kidneys after SCI in rats. These results suggest that this hormone could be a potential preventive treatment for SCI patients at risk of neurogenic bladder and kidney damage.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308224","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":"Development and Testing of the Spinal Cord Injury Bladder and Bowel Control Questionnaire (SCI-BBC-Q).","authors":"Thomas N Bryce, Chung-Ying Tsai, Jill M Wecht, Lisa Spielman","doi":"10.1002/nau.25589","DOIUrl":"https://doi.org/10.1002/nau.25589","url":null,"abstract":"<p><strong>Introduction: </strong>Recovery of lower urinary tract (LUT) and lower gastrointestinal tract (LGIT) is a high priority for people with lived experience following spinal cord injury (SCI). A universally accepted validated patient-reported outcome (PRO) measure of the individual sensory and motor components of LGIT and LUT function, which allows tracking of recovery is lacking. To address this literature gap, the SCI Bladder and Bowel Control Questionnaire (SCI-BBC-Q) was developed.</p><p><strong>Methods: </strong>The SCI-BBC-Q was developed as a direct assessment of the micturition and defecation experiences of an individual with SCI with possible neurogenic LUT and LGIT dysfunction. The SCI-BBC-Q development process consisted of two phases, measure development and evaluation. Measure development was guided by a conceptual framework, review of existing instruments and literature, and an iterative process of item incorporation, review, feedback, and consensus revision. Evaluation included cognitive interviewing, and assessments of feasibility, reliability, and content validity.</p><p><strong>Results: </strong>The final 6-item SCI-BBC-Q is a PRO, which assesses motor and sensory function related to micturition and defecation, requiring ~5 min to complete. Assessments of clarity of the instrument components with regard to understanding of what is being asked in the questionnaire, feasibility of administration, reliability, internal consistency, and agreement with proxy measures have demonstrated that the SCI-BBC-Q provides consistent, stable, and reproducible data. Significant correlations were found between SCI-BBC-Q scores and the anorectal motor and sensory components of the International Standards for the Neurological Classification of SCI.</p><p><strong>Conclusion: </strong>The SCI-BBC-Q is a practical and reliable method for baseline and ongoing evaluation of patients with neurogenic LUT and LGIT dysfunction, especially in the acute and subacute period when function is changing due to neurological plasticity. It is also appropriate for use in monitoring response to treatments related to neurological recovery.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308222","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":"Growing Up With Neurogenic Bladder: Navigating the Challenges and Controversies in Pediatric to Adult Transition and Lifelong Care: A Report From the Neurogenic Bladder Research Group (NBRG).","authors":"Dan Wood, Blayne Welk, Rose Khavari, John Stoffel, Sean Elliott, Argy Stampas, Zhina Sadeghi, Chris Elliott, Sara Lenherr","doi":"10.1002/nau.25590","DOIUrl":"10.1002/nau.25590","url":null,"abstract":"<p><strong>Objective: </strong>Young adults with spina bifida (and other congenital neurologic diseases) have their own aspirations that may include education, employment, relationships and having children. As they move from pediatric to adult care, they must eventually transition to an adult healthcare team. The objective of this paper is to review the challenges and controversies in the transitional and adult care of people with congenital neurourological diseases.</p><p><strong>Methods: </strong>The Research Group convened a meeting of its members and invited guests to better understand the healthcare challenges faced by these patients as they become adults. The group examined potential research opportunities focused on people with these diagnoses and themes related to their healthcare.</p><p><strong>Results: </strong>Trust and clear communication are essential for effective patient transition. Ideally parents are involved in the transition to help reinforce independent self-care and responsibility. Adolescents require education about sexual health and independence, which may not be part of the core skillset of a urologist. The healthcare team must promote self-management and autonomy as early as practical. One of the major limitations is that adult care lacks the coordination of pediatric care, and patients may not have a \"medical home.\" Multidisciplinary clinics are ideal but face logistical barriers in adult medicine. Additional barriers include limited physicians with the required specialized training. In the adult system, financial constraints are a key challenge for patients and providers.</p><p><strong>Conclusion: </strong>Collaboration, supported by institutions and new research, is vital for improving the neurourological care of young adults with complex diseases.</p><p><strong>Trial registration: </strong>This study reports on the proceedings of a meeting, and therefore clinical trial registration was not necessary.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308223","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":"Iltamiocel Autologous Cell Therapy for the Treatment of Female Stress Urinary Incontinence: A Double-Blind, Randomized, Stratified, Placebo-Controlled Trial.","authors":"Melissa R Kaufman, Howard B Goldman, Christopher J Chermansky, Roger Dmochowski, Michael J Kennelly, Kenneth M Peters, Lieschen H Quiroz, Jason B Bennett, Sherry Thomas, Charles G Marguet, Kevin D Benson, Una J Lee, Eric R Sokol, Christopher E Wolter, Daniel M Katz, Christopher M Tarnay, Danielle Antosh, Michael H Heit, Christian Rehme, Mickey Karram, Scott Snyder, Emanuele Canestrari, Ron J Jankowski, Michael B Chancellor","doi":"10.1002/nau.25588","DOIUrl":"https://doi.org/10.1002/nau.25588","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to determine the efficacy and safety of iltamiocel investigational autologous muscle cell therapy in females with stress urinary incontinence (SUI).</p><p><strong>Methods: </strong>Adult females were randomized 2:1 to iltamiocel (150 × 10⁶ cells) or placebo and stratified by severity and prior SUI surgery. The primary objective was efficacy based on the frequency of stress incontinence episodes (SIE) recorded in a 3-day diary at 12 months posttreatment. After 12 months, placebo participants could elect to receive open-label iltamiocel. Efficacy and safety analyses were performed using all patients as treated populations.</p><p><strong>Results: </strong>The study enrolled 311 patients, 297 were randomized to either iltamiocel (n = 199) or placebo (n = 98). Of the 295 participants that completed 12 months blinded follow-up, the proportion achieving the primary endpoint of ≥ 50% SIE reduction was not statistically different between treatment groups (52% vs. 53.6%; p = 0.798). A significantly greater proportion of iltamiocel participants in the prior SUI surgery stratum group achieved ≥ 75% SIE reduction compared with placebo, (40% vs. 16%; p = 0.037). Treatment response was maintained at 24 months in 78.4% and 64.9% of iltamiocel participants who achieved ≥ 50% and ≥ 75% SIE reduction, respectively, at Month 12. Adverse events related to the treatment were reported in 19 (9.5%) iltamiocel participants and 6 (6.1%) placebo participants.</p><p><strong>Conclusion: </strong>The study did not meet its primary endpoint however, iltamiocel cell therapy is safe and may be ideally suited to female patients who have undergone prior surgery for SUI. Additional study in this group of patients with high unmet medical needs is warranted.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT01893138; EudraCT number: 2014-002919-41.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292201","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":"Coping With Interstitial Cystitis/Bladder Pain Syndrome.","authors":"Susanna Sutherland, A Grace Kelly, Lindsey C McKernan, Roger R Dmochowski, William Stuart Reynolds, Elisabeth M Sebesta","doi":"10.1002/nau.25579","DOIUrl":"https://doi.org/10.1002/nau.25579","url":null,"abstract":"<p><strong>Aims: </strong>Compensatory coping, or maladaptive alterations in behavior with the intention of preventing or managing symptoms, is increasingly being explored as a key factor in how people respond to bladder conditions. Preliminary investigations have identified relations between coping behaviors and psychological distress in urologic conditions, including interstitial cystitis/bladder pain syndrome (IC/BPS). However, previous explorations of coping have not accounted for heterogeneity in coping behaviors or addressed the likelihood that some coping behaviors may be more adaptive than others. This study sought to examine how two specific types of coping behaviors, primary control coping and disengaged coping, are related to distress and symptoms in IC/BPS, and to explore the potential role of pain phenotype in this relationship.</p><p><strong>Materials and methods: </strong>A secondary data analysis was conducted with a large community data set (N = 677 women with IC/BPS) and employed descriptive and inferential statistics to characterize coping patterns and explore novel predictors of distress.</p><p><strong>Results: </strong>Results indicated that almost all participants engaged in at least one compensatory coping behavior within the last week. Both types of coping behaviors correlated with psychological symptoms, and when controlling for relevant clinical variables (i.e., age and severity of urinary symptoms), disengaged coping behaviors were significantly associated with psychological distress. Further, the addition of pain phenotype to multiple regression models resulted in a more effective predictive model when considering the relation between coping behaviors and depression.</p><p><strong>Conclusions: </strong>By investigating more deeply the relationship between coping and distress, understanding of potential risk factors and mechanisms is increased, offering valuable insights for intervention strategies for IC/BPS patients.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292200","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":"Association of Smoking Status and Pack Year History With Urinary Urgency Symptoms","authors":"Katharine F. Michel, Avanti N. Rangnekar, Michelle Slinger, Zoe S. Gan, Ariana L. Smith","doi":"10.1002/nau.25587","DOIUrl":"https://doi.org/10.1002/nau.25587","url":null,"abstract":"Background and ObjectivesOveractive bladder and its hallmark symptom, urgency, are thought to be multifactorial in pathogenesis. Smoking is a particularly important risk factor to understand because it is modifiable; studies evaluating an association between smoking and urgency have been inconclusive. We therefore sought to rigorously assess the relationship between smoking and urgency in terms of both a temporal and quantitative pack year history of smoking while controlling for other possible confounding factors.MethodsCommunity‐based adult women were recruited using the ResearchMatch website to participate in an online survey of bladder health which included questions to assess urgency symptoms, medical comorbidities, and detailed smoking history. Smoking history was studied as the independent variable in three different formulations: smoking status (never vs. former vs. current), continuous pack year history, and categorical pack year history. The outcomes studied included urgency (any urgency in the past 7 days), moderate urgency (urgency at least half the time), and urgency urinary incontinence (UUI). Chi‐square tests were performed to detect associations between smoking and these outcomes, and multivariate regression was then performed to control for possible confounders and to help determine the comparative influence of temporality versus quantity of smoking history.ResultsIn 1720 women who completed the questionnaire, current smoking status was associated with a 23% increase in the risk of experiencing urgency (RR 1.23) and a 78% increase in the risk of experiencing moderate urgency (RR 1.78) relative to never smokers. The risk of experiencing UUI was 40% higher (RR 1.40). Lifetime pack year history was also significantly associated with urgency outcomes, although only in smokers/former smokers who had a 20+ pack year history (RR 1.15, 1.60, and 1.25 for urgency, moderate urgency, and UUI, respectively). The presence of former smoking history was not significantly associated with urgency outcomes, even when controlling for cumulative pack years.ConclusionsThis analysis of a large cross‐sectional database of women suggests a strong, consistent link between current smoking status and urinary urgency and UUI. By contrast, no increased risk of urgency was attributed to former smoking status. Analysis of pack year history suggests a dose–response relationship wherein ≥ 20 pack years was significantly associated with a higher risk of all urgency outcomes. In models controlling for pack year history, the association of current smoking with urgency remained significant and former smoking remained nonsignificant. Taken together, this supports greater attention being given to the contribution of current smoking to urgency symptoms, and to the need for further longitudinal work to determine if smoking cessation can be a strategy to treat urgency.","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253221","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":"A new nomogram for the evaluation of detrusor underactivity and bladder outlet obstruction in nonneurogenic female patients with lower urinary tract symptoms who undergo urodynamic studies","authors":"Catalina Barco‐Castillo, Melida Sotelo Perilla, Jaime Rangel Amaya, Juan Carlos Castaño","doi":"10.1002/nau.25553","DOIUrl":"https://doi.org/10.1002/nau.25553","url":null,"abstract":"IntroductionMicturition physiology differs in men and women. However, the results in standard urodynamic studies in women with lower urinary tract symptoms (LUTS) were extrapolated from studies in men. Nowadays, the only validated nomogram for females is Solomon–Greenwell's. However, it only evaluated bladder outlet obstruction (BOO) without considering detrusor underactivity (DU). This study aims to create a nomogram that includes an evaluation of DU and BOO in nonneurogenic women and validate it against videourodynamic studies along with other nomograms.Materials and MethodsFor the first analysis (creation cohort), we included 183 women with LUTS who underwent videourodynamic study between 2022 and 2023. Exclusion criteria were females with neurologic diseases, renal transplantation, and trouble performing the flow‐pressure study. Baseline characteristics of the patients, urodynamic parameters, and classifications on different nomograms and indexes were evaluated. A logistic regression found Qmax and PdetQmax as predictors for DU and BOO. The Barco–Castillo nomogram was created by clustering analysis and adjusted by the results of the logistic regression. A second (test) cohort was evaluated from 2023 to 2024, including 142 patients for the validation of the nomogram. A <jats:italic>p</jats:italic> &lt; 0.05 was considered significant.ResultsAll urodynamic parameters were compared between both cohorts, with no significant differences. The median age of the creation cohort was 50 years old (interquartile range [IQR] 39–63). All patients had LUTS and a previous standard urodynamic study without a clear diagnosis. The cluster analysis had a <jats:italic>p</jats:italic> &lt; 0.05 for two groups of BOO (yes/no) and two of DU (yes/no). We created the graph based on the logistic regression results and adjusted it according to the data. The median age of the test cohort was 44 years old (IQR 33.75–59) and had the same indication for the videourodynamic study. The receiver operating characteristic (ROC) curve for BOO showed an accuracy of 85.4% for Barco–Castillo nomogram, 68.5% for Blaivas–Groutz, 58.1% for Solomon–Greenwell, 57.1% for BOOI, and 50% for LinPURR. For DU, accuracy was 80.5% for PIP‐1, 80.2% for Barco–Castillo, 76.6% for BCI, and 70.1% for LinPURR.ConclusionsWhen evaluating women's urodynamic studies, it is important to focus on female physiology and discourage the use of parameters previously standardized in men. We encourage using the new Barco–Castillo nomogram to determine BOO and DU in women as the currently easiest and more accurate tool.","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253217","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":"Reliability of Uroflowmetry Pattern Interpretation in Adult Women.","authors":"Leslie M Rickey,Elizabeth R Mueller,Diane K Newman,Alayne D Markland,Chloe Falke,Kyle Rudser,Ariana L Smith,Margaret G Mueller,Jerry L Lowder,Emily S Lukacz,","doi":"10.1002/nau.25584","DOIUrl":"https://doi.org/10.1002/nau.25584","url":null,"abstract":"INTRODUCTIONUroflowmetry is often used to assess lower urinary tract symptoms (LUTS). Criteria for characterization of flow patterns are not well established, and subjective interpretation is the most common approach for flow curve classification. We assessed the reliability of uroflowmetry curve interpretation in adult women.MATERIALS AND METHODSUroflowmetry studies were obtained in 296 women who participated in an observational cohort study. Four investigators with expertise in female LUTS and urodynamics reviewed and categorized each tracing for interrater reliability. A random subset of 50 tracings was re-reviewed by each investigator for intrarater reliability. The uroflowmetry tracings were rated using categories of continuous, continuous fluctuating, interrupted, and prolonged. Other parameters included flow rate, voided volume, time to maximum flow, and voiding time. Agreement between raters is summarized with kappa (k) statistics and percentage where at least three raters agreed.RESULTSThe mean age of participants was 44.8 ± 18.3 years. Participant age categories were 18-24 years: 20%; 25-34 years: 17%; 35-64 years: 42%; 65+ years: 18%. Nine percent described their race as Asian, 31% Black, 62% White, and 89% were of non-Hispanic ethnicity. The interrater reliability was highest for the continuous flow category (k = 0.65), 0.47 for prolonged, 0.41 for continuous fluctuating, and 0.39 for interrupted flow curves. Agreement among at least three raters occurred in 74.3% of uroflow curves (69% for continuous, 33% for continuous fluctuating, 23% for interrupted, and 25% for prolonged). For intrarater reliability, the mean k was 0.72 with a range of 0.57-0.85.CONCLUSIONSCurrently accepted uroflowmetry pattern categories have fair to moderate interrater reliability, which is lower for flow curves that do not meet \"continuous\" criteria. Given the subjective nature of interpreting uroflowmetry data, more consistent and clear parameters may enhance reliability for use in research and as a screening tool for LUTS and voiding dysfunction.TRIAL REGISTRATIONParent trial: Validation of Bladder Health Instrument for Evaluation in Women (VIEW); ClinicalTrials.gov ID: NCT04016298.","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193423","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}