Neurourology and Urodynamics最新文献

{"title":"Noninvasive High-Intensity Focused Electromagnetic Therapy in Women With Urinary Incontinence: A Systematic Review and Meta-Analysis.","authors":"Kevin Leonardo, Harrina E Rahardjo, Andika Afriansyah","doi":"10.1002/nau.25658","DOIUrl":"https://doi.org/10.1002/nau.25658","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary incontinence (UI) is an uncontrollable expulsion of urine at a time. UI is obviously not life-threatening, but its impact on the patient's quality of life (QoL) is often devastating. Many treatments method to address this problem but all these methods have limitations. Recently, a brand-new noninvasive treatment for pelvic floor muscles (PFM) using a high-intensity focused electromagnetic (HIFEM) field was unveiled. HIFEM therapy may provide better results thus in this study, we aim to summarize the existing evidence and assess the efficacy and safety of HIFEM.</p><p><strong>Method: </strong>The databases used were Pubmed, Cochrane, EMBASE, and SCOPUS. The literature search was performed using strategic keywords (women) AND ((High Intensity Electromagnetic Field) OR (Electromagnetic Stimulation)) AND ((urinary incontinence) OR (overactive bladder) OR (pelvic floor dysfunction)). Articles that meet the inclusion and exclusion criteria are then analyzed.</p><p><strong>Results: </strong>Seven studies were included in this review, most of the studies concluded that the usage of HIFEM can reduce the symptoms related to UI significantly and improve QoL. There was higher decrease of UI episodes (MD: -4.10, 95% CI: -7.34 to -0.85, p = 0.01) and improvement of ICIQ-UI SF score (MD: -3.03, 95% CI: -3.27 to -2.79, p = < 0.00001) in HIFEM group compared to control. Subgroup analyses showed better QoL parameter (MD -3.40; p = 0.01, MD -0.70; p = 0.04) compared to control, albeit statistically comparable overall (p = 0.09). However, both pooled analyses for contraction and resting tone changes revealed that there were no significant differences between both groups (SMD: 0.98, 95% CI: -0.70 to 2.660, p = 0.25 and SMD: 0.20, 95% CI: -0.18 to 0.58, p = 0.30, respectively). Finally, there was no safety issue highlighted in most of the studies included.</p><p><strong>Conclusion: </strong>Current published studies suggest that HIFEM may be an effective and safe noninvasive treatment for female UI by promoting QoL. However, due to being high in heterogeneity and possible bias, future high-quality trials with proper blinding and standardized outcomes are necessary to conclude the applicability of HIFEM for UI.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932584","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":"Sleep-Related Breathing Disorders and Lower Urinary Tract Dysfunction in Children and Adolescents: A Scoping Review.","authors":"Maayke van Galen, Bibi Huskens, Benodet Tak, Alexander von Gontard, Robert Didden","doi":"10.1002/nau.25652","DOIUrl":"https://doi.org/10.1002/nau.25652","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;Sleep disordered breathing (SDB), lower urinary tract dysfunction (LUTD), and enuresis (NE) are common in children and adolescents and have serious consequences, especially on social and emotional development. Even though much is known about the association between SDB and NE among adults, the number of articles in children and adolescents is limited. Therefore, the aim of the present scoping review was to map out the current knowledge about SDB and LUTD in children and adolescents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Four electronic databases (i.e., Embase, PsychInfo, Pubmed, Web of Science) were searched in accordance with the Johanna Briggs Institute (JBI) manual for Evidence Synthesis&lt;sup&gt;1&lt;/sup&gt; and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR).&lt;sup&gt;2&lt;/sup&gt; The Quality Assessment Tool for Quantitative Studies (QATQS) was used to evaluate the methodological quality of the included studies.&lt;sup&gt;63,64&lt;/sup&gt; All articles in this scoping review met the following inclusion criteria: (a) the sample included children/adolescents between the ages of 5 and 18; (b) there was a presence of both LUTD and (a clinical manifestation of) SDB, (c) the article was published in English and/or Dutch; (d) the article was available in full text. The following exclusion criteria were used: (a) studies with solely one of the two main concepts (e.g., LUTD or SRBD); (b) studies with a third variable, other than treatment-oriented variables; (c) articles published in a language other than English or Dutch; (d) meta-analyses and reviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The search resulted in the inclusion of 17 articles related to SDB and LUTD in children and adolescents. Even though all included articles found a clear association between SDB and NE in children, very limited information was found on SDB and other LUTS and/or how the association impacts children and adolescents with developmental delays (DD's). In addition, limited and/or conflicting results were found related to SDB, NE and other variables (e.g., family history of NE, obstructive sleep apnea (OSA) severity, gender, preoperative ADH/BNP levels, obesity and ADHD). An adenotonsillectomy (T&A) had a significant beneficial therapeutic effect on NE in children and adolescents with SDB.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This scoping review found a clear association between SDB/OSA and NE, as the arousability and urine production at night are impacted. T&A could be considered as a treatment option for children and adolescents who do not respond to standard NE treatment. However, more research is needed to determine mechanisms involved in responders and non-responders and to examine the possible association between SDB in children and adolescents with other LUTS and/or developmental delays. The need for a multidisciplinary approach and future research is highlighted to provide children and adolescents with comorbid disord","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932589","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":"Buccal Mucosal Graft as a Second Layer in the Vaginal Repair of Vesicovaginal Fistulas.","authors":"Kareem M Taha, Mohamed Ismail Mohamed, Esam Desoky, Mohammed M Seleem, Amr M Fawzi","doi":"10.1002/nau.25657","DOIUrl":"https://doi.org/10.1002/nau.25657","url":null,"abstract":"<p><strong>Objective: </strong>Vesicovaginal fistula (VVF) is a pathological communication between the urinary bladder and the vagina. The most common cause of VVF is hysterectomy, while less common causes include obstetric trauma and pelvic surgery. Most cases require surgical intervention. Although various techniques have been described for the management of VVF, none has been considered the gold standard of management. In this study, we describe our technique using buccal mucosal graft (BMG) as a second layer in the repair of VVF through a vaginal approach.</p><p><strong>Methods: </strong>A total of 10 patients underwent surgery between May 2023 and December 2023. Patients were scheduled for follow-up 3 weeks after surgery or earlier for any new symptoms of urinary incontinence, overactive bladder, or dysuria. Before catheter removal, a CT cystogram was performed to confirm fistula closure. Additional follow-up visits were scheduled at 3-6 months after repair to assess outcome.</p><p><strong>Results: </strong>Ten patients with a mean age of 35.7 ± 7.18 years were operated with the described technique. All patients had no recurrence of the fistula at the 6-month follow-up. None of them had additional morbidity due to the procedure. There were no post-operative complications.</p><p><strong>Conclusions: </strong>Although the success rates of simple VVF are very high, the interposition of a tissue graft between the bladder and the vagina is required in the treatment of VVF, especially in those recurrent, large complex and radiation-induced fistulas. The buccal mucosa has a thick epithelium that provides strength to the graft and a thin submucosa that is important for revascularization, so its use as a second layer in VVF repair may be beneficial. Its harvesting is a relatively simple procedure. It is not time-consuming and is associated with low morbidity compared to Martius flap harvesting.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922445","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, Validation, and Usability of a Virtual Game for Consciousness and Relaxation of the Pelvic Floor Muscles.","authors":"Robson Arruda Souza, Alberto Galvão de Moura-Filho, Renato S Melo, Andrea Lemos","doi":"10.1002/nau.25656","DOIUrl":"https://doi.org/10.1002/nau.25656","url":null,"abstract":"<p><strong>Background: </strong>Applicability of the virtual games has been increasingly added to rehabilitation treatments, including women's health interventions.</p><p><strong>Objective: </strong>To develop a virtual interface designed to increase consciousness and relax the pelvic floor muscles, validate its content and appearance, and check the level of usability and satisfaction.</p><p><strong>Methods: </strong>Physiotherapy specialists with experience in pelvic floor rehabilitation and database research were consulted to define the content. Thus, 13 physiotherapists specialized in the area participated in the content and appearance validation of the virtual game with a minimum agreement level of 80%. An evaluation of the usability level was conducted through MATCH (Checklist for Evaluation of the Usability of Applications for Touchscreen Phones) and the satisfaction level through a visual analog scale.</p><p><strong>Results: </strong>The game is presented in two-dimensional (2D) configuration and is based on parachuting. The main activity required is muscle relaxation to open the parachute and descend to the target. The goal is to reach the target by traveling as long as possible with the parachute open. A physical exercise protocol from the American College of Sports Medicine was used to define the contraction/relaxation time. A total of 4 of the 15 items which represented the content and appearance for validation needed a second round to reach the desired level of agreement. The game showed a high level of usability M: 63.04 (±5.28) and the level of satisfaction of the virtual game showed an average of 9.7 (±0.55).</p><p><strong>Conclusion: </strong>The virtual game developed for the pelvic floor muscle relaxation training showed content validity and adequate appearance and a high level of usability and satisfaction.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922450","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":"Unilateral and Bilateral Transcutaneous Tibial Nerve Stimulation in Women With Overactive Bladder Syndrome: A Randomized Controlled Study (UBTTNS-OAB Study).","authors":"Letícia Martinelli Galhardo, Geovanna Volta Giorgenon, Marina Rótoli, Camila Carvalho de Araújo, Luiz G O Brito, Cássia R T Juliato","doi":"10.1002/nau.25608","DOIUrl":"10.1002/nau.25608","url":null,"abstract":"<p><strong>Introduction: </strong>The efficacy of unilateral versus bilateral Transcutaneous Tibial Nerve Stimulation (TTNS) for women with Overactive Bladder Syndrome (OAB) remains uncertain.</p><p><strong>Objective: </strong>To compare the efficacy of unilateral and bilateral TTNS in the tibial region in women with OAB.</p><p><strong>Methods: </strong>This randomized, controlled, triple-blind clinical trial included women with OAB or urgency-predominant urinary incontinence (UUI). Participants were randomized (1:1) into the Unilateral Tibial Group or Bilateral Tibial Group. Before treatment, they underwent a pre-assessment including peripheral sensitivity examination and completion of sociodemographic data and seven validated questionnaires on urinary symptoms, quality of life, sleep, and psycho-emotional aspects. TTNS interventions were administered twice weekly (12 sessions, 30 min each). Posttreatment, participants underwent another physical examination and completed the same questionnaires, with a 30-day follow-up. Categorical variables were analyzed using Chi-square or Fisher's Exact Test, while numerical variables were assessed with the Mann-Whitney test. Group comparisons over time utilized intention-to-treat ANOVA (p < 0.05).</p><p><strong>Results: </strong>Thirty-five women participated: 17 in the unilateral group and 18 in the bilateral group. Mean ages were 55.1 (±14.7) years and 52.7 (±12.6) years, respectively (p = 0.680). Initial OAB severity (ICIQ-OAB) did not differ significantly between groups (p = 0.561). Both groups showed significant improvement in ICIQ-OAB scores: unilateral group from 10.1 (±3.4) to 5.8 (±3.4) (p < 0.001), bilateral group from 9.3 (±3.3) to 5.1 (±4) (p < 0.001), with no intergroup difference (p = 0.395). Improvement in UUI symptoms was observed: unilateral group from 2.2 (±1.4) to 0.7 (±1.5), bilateral group from 1.5 (±1.9) to 0.2 (±0.5), without significant intergroup difference (p = 0.645). Quality of life scores improved similarly between groups (p = 0.055).</p><p><strong>Conclusion: </strong>TTNS appears to be effective in improving bladder storage and UUI symptoms in women with OAB, with no difference between unilateral and bilateral applications.</p><p><strong>Clinical trial registration: </strong>Brazilian Registry of Clinical Trials (REBEC) (RBR: 96f2fgkn).</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"125-135"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504857","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":"Prediction Value of Bladder Deformity Index for Upper Urinary Tract Damage in Patients With Neurogenic Bladder.","authors":"Ran Chang, Limin Liao, Huafang Jing, Yi Gao, Siyu Zhang, Yue Wang, Juan Wu","doi":"10.1002/nau.25610","DOIUrl":"10.1002/nau.25610","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to assess the predictive value of the Bladder Deformity Index (BDI) in determining upper urinary tract (UUT) damage among patients with neurogenic bladder (NB).</p><p><strong>Methods: </strong>Clinical data of 132 NB patients admitted to the China Rehabilitation Research Center between January 2018 and December 2023 were retrospectively analyzed. Patients were categorized into UUT damage and normal UUT function groups based on the MRU and ultrasound grading systems for hydronephrosis, patients with the grade greater than or equal to I degree were considered to have UUTD. Patient demographics, biochemical parameters, and video-urodynamics (VUDS) findings were collected, and BDI was calculated. Independent sample t tests were employed to compare general characteristics and VUDS parameters between groups. Receiver operating characteristic (ROC) curves were utilized to evaluate the predictive capability of UUT damage.</p><p><strong>Results: </strong>The study comprised 132 patients (86 males and 46 females) with an average NB duration of 7.37 ± 9.37 years (range: 0.2-44 years). UUT damage was present in 40.91% (n = 54) of patients. Significant differences (p < 0.05) were observed between the UUT damage and normal groups in terms of the duration of LUTS (9.98 ± 10.52 vs. 4.83 ± 7.32 years), creatinine levels (135.58 ± 110.51 vs. 57.66 ± 12.26 μmol/L), and BDI (103.28 ± 71.6 vs. 19.23 ± 15.03%). No significant differences were noted in age, bladder volume, or residual urine between the groups (p > 0.05). The AUC for the duration of LUTS, creatinine, and BDI were 0.691, 0.786, and 0.908, respectively, with a BDI Yoden index of 77%.</p><p><strong>Conclusion: </strong>Long-term LUTS, elevated creatinine levels, and high BDI are associated with UUT damage. BDI demonstrates high sensitivity and specificity in diagnosing UUT damage, outperforming creatinine levels and NB duration. Patients with BDI values exceeding 77% are at a heightened risk of UUT damage. BDI facilitates quantitative evaluation of cystography and preliminary evaluation upper and lower urinary tract function in NB patients. Further research is warranted to validate BDI's feasibility in quantifying cystography and diagnosing UUT damage.</p><p><strong>Trial registration: </strong>This study is retrospective and does not require clinical trial registration.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"103-108"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624916","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":"Efficacy of Biofeedback Therapy for Giggle Incontinence in Children: How Many Sessions Are Required?","authors":"Furkan Adem Canbaz, Gonca Gerçel, Sefa Sağ","doi":"10.1002/nau.25605","DOIUrl":"10.1002/nau.25605","url":null,"abstract":"<p><strong>Introduction: </strong>Giggle incontinence (GI) is characterized by the sudden and involuntary expulsion of urine coinciding with episodes of laughter. The underlying pathophysiology of this condition remains unclear, and various treatment approaches are employed. The objective of this study is to assess the effectiveness of biofeedback (BF) therapy in treating GI and ascertain the requisite number of therapy sessions needed for efficacy.</p><p><strong>Methods: </strong>Medical records of children treated with BF therapy for GI between November 2022 and November 2023 were retrospectively analyzed. The success of treatment was assessed after four and eight sessions, as well as following three maintenance sessions. Treatment outcomes were evaluated using the scoring system recommended by the International Children's Continence Society (ICCS), which categorizes responses into three levels: no response (Score 0), partial response (Score 1), and complete response (Score 2).</p><p><strong>Results: </strong>Thirteen patients were initially diagnosed with GI. Of these, 10 patients were included in the study as three discontinued treatments. The cohort comprised an equal gender distribution with five females (50.0%) and five males (50.0%). The mean age of patients was 8.9 ± 3.3 (range 5-16) years. Two out of ten patients had a history of previous treatment for overactive bladder, while three had received treatment for primary monosymptomatic nocturnal enuresis. Following the completion of all BF sessions, the rate of complete response was observed at 80.0% (n = 8), while the partial response rate accounted for 10.0% (n = 1). Statistical analysis revealed significant differences in response scores after four and eight sessions (p < 0.01) as well as between the results after eight sessions and the completion of maintenance sessions (p < 0.01).</p><p><strong>Conclusion: </strong>BF therapy demonstrates a high success rate in managing GI. Completion of at least eight BF therapy sessions enhances the probability of a successful outcome in the treatment of GI. Additionally, it has been observed that maintenance sessions contribute to the increased efficacy of the treatment.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"207-211"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470978","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":"The Association Between Urinary Incontinence With Pelvic Pain and Sensory-Motor Function in Older Women With Stroke.","authors":"Fatih Özden, Yalcin Golcuk, Özgür Nadiye Karaman, Mehmet Özkeskin","doi":"10.1002/nau.25613","DOIUrl":"10.1002/nau.25613","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to investigate the association between urinary incontinence (UI) severity, pelvic pain, and sensory-motor function in older women with stroke.</p><p><strong>Methods: </strong>A cross-sectional prospective study was carried out with 102 older women individuals with stroke. Barthel Index (BI), Incontinence Impact Questionnaire Short Form (IIQ-7), Urogenital Distress Inventory (UDI-6), Pelvic Pain Impact Questionnaire (PPIQ), Somatosensory Amplification Scale (SASS), and Somatic Sensitivity Scale (SeSS) were used for clinical measurements.</p><p><strong>Results: </strong>Partial correlational analyses with age, stroke duration, and BMI as covariates revealed a moderate positive correlation between SASS and IIQ-7 (r = 0.315, p < 0.001) and UDI-6 (r = 0.376, p < 0.001). On the other hand, there was a strong positive correlation between SASS and PPIQ (r = 0.522, p < 0.001). SeSS had a low positive correlation with IIQ-7 (r = 0.198, p < 0.05) and UDI-6 (r = 0.203, p < 0.05). In addition, there was a positive and moderate correlation between SeSS and PPIQ (r = 0.384, p < 0.001). Multivariate linear regression analysis revealed causality of SASS (R² = 0.381, p < 0.001) and SeSS (R² = 0.167, p < 0.001) with PPIQ.</p><p><strong>Conclusions: </strong>Increased abnormal sensory sensitivity is associated with increased pelvic pain levels in women with stroke. Clinicians should consider sensory abnormalities, especially pain, within the scope of UI in women with stroke. Our results provide preliminary essential data for sensory and pain awareness during pelvic rehabilitation in stroke patients.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"165-170"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522515","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":"Surgery for female urethral stricture.","authors":"Béatrice Bouchard, Lysanne Campeau","doi":"10.1002/nau.25358","DOIUrl":"10.1002/nau.25358","url":null,"abstract":"<p><strong>Background: </strong>Female urethral stricture (FUS) is a rare entity that causes great morbidity and suffering in those affected. As the available scientific data is sparce, there are no formal guidelines or standard of care for this disease.</p><p><strong>Methods: </strong>This is a narrative review of the surgical management for female urethral stricture. The literature review was performed on PubMed. Articles were limited to English, but there was no limitation in terms of date.</p><p><strong>Results: </strong>Management of FUS is divided between endoscopic and open surgical repair. Urethral dilation with or without urethrectomy can be offered as a first-line treatment. However, the rate of success of this procedure remains inferior to open surgical repair, and its efficacy decreases with the number of previous dilations. For distal urethral strictures, distal urethrectomy and advancement meatoplasty may be considered. Vaginal flaps are readily available, easy to harvest, well-vascularized, and allow for a dorsal or ventral orientation urethroplasty. The results of this procedure are promising, but most studies are small and retrospective. Labia flaps are easily accessible, wet, hairless, and elastic. The main limitations with the use of vaginal or labial tissues are co-existing conditions such as lichen sclerosis or vaginal atrophy, which may affect future results. Vaginal and labial graft urethroplasty can be used when it is not possible to mobilize an adequate flap. Stricture-free rates of this technique are variable. In cases of more severe stricture, an augmentation urethroplasty using buccal mucosa graft may be necessary. The techniques used in FUS replicate those for male urethral strictures, where both ventral and dorsal approaches can be utilized.</p><p><strong>Conclusions: </strong>Although there is growing interest in the field, the optimal management of FUS remains to be determined.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"51-62"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139403814","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 outlet obstruction in women: Advanced evaluation.","authors":"Patrick M Lec, Victor W Nitti","doi":"10.1002/nau.25298","DOIUrl":"10.1002/nau.25298","url":null,"abstract":"<p><strong>Introduction: </strong>Herein, we provide a review of the indications, practical considerations, and interpretation of urodynamics (UDS) with or without fluoroscopy, as well as cystourethroscopy, for women with suspected bladder outlet obstruction (BOO).</p><p><strong>Methods and results: </strong>A narrative review was performed focusing on the current primary literature and society guidelines around advanced diagnostic modalities for female BOO patients. UDS studies help diagnose BOO by identifying high-pressure low-flow voiding patterns and/or the characteristic radiographic appearance of the bladder neck and urethra during micturition. Cystourethroscopy aids in evaluating structural aberrations of the bladder outlet, and in surgical planning.</p><p><strong>Conclusions: </strong>UDS studies and cystourethroscopy are useful adjuncts in carefully-selected female patients with suspected BOO.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"30-36"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576733","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}