Neurourology and Urodynamics最新文献

{"title":"Evaluating the Benefits of Pelvic Floor Muscles Exercises Combined With Biofeedback Therapy for Improving Functional Urinary Incontinence in Children.","authors":"Lida Sharifi-Rad, Mazyar Zahir, Seyedeh-Sanam Ladi-Seyedian, Abdol-Mohammad Kajbafzadeh","doi":"10.1002/nau.70026","DOIUrl":"https://doi.org/10.1002/nau.70026","url":null,"abstract":"<p><strong>Background: </strong>Pelvic floor muscles training (PFMT), with or without biofeedback (BF), is widely utilized as an alternative treatment for various refractory lower urinary tract dysfunctions in adults and children. This study aimed to compare the efficacy of PFMT alone versus in combination with BF on functional urinary incontinence (UI) in children.</p><p><strong>Patients and methods: </strong>Medical records of children who had undergone pelvic floor rehabilitation for non-neuropathic intermittent UI from 2018 to 2022 were retrieved. Patients were categorized based on their treatment regimen. Group I had undergone standard urotherapy and PFMT, twice weekly for 5 weeks. Group II had undergone a similar 5-week treatment with addition of 10 BF sessions conducted at the end of each appointment. All children had been evaluated with kidney and bladder ultrasounds, uroflowmetry/EMG, and a 7-day voiding and bowel diary before and after treatment. Response to treatment was defined according to International Children's Continence Society (ICCS) protocols.</p><p><strong>Results: </strong>A total of 32 patients (71.9% female) with a mean age of 8.4 ± 2.1 (range: 5-13) years were included in the analyses (each group N = 16). In group I, nine (56.2%) and two (12.5%) patients demonstrated complete (100% reduction in UI episodes) and partial (50%-100% reduction in UI episodes) clinical response, respectively. In group II, 11 (68.7%) and 3 (18.8%) patients showed complete and partial response, respectively. The two groups were not significantly different with regard to clinical response (p = 0.430). No significant difference was observed between the two groups in terms of enuresis, urgency, constipation, and uroflowmetry parameters.</p><p><strong>Conclusions: </strong>PFMT under the supervision of an expert physical therapist appears to be as effective as combined PFMT and BF in improving UI in children without underlying neurologic disease.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625491","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 Randomized Controlled Trial of Percutaneous Tibial Nerve Stimulation in the Treatment of Female Sexual Dysfunction.","authors":"Zhenyue Huang, Sina Mehraban Far, Jonathan Aronov, Arshia Aalami Harandi, Kuemin Hwang, Xiaoyue Zhang, Varun Talanki, Heng Ruan, Tal Meir Cohen, Steven Weissbart, Justina Tam, Jason Kim","doi":"10.1002/nau.70032","DOIUrl":"https://doi.org/10.1002/nau.70032","url":null,"abstract":"<p><strong>Background: </strong>Female sexual dysfunction (FSD) is a prevalent and multifaceted condition affecting women's sexual well-being. This randomized controlled trial aimed to evaluate the efficacy of percutaneous tibial nerve stimulation (PTNS) compared to a validated sham control in the treatment of FSD.</p><p><strong>Methods: </strong>We conducted a single-center randomized controlled trial. Participants with FSD were recruited and randomly assigned at a 1:1 allocation ratio to either PTNS or a validated sham control using transcutaneous nerve stimulation (TENS). Treatment was performed through weekly 30-min session for 12 weeks total. Sexual function was assessed at baseline, 6 weeks, and 12 weeks primarily using the Female Sexual Function Index (FSFI) questionnaire. Urogenital distress inventory-6 was collected to evaluate for any baseline urinary incontinence/voiding dysfunction. Linear mixed-effect models for longitudinal data were used to compare FSFI scores across different time points. Statistical analysis was performed using SAS 9.4 (SAS Institute Inc. Cary, NC).</p><p><strong>Results: </strong>In total, 34 PTNS and 31 TENS subjects were included in our final analysis. Overall, 48% (16/34) of PTNS subjects versus 29% (11/33) of TENS subjects were no longer at risk for FSD (FSFI > 26.55) after 12 weekly treatments. Both PTNS and TENS subjects demonstrated similar improvements in FSFI total scores after 12 weeks of treatments. Interestingly, patients who did not present with baseline urogenital distress symptoms reported a statistically significant larger improvement in sexual satisfaction after PTNS treatments as compared to placebo (p = 0.017).</p><p><strong>Conclusion: </strong>This study demonstrated a sustained efficacy of PTNS in improving sexual function. Specifically, patients who did not have coexisting urinary dysfunction reported significant improvement in sexual satisfaction after PTNS. Our study suggested that PTNS may have a direct neuromodulation effect on sexual dysfunction and may hold promise as a treatment modality for FSD.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605807","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":"United Kingdom Continence Society: Certification and Recertification in Urodynamics.","authors":"Paul Abrams, Sharon Eustice, Andrew Gammie, Chris Harding, Rohna Kearney, Angie Rantell, Sheilagh Reid, Eskinder Solomon, Philip Toozs-Hobson, Mark Woodward","doi":"10.1002/nau.70020","DOIUrl":"https://doi.org/10.1002/nau.70020","url":null,"abstract":"<p><strong>Aims: </strong>Patients coming for urodynamics expect those delivering the service to be fully trained, with assurance of competence and quality. This document proposes a single UKCS Certification and Re-certification process for all health care professionals who perform or interpret urodynamics.</p><p><strong>Methods: </strong>The Working Group of the United Kingdom Continence Society engaged with stakeholders in relevant professional societies and institutions, recirculating drafts until consensus was reached.</p><p><strong>Results: </strong>A process of Certification has been designed to ensure that patients attending urodynamics undergo high quality investigations, the results of which are accurately interpreted, in order to guide both the patient and their clinicians in the patient's future management.</p><p><strong>Conclusions: </strong>The United Kingdom Continence Society strongly recommends that all urodynamic investigations are carried out by, or under the supervision of, certified individuals. This document presents such a process of Certification and Re-certification that aims to ensure that quality standards are maintained and that patients have high quality urodynamics.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605735","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":"Urodynamic Changes Following a Staged Trial of Sacral Neuromodulation in Patients With Detrusor Underactivity.","authors":"Stewart Whalen, Jaraspong Vuthiwong, Liang G Qu, Johan Gani","doi":"10.1002/nau.70035","DOIUrl":"https://doi.org/10.1002/nau.70035","url":null,"abstract":"<p><strong>Objective: </strong>Sacral neuromodulation (SNM) is an established treatment for detrusor underactivity (DU) and nonobstructive urinary retention. The mechanism of action for SNM in DU, however, remains poorly understood. The objective of this study was to investigate the urodynamic study (UDS) changes in DU patients during the trial period following first stage tined-lead placement (FSTLP).</p><p><strong>Materials and methods: </strong>Retrospective chart review was performed to identify patients diagnosed with DU on initial UDS, who had repeat UDS during the 2-week trial period following FSTLP by a single clinician. Urodynamic parameters including maximum flow rate (Qmax), detrusor pressure at maximum flow (PdetQmax), post-void residual (PVR), voiding efficiency (VE), and detrusor contractility index (DCI) were collected. Using the definition of improvement in baseline VE of ≥ 50% post-FSTLP or improvement in DCI of ≥ 50% in complete voiders, patients were divided into \"responders\" and \"nonresponders.\" Pre- and post-FSTLP urodynamic findings were compared using Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>A total of 17 patients were identified who met the inclusion criteria. Repeat UDS were done on account of inability or unwillingness to perform clean intermittent catheterization and thus inability to chart an accurate bladder diary. There were 9 female and 8 male patients. Four patients (23.5%) had pure DU while the other 13 (76.5%) had concurrent detrusor overactivity (DO-DU). Among all patients, there was a statistically significant improvement in PdetQmax (14 vs. 29 cmH₂O, p < 0.01) and DCI (62 vs. 92, p < 0.01). Six patients (35.3%) responded to the trial of SNM for DU. Among responders, statistically significant improvements in Qmax (5 vs. 15.5 mL/s, p = 0.03), PVR (215 vs. 80 mLs, p = 0.04), VE (22.9% vs. 82.5%, p = 0.04), and DCI (29 vs. 97.5, p = 0.03) were observed. Nonresponders had improvement in PdetQmax (14 vs. 29 cmH₂O, p = 0.02), but not in Qmax (9 vs. 10 mL/s, p = 0.89).</p><p><strong>Conclusions: </strong>Among all patients, an improvement in PdetQmax and DCI was observed. Responders exhibited improvement in Qmax, PVR, VE, and DCI without statistically significant improvement in PdetQmax. Nonresponders had statistically significant improvement in PdetQmax, but not in Qmax. Possible mechanisms of action of SNM in DU patients based on our data are inhibition of the guarding reflex/relaxation of the urethra (shown by improvement in Qmax in responders only) and direct strengthening of bladder contractility (shown by improvement in PdetQmax in all patients). Improvement in Qmax was observed exclusively in responders suggesting the former mechanism is the predominant one. Further larger prospective studies are required to confirm these findings.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586450","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":"Third Artificial Urinary Sphincter Cuff Placement Following Two Failures in Males: A Real-World Multicenter Study.","authors":"Francois Meyer, Juliette Cotte, Lucas Bento, Guillaume Nicaud, Hubert Werth, Alexandre Dubois, Christian Saussine, François Desgranchamps, Emmanuel Chartier-Kastler, Xavier Gamé, Jean-François Hermieu, Jean-Nicolas Cornu, Benoît Peyronnet","doi":"10.1002/nau.70030","DOIUrl":"https://doi.org/10.1002/nau.70030","url":null,"abstract":"<p><strong>Introduction: </strong>The reoperation rate for artificial urinary sphincters (AUS) in men is about 25%, with poorer survival rates when reimplantation occurs after urethral erosion or infection. Data on the outcomes of second AUS implants are rare, and no data exist for third AUS implants. We aimed to evaluate the functional and survival outcomes of a third AUS after two previous explantations.</p><p><strong>Methods: </strong>The records of all patients implanted with a third AUS between 2006 and 2023 in seven French university hospitals were reviewed retrospectively. Only AUS implants following two previous AUS cuff explantations or revisions were included. The primary endpoint was the reoperation-free survival of the third AUS. Secondary endpoints included functional outcomes at 6 months and at the last follow-up, and overall functional outcomes after possible subsequent AUS implants, as well as reoperations.</p><p><strong>Results: </strong>A total of 75 patients were included. Early complications occurred in 16.7% of patients. Median follow-up was 11 months (1-122), 28 explantations were required (37.3%). The 5-year reoperation-free survival rate was 34.8%. The only significant predictive factor for explantation was smoking. At 6 months, 66.2% of patients were socially continent (0-1 protection per day), 10.8% were improved, and 23% were unchanged or worsened. At the last follow-up of the third AUS, these results were 40%, 5.3%, and 54.7%, respectively. However, at the last overall follow-up (median 12 months, 1-183), social continence was 54.8%, improvement 9.6%, and failure 35.6%, with 23 patients (30.7%) receiving a fourth or fifth AUS.</p><p><strong>Conclusion: </strong>Early functional outcomes of a third AUS are similar to primary AUS, but survival rates and late functional outcomes are inferior. Predictive factors for outcomes were related to patients, not the surgery itself. A third AUS may be suitable for motivated patients with limited therapeutic options. Further studies are needed to refine patient selection and assess the impact of reimplantation techniques on outcomes.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573542","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":"Repair of Pelvic Organ Prolapse Can Cure Symptoms of Bladder Outlet Obstruction in Anterior, Apical, and Posterior Pelvic Organ Prolapse Even in Second Stages.","authors":"Bernhard Liedl, Aleksander Antoniewicz, Maren Wenk","doi":"10.1002/nau.70005","DOIUrl":"https://doi.org/10.1002/nau.70005","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567784","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":"Pascal's Law Has No Role in Intraurethral Pressure Transmission or Urethral Closure.","authors":"Pep Petros","doi":"10.1002/nau.70014","DOIUrl":"https://doi.org/10.1002/nau.70014","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567779","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: Pascal's Law has no Role in Intraurethral Pressure Transmission or Urethral Closure.","authors":"Bo S Bergström","doi":"10.1002/nau.70029","DOIUrl":"https://doi.org/10.1002/nau.70029","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567786","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":"Re: Conformity of ChatGPT Recommendations With the AUA/SUFU Guideline on Postprostatectomy Urinary Incontinence. Neurourol Urodyn. 2024 Apr;43(4):935-941. Doi: 10.1002/nau.25442. Epub 2024 Mar 7. PMID: 38451040.","authors":"Mara Bacchiani, Michele Marchioni, Riccardo Lombardo, Vincenzo Li Marzi","doi":"10.1002/nau.70015","DOIUrl":"https://doi.org/10.1002/nau.70015","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567781","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":"Water Intake in Drinks and Food: How Should We Advise Patients With Lower Urinary Tract Dysfunction on Their Water Intake and/or Urine Output, as a Cornerstone of Lifestyle Interventions? ICI-RS 2024.","authors":"Andrew Gammie, Vik Khullar, Angie Rantell, Nikki Cotterill, Paul Abrams, Qi-Xiang Song, Matthew Smith, Sanjay Sinha","doi":"10.1002/nau.25601","DOIUrl":"10.1002/nau.25601","url":null,"abstract":"<p><strong>Context: </strong>Water intake in drinks and food is essential for life. Multiple guidelines exist to help give recommendations for healthy water intake and urine output, but few of these are specific to patients with lower urinary tract symptoms.</p><p><strong>Methods: </strong>A debate held at the International Consultation on Incontinence-Research Society meeting, held in Bristol in June 2024, considered ways to improve this situation.</p><p><strong>Results and conclusion: </strong>There are challenges in measuring both total water intake and also urine output, but we suggest that urine output may be the most helpful measure to focus on for future guidelines for patients.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"631-636"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470980","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}