Neurourology and Urodynamics最新文献

{"title":"Overactive Bladder and Falls: Interpreting an Uncertain Association in the Context of Confounding and Measurement Limitations.","authors":"Ali Furkan Batur","doi":"10.1002/nau.70294","DOIUrl":"https://doi.org/10.1002/nau.70294","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691404","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":"Impact of Urodynamic Parameters on Treatment Decision-Making in Men Under 50 With Treatment-Resistant Chronic Lower Urinary Tract Symptoms.","authors":"Hossein Karami, Farzad Allameh, Sina Samenezhad, Mohammad Seifipoor","doi":"10.1002/nau.70293","DOIUrl":"https://doi.org/10.1002/nau.70293","url":null,"abstract":"<p><strong>Background: </strong>Lower urinary tract symptoms (LUTS) in young men are heterogeneous, and symptom-based management often fails to identify the underlying dysfunction, particularly in treatment-resistant cases.</p><p><strong>Objective: </strong>To assess the impact of multichannel urodynamic studies (UDS) on clinical management decisions and identify urodynamic predictors of treatment modification in men under 50 years with chronic LUTS.</p><p><strong>Methods: </strong>In this prospective cross-sectional study, men aged 18-49 years with LUTS persisting for ≥ 6 months despite prior guideline-concordant therapy underwent standardized multichannel UDS. Clinical management plans were recorded immediately before and after UDS interpretation. Management changes were classified as major or minor. Associations between urodynamic diagnoses, objective parameters, symptom scores, and management changes were evaluated using multivariable logistic regression.</p><p><strong>Results: </strong>A total of 723 men (mean age 38.4 ± 8.9 years) were included. Overall, 63.3% experienced a UDS-guided management change, including 41.6% with major treatment modifications. Major changes occurred predominantly in patients with abnormal urodynamic findings, especially underactive detrusor, low compliance, bladder neck dysfunction, and combined abnormalities, while no major changes occurred in patients with normal UDS. Bladder compliance, bladder contractility index, bladder outlet obstruction index, and urodynamic diagnosis were the strongest predictors of management change (AUC = 0.954). Symptom scores and post-void residual alone were poor discriminators of underlying pathology.</p><p><strong>Conclusions: </strong>Urodynamic studies play a pivotal role in guiding individualized management in young men with treatment-resistant LUTS, providing objective information that meaningfully alters clinical decision-making.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691365","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":"Symptom Relief and Practice Setting Variation in Bulkamid Injections for Stress Urinary Incontinence.","authors":"Christina Sze, Dhillon Advano, Carolina Martinez Fernandez, Maali LaFrance, Maude Carmel, Ramy Goueli, Gary E Lemack","doi":"10.1002/nau.70289","DOIUrl":"https://doi.org/10.1002/nau.70289","url":null,"abstract":"<p><strong>Introduction: </strong>Bulkamid™ transurethral injection is a minimally invasive treatment for stress urinary incontinence (SUI) and mixed urinary incontinence (MUI). While effective, predictors of repeat injection, progression to sling, and the influence of anesthesia type on treatment efficacy remain incompletely defined.</p><p><strong>Methods: </strong>We retrospectively reviewed 284 women who underwent Bulkamid™ injection for SUI/MUI. Baseline demographics, comorbidities, and symptom scores were collected. Outcomes were assessed with paired Wilcoxon signed-rank tests. Univariate logistic regression identified predictors of repeat injection and progression to sling. Subgroup analysis compared outcomes by anesthesia use.</p><p><strong>Results: </strong>The cohort had a median age of 63.5 years (IQR 50-72) and BMI of 28.3 kg/m² (24.0-31.7). Most were White (82.4%), with 77.8% having SUI and 22.2% MUI. Comorbidities included diabetes (21.1%), hypertension (48.2%), and prior hysterectomy (44.0%). Median follow-up was 6.7 months (IQR 1.1-17.4). Bulkamid™ significantly improved continence and quality-of-life measures. Median pad use decreased from 2.0 to 1.0 per day (p < 0.001). UDI-6 total scores declined from 45.8 to 16.7 (p < 0.001), with improvements in frequent urination, urgency leakage, physical activity leakage, difficulty emptying, and pain/discomfort (all p < 0.001). Comparison by anesthesia type (general/sedation vs none) showed similar pad reduction and UDI-6 score improvements, but differences in voiding outcomes. Symptom score improvements were otherwise comparable, though those without anesthesia had shorter UDI-6 follow-up intervals (84 vs. 218 days, p = 0.002) and longer overall follow-up (13.4 vs. 6.2 months, p = 0.016). On logistic regression, repeat injection was required in 16.5% at a median of 7.6 months, with procedure done without general/sedative anesthesia as strong predicator for repeat injection (OR 2.82, 95% CI 1.33-5.79, p = 0.005). Seventeen patients (6.0%) progressed to sling, with younger age predicting progression (OR 0.95 per year, 95% CI 0.91-0.98, p = 0.007).</p><p><strong>Conclusions: </strong>Bulkamid™ injection is a safe, effective, and minimally invasive treatment for stress and mixed urinary incontinence, offering significant symptom improvement with low rates of repeat injection and sling conversion. Younger age was associated with progression to sling, while procedures performed without general/sedative anesthesia were associated with higher likelihood of repeat injection. Bulkamid™ remains a valuable option for women seeking alternatives to sling surgery.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639397","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":"How Can We Personalize the Delivery of Onabotulinumtoxin-A for Patients With Neurogenic Lower Urinary Tract Dysfunction?","authors":"Shirley L Wang, William I Jaffe, Ariana L Smith","doi":"10.1002/nau.70290","DOIUrl":"https://doi.org/10.1002/nau.70290","url":null,"abstract":"<p><strong>Background & aims: </strong>Neurogenic lower urinary tract dysfunction (NLUTD) can produce bothersome urinary symptoms, impact quality of life, and in some cases, lead to deterioration of upper urinary tract function. Intradetrusor injection of onabotulinumtoxin-A (BoNT-A) is approved for NLUTD in patients who have an inadequate response to or intolerance of oral pharmacologic therapy (with beta-3 agonists and/or antimuscarinics) for urinary frequency, urgency, urgency incontinence, and/or impaired compliance. Modifications of its use, including dose, injection location, number of injections, setting of procedure, combination therapy with oral agents, and use among different patient populations have since been explored. Here, we aim to review the literature on BoNT-A in NLUTD with a focus on unique neurologic patient groups as well as patient and technical factors to inform personalized treatment strategies.</p><p><strong>Methods: </strong>We performed a narrative review evaluating the existing literature on BoNT-A in NLUTD, focusing on outcomes across neurologic etiologies, and variation in patient-specific and technical factors.</p><p><strong>Results: </strong>Across neurologic etiologies, BoNT-A improves quality of life and urodynamic parameters with low rates of adverse effects. Patient factors, including baseline voiding status, ability to self-catheterize, and age are important considerations in treatment selection and initial dosing of BoNT-A. Technical modifications such as reduced injection sites or trigone-including templates have been suggested to reduce adverse effects or improve efficacy but require further study.</p><p><strong>Conclusions: </strong>BoNT-A is an established therapy for NLUTD. Individualized treatment strategies that account for patients' neurologic etiology and functional status are beneficial in optimizing outcomes.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633943","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":"Urinary Incontinence and Risk of All-Cause Mortality: A Systematic Review and Meta-Analysis of Observational Studies.","authors":"Yanyan Zhou, Liwei Wang, Weijia Sun, Zhong Wang, Kuiqing Shao, Feng Xu, Zhan Gao","doi":"10.1002/nau.70283","DOIUrl":"https://doi.org/10.1002/nau.70283","url":null,"abstract":"<p><strong>Aims: </strong>Urinary incontinence (UI) is a prevalent condition among adults and imposes a substantial societal burden, yet its association with all-cause mortality remains uncertain. This study systematically reviewed and quantified the association between UI and mortality risk.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, EMBASE, and the Cochrane Library from inception to January 10, 2026, following PRISMA guidelines. Observational cohort studies comparing all-cause mortality between individuals with and without UI were included. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using random-effects models. Prespecified subgroup analyses and random-effects meta-regression were performed to explore heterogeneity, and the certainty of evidence was assessed using the GRADE approach.</p><p><strong>Results: </strong>Seventeen studies involving 82,739 participants were included. UI was associated with a higher risk of all-cause mortality (HR = 1.20, 95% CI: 1.07-1.34), although heterogeneity was substantial (I² = 80.4%). Sensitivity analyses supported the robustness of the observed association. Subgroup analyses suggested stronger associations with increasing UI severity (HR = 1.20, 1.27, and 1.67 across severity categories) and in studies with shorter follow-up ( < 5 years, HR = 1.89, 95% CI: 1.20-2.98), raising the possibility of reverse causation. Meta-regression identified diagnostic modality (p = 0.026) as a potential contributor to heterogeneity. The certainty of evidence was rated as very low.</p><p><strong>Conclusions: </strong>UI was associated with increased all-cause mortality; however, this finding should be interpreted cautiously due to substantial heterogeneity, potential residual confounding, and potential reverse causation. Rather than indicating a direct causal effect, UI may function primarily as a clinical marker of frailty, multimorbidity, and overall health decline. Further well-designed prospective studies with repeated exposure assessment and more comprehensive adjustment for frailty and comorbidity are needed.</p><p><strong>Trial registration: </strong>This systematic review and meta-analysis was registered with PROSPERO (International Prospective Register of Systematic Reviews) under the registration number CRD42024618197.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633976","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, Re: Lavelle J, Hornberger J. No Cystometrogram Among Veterans With Spinal Cord Injury Results in Adverse Urinary System Outcomes. Neurourol Urodyn. 2026 Mar;45(3):494-502: The Heterogeneity of 'Suprasacral' Lesions.","authors":"Necmettin Yıldız, Serhat Ötken","doi":"10.1002/nau.70285","DOIUrl":"https://doi.org/10.1002/nau.70285","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633928","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 Parameters and Motor Activity in Children With Nocturnal Enuresis and Daytime Urinary Incontinence.","authors":"Justine Hussong, Giuseppina Grillo, Silvia Noori, Leopold Curfs, Alexander von Gontard","doi":"10.1002/nau.70281","DOIUrl":"https://doi.org/10.1002/nau.70281","url":null,"abstract":"<p><strong>Introduction: </strong>Nocturnal enuresis (NE) and daytime urinary incontinence (DUI) are common in childhood. They are associated with sleep disorders, which, in turn, can affect physical activity. The aim of the present study was to investigate sleep quality and motor activity in children with NE and DUI by using actigraphy as an objective assessment method.</p><p><strong>Methods: </strong>Thirty-four children with NE or DUI, aged 5-13 years, and 33 controls were included in the study. Of the patients, 16 (47.1%) children had isolated NE and 18 (52.9%) DUI (isolated or combined with NE). Sleep quality and motor activity were measured by a wrist-worn actigraph for 4 days and 4 nights. Further assessment included a physical examination, a 48 h bladder diary, standardized questionnaires on incontinence and behavioral symptoms (CBCL), a structured psychiatric interview, and an intelligence test.</p><p><strong>Results: </strong>Children with incontinence had significantly shorter wake times after sleep onset (WASO), as well as a lower number of awakenings per night than controls. There were no differences in sleep quality parameters between children with NE and DUI. During the day, motor activity did not differ between patients and controls nor between children with NE and DUI. Patients had a significantly higher rate of CBCL total and externalizing problem scores. 44.1% of patients and 30.3% of controls had psychiatric disorders. In the patient group, there was a significant positive correlation between externalizing symptoms and sleep efficiency. Children with incontinence had significantly higher voiding frequency, a lower minimal voided volume, and a lower maximal voided volume. Sleep efficiency and voiding frequency were negatively correlated in the patient group.</p><p><strong>Conclusion: </strong>In conclusion, children urinary incontinence (DUI, not only NE) show differences in sleep parameters, but not major differences in daytime activity. Sleep disturbances are heterogeneous and require more detailed studies, taking psychiatric comorbidity into consideration. Actigraphy is a valid tool to study children in a naturalistic setting over the day and night. In clinical practice, sleep disturbances need to be taken into consideration in the assessment and treatment of children with NE and DUI.</p><p><strong>Trial registration: </strong>DRKS00015110.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633959","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":"Symptomatic and Urodynamic Outcomes After Spinal Cord De-Tethering in Primary Tethered Cord Patients.","authors":"Emily A Reeson, Ryan Didde, Chung Yon Lin, Ryan Nelson, Daniel Salevitz, Grace Tolan, Jennifer S Ronecker, Gwen M Grimsby","doi":"10.1002/nau.70288","DOIUrl":"https://doi.org/10.1002/nau.70288","url":null,"abstract":"<p><strong>Introduction: </strong>It is controversial whether surgical correction of tethered spinal cord in non-myelomeningocele tethered cord patients results in reversal versus stabilization of urologic (GU), gastrointestinal (GI), and musculoskeletal (MSK) symptoms.</p><p><strong>Objective: </strong>To determine factors associated with clinical improvement in symptoms after spinal cord de-tethering, and evaluate whether pre-operative urodynamic testing predicts post-operative clinical outcomes.</p><p><strong>Methods: </strong>213 non-myelomeningocele children who underwent primary spinal cord de-tethering at a quaternary children's hospital from 2012 to 2020 were retrospectively reviewed. Age at surgery, gender, and presence of GU symptoms, constipation, MSK symptoms, and urodynamic studies were collected. Pre-operative symptoms and demographics were compared between patients with and without resolution of GU symptoms after surgery.</p><p><strong>Results: </strong>Mean age at surgery was 5.36 years, 48% were female, and mean length of follow up was 1.8 years. Before surgery, 133/213 (62%) experienced a GU symptom. 105/213 (49%) patients were potty-trained. Of 105 potty-trained patients, 50 (48%) had daytime incontinence and 55 (52%) had nocturnal enuresis. Of 88 potty-trained patients with urinary symptoms, 22 (25%) had resolution of and 59 (67%) had improvement following surgery. Of the 102 with constipation, 45 (44%) had improvement. Of the 116 with musculoskeletal symptoms, 60 (52%) had improvement. Patients with resolution of GU symptoms were younger (4.97 vs. 8 years, p = 0.0019). Patients with daytime urinary incontinence (p = 0.0119) were less likely to have resolution of GU symptoms. There was no difference in urodynamic findings between patients with and without improvement or resolution of urologic symptoms.</p><p><strong>Conclusion: </strong>Younger age at de-tethering surgery is associated with improvement in genitourinary symptoms. Preoperative urodynamic studies may not be predictive of postoperative outcomes.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628258","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":"Urethral Closure Mechanism Caused by Prostate Rotation During Abdominal Pressure in Men: A Dynamic Magnetic Resonance Imaging Study.","authors":"Hiroshi Kano, Yoshifumi Kadono, Ryunosuke Nakagawa, Taiki Kamijima, Renato Naito, Tomoyuki Makino, Hiroaki Iwamoto, Hiroshi Yaegashi, Shohei Kawaguchi, Takahiro Nohara, Kazuyoshi Shigehara, Kouji Izumi, Atsushi Mizokami","doi":"10.1002/nau.70287","DOIUrl":"https://doi.org/10.1002/nau.70287","url":null,"abstract":"<p><strong>Objectives: </strong>To elucidate the urethral closure mechanism during abdominal pressure in men, we investigated changes in pelvic anatomy during abdominal pressure using dynamic Magnetic Resonance Imaging (MRI).</p><p><strong>Methods: </strong>This study retrospectively analyzed data from 145 patients scheduled for robot-assisted radical prostatectomy at Kanazawa University Hospital from 2016 to 2022. Preoperative dynamic MRI was used to take measurements at several anatomical points to assess changes in pelvic anatomy during abdominal pressure.</p><p><strong>Results: </strong>Dynamic MRI measurements during abdominal pressure revealed that the prostate apex rotates anteriorly at an average of 5.6°, and the internal urethral orifice shifts dorsally. Additionally, the prostate apex moves 1.2 mm toward the pubic bone. Conversely, the distal end of the membranous urethra shifts 0.9 mm dorsally during abdominal pressure. Consequently, a misalignment between the prostate apex and the membranous urethra is observed, resulting in the closure of the anterior-posterior direction of the proximal membranous urethra that may contribute to urethral closure during abdominal pressure.</p><p><strong>Conclusion: </strong>These results may suggest that prostate rotation during abdominal pressure creates a step-like displacement at the proximal membranous urethra, which could contribute to urethral closure in men with an intact prostate. Dynamic MRI provides anatomical evidence supporting a complementary role of prostate motion in this mechanism.</p><p><strong>Clinical trial registration: </strong>Not applicable. This study was conducted prospectively with written informed consent and institutional ethical approval; however, it was not designed as a clinical trial because it was a non-interventional observational study in which a specialized MRI protocol was added to standard clinical imaging without any therapeutic intervention or treatment allocation.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628199","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 Long-Term Effects of Sacral Neuromodulation on Urodynamic Parameters in Female Patients With Functional High-Pressure Low-Flow Voiding: A Ticking Time-Bomb?","authors":"Ross Stephens, Sachin Malde, Arun Sahai, Eskinder Solomon","doi":"10.1002/nau.70286","DOIUrl":"https://doi.org/10.1002/nau.70286","url":null,"abstract":"<p><strong>Introduction: </strong>Sacral neuromodulation (SNM) is used to treat women with dysfunctional voiding (DV), including those with high-pressure, low-flow (HP-LF) voiding. In this subgroup, persistent elevated voiding pressures raise concerns about long-term bladder and upper tract deterioration. Conventional urodynamic measures such as Pdet.Qmax and Qmax reflect only a single point in the voiding cycle and do not capture the full detrusor workload. The area under the pressure-flow curve (AUC) offers a more comprehensive metric of cumulative voiding pressure.</p><p><strong>Aim: </strong>To assess whether long-term SNM reduces AUC in women with HP-LF due to DV, and how this compares to changes in standard urodynamic parameters.</p><p><strong>Methods: </strong>Seven women with DV and HP-LF underwent urodynamics before and after SNM. Inclusion criteria included female patients with prolonged or irregular flow rates on urodynamics, high voiding pressures (BOOIf > 18) and either radiological evidence of dynamic mid-urethral narrowing or elevated mid-urethral closure pressure for age. Outcomes included AUC, AUC/VV (normalised to voided volume), and standard voiding/storage metrics. Symptom change was assessed via PGIC score.</p><p><strong>Results: </strong>Median age was 42. Median follow-up was 986 days. PGIC scores ranged 4-7 (median 6). Median (IQR) AUC decreased from 3548 (2540-6228) to 2998 (1714-4605)  cmH₂O·s (p  = 0.297) and AUC/VV from 20 (10-47) to 17 (3-21) cmH₂O·s·mL⁻¹ (p = 0.688). Median (IQR) Pdet.max decreased by from 54 (49-66) to 44 (40-59) cmH₂O (p = 0.047). No other pressure or flow parameters demonstrated a statistically detectable change.</p><p><strong>Conclusion: </strong>Long-term SNM improves symptoms in women with HP-LF voiding but does not significantly reduce cumulative detrusor pressure. These patients may remain at risk of bladder dysfunction and warrant continued follow-up.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628279","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}