Neurourology and Urodynamics最新文献

{"title":"Letter to the Editor, Re: Development and Validation of Urodynamic Report Writer: A Chat GPT App, by Lombardo et al.","authors":"Necmettin Yıldız, Emre Bezmez","doi":"10.1002/nau.70477","DOIUrl":"https://doi.org/10.1002/nau.70477","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128213","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":"Sex-Specific Digital Phenotyping of Lower Urinary Tract Symptoms: A Cross-Sectional Study of 1586 Adults From 35 Centers in China.","authors":"Peixian Chen, Baojun Wang, Xiangjun Lyu, Caixia Zhang, Qingqing He, Qingwei Wang, Yanlan Yu, Lijuan Ren, Xiande Huang, Juan Chen, Jiao Liu, Haihong Jiang, Fei Liu, Jianjun Zhang, Yuting Wu, Wei Wen, Juan Li, Guanghui Du, Xiaofen Wu, Jianwei Lv, Huasheng Zhao, Xijun Weng, Xiaoxin Meng, Qi Chen, Dongxiang Zheng, Yan Li, Li Wen, Weifang Chen, Peng Zhang, Ning Xiao, Xi Xie, Suibin Huang, Youhui Yang, Yipeng Liu, Shuxin Qu, Long Cheng, Xin Zhang, Dachuang Liu, Yi Zhang, Hao Huang, Fan Fan, Hai Huang","doi":"10.1002/nau.70466","DOIUrl":"https://doi.org/10.1002/nau.70466","url":null,"abstract":"<p><strong>Background and purpose: </strong>Lower urinary tract symptoms (LUTS) represent a complex clinical syndrome with significant sexual dimorphism. Traditional \"one-size-fits-all\" management often overlooks intra-sex phenotypic heterogeneity. This study utilized unsupervised machine learning to identify sex-specific digital phenotypes of LUTS within a large-scale clinical cohort to provide a foundation for precision urological care.</p><p><strong>Materials and methods: </strong>We analyzed a multicenter database of 1586 treatment-seeking adults (1098 females, 488 males) across 35 centers. Baseline clinical characteristics and LUTS parameters from standardized voiding diaries and validated scales were collected. K-means clustering was performed separately by sex to identify phenotypic subtypes, with the optimal number of clusters determined by the Elbow Method and visualized via Principal Component Analysis (PCA).</p><p><strong>Results: </strong>Significant sex-specific disparities were observed: women reported a higher symptomatic burden across almost all domains but maintained better voiding satisfaction (p < 0.001), while men exhibited poorer sleep quality (p < 0.001). Clustering identified a consistent three-subtype framework for both genders: Subtype 1 (Mild/Compensated): Characterized by the lowest symptom burden and highest tolerance. Subtype 2 (Storage-Dominant with Sleep Fragmentation): Found in older populations, defined by severe nocturia, reduced bladder capacity, and profound sleep disruption. Subtype 3 (Voiding-Dominant): Characterized by prominent dysuria and incomplete emptying.</p><p><strong>Conclusions: </strong>This exploratory sex-stratified clustering study identified symptom-based phenotypic patterns among treatment-seeking Chinese adults with LUTS. These findings support the potential value of a subtype-plus-sex framework for LUTS assessment, but prospective validation using objective functional measures and treatment outcomes is needed.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor on \"Ultrasonographic Findings of Successful Polyvinylidene Fluoride Mid-Urethral Sling Surgery and Their Clinical Relevance\".","authors":"Wen-Chen Huang, Evelyn Yang, Jenn-Ming Yang","doi":"10.1002/nau.70476","DOIUrl":"https://doi.org/10.1002/nau.70476","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to Editor on \"Symptom Relief and Practice Setting Variation in Bulkamid Injections for Stress Urinary Incontinence\".","authors":"Dhillon Advano, Christina Sze, Carolina Martinez Fernandez, Maali LaFrance, Maude Carmel, Ramy Goueli, Gary E Lemack","doi":"10.1002/nau.70456","DOIUrl":"https://doi.org/10.1002/nau.70456","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"[Zeroing Pressures in Urodynamics: Revisiting Current Practice and Pressure Interpretation]\".","authors":"Rafaela Mendonça","doi":"10.1002/nau.70475","DOIUrl":"https://doi.org/10.1002/nau.70475","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128185","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":"Long-Term Clinical Effectiveness of and Adherence to Onabotulinumtoxin A Injections for Neurogenic Detrusor Overactivity.","authors":"Julia Neuenschwander, Jürgen Pannek, Jens Wöllner, Jörg Krebs","doi":"10.1002/nau.70469","DOIUrl":"https://doi.org/10.1002/nau.70469","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study in consecutive patients.</p><p><strong>Objective: </strong>To evaluate the long-term effectiveness of and treatment adherence to intradetrusor onabotulinumtoxin A (BoNT-ONA) injections in patients with neurogenic detrusor overactivity (NDO).</p><p><strong>Methods: </strong>Consecutive patients with NDO who had undergone intradetrusor BoNT-ONA treatment at a single tertiary neuro-urology referral center were identified from a registry documenting off-label use of BoNT-ONA prior to formal regulatory approval. Demographic, clinical, and urodynamic data obtained before and after each treatment were collected. In patients performing intermittent catheterization, treatment success was defined by the following urodynamic criteria: bladder capacity ≥ 400 mL, bladder compliance ≥20 mL/cmH₂O, and maximum detrusor storage pressure <40 cmH₂O. In patients with an indwelling catheter, treatment success was defined as the achievement of urinary continence. In addition, data regarding treatment discontinuation and the underlying reasons were collected. Descriptive statistical analyses were performed to evaluate treatment effectiveness, adherence, and discontinuation patterns.</p><p><strong>Results: </strong>The data of 142 patients (51 females) with a mean age of 35.9 ± 13.1 years and a mean NDO duration of 6.4 ± 8.1 years at the beginning of the BoNT-ONA treatment were analyzed. Over a mean follow-up period of 12.0 ± 6.1 years, evaluated patients received a mean 7.9 ± 5.5 treatments. The BoNT-ONA treatment was continued in 34 (23.9%) patients. In 95 (66.9%) patients, the treatment was discontinued, and 13 (9.2%) patients were lost to follow-up. Five of the 34 patients (14.7%) who continued BoNT-ONA treatment received additional oral medication for NDO. Two (5.9%) and three (8.8%) patients showed reduced bladder compliance and increased detrusor storage pressure, respectively. Ten (34.5%) patients showed increased cystatin C values during the follow-up. The main reason for BoNT-ONA treatment discontinuation was insufficient effectiveness in 56 (58.9%) patients. Most patients who discontinued treatment transitioned to oral medication (45/95, 47.4%) and surgical interventions (25/95, 26.3%).</p><p><strong>Conclusion: </strong>Treatment of NDO with BoNT-ONA injections into the detrusor demonstrated sustained effectiveness in one quarter of the evaluated patients during a follow-up period of more than 12 years. The main reason for BoNT-ONA treatment discontinuation was insufficient effectiveness.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to Editor on \"Association Between Toilet Training Timing and Prognosis of Nocturnal Enuresis in Children: A Retrospective Study\".","authors":"Aimen Maryam, Wardha Iqbal, Muhammad Abdullah","doi":"10.1002/nau.70479","DOIUrl":"https://doi.org/10.1002/nau.70479","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127949","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":"Predictors of 2-Week Post-Void Residual After Intradetrusor OnabotulinumtoxinA Injection for Overactive Bladder: A Sex- and Neurogenic Status-Stratified Analysis.","authors":"Saawan D Patel, Evan Rosario, Ariana L Smith","doi":"10.1002/nau.70473","DOIUrl":"https://doi.org/10.1002/nau.70473","url":null,"abstract":"<p><strong>Objective: </strong>Urinary retention rates after intradetrusor onabotulinumtoxinA (BTX-A) peak at 2 weeks, yet risk stratification by sex and neurogenic status remains limited. We evaluated predictors of 2-week post-void residual (PVR) and differences by sex and neurogenic bladder status using the largest retrospective cohort to date.</p><p><strong>Methods: </strong>We reviewed all BTX-A procedures at a single academic institution from January 2020 to June 2025. Patients younger than 18 years, those with mean preprocedural PVR ≥ 150 mL, prior pelvic radiation, or preprocedural catheterization requirements were excluded. Two-week PVR was analyzed using multivariable regression of demographics and urodynamic parameters, adjusting for total injections per patient, with subgroup analyses by sex-assigned-at-birth and neurogenic status.</p><p><strong>Results: </strong>A total of 824 patients underwent 2282 BTX-A injections. The cohort was predominantly female (95.9%) and non-neurogenic (93.7%), with mean preprocedural PVR of 24 mL, mean BTX-A dose of 120.8 units, and mean 2-week PVR of 66.7 mL. Higher preprocedural PVR was associated with higher 2-week PVR among female patients (β = 0.593 mL, 95% CI [0.303, 0.883]) and non-neurogenic patients (β = 0.555, 95% CI [0.284, 0.825]), but not among male or neurogenic patients. Higher BTX-A dose was similarly associated with higher 2-week PVR among female patients (β = 25.7 mL per 100 U, 95% CI [6.16, 45.2]) and non-neurogenic patients (β = 28.1 mL per 100U, 95% CI [10.5, 45.6]). Lower maximum flow rate (Qmax) was associated with higher 2-week PVR among female patients (β = -1.25 mL per mL/sec, 95% CI [-1.94, -0.56]), neurogenic patients (β = -17.4, 95% CI [-31.5, -3.26]), and non-neurogenic patients (β = -1.08, 95% CI [-1.74, -0.418]). Higher detrusor pressure at maximum flow (pDet@Qmax) was associated with higher 2-week PVR among female (β = 0.557 mL/cmH₂O, 95% CI 0.136, 0.979]) and neurogenic patients (β = 2.68 mL/cmH₂O, 95% CI 0.126, 5.23]), whereas lower pDet@Qmax was associated with higher PVR among male patients (β = -8.34 mL/cmH₂O, 95% CI -12.9, -3.76]).</p><p><strong>Conclusions: </strong>Pre-procedural PVR and BTX-A dose were consistent predictors of elevated 2-week PVR in females and non-neurogenic patients. These findings support sex- and neurogenic-specific risk stratification and dose considerations prior to BTX-A injection.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112799","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":"Comparative Performance of Large Language Models in Urodynamic Trace Interpretation Using an Adapted Expert-Led Evaluation of Generative AI Competence and Excellence Framework.","authors":"Oguzhan Akpinar, Anil Erkan, Alper Keskin, Muhammet Guzelsoy","doi":"10.1002/nau.70470","DOIUrl":"https://doi.org/10.1002/nau.70470","url":null,"abstract":"<p><strong>Objectives: </strong>Interpretation of urodynamic studies is complex and subject to substantial inter-observer variability, even among experienced clinicians. While artificial intelligence has shown promise in urology, evidence regarding the performance of large language models (LLMs) in urodynamic trace interpretation remains limited. This study aimed to systematically compare the performance of multiple contemporary LLMs in interpreting standard urodynamic traces using an adapted ELEGANCE framework.</p><p><strong>Methods: </strong>In this retrospective, single-centre comparative study, 119 anonymised urodynamic machine printouts retrieved from the institutional patient archive were independently interpreted by five LLM-based platforms (ChatGPT-5.2, Gemini 3, Perplexity AI Pro, DeepSeek-V3.2, and Grok 4.1). Case-specific expert reference interpretations were produced by one of three urologists, whereas all LLM-generated interpretations were independently evaluated by all three urologists. LLM-generated interpretations were assessed using an adapted version of the \"Expert-Led Evaluation of Generative AI Competence and Excellence\" (ELEGANCE) questionnaire, which evaluates relevance, completeness, applicability, structure, language/terminology, satisfaction, and hallucination. Between-model comparisons were performed using Friedman and post-hoc Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>Overall ELEGANCE scores differed significantly among models (χ²[4] = 12.67, p = 0.013). Gemini achieved the highest mean score (25.77 ± 3.74), followed by Perplexity, DeepSeek, and ChatGPT-5.2, while Grok demonstrated significantly lower performance. Gemini consistently outperformed other models in clinically oriented domains, including relevance, completeness, and applicability (all p < 0.05). No hallucinations were identified in any model output. Inter-rater reliability among the three expert reviewers was good (average-measures ICC = 0.898, 95% CI 0.853-0.929; p < 0.001).</p><p><strong>Conclusion: </strong>Contemporary LLMs can generate structured interpretations of urodynamic traces, with meaningful performance differences across the evaluated platforms. While strengths in structure and terminology are evident, limitations in clinical reasoning persist. LLMs may serve as valuable assistive tools for standardisation and quality assurance in urodynamics but are not yet suitable for autonomous clinical decision-making.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112744","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":"Factors Affecting the Clinical Response to Desmopressin Treatment for Primary Monosymptomatic Nocturnal Enuresis in Children.","authors":"Ismail Selvi, Furkan Adem Canbaz","doi":"10.1002/nau.70468","DOIUrl":"https://doi.org/10.1002/nau.70468","url":null,"abstract":"<p><strong>Introduction: </strong>Desmopressin is the first-line treatment option for primary monosymptomatic nocturnal enuresis (MNE), particularly when nocturnal polyuria is a key symptom. This study aimed to investigate the factors affecting clinical response to desmopressin and relapse status in children with primary MNE during follow-up.</p><p><strong>Methods: </strong>Files of 576 paediatric patients presenting with primary MNE between September 2022 and March 2025, who commenced desmopressin treatment, were analysed retrospectively. The patients' demographic and clinical data were recorded. The clinical response to treatment was categorised according to the classification system of the International Children's Continence Society. A Cox regression analysis was performed to identify the factors that predict both treatment success and relapse.</p><p><strong>Results: </strong>The median age of the patients was 8 (IQR 7-10) years, and 322 patients (55.9%) were male. At the 3-month follow-up, a complete response was observed in 346 patients (60.1%), a partial response in 102 patients (17.7%), whereas 128 patients (22.2%) had no clinical response. Of the 448 patients who showed a clinical response, 148 (33%) experienced a relapse following the discontinuation of desmopressin at a median follow-up period of 8 months. The results of the multivariable analysis identified advanced age at admission (≥ 11 years old) (HR: 1.949, p < 0.001), no history of SARS-CoV-2 (HR: 1.921, p < 0.001), absence of constipation (HR: 1.851, p = 0.039) and no history of allergy (HR: 1.769, p = 0.042) as factors increasing the clinical response to treatment. The factors that may have caused relapse during follow-up were: a history of SARS-CoV-2 (HR: 3.918, p = 0.007); a history of allergy (HR: 3.845, p = 0.001); advanced age at admission (≥ 11 years old) (HR: 3.105, p < 0.001); and constipation (HR: 2.936, p = 0.001).</p><p><strong>Conclusion: </strong>According to our findings, desmopressin induced a clinical response in around three-quarters of cases, but relapse was observed in around one-third of patients. Advanced age at admission (≥ 11 years old), a history of SARS-CoV-2 infection, constipation, and allergies were found to be predictors of treatment response and relapse rates during follow-up.</p><p><strong>Clinical trial registration: </strong>As it was a retrospective study, registration was waived.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112755","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}