Neurourology and Urodynamics最新文献

{"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}

{"title":"Think Tank 2: How Do We Precisely Define the \"High Risk Bladder\" and What Are the Interrelationships Between Inflammation, Blood Flow, Fibrosis, and Loss of Bladder Compliance?","authors":"Salvador Arlandis, Christopher Fry, Michel Wyndaele, Apostolos Apostolidis, Enrico Finazzi-Agró, Pradeep Tyagi, Michael Winder, Hikaru Hashitani, Giovanni Mosiello, Marcio Augusto Averbeck, Alan Wein, Paul Abrams","doi":"10.1002/nau.25604","DOIUrl":"10.1002/nau.25604","url":null,"abstract":"<p><strong>Introduction: </strong>Defining \"high-risk bladder\" or \"high-pressure bladder\" involves recognizing the potential for an unsafe lower urinary tract, where dysfunction in storage and micturition can threaten upper urinary tract health, leading to unfavorable outcomes like dialysis, recurrent infections, systemic impact, or mortality.</p><p><strong>Methods: </strong>ICI-RS was held in Bristol in June 2024, and Think Tank 2 aimed to define research priorities including identifying clinical predictors and developing prevention and monitoring strategies.</p><p><strong>Results: </strong>Risk factors encompass both congenital and neurogenic lower urinary tract dysfunction, bladder outlet obstruction, vascular diseases, and inflammatory disorders, but a validated stratification risk is lacking. Reduced compliance and detrusor overactivity lead to high filling pressures and raised detrusor leak point pressure, playing urodynamic studies a crucial role in risk assessment, though further research is needed for different neurogenic populations. Congenital conditions such as spina bifida, posterior urethral valves, and bladder exstrophy also contribute to a high-risk bladder through fibrosis and reduced compliance. Inflammation and ischemia are key factors, with inflammation leading to fibrosis and impaired bladder storage and voiding function. Novel treatments, including sGC activators, PDE5 inhibitors, and regenerative therapies like stem cell injections and extracorporeal shock wave treatment, show promise in mitigating fibrosis and improving bladder compliance.</p><p><strong>Conclusions: </strong>Identifying and validating clinical risk stratification models, precise biomarkers and therapeutic windows remains essential for effective management and reversal of bladder fibrosis and dysfunction.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"539-547"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546454","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":"Moving Beyond the Bladder Diary: Does New Technology Now Allow Us to Take Investigation of LUTS Into the Community? ICI-RS 2024.","authors":"Michael Drinnan, Paul Abrams, Salvador Arlandis, Marcus J Drake, Andrew Gammie, Chris Harding, Angela Rantell, Françoise Valentini","doi":"10.1002/nau.25646","DOIUrl":"10.1002/nau.25646","url":null,"abstract":"<p><strong>Context: </strong>Lower Urinary Tract Symptoms (LUTS) are defined by their distressing effect on patients' day-to-day life. Given the pressures on secondary care resources, LUTS may be overlooked or inadequately assessed and therefore patients may be burdened for an extended period before treatment.</p><p><strong>Methods: </strong>In a debate held at the International Consultation on Incontinence Research Society (ICI-RS) meeting in Bristol in June 2024, we considered how new technologies might contribute to an expedited, dignified and effective investigation of LUTS.</p><p><strong>Results: </strong>We describe three broad areas where technology has a role to play: streamlining of existing investigations through mobile and miniaturized technology; entirely new investigations made possible by the technology; and advanced analytics to provide better insights from the data available.</p><p><strong>Conclusion: </strong>We describe key research questions that will signpost us toward answering the question raised in the title.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"601-608"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896473","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":"Is It Possible to Regenerate the Underactive Detrusor? Part 1. Molecular and Stem Cell Therapies Targeting the Urinary Bladder and Neural Axis - ICI-RS 2024.","authors":"Sanjay Sinha, Francisco Cruz, Esther Martinez Cuenca, Mikolaj Przydacz, George Bou Kheir, Anthony J Kanai, Andries Van Huele, Jerzy B Gajewski, Tufan Tarcan, Jason M Lazar, Jeffrey P Weiss, Pradeep Tyagi, Paul Abrams, Alan Wein","doi":"10.1002/nau.25597","DOIUrl":"10.1002/nau.25597","url":null,"abstract":"<p><strong>Introduction: </strong>Detrusor muscle weakness is commonly noted on urodynamics in patients with refractory voiding difficulty. No approved therapies have been proven to augment the strength of a detrusor voiding contraction.</p><p><strong>Methods: </strong>This subject was discussed by a think-tank at the International Consultation on Incontinence- Research Society (ICI-RS) meeting held in Bristol, June 2024. The discussions of the think-tank are being published in two parts. This first part discusses molecular and stem cell therapies targeting the urinary bladder and the neural axis.</p><p><strong>Results: </strong>Senescence of the urothelium and extracellular ATP acting through P2X3 receptors might be important in detrusor underactivity. Several molecules such as parasympathomimetics, acotiamide, ASP8302, neurokinin-2 agonists have been explored but none has shown unequivocal clinical benefit. Different stem cell therapy approaches have been used, chiefly in neurogenic dysfunction, with some studies showing benefit. Molecular targets for the neural axis have included TRPV-4, Bombesin, and serotoninergic receptors and TAC-302 which induces neurite growth.</p><p><strong>Conclusions: </strong>Several options are currently being pursued in the search for an elusive molecular or stem cell option for enhancing the power of the detrusor muscle. These encompass a wide range of approaches that target each aspect of the contraction mechanism including the urothelium of bladder and urethra, myocyte, and neural pathways. While none of these have shown unequivocal clinical utility, some appear promising. Lessons from other fields of medicine might prove instructive.</p><p><strong>Clinical trial registration: </strong>Not necessary. Not a clinical trial.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"577-584"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381318","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 Show That Artificial Intelligence May Improve Our Assessment and Management of Lower Urinary Tract Dysfunctions?-ICI-RS 2024.","authors":"Enrico Finazzi Agrò, Eleonora Rosato, George Bou Kheir, Kevin Rademakers, Márcio Augusto Averbeck, Tufan Tarcan, Hashim Hashim, Andrew Gammie, Sanjay Sinha, Qi-Xiang Song, Rayan Mohamed-Ahmed, Anasofia Da Silva, Riccardo Lombardo, Paul Abrams, Alan Wein, Glenn T Werneburg","doi":"10.1002/nau.25606","DOIUrl":"10.1002/nau.25606","url":null,"abstract":"<p><strong>Aims: </strong>The integration of artificial intelligence (AI) into functional urology management must be assessed for its clinical utility, but hopefully will change, perhaps to revolutionize the way LUTD and other conditions are assessed, the aim being to offer patients more rapid and effective management which enhances patient outcomes. The aim of this proposal, discussed at the ICI-RS annual meeting, is to evaluate the available evidence on AI and the way it might change the approach to urodynamic (UDS) diagnoses, including overactive bladder syndrome (OAB), and perhaps other LUTDs such as bladder outflow obstruction.</p><p><strong>Methods: </strong>A compendium of discussion based on the current evidence related to AI and its potential applications in UDS and OAB.</p><p><strong>Results: </strong>AI-powered diagnostic tools are being developed to analyze complex datasets from urodynamic studies, imaging, and other diagnostic tests. AI systems can leverage large volumes of clinical data to recommend personalized treatment plans based on individual patient profiles to optimize surgical procedures, enhance diagnostic precision, tailor the therapy, reduce the risk of complications, and improve outcomes. In the future, AI will be able to provide tailored counseling regarding the outcomes and potential side effects of drugs and procedures to a given patient.</p><p><strong>Conclusion: </strong>AI's role in functional urology has been poorly investigated, and its implementation across several areas may improve clinical care and the pathophysiological understanding of functional urologic conditions.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"616-621"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504856","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":"LUTS in Older Adults: Definitions, Comorbidity Impact, Patient Priorities, and Treatment Strategies for Managing Daytime and/or Nighttime Symptoms - ICI-RS 2024.","authors":"Andries Van Huele, Karel Everaert, William Gibson, Adrian Wagg, Paul Abrams, Alan Wein, Wendy F Bower","doi":"10.1002/nau.25624","DOIUrl":"10.1002/nau.25624","url":null,"abstract":"<p><strong>Introduction: </strong>Lower urinary tract symptoms (LUTS) are prevalent among older adults, a population that faces multiple medical challenges, with frailty being a major concern. Despite the high prevalence of LUTS, current treatment strategies for older adults are often inadequate. This paper aims to address these issues by defining daytime and/or nighttime LUTS and examining the impact of comorbid conditions on these symptoms. We will identify the priorities of older patients regarding LUTS management and propose treatment strategies to improve outcomes in this vulnerable population.</p><p><strong>Methods: </strong>This review is based on discussions at the ICI-RS 2024 meeting in Bristol, UK, alongside an extensive literature review examining LUTS in older adults. The review explores distinctions between daytime and nighttime symptoms, the impact of frailty, patient priorities, treatment strategies and the role of comorbidities.</p><p><strong>Results: </strong>LUTS in older adults present a complex and multifaceted challenge, with notable differences between daytime and nighttime manifestations, which may coexist. Clear definitions are needed. There is a lack of evidence that treating associated comorbidities will improve LUTS or urinary incontinence. Personalized care approaches, integrated into broader geriatric health strategies, are essential for addressing these symptoms. An ideal treatment strategy is proposed, focusing on daytime, nighttime or combined day- and nighttime LUTS. Further research is needed to refine treatment pathways and optimize outcomes for this population.</p><p><strong>Conclusions: </strong>A comprehensive, individualized approach is necessary to address LUTS in older adults. Future research should focus on refining diagnostic definitions, exploring the interplay between comorbidities and LUTS, and developing patient-centered treatment strategies that account for both daytime and nighttime (or combined) symptoms.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"592-600"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624895","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":"Systematic Evaluation of Lower Urinary Tract Sensations to Improve Management of LUTS: ICI-RS 2024.","authors":"Mathijs de Rijk, Claire Hentzen, Caroline Selai, Stefania Musco, Riccardo Lombardo, Gommert van Koeveringe, Christopher Chapple, Paul Abrams, Jean J Wyndaele, Karen McCloskey","doi":"10.1002/nau.25636","DOIUrl":"10.1002/nau.25636","url":null,"abstract":"<p><strong>Aims: </strong>Lower urinary tract (LUT) sensations form an essential part of diagnostic criteria for many LUT symptoms, additionally LUT sensations are used to evaluate the effectivity of therapeutic interventions. The accurate measurement of LUT sensations, however, is severely hampered by the subjective nature of these sensations.</p><p><strong>Methods: </strong>This paper summarizes the discussions from the 2024 meeting of the International Consultation for Incontinence-Research Society (ICI-RS 2024) regarding systematic evaluations of LUT sensations and the design of more objective tools to measure these.</p><p><strong>Results: </strong>Here, we discuss factors that influence sensations that are under the control of the caregiver/investigator, the signaling of sensations from the LUT toward the central nervous system, and currently used diagnostic tools to measure LUT sensations. Recent methodological advances to objectively measure factors that correspond with changes in LUT sensations are introduced along with recommendations for future research to optimally enable objective assessment of processes underlying LUT sensations.</p><p><strong>Conclusions: </strong>Advancing the objective measurement of LUT sensations will require interdisciplinary collaboration, integrating insights from neuroscience, engineering, and clinical practice. Such efforts hold the potential to transform patient care by enabling more precise diagnostics and personalized therapeutic strategies.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"622-630"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Our Limited Understanding of the Effects of Nerve Stimulation Resulting in Poor Outcomes and the Need for Better \"Rescue Programming\" in SNM and PTNS, and Lost Opportunities for New Sites of Stimulation? ICI-RS 2024.","authors":"Marcio Augusto Averbeck, Jerzy B Gajewski, Enrico Finazzi-Agrò, Christopher John Chermansky, Arun Sahai, Michał Późniak, Sanjay Sinha, Giovanni Mosiello, Christopher Harding, Hashim Hashim, Roger Dmochowski, Mohammed Belal, Paul Abrams","doi":"10.1002/nau.25600","DOIUrl":"10.1002/nau.25600","url":null,"abstract":"<p><strong>Aims: </strong>Sacral neuromodulation (SNM) and percutaneous tibial nerve stimulation (PTNS) are strongly recommended by international guidelines bodies for complex lower urinary tract dysfunctions. However, treatment failure and the need for rescue programming still represent a significant need for long-term follow-up. This review aimed to describe current strategies and future directions in patients undergoing such therapies.</p><p><strong>Materials and methods: </strong>This is a consensus report of a Think Tank discussed at the Annual Meeting of the International Consultation on Incontinence - Research Society (ICI-RS), June 6-8, 2024 (Bristol, UK): \"Is our limited understanding of the effects of nerve stimulation resulting in poor outcomes and the need for better 'rescue programming' in SNM and PTNS, and lost opportunities for new sites of stimulation?\"</p><p><strong>Results: </strong>Rescue programming is important from two different perspectives: to improve patient outcomes and to enhance device longevity (for implantable devices). Standard SNM parameters have remained unchanged since its inception for the treatment of OAB, nonobstructive urinary retention, and voiding dysfunction. SNM rescue programming includes intermittent stimulation (cycling on), increased frequency and changes in pulse width (PW). The effect of PW setting on SNM outcomes remains unclear. Monopolar configurations stimulate more motor nerve fibers at lower stimulation voltage; hence, this could be an option in patients who failed bipolar stimulation in the long term. Unfortunately, there is little evidence for rescue programming for PTNS. However, the development of implantable devices for intermittent stimulation of the tibial nerve may increase long-term adherence to therapy and increase interest in alternative programming. There has been recent promising neurostimulation targeting the pudendal nerve (PNS), especially in BPS/IC. More recently, preliminary data addressed the benefits of high-frequency bilateral pudendal nerve block for DESD and adaptive PNS on both urgency and stress UI in women.</p><p><strong>Conclusion: </strong>The exploration of rescue programming and new stimulation sites remains underutilized, and there are opportunities that could potentially expand the therapeutic applications of nerve stimulation. By broadening the range of target sites, clinicians may be able to tailor treatments according to individual patient needs and underlying conditions, thereby improving overall outcomes. However, further studies are still needed to increase the level of evidence, potentially allowing for an individualized treatment both in patients who are candidates for electrostimulation and in those who have already received surgical implants but seek a better outcome.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"676-682"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400850","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}