Neurourology and Urodynamics最新文献

{"title":"Lived Experiences of Emotional Distress Among Patients With Lower Urinary Tract Symptoms: A Mixed-Methods Study.","authors":"Grace E Bardwick, Alan J Fossa, Hosanna An, Jessica Thomas, Brian Bieber, Kathryn E Flynn, Giulia M Ippolito, Melissa Marquez, Michelle Taddeo, James W Griffith","doi":"10.1002/nau.70448","DOIUrl":"https://doi.org/10.1002/nau.70448","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to describe the association of lower urinary tract symptoms (LUTS) with emotional distress using questionnaires and qualitative interviews.</p><p><strong>Methods: </strong>We used a convergent parallel mixed methods design to examine relationships between the LURN Symptom Index-29 (LURN SI-29) questionnaire and emotional distress, measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety and Depression Short Forms and the Perceived Stress Scale. Quantitative analyses assessed correlations between the SI-29 total and subscale scores and emotional distress measures. Qualitative interviews explored the emotional impact of LUTS, with representative quotations used to contextualize quantitative findings.</p><p><strong>Results: </strong>The total and pain subscale scores of the LURN SI-29 demonstrated the strongest positive correlations with anxiety (r = 0.25-0.33), depression (r = 0.24-0.30), and stress (r = 0.21-0.28). Urgency, incontinence and voiding subscales had weaker associations, while nocturia showed minimal or slighting negative correlations (|r| < 0.12). Although most of the relationships were statistically significant, effect sizes were generally small. Qualitative narratives converged with these findings, describing how pain, unpredictability, and loss of control contributed to anxiety, depression, and stress.</p><p><strong>Conclusions: </strong>Pain and overall LUTS burden were the primary contributors to emotional distress, whereas nocturia played a minimal role. Despite cohort selection for urinary urgency, pain was a driver of emotional distress, highlighting the need to assess bladder-related pain and its psychosocial impacts in LUTS care.</p><p><strong>Trial registration: </strong>NCT02485808.</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":"149112761","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":"Advancing Personalized Care for Neurogenic Bladder: Editorial.","authors":"Genevieve Nadeau, Blayne Welk","doi":"10.1002/nau.70463","DOIUrl":"https://doi.org/10.1002/nau.70463","url":null,"abstract":"","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":"149112769","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 the Editor on \"Unveiling 'Idiopathic' Nocturia: The Central Role of Sleep-Induced Hypogonadism and ANP-Mediated Hemodynamics\".","authors":"Qi-Xiang Song, Sanjay Sinha, Bahareh Vahabi, Anthony Kanai, Christopher Fry, Pradeep Tyagi, Stefania Musco, Dudley Robinson, Marcus J Drake, Paul Abrams, Alan Wein, Christopher R Chapple","doi":"10.1002/nau.70465","DOIUrl":"https://doi.org/10.1002/nau.70465","url":null,"abstract":"<p><strong>Background: </strong>We respond to the comments of Lin et al. on our Think Tank review of potential therapeutic avenues for idiopathic nocturia.</p><p><strong>Methods: </strong>Evidence was synthesized from relevant literature on OSA-associated nocturia, testosterone decline with sleep-induced hypogonadism, and natriuresis-mediated impairment of aquaporin (AQP)-dependent water reabsorption.</p><p><strong>Result: </strong>We first clarify that our review was confined to idiopathic nocturia. We also note that \"occult OSA\" should more accurately be termed undiagnosed OSA, and that the associated nocturia should be classified as secondary rather than idiopathic. Nonetheless, we acknowledge the value of the proposed sleep-induced hypogonadism hypothesis, while emphasizing that the causal link between OSA-related testosterone decline and nocturia remains unestablished and that available evidence is currently male-specific. We further recognize that natriuresis attributed to atrial natriuretic peptide may impair aquaporin-mediated water reabsorption; however, existing evidence pertains mainly to renal tubular aquaporins, whereas our review focused on bladder urothelial aquaporins and transvesical water reabsorption, a largely unexplored extrarenal mechanism.</p><p><strong>Conclusions: </strong>We are grateful to Lin et al. for their letter, which raises additional mechanisms as critical drivers of nocturia. We believe that cross-disciplinary research into OSA-associated secondary nocturia is warranted to translate these mechanistic insights into clinical benefit.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112737","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 the Editor on \"Artificial Intelligence Large Language Models for Pelvic Floor Rehabilitation: Readability, Usability and Consistency\".","authors":"Ayse Naz Kalem Ozgen, Esra Celik Karbancioglu, Nihal Tezel","doi":"10.1002/nau.70472","DOIUrl":"https://doi.org/10.1002/nau.70472","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112758","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 Temporary Incontinent Vesicostomy Associated With Fewer Early Urinary Outflow-Related Complications After Pediatric Ileocystoplasty?","authors":"Vasily V Nikolaev, Nikita V Demin, Elizaveta A Ladygina, Viacheslav S Korkosh","doi":"10.1002/nau.70450","DOIUrl":"https://doi.org/10.1002/nau.70450","url":null,"abstract":"<p><strong>Aims: </strong>Pediatric augmentation ileocystoplasty carries a risk of urinary outflow-related complications (ORC), including anastomotic leakage, obstruction of the catheterizable stoma, and febrile urinary tract infection. We evaluated whether temporary incontinent vesicostomy (TIV) reduces early ORC and emergency readmissions, and whether it affects 24-month function.</p><p><strong>Methods: </strong>We retrospectively analyzed 168 children who underwent perimesenteric ileal augmentation with a catheterizable continent stoma between 2000 and 2023: TIV (n = 133) versus no TIV (n = 35). The primary endpoint was ORC within 6 months. Secondary endpoints were all-cause emergency readmissions within 180 days and 24-month daytime continence, augmented bladder capacity and compliance.</p><p><strong>Results: </strong>ORC were less frequent with TIV than without (2.3% [3/133] vs. 28.6% [10/35]; p < 0.001), driven by lower rates of anastomotic leakage (1.5% vs. 11.4%; p = 0.018), urgent obstruction of the catheterizable channel (0% vs. 11.4%; p = 0.002) and febrile urinary tract infection/pyelonephritis (0.8% vs. 8.6%; p = 0.029). At 24 months, daytime continence, augmented bladder capacity (424 ± 113 vs. 406 ± 144 mL; p = 0.402) and compliance (31.4 ± 7.5 vs. 28.1 ± 9.6 mL/cm H₂O; p = 0.069) did not differ between groups, whereas all-cause emergency readmissions within 180 days were markedly lower with TIV (3.0% [4/133] vs. 22.9% [8/35]; p < 0.001).</p><p><strong>Conclusions: </strong>TIV is associated with markedly fewer early urinary ORC and 180-day emergency readmissions after pediatric perimesenteric ileocystoplasty, without compromising 24-month continence or reservoir dynamics. Temporary abdominal urinary drainage and the need for planned TIV closure should be discussed during patient selection and family counseling. The benefit appears most relevant after bladder neck closure and in children at risk for delayed access to specialist care; prospective studies should define optimal patient selection, closure timing and long-term upper-tract and channel outcomes.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081168","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":"Diagnosis of Urethral Resistance in Men: 70 Years of History.","authors":"Wouter van Dort, Peter F W M Rosier, Laetitia M O de Kort","doi":"10.1002/nau.70471","DOIUrl":"https://doi.org/10.1002/nau.70471","url":null,"abstract":"<p><strong>Background and aims: </strong>The urethral resistance (UR) is one of the key outcomes of the urodynamic pressure-flow study (PFS) in men. Combined with a clinical meaningful cut-off point, urodynamic bladder outflow obstruction (BOO) can be determined. This characterization of BOO provides guidance in the management of lower urinary tract symptoms (LUTS), enabling the differentiation between BOO and detrusor underactivity. In this way, the UR can be objectified and monitored, providing insight into the expected results of a clinical intervention. The route from the raw urodynamic measurement towards the diagnosis has faced fundamental challenges over the years. This narrative review aims to give an overview of the background of our current UR measures in men and provides an outlook towards new developments.</p><p><strong>Methods: </strong>A non-structured literature search was conducted into the development of assessment of UR.</p><p><strong>Results: </strong>A narrative historic overview is given of the development of assessment of UR.</p><p><strong>Conclusion: </strong>The history of assessing urethral resistance centers on simplifying complex fluid dynamics into clinical tools, evolving from static calculations to dynamic, tissue-elasticity. Today, a renewed focus on voiding physiology, paired with machine learning and computational fluid dynamics, promises mathematically valid, patient-specific diagnostics to optimize the management of bladder outflow obstruction.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081647","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":"Lead Migration Following Sacral Neuromodulation Implantation: Contemporary Real-World Experience From a High-Volume Academic Center.","authors":"Zhenyue Huang, Spencer H Griffin, Sargam Panpaliya, Eshwin Varghese, Sara O'Sullivan-Bakshi, Kathryn Bass, Heng Ruan, Tiffany Lynn Damm, Tal Cohen, Justina Tam, Steve Weissbart, Jason Kim","doi":"10.1002/nau.70464","DOIUrl":"https://doi.org/10.1002/nau.70464","url":null,"abstract":"<p><strong>Introduction: </strong>Lead migration is a recognized cause of recurrent symptoms and revision following sacral neuromodulation (SNM), yet its radiographic characteristics and associated risk factors remain poorly defined. We evaluated postoperative sacral imaging obtained for suspected lead migration to characterize migration patterns and to identify factors independently associated with lead migration in a contemporary cohort of patients undergoing SNM implantation.</p><p><strong>Materials and methods: </strong>We performed a retrospective review of all patients undergoing SNM implantation at a tertiary academic referral center between September 2019 and June 2025. Lead migration was assessed by comparing baseline intraoperative fluoroscopic images with follow-up radiographs using a standardized radiographic measurement protocol.</p><p><strong>Results: </strong>Among 445 patients undergoing SNM implantation, 173 met at least one predefined indication for postoperative imaging. Ninety-two had both baseline and follow-up imaging available for quantitative assessment. Overall, 35/445 (7.86%) patients had confirmed lead migration. Migration occurred predominantly in the forward direction (62.9%), with a median time to migration of 16 months (interquartile range, 7-28 months). A total of 29/35 patients (82.9%) underwent surgical revision or device removal. On Firth bias-reduced multivariable logistic regression analysis, Axonics devices were associated with higher odds of lead migration compared with Medtronic devices (adjusted odds ratio [aOR], 2.66; 95% confidence interval [CI], 1.09-6.62; p = 0.031), after adjustment for implantation approach, rechargeable device status, BMI, and age-adjusted CCI. Massive migration (> 21 mm) occurred only in Axonics devices.</p><p><strong>Conclusions: </strong>Lead migration following SNM implantation was uncommon but frequently resulted in surgical intervention. Axonics devices were associated with higher odds of lead migration after adjustment for selected clinical and device-related factors. Importantly given the relatively small number of migration events and retrospective study design, this finding should be considered hypothesis-generating rather than evidence of a causal association. Prospective multicenter studies are warranted to validate these findings and further define the mechanisms and clinical significance of SNM lead migration.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081277","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":"Fear-Avoidance and Overactive Bladder: Toward a Mechanism-Informed Model of Care.","authors":"Rupal M Patel, Andrea Wood","doi":"10.1002/nau.70458","DOIUrl":"https://doi.org/10.1002/nau.70458","url":null,"abstract":"<p><strong>Aims: </strong>Overactive bladder (OAB) is associated with substantial psychological burden, yet existing biopsychosocial frameworks acknowledge that psychological factors shape outcomes without explaining the cognitive and behavioral mechanisms through which that influence operates. This paper aimed to propose the fear-avoidance as a missing explanatory framework for OAB symptom maintenance, and to introduce a phenotyping model for clinical application.</p><p><strong>Methods: </strong>We synthesized literature on fear-avoidance theory, cognitive appraisal and coping, and OAB epidemiology and psychosocial burden to construct a theoretical model linking urinary urgency to fear-avoidance mechanisms and developed a phenotyping framework distinguishing idiopathic and physiological OAB subtypes.</p><p><strong>Results: </strong>We propose that urinary urgency, characterized by unpredictability and difficulty deferring, functions as a potent stimulus for catastrophic threat appraisal, initiating a self-sustaining cycle of avoidance, hypervigilance, and perceived uncontrollability that perpetuates symptom burden independent of underlying pathology. We further distinguish two OAB subgroups: idiopathic OAB (iOAB), in which fear-avoidance functions as a primary, symptom-originating mechanism driven by maladaptive toileting behaviors and, in some cases, trauma-related hypervigilance; and physiological OAB (pOAB), in which an identifiable physiological cause (e.g., menopause, prostatectomy, radiation cystitis, neurogenic bladder) drives symptom onset while fear-avoidance operates as a secondary but clinically meaningful amplifier.</p><p><strong>Conclusions: </strong>This distinction carries direct implications for treatment prioritization, positioning fear-avoidance-informed behavioral care as either a primary intervention or a necessary adjunct to medical management. The framework offers clinicians a testable, mechanism-informed model for understanding and addressing avoidance behavior across the OAB clinical spectrum, and provides direction for empirical research on OAB phenotyping and behavioral intervention.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070045","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":"Sensing in Sacral Neuromodulation: Objective, Individualized Stimulation Response Thresholds Directly From the Lead.","authors":"Colin Goudelocke, Henry Ruiz, Charles R Powell, David Sheyn, Brian J Linder, Ketul Shah, Gustavo Villegas, Joseph Henderson, Anne G Sammarco, Sarah J Offutt, David U J Keller, Katie C Bittner, Hank Bink, Ivan Merlo, Julia P Slopsema, Lisa Jungbauer Nikolas","doi":"10.1002/nau.70443","DOIUrl":"https://doi.org/10.1002/nau.70443","url":null,"abstract":"<p><strong>Objectives: </strong>Sacral neuromodulation (SNM) therapy today relies on visually observed motor responses (e.g., anal bellows contraction, toe flexion) and subjective patient feedback (pelvic region sensations) to optimize lead placement and perform device programming. Measures of sacral nerve activation used in current practice include motor and sensory thresholds, described as the stimulation amplitudes associated with first observed or reported stimulation responses. This study evaluated the utility of sacral evoked responses (SERs), recorded directly from implanted commercial SNM leads, as objective indicators of sacral nerve activation.</p><p><strong>Materials and methods: </strong>The PEER 2 Cohort 1 study was a multi-center, prospective, clinical feasibility study in female overactive bladder patients undergoing a tined lead evaluation for SNM using InterStim™ SureScan™ MRI leads. An investigational external neurostimulator was used to collect electrophysiological signal recordings directly from the implanted lead (SER recordings), in addition to motor and sensory thresholds at three timepoints: intraoperatively (OR), immediately postoperatively (PO), and at the end of therapy evaluation (Trial End). SER recordings were processed to determine stimulation amplitudes associated with first detectable signal (SER threshold, SERT) and analyzed for comparison with the motor and sensory thresholds.</p><p><strong>Results: </strong>Lead-recorded SERs were reliably detected across subjects and timepoints: OR: 100% (89/89 subjects); PO 98.9% (87/88 subjects); Trial End: 97.7% (86/88 subjects). SERTs demonstrated statistically significant correlation with both motor and sensory thresholds across six bipolar electrode configurations (R = 0.46-0.92; p < 0.001). Compared to sensory thresholds, SERTs were a more sensitive measure of sacral nerve activation, detected at or below sensory thresholds in 57%-84% of subjects. SERTs also exhibited less variability across repeated measurements compared to sensory thresholds (p < 0.001). Replicate SERTs showed no change in 55.9% of subjects, whereas sensory thresholds showed no change in only 20.6% of subjects.</p><p><strong>Conclusions: </strong>The study results demonstrate that SERs recorded from SNM leads are reliably detected, clinically relevant, sensitive, and consistent markers of sacral nerve activation, offering an objective alternative to present-day subjective measures. Integrating lead-sensed SERs may streamline SNM programming and lead placement, introducing a simplified and standardized measure for optimizing and delivering patient-specific SNM therapy.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov NCT05200923. Investigational device. Limited by Federal (U.S.) law to investigational use. The research system and sensing feature are not approved by the FDA or any other regulatory authority and are not for sale in the US or internationally.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040011","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 \"Differences Between Men and Women With Urinary Incontinence as They Seek Medical Care\".","authors":"N V L Suvarchala Reddy, Praveen Kumar Annagowni, M Lakshmi Madhuri","doi":"10.1002/nau.70462","DOIUrl":"https://doi.org/10.1002/nau.70462","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039963","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}