Neurourology and Urodynamics最新文献

{"title":"Comparative Risk of Developing Interstitial Cystitis With Childhood Gastrointestinal, Urological, Autoimmune, or Psychiatric Disorders.","authors":"Mohammad Alipour-Vaezi, Robert S McNamara, Margaret R Rukstalis, Emily C Gentry, Daniel B Rukstalis, Donald B Penzien, Kwok-Leung Tsui, Huaiyang Zhong","doi":"10.1002/nau.70104","DOIUrl":"10.1002/nau.70104","url":null,"abstract":"<p><strong>Aims: </strong>Interstitial cystitis (IC) is a chronic urological condition associated with significant discomfort, posing diagnostic and therapeutic challenges. Although its etiology remains unclear, early-life conditions such as gastrointestinal (GI) disorders, urological anomalies (UA), psychiatric disorders (PD), and autoimmune diseases (AD) have been hypothesized as potential risk factors for developing IC in adulthood. This study aims to investigate these associations by conducting a retrospective cohort analysis utilizing data from the TriNetX US Collaborative Network, encompassing over 118 million patient records.</p><p><strong>Methods: </strong>The study and control groups were established across four categories of childhood disorders, with IC incidence monitored over a 14-year period. Statistical methodologies, including propensity score matching and Kaplan-Meier survival analysis, were employed to compare outcomes between cohorts.</p><p><strong>Results: </strong>Findings indicate that childhood GI and UA conditions significantly elevate the risk of IC in adulthood, with irritable bowel syndrome (IBS) and urinary tract infections (UTIs) exhibiting risk ratios of 2.9 and 3.2, respectively. Gender disparities were also noted, with females exhibiting higher incidences of diseases included, particularly UA and AD during adolescence. Additionally, individuals with these early-life conditions demonstrated a higher prevalence of comorbidities, underscoring the complex interplay of health factors contributing to IC pathogenesis.</p><p><strong>Conclusions: </strong>These findings suggest that childhood GI and UA conditions may serve as predictive markers for IC, emphasizing the need for targeted early interventions and preventative care strategies. By identifying at-risk populations, this study provides valuable insights into early detection and management approaches, potentially mitigating the long-term burden of IC on affected individuals.</p><p><strong>Trial registration: </strong>This paper includes an observational retrospective study. No clinical trial has been conducted.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1448-1454"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497548","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":"Under-Investigated and Underestimated: Disparities in Toilet and Sanitation Insecurity in a Sample of United States Adults.","authors":"William Furuyama, Roger Dmochowski, Elisabeth Sebesta","doi":"10.1002/nau.70109","DOIUrl":"10.1002/nau.70109","url":null,"abstract":"<p><strong>Introduction: </strong>Most estimates of toilet and sanitation access in the United States rely on limited data from the US Census that examine the presence or absence of plumbing. This study aims to understand the prevalence of toilet and sanitation insecurity using a broader definition that considers issues of accessibility and reliability.</p><p><strong>Methods: </strong>We recruited from an electronic research database between September 2021 and January 2022 and identified participants at risk for toilet and sanitation insecurity.</p><p><strong>Results: </strong>About 4218 participants completed the study and 725 (17%) were identified as at-risk for home toilet and sanitation insecurity. The at-risk population was more likely to be younger, be of nonwhite race and ethnicity, live in rural or urban communities, have lower socioeconomic status, have less education, be unemployed, use a septic sewage system, and be non-homeowners.</p><p><strong>Conclusions: </strong>A significant percentage of people with toilets and plumbing experience home toilet and sanitation insecurity, demonstrating the inadequacy of measures that rely on the presence or absence of plumbing. Methods to estimate toilet and sanitation insecurity should account for accessibility and reliability. Understanding more about those affected by home toilet and sanitation insecurity using this broader definition may also have implications for managing bladder health and urinary symptoms.</p><p><strong>Clinical trial registration: </strong>This study was not a clinical trial and did not require clinical trial registration.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1432-1438"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497550","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":"Comment on: \"Noninvasive High-Intensity Focused Electromagnetic Therapy in Women With Urinary Incontinence: A Systematic Review and Meta-Analysis\".","authors":"Jie Hao","doi":"10.1002/nau.70077","DOIUrl":"10.1002/nau.70077","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1525-1526"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199720","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":"Commentary on \"Portable Ultrasound Bladder Volume Measurement Over Entire Volume Range Using a Deep Learning Artificial Intelligence Model in a Selected Cohort: A Proof of Principle Study\".","authors":"Saraswati Sah, Renu Sah","doi":"10.1002/nau.70102","DOIUrl":"10.1002/nau.70102","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1527-1528"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659707","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":"Utilizing Predictive Analytics to Understand Neurogenic Bladder Symptom Score (NBSS) Variations in Adults With Acquired Spinal Cord Injury.","authors":"Mehran Nejad-Mansouri, Daniel Lizotte, Jeremy Myers, Sean Elliott, John T Stoffel, Sara Lenherr, Rhiannon Lyons, Tianyue Zhong, Blayne Welk","doi":"10.1002/nau.70116","DOIUrl":"10.1002/nau.70116","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals with spinal cord injury (SCI) have varying bladder health trajectories after their injury. We explored whether a predictive machine learning model could identify which variables impact urinary symptoms.</p><p><strong>Methods: </strong>We used 238 variables from the Neurogenic Bladder Research Group SCI registry for a Decision Tree analysis (eCHAID technique). The primary outcomes were the baseline Neurogenic Bladder Symptom Score (NBSS), and the change from the baseline NBSS at 1-year follow up (measured as better/worse than the median change).</p><p><strong>Results: </strong>Among the 1479 participants, mean baseline NBSS was 24.16 ± 0.28 (standard error of the mean). Our decision tree that evaluated the NBSS at baseline predicted that individuals with a suprapubic tube/urostomy as their primary bladder management method and good bowel QOL at baseline had the lowest (best) mean baseline NBSS at 13.44 ± 0.83. In contrast, females with baseline spontaneous voiding had the highest (worst) mean baseline NBSS at 34.42 ± 1.05. Our second decision tree evaluated the change in the NBSS at 1-year follow-up. Of the 711 participants that performed better than the median change (i.e., improved), 45% were accounted for jointly by women who did not use bladder relaxing medications at baseline, and men without a history of prior urinary tract infections who used a single bladder management method at follow-up. The predictive capacity the decision tree was 57%.</p><p><strong>Conclusions: </strong>Decision tree models help identify combinations of patient characteristics which correlate with urinary symptoms after SCI. However, there was a limited predictive capacity of the decision tree to forecast future bladder symptoms.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1466-1473"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591809","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":"Diagnostic and Therapeutic Outcomes of Ambulatory Urodynamics in a Tertiary Referral Center.","authors":"Charlotte Mary Hughes, Nikita Rajiv Bhatt, Johanna Catherine Georgina Penfold, Emily Jane Speck, Thomas Giles Gray, Ilias Giarenis, Sarah Jane Wood, Charlotte Elizabeth Dunford, Ruth Danielle Doherty","doi":"10.1002/nau.70111","DOIUrl":"10.1002/nau.70111","url":null,"abstract":"<p><strong>Introduction: </strong>Conventional urodynamic studies have been variably reported to be unable to reproduce a patients' symptoms (3.5%-68%) and detrusor overactivity (DO) can be missed in up to 54% of cases. Tertiary referral centers have reported successful diagnostic yield of ambulatory urodynamic studies (AUDS) in 74%-98%. However, it's clinical utility has been questioned. We aimed to evaluate the diagnostic and therapeutic outcomes of our tertiary AUDS service.</p><p><strong>Methods: </strong>A retrospective review was undertaken of consecutive patients attending for AUDS, including local and regional referrals. Data was collected on patient demographics, indication, urodynamic diagnosis, and subsequent management.</p><p><strong>Results: </strong>One hundred and forty two AUDS procedures were evaluated. Median age was 59 years (range 23-90); 18% were male and 42% regional referrals. A urodynamic diagnosis was made in 80% patients. Thirty-five percent were diagnosed with idiopathic detrusor overactivity, 32% with stress urinary incontinence and 11% were found to have mixed urinary incontinence. There was a change from baseline urodynamic diagnosis in 69%. Of those with follow-up information available (n = 81), 74% had a change in management, including 59% considered for surgical intervention. No patients went on to require further urodynamic investigation when symptoms were not reproduced on AUDS.</p><p><strong>Conclusion: </strong>AUDS successfully diagnosed 80% of patients referred with inconclusive conventional UDS, translating to change in management and surgical intervention. AUDS is an important tool in select patient groups, to reproduce symptoms and guide management, where conventional UDS has failed.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1491-1497"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Medium to Long-Term Study Comparing Stress Urinary Incontinence Procedures.","authors":"Ifeoma Offiah, D Carolina Ochoa, Jennifer M Alvarado, Millie Mercer, Chendrimada Madhu, Herney A Garcia-Perdomo, Hashim Hashim","doi":"10.1002/nau.70101","DOIUrl":"10.1002/nau.70101","url":null,"abstract":"<p><strong>Background and objectives: </strong>Concerns remain regarding the safety of the retropubic tape (TVT) procedure. We assess the efficacy, satisfaction and long-term outcomes of the TVT procedure and compare it to the autologous fascial sling (AFS), colposuspension, and urethral bulking procedures.</p><p><strong>Methods: </strong>A review of prospective data of all patients post stress urinary incontinence (SUI) surgery in our tertiary center between January 2012 and December 2020 was performed. Patients were invited to complete three validated questionnaires: International Consultation of Incontinence Modular Questionnaire Vaginal Symptoms (ICIQ-VS), ICIQ Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and ICIQ satisfaction (ICIQ-S). Fisher's exact test was used to evaluate complications. Kruskal-Wallis test was used to evaluate satisfaction.</p><p><strong>Key findings: </strong>Eight hundred fifty-three SUI procedures were performed in the study period. The responses from 395 questionnaires were analyzed. Median follow up: 5.9 years (range 1-10.1). The TVT and AFS procedures were the most efficacious procedures: 64% TVT, 62% AFS, 40% Colposuspension, 26% urethral bulking, p < 0.001. The AFS group had the lowest reported rate of complications: 22.6% AFS, 65.7% TVT, 67.1% colposuspension, 71.74% Urethral bulking (p < 0.001). Pain was the most reported complication and the AFS group had the lowest reporting of severe pain: 68% AFS, 74% TVT, 80% Colposuspension, 78% urethral bulking (p = 0.350).</p><p><strong>Limitations: </strong>Mesh exposure was not evaluated due to the lack of validated questionnaires.</p><p><strong>Conclusion: </strong>The AFS and TVT procedures are reported as the most successful procedures for the surgical management of SUI. Due to the associated risk of mesh complications, we recommend AFS as the procedure of choice for the surgical management of SUI.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1425-1431"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575935","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":"A Randomized Non-Inferiority Trial for Telemedicine in the Follow-Up of Overactive Bladder Patients.","authors":"James M Weinberger, Cindy Gu, Hannah Romeo, Lorna Kwan, Mehrnaz Siavoshi, John Cabri, Victor W Nitti","doi":"10.1002/nau.70123","DOIUrl":"10.1002/nau.70123","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the increasing use of telemedicine in Urology, regulatory barriers and lack of care-team training have limited its imprint on healthcare delivery. We designed a non-inferiority trial to delineate the use-case of telemedicine in the management of overactive bladder. This prospective, randomized controlled trial aims to validate the telemedicine paradigm as a feasible alternative to traditional in-person clinic visits, evaluating effectiveness, patient satisfaction, safety, and cost metrics.</p><p><strong>Materials and methods: </strong>Men and women with idiopathic (non-neurogenic) overactive bladder were prospectively enrolled and randomized to either the telemedicine or in-person arm. Participants completed standardized surveys at baseline and up to 6 consecutive follow-up visits to assess response to treatment and satisfaction. The primary outcome was patient satisfaction with treatment (Treatment Satisfaction Visual Analogue Scale, TS-VAS); secondary outcomes included OAB-q SF Symptom Bother Scale, PGI-I, PGI-S, safety, patient burden (time and out-of-pocket costs), and progression to minimally invasive therapy. Intent-to-treat analysis was conducted to compare the arms with Fisher's exact, Median, and Kruskal-Wallis tests.</p><p><strong>Results: </strong>Of the 164 participants enrolled, the analytic cohort was comprised of 147 with at least one follow-up visit: 80 in the telemedicine arm (232 visits) and 67 in the in-person arm (208 visits). The cohort was primarily female. There were no differences in demographics or clinical characteristics across arms. Treatment satisfaction at last visit was high across both arms, and telemedicine was found to be non-inferior to in-person (TS-VAS: IP 83.0 vs. T 80.0, p = 0.42). PGI-I and PGI-S were similarly non-inferior. There was no difference in OAB-q (p = 0.99) or rate of progression to minimally invasive therapies. Total burden for patients, measured in hours of travel, missed work, and cost, favored telemedicine. Utilization of urgent care, ER, or outside provider care visits for one's bladder condition was higher in the IP arm (10.4% vs. 1.3%, p = 0.024). There was no difference in rate of loss to follow-up.</p><p><strong>Conclusions: </strong>In this prospective, randomized trial, the telemedicine approach for the management of OAB was found to be non-inferior across patient satisfaction and efficacy, while comparing favorably in decreasing patient burden. Interestingly, the composite measure of safety showed higher utilization of outside care in the in-person cohort. Telemedicine offers an alternative option for care delivery for OAB that may result in improved satisfaction and compliance, and decreased cost, time, and travel burden for patients, allowing urologists to extend care to rural communities and non-mobile patients.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1403-1411"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708261","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 Patterns and Risk of New-Onset Stress Urinary Incontinence: The UK Biobank Prospective Cohort Study.","authors":"Yuyang Yuan, Xu Hu, Hanbin Yang, Fuchun Zheng, Lizhi Zhou, Bin Fu","doi":"10.1002/nau.70134","DOIUrl":"https://doi.org/10.1002/nau.70134","url":null,"abstract":"<p><strong>Objective: </strong>The association between sleep behaviors and stress urinary incontinence (SUI) risk remains uncertain. We aimed to evaluate the relationship between sleep patterns, based on a combination of five major sleep behaviors, and the risk of new-onset SUI.</p><p><strong>Methods: </strong>The study included 406 921 participants from the UK Biobank who were free of SUI at baseline. A healthy sleep score was created by combining five major sleep behaviors: chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. The primary outcome was new-onset SUI.</p><p><strong>Results: </strong>During a median follow-up of 12.0 years, 6948 (1.7%) participants developed new-onset SUI. Compared to participants with poor sleep patterns (healthy sleep score 0 to 1), those with healthy sleep patterns (healthy sleep score 4 to 5) had a significantly lower risk of new-onset SUI (HR: 0.70; 95% CI: 0.58-0.84).</p><p><strong>Conclusions: </strong>Among the general population, a healthy sleep pattern was associated with a significantly lower risk of new-onset SUI.</p><p><strong>Clinical trial registration: </strong>The study utilizes data from the UK Biobank, which is an observational research resource containing deidentified participant data collected without any intervention. According to ICMJE guidelines and WHO standards, purely observational studies (such as cohort analyses using existing datasets) do not require clinical trial registration as they involve no experimental interventions or assignment of participants to specific exposures. This position is consistent with current practices in epidemiological research using biobank data.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963108","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":"Insights Into the Application of Microablative Radiofrequency for the Treatment of Female Stress Urinary Incontinence: A Structured Appraisal.","authors":"Ali Furkan Batur","doi":"10.1002/nau.70141","DOIUrl":"https://doi.org/10.1002/nau.70141","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963098","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}