Neurourology and Urodynamics最新文献

{"title":"Treatment Dropout in Pediatric Enuresis: A Retrospective Cohort Study at a Tertiary Children's Hospital.","authors":"Sebastián Tobía-González, Natalie Barganski, Melissa Miller, Jocyline Nanyange, Aqsa Ameer, Precious Nzeribe, Oluwafemi Ojo, Leon Smith-Harrison, Juan Pablo Corbetta","doi":"10.1002/nau.70361","DOIUrl":"10.1002/nau.70361","url":null,"abstract":"<p><strong>Background: </strong>Pediatric enuresis is a frequent reason for referral to pediatric urology clinics; however, the real-world effectiveness of available therapies is limited by high treatment dropout. Despite multiple validated interventions, adherence patterns and predictors of dropout remain poorly characterized.</p><p><strong>Objective: </strong>To quantify treatment dropout rates in pediatric enuresis and identify clinical predictors of dropout across enuresis phenotypes in a tertiary care setting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including children aged 5-18 years treated for enuresis between 2019 and 2024 at a tertiary pediatric hospital. Patients were classified according to the International Children's Continence Society principles into clinically relevant phenotypes. Treatment dropout was defined as failure to initiate, continue, or complete prescribed therapy, or absence from scheduled follow-up without documented resolution or formal discharge. Multivariate logistic regression was used to identify independent predictors of dropout.</p><p><strong>Results: </strong>A total of 961 patients were included. Overall treatment dropout occurred in 51.4% of cases, with significant variation among clinical phenotypes (p = 0.003). Bladder bowel dysfunction (BBD) accounted for the largest absolute number of dropouts, whereas secondary enuresis showed the highest relative dropout rate. Lack of early clinical improvement was the strongest independent predictor of treatment dropout. Age showed a small but statistically significant association, whereas sex and BBD phenotype were not independently associated with attrition after adjustment.</p><p><strong>Conclusion: </strong>Treatment dropout affects more than half of children undergoing management for enuresis in a tertiary referral setting. Lack of early clinical improvement was the strongest predictor of attrition. Reducing dropout will likely require structured early reassessment, realistic-expectation counseling, and adherence-support strategies targeted to higher-risk patients.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1707-1710"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352707","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":"Comment on \"Impact of COVID-19 and Vaccination on Lower Urinary Tract Symptoms: Insights From a Prospective Cohort Study\".","authors":"Palavardhan Peddapalegani, Raghav Gupta, Priyanka Bansal, Pankaj Nainwal, Hariharan Srinivasan","doi":"10.1002/nau.70250","DOIUrl":"10.1002/nau.70250","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1741-1742"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150209","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":"Engineering Advances in Neurogenic Lower Urinary Tract Dysfunction (NLUTD): Current State and Future Directions - A Report From the Neurogenic Bladder Research Group (NBRG).","authors":"Betsy H Salazar, Kristopher A Hoffman, Melody Ong, Blayne Welk, John T Stoffel, Dan Wood, Argy Stampas, Rose Khavari","doi":"10.1002/nau.70356","DOIUrl":"10.1002/nau.70356","url":null,"abstract":"<p><strong>Background and objective: </strong>Neurogenic lower urinary tract dysfunction (NLUTD), stemming from neurodegenerative diseases or injuries such as cerebrovascular accidents, spinal cord injuries, and Alzheimer's disease, significantly impacts quality of life. Symptoms, including urinary frequency, urgency, incontinence, and retention, are managed with devices ranging from catheters to sacral neuromodulation. This Neurogenic Bladder Research Group (NBRG) report explores the intersection between clinical, basic science, and engineering research in personalized NLUTD treatment, identifies critical gaps for future investigation, and examines how interdisciplinary collaboration can drive engineering solutions to improve care.</p><p><strong>Methods: </strong>In December 2024, NBRG convened its annual meeting, gathering experts from engineering, clinical practice, research, and patient advocacy to discuss challenges in NLUTD research and explore collaborative solutions.</p><p><strong>Results: </strong>Enhanced collaboration between clinicians and engineers offers promise for improving NLUTD care. Clinicians provide critical insight into patient needs but often lack time for sustained research, while engineers contribute technical innovation yet may lack clinical exposure. Integrating patient perspectives emerged as a key theme, ensuring that technologies are practical, acceptable, and aligned with end-user needs. Discussions emphasized expanding programs that support cross-disciplinary, multi-institutional research and identifying funding pathways tailored to interdisciplinary efforts. Strategies to enhance patient involvement and foster inclusive research that reflects patient diversity and socio-demographic factors influencing care were also discussed.</p><p><strong>Conclusion: </strong>Institutional support, interdisciplinary collaboration, and the active engagement of patients are key to advancing clinical care and NLUTD treatments.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1527-1535"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345986","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":"Tips and Tricks for Preventing and Managing Urinary Stoma Complications in the Neurogenic Bladder Population.","authors":"John T Stoffel","doi":"10.1002/nau.70339","DOIUrl":"10.1002/nau.70339","url":null,"abstract":"<p><strong>Background and aims: </strong>Incontinent and continent stomas can improve urinary quality of life for people with a neurogenic bladder. However, outcomes and satisfaction of the procedures can be impacted by complications such as stomal retraction and stenosis. This manuscript presents recommendations and observations for reducing morbidity in incontinent and continent stomas for the neurogenic bladder population.</p><p><strong>Methods: </strong>Literature review was performed using key words urostomy, urinary stoma, continent stoma, and complications. Relevant studies were included in this review article. The author's 20+ years of surgical experience in neurogenic bladder surgery was used as the basis for recommendations.</p><p><strong>Results/conclusions: </strong>Surgical techniques to prevent intraabdominal tension on stomas can reduce risk of stomal retraction. Stomal stenosis can be treated with dilation or reconstructive surgical options. Preventing complications requires knowledge of anatomy and adaptive products which patients can use after surgery.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1521-1526"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361895","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 Knowledge and Information Sources Among College Women: A Cross-Sectional Survey.","authors":"Ria Patel, Zoha Aziz, Jairam R Eswara","doi":"10.1002/nau.70377","DOIUrl":"10.1002/nau.70377","url":null,"abstract":"<p><strong>Objective: </strong>Although urinary incontinence (UI) is highly prevalent among women, treatment seeking remains low, in part due to limited knowledge of the condition. Awareness and knowledge of pelvic floor dysfunction (PFD) among young women in the United States remains poorly characterized despite growing interest in early pelvic floor health education. This study aimed to assess baseline knowledge of UI, identify sources of information, and evaluate predictors of higher knowledge among female undergraduate students.</p><p><strong>Materials and methods: </strong>We administered an online survey to 175 female undergraduates at a single institution that included year in school, background knowledge items, and the validated Prolapse and Incontinence Knowledge Quiz (PIKQ-UI). Responses were analyzed using descriptive statistics, one-way analysis of variance (ANOVA), and multivariable linear regression.</p><p><strong>Results: </strong>Although 54.9% of respondents reported prior awareness of PFD, we found that overall knowledge was poor (57.7% correct), significantly below the 80% competency threshold (p < 0.001). Online and social media platforms were the most reported sources of information (42.9%). Prior knowledge of UI was independently associated with higher PIKQ-UI scores (p = 0.03), whereas advancing year in school, personal UI history, and familiarity with someone affected by UI were not associated with higher performance. Knowledge gaps were most pronounced regarding age-related risk, treatment, and diagnostic testing (43%, 49%, 48% correct, respectively). Nearly all participants (91.4%) expressed interest in learning more about PFD.</p><p><strong>Conclusion: </strong>Despite widespread exposure to pelvic floor health information through online and social media sources, knowledge of UI among female undergraduate students remained low. Although prior awareness of UI was associated with higher knowledge scores, substantial gaps persisted, suggesting that exposure alone does not translate into understanding. Leveraging online platforms to deliver accurate, evidence-based education may improve pelvic floor health literacy and reduce the burden of untreated UI.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1625-1629"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437317","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":"Synchronous Cystosphincterometry Using an Air-Filled Catheter for Assessing Detrusor-External Sphincter Coordination: Preliminary Feasibility With Fluoroscopic Correlation.","authors":"Baihui Wang, Yue Wang, Yanhe Ju, Guoqing Chen, Fan Zhang, Haichao Liu, Fei Zhou, Limin Liao, Peng Zhang","doi":"10.1002/nau.70369","DOIUrl":"10.1002/nau.70369","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To describe an air-filled catheter (AFC)-based technique for synchronous cystosphincterometry and to preliminarily evaluate its technical feasibility and fluoroscopic correlation for assessing detrusor-external sphincter coordination during voiding. This study also explored whether this simplified pressure-based method could provide a practical adjunctive assessment option in urodynamic laboratories where fluoroscopy or external urethral sphincter electromyography is unavailable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-center retrospective methodological feasibility study included patients who underwent clinically indicated video urodynamic studies between July 2024 and March 2025. A 7-Fr air-filled dual-balloon catheter was used to record vesical pressure and urethral pressure at the external sphincteric urethra. Detrusor pressure and sphincteric urethral pressure were recorded simultaneously during filling and voiding. Voiding-phase fluoroscopic images were reviewed as contemporaneous anatomical correlation for pressure-based interpretation. Feasibility outcomes included technical completion, interpretability of pressure recordings, suspected catheter displacement, premature termination, and procedure-related adverse events. Findings were analyzed descriptively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 32 patients were included in the analysis. The cohort included 3 males and 29 females, with a mean age of 32.6 years; range, 18-68 years. One patient had a sacral spinal cord injury, whereas the remaining patients had no documented neurological disorder. Synchronous bladder-urethral pressure measurement was completed in all 32 patients, with no premature termination or procedure-related adverse events. During voiding, four pressure-fluoroscopy patterns were identified: impaired external sphincter relaxation during detrusor contraction in 12 patients; preserved sphincter relaxation with effective voiding in 6 patients; preserved sphincter relaxation with detrusor contraction but no urine flow, suggesting non-sphincteric outlet obstruction in 4 patients; and sphincter relaxation without evident detrusor contraction, suggesting detrusor underactivity or functional inhibition in 8 patients. Two recordings showed an unexpectedly low urethral pressure pattern during filling, suggesting probable catheter displacement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Air-filled catheter-based synchronous cystosphincterometry was technically feasible in this preliminary single-center experience and allowed real-time characterization of detrusor-external sphincter pressure relationships. Fluoroscopic correlation supported the anatomical plausibility of pressure-defined sphincteric relaxation and non-relaxation patterns. Therefore, this method may provide a simplified adjunctive pressure-based assessment tool for evaluating detrusor-external sphincter coordination, particularly in centers where fluoroscopy or external urethral sphinc","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1585-1596"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471321","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":"Geneviève Nadeau, Blayne Welk","doi":"10.1002/nau.70463","DOIUrl":"10.1002/nau.70463","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1471-1472"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","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":"Re: \"Transurethral Resection of the Prostate in Patients With Neurogenic Lower Urinary Tract Dysfunction\".","authors":"Vasileios Sakalis, Ioannis Charalampous, Petros Tsafrakidis","doi":"10.1002/nau.70368","DOIUrl":"10.1002/nau.70368","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1720-1721"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376482","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":"Microablative Radiofrequency Versus Sham for Overactive Bladder: A Randomized Controlled Trial With 6 Months Follow Up.","authors":"Constanza Alvear, Cássia Raquel Teatin Juliato, Anna Lygia B Lunardi, Juliana C Fazzolari, Helena Slongo, Ana Luisa Zambelli Mesquita de Oliveira, Simone Botelho, Cássio L Z Riccetto","doi":"10.1002/nau.70362","DOIUrl":"10.1002/nau.70362","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Overactive bladder (OAB) is highly prevalent among women. Energy-based treatments, such as radiofrequency (RF), have shown promising results in urinary incontinence, but evidence for OAB remains limited. This study evaluated the efficacy of microablative RF compared with sham in women with OAB over 6 months of follow-up.</p><p><strong>Methods: </strong>Bicenter, randomized, double-blind, parallel-group trial was conducted between March 2023 and July 2025 at two public hospitals in Brazil (UNICAMP and UFPR), following CONSORT guidelines. Women aged 45-65 years with OAB or mixed urinary incontinence with urgency predominance were randomized (1:1) to RF or sham treatment, both combined with behavioral therapy (BT). Participants underwent 3 monthly sessions. Assessments included validated questionnaires (ICIQ-OAB, ICIQ-OAB QoOL, ICIQ-UI SF, ICIQ-VS, FSFI), bladder diaries, pelvic floor evaluation (PERFECT and manometry), VHI, and vaginal cytology. The primary outcome was changes in ICIQ-OAB score at 6 months. Analyses followed the intention-to-treat principle.</p><p><strong>Results: </strong>140 women were randomized (RF = 72; sham = 68). Both groups showed significant improvement in OAB symptoms, with effects maintained at follow-up. ICIQ-OAB QoL, ICIQ UI-SF and ICIQ-VS improved in both groups. In the RF group, pelvic floor tone normalized and pain on palpation decreased (p = 0.026 and p = 0.035), repetitions of sustained and rapid contractions improved (p = 0.039, p = 0.015), with more adverse events than sham (44.2% vs. 22.9%; p = 0.025).</p><p><strong>Conclusion: </strong>RF combined with BT improved OAB symptoms with effects sustained at 6 months. However, no superiority over sham treatment was observed, reinforcing the value of BT as the, current first-line treatment recommendation for patients with OAB.</p><p><strong>Clinical trial registration: </strong>Registered in REBEC (Registro Brasileiro de Ensaios Clínicos; Brazilian Registry of Clinical Trials) under number RBR-7xqzb9h (http://www.ensaiosclinicos.gov.br/rg/RBR-7xqzb9h/).</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1660-1670"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391462","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":"β3-Adrenoceptor Agonists for Neurogenic Lower Urinary Tract Dysfunction: Evidence and Clinical Rationale for First-Line Therapy.","authors":"Sharon E Fishberg, Rano Matta","doi":"10.1002/nau.70175","DOIUrl":"10.1002/nau.70175","url":null,"abstract":"<p><strong>Aims: </strong>To summarize current evidence on β3-adrenoceptor agonists for managing neurogenic lower urinary tract dysfunction (NLUTD), focusing on their efficacy, safety, and clinical role in optimizing bladder storage and protecting upper tracts.</p><p><strong>Methods: </strong>Evidence from randomized controlled trials, meta-analyses, and observational studies in spinal cord injury (SCI), multiple sclerosis (MS), and spina bifida populations was reviewed. Outcomes included bladder storage parameters, patient-reported measures, and cardiovascular and cognitive safety profiles.</p><p><strong>Results: </strong>β3-adrenoceptor agonists such as Mirabegron improve cystometric capacity, reduce detrusor pressure, and enhance quality of life. A recent individual-patient meta-analysis confirmed these benefits. Early data on Vibegron in SCI and spina bifida show increased bladder compliance and capacity without new safety concerns. Cardiovascular safety signals are reassuring: one randomized trial in SCI/MS and a large multinational cohort both showed no excess risk. Observational studies continue to associate antimuscarinics with cognitive adverse effects, whereas β3-agonists demonstrate a more favorable tolerability profile.</p><p><strong>Conclusions: </strong>β3-adrenoceptor agonists represent a safe, effective, and well-tolerated first-line option in NLUTD management. They preserve bladder safety and continence with fewer systemic side effects. OnabotulinumtoxinA remains an important escalation therapy for refractory cases but carries higher procedural and retention risks. A β3-agonist-based strategy offers a rational, patient-centered foundation for treatment.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1476-1478"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452533","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}