Neurourology and Urodynamics最新文献

{"title":"Association Between Urodynamic Findings and Urinary Retention After Onabotulinumtoxin A for Idiopathic Overactive Bladder.","authors":"Anjali Kapur, Monica Van Til, Stephanie Daignault-Newton, Caitlin Seibel, Shavy Nagpal, Giulia M Ippolito, Ariana L Smith, Alvaro Lucioni, Una Lee, Anne Suskind, Jennifer Anger, Doreen Chung, W Stuart Reynolds, Anne Cameron, Christopher Tenggardjaja, Priya Padmanabhan, Benjamin M Brucker","doi":"10.1002/nau.70050","DOIUrl":"https://doi.org/10.1002/nau.70050","url":null,"abstract":"<p><strong>Introduction: </strong>Onabotulinumtoxin A (BTX-A) is a minimally invasive therapy for idiopathic overactive bladder (iOAB). Incomplete bladder emptying is a known risk of the procedure, with an overall rate as high as 20% in male and female patients. Risk factors for incomplete bladder emptying after BTX-A have been reported in the literature, but are widely variable amongst studies and therefore patients at increased risk of this adverse effect cannot easily be identified by clinicians. The aim of this study was to evaluate whether pre-procedure urodynamics (UDS) findings are associated with incomplete bladder emptying after intradetrusor BTX-A injection for iOAB.</p><p><strong>Methods: </strong>Data were analyzed from the SUFU Research Network (SURN) multi-institutional retrospective database. Men and women undergoing first-time injection of 100 units BTX-A for iOAB in 2016 were included. Subjects were excluded if they did not have record of pre-procedure and post-procedure (within 1 month) post-void residual volume (PVR). The primary outcome was incidence of urinary retention within 1 month after BTX-A, defined as PVR > 300 mL and/or initiation of self-catheterization or indwelling catheter. We assessed the association of pre-procedure UDS parameters with urinary retention using Wilcoxon rank tests, Fisher's exact test, and chi-squared tests.</p><p><strong>Results: </strong>A total of 167 subjects (141 women, 26 men) were included. Ninety-nine subjects (59%) had urodynamic data. Thirty-seven subjects (22%) had urinary retention within 1 month of BTX-A. There were no significant differences in age, gender, race, or body mass index between the retention and non-retention groups. There was no statistically significant difference in median Qmax between those who did and did not have postprocedure retention (10.0 vs. 14.3 mL/s respectively, p = 0.06). Mean PVR at the start of UDS was not statistically significant when comparing the retention and non-retention groups (22.5 vs. 10.0 mL respectively, p = 0.70). Bladder outlet obstruction index (BOOI), bladder contractility index (BCI), and presence of detrusor overactivity (DO) were not found to be associated with posttreatment retention.</p><p><strong>Conclusion: </strong>This retrospective multi-institutional cohort study revealed that of patients who receive UDS before BTX-A, there are no significant UDS parameters or baseline demographic factors associated with incomplete bladder emptying after intradetrusor BTX-A injections for iOAB. Future studies that focus on better defining objective evidence-based predictors of incomplete emptying after BTX are needed to optimize patient perception of efficacy and satisfaction with this therapy.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036360","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":"Sacral Neuromodulation for Neurogenic Lower Urinary Tract, Bowel and Sexual Dysfunction in Patients With Multiple Sclerosis: A Pilot Trial.","authors":"Hanne Kobberø, Jan Krhut, Peter Zvara, Torben Brøchner Pedersen, Mikkel Fode, Helle Hvilsted Nielsen, Mads Hvid Poulsen","doi":"10.1002/nau.70052","DOIUrl":"https://doi.org/10.1002/nau.70052","url":null,"abstract":"<p><strong>Aims: </strong>We present results of a two-arm pilot study assessing the feasibility of conducting a double-blind randomized controlled trial (RCT) to evaluate the efficacy of sacral neuromodulation (SNM) in patients with multiple sclerosis (MS) suffering from neurogenic lower urinary tract dysfunction (NLUTD).</p><p><strong>Methods: </strong>Eligible subjects with refractory NLUTD and EDSS < 5 underwent SNM test phase. Those showing more than a 50% improvement of bladder variables, received implantable pulse generators (IPG) and were randomized to either treatment group (IPG ON) or to sham group (IPG OFF) for 1 month. During second month, all patients had the IPG ON until the end of the trial. The primary endpoints were trial feasibility, recruitment potential, and response rate at the end of SNM test phase. Secondary endpoint was safety. Changes in key bladder diary-derived variables and patient reported outcomes were recorded as well.</p><p><strong>Results: </strong>Thirty-two patients were screened, 17 were eligible and 13 were included in the SNM test phase. Eleven were considered responders and were implanted with IPG. Subsequently, six patients were randomized to the treatment group and five to the sham group. No serious adverse events were reported. In the intervention phase, both objective and subjective improvements were seen in the treatment group, while the symptoms in the sham group remained mostly unchanged. At study completion, six patients reported being completely satisfied, three were mostly satisfied, and two were indifferent to the treatment.</p><p><strong>Conclusions: </strong>This pilot trial demonstrated feasibility of double-blind RCT assessing safety and efficacy of SNM in MS patients.</p><p><strong>Trial registration: </strong>ClinicalTrials. gov NCT05380856.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021979","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":"The Efficacy and Safety of Dimethyl Sulfoxide Into the Bladder for the Treatment of Interstitial Cystitis/Bladder Pain Syndrome: A Systematic Review and Meta-Analysis.","authors":"Hai-Rui Li, Si-Hong Shen, Xiao-Shuai Gao, Liao Peng, De-Yi Luo","doi":"10.1002/nau.70036","DOIUrl":"https://doi.org/10.1002/nau.70036","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy and safety of intravesical DMSO instillation for the treatment of interstitial cystitis/bladder pain syndrome.</p><p><strong>Method: </strong>The following databases were searched for relevant studies: PubMed, EMBASE, MEDLINE, Cochrane Library, and Web of Science (updated August 10, 2024). All studies on intravesical DMSO met the inclusion criteria and were evaluated using various quality assessment methods based on the type of study. Data were then analyzed using Review Manager 5.4 (Cochrane Collaboration software). The primary outcomes and indicators included the Interstitial Cystitis Symptom Index, the Interstitial Cystitis Problem Index, and Pain Scores. The secondary outcomes were bladder diary metrics and Pelvic Pain and Urgency/Frequency Symptom Scale (PUF).</p><p><strong>Results: </strong>This systematic review and meta-analysis included 5 randomized controlled trials and 9 single-arm or cohort studies, involving 554 patients. The combined statistics indicated an average pretreatment Interstitial Cystitis Symptom Index score was 14.27, an average Interstitial Cystitis Problem Index Score was 12.72, and an average Pain Score was 7.06. Compared to pretreatment values, the results indicated that the Interstitial Cystitis Symptom Index score decreased by 5.59 (95% CI: -6.68 to -4.50, p < 0.00001), the Interstitial Cystitis Problem Index score decreased by 5.14 (95% CI: -6.45 to -3.83, p < 0.00001), and the Pain Score decreased by 3.27 (95% CI: -3.95 to -2.60, p < 0.00001). Additionally, the overall incidence rate of adverse events in patients was 37.6%. Although 37% of cases had adverse events, the majority were considered mild and acceptable.</p><p><strong>Conclusion: </strong>Evidence-based statistical analysis of the literature on intravesical DMSO treatment for interstitial cystitis/bladder pain syndrome indicates that this therapy is both effective and safe. Therefore, intravesical DMSO instillation can be considered a standard treatment method for interstitial cystitis/bladder pain syndrome.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006154","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":"Revision Rates for Rechargeable Versus Non-Rechargeable Sacral Neuromodulation Devices in the Management of Overactive Bladder.","authors":"Tal Cohen, Zhenyue Huang, Arshia Aalami-Harandi, Jiyeon Park, Kaitlyn Sbrollini, Natalie Braun, Steven Weissbart, Justina Tam, Jason Kim","doi":"10.1002/nau.70053","DOIUrl":"https://doi.org/10.1002/nau.70053","url":null,"abstract":"<p><strong>Purpose: </strong>Overactive bladder (OAB) is a prevalent condition that can have a significant impact on quality of life. Sacral neuromodulation (SNM) is proven as an effective treatment option for OAB patients. Rechargeable devices have gained popularity in recent years. However, there is a paucity of data investigating revision rates for rechargeable SNM devices and associated impacting factors.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study to investigate the revision rates of SNM devices in patients diagnosed with OAB. Patients who underwent implantation of rechargeable or non-rechargeable SNM devices at our institution between January 2019 and June 2023 were included. Revision events, reasons for revisions, and patient demographics were analyzed and compared between the device groups.</p><p><strong>Results: </strong>The study included 246 patients. One hundred fifty received rechargeable SNM devices and 96 received non-rechargeable devices. Revision rates were significantly different between the two groups, with 34% of patients in the rechargeable device group requiring revisions compared to 13.5% in the non-rechargeable group (p < 0.001). The most common reasons for revision in the rechargeable group included difficulty charging (35.3%) and reduction of symptom improvement (23.5%). Having a rechargeable device resulted in a significantly higher probability of requiring a revision over time compared to non-rechargeable (p < 0.001).</p><p><strong>Conclusion: </strong>Our study demonstrated that patients who received rechargeable SNM devices were more likely to require revision. Factors such as device malfunction or difficulties connecting to the device may contribute to the higher revision rates. Further studies are needed to elucidate factors affecting revision rates in SNM devices.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991355","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":"Do Artificial Urinary Sphincter (AMS 800, Boston Scientific, USA) Have Any Impact on Sexuality in Women?","authors":"Anne Denormandie, Juliette Cotte, Alexia Even, Pierre Mozer, Aurélien Beaugerie, Emmanuel Chartier-Kastler","doi":"10.1002/nau.70045","DOIUrl":"https://doi.org/10.1002/nau.70045","url":null,"abstract":"<p><strong>Purpose: </strong>Artificial urinary sphincter (AUS) AMS 800 has been used for many years in women in Europe for the treatment of stress urinary incontinence. However, there is a lack of studies evaluating its impact on women's sexual function. This study aimed to assess impacts of AUS implantation on women's sexual activity.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included all women seen in clinics between February 2019 and April 2020 for follow-up after an AMS 800 AUS's implantation. The primary outcome was the modification of sexuality, comparing sexual function before and after implantation of the device using a Likert scale called PGII (Patient Global Impression of Improvement). Our secondary outcomes were the assessment of sexual function (Questionnaries FSFI and ICIQ-FLUTSsex) and continence (number of pads). Two groups were separately assessed: patients who were sexually active at the time of surgery and those who were not sexually active at the time of surgery.</p><p><strong>Results: </strong>A total of 55 women were included from a single large tertiary center. The median time from the first implantation of AUS was 7.5 years (5.3-14.2). 60% of patients reported no change on sexual activity after the implantation of the AMS 800 AUS. There was a modification of sexual activity in 40% of patients: 20% showing improvement, 20% showing deterioration. In patients having sexual intercourse before AUS implantation, the rate of change in sexuality was higher (61.7%). Regarding postoperative improvement, 91% of women attributed it to the disappearance of coital incontinence. For patients experiencing deterioration in their sexuality, all reported that it was related to the presence of the AUS.</p><p><strong>Conclusions: </strong>This study suggests that AMS 800 AUS implantation can modify the sexuality of women. Talking about the subject of sexuality, assessing sexual function, and educating patients are necessary before the surgery.</p><p><strong>Trial registration: </strong>The clinical trial was registered at the \"Commission Nationale de l'Informatique et des Libertés\" (CNIL) under the number 20201020155100.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795831","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":"Transurethral Fulguration of Hunner Lesion Was Effective for Primary Management of Pelvic Pain in Patients With Interstitial Cystitis: A Long-Term Follow-Up Study.","authors":"Hyun Ju Jeong, Yu Jin Kang, Min Soo Choo, Seong Jin Jeong, Seung-June Oh","doi":"10.1002/nau.70051","DOIUrl":"https://doi.org/10.1002/nau.70051","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the outcomes of clinical management of patients with interstitial cystitis (IC).</p><p><strong>Patients and methods: </strong>We retrospectively analyzed the electronic medical records of patients with IC who visited outpatient clinics with pelvic pain between October 2005 and December 2019. Pain was managed with cystoscopic surgery based on transurethral fulguration (TUF) for bladder ulcers. Cystectomy was performed for intractable pelvic pain. Patients were regularly followed and clinical outcomes were analyzed.</p><p><strong>Results: </strong>Of the 275 patients, 240 patients (57 men, 23.7% and 183 women, 76.3%) underwent initial cystoscopic surgery. Overall median follow-up duration was 21.0 months and mean number of TUF was 1.0 (±0.8). Of these 240 patients, 71 (29.6%) did not require further surgical treatment, whereas 64 (26.7%) required a second TUF for recurrent pelvic pain. The median recurrence interval was 12.0 (interquartile range: 6.0-25.0) months. Of the 64 patients who received a second TUF, 15 (23.4%) underwent a third TUF after a median of 12.0 (interquartile range: 12.0-32.0) months. Of the 15 patients who received a third TUF, five patients required a fourth TUF because of recurrence of pain. One patient received until a seventh TUF. Overall, 168 of 240 patients (70.0%) achieved pain control with TUF. Eighteen patients (7.5%) underwent cystectomy (six patients with urinary diversion and 12 patients with cystectomy with bladder replacement).</p><p><strong>Conclusion: </strong>TUF-based cystoscopic surgery is an effective basic treatment for pelvic pain management in patients with IC.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772439","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":"Critical Appraisal of Guidelines for Daytime Urinary Incontinence in Children: Evaluation of Quality and Recommendations on Diagnostics.","authors":"J Marleen Linde, Ilse Hofmeester, Martijn G Steffens, Francis J Kloosterman-Eijgenraam, Rien J M Nijman, Marco H Blanker","doi":"10.1002/nau.70047","DOIUrl":"https://doi.org/10.1002/nau.70047","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to evaluate the quality of currently available guidelines on non-neurogenic daytime urinary incontinence (DUI) in children and compare their content regarding the assessment of a child with DUI.</p><p><strong>Methods: </strong>We conducted a systematic search for guidelines on non-neurogenic DUI in children. A multidisciplinary team assessed the quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE) instrument, which contains 23 items organized into six domains. Besides, each member evaluated if they would recommend using the guidelines. We extracted diagnostic recommendations from all guidelines for a descriptive comparison.</p><p><strong>Results: </strong>Eight guidelines were included. Overall quality scores ranged from 2.6 to 5.8 on a 7-point scale, (1 for lowest and 7 for highest quality). Three guidelines were rated as good, four as moderate, and one as low quality. The AGREE-II domain Clarity and Presentation received high scores across all guidelines, while Rigour of Development and Applicability received the lowest scores. Recommendations for diagnostics were generally similar, with variations observed in guidelines targeting primary and secondary healthcare.</p><p><strong>Conclusions: </strong>This study is the first to assess the quality of guidelines on non-neurogenic DUI in children. The quality varies, only two out of eight guidelines were recommended by the review team without adjustments. Guideline developers could improve the quality of their guidelines by using tools like AGREE II. Clinicians should consider the findings of our study when selecting a guideline to use in their daily practice.</p><p><strong>Clinical trial registration: </strong>As this is a review, no clinical trial registration was conducted. The review protocol has been registered in PROSPERO (CRD42021149059).</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764333","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":"The Effects of Gentamicin Intravesical Bladder Instillations on Decreasing Urinary Tract Infections After Spinal Cord Injury and Disease.","authors":"Denise G Tate, Gianna M Rodriguez, Elizabeth Sullivan, Martin Forchheimer, Jonathan Troost, Misty Gravelin, Anne P Cameron","doi":"10.1002/nau.70037","DOIUrl":"10.1002/nau.70037","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent urinary tract infections (UTIs) are common and source of significant morbidity for patients with spinal cord injury/disease (SCI/D) who require clean intermittent catheterization (CIC) bladder management. The purpose of this study was to examine the effectiveness of gentamicin bladder instillations in reducing recurrent UTIs and their impact on neurogenic bladder and bowel (NBB) symptoms and common complications; on quality of life (QOL) and community participation for patients with SCI/D performing CIC.</p><p><strong>Materials and methods: </strong>This is a Prospective single arm feasibility trial of gentamicin bladder instillations. The 6 month intervention consisted of nightly bladder instillations of 30 mg of gentamicin diluted in 50 mL of normal saline. Participants underwent blood and urine testing and completed patient reported measures, both before and after treatment. The primary outcome was the count of UTIs compared across time points (pre-, during and post-treatment) using an UTI incidence rate ratio and paired t tests. Qualitative data was collected post-treatment.</p><p><strong>Results: </strong>Twenty-one participants enrolled and 11 completed the trial. The rate of UTIs per person per month decreased significantly over time. Before treatment, the total number of UTIs was 35 (0.53 UTI per person per month); during treatment was 6 (0.09 per person per month) and at follow up, 13 (0.18 per person per month). QOL improved significantly with exception of satisfaction with role activities and community participation. There were no significant changes in NBB symptoms and related complications. Participants reported few adverse events (AEs) and qualitative data indicated high overall treatment satisfaction.</p><p><strong>Conclusions: </strong>Gentamicin instillations were effective in reducing the rate of UTIs by 83% and improving QOL. Findings helped identify potential challenges and opportunities for future studies.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"829-838"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649693","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":"Determinants of Healthcare Seeking Patterns in Women With Pelvic Floor Disorders.","authors":"Rachan Ghandour, Julia Shen, Morgan Bou Zerdan, Sasha Aljamal, Vatche A Minassian","doi":"10.1002/nau.70004","DOIUrl":"10.1002/nau.70004","url":null,"abstract":"<p><strong>Objective: </strong>To determine if sociodemographic and health determinants of women with pelvic floor disorders (PFDs) affect health-seeking behavior, and whether this varies by disease subtype and severity.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study of women with PFDs at an academic urogynecology practice between January 2021 and May 2022. Groups were compared across sociodemographic and clinical variables and by pelvic organ prolapse (POP) stage and urinary incontinence (UI) subtype/severity. The primary outcomes of interest were POP stage and UI severity at initial presentation with duration of symptoms as a key determinant. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>The study included 684 [307 POP (44.9%) and 377 UI (55.1%)] women. Of those with POP, 190 (61.9%) presented with stages I/II and 117 (38.1%) with stages III/IV. In women with UI, 188 (49.9%) had mild-moderate UI and 179 (47.5%) had severe UI. Approximately 76% of women reported PFD symptoms for over 6 months and 47% for 2 years or more upon presentation. Women with advanced-stage POP had 1.27 increased odds (95% CI: 1.01-1.61) of delaying care for > 24 months, were older (1.07 adjusted OR, 95% CI: 1.03-1.11), and had fewer healthcare visits (0.95 adjusted OR, 95%: CI: 0.91-0.98) in the prior year. Women with severe UI had 1.88 increased odds (95% CI: 1.52-2.35) of delaying care > 24 months, 1.20 odds with government insurance (CI: 1.01-1.32), and 1.18 odds of other comorbidities (CI: 1.02-1.40).</p><p><strong>Conclusion: </strong>Most women with PFD reported symptoms for over 6 months at presentation. Women with advanced POP or severe UI were more likely to seek care over 24 months after the onset of symptoms.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"899-907"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365301","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 Randomized Controlled Trial of Percutaneous Tibial Nerve Stimulation in the Treatment of Female Sexual Dysfunction.","authors":"Zhenyue Huang, Sina Mehraban Far, Jonathan Aronov, Arshia Aalami Harandi, Kuemin Hwang, Xiaoyue Zhang, Varun Talanki, Heng Ruan, Tal Meir Cohen, Steven Weissbart, Justina Tam, Jason Kim","doi":"10.1002/nau.70032","DOIUrl":"10.1002/nau.70032","url":null,"abstract":"<p><strong>Background: </strong>Female sexual dysfunction (FSD) is a prevalent and multifaceted condition affecting women's sexual well-being. This randomized controlled trial aimed to evaluate the efficacy of percutaneous tibial nerve stimulation (PTNS) compared to a validated sham control in the treatment of FSD.</p><p><strong>Methods: </strong>We conducted a single-center randomized controlled trial. Participants with FSD were recruited and randomly assigned at a 1:1 allocation ratio to either PTNS or a validated sham control using transcutaneous nerve stimulation (TENS). Treatment was performed through weekly 30-min session for 12 weeks total. Sexual function was assessed at baseline, 6 weeks, and 12 weeks primarily using the Female Sexual Function Index (FSFI) questionnaire. Urogenital distress inventory-6 was collected to evaluate for any baseline urinary incontinence/voiding dysfunction. Linear mixed-effect models for longitudinal data were used to compare FSFI scores across different time points. Statistical analysis was performed using SAS 9.4 (SAS Institute Inc. Cary, NC).</p><p><strong>Results: </strong>In total, 34 PTNS and 31 TENS subjects were included in our final analysis. Overall, 48% (16/34) of PTNS subjects versus 29% (11/33) of TENS subjects were no longer at risk for FSD (FSFI > 26.55) after 12 weekly treatments. Both PTNS and TENS subjects demonstrated similar improvements in FSFI total scores after 12 weeks of treatments. Interestingly, patients who did not present with baseline urogenital distress symptoms reported a statistically significant larger improvement in sexual satisfaction after PTNS treatments as compared to placebo (p = 0.017).</p><p><strong>Conclusion: </strong>This study demonstrated a sustained efficacy of PTNS in improving sexual function. Specifically, patients who did not have coexisting urinary dysfunction reported significant improvement in sexual satisfaction after PTNS. Our study suggested that PTNS may have a direct neuromodulation effect on sexual dysfunction and may hold promise as a treatment modality for FSD.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"908-913"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605807","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}