Neurourology and Urodynamics最新文献

{"title":"Utility of Pelvic Floor Therapy and Behavioral Interventions in the Neurogenic Lower Urinary Tract Dysfunction (NLUTD) Population.","authors":"Sara M Lenherr","doi":"10.1002/nau.70249","DOIUrl":"10.1002/nau.70249","url":null,"abstract":"<p><strong>Aims: </strong>Neurogenic lower urinary tract dysfunction (NLUTD) describes a wide range of symptoms depending on neurologic diagnosis and the resulting bladder and sphincter dysfunction. This narrative review is designed to address the question regarding which NLUTD population benefits most from pelvic floor therapy and behavioral interventions, and how to deliver these therapies.</p><p><strong>Results: </strong>Most NLUTD treatment guidelines encourage least-invasive, low-risk therapies like behavioral therapy (BT) and pelvic floor muscle therapy (PFMT)/pelvic floor physical therapy (PFPT), but they are often underutilized because of a multitude of reasons. Studies show that PFMT along with electrostimulation or biofeedback to facilitate understanding of the pelvic floor activity, may offer significant improvement in urinary symptoms and quality of life in certain NLUTD populations.</p><p><strong>Conclusions: </strong>Education, adherence support, and supervised exerciseappear to enhance outcomes. Finally, evidence suggests that telerehabilitation-based PFMT is feasible, effective and associated with higher adherence and satisfaction compared with home exercise alone.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1493-1499"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276761","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":"The Argument for Ileal Conduit for the Poorly Compliant Bladder in the Neurogenic Lower Urinary Tract Dysfunction Patient Refractory to Minimally Invasive Treatment.","authors":"David A Ginsberg","doi":"10.1002/nau.70220","DOIUrl":"10.1002/nau.70220","url":null,"abstract":"<p><strong>Aims: </strong>To describe why ileal conduit is the best option for the poorly compliant bladder in the neurogenic lower urinary tract dysfunction patient refractory to minimally invasive treatment.</p><p><strong>Methods: </strong>Evidence from prior studies evaluating this patient population were reviewed.</p><p><strong>Results: </strong>There are few options that can address the urinary incontinence that often accompanies this scenario while also eliminating the elevated storage pressures placing the patients' renal function at risk. Once less invasive options such as oral therapy and intradetrusor high-dose botulinum toxin have failed then surgical options should be considered. Construction of an ileal conduit removes the concern for elevated bladder pressures negatively impacting future renal function, is easy to care for without the need for intermittent catheterization and has demonstrated improved quality of life in patients with neurogenic lower urinary tract dysfunction. In addition, an ileal conduit does not have some of the risks that can be seen with bladder augmentation (with or without continent urinary stoma construction) such as the need for lifelong mucus irrigation, bladder stones, bladder cancer and the need for surgical revision related to the stoma.</p><p><strong>Conclusions: </strong>Construction of an ileal conduit is an excellent option for the poorly compliant bladder in the neurogenic lower urinary tract dysfunction patient refractory to minimally invasive treatment. Patient satisfaction rates are high and the risk of damage to the upper urinary tracts are minimized with acceptable short- and long-term morbidity.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1487-1488"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053464","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":"Long-Term Functional Outcomes and Complications of AdVance™/AdVance XP™ Male Suburethral Slings in the Management of Post-Prostatectomy Incontinence: Multicentric Prospective Ten-Year Follow-Up Study.","authors":"Argimiro Collado, Luís Resel Folkersma, Antonio Romero, María Riaza, Augusto Wong, José Dominguez-Escrig, José A Gallego Sánchez, Tomas Fernandez, Jesus Moreno, Alvaro Gomez-Ferrer","doi":"10.1002/nau.70341","DOIUrl":"10.1002/nau.70341","url":null,"abstract":"<p><strong>Introduction: </strong>Male sling implants are an acceptable treatment for post-prostatectomy stress urinary incontinence, but more long-term follow data is needed to assess clinical effectiveness. This study provides long-term continence and quality of life outcomes using complete 10-year follow up data from patients with AdVance™/AdVance XP™ Male Sling Systems.</p><p><strong>Methods: </strong>In an observational multicenter study, prospective data collection included preoperative patient characteristics, perioperative course, and postoperative outcomes. Continence was assessed using the 24 h pad weight test and patient-reported outcome measures (PROMs) were measured with the International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI SF). Follow-up over 10 years included re-intervention.</p><p><strong>Results: </strong>Of 111 patients who underwent surgery between February 2008 and February 2012, 87 completed 10-year follow-up (median follow-up was 136.6 months (range:121.9-170.5). At 3-month follow-up, 59 patients (67.8%) were considered cured. Of the 59 patients initially cured, 17 patients (28.81%) lost continence during follow-up, 11 due to stress urinary incontinence recurrence (65%), four due to de novo urge incontinence (23%), and two due to salvage radiotherapy (12%). Of the 17 who lost continence, six received a second surgical treatment, with no reported intra or preoperative surgical problems due to the first surgery. In cured patients, surgery resulted in a reduction of the median ICIQ-SF score from 16.27 (SD 3.53) to 4.03 (SD 3.36) (p < 0.01). In the patients considered not cured, a reduction on the median ICIQ-SF score from 16.39 (SD 3.05) to 11.29 (SD 5.34) was observed (p < 0.01).</p><p><strong>Conclusions: </strong>Our findings suggest that long-term continence rates after sling implant are acceptable, especially in ideal patients with mild to moderate incontinence and naïve for prior pelvic irradiation or surgical treatment for urinary incontinence or urethral stricture disease.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1616-1624"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278231","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 \"Long-Term Outcomes of Sacral Neuromodulation Explantation: A 12-Year Experience at a High-Volume Tertiary Center\".","authors":"Dean Elterman","doi":"10.1002/nau.70415","DOIUrl":"10.1002/nau.70415","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1728-1729"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795970","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: The Case for Continent Urinary Diversion.","authors":"Francis A Jefferson, Maude E Carmel","doi":"10.1002/nau.70347","DOIUrl":"10.1002/nau.70347","url":null,"abstract":"<p><strong>Introduction: </strong>Neurogenic lower urinary tract dysfunction (NLUTD) with a poorly compliant bladder that is refractory to minimally invasive therapies (MIT) represents an \"end-stage\" phenotype in which the principal objectives are durable upper urinary tract protection and restoration of continence with acceptable long-term morbidity. For most surgically eligible patients in this setting, continent urinary diversion-most commonly a continent cutaneous catheterizable reservoir (e.g., Indiana pouch) and, in highly selected cases, an orthotopic continent diversion-offers a uniquely definitive strategy.</p><p><strong>Methods: </strong>We conducted a literature review to better characterize the role of continent urinary diversion in the management of refractory NLUTD.</p><p><strong>Results: </strong>Continent diversion creates a low-pressure, high-capacity urinary reservoir while bypassing and often removing the hostile native bladder and dysfunctional outlet, thereby reducing ongoing pelvic urinary morbidity and the surveillance dilemmas inherent to augmentation enterocystoplasty. Compared with an ileal conduit, continent diversion prioritizes continence without an external appliance, an outcome strongly aligned with independence, body image, and sexual well-being in many neuro-urological patients.</p><p><strong>Conclusion: </strong>Although complication and revision rates are meaningful and the need for lifelong follow-up remains, contemporary long-term series support durability, preserved renal function, and high satisfaction when patient selection and structured surveillance are optimized.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1489-1492"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391501","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":"Response to Letter to the Editor on \"Incidence of Urinary Tract Infection After Combined Cystoscopy and Urodynamic Testing: A Prospective Cohort Study\".","authors":"Camilo Andres Torres Sandoval, María Juliana Arcila, Andrés Duarte Osorio, Juan Guillermo Cataño, Sebastian Peña Rodriguez","doi":"10.1002/nau.70380","DOIUrl":"10.1002/nau.70380","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1736"},"PeriodicalIF":2.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520638","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":"Research Progress on the Precise Classification and Individualized Diagnosis and Treatment of Nocturia.","authors":"Xu Sheng, Li Xiaodan, Fan Hongqin, Duan Yue, Huang Xi, Yu Hanchi, Zhang Jie","doi":"10.1002/nau.70495","DOIUrl":"https://doi.org/10.1002/nau.70495","url":null,"abstract":"<p><strong>Background: </strong>Nocturia is a common urological symptom whose prevalence increases progressively with age. It not only impairs sleep and quality of life but also increases the risk of adverse events, including falls and fractures. Clinical management remains limited by inadequate evaluation of underlying etiologies, imprecise phenotyping, and suboptimal therapeutic responses.</p><p><strong>Summary: </strong>To facilitate standardized diagnostic and therapeutic strategies, we reviewed and summarized relevant literature published over the past decade. Focusing on four major subtypes, nocturnal polyuria (NP), diminished bladder capacity (DBC), global polyuria (GP), and sleep disorder-predominant nocturia (SDP), we developed a clinical framework integrating precise assessment, phenotypic classification, and individualized treatment. This review compares the pathophysiological mechanisms underlying different phenotypes, identifies the voiding diary as the cornerstone of assessment, and proposes a streamlined three-step clinical phenotyping algorithm. A stepwise treatment strategy tailored to different subtypes is outlined, incorporating psychological counseling, lifestyle modification, pharmacotherapy, physical therapy, and surgery.</p><p><strong>Key messages: </strong>This review provides a reference for the precise and individualized management of nocturia and highlights the potential future roles of digital assessment and multidisciplinary care.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239145","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 Effect of Conservative Treatment on Bladder Diary Parameters in Women With Urgency Urinary Incontinence and Mixed Urinary Incontinence.","authors":"Annelie Olofsson, Towe Wadensten, Anna Lindam, Ina Asklund, Emma Nyström","doi":"10.1002/nau.70493","DOIUrl":"https://doi.org/10.1002/nau.70493","url":null,"abstract":"<p><strong>Background: </strong>Urinary incontinence (the involuntary loss of urine) is a worldwide problem, and bladder diaries are used to characterize the nature and severity of the disease. eHealth and mobile apps are used as tools to aid in conservative treatment, and the mobile app TätII has been developed for the treatment of urgency urinary incontinence (UUI) and mixed urinary incontinence (MUI) in women.</p><p><strong>Purpose: </strong>The aim of this study was to evaluate how conservative treatment affected bladder diary parameters in women with UUI and MUI.</p><p><strong>Methods: </strong>For this purpose, bladder diaries produced by 123 participants in a previously performed randomized controlled trial (RCT) using TätII were analyzed before and after 15 weeks of treatment. The variables extracted from the bladder diaries included measures of voiding volume, voiding frequency, urinary leakage, and urgency; these were analyzed with non-parametric methods, with between-group comparisons performed using the Mann-Whitney U test.</p><p><strong>Results: </strong>Compared to the control group, the participants in the treatment group reported a significant decrease (p < 0.01) in voiding frequency (6 vs. 7.5), leakage episodes (0.5 vs. 1.5), leakage grade (0.5 vs. 1.29), and urgency intensity (1.17 vs. 1.5) at the 15-week follow-up. Interestingly, the voiding volume did not change.</p><p><strong>Conclusion: </strong>The results show that treatment of UUI and MUI with TätII has a significant effect on bladder diary parameters. This is the first study to describe a change in bladder diary parameters after conservative treatment of UUI and MUI and provides objective measurements of treatment effects.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov-NCT03097549.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239200","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 Symptoms, Mobility Limitation, and Subsequent Falls in Older Adults Across Two Longitudinal Cohorts.","authors":"Renjie Huang, Miao Huang, Rui Zhang","doi":"10.1002/nau.70494","DOIUrl":"https://doi.org/10.1002/nau.70494","url":null,"abstract":"<p><strong>Aims: </strong>To examine whether urinary symptoms were associated with subsequent falls according to reported mobility limitation and whether they added meaningful information.</p><p><strong>Methods: </strong>We analysed the first eligible window for adults aged ≥ 60 years in the English Longitudinal Study of Ageing (ELSA; N = 11,676) and Mexican Health and Aging Study (MHAS; N = 11,071). ELSA assessed generic urinary incontinence over 12 months; MHAS assessed urgency urinary incontinence over 2 years. Mobility was a cohort-specific high-demand walking limitation, and the outcome was any next-wave fall. Modified Poisson RRs, multiple imputation, marginal standardized risks, interaction, and effect modification were used.</p><p><strong>Results: </strong>With neither urinary symptoms nor mobility limitation as the reference, urinary-only RRs were 1.29 (95% confidence interval [CI] 1.19-1.39) in ELSA and 1.14 (95% CI 1.07-1.22) in MHAS; risk differences were +7.6 and +5.9 percentage points. ELSA showed sub-multiplicative interaction with mobility limitation (ratio 0.80, 95% CI 0.70-0.92) and age attenuation; at ≥ 75 years, the urinary-only RR was 1.03 (95% CI 0.88-1.21). Optimism-corrected ΔAUC was 0.0044 in ELSA and 0.0015 in MHAS.</p><p><strong>Conclusions: </strong>Urinary symptoms were associated with subsequent falls without reported mobility limitation, but the association was context-dependent. ELSA showed mobility-context and age heterogeneity, and incremental discrimination was small. Urinary symptoms were not supported as a stand-alone or universal fall-screening marker.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239131","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":"Chronic High-Dose Ketamine Fails to Induce a Cystitis-Like Phenotype in Mice Despite High Urinary Metabolite Levels.","authors":"Jill Dewez, Ashlee Caldwell, Laura Schillebeeckx, Margot De Vis, Sylvia João Poseiro Coutinho Pinto, Evy Van Den Broek, Véronique Hendrickx, Katrien Luyten, Marcella Baldewijns, Jan Tytgat, Thomas Voets, Wouter Everaerts","doi":"10.1002/nau.70483","DOIUrl":"https://doi.org/10.1002/nau.70483","url":null,"abstract":"<p><strong>Aims: </strong>Ketamine‑induced cystitis (KIC) is a severe complication of chronic ketamine misuse, yet the underlying mechanisms remain poorly understood. Established rodent models have demonstrated variable changes in voiding behavior and bladder histology, without exploring the sensory mechanisms underlying altered voiding and pain at all. This study aimed to establish a murine model of chronic ketamine-induced cystitis to investigate changes in pain behavior and sensory signaling.</p><p><strong>Methods: </strong>Male and female C57BL/6 J mice received intraperitoneal ketamine (100 mg/kg, n = 20) or saline (n = 20) for 12 weeks. Urine and plasma ketamine, norketamine, and dehydronorketamine concentrations were determined using LC-QTOF/MS. Voiding behavior was assessed fortnightly using spontaneous voiding assays, suprapubic mechanical sensitivity was evaluated using von Frey filaments, and wellbeing was assessed using nesting and open field assays. Finally, histopathological analysis was performed on bladder and kidney tissues.</p><p><strong>Results: </strong>Despite high urinary and plasma concentrations of ketamine, norketamine, and dehydronorketamine, ketamine-treated mice showed no significant differences in voiding behavior, suprapubic sensitivity, natural behavior, or bladder and kidney histopathology compared with controls.</p><p><strong>Conclusion: </strong>Chronic high-dose ketamine treatment did not induce a robust phenotype of ketamine-induced cystitis in C57BL/6 J mice, highlighting limitations of using rodent models for recapitulating human ketamine‑induced cystitis.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239209","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}