Neurourology and Urodynamics最新文献

{"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":"Predictive Factors for Complete Response to Desmopressin Treatment in Children With Primary Monosymptomatic Nocturnal Enuresis.","authors":"Gunal Ozgur, Cagri Akin Sekerci, Yiloren Tanidir, Tufan Tarcan, Selcuk Yucel","doi":"10.1002/nau.70012","DOIUrl":"10.1002/nau.70012","url":null,"abstract":"<p><strong>Objectives: </strong>Primary monosymptomatic nocturnal enuresis (MNE) is a common problem in pediatric urology and desmopressin is the first-line medical treatment. We aimed to evaluate the predictive factors of complete response to desmopressin and the effect of desmopressin on urinary electrolyte levels in children with primary MNE.</p><p><strong>Methods: </strong>Children with MNE who were started on sublingual 120 mcg of desmopressin treatment included in the study. Children were evaluated by physical examination, urinalysis, voiding dysfunction symptom score, voiding diary and uroflowmetrics with postvoid residuals. 24-h urine was collected for density and electrolyte measurements before and at the first and third months of treatment. The children were divided into two groups according to wetting episodes at the third month, as those with complete response to the treatment (group 1) and the others (resistant or partial-response) (group 2).</p><p><strong>Results: </strong>Thirty-four children (24 boys, 10 girls) were included in the study. Median age was 8 (5-15) years. There was no difference between the urinary density, sodium, potassium, and calcium values before and during treatment (first and third months) (p = 0.737, 0.549, 0.166, 0.386 respectively). The number of wet nights in a month and the number of wetting at a night were found as the predictive factors for complete response to desmopressin (p = 0.027, p = 0.003, respectively). The number of 17 wet nights per month was calculated as the optimized cut-off point for predicting desmopressin treatment failure (p = 0.027, sensitivity = 92.3%, specificity = 47.6%, AUC [95%]: 0.729 [0.552-0.906]). Age, gender, family history, maximum voided volume in voiding diary (MVV)/expected bladder capacity (EBC) ratio, maximum bladder capacity (MBC)/EBC ratio and pretreatment urinary density, sodium, potassium, calcium levels could not predict complete response (p = 0.292, 0.051, 0.533, 0.552, 0.101, 0.570, 0.326, 0.735, 0.246 respectively).</p><p><strong>Conclusions: </strong>Desmopressin treatment had no effect on urine density and urinary sodium, potassium, calcium electrolytes similar to the literature. Urine density and electrolyte levels are not helpful in predicting desmopressin treatment response in enuretic children. Low frequency of wet nights (< 17) in a month and single bedwetting at a night are the significant factors to predict complete response to desmopressin treatment in children with primary MNE.</p><p><strong>Clinical trial registration: </strong>The study does not have a clinical trial registration number, because the study was not a randomized controlled trial and the data in the study were collected retrospectively.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"878-884"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382852","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}

{"title":"Potential for Misdiagnosis of Detrusor Underactivity Due to Urodynamic Voiding Position and Seating Characteristics.","authors":"Rachel Vancavage, Oyenike Ilaka, Shreya Patel, Rosalie Zurlo, Paul Feustel, Rebecca G Rogers, Elise J B De, Brittany L Roberts","doi":"10.1002/nau.25650","DOIUrl":"10.1002/nau.25650","url":null,"abstract":"<p><strong>Background: </strong>Detrusor underactivity (DUA) is a lower urinary tract (LUT) diagnosis that is diagnosed with multichannel urodynamic studies (UDS). The effect of voiding position and DUA detection is unclear.</p><p><strong>Objectives: </strong>We investigated whether moving individuals from the UDS chair to their typical voiding position would more accurately assess detrusor function in cases of absent or nonrepresentative voiding. We hypothesized that patients unable to achieve a representative void while on the UDS chair may be misdiagnosed with DUA, and that changing position may reveal intact detrusor function.</p><p><strong>Methods: </strong>We retrospectively studied patients who underwent UDS with a single provider over 2 years. Studies were included if a patient was moved to a new position after unsuccessful or unrepresentative void attempts on the UDS chair. Two neurourologists reanalyzed the studies and recorded: time spent attempting to void on UDS chair and after moving position, whether a bladder contraction occurred on UDS chair, pdet Q max and Q max when voiding occurred, presence of a bladder contraction in new position, and pdet Q max and Q max in new position, and Valsalva effort.</p><p><strong>Results: </strong>503 patients underwent UDS; 94/503 patients were moved to a new position and 81/94 studies were interpretable. 71% of patients without a bladder contraction on the UDS chair demonstrated contraction in new position.</p><p><strong>Conclusion: </strong>UDS voiding position and surface can impact whether patients produce a bladder contraction and representative void during urodynamic testing. Positional change to more natural voiding positions and surfaces improves detection of intact detrusor function.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"768-774"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047341","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":"Investigating the Link Between Free Androgen Index and Nocturia in Women: Findings From National Health and Nutrition Examination Survey.","authors":"Shang Gao, Lianhui Fan, Jingteng He, Hongtao Liu, Renli Tian","doi":"10.1002/nau.70006","DOIUrl":"10.1002/nau.70006","url":null,"abstract":"<p><strong>Background: </strong>Nocturia is the most prevalent lower urinary tract symptom in women, affecting approximately 54.5% of female patients and significantly impacting the quality of life. While the androgen levels may be related to urinary function, its association with nocturia in women remains unclear. This study aims to explore the relationship between androgen levels and nocturia in women.</p><p><strong>Methods: </strong>This study utilized data from the 2013-2016 National Health and Nutrition Examination Survey (NHANES), including 4531 women aged 20 and above. The level of androgen is reflected by the total testosterone (TT) and free androgen index (FAI). Weighted logistic regression models were employed to analyze the association between FAI, TT, and nocturia.</p><p><strong>Results: </strong>After comprehensive adjustment for confounding factors, higher FAI levels were significantly associated with a reduced risk of nocturia (OR = 0.84, 95% CI: 0.74-0.95). Women in the highest FAI tertile had a significantly lower incidence of nocturia compared to those in the lowest tertile (OR = 0.75, 95% CI: 0.60-0.93). Trend analysis indicated a significant decrease in nocturia occurrence with increasing FAI levels (P for trend = 0.0177). No significant association was found between TT levels and nocturia.</p><p><strong>Conclusions: </strong>Higher FAI levels are significantly inversely associated with nocturia in women, suggesting that bioavailable testosterone may have a protective effect against nocturia. This finding underscores the importance of considering FAI levels in research and clinical practice, and future studies should explore the potential benefits of modulating FAI levels in women with nocturia.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"728-735"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382837","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":"Intravesical Botulinum Toxin Injection for Treating Detrusor Overactivity and Poor Compliance in Posterior Urethral Valves-A Preliminary Experience.","authors":"Sharon Mohan Kunnath, Eskinder Solomon, Pankaj Mishra, Anne J Wright, Joanna Clothier, Massimo Garriboli","doi":"10.1002/nau.70039","DOIUrl":"10.1002/nau.70039","url":null,"abstract":"<p><strong>Purpose: </strong>To report our preliminary experience on the use of Botulinum toxin A in boys with posterior urethral valves for treating detrusor overactivity and/or reduced bladder compliance not responsive to medical treatment.</p><p><strong>Material and methods: </strong>Primary outcome measures studied were change in baseline end fill pressure (pDet), compliance, maximum Detrusor overactivity pressure (DO), fractional bladder capacity (FBC), vesicoureteric reflux (VUR) grade/resolution. Secondary outcome measures were serum creatinine and estimated glomerular filtration rate (eGFR). Low compliance group was defined as rise in baseline pDet > 20 cmH₂O. High pressure DO was defined as maximum pDet > 40 cmH₂0.</p><p><strong>Results: </strong>A total of 15 children were included in the analysis. The median decrease in end fill pDet in the whole cohort was from 20 cmH₂O (14.5-30) to 16 cmH₂O (10.5-22) (p = 0.065). By analyzing the patients with low compliance, we identified a median decrease in end fill pDet from 32 cmH₂O (26.5-44.5) to 19 cmH₂O (16.5-25.5) (p = 0.028). The median change in compliance for all the boys was from 6 mL/cmH₂O (4.51-7.3) to 12.1 mL/cmH₂O (7.44-17.3) (p < 0.001). The median change in compliance in the low compliance group was from 5.5 mL/cmH₂O (4.42-7.1) to 8.8 mL/cmH₂O (7.39-13.3) (p = 0.018). The median change in fractional bladder capacity for all the boys was from 0.70 (0.55-0.92) to 0.98 (0.79-1.42) (p = 0.061). A complete resolution of DO was observed in 7 out of 11 patients. Complete resolution of VUR was observed in 5 out of 8 renal units.</p><p><strong>Conclusion: </strong>Botulinum toxin A can be considered in the treatment strategy for reduced bladder compliance and detrusor overactivity in boys with PUV.</p><p><strong>Trial registration: </strong>15894.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"760-767"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664013","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 Bladder Sensor for Adults With Urinary Incontinence.","authors":"Filine van den Bosch, Paul van Leuteren, Sandra Tobisch, Diederick Duijvesz","doi":"10.1002/nau.70009","DOIUrl":"10.1002/nau.70009","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Urinary incontinence (UI) is a very common hygiene and health problem in adults which has an enormous impact on quality of life (QoL). Noninvasive treatment options are the first line of treatment. It would be beneficial to know when the bladder reaches its maximum capacity, to enable to prompt going to the bathroom on time and thereby potentially prevent an UI event. Recently, a wearable bladder sensor was developed, the TENA SmartCare Bladder Sensor (Bladder Sensor), which is intended to support children ( ≥ 6 years) and adults (BMI ≤ 25 kg/m&lt;sup&gt;2&lt;/sup&gt;). The Bladder Sensor tracks the bladder filling status and notifies the user when it is time to go to the bathroom by a vibration of the device and/or a notification in an app on a mobile device (e.g., smartphone and/or Apple Watch®). The primary objective of this first pivotal study was to demonstrate that the Bladder Sensor can detect the bladder before urination among adult intended users. The secondary objectives were to collect real-life data to evaluate performance, safety, usability, and subject satisfaction with the device as well as impact on QoL. The primary hypothesis was to evaluate if the median bladder detection rate in the evaluated population is greater than the threshold of 85% (H0: ≤ 0.85, H1: &gt; 0.85, p-value &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients & methods: &lt;/strong&gt;Adults ( ≥ 18 years) suffering from UI during day and/or night tested the Bladder Sensor independently at home for 1 week. Device performance, safety, usability, user satisfaction and self-reported disease specific information, and QoL were assessed at pre-defined times. Intra-individual results were compared. Any episodes of urination and/or urine loss were documented by subjects in a paper diary. Raw data of the Bladder Sensor was analyzed to evaluate the bladder detection rate and full bladder notification rate(s).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;30 adults (female/male: 67%/33%; median age: 53 years (Interquartile range (IQR) 32-61 years); median BMI of 22.6 kg/m&lt;sup&gt;2&lt;/sup&gt; (IQR 20.7-23.8 kg/m&lt;sup&gt;2&lt;/sup&gt;)) completed the study testing the Bladder Sensor at home for 6.9 days on average. The median bladder detection rate was 89.8% (IQR 82.6-95.3%) in a sample without statistically and clinically identified outliers (n = 28). The null hypothesis was rejected among those (z = 69, p &lt; 0.05). The median actual full bladder notification rate was 63.1% (IQR 50.0-71.4%), and the median perceived full bladder notification rate was 94.4% (IQR 87.0-105.6%). The device showed to have a positive effect on subjects' UI problems (e.g., 67% reduced number of unwanted leakages) and QoL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;It was demonstrated that the Bladder Sensor can detect the bladder under real-life conditions among its intended users and can support in the prevention of UI. This seemed dependent on anatomical limitations (e.g., BMI and body shape), bladder volume (low bladder detection rate &lt; 100 ","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"795-803"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382834","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":"Impact of Bladder Management Strategies on Autonomic Dysreflexia Severity in People With Spinal Cord Injuries.","authors":"Rita Palanjian, Blayne Welk, Jeremy B Myers, Sara M Lenherr, Sean P Elliott, Diana O'Dell, John T Stoffel","doi":"10.1002/nau.70002","DOIUrl":"10.1002/nau.70002","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated whether severity of autonomic dysreflexia (AD) was associated with more patient-reported bladder and bowel symptoms and compared AD severity by bladder management strategy in people with spinal cord injury (SCI).</p><p><strong>Methods: </strong>The Neurogenic Bladder Research Group SCI Registry is a prospective study which evaluated quality of life after SCI. Bladder and bowel symptoms were assessed through Neurogenic Bladder Symptom Score and Neurogenic Bowel Dysfunction score, respectively. AD severity was assessed with the Autonomic Dysreflexia Following Spinal Cord Injury (ADFSCI) instrument. Bladder management was classified as volitional voiding, clean intermittent catheterization (CIC), indwelling catheter (IDC), and surgery (augmentation and diversion).</p><p><strong>Results: </strong>AD scores were identified for 1473 people. The mean age was 45. Bladder management was CIC in 754 (51%), IDC in 271 (18%), surgery in 195 (13%) and voiding in 259 (18%). On univariate analysis, higher ADFSCI scores occurred with complete injuries (3.1 vs 3.4, p = 0.03), cervical/thoracic injuries (3.8 vs 1.5, p < 0.0001), and chronic pain (3.9 vs 2.9, p = 0.0004). IDC (5.2) and surgery (4.5) had higher ADFSCI scores than CIC (3.0) and volitional voiding (2.8) (p < 0.0001). Sub-analysis showed bladder augmentation had significantly higher ADSCI scores than diversion (4.7 vs 3.7, p = 0.03). On multivariate analysis, level of injury, bladder management, and bowel and bladder symptoms remained associated with worse AD.</p><p><strong>Conclusion: </strong>Level of injury, age, worse bowel and bladder symptoms and bladder management type were associated with higher AD scores. Bladder management with surgery, particularly bladder augment, and IDC had associated greater AD symptoms compared to CIC or voiding.</p><p><strong>Trial registration: </strong>clinicaltrials.gov NTC06216081 and HSRP20153564, U.S. National Library of Medicine, wwwcf.nlm.nih.gov.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"754-759"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256355","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}