Neurourology and Urodynamics最新文献

{"title":"Repair of Pelvic Organ Prolapse Can Cure Symptoms of Bladder Outlet Obstruction in Anterior, Apical, and Posterior Pelvic Organ Prolapse Even in Second Stages.","authors":"Bernhard Liedl, Aleksander Antoniewicz, Maren Wenk","doi":"10.1002/nau.70005","DOIUrl":"10.1002/nau.70005","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1392-1393"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567784","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":"Dysfunctional Urinary Incontinence Strategies: A Mediation Model to Explain Why Urinary Incontinence Symptoms Are Associated With Social Isolation Among Women.","authors":"Marta G Porto, João Marôco, Teresa Mascarenhas, Filipa Pimenta","doi":"10.1002/nau.70079","DOIUrl":"10.1002/nau.70079","url":null,"abstract":"<p><strong>Objective: </strong>Female urinary incontinence (UI) can lead to social isolation (SI). To reduce UI's probable impact, women tend to self-manage their symptoms and employ coping strategies which can sometimes be dysfunctional and exacerbate SI. UI dysfunctional coping strategies are primarily employed as a means of self-management, with women failing to engage in efforts to seek treatment. Literature regarding the mediating role of dysfunctional UI strategies in the relationship between UI severity and SI is scarce. Therefore, this study investigated the mediating role of dysfunctional UI hiding and defensive coping strategies in explaining the relationship between UI severity and SI, among middle-aged women experiencing stress, urgency, and mixed UI.</p><p><strong>Study design: </strong>The study adopted a cross-sectional, observational, descriptive, and correlational design, and recruited 1090 women online (social media) aged 40-65 years, who reported occasional or frequent urine loss and were not receiving any treatment for UI.</p><p><strong>Main outcome measures: </strong>The predictor was symptom severity; the mediator outcome was dysfunctional UI strategies, and the main outcome measure was SI.</p><p><strong>Results: </strong>Mediation analysis with structural equation modeling indicated that dysfunctional coping strategies significantly mediated the relationship between UI severity and SI, explaining a variability of 0.45 in SI. The direct effect between UI severity and SI was nonsignificant when indirect paths were included. Multigroup analysis indicated that the mediation model was consistent across different UI types, showing that the influence of dysfunctional strategies on SI was similar, regardless of the UI type.</p><p><strong>Conclusions: </strong>UI severity influences social isolation through coping behaviors focused on defensive and hiding behaviors in women who have not sought treatment for UI and across the different UI types, highlighting the importance of addressing these strategies in healthcare interventions. Tailoring interventions to modify maladaptive coping strategies is crucial for reducing SI, and enhancing the quality of life of women experiencing UI.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1361-1369"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094439","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":"Effectiveness of Extracorporeal Magnetic Stimulation in the Treatment of Pelvic Floor Dysfunction: A Systematic Review and Meta-Analysis.","authors":"Zhen Yang, Jiaquan Liao, Shangang Zhang, Minyan Zhang, Linru Qiao","doi":"10.1002/nau.70082","DOIUrl":"10.1002/nau.70082","url":null,"abstract":"<p><strong>Objectives: </strong>This study employs systematic review and meta-analysis methodologies to investigate the efficacy and safety of extracorporeal magnetic stimulation in treating pelvic floor dysfunction, based on published randomized clinical trials. The aim is to provide high-level evidence in evidence-based medicine for clinical decision-making and treatment interventions.</p><p><strong>Data sources: </strong>Study were conducted to include randomized clinical trials from the inception of databases until March 2024 in four databases: PubMed, the Cochrane Library, Web of Science, and EMBASE.</p><p><strong>Review methods: </strong>Eligible studies were selected by two independent investigators. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Meta-analysis was performed using the RevMan 5.3 software. The review protocol was registered on PROSPERO (CRD42024526565).</p><p><strong>Results: </strong>A systematic review incorporating 24 studies and a meta-analysis involving 14 studies demonstrated significant differences in the improvement of patients with urinary incontinence when subjected to extracorporeal magnetic stimulation compared to control groups, as evidenced by the changes in ICIQ-SF and QOL scores (Standardized Mean Difference [SMD] = -0.73, 95% Confidence Interval [CI] [-1.05, -0.41], and SMD = -0.43, 95% CI [-0.82, -0.04], respectively). However, no substantial therapeutic effects were observed in improving functional impairments among patients with overactive bladder (OAB) or chronic pelvic pain (CPP).</p><p><strong>Conclusion: </strong>There is considerable evidence supporting the efficacy of magnetic stimulation for treating urinary incontinence. However, further high-quality, large sample randomized controlled trials are necessary to strengthen the evidence for its effectiveness in addressing other pelvic floor dysfunctions.</p><p><strong>Clinical trial registration: </strong>This study does not involve a real-world clinical trial. The data used are from published clinical trials for secondary analysis. Therefore, clinical trial registration is not applicable. However, the review protocol was registered on PROSPERO (CRD42024526565).</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1302-1317"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120389","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":"Diagnostic Performances of Patient's Interview, Uroflowmetry Alone and Uroflowmetry Paired With Electromyography as Screening Tools to Identify Straining to Void.","authors":"Sami Lasri, Pierre-Luc Dequirez, Émeline Caillau, Laurence Queval, Marie-Aimée Perrouin-Verbe, Xavier Biardeau","doi":"10.1002/nau.70083","DOIUrl":"10.1002/nau.70083","url":null,"abstract":"<p><strong>Aims: </strong>To assess the diagnostic performances of patient's interview, final uroflowmetry alone and final uroflowmetry paired with rectus abdominis muscle electromyography (EMG) as screening tools to identify straining to void.</p><p><strong>Methods: </strong>All consecutive patients who underwent a multi-channel urodynamic study to explore filling phase disorders - including final uroflowmetry associated with intrarectal pressure monitoring - between 2020 and 2021 in our department of urology were considered eligible. Intrarectal pressure curves (gold-standard) were examined by two senior urologists and a continence nurse to determine by consensus the presence of straining to void. The final uroflowmetry curves and final uroflowmetry paired with EMG curves were retrospectively submitted for interpretation to 3 groups of urologists with different levels of experience (residents, fellows, seniors). Each group was composed of 3 independent examiners blinded to intrarectal pressure. The diagnostic performances of patient's interview, and the diagnostic performances as well as the inter- and the intra-examiner correlation of final uroflowmetry alone and final uroflowmetry paired with EMG were assessed.</p><p><strong>Results: </strong>Overall, 282 neurogenic and non-neurogenic patients were included in the present study. The patient's impression to identify straining to void was associated with a sensitivity, a specificity, a predictive positive value (PPV) and a negative predictive value (NPV) of 68.4%, 63.9%, 68.0% and 64.3%, respectively. Final uroflowmetry alone was associated with a sensitivity, a specificity, a PPV and a NPV of 60.4%, 75.1%, 73.1% and 62.8%, respectively. Final uroflowmetry paired with EMG was associated with a sensitivity, a specificity, a PPV and a NPV of 61.3%, 84.9%, 81.6% and 66.8%, respectively. The inter- and intra-examiner agreement of final uroflowmetry alone was reported as moderate to poor, ranging between 0.17 and 0.72 and 0.58-0.79, respectively. The inter- and intra-examiner agreement of final uroflowmetry paired with electromyography was reported as moderate to poor, ranging between 0.26 and 0.73 and 0.59-0.81, respectively.</p><p><strong>Conclusion: </strong>Patient's interview, final uroflowmetry alone and paired with rectus abdominis muscle EMG, are not reliable enough to be considered as screening tools for straining to void.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1245-1254"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143076","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":"Patient Experience and Healthcare Access Among Women With Recurrent Urinary Tract Infections.","authors":"Neda Izadyar, Alejandra Cacheiro, Olivia H Chang","doi":"10.1002/nau.70092","DOIUrl":"10.1002/nau.70092","url":null,"abstract":"<p><strong>Introduction: </strong>Up to 60% of women in the United States will experience a urinary tract infection (UTI) in their lifetime, making it one of the most common infections amongst women. This study aims to explore themes related to patient experiences and barriers to care when accessing and receiving care for recurrent UTIs (rUTIs).</p><p><strong>Methods: </strong>This was a qualitative cohort study with a cross-sectional survey. Participants were 18 years or older, assigned female at birth, English-speaking, and had a diagnosis of rUTIs. Demographics, clinical data, and the validated Patient Satisfaction Questionnaire (PSQ-18) and Quality-of-Life Survey (ICIQ-LUTSqol) were administered. The semi-structured qualitative interviews focused on patient experiences including barriers to care related to the diagnosis of rUTIs. Participants were stratified by age (18-40, 41-64, and 65+ years) to capture diverse opinions. Interview transcripts were coded using NVIVO14 software.</p><p><strong>Results: </strong>This study consisted of 16 participants in 18-40 (n = 5), 41-64 (n = 6), and 65+ (n = 5) age groups. The mean age was 53 ( ± 19.5) years old. Both PSQ-18 score analysis and ICIQ-LUTSqol score analysis revealed no statistically significant difference between any age group. On qualitative analysis, two main themes and six subthemes were identified. First, participants shared negative experiences when accessing rUTI care, especially centered around the stigma of having an rUTI diagnosis, the negative impact of rUTIs on emotional wellbeing, invalidated concerns, and limited knowledge on preventative measures. Second, participants discussed barriers they faced when accessing rUTI, with limited urologist/urogynecologist access and financial burden of rUTI care being the most prominent. Matrix analysis revealed that the 18-40 and 65+ age group more frequently discussed topics of shame, guilt, and stigma associated with rUTIs.</p><p><strong>Conclusions: </strong>In this qualitative study, patients shared their negative experiences receiving care for rUTI's and the barriers they faced in accessing care. Concerns of stigma, negative emotional impact, invalidated concerns, and limited information on preventative measures provide insight to the experiences of women when engaging with providers for rUTI care. Potential barriers to care include limited access to a urologist/urogynecologist and the financial burden of rUTI care. These findings may serve as the foundation for optimizing patient experience and reducing barriers to care for women living with rUTIs.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1264-1270"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199722","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":"Inspiration From Simplified Ligament Repair in Stress Urinary Incontinence.","authors":"Aybüke Tayarer, Filiz Dişçi","doi":"10.1002/nau.25668","DOIUrl":"10.1002/nau.25668","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1385-1386"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008984","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 Novel Scoring System to Assess Continence Quality Outcomes of Orthotopic Ileal Neobladders After Open and Robot-Assisted Radical Cystectomy: The Urodynamic Trifecta.","authors":"Umberto Anceschi, Fabrizio Di Maida, Giuseppe Chiacchio, Riccardo Mastroianni, Gabriele Tuderti, Luca Lambertini, Simone Albisinni, Manuela Mattioli, Anna Cadenar, Simone Flammia Rocco, Samuele Nardoni, Francesco Prata, Eleonora Rosato, Francesca Valastro, Aldo Brassetti, Mara Bacchiani, Anastasios Asimakopoulos, Vincenzo Salamone, Salvatore Basile, Sofia Giudici, Giulia D'Ippolito, Andrea Grosso Antonio, Antonio Tufano, Leslie Licari, Eugenio Bologna, Andrea Mari, Agostino Tuccio, Enrico Finazzi Agrò, Cosimo De Nunzio, Rocco Papalia, Costantino Leonardo, Andrea Minervini, Giuseppe Simone","doi":"10.1002/nau.70078","DOIUrl":"10.1002/nau.70078","url":null,"abstract":"<p><strong>Introduction: </strong>A comprehensive scoring system for standardizing quality of functional outcomes of orthotopic ileal neobladders (OINs) is still unavailable. In this study we propose a novel trifecta for both open and robot-assisted radical cystectomy conceived on urodynamic parameters that summarize OINs functional outcomes regardless of the surgical technique used and predicts continence status.</p><p><strong>Materials & methods: </strong>Between June 2017 and May 2023 two prospective, institutional review board approved, radical cystectomy datasets were matched and queried for \"OINs\" \"and \"urodynamic evaluation\" (n = 149). Urodynamic assessment was performed between 6 and 9 months after surgery. Baseline data and complete urodynamic profile including uroflowmetry, cystometry, compliance, presence of residual peristaltic activity, abdominal leak point pressures (ALPP) and daytime and night-time continence were reported. Descriptive analyses were used. Frequencies and proportions were reported for categorical variables while medians and interquartile ranges (IQRs) were reported for continuously coded variables. Trifecta was defined as the coexistence of: cystometric capacity ≥ 250 cc; neobladder compliance ≥ 35 cmH₂0; negative Valsalva and abdominal leak point pressure testing. Simultaneous achievement of only two of the presented criteria was considered a suboptimal result. Logistic regression analyses were built to identify predictors of daytime and night-time urinary continence. For all analyses, a two-sided p < 0.05 was considered significant.</p><p><strong>Results: </strong>Overall, at a median follow-up of 25 months (IQR 16-37), 149 patients achieved a complete urodynamic evaluation. In the current series, the complete trifecta rate was 40.2% while a suboptimal trifecta achievement was observed in 35.6% of patients. On multivariable analysis, complete trifecta achievement was the only independent predictor of daytime (OR 7.29, 95% CI 2.05-25.9) and night-time (OR 8.13; 95% CI 2.94-22.4) urinary continence, respectively (each p < 0.003). A complete UDM-T at urodynamic testing was associated with a day-time continence, night-time continence, and complete dry status rates of 93.2%, 83.1%, and 79.7%, respectively.</p><p><strong>Conclusion: </strong>This novel urodynamic trifecta for OINs is based on standardized parameters and seems to be predictor of either daytime or night-time urinary continence at a midterm follow-up. Satisfactory continence outcomes may be also expected when a suboptimal trifecta rate is achieved.</p><p><strong>Clinical trial registration: </strong>Not applicable.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1255-1263"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094435","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 \"Potential for Misdiagnosis of Detrusor Underactivity Due to Urodynamic Voiding Position and Seating Characteristics\".","authors":"Juan Pablo Valdevenito, Alejandro Mercado-Campero","doi":"10.1002/nau.70021","DOIUrl":"10.1002/nau.70021","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1394-1395"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664008","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":"Urologic Chronic Pelvic Pain Syndrome: A Scoping Review of Syndrome-Specific Instruments.","authors":"Arya Catna, Victoria L Brown, Claire Gwak, Deeksha Kanagarag, Madeline Meyer, Srinitya Rapolu, Ratna Pakpahan, Lauren Yaeger, James W Griffith, Aimee S James, H Henry Lai, Jerry L Lowder, Siobhan Sutcliffe","doi":"10.1002/nau.70087","DOIUrl":"10.1002/nau.70087","url":null,"abstract":"<p><strong>Objective: </strong>To facilitate research on interstitial cystitis/bladder pain syndrome (IC/BPS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) symptom variability or flares, we reviewed the published literature to document existing data collection instruments (e.g., questionnaires and diaries), and to identify those relevant for flare research.</p><p><strong>Methods: </strong>Seven databases were searched systematically for articles describing the development of instruments: (1) specific for IC/BPS, CP/CPPS, or both; and (2) intended for use by investigators beyond the development team. In total, 1216 abstracts and 79 full-text articles were reviewed, and data were extracted in duplicate.</p><p><strong>Results: </strong>We identified 17 instruments, 11 for IC/BPS, 5 for CP/CPPS, and 1 for both. In total, 13 instruments (12 questionnaires and 1 electronic diary) assessed symptoms for diagnostic, symptom evaluation, and/or symptom monitoring purposes, and included items assessing the presence, location, intensity (mostly typical intensity), and/or amount of time experienced pelvic pain and/or urinary symptoms. No instruments included items related to symptom variability or flares.</p><p><strong>Conclusion: </strong>In addition to describing existing instruments for future urologic CPPS research, our review identified a lack of validated instruments for flares. Future studies should address this gap to facilitate rigorous research on this understudied topic.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1271-1289"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266846","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":"Envisioning the Future of AI in Urodynamics: Exploratory Interviews With Experts.","authors":"Catharina Margaretha van Leersum, Andrew Gammie, Enrico Finazzi Agrò, Kevin Rademakers","doi":"10.1002/nau.70075","DOIUrl":"10.1002/nau.70075","url":null,"abstract":"<p><strong>Background: </strong>Urodynamics monitors various parameters while the urinary bladder fills and empties, to diagnose functional or anatomic disorders of the lower urinary tract. It is an invasive and complex test with technical challenges, and it needs rigorous quality assessment and training of clinicians to avoid misdiagnosis. Applying AI to urodynamic pattern recognition and noisy data signals seems promising.</p><p><strong>Aim: </strong>To understand desirable and appropriate applications, this study aims to explore the envisioned future of AI in urodynamics according to experts in AI and/or urodynamics.</p><p><strong>Method: </strong>Ten semi-structured interviews were conducted to explore expectations, trust and possibilities of AI in urodynamics. Content analysis with an inductive approach was performed on all data.</p><p><strong>Results: </strong>The analysis resulted in seven overarching themes: difficulties with urodynamics, quality of urodynamics, AI will be supportive, development and training of AI systems, desirable outcomes, challenges, and envisioning the future of AI in urodynamics.</p><p><strong>Discussion and conclusion: </strong>In the vision of experts, urodynamics practices will change with the introduction of AI. In the beginning, clinicians will probably desire to check AI-made outcomes of UDS tests to gain trust the system. After experiencing the value of these systems, clinicians might let the system independently provide suggested UDS analyses, and they will use more of their time to spend on their patients.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1231-1237"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302588","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}