Neurourology and Urodynamics最新文献

{"title":"Using a Back-Worn Accelerometer to Capture Nocturia Frequency in Parkinson's: An Exploratory Study.","authors":"Anisha Cullen, Matthew D Smith, Emily J Henderson","doi":"10.1002/nau.70011","DOIUrl":"10.1002/nau.70011","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1389-1391"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441559","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":"Out-of-Office Digitalized and Connected Devices for Assessing Voiding Behavior: Patients' Point of View.","authors":"Pierre-Luc Dequirez, Jessica Schiro, Anne Wojtanowski, Julien De Jonckheere, Xavier Biardeau","doi":"10.1002/nau.70100","DOIUrl":"10.1002/nau.70100","url":null,"abstract":"<p><strong>Objective: </strong>We aim to question patients' a priori opinion on recently developed digitalized and connected bladder diaries and ambulatory uroflowmeters.</p><p><strong>Methods: </strong>All patients > 18 years old, presenting with lower urinary tract symptoms (LUTS) and seen for a urology consultation at our center between May and December 2022, were proposed a standardized interview. An investigator explained the different types of devices and technologies (\"paper\" and \"digitalized bladder diary\", connected and non-connected \"home\" and \"portable uroflowmeter\", \"sono-uroflowmeter\" and \"video-uroflowmeter\") using a standardized presentation. Each device was then rated from 0 (very negative) to 5 (very positive) by patients for 5 subdomains: cumbersomeness, stigmatization, ease of use, confidentiality, and hygiene. Subgroup analyses including sex, age, activity, working conditions, presence of an underlying neurologic disease, and the type of LUTS, were carried out.</p><p><strong>Results: </strong>Seventy-seven patients participated in the study, including 51 female and 26 male patients. The highest median score was obtained by the \"sono-uroflowmetry\" (23/25) while the \"video-uroflowmetry\" got the lowest median score (9/25). When compared with \"paper\", the \"digitalized bladder diary\" was anticipated to be less cumbersome (p < 0.001) and was rated higher by patients < 50 years old (p = 0.011). When compared with \"portable\", \"home uroflowmeters\" were considered easier to use. The female sex was associated with a lower score for \"portable uroflowmeters\".</p><p><strong>Conclusion: </strong>Most digitalized and connected bladder diaries and ambulatory uroflowmeters are viewed positively by patients, with a higher score for \"sono-uroflowmetry\". However, the anticipated preferences varied according to sex, age, and working conditions.</p><p><strong>Clinical trial registration: </strong>This study was not a clinical trial.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1344-1350"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529058","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 Neurostimulation in Neurogenic Lower Urinary Tract and Bowel Dysfunction Caused by Multiple System Atrophy.","authors":"André Reitz, Axel Haferkamp, Christian Gilfrich, Stephan Buse","doi":"10.1002/nau.70091","DOIUrl":"10.1002/nau.70091","url":null,"abstract":"<p><strong>Objective: </strong>Multiple system atrophy (MSA) is a progressive neurodegenerative disorder categorized as an atypical Parkinsonian syndrome, affecting extrapyramidal, pyramidal, cerebellar, and autonomic systems. Lower urinary tract dysfunction (LUTD), including urgency, frequency, urge incontinence, and incomplete voiding, is a prevalent symptom, often appearing early in the disease. Conservative treatments, such as anticholinergic and alpha-blocker therapies, frequently fail due to poor tolerance and limited efficacy. Many patients also experience bowel symptoms, including constipation and fecal incontinence. This study evaluates sacral neuromodulation (SNM) as a treatment option for LUTD and bowel symptoms in advanced MSA.</p><p><strong>Materials and methods: </strong>In this retrospective case series eight patients (4 females, 4 males; mean age 53 years, range 45-61) with refractory LUTD and bowel symptoms underwent detailed urodynamic evaluations and percutaneous sacral nerve test stimulation. Electrodes were placed bilaterally at the S3 and S4 sacral nerve roots under local anesthesia. During an 8-day test phase, unilateral and bilateral stimulations were applied at frequencies of 3-120 Hz. Success was defined as a ≥ 50% reduction in symptoms, assessed through bladder diaries.</p><p><strong>Results: </strong>Seven patients qualified for permanent SNM implantation (4 unilateral S3, 3 bilateral S3/S4). At 2 months postimplantation, six patients exhibited ≥ 50% LUT symptom reduction. One patient showed improvement after reprogramming at 9 months. During a median 35-month follow-up, LUT relief was maintained in 36 of 44 visits, with reprogramming required in 19. SNM efficacy diminished over time, with five patients eventually requiring suprapubic tubes. Initially, three patients reported bowel symptoms; during follow-up, four additional cases emerged. Despite waning LUT effects, SNM facilitated defecation in some patients.</p><p><strong>Discussion: </strong>This retrospective case series indicate that SNM targeting S3 and S4 nerves offers temporary relief for LUTD and bowel symptoms in advanced MSA. Further research is necessary to optimize patient selection, stimulation parameters, and long-term management strategies.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1296-1301"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226070","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":"Relative Impact of Male Urinary Conditions on Overall Quality of Life.","authors":"Vishrudh Vasudevan, Golena Moncaleano Fernandez, Rodney L Dunn, Martin Miner, Claus Roehrborn, Raymond Rosen, Allen Seftel, Cathie Spino, John T Wei, Aruna V Sarma","doi":"10.1002/nau.70090","DOIUrl":"10.1002/nau.70090","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the impact of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH) and other urinary conditions on quality of life (QoL), in comparison to other comorbidities, after adjusting for lifestyle and demographic factors.</p><p><strong>Methods: </strong>The BPH Registry and Patient Survey is a multicenter, longitudinal, observational database of management practices and patient outcomes in a population of 6924 patients with BPH in the USA, managed with watchful waiting or pharmacotherapy. QoL was assessed using the Medical Outcomes Study-Short Form 12 physical (SF12 PCS) and mental health (SF12 MCS) component scores. The following urinary conditions were evaluated: lower urinary tract symptoms (LUTS) assessed using the International Prostate Symptom Score (IPSS), physician diagnosed urinary incontinence (UI), overactive bladder (OAB) and urinary tract infection (UTI). Associations between QoL and urinary conditions and other co-morbidities adjusted for demographic/lifestyle factors were estimated in 3818 men with complete data using linear regression models.</p><p><strong>Results: </strong>Approximately 21.1% of the population reported having at least one urinary condition; however, prevalence of specific urinary conditions was less than other co-morbidities. After adjusting for age, marital status, education, income, employment, alcohol use and smoking status, severe LUTS (IPSS ≥ 20) and UI were associated with a 3.9- and 2.9-point decrease in the SF12 PCS, respectively. These associations were similar to those observed with arthritis and depression, and more significant than the PCS reductions associated with cardiovascular disease (CVD), cancer, and diabetes. Urinary conditions also led to greater reductions in the SF12 MCS compared to other comorbidities, with only depression showing a greater impact on MCS scores.</p><p><strong>Conclusions: </strong>These results highlight that the impact of urinary conditions, particularly LUTS and UI, on QoL is similar to, if not more substantial than, that of other major chronic diseases. These conditions affect not only the physical component of QoL but also significantly influence the mental domains.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1325-1331"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199723","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":"Comment on \"Intravesical Botulinum Toxin Injection for Treating Detrusor Overactivity and Poor Compliance in Posterior Urethral Valves-A Preliminary Experience\".","authors":"Amir K Moaveni, Abdol-Mohammad Kajbafzadeh","doi":"10.1002/nau.70069","DOIUrl":"10.1002/nau.70069","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1378-1379"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199721","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":"Portable Ultrasound Bladder Volume Measurement Over Entire Volume Range Using a Deep Learning Artificial Intelligence Model in a Selected Cohort: A Proof of Principle Study.","authors":"Hyun Ju Jeong, Aeran Seol, Seungjun Lee, Hyunji Lim, Maria Lee, Seung-June Oh","doi":"10.1002/nau.70057","DOIUrl":"10.1002/nau.70057","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to prospectively investigate whether bladder volume measured using deep learning artificial intelligence (AI) algorithms (AI-BV) is more accurate than that measured using conventional methods (C-BV) if using a portable ultrasound bladder scanner (PUBS).</p><p><strong>Patients and methods: </strong>Patients who underwent filling cystometry because of lower urinary tract symptoms between January 2021 and July 2022 were enrolled. Every time the bladder was filled serially with normal saline from 0 mL to maximum cystometric capacity in 50 mL increments, C-BV was measured using PUBS. Ultrasound images obtained during this process were manually annotated to define the bladder contour, which was used to build a deep learning AI model. The true bladder volume (T-BV) for each bladder volume range was compared with C-BV and AI-BV for analysis.</p><p><strong>Results: </strong>We enrolled 250 patients (213 men and 37 women), and a deep learning AI model was established using 1912 bladder images. There was a significant difference between C-BV (205.5 ± 170.8 mL) and T-BV (190.5 ± 165.7 mL) (p = 0.001), but no significant difference between AI-BV (197.0 ± 161.1 mL) and T-BV (190.5 ± 165.7 mL) (p = 0.081). In bladder volume ranges of 101-150, 151-200, and 201-300 mL, there were significant differences in the percentage of volume differences between [C-BV and T-BV] and [AI-BV and T-BV] (p < 0.05), but no significant difference if converted to absolute values (p > 0.05). C-BV (R² = 0.91, p < 0.001) and AI-BV (R² = 0.90, p < 0.001) were highly correlated with T-BV. The mean difference between AI-BV and T-BV (6.5 ± 50.4) was significantly smaller than that between C-BV and T-BV (15.0 ± 50.9) (p = 0.001).</p><p><strong>Conclusion: </strong>Following image pre-processing, deep learning AI-BV more accurately estimated true BV than conventional methods in this selected cohort on internal validation. Determination of the clinical relevance of these findings and performance in external cohorts requires further study.</p><p><strong>Trial registration: </strong>The clinical trial was conducted using an approved product for its approved indication, so approval from the Ministry of Food and Drug Safety (MFDS) was not required. Therefore, there is no clinical trial registration number.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1238-1244"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094444","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":"Patterns of Care Following Procedural Intervention Among Women With Overactive Bladder.","authors":"Francis A Jefferson, Kristine T Hanson, Aqsa A Khan, John B Gebhart, Daniel S Elliott, Brian J Linder","doi":"10.1002/nau.70088","DOIUrl":"10.1002/nau.70088","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Procedural therapies for overactive bladder (OAB) most often include intradetrusor onabotulinumtoxinA (BTX) injections, sacral neuromodulation (SNM), and percutaneous tibial nerve stimulation (PTNS). Despite their proven efficacy, real-world data on therapy continuation and crossover rates between these modalities remain limited. This study aimed to evaluate longitudinal patterns of treatment continuation and therapy crossover among women receiving procedural OAB treatments.</p><p><strong>Methods: </strong>We conducted a multi-institutional retrospective cohort study of women with idiopathic OAB who underwent index BTX, SNM, or PTNS between 2014 and 2022. Patients were identified using electronic medical records, and follow-up data were collected through December 31, 2023. The primary outcomes included duration of maintenance treatments and crossover to another procedural therapy for OAB. Kaplan-Meier survival analysis estimated rates of continued treatment, and a log-rank test assessed differences in crossover rates among treatment groups.</p><p><strong>Results: </strong>A total of 506 women met inclusion criteria: 266 (52.6%) received BTX, 114 (22.5%) underwent SNM, and 126 (24.9%) received PTNS. Ongoing treatment rates were lowest for PTNS, with only 17.1% maintaining therapy between 3 and 5 years and 26.1% crossing over to another procedure within 3 years. Among BTX patients, 65.2% underwent repeat treatment within 3 years, and 9.5% of patients crossed over to another procedure within 3 years. Of those with 5 or more years of follow-up, 39.1% of patients continued with BTX procedures in the 3-5-year follow-up timeframe. Among SNM patients, the cumulative revision rates were 7.6% at 1 year and 10.9% at 2 years. 13.1% of patients crossed over from SNM to another procedure within 3 years (the vast majority to BTX).</p><p><strong>Conclusions: </strong>PTNS had the lowest ongoing therapy rates and the highest crossover rates. BTX and SNM demonstrated similar crossover rates. These findings underscore the importance of individualized patient counseling and treatment selection based on expectations of therapy persistence. Future research should focus on optimizing patient selection, improving long-term adherence strategies, and evaluating novel or combined therapeutic approaches for OAB management.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1332-1338"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216358","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":"Medium Term Outcomes for Robotic Sacral Colpopexy With Autologous Fascia Lata.","authors":"Ramzy T Burns, Morgan Black, Ginnie Jeng, Charles R Powell","doi":"10.1002/nau.70094","DOIUrl":"10.1002/nau.70094","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the medium-term outcomes of robotic sacral colpopexy (RSC) using autologous fascia lata for the treatment of apical pelvic organ prolapse.</p><p><strong>Methods: </strong>An IRB-approved retrospective review was conducted on patients who underwent RSC with autologous fascia lata at a single institution between November 2017 and August 2022. Only patients with a minimum of 24 months of follow-up were included as short-term results have already been published. Data collected included patient demographics, operative details, surgical complications, Pelvic Organ Prolapse Quantification (POP-Q) measurements, and patient-reported outcomes using the Urogenital Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7). The primary outcome was the medium-term durability of autologous fascia lata RSC, with recurrence defined as > 0 cm from the hymen in any compartment on postoperative POP-Q examination or recurrence at the apex of ≥ 2 cm.</p><p><strong>Results: </strong>Nineteen patients met the inclusion criteria, with a mean follow-up of 42.8 ± 11.9 months. All POP-Q values showed significant improvement postoperatively, with only one (6.3%) patient experiencing posterior compartment recurrence and one (6.3%) with exactly 2 cm of apical descent. One patient (5.2%) required surgical retreatment with posterior colporrhaphy and a pubovaginal sling. Patient-reported outcomes demonstrated significant improvement in UDI-6 and IIQ-7 scores (p < 0.05). Minor complications related to fascia lata harvest were observed, including seroma (10.5%), transient paresthesia (21%), hematoma (5.2%), and deep vein thrombosis (5.2%), with most resolving spontaneously.</p><p><strong>Conclusions: </strong>RSC with autologous fascia lata provides durable medium-term anatomic and symptomatic improvement for apical POP, with low recurrence and retreatment rates. While minor harvest-related complications were observed, most were self-limiting. These findings support the use of autologous fascia lata as a viable alternative to synthetic mesh in RSC. Larger, multicenter studies with extended follow-up are needed to further validate these results.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1339-1343"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507072","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":"Acute Chemodenervation of the Bladder With Botulinum Toxin After Spinal Cord Injury Resulted in Preserved Bladder Function in Rodents.","authors":"Noor Al-Khayat, Lindsay N Cates, Benjamin R Valenti, Mark P Hudson, Claire C Yang, Zin Z Khaing","doi":"10.1002/nau.70124","DOIUrl":"https://doi.org/10.1002/nau.70124","url":null,"abstract":"<p><p>Despite modern bladder management methods, lower and upper urinary tract complications still contribute significantly to morbidity and diminished quality of life in persons with spinal cord injuries (SCI). Neurogenic overactive bladders often develop after SCI and this can result in loss of compliance, with concomitant urinary tract complications. Currently, there is no treatment available to prevent the development of neurogenic bladder.</p><p><strong>Aims: </strong>In this study, we tested whether acute application of botulinum toxin A (BoNT-A) to the detrusor can limit the development of poorly compliant neurogenic bladders.</p><p><strong>Methods: </strong>Rats sustained contusion type spinal cord injury at T8 and either received intradetrusor saline or BoNT-A injections immediately (acute) or at 4-weeks post injury (wpi)(chronic). Cystometry studies were performed at 6-8 wpi for all animals.</p><p><strong>Results: </strong>We found that acute BoNT-A treatment after SCI resulted in animals normalized bladder capacity, improved compliance, and reduction in non-voiding contractions compared to control animals. Only acute BoNT-A treatment, but not chronic BoNT-A treatment, resulted in improving bladder compliance, retaining micturition reflexes, and reducing non-voiding contractions. These bladder physiological changes in acute BoNT-A treated SCI animals were accompanied by significant decreases in calcitonin gene related peptide (CGRP)-positive sensory fibers in the dorsal horn and growth associated protein (GAP)-43 expression, a marker for regenerating axons, compared to SCI animals.</p><p><strong>Conclusions: </strong>Acute application of BoNT-A to the detrusor muscle after SCI can reduce pathophysiological bladder alterations and limits aberrant bladder afferent sprouting in the L5/S1 dorsal horn after SCI in a rat model.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743327","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":"Toward Novel Targeted Therapy for Overactive Bladder: A Cadaver Study Identifying Critical Autonomic Nerve Structures.","authors":"Gamal Ghoniem, Mickey Karram, Muhammed A M Hammad","doi":"10.1002/nau.70121","DOIUrl":"https://doi.org/10.1002/nau.70121","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Targeted radiofrequency (RF) therapy is a promising treatment for overactive bladder (OAB), aiming to modulate autonomic nerve pathways for symptom control. This cadaveric study focuses on identifying areas of high nerve density in the bladder and corresponding vaginal wall (AVW) to support RF use in a minimally invasive fashion throughout the anterior vaginal wall.</p><p><strong>Methods: </strong>AVW samples were obtained from two cadaveric specimens (T1 & T2). Hematoxylin and eosin (H&E) staining was employed to assess anatomical structures, while S100 immunohistochemistry was used to visualize nerve distribution. Nerve size and density across the anterior and posterior bladder walls, along with the attached anterior vaginal wall were quantified using image analysis software. Statistical analyses, including one-way ANOVA and pairwise t-tests, were conducted to assess differences across different regions in the posterior bladder wall divided into: \"Towards Vagina,\" \"High nerve density\" (HND), and \"Towards Bladder\" at 0-2.4 mm, 4.8-7.2 mm, and 7.2-9.6 mm in depth from the vaginal surface, respectively.</p><p><strong>Results: </strong>H&E staining confirmed intact anatomy. S100 staining revealed areas of higher nerve density at the regions associated with posterior bladder wall compared to the anterior wall, especially at HND targeted at 4.8-7.2 mm deep from the vaginal surface. ANOVA revealed significant differences in nerve size (p = 0.0017 in T1, p = 0.0006 in T2) and density (p = 0.036 in T1, p = 0.0007 in T2) in the HND region compared to those of the other regions. Similarly, pairwise t-tests indicated statistically significant differences between the HND region and any other region in the posterior wall. The HND zone consistently displayed the largest nerves and highest density across both specimens.</p><p><strong>Conclusions: </strong>This study highlights the importance of the HND zone, as a critical target for RF therapy and other neuromodulation-based management in OAB treatment. The identification of this high-innervation zone guides the precise application of RF energy and supports the use of targeted RF therapy delivered through the anterior vaginal wall, potentially improving therapeutic outcomes with a minimally invasive modality.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682824","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}