Neurourology and Urodynamics最新文献

{"title":"Constrictive versus compressive bladder outflow obstruction in men: Does it matter?","authors":"Wouter van Dort, Peter F W M Rosier, Thomas R F van Steenbergen, Bernard J Geurts, Laetitia M O de Kort","doi":"10.1002/nau.25520","DOIUrl":"10.1002/nau.25520","url":null,"abstract":"<p><strong>Introduction: </strong>Bladder outflow obstruction (BOO) is a urethral resistance (UR) at a level above a clinically relevant threshold. UR is currently graded in terms of the existence and severity of the BOO based on maximum flowrate and associated detrusor pressure only. However, the pressure-flow relation throughout the course of voiding includes additional information that may be relevant to identify the type of BOO. This study introduces a new method for the distinction between the provisionally called compressive and constrictive types of BOO and relates this classification to underlying patient and urodynamic differences between those BOO types.</p><p><strong>Methods: </strong>In total, 593 high-quality urodynamic pressure-flow studies in men were included in this study. Constrictive BOO was identified if the difference Δp between the actual minimal urethral opening pressure (p_muo) and the expected p_muo according to the linearized passive urethral resistance relation (linPURR) nomogram was >25 cmH₂O. Compressive BOO is identified in the complementary case where the pressure difference Δp ≤ 25 cmH₂O. Differences in urodynamic parameters, patient age, and prostate size were explored.</p><p><strong>Results: </strong>In 81 (13.7%) of the cases, constrictive BOO was found. In these patients, the prostate size was significantly smaller when compared to patients diagnosed with compressive BOO, while displaying a significantly lower maximum flowrate, higher detrusor pressure at maximal flowrate and more postvoid residual (PVR).</p><p><strong>Conclusion: </strong>This study is an initial step in the validation of additional subtyping of BOO. We found significant differences in prostate size, severity of BOO, and PVR, between patients with compressive and constrictive BOO. Subtyping of voiding-outflow dynamics may lead to more individualized management in patients with BOO.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"2178-2184"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284361","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 theoretical model for brisk walking- and running-induced lower urinary tract symptoms (BRUTS) and the development of the BRUTS-questionnaire (BRUTS-Q): A focus group and Delphi study.","authors":"Olena Klahsen, Stéphanie Thibault-Gagnon, Linda McLean","doi":"10.1002/nau.25523","DOIUrl":"10.1002/nau.25523","url":null,"abstract":"<p><strong>Aims: </strong>Existing questionnaires provide limited information on the nature, severity and context surrounding lower urinary tract symptoms (LUTS) experienced during running, jogging and brisk walking. The aims of this study were to develop a theoretical model of the experience of LUTS by females participating in gait-based exercise activities and to use this model to generate a questionnaire to evaluate the presence, symptoms and bother associated with LUTS experienced by females during gait-based activities.</p><p><strong>Methods: </strong>A theoretical model was developed through a review of the literature and refined through a focus group consultation including pelvic health physiotherapists, females who experienced leakage during exercise and academic researchers who studied female LUTS. A draft questionnaire was developed using key constructs identified in the model by the focus group. A new expert panel was recruited, which included physiotherapists, women with self-reported gait-induced LUTS and urogynecologists. This panel followed a DELPHI process to evaluate the relevance and completeness of the constructs within the questionnaire.</p><p><strong>Results: </strong>Two rounds of consultation were required to reach consensus on the completeness of included constructs as well as the inclusion and wording of questions. The resulting questionnaire contains questions related to five key constructs: physical activity characteristics, symptoms of urgency, urgency urinary incontinence, stress urinary incontinence experienced during exercise and management/mitigation strategies adopted by respondents.</p><p><strong>Conclusions: </strong>The content validity of the brisk walking- and running-induced lower urinary tracts symptoms questionnaire has been established. The next steps are to ensure that the questionnaire has adequate comprehensibility, followed by adequate measurement properties.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"2185-2194"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731323","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 better understanding of basic science may help our management of LUTS/LUTD in older persons with nocturnal polyuria and nocturia: ICI-RS 2024.","authors":"Anthony Kanai, Karel Everaert, Apostolos Apostolidis, Christopher Fry, Pradeep Tyagi, Andries Van Huele, Bahareh Vahabi, Wendy Bower, Alan Wein, Paul Abrams","doi":"10.1002/nau.25565","DOIUrl":"10.1002/nau.25565","url":null,"abstract":"<p><strong>Aims: </strong>To discuss the role of autocrine/paracrine signaling of urothelial arginine vasopressin (AVP) on mammalian bladder capacities and micturition thresholds, impact of distension on water/urea reabsorption from the bladder, review of the literature to better characterize the central/peripheral effects of AVP, desmopressin (dAVP) toxicity, and urine biomarkers of nocturia.</p><p><strong>Methods: </strong>This review summarizes discussions during an International Consultation on Incontinence-Research Society 2024 think tank with respect to the role of urothelial AVP in aged individuals with nocturnal polyuria, impact of solute and water reabsorption by the bladder on uninterrupted sleep, central effects of AVP, pharmacological basis of dAVP toxicity, and biomarkers in nocturia/lower urinary tract dysfunction (LUTD) with neurological diseases.</p><p><strong>Results: </strong>Consensus recognized AVP function and pathways in the central nervous system (CNS), pre-proAVP localized using immunohistochemistry in bladder sections from adult/aged noncancerous human punch biopsies and rodent bladder sections is likely to accelerate the systemic uptake of water and urea from the bladder of anesthetized mice instilled with ³H-water and ¹⁴C-urea. Mechanisms for charged and uncharged solutes and water transport across the bladder, mechanism of dAVP toxicity, and utility of urine biomarkers in those with neurological diseases/nocturia were determined from literature reviews.</p><p><strong>Conclusion: </strong>Pre-proAVP is present in human/rodent bladders and may be involved in water reabsorption from bladder that prevents the sensation of fullness for uninterrupted sleep in healthy adults. The mechanism of action of AVP in the CNS was discussed, as was electrolyte/water transport across the bladder, the basis for dAVP toxicity, and feasibility of urine biomarkers to identify nocturia/LUTD with neurological diseases.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"2300-2307"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760079","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":"Predicting success using response after lead implantation with sacral neuromodulation for urgency incontinence.","authors":"Whitney K Hendrickson, Chong Zhang, James A Hokanson, Ingrid E Nygaard, Angela P Presson","doi":"10.1002/nau.25562","DOIUrl":"10.1002/nau.25562","url":null,"abstract":"<p><strong>Importance: </strong>Many women report inadequate symptom control after sacral neuromodulation (SNM), despite 50% reduction in urgency incontinence episodes (UUIE) after test stimulation.</p><p><strong>Objective: </strong>To determine the ideal percent UUIE reduction after test stimulation that predicts 24-month success.</p><p><strong>Study design: </strong>Using data from a multicenter SNM trial, we constructed receiver operating characteristic curves to identify an ideal threshold of percent UUIE reduction after test stimulation. We defined 24-month success as Patient Global Impression of Improvement of \"very much better\" to \"better.\" We compared predictive accuracy of two models predicting success: (1) percent UUIE reduction alone and (2) with baseline characteristics.</p><p><strong>Results: </strong>Of 149 women (median [IQR] baseline daily UUIE 4.7 [3.7, 6.0]), the ideal threshold for 24-month success was 72% (95% confidence interval 64,76%) UUIE reduction with accuracy 0.54 (0.42, 0.66), sensitivity 0.71 (0.56, 0.86) and specificity 0.27 (0.05, 0.55). The accuracy of the 50% reduction threshold was 0.60 (0.49, 0.71), sensitivity 0.95 (0.88, 1.0) and specificity 0.04 (0.0, 0.12). Percent reduction in UUIE was not better than chance in predicting 24-month success (concordance index [c-index] 0.47 [0.46, 0.62]); adding age, body mass index, diabetes mellitus and visual or hearing impairment the c-index was 0.68 (0.61, 0.78).</p><p><strong>Conclusions: </strong>Among women who received an internal pulse generator (IPG) due to ≥50% UUIE reduction after test stimulation, we found no ideal threshold that better predicted 24-month success. Percent reduction in UUIE after test stimulation poorly predicts 24-month success with or without clinical factors. Given this, re-evaluating how we determine who should receive an IPG is needed.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1776-1783"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792912","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":"Case log trends of urogynecology and reconstructive pelvic surgery fellows: A comparison of urology- and gynecology-based fellowship programs.","authors":"Alexandra L Tabakin, Rohan Sawhney, Adam M Daily, Harvey A Winkler, Dara F Shalom, Justina Tam, Wai Lee","doi":"10.1002/nau.25533","DOIUrl":"10.1002/nau.25533","url":null,"abstract":"<p><strong>Aims: </strong>Urogynecology and Reconstructive Pelvic Surgery (URPS) fellowship can be pursued after completion of either a urology (URO) or obstetrics and gynecology (GYN) residency. Our aim is to determine differences in graduating fellow cohort (GFC) case logs between URO- and GYN-based URPS programs.</p><p><strong>Methods: </strong>Accreditation Council for Graduate Medical Education case logs for URPS GFCs in both GYN- and URO-based programs were analyzed for the 2019-2023 academic years (AY). Unpaired t-tests with Welch's correction were used to compare annual mean logged cases between URO- versus GYN-based GFCs for select surgical categories and the top 11 most logged index cases.</p><p><strong>Results: </strong>GYN-based GFCs logged more cases for all pelvic organ prolapse (POP) categories including surgery on apical POP, anterior wall POP, and posterior wall POP (all p < 0.01), while URO-based GFCs logged more cases for surgery on the urinary system (p = 0.03). For the top 11 logged procedures, URO-based GFCs logged more sacral neuromodulation cases (p = 0.02), whereas GYN-based GFCs logged more slings, vaginal hysterectomies, minimally-invasive hysterectomies, vaginal apical POP, vaginal posterior POP, vaginal anterior POP, and minimally-invasive apical POP cases (all p < 0.01). There was no difference between URO- and GYN-based GFCs for complex urodynamics, cystoscopy with botox injection, or periurethral injection cases.</p><p><strong>Conclusions: </strong>URO-based URPS fellows tend to graduate with more surgery on the urinary system and sacral neuromodulation cases, while GYN-based fellows perform more slings, hysterectomies, and POP surgery. These findings may help fellowships better understand potential differences in training among graduates from URO- and GYN-based programs and encourage collaboration to lessen these discrepancies.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1970-1976"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458397","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":"Early bladder dysfunction after vesicovaginal fistula repair: A prospective comparative analysis of transvaginal, open, and laparoscopic abdominal approaches.","authors":"Madhur Anand, Manoj Kumar, Mayank Jain, Amber Gupta, Abhijeet Kumar, Bhupendra Pal Singh, Vishwajeet Singh, Apul Goel","doi":"10.1002/nau.25548","DOIUrl":"10.1002/nau.25548","url":null,"abstract":"<p><strong>Introduction: </strong>We aim to compare the clinical and urodynamic profile of lower urinary tract symptoms (LUTS) in patients undergoing laparoscopic, open transabdominal, and laparoscopic transabdominal vesicovaginal fistulae (VVF) repair at 3 months of repair, that is, in early postoperative period.</p><p><strong>Materials and methods: </strong>Fifty-one consecutive patients with endoscopically confirmed VVF were enrolled in our study over 2 years. Malignant fistulae, radiation-induced, and complex fistulae were excluded after cross-sectional imaging. All patients underwent a postoperative assessment for the success of the repair. Then at 3 months, they completed the American Urological Association Symptom Score questionnaire and underwent a dual channel pressure-flow urodynamic study. The results of transvaginal, laparoscopic, and open transabdominal repairs were compared.</p><p><strong>Results: </strong>All patients belonged to the Indian Caucasian race. The mean age was 35.43 ± 6.63 years. Thirty-two patients had supratrigonal and 19 had trigonal fistulae. Laparoscopic transabdominal repair was done in 15 patients, open transabdominal repair in 22 patients, and transvaginal repair in 14 patients. Forty-six patients reported some LUTS at a median follow-up of 5.83 ± 2.37 months postoperatively. Only 18 (35.2%) of these patients had moderate to severe symptoms The postoperative bladder dysfunction rates in open transabdominal, transvaginal and laparoscopic transabdominal groups were 36.4%, 28.6%, and 20%, respectively. Twenty-seven patients (52.9%) had some urodynamic abnormality, that is, small capacity (5), high voiding pressures (14), genuine stress incontinence (3), and poor compliance (3). Bladder capacity was a significant predictor of bladder dysfunction in our patients.</p><p><strong>Conclusions: </strong>In our study, all three surgical approaches were associated with bladder dysfunction, however, it was the least in the laparoscopic transabdominal approach. Postoperative bladder capacity is a significant predictor of bladder dysfunction.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"2101-2109"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559359","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 editor: Comparison of perioperative adverse events following suburethral sling placement using synthetic mesh, autologous rectus fascia, and autologous fascia lata in a National Surgical Registry.","authors":"Christopher X Hong, Young Son, Vaishnavi J Patel, Kimberly Lince, Priyanka Gupta","doi":"10.1002/nau.25531","DOIUrl":"10.1002/nau.25531","url":null,"abstract":"","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"2314-2315"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620508","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":"Supporting the Choice for Conservative and Surgical Treatment in Female Stress Urinary Incontinence: Development and Evaluation of a Patient Decision Aid.","authors":"Maria B E Gerritse, Marieke de Vries, Regina The, John P F A Heesakkers, Antoine L M Lagro-Janssen, C Huub van der Vaart, Kirsten B Kluivers","doi":"10.1002/nau.25578","DOIUrl":"10.1002/nau.25578","url":null,"abstract":"<p><strong>Introduction: </strong>Making a treatment decision for female stress urinary incontinence (SUI) can be challenging for patients and healthcare providers. Dutch guidelines advise to counsel both pelvic floor muscle therapy and midurethral sling surgery as primary treatment options in uncomplicated moderate to severe cases. The use of a patient decision aid (PDA) can support decision-making, reduce decisional conflict and decisional regret, and increase knowledge. The aim of this study was to develop and evaluate an online PDA for females (SUI).</p><p><strong>Methods: </strong>This mixed-methods study was performed in consecutive stages by a multidisciplinary working group. PDA design was based on the International Patient Decision Aids Standards (IPDAS) and on outcomes of needs assessments amongst patients and healthcare providers. Content was based on Dutch guidelines, targeted literature searches and patient information from the Dutch scientific society for gynecology. The concept version was evaluated by patients, patients' advocates, and healthcare providers.</p><p><strong>Results: </strong>Using the nominal group technique, the working group established the design and format of the PDA. Fifty-six out of 58 applicable items of the IPDAS were met. The PDA contains information on the condition, advice on lifestyle adaptations, and describes surgical and nonsurgical treatment options. The option grid contains comparisons of the primary treatment options. Furthermore, value clarification exercises and narratives were included. Acceptability and usability evaluation of the concept version was performed by 15 healthcare providers, three patients, and two patients' advocates. Comments were processed in the working group, resulting in the final version of the PDA, which was supported by all assessors.</p><p><strong>Conclusion: </strong>Our multidisciplinary working group developed an online PDA for women with moderate to severe SUI including conservative and surgical treatment options, based on IPDAS criteria, guidelines, scientific evidence, and needs assessments from patients and healthcare providers. This PDA is supported by patients, healthcare providers, scientific societies, and the Dutch patients' association. The next step is to evaluate and implement this PDA in daily practice.</p><p><strong>Trial registration: </strong>ID 2014-308.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"2052-2059"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133362","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":"Increased prevalence of metabolic syndrome in female patients with overactive bladder: A population-based study.","authors":"Omer Anis, Arnon Dov Cohen, Shachar Aharony, Noam D Kitrey, Idit Dotan, Chen Shenhar, Doron Comaneshter, Tanya Beckenstein, Shlomit Yaron","doi":"10.1002/nau.25521","DOIUrl":"10.1002/nau.25521","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the association between overactive bladder syndrome (OAB) and the metabolic syndrome (MetS).</p><p><strong>Patients and methods: </strong>A population-based study was conducted to compare OAB patients with age-, sex- and ethnicity-matched control subjects regarding the prevalence of the parameters of the MetS, with respect to obesity, hyperlipidemia, hypertension and diabetes mellitus. The characteristics of the OAB population were assessed. Adjusted odds ratios (OR) were calculated by logistic regression.</p><p><strong>Results: </strong>110 024 OAB patients and 220 455 controls. were identified. OAB was associated with a higher prevalence of MetS (35.4% vs. 27.5%, p < 0.001). The fully adjusted OR for MetS in patients with OAB compared to controls was 1.44; 95% confidence interval (CI) 1.42-1.46; p < 0.001. Among metabolic parameters, obesity was found to be the strongest factor associated with OAB (OR 1.55, 95% CI 1.53-1.58, p < 0.001), and higher high-density lipoprotein cholesterole levels (>50) had a protective effect on the risk of OAB (OR 0.75, 95% CI 0.73-0.76, p < 0.001).</p><p><strong>Conclusions: </strong>Data from this cohort suggest that OAB is positively associated with MetS. Clinicians approaching patients with OAB should be aware of this association. A multimodal treatment focusing on the MetS may be considered in these patients.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"1809-1816"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262361","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":"Determination of voiding pressure in infants with normal lower urinary tracts: Exploring the possible effect of sacral development.","authors":"Mazyar Zahir, Seyedeh-Sanam Ladi-Seyedian, Masoumeh Majidi Zolbin, Lida Sharifi-Rad, Pooya Hekmati, Abdol-Mohammad Kajbafzadeh","doi":"10.1002/nau.25525","DOIUrl":"10.1002/nau.25525","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between sacral underdevelopment, as defined by subnormal sacral ratio (SR) measurements, with increased maximum detrusor voiding pressure (P det. Max) in infants.</p><p><strong>Methods: </strong>In this 2007-2015 retrospective cohort study, the medical records of all infants who underwent a pyeloplasty due to congenital ureteropelvic junction obstruction were added. Their P det. Max was evaluated through the suprapubic catheter utilized for urinary drainage intraoperatively, without imposing any additional risk of urethral catheterization on the infant. SR was calculated via the plain kidney, ureter, and bladder (KUB) radiography film obtained during the voiding cystourethrogram (VCUG) evaluation before the surgery. Participants were categorized into SR < 0.74 or SR ≥ 0.74. P det. Max was subsequently compared between these two groups.</p><p><strong>Results: </strong>A total of 45 patients were included in our analysis. Twenty-eight (62.2%) patients had a (SR < 0.74), while 17 (37.8%) had a (SR ≥ 0.74). P det. Max was shown to be significantly higher in the SR < 0.74 compared to the SR ≥ 0.74 group (167.5 ± 60.8 vs. 55.7 ± 17.9 cmH₂O, p < 0.001). After adjusting for age and sex, SR remained a significant contributor to P det. Max (p < 0.001). Physiologic detrusor sphincter dyscoordination (PDSD) rate was significantly higher in the SR < 0.74 versus SR ≥ 0.74 group (100.0% vs. 70.6%, respectively; p = 0.005).</p><p><strong>Conclusion: </strong>Lumbosacral underdevelopment, as indicated by subnormal sacral ratios, is associated with sphincter-detrusor dyscoordination, which causes PDSD and can ultimately result in higher P det. Max in infants.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":"2123-2129"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555287","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}