Bladder (San Francisco, Calif.)最新文献

{"title":"An unusual distal tibial metastasis from urothelial carcinoma: A case report.","authors":"Tran Ngoc An Huynh, Darren Trinh, Janan Chandrananth, James Sewell","doi":"10.14440/bladder.2024.0077","DOIUrl":"10.14440/bladder.2024.0077","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer (BCa) frequently metastasizes to bones, typically affecting the spine and pelvis.</p><p><strong>Case presentation: </strong>Presented here is a case of rare extensive distal tibia metastasis in an 84-year-old female with invasive high-grade urothelial carcinoma, who suffered from rapidly progressive ankle pain and reduced mobility. Imaging and biopsy confirmed metastatic urothelial carcinoma in the tibia, which was managed with surgical fixation and palliative radiotherapy. Although bone metastases in BCa commonly affect other sites, clinicians should consider atypical locations like the tibia in patients with unexplained bone pain.</p><p><strong>Conclusion: </strong>Early diagnosis and intervention are essential for improving patient outcomes and quality of life.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"12 1","pages":"e21200041"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A standardized protocol for modified platelet-rich plasma collection for the treatment of interstitial cystitis/bladder pain syndrome.","authors":"Qiangping Zheng, Peng Zhang, Wei Guo, Jianzhong Zhang, Fan Zhang, Changran Ma, Yuanru Yang, Liyan Cui, Yuling Wu, Lei Zhang","doi":"10.14440/bladder.2024.0052","DOIUrl":"10.14440/bladder.2024.0052","url":null,"abstract":"<p><strong>Background: </strong>Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic and diagnostically challenging condition with limited treatment options and poor prognosis. Platelet-rich plasma (PRP) is a potential treatment for IC/BPS. Nonetheless, conventional preparation methods are inefficient, necessitating an improved approach.</p><p><strong>Objective: </strong>To design an effective and safe protocol for collecting PRP for intravesical injections for the treatment of IC/BPS.</p><p><strong>Methods: </strong>We evaluated the feasibility of the PRP collection protocol from 17 patients. After venipuncture, blood was processed using a blood cell separator containing saline and anticoagulant. One milliliter of PRP was retained for platelet concentration analysis. Each patient received six PRP injections, and their clinical data were taken before and after the procedure to assess efficacy.</p><p><strong>Results: </strong>The mean platelet enrichment coefficient was 5.11 ± 1.27, the mean flow rate was 33.19 ± 6.77 mL/min, the mean collection volume was 125.13 ± 17.49 mL, and the mean collection time was 73.69 ± 10.17 min. Eleven patients required deep venous catheterization because superficial venipuncture failed. No adverse reactions were observed during collection, and all other blood components were retained. Three patients completed six injections, four received five injections, three received four injections, one received three injections, two received two injections, and four received one injection. After treatment, 12 of 17 patients showed symptom improvement on the Global Response Assessment scale (≥5), and all demonstrated statistically significant improvements in terms of O'Leary-Sant and Visual Analog Scale scores against baseline. One patient, however, developed gross hematuria after the fourth injection.</p><p><strong>Conclusions: </strong>The proposed PRP collection protocol is relatively safe and effective. Preliminary data suggest that intravesical PRP injection is a promising treatment for IC/BPS.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"12 1","pages":"e21200034"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression profiles and clinical significance of cystatin family genes in transitional cell carcinoma of the urinary bladder.","authors":"Haixia Xu, Wang Liu, Xiangxing Kuang, Jiang Zhao, Xiangwei Wang, Benyi Li","doi":"10.14440/bladder.2024.0057","DOIUrl":"10.14440/bladder.2024.0057","url":null,"abstract":"<p><strong>Background: </strong>Cystatins, encoded by the <i>CST</i> gene family, are a superfamily of cysteine protease inhibitors involved in a wide array of biological functions, including immune modulation and antimicrobial defense. Cystatin proteins are implicated in tumor progression through multiple mechanisms. However, their roles in bladder cancer remain poorly understood.</p><p><strong>Objective: </strong>This study examined the expression profiles of the cystatin family genes and analyzed their correlation with clinicopathological parameters using the Cancer Genome Atlas Bladder Cancer RNA-seq dataset.</p><p><strong>Methods: </strong>The RNAseq dataset derived from the Cancer Genome Atlas project was utilized for the gene expression analysis on the XIANTAO online platform. The UALCAN online platform was used for the analysis of gene expression in molecular subgroups. The differences among various subgroups were statistically analyzed to define the significance.</p><p><strong>Results: </strong>Our results showed that <i>CST3, CST6, CST7, CSA</i>, and <i>CSTB</i> were predominantly expressed in bladder tissues. <i>CST6, CSTA</i>, and <i>CSTB</i> were upregulated, while <i>CST3</i> and <i>CST7</i> were downregulated in bladder cancer tissues. <i>CST1</i> and <i>CST2</i> were moderately expressed but significantly upregulated in malignant tissues. Specifically, malignant tissues could be effectively differentiated from benign tissues in terms of <i>CST1</i> expression, with an area under the curve value of 0.904. Upregulation of <i>CST2</i> was associated with multiple clinicopathological parameters, while downregulation of <i>CST3</i> was correlated with unfavorable outcomes in overall survival, disease-specific survival, and progression-free survival. Further analysis revealed that <i>CST7</i> expression bore an association with immune infiltration, suggesting that it plays a role in the modulation of immune cells.</p><p><strong>Conclusion: </strong><i>CST</i> genes were distinctly expressed in bladder cancer with different clinical implications.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"12 1","pages":"e21200035"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role and clinical potential of RNA modifications in bladder cancer.","authors":"Yuqing Wu, Fenghao Zhang, Yufan Ying, Jiangfeng Li, Xiangyi Zheng, Liping Xie","doi":"10.14440/bladder.2024.0062","DOIUrl":"10.14440/bladder.2024.0062","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer (BC) represents a common malignancy and is characterized by high heterogeneity and complex biological behaviors, which pose substantial challenges to its effective treatment. Mounting evidence highlights the pivotal roles of ribonucleic acid (RNA) modifications, particularly N6-methyladenosine, alongside others such as 1-methyladenosine, 5-methylcytosine, N4-acetylcytidine, and 7-methylguanosine, in the regulation of the proliferation, migration, drug resistance, and immune evasion of BC cells.</p><p><strong>Objective: </strong>This article comprehensively reviewed the regulatory mechanisms and biological impacts of these RNA modifications in BC, with a focus on the interplay between RNA modifications and immune evasion, as well as their emerging roles in precision medicine. By looking into these underexplored areas, this work provided novel insights into RNA modifications as diagnostic markers, prognostic indicators, and therapeutic targets, paving the way for advancements in BC precision medicine.</p><p><strong>Conclusion: </strong>RNA modifications impact key processes such as proliferation, migration, drug resistance, and immune evasion of BC cells. Targeting RNA modification pathways offers promising strategies for enhancing the efficacy of current treatments for and overcoming drug resistance of BC.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"12 1","pages":"e21200037"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney function improvement after urinary diversion for cisplatin eligibility in bladder cancer patients.","authors":"Fernando Korkes, José Henrique DallAcqua Santiago, André Marantes Masciarelli Pinto, Artur da Silva Farias, Frederico Timóteo, Suelen Patricia Dos Santos Martins, Sidney Glina","doi":"10.14440/bladder.2024.0034","DOIUrl":"10.14440/bladder.2024.0034","url":null,"abstract":"<p><strong>Background: </strong>Muscle-invasive bladder cancer (MIBC) is an aggressive disease typically treated with radical cystectomy following neoadjuvant chemotherapy (NAC). However, the presence of hydronephrosis - a significant marker of advanced disease - can impair renal function, potentially precluding patients from receiving cisplatin-based NAC.</p><p><strong>Objective: </strong>The present study aimed to assess the role of urinary diversion in patients with MIBC, specifically in reversing renal function impairment and enabling eligibility for cisplatin-based therapy.</p><p><strong>Methods: </strong>A retrospective study was performed by evaluating a database of patients treated for urothelial MIBC from 2018 to 2021. Case notes were reviewed to identify patients with hydronephrosis who underwent urinary diversion. The types of urinary diversion recorded included percutaneous nephrostomy, ureteral stenting, or surgical obstruction release. Renal function was assessed retrospectively using the glomerular filtration rate (GFR), estimated from creatinine clearance.</p><p><strong>Results: </strong>Records of a total of 72 patients were evaluated. The mean GFR before urinary diversion was 44.1 ± 26.4 mL/min, which improved to 59.1 ± 31.9 mL/min post-diversion, resulting in a mean GFR improvement of 15.0 ± 20.0 mL/min. Forty-four patients had an initial GFR below 50 mL/min, with 75% of them achieving a GFR >50 mL/min after urinary diversion. More than half of these patients (<i>n</i> = 25, 56%) experienced an improvement to a GFR exceeding 60 mL/min. The time to reach the best GFR varied widely (mean: 59 ± 33 days, range 9 - 165 days). Logistic regression analysis identified initial GFR as a significant predictor of GFR recovery (odds ratio = 1.11, 95% confidence interval = 1.02 - 1.21, <i>p</i> = 0.012).</p><p><strong>Conclusion: </strong>Urinary diversion can benefit patients with upper tract obstruction secondary to MIBC by improving renal function, thereby enabling eligibility for cisplatin-based chemotherapy. Notably, the time to GFR recovery following urinary diversion varied among individuals.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"12 1","pages":"e21200027"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in surgical procedures for bladder cancer within the Brazilian public health system: An 11-year analysis.","authors":"Heveline R M Roesch, Mehrsa Jalalizadeh, Caio de Oliveira, Leonardo O Reis","doi":"10.14440/bladder.2024.0045","DOIUrl":"10.14440/bladder.2024.0045","url":null,"abstract":"<p><strong>Background: </strong>Continuous updates to procedures and hospital admissions for bladder cancer (BC) are crucial for understanding trends, particularly within Brazil's public health system. Monitoring these data is vital for informed decision-making.</p><p><strong>Objective: </strong>The objective of the study was to understand the trends in surgical procedures for BC within the Brazilian public health system.</p><p><strong>Methods: </strong>Data were collected from the Brazilian Data Center for the Public Health System, focusing on hospital admissions related to bladder surgeries from 2013 to 2023. Information was categorized in terms of procedure urgency, hospitalization duration, costs, and mortality rates.</p><p><strong>Results: </strong>A total of 123,434 BC-related surgical procedures were performed, the majority of which were elective (73.4%) and bladder-preserving (BP, 96.2%). There were 1,710 reported mortalities, with a consistent procedure-specific mortality rate (PSMR) across the 11-year period for all procedures. The average hospitalization duration for elective BP (β = -0.12, <i>p</i> < 0.001), elective non-BP (β = -0.46, <i>p</i> < 0.001), and urgent non-BP procedures (β = -0.41, <i>p</i> = 0.012) steadily decreased. Elective and urgent BPs showed the lowest annual PSMRs (0.66% and 4.25%, respectively), compared to elective and urgent non-BPs (6.93% and 10.72%). The northern and northeastern regions reported significantly fewer cases but higher mortality rates after 2018, despite reduced average hospital stays. While hospital costs for these procedures increased, the standalone costs of surgical interventions remained stable over the 11-year period.</p><p><strong>Conclusion: </strong>BC-related hospital admissions, particularly for BP procedures, have increased, reflecting improved access to healthcare. However, regional disparities in surgical care, mortality rates, and hospital stays persist across Brazil.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"12 1","pages":"e21200030"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of lower urinary tract symptoms and their impact on quality of life following radiation therapy for bladder cancer.","authors":"Josephine Hyldgaard, Anne Birgitte Als, Benedicte Ulhøi, Jørgen Jensen, Charlotte Graugaard-Jensen","doi":"10.14440/bladder.2024.0046","DOIUrl":"10.14440/bladder.2024.0046","url":null,"abstract":"<p><strong>Background: </strong>Radiation therapy is a common treatment modality for muscle-invasive bladder cancer (BC). Unfortunately, approximately 5 - 10% of treated patients suffer from long-term complications, such as radiation cystitis. While radiation cystitis initially causes urinary symptoms, it can progress to chronic late effects over time. This treatment may have significant physical and psychological implications for cancer survivors.</p><p><strong>Methods: </strong>This prospective, observational multicenter study was conducted in Denmark from 2020 to 2023. Male patients undergoing radiation treatment for BC were included and stratified into two groups based on radiation strategy: 64 Gy/32 fractions versus 36 Gy/6 fractions. Patients completed baseline and follow-up questionnaires assessing lower urinary tract symptoms and quality of life (QoL).</p><p><strong>Results: </strong>A total of 26 patients were enrolled into the study, with three patients withdrawing consent. Eleven patients were assigned to the 64 Gy/32 fraction group and 12 to the 36 Gy/6 fraction group. At baseline, patients receiving 64 Gy/32 fraction reported a lower impact on QoL, with a median (interquartile range [IQR]) score of 2 (24) compared to 20 (27) in the 36 Gy/6 fraction group. At the 4-month follow-up, the median (IQR) total QoL score was 25 (27) in the 64 Gy 32 fraction group and 6 (14) in the 36 Gy/6 fraction group. At 12 months, the scores were 16 (35) and 3 (3), respectively.</p><p><strong>Conclusion: </strong>These findings suggest that the total radiation dose has a greater impact on urinary symptoms and QoL than the fractionation strategy. However, due to the low inclusion rate, these findings should be interpreted with caution.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"12 1","pages":"e21200033"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in genetic circuits as part of intelligent biotherapy for the treatment of bladder cancer: A review.","authors":"Chu Liu, Junlin Lu, Jiajian Lai, Kaiwen Jie, Tianxin Lin, Haifeng Wang, Xu Chen","doi":"10.14440/bladder.2024.0044","DOIUrl":"10.14440/bladder.2024.0044","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer poses a significant threat to human health. In recent years, genetic circuit therapy has emerged as a novel alternative for precision tumor treatment, demonstrating promising potential for clinical application. Compared to traditional drugs, genetic circuits - typically carried by plasmids - offer advantages such as modularity, druggability, and shorter drug development cycles. These circuits can identify multiple molecular signals from tumors and integrate them through logic gates to specifically target tumor cells. Furthermore, by assembling effector modules, they can induce specific forms of cell death in tumor cells or alter malignant phenotypes, thereby reshaping the immune microenvironment to produce efficient, durable, and controllable antitumor effects. The urinary system serves as an ideal model for this new therapy due to its accessibility from the outside. Several genetic circuits have already been validated for the treatment of bladder cancer. This review outlined the effectiveness and potential value of genetic circuits in bladder cancer therapy.</p><p><strong>Objective: </strong>This review focused on the design principles of genetic circuits, their ability to recognize and convert signals, their therapeutic signal output, and the associated delivery vehicles. We also discussed the challenges and future prospects of genetic circuits as a novel form of \"intelligent biotherapy.\"</p><p><strong>Conclusion: </strong>The gene circuit can identify multiple signals, processing complex information, and generating multiple effects, thus providing a new approach for personalized treatment of tumors.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"12 1","pages":"e21200032"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of mitotic figure counts in tumor progression of non-invasive high-grade papillary urothelial carcinoma of the urinary bladder: A retrospective study from a single cancer center.","authors":"Yan Hu, Susan Karki, Weiwei Chen, Yunguang Liu, Norbert Sule, Bo Xu","doi":"10.14440/bladder.2024.0021","DOIUrl":"10.14440/bladder.2024.0021","url":null,"abstract":"<p><strong>Background: </strong>Urothelial carcinoma (UC) is the most common type of bladder malignancy. Although the majority of UC present as non-invasive tumors, a subset of them progress into invasive cancer and cause significant morbidity and mortality.</p><p><strong>Objective: </strong>In this study, we examined the association between tumor mitotic activity associated and the progression of non-invasive high-grade papillary UC of the bladder.</p><p><strong>Methods: </strong>Forty-four cases of tumors that met the selection criteria were retrieved from the Department of Pathology archives, and, for each case, mitotic figures were counted in 10 high-power fields (HPF) by two independent pathologists. Tumor progression was defined as the invasion of the tumor into the subepithelial connective tissue (lamina propria) or beyond during follow-ups. In addition, tumors that later exhibited distant metastases were included in the tumor progression group.</p><p><strong>Results: </strong>Our study revealed that the average mitotic count per 10 HPF in the tumor progression group was significantly higher (<i>p =</i> 0.001) than in the progression-free group. Furthermore, tumors with more than three mitotic counts per HPF in initial biopsies posed a high risk of tumor progression within the 19.5 ± 6.1 months of follow-ups.</p><p><strong>Conclusion: </strong>The findings of our study provided valuable information for further stratification of risk factors among patients with non-invasive high-grade papillary UC of the bladder. Patients with high mitotic figure count in their initial biopsies should be monitored closely or treated earlier to prevent their tumors from progressing into invasive carcinoma.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"12 1","pages":"e21200026"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urethral bulking agents and pelvic floor muscle training for the treatment of stress urinary incontinence in female patients with multiple sclerosis.","authors":"Georgios Antoniadis, Ioannis Tsikopoulos, Aikaterini Tsionga, Konstantinos Galanoulis, Nikolaos Bousdroukis, Michael Samarinas","doi":"10.14440/bladder.2024.0049","DOIUrl":"10.14440/bladder.2024.0049","url":null,"abstract":"<p><strong>Background: </strong>Stress urinary incontinence (SUI), characterized by involuntary urine leakage during increased abdominal pressure, is prevalent among women with multiple sclerosis (MS), significantly impacting their quality of life (QoL). Traditional treatments are less suitable for MS patients due to potential complications, highlighting the need for less invasive alternatives, <i>that is</i>, urethral bulking agents (UBAs) and pelvic floor muscle training (PFMT). UBAs increase urethral tissue volume, while PFMT strengthens pelvic muscles. Despite promising outcomes, their efficacy in MS-related SUI is under-researched.</p><p><strong>Objective: </strong>This study assessed the effectiveness of UBAs and PFMT in managing SUI among female patients with MS.</p><p><strong>Methods: </strong>This nine-month study involved 14 female MS patients with moderate SUI, who were equally divided into two groups to evaluate the effectiveness of UBAs and PFMT. UBAs were administered through injections to enhance urethral resistance, while PFMT used guided exercises to improve pelvic control. Outcomes were assessed in terms of urinary pad usage, scores of International Consultation on Incontinence Questionnaire-Short Form, and QoL metrics to evaluate reductions in incontinence and symptom severity.</p><p><strong>Results: </strong>Both treatment groups showed significant improvement with SUI management. Daily pad usage decreased to 0-1 in both groups, with reductions in symptom severity and improvements in QoL scores. UBAs provided quicker symptomatic relief, while PFMT supported long-term management. However, two participants in the PFMT group discontinued follow-up due to MS-related complications, highlighting the challenges of maintaining adherence in progressive conditions.</p><p><strong>Conclusion: </strong>UBAs and PFMT are effective management options for SUI in MS patients, improving symptom control and QoL. This study underscored the importance of individualized, multimodal approaches to optimize outcomes for women with MS-related SUI. Nevertheless, further research is needed for long-term validation.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"11 4","pages":"e21200028"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}