Bladder (San Francisco, Calif.)最新文献

{"title":"Treatment of stress urinary incontinence with a percutaneously implantable wireless microstimulator device (NuStim^®) plus pelvic floor muscle exercises: a pilot study.","authors":"Fan Zhang,&nbsp;Limin Liao","doi":"10.14440/bladder.2022.845","DOIUrl":"https://doi.org/10.14440/bladder.2022.845","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the utility and safety of pelvic floor muscle exercises in combination with a wireless percutaneously implantable microstimulator device (NuStim^®) for the treatment of stress urinary incontinence.</p><p><strong>Methods: </strong>In this prospective self-controlled pilot trial, three patients aged 35-75 years with incontinence symptoms were treated by pelvic floor muscle exercises plus implantation of NuStim^® from June 2017 to March 2019. The patients received 25 weeks of pelvic floor training, during which the patients' incontinence was quantitatively assessed by a 1-h pad test. Self-reported scores were used to rate the effect of treatment in terms of the quality of daily life, with pelvic floor muscle strength evaluated on the modified Oxford scale at each follow-up visit.</p><p><strong>Results: </strong>All three patients (2 males and 1 female) completed the trial without dropouts. The results showed that their incontinence symptoms were alleviated, as measured by a decrease in the normalized weight of the 1-h pad test, which presented a significant linear trend (<i>P</i> = 0.0021). An intragroup analysis revealed that all participants achieved statistically significant improvement in terms of the 1-h pad test score at 25 weeks as compared with pre-training findings. Nonetheless, no significant difference was found between the results of the other follow-up points and the baseline before treatment (<i>P</i> = 0.058). Comparison of the secondary outcome variable scores in each participant showed no significant difference at the conclusion of the study.</p><p><strong>Conclusions: </strong>Use of the NuStim^® during pelvic floor muscle exercises resulted in significant improvement in incontinence symptoms. The device was shown to be useful and safe as an adjunct to the pelvic floor training for the treatment of stress urinary incontinence.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":" ","pages":"e48"},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/1e/bladder-9-1-e48.PMC9680469.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40494186","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":"Safety and Effectiveness of Nustim System Implantation in Dogs.","authors":"Xing Li,&nbsp;Han Deng,&nbsp;Zhaoxia Wang,&nbsp;Hao Li,&nbsp;Limin Liao","doi":"10.14440/bladder.2022.844","DOIUrl":"https://doi.org/10.14440/bladder.2022.844","url":null,"abstract":"<p><strong>Objectives: </strong>To verify the safety and effectiveness of a novel micro-implantable wireless nerve stimulation device in healthy adult beagles and evaluate the feasibility of using the device in clinical practice.</p><p><strong>Methods: </strong>The stimulator was experimentally implanted into the quadriceps femoris of three adult beagles. The animals were subjected to training on daily basis for 14 days, and the threshold test was administered once a week. At the end, we analyzed the images of light microscopy and electron microscopy.</p><p><strong>Results: </strong>The implantation was easy to perform and the whole stimulation system worked stably and reliably. The stimulation threshold was stable. During the process, the stimulator did not move or cause damage to adjacent tissues. The whole system showed a good biocompatibility with recipient animals. The stimulator could induce muscular contraction and enhance the motor function of muscles.</p><p><strong>Conclusions: </strong>The preliminary results showed that the stimulator could be safely implanted into animal body, with good tissue compatibility, stability and reliability. In addition, it also worked well in eliciting muscle contraction. It promises to be used for the treatment of stress urinary incontinence in future.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":" ","pages":"e49"},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/52/54/bladder-9-1-e49.PMC9680465.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40494187","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":"Chinese botulinum toxin A for the treatment of lower urinary tract dysfunction: It works just as well.","authors":"Fan Zhang,&nbsp;Qinggang Liu,&nbsp;Limin Liao,&nbsp;Xiaojuan Li,&nbsp;Xueping Zhang","doi":"10.14440/bladder.2022.847","DOIUrl":"https://doi.org/10.14440/bladder.2022.847","url":null,"abstract":"<p><p>The botulinum neurotoxin type A (BoNT/A) is a neurotoxin produced by <i>Clostridium botulinum</i>. It causes botulism and represents the most powerful natural poison. In urological practice, the indications for BoNT/A therapy include neurogenic detrusor overactivity (NDO), idiopathic overactive bladder (OAB) or idiopathic detrusor overactivity (IDO), detrusor-sphincter dyssynergia (DSD), interstitial cystitis/bladder pain syndrome (IC/BPS), urinary tract infections (UTI), benign prostatic hyperplasia (BPH), and, more recently, chronic prostatic pain (CPP). BoNT/A is not only conducive to the treatment of muscle spasticity but also effectively works on hyperalgesia associated with various disorders of the lower urinary tract, thanks to its anti-nociceptive properties. While Botox^® (Allergan Inc., Irvine, CA) is currently being used across the globe, we have been using Chinese BoNT/A for many years for the treatment of DSD, NDO, idiopathic OAB, IC/BPS, BPH and UTI. Our experience showed that Chinese BoNT/A was as good as other BoNT/A products in terms of efficacy, safety, and tolerability. In this study, we explored the current and potential applications of Chinese BoNT/A in urology, and reviewed the background information regarding the toxin.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":" ","pages":"e47"},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/70/f8/bladder-9-1-e47.PMC9680463.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40722277","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":"Nerve-spring technique could achieve a functional trifecta outcome of robotic intracorporeal studer's orthotopic neobladder in the male.","authors":"Qiang Cheng,&nbsp;Liangyou Gu,&nbsp;Wenzheng Chen,&nbsp;Xupeng Zhao,&nbsp;Xin Ma,&nbsp;Xiao Chang,&nbsp;Qing Ai,&nbsp;Hongzhao Li","doi":"10.14440/bladder.2022.850","DOIUrl":"https://doi.org/10.14440/bladder.2022.850","url":null,"abstract":"<p><strong>Objectives: </strong>To summarize some key steps of functional improvement in robotic intracorporeal studer's orthotopic neobladder (RISON) of males, especially for nerve-spring technique. We also presented the result of 1-year follow-up aimed to illustrate its functional trifecta outcomes.</p><p><strong>Methods: </strong>Robotic radical cystectomy with intracorporeal studer's orthotopic neobladder was performed on 33 male patients by the same surgeon from April 2018 to March 2019. Nerve-sparing technique had been used in 11 of the 33 patients. A prospectively maintained dataset was retrospectively searched and the related perioperative and follow-up data were analyzed. The functional trifecta outcomes referred to the freedom from recurrence, urinary continence and sexual function recovery after one year.</p><p><strong>Results: </strong>A total of 33 males were included in our study. All perioperative information was recorded in detail. Thirty-two cases were confirmed to have negative surgical margin, except one pT3a case. And another case of incidental prostate cancer was diagnosed pathologically. All patients (100%) were recurrence-free one year after the operation. Eleven patients underwent nerve-sparing surgeries, including inter-fascial techniques or intra-fascial techniques. All these patients attained daytime continence (0 pad) at 1 month. With the nighttime continence, nerve-sparing group (2, 2,1) used fewer pads than other 22 cases (3, 3,2) at 1, 6 or 12 month(s) respectively. We defined urinary continence as 0 pad in daytime and no more than 1 pad in nighttime. The median preoperative score of International Index of Erectile Function (IIEF-6) in the 11 cases was 24. The sexual function recovery was defined as IIEF-6 > 20. The final trifecta rate was 54.5% and the median follow-up time lasted 17 months (range, 12 to 22 months).</p><p><strong>Conclusions: </strong>RISON could be a safe and feasible choice of urinary diversion. Nerve sparing techniques might help the patients achieve a relatively higher functional trifecta rate.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"9 1","pages":"e50"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/d7/bladder-9-1-e50.PMC10040301.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9589777","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":"Does deep brain stimulation improve Parkinson's disease-related lower urinary tract symptoms and voiding dysfunction?","authors":"Alexandra L Tabakin,&nbsp;Hari S G R Tunuguntla","doi":"10.14440/bladder.2021.825","DOIUrl":"https://doi.org/10.14440/bladder.2021.825","url":null,"abstract":"<p><p>Parkinson's disease (PD), caused by degeneration of dopaminergic neurons, leads to motor and autonomic symptoms. A large proportion of PD patients experience lower urinary tract symptoms (LUTS) and voiding dysfunction, associated with poor quality of life. Deep brain stimulation (DBS) is an adjunctive therapy used in combination with medication for Parkinsonian motor symptoms and is currently being explored to treat PD-related LUTS. This review discusses the current literature on the effects of DBS on lower urinary tract function and whether this modality can be used to modulate PD-related LUTS and voiding dysfunction.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"8 2","pages":"e46"},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/a7/bladder-8-2-e46.PMC8417036.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39416770","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":"Biomechanics of urinary bladder: slow-filling and slow-emptying cystometry and accommodation.","authors":"Wim A van Duyl","doi":"10.14440/bladder.2021.826","DOIUrl":"https://doi.org/10.14440/bladder.2021.826","url":null,"abstract":"<p><strong>Objective: </strong>In a concept of accommodation of detrusor pressure to volume as an autonomous potency of the bladder, a crucial physiological biomechanical role has been attributed to spontaneous contraction activity. This concept is experimentally investigated on pig bladder <i>in vitro</i>.</p><p><strong>Methods: </strong>Slowly emptying of not-stimulated pig bladders <i>via</i> a flow resistor has been recorded and the effect of spontaneous contractions on the tonic pressure during emptying by expulsion has been studied.</p><p><strong>Results: </strong>The expulsed volume can be separated in a reduction of elastic volume and of rest volume. Tonic pressure is determined by the elastic volume in combination with elastic compliance. In an accommodated state completely transient superimposed pressure waves affect rest volume not elastic volume. Accommodation of tonic detrusor pressure to bladder volume is based on equilibration between passive elongations and active transient contractions distributed in bladder wall.</p><p><strong>Conclusion: </strong>Maintenance of a tonic accommodated detrusor pressure to a constant or slowly varying volume, obtained by a process of equilibration between passive elongations and active contractions, can be understood as an autonomous potency of a bladder. The earlier presented concept of active accommodation has been validated by the experiments. The pressure-volume relation of the bladder is fundamentally revised. Total volume V can be virtually separated in an elastic volume V_E and a plastic or rest volume V_R. Both parts change with V and in changing ratio. Tonic pressure marks a border between V_E and V_R.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"8 1","pages":"e45"},"PeriodicalIF":0.0,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/78/bladder-8-1-e45.PMC8417037.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39416769","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":"Malakoplakia, a malignant mimic.","authors":"Cameron James Parkin,&nbsp;George Acland,&nbsp;Ban Sulaiman,&nbsp;Mark Louie Johnsun,&nbsp;Edward Latif","doi":"10.14440/bladder.2020.818","DOIUrl":"https://doi.org/10.14440/bladder.2020.818","url":null,"abstract":"<p><p>Malakoplakia is a chronic inflammatory condition that affects multiple systems, most commonly the urogenital tract. Its clinical presentation is often non-specific, but is typically characterized by recurrent urinary tract infections and haematuria. We report a rare case of intravesical malakoplakia mimicking an aggressive transitional cell carcinoma both in its clinical presentation and in its macroscopic appearance on cystoscopy in an 82-year patient, the oldest reported case in the literature. Malakoplakia has been described in the literature as a benign disease process presenting typically in younger patients. This case demonstrates its ability to cause obstructive uropathy and affect elderly patients. Thus, this case serves as a reminder to consider malakoplakia as a differential in the evaluation of suspected bladder malignancy in patients of all ages.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"7 3","pages":"e44"},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/f3/bladder-7-3-e44.PMC7483825.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38385288","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":"Classification of the urinary metabolome using machine learning and potential applications to diagnosing interstitial cystitis.","authors":"Feng Tong,&nbsp;Muhammad Shahid,&nbsp;Peng Jin,&nbsp;Sungyong Jung,&nbsp;Won Hwa Kim,&nbsp;Jayoung Kim","doi":"10.14440/bladder.2020.815","DOIUrl":"https://doi.org/10.14440/bladder.2020.815","url":null,"abstract":"<p><p>With the advent of artificial intelligence (AI) in biostatistical analysis and modeling, machine learning can potentially be applied into developing diagnostic models for interstitial cystitis (IC). In the current clinical setting, urologists are dependent on cystoscopy and questionnaire-based decisions to diagnose IC. This is a result of a lack of objective diagnostic molecular biomarkers. The purpose of this study was to develop a machine learning-based method for diagnosing IC and assess its performance using metabolomics profiles obtained from a prior study. To develop the machine learning algorithm, two classification methods, support vector machine (SVM) and logistic regression (LR), set at various parameters, were applied to 43 IC patients and 16 healthy controls. There were 3 measures used in this study, accuracy, precision (positive predictive value), and recall (sensitivity). Individual precision and recall (PR) curves were drafted. Since the sample size was relatively small, complicated deep learning could not be done. We achieved a 76%-86% accuracy with leave-one-out cross validation depending on the method and parameters set. The highest accuracy achieved was 86.4% using SVM with a polynomial kernel degree set to 5, but a larger area under the curve (AUC) from the PR curve was achieved using LR with a <i>l</i> ₁-norm regularizer. The AUC was greater than 0.9 in its ability to discriminate IC patients from controls, suggesting that the algorithm works well in identifying IC, even when there is a class distribution imbalance between the IC and control samples. This finding provides further insight into utilizing previously identified urinary metabolic biomarkers in developing machine learning algorithms that can be applied in the clinical setting.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"7 2","pages":"e43"},"PeriodicalIF":0.0,"publicationDate":"2020-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/80/c3/bladder-7-2-e43.PMC7401992.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38247411","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":"Repeat transurethral resection is still an essential tool in treating non-muscle invasive bladder cancer: the Western Australian experience.","authors":"Dwayne T S Chang,&nbsp;Alarick Picardo","doi":"10.14440/bladder.2020.814","DOIUrl":"https://doi.org/10.14440/bladder.2020.814","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the rate of residual disease and under-staging after primary transurethral resection (TUR) of bladder tumors (TURBT) in tertiary hospitals in Western Australia.</p><p><strong>Methods: </strong>A retrospective study was performed evaluating all patients with TaHG (stage Ta, high-grade), T1LG (stage T1, low-grade) or T1HG (stage T1, high-grade) bladder cancer on primary TURBT conducted between January 1, 2012 and December 31, 2017 at the four largest metropolitan public hospitals in Western Australia. Only patients who underwent repeat resection within 3 months from initial resection were included. Those with previous history of bladder cancer, incomplete follow-up data and visibly incomplete initial resection were excluded. Baseline patient demographics, macroscopic clearance at initial resection, and disease data at initial and repeat resections were recorded.</p><p><strong>Results: </strong>Sixty-seven patients with a median age of 71 years were included in this study. At initial resection, T1HG was the most common disease stage (64.2%) and detrusor muscle was present in 82.1% of initial resections. At repeat resection, 41.8% of cases had residual disease. The rate of upstaging to muscle-invasive bladder cancer was 3.0%. Patients treated by operators with five or less years of formal training did not have a significantly different rate of residual disease from patients treated by operators with more than five years of experience.</p><p><strong>Conclusions: </strong>Repeat TUR should remain an essential practice due to high rates of residual disease and a small risk of tumor under-staging. The presence of detrusor muscle and macroscopic clearance should not be used as surrogates for adequacy of resection or consideration of avoiding a repeat TUR, even for TaHG disease.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"7 2","pages":"e42"},"PeriodicalIF":0.0,"publicationDate":"2020-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/d1/bladder-7-2-e42.PMC7401982.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38247410","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":"Calcification of bladder wall after intravesical mitomycin C therapy: a case report and review of literature.","authors":"Dwayne T S Chang,&nbsp;Mikhail Lozinskiy","doi":"10.14440/bladder.2020.810","DOIUrl":"https://doi.org/10.14440/bladder.2020.810","url":null,"abstract":"<p><p>Bladder wall calcification is an under-reported adverse effect of intravesical mitomycin C therapy. We report our experience of a man who developed extensive bladder wall calcification within three weeks of being treated with just a single 40 mg dose of intravesical mitomycin C for non-muscle invasive, low-grade transitional cell carcinoma of the bladder. To date, only six other cases were reported in the scientific literature in English, all of which used higher doses of mitomycin and had a longer time to diagnosis than this case. We compared the salient points of this case with previously reported cases.</p>","PeriodicalId":72421,"journal":{"name":"Bladder (San Francisco, Calif.)","volume":"7 1","pages":"e41"},"PeriodicalIF":0.0,"publicationDate":"2020-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/a7/bladder-7-1-e41.PMC7401980.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38247409","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}