Continence (Amsterdam, Netherlands)最新文献

{"title":"The first report of vesicovaginal fistula repair experience in Afghanistan","authors":"Zamari Noori ,&nbsp;Ghulam Rabbani Habibi ,&nbsp;Mohammad Arif Aslami ,&nbsp;Sayed Manan Hashemi ,&nbsp;Lina Naimi ,&nbsp;Mohammad Jawid Nazari ,&nbsp;Hadi Mostafaei ,&nbsp;Helia Mostafaei ,&nbsp;Hanieh Salehi-Pourmehr ,&nbsp;Sakineh Hajebrahimi","doi":"10.1016/j.cont.2025.102289","DOIUrl":"10.1016/j.cont.2025.102289","url":null,"abstract":"<div><h3>Background</h3><div>Vesicovaginal fistulas (VVF) are the most common type of acquired fistula, with various causes, etiologies, and management trends worldwide. We aimed to provide our first report on VVF repair experience in Afghanistan.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 46 patients who underwent VVF repair between June 2019 and June 2024. Preoperative assessment included physical examination, imaging, and cystoscopy. In cases where the diagnosis was uncertain, a patient-reported pad count (number of pads used per day) was recorded as a supplementary measure of incontinence severity. The surgical procedure involved a transabdominal transvesical approach with circumferential excision of a bladder mucosal cuff around the fistula; the fistulous tract itself was not excised. Closure was performed in two layers, and an interposition flap (peritoneal or omental) was utilized in all cases. Success was defined as the absence of urine leakage one month post-surgery. Postoperative management involved suprapubic catheter drainage for 10–15 days, antibiotics for one week, and antimuscarinics. Complications were classified using the Clavien-Dindo system.</div></div><div><h3>Results</h3><div>All 46 VVFs were of iatrogenic origin: 35 followed total hysterectomy and 11 followed Cesarean section. Seven fistulas were larger than 2.5 cm, and 39 were 1 cm or smaller. The mean follow-up period was 38.43 months. The surgical success rate was 100 %. There were no major complications (Clavien-Dindo class ≥2); five patients had a surgical site infection, and one had a hematoma that required drainage.</div></div><div><h3>Conclusion</h3><div>Transabdominal VVF repair with an interposition flap, utilizing a technique that preserves the fistulous tract, achieved a 100 % success rate in this cohort. This approach is a highly effective management strategy for iatrogenic VVF in a challenging healthcare setting.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"16 ","pages":"Article 102289"},"PeriodicalIF":1.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive symptoms as mediator between adverse childhood events and fecal incontinence and constipation in community-dwelling men and women","authors":"Dina M. Mahjoob ,&nbsp;Gommert A. van Koeveringe ,&nbsp;Marco H. Blanker ,&nbsp;Grietje E. Knol‐de Vries","doi":"10.1016/j.cont.2025.102287","DOIUrl":"10.1016/j.cont.2025.102287","url":null,"abstract":"<div><h3>Background</h3><div>Fecal incontinence (FI) and constipation affect quality of life and are influenced by intricate interactions between psychological and physiological factors. This study explores the association between adverse childhood events (ACEs) and adult bowel dysfunction (FI and constipation) in community-dwelling men and women, examining depressive symptoms as a potential mediator.</div></div><div><h3>Method</h3><div>A secondary analysis was conducted using baseline data from a population-based cohort (n = 1,691, age ≥16 years). Participants completed validated questionnaires on FI, constipation, history of emotional neglect, psychological, physical, sexual abuse, and depressive symptoms. Regression models were used, for men and women separately, to examine the associations between ACEs, FI, and constipation, and to test for mediation via depressive symptoms. Analyses were adjusted for age, body mass index, and smoking status.</div></div><div><h3>Result</h3><div>Complete data were available for 553 men and 787 women. Depressive symptoms significantly mediated the relationship between ACEs and both FI and constipation. For FI, ACEs had a small direct effect (β = 0.104, p &lt; 0.001) and a small, mediated effect (β = 0.057, p &lt; 0.001, Sobel test: z = 6.47). For constipation, ACEs showed a moderate direct effect (β = 0.171, p &lt; 0.001) and a moderate mediated effect (β = 0.130, p &lt; 0.001, Sobel test: z = 10.84).</div></div><div><h3>Conclusion</h3><div>Depression mediates the relationship between ACEs and bowel dysfunction, with a stronger role in constipation (moderate effect) compared to FI (small effect). These findings underscore the importance of addressing psychological factors and childhood adversity in understanding bowel dysfunction and informing clinical approaches.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"16 ","pages":"Article 102287"},"PeriodicalIF":1.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic dysreflexia during urodynamics: A systematic review of incidence and predictors","authors":"Yash Khanna ,&nbsp;Tran Ngoc An Huynh ,&nbsp;Paul Manohar","doi":"10.1016/j.cont.2025.102288","DOIUrl":"10.1016/j.cont.2025.102288","url":null,"abstract":"<div><h3>Objectives</h3><div>Urodynamic investigation is a mainstay in assessment of lower urinary tract dysfunction in spinal cord injury (SCI). However, like with many forms of urological intervention in the SCI cohort – it carries a risk of autonomic dysreflexia (AD). This systematic review aims to ascertain the incidence and predictors of autonomic dysreflexia during urodynamic investigation, in those with SCI.</div></div><div><h3>Methods</h3><div>Systematic review was conducted according to PRISMA guidelines, and prospectively registered on PROSPERO (ID CRD420251000507). Ovid MEDLINE, Embase, Web of Science Core Collection and CINAHL databases were searched.</div></div><div><h3>Results</h3><div>Of total 2098 articles screened, 21 were ultimately included for systematic review. Of the 21 included studies, 13 reported incidence of AD during urodynamics, with reported incidence varyingly broadly from 7.9 to 90.9 %. In studies reporting SCI above T6 specifically, incidence of AD during urodynamics varied from 42.5 to 83.7 %, while in studies reporting incidence in SCI below T6, incidence varied from 5.9 to 82.3 %. There was heterogeneity in results regarding predictors of AD during urodynamics: level of injury was generally predictive of AD incidence, completeness of injury and patient age did not predict AD incidence but did potentially predict severity, and data regarding urodynamic predictors (detrusor overactivity, detrusor-sphincter dyssynergia, compliance, detrusor pressures) was conflicting. Several studies had high proportion of silent/asymptomatic AD (38–63 %), hence some authors suggested continuous/beat-to-beat cardiac monitoring during urodynamics in SCI patients to allow early identification and intervention for AD.</div></div><div><h3>Conclusion</h3><div>This systematic review identified the incidence of AD during urodynamics in SCI to be high, although results regarding predictors of AD were variable. Clinicians should consider continuous cardiac monitoring during urodynamics in at-risk SCI patients, and remain vigilant to risk of AD in SCI below T6. Future studies should aim to adopt a universal definition of AD and be prospective, to permit statistical synthesis and meta-analysis to conclusively define predictors of AD during urodynamics.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"16 ","pages":"Article 102288"},"PeriodicalIF":1.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promotion of continence care in low resource settings: a needs assessment from 17 countries","authors":"Helia Mostafaei ,&nbsp;Andrew Gammie ,&nbsp;Sherif Mourad ,&nbsp;Hanieh Salehi-Pourmehr ,&nbsp;Sakineh Hajebrahimi","doi":"10.1016/j.cont.2025.102282","DOIUrl":"10.1016/j.cont.2025.102282","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Continence care remains a neglected area of health services in low-resource settings. This needs assessment aimed at exploring the organizational landscape, available support, and priority areas for strengthening continence care across 17 countries, with particular attention to awareness of and engagement with the International Continence Society (ICS).</div></div><div><h3>Methods</h3><div>A structured online survey was distributed to healthcare professionals involved in continence care. The questionnaire covered organizational affiliations, professional and patient support, educational needs, and preferred resources. Responses were analyzed descriptively.</div></div><div><h3>Key Findings and Limitations</h3><div>Twenty-two professionals, mainly urologists and urogynecologists from Afghanistan, Azerbaijan, Jordan, Egypt, UAE, The Gambia, Lebanon, Tanzania, Ghana, Pakistan, Armenia, Bangladesh, India, Turkey, and Iran, completed the survey. Many were affiliated with professional continence or urology/urogynecology organizations, indicating potential networks for collaboration. Support for healthcare providers and patients varied widely. Respondents emphasized the need for workshops, short courses, fellowships, and ICS lectures at regional conferences, along with translated patient information, online learning platforms, and affordable continence care materials. A strong interest in further engagement with the ICS was reported. Study limitations include the small sample size, potential self-selection bias, and a survey framed largely around ICS activities, which may have influenced responses.</div></div><div><h3>Conclusions and Clinical Implications</h3><div>This survey highlights unmet educational and resource needs in continence care across low-resource countries. Targeted interventions—such as professional training, accessible patient information, and low-cost materials—are required to strengthen services and improve quality of life for individuals with incontinence. Broader studies are needed to guide sustainable global initiatives.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"16 ","pages":"Article 102282"},"PeriodicalIF":1.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes and complications of augmentation cystoplasty in pediatric neurogenic bladder patients: A systematic review and meta-analysis","authors":"Putu Angga Risky Raharja,&nbsp;Vidi Ibrahim Pratomo Affandi,&nbsp;Fina Widia,&nbsp;Gerhard Reinaldi Situmorang,&nbsp;Harrina Erlianti Rahardjo,&nbsp;Arry Rodjani,&nbsp;Irfan Wahyudi","doi":"10.1016/j.cont.2025.102280","DOIUrl":"10.1016/j.cont.2025.102280","url":null,"abstract":"<div><h3>Background</h3><div>Augmentation cystoplasty (AC) is a surgical procedure used to manage pediatric neurogenic bladder (NB) when conservative treatments fail. While AC improves bladder function and continence, it carries significant long-term risks. This systematic review and meta-analysis evaluate the functional benefits and complications of AC in pediatric NB patients.</div></div><div><h3>Methods</h3><div>A comprehensive search of PubMed, Embase, Scopus, Web of Science, <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, and the Cochrane Library was conducted from inception until February 14, 2025. Eligible studies included pediatric patients (≤18 years) with NB who underwent AC. Primary outcomes were continence improvement and bladder capacity increase, while secondary outcomes included complications such as bladder stones, perforation, and reoperation rates. A one-group meta-analysis was performed using logit transformation for categorical outcomes and weighted mean differences (WMD) for continuous outcomes. Heterogeneity was assessed using I² statistics.</div></div><div><h3>Results</h3><div>Nine retrospective cohort studies comprising 696 pediatric patients were included. The pooled continence improvement rate was 78.1 % (95 % CI: 62–89 %), and bladder capacity increased by 82.1 % (95 % CI: 64.3–99.9 %). The incidence of bladder stones was 19.3 %, bladder perforation was 6.0 %, and reoperation occurred in 24 % of cases. Significant heterogeneity was observed for reoperation rates (I² = 97 %).</div></div><div><h3>Conclusion</h3><div>AC effectively improves continence and bladder capacity in pediatric NB patients, but it carries a substantial risk of complications. The high reoperation and complication rates underscore the need for careful patient selection, standardized surgical techniques, and structured follow-up.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"16 ","pages":"Article 102280"},"PeriodicalIF":1.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased prevalence of type 2 diabetes mellitus in urologic chronic pelvic pain syndrome","authors":"Benjamin E. Rubin ,&nbsp;Jacob I. Bleau ,&nbsp;Curtis A. Plante ,&nbsp;Craig V. Comiter","doi":"10.1016/j.cont.2025.102281","DOIUrl":"10.1016/j.cont.2025.102281","url":null,"abstract":"<div><h3>Background and objective</h3><div>Urologic chronic pelvic pain syndrome (UCPPS) includes interstitial cystitis/bladder pain syndrome (IC/BPS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). These conditions, hypothesized to be inflammatory in nature, are characterized by pelvic pain and urinary symptoms. Recent research has identified a higher prevalence of type 2 diabetes mellitus (T2DM) in females with IC/BPS; however, this association remains underexplored in males with CP/CPPS.</div></div><div><h3>Methods</h3><div>We conducted an observational study using the TriNetX database from 2004 to 2024. Males and females (≥18 years) were categorized into cohorts based on IC/BPS or CP/CPPS diagnoses. Each cohort was compared to a control group using propensity score matching based on age and BMI. Odds ratios (ORs) with 95 % confidence intervals were calculated for T2DM prevalence.</div></div><div><h3>Key findings and limitations</h3><div>T2DM was more prevalent in patients with UCPPS than in controls. Among IC/BPS patients, the OR for T2DM was 2.27 in males and 1.54 in females. In males with CP/CPPS, the OR was 1.75. All associations were statistically significant (p &lt; 0.0001). The use of ICD-10 codes introduces the potential for misclassification and missing data. Additionally, the severity of UCPPS cannot be captured using only ICD-10 codes.</div></div><div><h3>Conclusions</h3><div>Our findings demonstrate a significant association between UCPPS and T2DM, particularly in males with IC/BPS and CP/CPPS. The increased T2DM prevalence in IC/BPS aligns with prior studies. These results suggest shared inflammatory or metabolic pathways and support consideration of T2DM screening in this population. Further research is warranted to elucidate underlying mechanisms linking chronic pelvic pain and T2DM.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"16 ","pages":"Article 102281"},"PeriodicalIF":1.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing neuro-urology in Ukraine – a better future for paraplegic patients","authors":"Ruth Kirschner-Hermanns","doi":"10.1016/j.cont.2025.102278","DOIUrl":"10.1016/j.cont.2025.102278","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"16 ","pages":"Article 102278"},"PeriodicalIF":1.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of bladder outlet obstruction after stress urinary incontinence surgery in women: Results of a North American Survey among surgeons","authors":"Andry Perrin ,&nbsp;Lysanne Campeau ,&nbsp;Jas Singh ,&nbsp;Jacques Corcos","doi":"10.1016/j.cont.2025.102277","DOIUrl":"10.1016/j.cont.2025.102277","url":null,"abstract":"<div><h3>Introduction</h3><div>To gather expert opinion and describe trends in the management of early and prolonged bladder outlet obstruction following stress urinary incontinence surgery.</div></div><div><h3>Methods</h3><div>Expert physicians and members of the Society of Urodynamics, Female Pelvic Medicine &amp; Urogenital Reconstruction (SUFU), were queried by means of an online survey regarding the management of bladder outlet obstruction following stress urinary incontinence surgery.</div></div><div><h3>Results</h3><div>Sixty surgeons answered the questionnaire (9 %). Most responders performed &gt;20 sling procedures per year, and 15 % of them were autologous fascial pubovaginal slings. The estimated prevalence of complete postoperative urinary retention was 3 %. The prevalence of post-void residual volume ≥200 ml, was estimated around 8 %. Of those presenting with post-void residual ≥200 ml, 35 % were symptomatic. For a inability to void 48 h after synthetic mid-urethral sling insertion, most responders would observe for a week before planning an incision of the sling. In the case of post-void residual ≥200 ml, the trend of the majority would be observation. In patient in inability to void 48 h following autologous fascial pubovaginal sling procedure, most participants would offer observation, as well as if the patient presented with post-void residual ≥200 ml.</div></div><div><h3>Conclusions</h3><div>According to expert opinion, although we could highlight some trends in the management of bladder outlet obstruction associated with urinary retention following the surgical management of female stress urinary incontinence, particularly with regards to observation, there was no consensus on the management in terms of method or timing of surgical revision.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 102277"},"PeriodicalIF":1.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ICS teaching module: Urodynamic testing for patients with post radical prostatectomy urinary incontinence","authors":"Carlos Arturo Levi D'Ancona ,&nbsp;Tufan Tarcan ,&nbsp;Stefania Musco ,&nbsp;Arthur Degani Ottaiano ,&nbsp;Peter F.W.M. Rosier","doi":"10.1016/j.cont.2025.102275","DOIUrl":"10.1016/j.cont.2025.102275","url":null,"abstract":"<div><h3>Aim</h3><div>To present the body of evidence on the practice of assessment and diagnosis of lower urinary tract dysfunction (LUTD) in post radical prostatectomy urinary incontinence (PRP-UI). This serves as a scientific background overview for a presentation made available on the International Continence Society (ICS) website.</div></div><div><h3>Methods</h3><div>ICS-Teaching module prepared by an ad-hoc working group instituted by the ICS Urodynamics Committee using an expert literature review focusing on guidelines and clinical practice and consensus formation by the members of the working group. Finally, the content was reviewed by the core members of the ICS Urodynamics and Standardisation Steering Committees.</div></div><div><h3>Results</h3><div>In addition to non-invasive initial assessment of PRP-UI, clinical practice guidelines state that a specialist (urologist-) assessment includes performing or considering invasive urodynamics to evaluate LUT functions before surgical treatment. We explain the practical elements and consequences of this.</div></div><div><h3>Conclusions</h3><div>This module provides expert guidance on the diagnosis of dysfunction in patients with signs and symptoms of PRP-UI. The coexistence of (other) LUTD with UI is plausibly relevant to management selection, although prospective evidence for this is understudied. Standard urodynamic techniques can be used but should in certain cases be adapted and supplemented for the testing of patients with PRP-UI.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 102275"},"PeriodicalIF":1.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Urinary Tract Dysfunction in Uncommon Neurological Diseases – Part IV: Infections, Inflammatory, Toxic, and Structural Disorders – A NUPC Report","authors":"Charalampos Konstantinidis ,&nbsp;Ryuji Sakakibara ,&nbsp;Desiree Vrijens ,&nbsp;Glenn T. Werneburg ,&nbsp;Blayne Welk ,&nbsp;Stephanie Kotes ,&nbsp;Marcus J. Drake ,&nbsp;Christina – Anastasia Rapidi ,&nbsp;Cristiano M. Gomes ,&nbsp;Luis Abranches-Monteiro ,&nbsp;Kadir Onem ,&nbsp;Stefan de Wachter ,&nbsp;Sanjay Sinha","doi":"10.1016/j.cont.2025.102274","DOIUrl":"10.1016/j.cont.2025.102274","url":null,"abstract":"<div><div>The manuscript examines the impact of various rare neurological disorders on lower urinary tract dysfunction (LUTD), building upon previous parts of this series. It discusses several infections and their sequelae, such as Neuroborreliosis (Lyme Disease), Herpes Zoster (HZ), and Neurosyphilis. Lyme Disease is a vector-borne infection leading to storage and voiding symptoms. Herpes Zoster (HZ) is associated with various types of LUTD due to its effect on spinal nerves. Neurosyphilis, historically, is a common cause of LUTD due to the degeneration of the spinal cord. In the manuscript, other miscellaneous conditions, such as Radiation Myelopathy, Decompression Sickness and Charcot Spine, are also discussed. Radiation Myelopathy is a chronic condition affecting bladder function post-radiation therapy. Decompression Sickness occurs in scuba divers and can lead to LUTD as a neurological complication. Charcot Spine represents a destructive spinal condition that can lead to LUTD and may require intensive management. Some degenerative disorders such as Progressive Multifocal Leucoencephalopathy (PML), Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), RSF1 related disorder – CANVAS (Cerebellar Ataxia, Neuropathy, Vestibular Areflexia Syndrome), Acute Disseminated Encephalomyelitis (ADEM) and Spinal Cord Sarcoidosis which have varying impacts on LUT function are also included in this report. Additionally, the paper includes two metabolic and toxic myelopathies (severe B12 deficiency and Nitrous oxide myelopathy), which may cause LUTD.</div><div>The document emphasizes the necessity for urologists to recognize and manage LUTD in patients with these uncommon neurological conditions, promoting a comprehensive understanding of their overlaps in clinical symptoms. The overall goal is to better inform clinicians and aid in patient management by summarizing current knowledge and encouraging further research. This serves as the fourth installment in a series aiming to provide insights into rare neuro-urological diseases.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 102274"},"PeriodicalIF":1.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}