Continence (Amsterdam, Netherlands)最新文献

{"title":"The role of urodynamic study in pudendal nerve entrapment syndrome","authors":"C. Fernandes ,&nbsp;V. Viegas ,&nbsp;A. Artiles Medina ,&nbsp;J. Morale Herrea ,&nbsp;J. Casado ,&nbsp;L. Vega ,&nbsp;C. Luque ,&nbsp;L. San José ,&nbsp;L. López-Fando Lavalle","doi":"10.1016/j.cont.2025.101917","DOIUrl":"10.1016/j.cont.2025.101917","url":null,"abstract":"<div><h3>Introductions and aims:</h3><div>Pudendal nerve entrapment is a rare cause of pelvic pain that can be associated with lower urinary tract symptoms (LUTS). The LUTS incidence among PNE patients and the urodynamic study (UDS) role are underexplored. This study aims to explore the role of the UDS in PNE diagnosis and describe the prevalence of LUTS in this population.</div></div><div><h3>Material and methods:</h3><div>This retrospective, multicentric, cross-sectional study analyzed 144 patients with suspected PNE syndrome between 2016 and 2024. Electronic medical urology records of chronic pelvic pain patients were evaluated. The diagnosis of PNE was established based on neurophysiological tests (NFS) and response to pudendal nerve block. Complaints of LUTS were recorded, and UDS was systematically performed as part of the diagnostic course. PNE patients with LUTS who underwent surgery were evaluated considering LUTS and pain improvement at 12 months postoperatively.</div></div><div><h3>Results:</h3><div>A total of 87 patients (60.4%) were diagnosed with PNE. Among them, 51% reported LUTS, with a similar prevalence in women (56%) and men (55%). A statistically significant difference was found between gender and UDS dysfunction (<span><math><mrow><mi>p</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>013</mn></mrow></math></span>), with underactive detrusor predominance in women (44%) and bladder outlet obstruction in men (40%). LUTS were more prevalent in patients with CPP from other causes, in both females (<span><math><mrow><mi>p</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>027</mn></mrow></math></span>) and males (<span><math><mrow><mi>p</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>030</mn></mrow></math></span>). UDS dysfunctions showed a statistically significant difference between PNE and other CPP causes only in females (<span><math><mrow><mi>p</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>023</mn></mrow></math></span>). Female PNE patients have more UDS anomalies in comparison to CPP from other causes. Of the PNE patients with LUTS, only 24 (60%) underwent surgery, and 11 (45.8%) experienced symptom improvement. In the univariate analysis, UDS results did not predict LUTS improvement after surgery (<span><math><mrow><mi>p</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>680</mn></mrow></math></span>).</div></div><div><h3>Conclusion:</h3><div><em>LUTS are highly prevalent in PNE and detectable in UDS. Assessing u</em>rinary symptoms is crucial in <em>PNE evaluation.</em> Urodynamic tests help clarify if LUTS stems from PNE or other CP causes. However, UDS findings do not predict LUTS improvement after surgery.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 101917"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330557","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 primary bladder neck obstruction in conditions associated with hyperadrenergic signaling","authors":"Benjamin E. Rubin ,&nbsp;Jacob I. Bleau ,&nbsp;Curtis A. Plante ,&nbsp;Craig V. Comiter","doi":"10.1016/j.cont.2025.101911","DOIUrl":"10.1016/j.cont.2025.101911","url":null,"abstract":"<div><div>Voiding dysfunction in primary bladder neck obstruction (PBNO) results from incomplete relaxation of the bladder neck, creating a functional obstruction. The efficacy of alpha-adrenergic antagonists supports the contention that adrenergic overactivity may contribute to increased bladder neck tone. This study examines the association between hyperadrenergic conditions and PBNO prevalence.</div><div>We conducted an observational study using the TriNetX database from 2004–2024. Males and females (<span><math><mo>≥</mo></math></span>18 years) were stratified into cohorts based on common disease states associated with hyperadrenergic signaling: anxiety, hypertension, obstructive sleep apnea, or heart failure. Each cohort was propensity score-matched to controls by age and BMI. Odds ratios (OR) with 95% confidence intervals (CIs) were calculated for PBNO prevalence, with statistical significance set at p &lt; 0.01.</div><div>PBNO prevalence was significantly higher in all hyperadrenergic cohorts than in control groups without the diseases. Hypertension showed the strongest association, with ORs of 3.86 (males) and 4.96 (females). Anxiety also demonstrated substantial associations (ORs: 2.68 males, 3.14 females). All comparisons were statistically significant (p &lt; 0.0001).</div><div>Our findings demonstrate a significant association between conditions characterized by increased adrenergic signaling and PBNO. The consistently higher ORs observed across all studied conditions, particularly hypertension and anxiety disorders, support the hypothesis that adrenergic overactivity may contribute to PBNO pathogenesis. These results suggest that patients with hyperadrenergic conditions may be at increased risk for PBNO and could benefit from targeted screening. Clinicians should consider the potential impact of these systemic conditions when evaluating and managing patients with lower urinary tract symptoms suggestive of PBNO.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 101911"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230450","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":"Urethral lesion by the cuff of the artificial urinary sphincter: A systematic review of optimal management at time of explantation","authors":"Lukas Costa de Salles,&nbsp;Carlos Arturo Levi D’Ancona,&nbsp;Juliano Cesar Moro,&nbsp;Arthur Degani Ottaiano","doi":"10.1016/j.cont.2025.101899","DOIUrl":"10.1016/j.cont.2025.101899","url":null,"abstract":"<div><h3>Introduction and Objective</h3><div>: Artificial Urinary Sphincter (AUS) is the gold standard for Stress urinary incontinence (SUI) surgical treatment. This systematic review pursues the optimal course of action during AUS cuff explantation due to urethral cuff erosion, the device’s main complication.</div></div><div><h3>Methods:</h3><div>Systematic review of Medline, Embase, Cochrane Library, and Scielo databases following the PRISMA statement, from January 2014 to April 2024. The risk of bias was assessed using the “Newcastle–Ottawa Scale for cohorts” and “Critical Appraisal Checklist for Case Series”. Our primary outcome was the stricture rate after treatment. There was no external funding for this review.</div></div><div><h3>Results</h3><div>: Of 362 initial studies, six were included, with 277 patients. There were five retrospective single-center studies and one multicentric study. Pelvic irradiation was a risk factor for cuff erosion and stricture formation. Severe lesions (larger than 33% of the urethra) are at higher risk for stricture development and present poor results when treated conservatively. Mild lesions (smaller than 33%) showed no difference between urinary diversion and surgical repair.</div></div><div><h3>Conclusions:</h3><div>Mild lesions should be addressed with urethral catheterization for 3-6 weeks associated with a suprapubic tube. Severe erosions should receive surgical correction. Prospective, randomized studies are needed.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 101899"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167365","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":"Ketamine-induced uropathy","authors":"Hann-Chorng Kuo","doi":"10.1016/j.cont.2025.101907","DOIUrl":"10.1016/j.cont.2025.101907","url":null,"abstract":"<div><div>Ketamine induced uropathy has become a new bladder pain syndrome affecting the bladder, kidney, and quality of life in ketamine abusers. Ketamine-associated cystitis (KC) is an emerging public health concern, particularly among young adults who abuse ketamine recreationally and, to a lesser extent, in patients receiving ketamine therapeutically for depression. Although currently rare in clinical psychiatry, the incidence of KC might rise as ketamine-based therapies become more prevalent. This manuscript reviews recent knowledge in the ketamine induced uropathy and potential clinical implications.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 101907"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178257","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":"In how many patients urodynamics should be omitted? Data from a single-centre database on the basis of the upstream trial","authors":"Eleonora Rosato ,&nbsp;Maria Cristina Mancini ,&nbsp;Giorgio Cerrelli ,&nbsp;Francesco Di Rocco ,&nbsp;Luca Orecchia ,&nbsp;Giuseppe Farullo ,&nbsp;Andrea Turbanti ,&nbsp;Simone Pletto ,&nbsp;Yuri Cavaleri ,&nbsp;Enrico Finazzi Agrò","doi":"10.1016/j.cont.2025.101903","DOIUrl":"10.1016/j.cont.2025.101903","url":null,"abstract":"<div><h3>Objective:</h3><div>The role of invasive urodynamics (iUDS) before surgery for benign prostatic obstruction (BPO) is debated. The UPSTREAM trial showed that adding iUDS to routine care does not decrease the number of patients who will undergo surgery nor ensure better outcomes after surgery. Ito and coworkers showed that patients could be divided into two categories according to certain parameters. The primary aim of this study was to determine the proportion of patients with BPO undergoing iUDS who exhibit characteristics predictive of good surgical outcome.</div></div><div><h3>Methods:</h3><div>This retrospective study included consecutive male patients with BPO and lower urinary tract symptoms (LUTS) who underwent iUDS at our centre between January 2013 and March 2024. Patients were categorized based on UPSTREAM trial criteria for good surgical outcomes (IPSS &gt; 16, IPSS QoL &gt; 4, <span><math><msub><mrow><mi>Q</mi></mrow><mrow><mi>max</mi></mrow></msub></math></span> &lt; 9.8 mL/s, age <span><math><mo>≤</mo></math></span> 74 years). Further analysis examined bladder outlet obstruction index (BOOI <span><math><mo>≥</mo></math></span> 48) and bladder contractility index (BCI <span><math><mo>≥</mo></math></span> 123).</div></div><div><h3>Results:</h3><div>Among 212 patients analysed, 38.2% met all criteria for good surgical outcomes, while 61.8% exhibited at least one unfavourable criterion. In particular, 90/131 patients had one unfavourable criterion, 32/131 had two, and 9/131 had three. Among these patients, concerning BOOI and BCI analysis, 74% had a BCI &lt; 123, 48.1% had a BOOI &lt; 48, and 45% had both a BCI &lt; 123 and BOOI &lt; 48.</div></div><div><h3>Conclusion:</h3><div>Our findings suggest that fewer than 40% of patients undergoing iUDS before potential BPO surgery have a good prognosis based on clinical characteristics. Among those with ‘unfavourable criteria’, given the high prevalence of detrusor underactivity (DU) and non-obstructive profiles, urodynamics may refine and optimize surgical selection.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"14 ","pages":"Article 101903"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084750","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":"Pharmacovigilance of lower urinary tract adverse events among commonly prescribed medications: A FAERS database analysis","authors":"Robert Adler,&nbsp;Michael Kozlov,&nbsp;Mark M. Shimanov ,&nbsp;Dylan S. Davie ,&nbsp;Benjamin Mishail ,&nbsp;David Musheyev,&nbsp;Jeffrey P. Weiss","doi":"10.1016/j.cont.2025.101902","DOIUrl":"10.1016/j.cont.2025.101902","url":null,"abstract":"<div><h3>Background:</h3><div>Lower urinary tract symptoms (LUTS) are a diverse group of urologic conditions characterized by dysfunction in storage, voiding, and post-micturition control. Previous studies estimate that medications account for 10% of LUTS in men. Pharmacovigilance studies, such as those using the Food and Drug Administration (FDA) Adverse Events Reporting System (FAERS), aid physicians in identifying adverse reactions and potential mechanisms to improve clinical practice. Our study sought to identify drugs that are potentially associated with LUTS and investigate the relationship between a variety of commonly prescribed medications and various LUTS.</div></div><div><h3>Methods:</h3><div>The FAERS Database was queried for a list of 17 Reaction Terms. Proportion of drug reactions to total and proportional reporting ratios were calculated for each drug. FDALabel was used to determine whether any LUTS were within the side effect profile of a drug.</div></div><div><h3>Results:</h3><div>LUTS accounted for .8% of total adverse reactions. Mirabegron (14.39) had the highest proportion of LUTS events compared to all adverse events, followed by Tolterodine Tartrate (10.95) Fesoterodine Fumarate (7.20), Tamsulosin Hydrochloride (7.07), and Warfarin Sodium (6.46). Other classes such as immunotherapeutics, proton pump inhibitors, and various psychiatric medications reported LUTS that were not within the FDALabel.</div></div><div><h3>Conclusion:</h3><div>Medications causing LUTS encompass a wide variety of classes. We discovered several medications for which FDA labels were inconsistent with reporting of adverse events. Physicians should be aware of potential medications that have not been previously reported to cause LUTS or do not contain specific LUTS within their FDA label.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"14 ","pages":"Article 101902"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116972","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":"Undiagnosed neurologic disease in refractory chronic pelvic pain: High yield in screen-positive patients","authors":"Talia Denis ,&nbsp;Dyer Pettijohn ,&nbsp;Elise J.B. De ,&nbsp;Charles E. Argoff","doi":"10.1016/j.cont.2025.101900","DOIUrl":"10.1016/j.cont.2025.101900","url":null,"abstract":"<div><h3>Introduction:</h3><div>Primary management of chronic pelvic pain depends on identifying and addressing its underlying etiologies. The prevalence of neurological conditions in the setting of chronic pelvic pain is poorly documented. In this study, we actively screened patients with chronic pelvic pain within our combined Urology/Urogynecology/Neurology Pain Management specialty clinics for multidisciplinary pelvic symptomatology, including neurologic, and, if present, facilitated multidisciplinary assessment of the patient.</div></div><div><h3>Methods:</h3><div>A standardized, systematic neurological history and physical was conducted when screening suggested a structural or functional nervous system disorder. Subsequent neurological testing was tailored to the clinical findings.</div></div><div><h3>Results:</h3><div>Of 188 patients who screened positive for neurological symptoms and signs and initiated combined evaluation, 126 (67%) completed recommended neurological evaluation and testing. Of the 126 who completed workup, 92 (73%) were found to have objective evidence of a neurological disorder, of which 77 (84%) were new diagnoses. The most common diagnoses included small fiber neuropathy, large fiber neuropathy, lumbosacral radiculopathy, and severe spinal stenosis.</div></div><div><h3>Conclusion:</h3><div>Neurologic disease is prevalent in people with chronic pelvic pain who have neurologic symptoms and signs. Most of the neurologic diagnoses in this study were previously unidentified; thus, many patients had experienced neurodiagnostic delay. Screening for neurologic symptomatology is recommended in patients with chronic pelvic pain to facilitate diagnostic accuracy.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"14 ","pages":"Article 101900"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084749","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":"Soluble vascular endothelial growth factor receptor 1 (VEGFR1): A possible biomarker in BPS/IC?","authors":"Pedro Abreu-Mendes ,&nbsp;Rui Almeida Pinto ,&nbsp;Diogo Dias ,&nbsp;Francisco Cruz ,&nbsp;Ana Charrua","doi":"10.1016/j.cont.2025.101898","DOIUrl":"10.1016/j.cont.2025.101898","url":null,"abstract":"<div><h3>Introduction:</h3><div>Interstitial cystitis/bladder pain syndrome (IC/BPS) pathophysiology is not fully understood. Vascular endothelial growth factor (VEGF) has been implicated in bladder vasculature alterations and nociception, but the role of its soluble receptor, VEGFR1, remains poorly explored. This study aimed to determine whether urinary VEGF and VEGFR1 levels could be biomarkers for IC/BPS. As a post hoc analysis, we also examined VEGFR1 variation and its relationship with the clinical characteristics of IC/BPS patients and urinary serotonin levels.</div></div><div><h3>Material and Methods:</h3><div>An observational cross-sectional pilot study was conducted after clearance from the ethics committee. Eighteen female IC/BPS patients and 19 healthy age-matched females without past urological conditions were included. ESSIC criteria were used to phenotype. The patient’s symptoms evaluated were bladder pain, urinary frequency, and life quality. Patients during flare episodes or taking antidepressant drugs were excluded. Urine samples from patients and healthy subjects were used to measure VEGF, VEGFR1, and serotonin urinary levels. The relation of VEGFR1 with serotonin and clinical parameters was assessed.</div></div><div><h3>Results:</h3><div>Patients and healthy volunteers had a similar median age. No statistical differences in VEGF were detected. Urinary VEGFR1 was significantly lower in patients. Soluble VEGFR1 did not correlate to serotonin levels or clinical parameters. The urinary serotonin levels were similar between groups.</div></div><div><h3>Conclusion:</h3><div>Urinary VEGFR1, but not urinary VEGF, might be a useful IC/BPS biomarker. Further investigation is necessary to confirm the present observation and validate the relationship of VEGFR1 with clinical parameters and serotonin.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"14 ","pages":"Article 101898"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069806","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":"A deeper exploration of functional connectivity of brain regions regulating bladder function in healthy adults","authors":"Arda Bayer ,&nbsp;Kris Hoffman ,&nbsp;Betsy Salazar ,&nbsp;Behnaam Aazhang ,&nbsp;Rose Khavari","doi":"10.1016/j.cont.2025.101897","DOIUrl":"10.1016/j.cont.2025.101897","url":null,"abstract":"<div><div>Functional magnetic resonance imaging (fMRI) has been the primary tool in human research for studying and advancing our understanding of neural control of the bladder. Although the current working model identifies several brain regions involved in bladder storage, there are unknowns regarding the full extent of collaboration among these regions. This study analyzes the changes in the resting state functional connectivity (rsFC) network involving regions of the brain, brainstem, and cerebellum in healthy adults with respect to conventional pairwise rsFC and four rsFC global network statistics. Healthy adult males and females (n=15), ages 22–33, were asked to consume 472–750 mL of water, empty their bladder, and enter the fMRI scanner, after which the “control” resting-state fMRI (rs-fMRI) scans were obtained. Participants remained in the scanner until they indicated a feeling of strong desire to void, or until 10 min had elapsed, at which point “strong desire to void” rs-fMRI scans were acquired. Functional connectivity (FC) analysis was performed using 19 <em>a priori</em> regions of interest (ROIs) in the brain, specifically incorporating the brainstem and cerebellum from previous studies. Statistical significance was gauged via t-tests with Bonferroni correction for multiple hypothesis testing. Our results revealed significance, p&lt;0.05, in the rsFC network, where the average rsFC during the strong sensation state was higher than in the control state. The pontine micturition center and cerebellum were associated with this significant increase in the average degree of 19 ROIs. The contrasts in network statistics were more substantial than the contrasts in pairwise rsFC.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"14 ","pages":"Article 101897"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941705","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":"Factors contributing to bladder fibrosis","authors":"Karl Swärd ,&nbsp;Karl-Erik Andersson ,&nbsp;Bengt Uvelius","doi":"10.1016/j.cont.2025.101763","DOIUrl":"10.1016/j.cont.2025.101763","url":null,"abstract":"<div><h3>Background:</h3><div>Bladder outlet obstruction, commonly resulting from benign prostatic hyperplasia or congenital urethral valves, is a prevalent cause of voiding dysfunction. This condition induces significant bladder hypertrophy, alters excitability, and increases residual urine. Obstruction has been extensively studied in experimental animal models using surgical obstruction. A frequent pathological endpoint is bladder fibrosis, characterized by structural and functional deterioration of the bladder wall</div></div><div><h3>Objective:</h3><div>This article examines the pathophysiological mechanisms linking bladder outlet obstruction to fibrosis, with particular attention to bladder wall overstretch, compromised perfusion, and neural impairment</div></div><div><h3>Methods:</h3><div>We conducted a targeted literature review, employing search terms including urinary bladder, obstruction, hypoxia, and fibrosis. In addition, we analysed a bank of electron micrographs and publicly available microarray datasets derived from obstructed rat bladders to support our synthesis of experimental findings</div></div><div><h3>Key Findings:</h3><div>Our analysis underscores the intricate interplay among mechanical forces, neural input, and molecular signalling in the pathogenesis of bladder fibrosis secondary to outlet obstruction. We present a flow chart that models fibrosis progression in obstructed rat bladders. This algorithm synthesizes experimental data and incorporates key parameters such as bladder wall tension, hemodynamics, inflammatory cytokine levels, leading to expression of fibrosis-driving proteins.</div></div><div><h3>Conclusions:</h3><div>The proposed model offers a conceptual and analytical framework for studying fibrosis in the context of bladder outlet obstruction. It holds promise for guiding future research and informing the development of targeted therapeutic strategies aimed at interrupting the progression of bladder dysfunction driven by ischemia, oxidative stress, and chronic inflammation.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"14 ","pages":"Article 101763"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904195","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}