Continence (Amsterdam, Netherlands)最新文献

{"title":"Bladder outlet obstruction surgery in patients undergoing radiation therapy for prostate cancer: Adverse events, functional outcomes and quality of life — A scoping review","authors":"Casper Vrij ,&nbsp;John Heesakkers ,&nbsp;Evert Jan Van Limbergen ,&nbsp;Marc de Jong ,&nbsp;Ronald Bos ,&nbsp;Dennis Oerlemans ,&nbsp;Harman Maxim Bruins ,&nbsp;Nathalie Biemold ,&nbsp;Tom Marcellissen ,&nbsp;Kevin Rademakers ,&nbsp;Peter de Vries ,&nbsp;Elisabeth JM Driessen ,&nbsp;Frits van Osch ,&nbsp;Joep van Roermund ,&nbsp;Tom Hermans","doi":"10.1016/j.cont.2025.101747","DOIUrl":"10.1016/j.cont.2025.101747","url":null,"abstract":"<div><h3>Introduction:</h3><div>Lower urinary tract symptoms are common in patients with prostate cancer that undergo radiotherapy. Here, we summarize evidence concerning genitourinary toxicity, lower urinary tract function and quality of life in patients with bladder outlet obstruction prior- and post prostate radiation.</div></div><div><h3>Methods:</h3><div>Pubmed, Cochrane and Medline (OVID) were searched for relevant articles concerning genitourinary toxicity, lower urinary tract function and quality of life in patients with prior and post radiation undergoing desobstructive surgery. 529 articles were found, of which 29 were selected.</div></div><div><h3>Results:</h3><div>17 studies reported outcomes in patients undergoing desobstructive surgery before radiotherapy. For urinary adverse events data was inconclusive with some studies suggesting no difference in early or late toxicity (n <span><math><mo>=</mo></math></span> 4), while others suggested increased toxicity after desobstruction (n <span><math><mo>=</mo></math></span> 4). Studies serially assessing the international prostate symptom score did not find significant differences between baseline and last follow-up for patients with a history of prior transurethral resection of the prostate. 3 studies described favorable outcomes of neo-adjuvant desobstruction in patients undergoing brachytherapy. Although little data is available, bladder outlet obstruction surgery after radiotherapy is associated with high rates of toxicity (such as incontinence).</div></div><div><h3>Conclusion:</h3><div>There is insufficient evidence to strongly suggest increased toxicity and/or diminished lower urinary tract function in patients receiving radiotherapy after desobstructive surgery. Furthermore, desobstruction after radiotherapy is unfavorable. Additional research is needed to assess whether neoadjuvant desobstruction is protective against genitourinary toxicity and lower urinary tract dysfunction after radiation therapy.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101747"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420305","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":"High adherence to nocturnal-only frequency volume charts in diagnosing nocturia: A Pilot Study","authors":"Tasmia Promi ,&nbsp;Joel Thomas ,&nbsp;Gulzhan Tologonova ,&nbsp;Alana Kosches ,&nbsp;Thomas F. Monaghan ,&nbsp;Louis Salciccioli ,&nbsp;Marie-Claire Roberts ,&nbsp;Jeffrey P. Weiss ,&nbsp;Jason M. Lazar","doi":"10.1016/j.cont.2025.101745","DOIUrl":"10.1016/j.cont.2025.101745","url":null,"abstract":"<div><h3>Purpose:</h3><div>Quantitative assessment of urine output by means of a frequency volume chart (FVC) is a standard of care for the workup of nocturia but limited by suboptimal return rates and incomplete data entry. Nocturia, defined by the International Continence Society (ICS) as the need to wake at night to void, often necessitates comprehensive evaluation. While FVCs are typically maintained across the entire 24 h period, restricting urine collection to only the hours of intended sleep have been proposed as a patient-centered approach for increasing return rates. This study aimed to determine return rates for nocturnal-only FVCs and identify demographic or clinical factors affecting chart completion.</div></div><div><h3>Methods:</h3><div>Three prospective studies were conducted between 2021 and 2024 at a Brooklyn academic medical center. Study 1 investigated the relationship between nocturia and blood pressure (BP) elevation in adolescents. Study 2 evaluated fluid overload and its association with nocturia prevalence in adults. Study 3 investigated the relationship between nocturia and BP in adults. In each study, participants were provided containers and FVC sheets for nocturnal voiding documentation. Follow-up occurred via cellphone. Data included demographics, self-reported voids, and completed FVC information.</div></div><div><h3>Results:</h3><div>Among 349 patients, aged 10–103 years, the cumulative FVC return rate was 90.5% (95% CI 87.0%–93.4%). Age, gender, and race were similar among returners and non-returners. Non-returners, however, self-reported more voids, which may indicate differing behavioral or clinical characteristics. Among 316 patients who returned FVCs, 314 (99.4%) completed every required chart category (95% CI 97.7%–99.9%).</div></div><div><h3>Conclusions:</h3><div>Among three studies employing the use of nocturnal-only FVC return, there were high rates of FVC return and accurate completion. Although direct comparative data with 24 h FVCs were not assessed, the high adherence rates suggest nocturnal-only FVCs offer a patient-centered and effective alternative or complement for nocturia evaluation. Future studies comparing utility and return rates between nocturnal-only and 24 h FVCs may further elucidate their comparative effectiveness.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101745"},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420332","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":"Ultrasound imaging measures of contraction characteristics of deep and superficial pelvic floor muscles differ during voluntary tasks","authors":"Rafeef Aljuraifani,&nbsp;Ryan E. Stafford,&nbsp;Paul W. Hodges","doi":"10.1016/j.cont.2025.101751","DOIUrl":"10.1016/j.cont.2025.101751","url":null,"abstract":"<div><div><strong>Aim:</strong> Pelvic floor muscles (PFM) are arranged in deep and superficial layers, Although the superficial layer is commonly considered with respect to sexual function, preliminary evidence shows coordinated contraction of layers during voluntary and involuntary tasks that challenge continence and organ support. This study aimed to investigate contraction characteristics of deep and superficial PFM layers across a range of tasks using transperineal ultrasound imaging (US).</div></div><div><h3>Methods:</h3><div>Seventeen females without pelvic floor dysfunction participated. Displacement of pelvic floor landmarks produced by contraction of deep and superficial PFM was measured from US images recorded during: submaximal voluntary contractions (two different verbal instructions), maximal voluntary contraction (MVC), and a ramped Valsalva manoeuvre.</div></div><div><h3>Results:</h3><div>Times of onset and peak displacement of superficial PFM were earlier (0.29–0.36 s) than deep PFM during submaximal and MVC (P <span><math><mo>≤</mo></math></span> 0.01). Displacement amplitude was greater during MVC than submaximal tasks for deep (P <span><math><mo>&lt;</mo></math></span> 0.001) but not superficial (P <span><math><mo>&gt;</mo></math></span> 0.42) PFM. Shortening of deep PFM was sustained for longer (24.5(29.9) s longer; P <span><math><mo>&lt;</mo></math></span> 0.005) and with greater steadiness during the MVC. During the ramped Valsalva, superficial PFM lengthened for most participants, whereas deep PFM shortened. In this task, shortening (when present) was less than for MVC and submaximal contractions (P <span><math><mo>&lt;</mo></math></span> 0.05)</div></div><div><h3>Conclusions:</h3><div>Properties of contraction differed between deep and superficial PFM across tasks. In general, superficial PFM contracted rapidly but was poorly sustained, whereas deep PFM contracted slower but was maintained smoothly for long periods. These data of asymptomatic women provide a foundation to investigate contraction properties of these muscles in symptomatic populations.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101751"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420333","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":"Sacral neuromodulation outcomes in the management of lower urinary tract symptoms in multiple sclerosis patients","authors":"Tyler Trump ,&nbsp;Po-Ming Chow ,&nbsp;Vivian Hua ,&nbsp;Omer Anis ,&nbsp;Mazen Mansour ,&nbsp;Howard B. Goldman","doi":"10.1016/j.cont.2025.101750","DOIUrl":"10.1016/j.cont.2025.101750","url":null,"abstract":"<div><h3>INTRODUCTION/OBJECTIVE:</h3><div>Multiple sclerosis (MS) is a common immune mediated disease of the central nervous system. The majority of patients will experience bothersome lower urinary tract symptoms (LUTS) over the course of their lifetime. Overactive bladder (OAB) symptoms are the most common followed by obstructive voiding symptoms and incomplete emptying. With disease progression, symptoms often change rendering previously effective therapies less effective. The objective of this study is to evaluate sacral neuromodulation (SNM) in the management of LUTS in MS patients</div></div><div><h3>METHODS:</h3><div>Retrospective chart review of patients with a diagnosis of MS undergoing SNM between 2013–2022. Demographics, indication for SNM, and outcomes were recorded. The primary endpoint was success rate as defined as progression from test phase to implantable pulse generator (IPG) insertion. Secondary endpoints included factors associated with progression to IPG implant and sustained treatment efficacy. Sustained treatment efficacy was recorded at time of last follow-up encounter based on the global response assessment (GRA) with &lt;50% indicating decreased efficacy and &gt;50% indicating sustained efficacy.</div></div><div><h3>RESULTS:</h3><div>We analyzed 58 patients with MS undergoing SNM. Demographics are summarized in Table 1. Mean follow-up was 6.1 years. Urinary urgency/frequency was the most common indication for placement with 40 patients (69%) compared to non-obstructive urinary retention (NOUR) with 18 patients (31%). 49/58 patients progressed to IPG implant for overall success rate of 84.5%. Success rate was higher for urinary urgency/frequency at 95% (38/40) compared to NOUR at 61% (11/18) (p=0.01). More patients underwent stage 1 trial (47/58) than peripheral nerve evaluation (11/58). Success rate was similar between trial types (83% and 90.9%, respectively) (p=0.085). NOUR was associated with decreased odds of success. BMI was positively correlated with success. Of the 49 patients who received IPG 25 (51%) were noted to have sustained efficacy. No factors were associated with sustained efficacy.</div></div><div><h3>CONCLUSION:</h3><div>SNM provides meaningful improvement in LUTS of MS patients with a success rate of 84.5% in our cohort. OAB symptoms were noted to be more amenable to SNM than non-obstructive urinary retention. Roughly half of patients will maintain efficacy with continued therapy.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101750"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378109","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":"Lifestyle and behavioral interventions for urinary incontinence in frail older adults: An integrative review of recent evidence","authors":"Kristine M.C. Talley ,&nbsp;Janie Thompson","doi":"10.1016/j.cont.2025.101749","DOIUrl":"10.1016/j.cont.2025.101749","url":null,"abstract":"<div><h3>Background:</h3><div>Frail older adults rely on conservative management to treat urinary incontinence (UI). Understanding the evidence on lifestyle and behavioral interventions for this population will inform optimal care and direct needed research.</div></div><div><h3>Aims:</h3><div>To conduct an integrative review summarizing recent research and evidence on lifestyle and behavioral interventions for UI in frail older adults published in recent clinical practice guidelines, systematic reviews, and clinical trial registries.</div></div><div><h3>Materials and Methods:</h3><div>We searched PubMed and professional organization websites for systematic reviews and clinical practice guidelines published since 2020. We searched the ClinicalTrials.gov and the International Clinical Trials Registry Platform registries to find clinical trials on the topic registered in the past 10 years.</div></div><div><h3>Results:</h3><div>We found two clinical practice guidelines both from the 7th International Consultation on Incontinence, five systematic reviews, and five registered clinical trials. The systematic reviews included 53 individual trials conducted between 1981 and 2021 with 82% published before 2010. The most evidence existed for prompted voiding and individualized combination therapy that includes functional training.</div></div><div><h3>Discussion:</h3><div>Frail older adults are rarely included in research on lifestyle and behavioral interventions for incontinence and are overlooked in clinical practice guidelines. There remains a paucity of evidence on the effectiveness of lifestyle and behavioral interventions for frail older adults with UI. We urge professionals to include considerations for frail older adults in their clinical practice guidelines, systematic reviews, and future research studies.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101749"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349794","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":"Disparities in surgical treatments for stress, urge and mixed urinary incontinence: Evidence from the 2019 National Ambulatory Surgery Sample (NASS)","authors":"Christabel Egemba ,&nbsp;Edie Duncan ,&nbsp;Katherine Amin ,&nbsp;Alan Wein ,&nbsp;Alberto J. Caban-Martinez ,&nbsp;Raveen Syan","doi":"10.1016/j.cont.2025.101748","DOIUrl":"10.1016/j.cont.2025.101748","url":null,"abstract":"<div><h3>Purpose:</h3><div>Treatment of urinary incontinence (UI) is influenced by severity of symptoms and knowledge of available treatments. However, the relationship between race/ethnicity, socioeconomic status and receiving treatment is poorly understood. We aim to characterize differences in surgical management of urinary incontinence subtypes (Stress UI (SUI), overactive bladder (OAB), Mixed UI (MUI)) and identify predictors of receiving the indicated surgical treatment for each.</div></div><div><h3>Methods:</h3><div>Using the 2019 National Ambulatory Surgery Sample (NASS) we used weighted data to identify 44,996 adult females with OAB, 87,737 with SUI, and 22,873 with MUI. Chi-square analysis was used to compare surgical treatments for each diagnosis, with significance assessed at &lt;0.05. Multivariable logistic regression models estimated the associations between socioeconomic factors of receiving the indicated treatment for OAB, SUI, or MUI.</div></div><div><h3>Results:</h3><div>Approximately 2.5% of the study population received surgical treatment for SUI, OAB or MUI. Sling was the most utilized surgical treatment for both SUI and MUI, at 75.2% and 60.8 % respectively. While SNS was the most utilized surgical treatment for OAB, 75% of OAB patients did not undergo surgical treatment. When considering age, insurance status, and income, Black women were significantly less likely to receive surgical treatment for MUI, OAB and SUI (0.69 [0.59, 0.80], 0.69[0.62, 0.76], 0.71 [0.65, 0.77]) respectively.</div></div><div><h3>Conclusion:</h3><div>Among female patients with UI, certain factors predict whether a patient will receive surgical treatment, including race, insurance status, and income level. These findings could inform further research to examine the factors contributing to the disparities seen.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101748"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349349","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":"Measuring the impact of managing incontinence on people with dementia and informal caregivers: Cognitive debriefing interviews of ‘ICIQ-Cog’ (English translation)","authors":"Miriam Avery ,&nbsp;Nikki Cotterill ,&nbsp;Mandy Fader ,&nbsp;Margaret Macaulay ,&nbsp;Ruth Kirschner-Hermanns ,&nbsp;Cathy Murphy","doi":"10.1016/j.cont.2024.101739","DOIUrl":"10.1016/j.cont.2024.101739","url":null,"abstract":"<div><h3>Aim:</h3><div>The ICIQ-Cog questionnaire was developed in German to measure the impact of incontinence and/or toilet use problems on people living with dementia and their paid carers and unpaid caregivers; it has been translated into English. This study aimed to (1) examine the linguistic validity of the ICIQ-Cog English translation and (2) determine whether it addresses what is important to unpaid caregivers.</div></div><div><h3>Methods:</h3><div>Cognitive debriefing interviews were conducted with 13 unpaid caregivers of people with dementia and problems with incontinence or toilet use recruited via Joint Dementia Research. Interviews were conducted across 3 rounds and transcribed then thematically analysed based on the questionnaire framework.</div></div><div><h3>Results:</h3><div>All participants were unpaid caregivers; they highlighted the need for the questionnaire. Changes were made to the title and response options were added to 10 of 12 questions; wording changes were made to 5 questions. One of the questions was deemed difficult to answer as an unpaid caregiver due to the need for more general caring experience; another used phraseology potentially more understandable by professional carers. Several participants emphasised missing questions (such as cost of buying continence aids and extra washing). The interviews were halted because the questionnaire did not fully meet unpaid caregivers needs.</div></div><div><h3>Conclusion:</h3><div>This linguistic validation of the ICIQ-Cog questionnaire identified that it is not appropriate for use among unpaid caregivers. A questionnaire to assess impact of managing incontinence designed purposefully for unpaid caregivers of a person with dementia is needed. Further work is required to finalise the English translation for paid carers.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101739"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155935","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":"What factors are predictive of urinary continence following pregnancy?","authors":"Ian Milsom,&nbsp;Maria Gyhagen","doi":"10.1016/j.cont.2025.101746","DOIUrl":"10.1016/j.cont.2025.101746","url":null,"abstract":"<div><h3>Introduction:</h3><div>The growing pregnant uterus exerts increasing pressure on the pelvic floor as pregnancy advances and in addition hormonal changes influence muscle and connective tissue function. Vaginal delivery may cause pelvic floor damage by several mechanisms such as muscle trauma, connective tissue damage, nerve injury and vascular damage. Thus, it is perhaps not surprising that pregnancy and in particular vaginal birth have been proposed as important risk factors for urinary incontinence (UI) and other forms of pelvic floor dysfunction such as pelvic organ prolapse and fecal incontinence</div></div><div><h3>Purpose of this review:</h3><div>The aim of this review was to summarize our current knowledge regarding pregnancy and childbirth as important risk factors for urinary incontinence.</div></div><div><h3>Summary:</h3><div>Urinary incontinence is more common in women than men and there is strong epidemiological evidence demonstrating an increased prevalence of UI during pregnancy. The prevalence of UI is higher in women who had undergone a pregnancy compared to nulliparous women of the same age. The risk of developing UI was higher after vaginal delivery (VD) than after caesarean section (CS) and the prevalence of UI&gt;10 years almost tripled after VD compared to CS.</div><div>Maternal body mass index and age and infant birth weight were other important risk factors. Nulliparous women and women who have undergone caesarean-only delivery rarely undergo urinary incontinence surgery.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101746"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386561","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":"Defining Nocturnal Polyuria in Adolescents","authors":"Tasmia Promi ,&nbsp;Anthony Brooks ,&nbsp;Gulzhan Tologonova ,&nbsp;Marie-Claire Roberts ,&nbsp;Sarita Dhuper ,&nbsp;Meseret Tena ,&nbsp;Oluwatoyin Bamgbola ,&nbsp;Monique Hanono ,&nbsp;Jeffrey P. Weiss ,&nbsp;Karel Everaert ,&nbsp;Tine DeBacker ,&nbsp;Thomas F. Monaghan ,&nbsp;Louis Salciccioli ,&nbsp;Stephen Wadowski ,&nbsp;Elka Jacobson-Dickman ,&nbsp;Jason M. Lazar","doi":"10.1016/j.cont.2025.101744","DOIUrl":"10.1016/j.cont.2025.101744","url":null,"abstract":"<div><div>Nocturnal polyuria (NP) is a leading cause of nocturia in adults. While diagnostic criteria for NP have been established in adult men, they have not been validated in other demographic groups including women, adolescents, and children, and little is known about appropriate reference values in these populations. Accordingly, the present study aimed to determine an hourly nocturnal urine production (NUP) rate in adolescents most predictive of the presence of nocturia. We analyzed prospectively collected data of 100 male and female adolescents aged 10-18 years. All subjects completed nocturnal voiding diaries and significant nocturia was defined as <span><math><mo>≥</mo></math></span>1 or more voids per night. Receiver operating characteristic (ROC) curves were used to test the performance of different NUP values in predicting nocturia. On ROC, the area under curve (AUC) was 0.85. On multivariable logistic regression with variables of sex, obesity, and elevated blood pressure, adding NUP as a categorical variable maximally increased the predictive value of the model upon utilizing a cutoff of 50 ml/h, increasing the R² from 0.491 to 0.683. A NUP <span><math><mo>&gt;</mo></math></span>50 ml/h had a sensitivity of 62.2% and a specificity of 96.4% in predicting nocturia. A cut-off value of NUP <span><math><mo>&gt;</mo></math></span>50 ml/h may be relevant to the clinical management of adolescents with nocturia.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101744"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143298519","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":"Comprehensive management of neurogenic stress urinary incontinence in women","authors":"Vicktor Bruno Pereira Pinto,&nbsp;Luísa Resende Tenório de Albuquerque,&nbsp;Bernardo Sachet de Andrade,&nbsp;Cristiano Mendes Gomes","doi":"10.1016/j.cont.2024.101742","DOIUrl":"10.1016/j.cont.2024.101742","url":null,"abstract":"<div><div><strong>Purpose of review:</strong> The management of neurogenic stress urinary incontinence (NSUI) in women presents significant challenges due to the complexity of underlying conditions, the variability in patient responses to treatments, and the limited evidence supporting various therapeutic options. Accurate diagnosis and tailored interventions are crucial, given the coexistence of bladder and bowel dysfunctions and the necessity to consider individual social circumstances. This review aims to update the current strategies for the surgical management of NSUI in women, emphasizing the importance of an individualized, patient-centered approach.</div><div><strong>Recent findings:</strong> The existing scientific literature on NSUI remains limited in both volume and quality, with most studies being retrospective, involving small patient populations and short follow-up periods. These studies often feature heterogeneous groups and varied definitions of success, complicating result interpretation. Promising outcomes have been observed with synthetic midurethral slings and robotic implantation of artificial urinary sphincters (AUS), while autologous fascial slings continue to be regarded as a reliable option. Despite the efficacy of the AUS, device-related complications remain a concern. Other treatments, such as bulking agents and adjustable continence devices, have shown limited success.</div><div><strong>Summary:</strong> A multidisciplinary, patient-tailored approach is essential for managing NSUI in women, aiming to enhance quality of life and protect urinary tract function. Regular follow-up is crucial to monitor and address potential complications, including declining continence rates and other treatment-related adverse events.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101742"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156444","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}