Continence (Amsterdam, Netherlands)最新文献

{"title":"Breaking the silence: Incontinence experiences of black, Asian & minoritised women in low-resource settings in the UK and Bangladesh","authors":"Lily Khandker","doi":"10.1016/j.cont.2026.102314","DOIUrl":"10.1016/j.cont.2026.102314","url":null,"abstract":"<div><div>This study explores how incontinence is experienced by Black, Asian and Minoritised (BA&amp;M) women in both the United Kingdom and Bangladesh, with a focus on low-resource settings shaped by financial, infrastructural, and cultural limitations. Although the UK is a high-income country, BA&amp;M women often encounter exclusion from mainstream continence care pathways due to language barriers, stigma, and lack of culturally competent services—rendering their context effectively low-resource. Similarly, in Bangladesh, limited access to continence services, public awareness, and health infrastructure constrains women's ability to seek care.</div><div>Using qualitative and participatory methods, we conducted seven workshops (six in Bristol, UK and one in Dhaka, Bangladesh) with 154 participants, gathering narratives, creative expressions, and peer discussions. Findings reveal common threads across both contexts: silence around incontinence, lack of information about treatment, low confidence in health systems, and a strong desire for community-led, culturally tailored interventions. A lack of public toilets and referral pathways were also identified as systemic barriers.</div><div>The study argues that “low-resource” should not only be defined by national GDP but also by cultural marginalisation, health inequalities, and service inaccessibility. We propose community-based education, culturally competent clinical engagement, and policy advocacy as cost-effective strategies for improving continence care in such settings.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102314"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448512","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":"Lessons learned from conducting a multi-center lower urinary tract physiology study: the LURN experience","authors":"Claire C. Yang ,&nbsp;James A. Hokanson ,&nbsp;Anna C. Kirby ,&nbsp;Brenda W. Gillespie ,&nbsp;H. Henry Lai ,&nbsp;Karl J. Kreder ,&nbsp;C. Emi Bretschneider ,&nbsp;Ziya Kirkali ,&nbsp;John O.L. Delancey","doi":"10.1016/j.cont.2026.102320","DOIUrl":"10.1016/j.cont.2026.102320","url":null,"abstract":"<div><h3>Purpose</h3><div>To document the logistics and technical considerations of a multi-center protocol evaluating the sensory and motor function of both the bladder and the urethra, in women with urgency only, urinary urgency with incontinence, and controls.</div></div><div><h3>Methods</h3><div>The study network organization and infrastructure are described, with attention to the technical training methods and continuous data quality control.</div></div><div><h3>Results</h3><div>The LURN Organ study was approved in March 2020 and enrolled participants from March 2021 – November 2023, through the COVID pandemic. One hundred five participants were enrolled from all 6 research sites and completed the study testing protocol with no adverse events. All participants had evaluable data, and the majority of the participants had evaluable data from all 4 lower urinary tract (LUT) tests of the protocol. One test cohort did not reach the target enrollment adequate for statistical analysis. The lessons of a pilot study and technical practice; virtual training for a LUT physiology study; early, continuous technical and data quality control; diverse expertise within the research team, and under-enrollment in one cohort are discussed.</div></div><div><h3>Conclusions</h3><div>The conduct of a large, multi-site extended lower urinary tract physiology study is necessarily complex, resource-intensive, and fraught with possible pitfalls. The lessons learned by the LURN-Organ study group, particularly in the context of unprecedented circumstances, will hopefully help and inspire future investigators to continue this much-needed clinical research in LUT function.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102320"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147449174","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":"Editorial – Continence issues in low resource settings","authors":"Sakineh Hajebrahimi,&nbsp;Andrew Gammie","doi":"10.1016/j.cont.2026.102326","DOIUrl":"10.1016/j.cont.2026.102326","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102326"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147538625","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":"Survey on the use of invasive urodynamic study in patients with orthotopic neobladder urinary diversion: Searching for a common ground","authors":"Eleonora Rosato ,&nbsp;Simone Albisinni ,&nbsp;Anastasios D. Asimakopoulos ,&nbsp;Ilaria De Vito ,&nbsp;Nunzia Abbate ,&nbsp;Daniele Bianchi ,&nbsp;Enrico Finazzi Agrò","doi":"10.1016/j.cont.2026.102315","DOIUrl":"10.1016/j.cont.2026.102315","url":null,"abstract":"<div><h3>Rational</h3><div>Radical cystectomy (RC) is a standard treatment for advanced or high-risk non-muscle invasive bladder cancer. Although orthotopic neobladder (ONB) typically improves quality of life (QoL), lower urinary tract symptoms (LUTS) are common and can negatively impact post-operative outcomes. Despite the possible importance of urodynamic studies (UDS) in this setting, there is limited evidence on standardised protocols for their execution, terminology and interpretation.</div></div><div><h3>Objectives</h3><div>The primary objective of this survey is to investigate how and when major Italian oncological centres perform UDS on patients with ONB. A survey consisting of 32 items. This survey was distributed to Italian oncological centres between September 2024 and January 2025. Responses were collected using the Google Forms® platform.</div></div><div><h3>Findings</h3><div>Approximately 37 % of contacted centres responded to the survey, and 64 % of them performed UDS in this setting. UDS timing varied, with 31.8 % performed at 6 months post-surgery, 13.6 % at 3 months, and 4.5 % at 12 months.</div><div>During cystomanometry the first sensation of filling was described as any abdominal change in 71.4 % by survey participants and there was no consensus on normal pressure values for stopping the filling. During pressure-flow studies, obstruction was assessed in 36.4 % of respondents using native bladder nomograms, while significant variability was observed in post-void residual volume (PVR, 31.8 % considering ≤100 mL acceptable, 13.6 % ≤ 150 mL and 13.6 % ≤ 50 mL.</div></div><div><h3>Conclusions</h3><div>The survey revealed substantial heterogeneity in UDS assessment and parameters designed for native bladders were often applied to ONB patients, raising concerns about their appropriateness. These results highlight the need for standardised protocols and guidelines in assessing functional outcomes.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102315"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147449182","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":"Is platelet rich plasma a promising treatment for erectile dysfunction? the first 2-year follow up randomized controlled study","authors":"Hussein Shaher,&nbsp;Tamer Diab,&nbsp;Mahmoud Farag,&nbsp;Kareem Noah","doi":"10.1016/j.cont.2025.102294","DOIUrl":"10.1016/j.cont.2025.102294","url":null,"abstract":"<div><h3>Background</h3><div>AIMS OF STUDY: To evaluate the therapeutic potential and safety of platelet-rich plasma (PRP) therapy in patients with mild to moderate erectile dysfunction, with a prospective observational follow-up of two years.</div><div>STUDY DESIGN, MATERIALS AND METHODS: Thirty-five patients with mild to moderate erectile dysfunction, based on the IIEF-EF score, received three injections of autologous PRP (3 mL per corpus), administered two weeks apart. Patients were evaluated at 1, 3, and 6 months, and then every 6 months for two years. After six months, the PRP group (18 patients) continued to receive maintenance PRP injections every six months, while the saline group (17 patients) received placebo injections at the same intervals.</div></div><div><h3>Results</h3><div>A total of 35 patients were categorized into two groups: 18 received PRP treatment, while 17 were assigned to the saline group.</div><div>As we were conducting a 2-year follow up of the patients who have achieved satisfactory results upon receiving 3 doses of PRP. During the first 6 months following the initial three injections, no significant differences were observed between the two groups. However, after 6 months, the PRP group showed continuous improvement in all parameters regarding cavernousal artery diameter, peak systolic velocity, end diastolic velocity, IIEF-EF, SEP Q3, IIEF intercourse satisfaction Q6, 7,8 and IIEF overall satisfaction Q13, 14 up to 2 years of follow up, while the saline group exhibited a gradual decline in all parameters, although still better than baseline. None of the patients exhibited plaque formation, subcutaneous bruising, or any other significant adverse effects.</div></div><div><h3>Conclusion</h3><div>CONCLUDING MESSAGE: Platelet-Rich Plasma appears to be a reliable long-term treatment option for improving erectile dysfunction, with satisfactory outcomes and no serious adverse events. However, larger multicenter studies with extended follow-up are needed to confirm these findings.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"16 ","pages":"Article 102294"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416933","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":"Pathophysiology and management of lower urinary tract dysfunction in parkinsonian Disorders: Update from the Neuro-Urology Promotion Committee of the ICS","authors":"Glenn T. Werneburg ,&nbsp;Marcus J. Drake ,&nbsp;Ryuji Sakakibara ,&nbsp;Mikolaj Przydacz ,&nbsp;Tatsuya Yamamoto ,&nbsp;Sanjay Sinha ,&nbsp;Members of the Neuro-urology Promotion Committee of the International Continence Society","doi":"10.1016/j.cont.2025.102303","DOIUrl":"10.1016/j.cont.2025.102303","url":null,"abstract":"<div><h3>Background and objective</h3><div>Parkinson's disease and other Parkinsonian disorders, including multiple system atrophy, dementia with Lewy Bodies, progressive supranuclear palsy, and corticobasal degeneration, are commonly associated with lower urinary tract symptoms, which contribute to morbidity and reduced quality of life.</div></div><div><h3>Methods</h3><div>The Neuro-urology Promotion Committee of the International Continence Society provides an update in the form of a scoping review, which includes literature since 2014. We focus on the pathophysiology of urinary dysfunction in the Parkinsonian disorders, as well as current and emerging treatment regimens.</div></div><div><h3>Key findings and limitations</h3><div>Data supporting the use of beta-3-agonists as well as botulinum toxin in the population with Parkinsonian disorders have accumulated rapidly, and support the safety and efficacy of these modalities in the population. Growing evidence suggests that deep brain stimulation (DBS), which is used primarily for motor symptoms, may have therapeutic potential for lower urinary tract dysfunction. However, further studies regarding patient selection and brain target selection for such therapy along with clinical trials to assess efficacy of DBS for lower urinary tract dysfunction in the Parkinsonian disorders are warranted.</div></div><div><h3>Conclusions and clinical implications</h3><div>Over the past decade, there has been meaningful progress in the understanding of lower urinary tract symptoms in Parkinsonian disorders. Further investigation and clinical trials are essential to further refine therapeutic strategies and improve quality of life for affected individuals.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"16 ","pages":"Article 102303"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519596","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":"2025-12-01","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":"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":"2025-12-01","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":"Feasibility of replacing a tibial nerve neuromodulation implant. A case series","authors":"Harry J. Kendall ,&nbsp;Martijn A.C. Smits ,&nbsp;Frank M.J. Martens ,&nbsp;John P.F.A. Heesakkers","doi":"10.1016/j.cont.2025.102293","DOIUrl":"10.1016/j.cont.2025.102293","url":null,"abstract":"<div><h3>Introduction</h3><div>Implantable tibial neuromodulation (iTNM) is a minimally invasive treatment for lower urinary tract dysfunction. In a previously reported study, patients received the first-generation Renova iStim System™, which consists of an implantable electrode powered by an external wearable unit. Following study completion, a second-generation wearable, non-compatible with the original implant, was developed, necessitating surgical revision to maintain therapy. This is the first report detailing the surgical, technical, and clinical aspects of such a revision.</div></div><div><h3>Methods</h3><div>Five patients with overactive bladder (OAB) who had completed a three-year follow-up in the original study opted for implant revision due to device incompatibility. The new implant was activated four weeks post-surgery, with efficacy assessed three months post-revision using a three-day voiding diary and compared to original baseline and 36-month data. Patient satisfaction was evaluated after six months using the Patient Global Impression of Improvement (PGI-I). Complications were monitored throughout routine follow-up.</div></div><div><h3>Results</h3><div>All patients originally received the implant in 2015; revisions were performed in 2022 without difficulties or complications. Mean operating time was 48 min. Leak episodes per day were 7.67 (SD 4.43) at baseline, 1.27 (SD 2.27) at 36 months, and 3.13 (SD 4.82) post-revision. Mean PGI-I score was 3 (SD 1.79). One patient required and responded well to device reprogramming.</div></div><div><h3>Conclusion</h3><div>Revision surgery for iTNM proved safe, easily performable, and restores clinical effectiveness and patient satisfaction, making it a promising long-term therapeutic option for OAB.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"16 ","pages":"Article 102293"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320653","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":"2025-12-01","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}