Continence (Amsterdam, Netherlands)最新文献

{"title":"Position of the Ibero-American Society of Neurourology and Urogynecology (SINUG) on the urodynamics (UDS) in women undergoing surgical treatment for stress urinary incontinence (SUI)","authors":"José Medina-Polo ,&nbsp;Salvador Arlandis-Guzmán ,&nbsp;Roberto Martínez-García ,&nbsp;Bárbara Padilla-Fernández ,&nbsp;David Manuel Castro-Díaz ,&nbsp;Francisco Cruz ,&nbsp;Carlos Errando-Smet ,&nbsp;Montserrat Espuña-Pons ,&nbsp;Carmen González-Enguita ,&nbsp;Luis López-Fando ,&nbsp;Alicia Martín-Martínez ,&nbsp;Esther Martínez-Cuenca ,&nbsp;Isabel Montes-Posada ,&nbsp;Carlos Müller-Arteaga ,&nbsp;Ana Belén Muñoz-Menéndez ,&nbsp;Inés Ramírez-García ,&nbsp;Cristina Ros ,&nbsp;Pedro Blasco-Hernández","doi":"10.1016/j.cont.2024.101714","DOIUrl":"10.1016/j.cont.2024.101714","url":null,"abstract":"<div><h3>Introduction:</h3><div>Most clinical practice guidelines currently recommend not to necessary perform routine urodynamic studies (UDS) before surgery for female stress urinary incontinence (SUI). However, there is no consensus in the literature. Our objective was to evaluate the available evidence and to establish a position as a scientific society.</div></div><div><h3>Methods:</h3><div>A search was conducted using PubMed, Web of Science and Scopus databases. Inclusion criteria were manuscripts in English with the terms “female urinary incontinence” and “urodynamics”. The analysis included 25 studies.</div></div><div><h3>Results:</h3><div>Regarding the usefulness of UDS in female undergoing SUI, two randomised, controlled trials have been published showing that preoperative UDS do not improve the results of SUI surgery. The review of data from different series on the surgical treatment of female SUI shows that up to 36% of patients undergoing surgery for SUI are complicated cases due to previous anti-incontinence surgery, pelvic prolapse that exceeds the hymen, radiotherapy or pelvic surgery. Moreover, the performance of UDS before treatment of SUI leads to a change in diagnostic orientation in 74% of patients with complicated SUI and 40% in the case of uncomplicated SUI. It should be noted that the UDS study modifies the proposed treatment in 23.8% and 11% of patients with complicated and uncomplicated SUI, respectively. A review by Serati et al. reported that the UDS results are congruent with the clinical diagnosis of SUI in 74.5% of cases. However, there is overactive detrusor in 10.6%, mixed urinary incontinence in 8% and the results of the UDS are inconclusive in 6.8% of cases. Therefore, it is estimated that UDS before surgery is more likely to change the management of SUI in 17% of patients.</div></div><div><h3>Conclusions:</h3><div>In women referring SUI, it is necessary to individualise the indication for UDS before surgical correction. UDS are complementary tests to be considered after non-invasive studies of the patient with a detailed clinical history, physical examination and other complementary tests such as a voiding diary, specific questionnaires and flowmetry with residual urine. We consider it necessary in cases of complicated or non-pure SUI.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"12 ","pages":"Article 101714"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534917","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":"The clinical application of a novel minimally invasive non-surgical treatment for stress urinary incontinence","authors":"Jin Yong ,&nbsp;Tricia L.C. Kuo ,&nbsp;Lay Guat Ng","doi":"10.1016/j.cont.2024.101712","DOIUrl":"10.1016/j.cont.2024.101712","url":null,"abstract":"<div><h3>Aim:</h3><div>This study introduces a pioneering approach to managing stress urinary incontinence (SUI) through a novel device that utilizes intravesical gas as a pressure dampener, leveraging the unique property of compressibility as dictated by Boyle’s law (<span><math><mi>P</mi></math></span>\u0000<span><math><mo>∝</mo></math></span>\u0000<span><math><mrow><mn>1</mn><mo>/</mo><mi>V</mi></mrow></math></span>). It aims to assess the device’s efficacy and its impact on the quality of life in women with SUI.</div></div><div><h3>Methods:</h3><div>Adhering to a protocol approved by SingHealth CIRB (reference 2017/2543), informed consent was secured from 27 patients who met the inclusion and exclusion criteria, of which 22 completed the full study protocol. The study’s primary outcome measures were the differences in 1-h and 24-h pad weight tests, while secondary outcomes included incontinence quality of life (I-QOL) scoring, urodynamics parameter changes and safety data. Outcome measures were analyzed using the Wilcoxon signed-rank test for non-normally distributed data and the paired t-test for normally distributed data, as appropriate.</div></div><div><h3>Results:</h3><div>The cohort comprised entirely of females, with a mean age of 49.1 years (range 29–65 years). The 1-h pad weight test demonstrated significant improvement, with the mean pad weight decreasing from 4.0 g to 1.41 g (<span><math><mi>p</mi></math></span> &lt; 0.05). Similarly, the 24-h pad weight test reflected a reduction from 13.06 g to 7.76 g (<span><math><mi>p</mi></math></span> &lt; 0.01). An increase in the mean Valsalva leak point pressure (VLPP) from approximately 90.91 cmH2O before treatment to 125.70 cmH2O post-treatment (<span><math><mi>p</mi></math></span> &lt; 0.01) was recorded. Notably, mean I-QOL scores significantly improved from 65.5 to 84.0 (<span><math><mi>p</mi></math></span> &lt; 0.01), reflecting enhanced quality of life across various domains. No patients experienced urinary tract infections, serious traumatic events, or required secondary or unplanned surgical interventions.</div></div><div><h3>Conclusion:</h3><div>The novel intravesical gas-based device demonstrates significant improvements in managing SUI, evidenced by both primary and secondary outcome measures. These findings suggest the device’s potential as a valuable addition to the spectrum of treatment options for SUI, promising enhanced physiological and quality of life benefits for affected women.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"12 ","pages":"Article 101712"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428422","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":"Complications associated with the use of mesh to treat female urinary incontinence and pelvic organ prolapse","authors":"Blayne Welk ,&nbsp;Roger Dmochowski ,&nbsp;Kathryn McCarthy ,&nbsp;James Keck ,&nbsp;Sherif Mourad ,&nbsp;Hashim Hashim","doi":"10.1016/j.cont.2024.101713","DOIUrl":"10.1016/j.cont.2024.101713","url":null,"abstract":"<div><div>Complications can result from the use of mesh to treat female stress urinary incontinence or pelvic organ prolapse. While some of these complications are also common to non-mesh-based procedures, the risk of vaginal exposure of mesh, or mesh extrusion into other pelvic organs are unique complications that must be considered when using mesh. Chronic pain after mesh-based procedures can be a difficult complication to manage and may occur. Patients with stress incontinence or prolapse that are considering surgical treatment should be counseled on the potential complications and the likelihood of them occurring. Although there has been focus on the development, introduction and regulation of mesh, the diagnostic clinical decision-making process has not been put under scrutiny, and likely significantly impacts patient outcomes. There is a need to develop patient reported outcome measures for mesh procedures, and further work is needed to create a standardized way to measure and communicate different types of mesh-related complications. Future research to focus on the diagnostic clinical decision making process is recommended, including education on the ‘whole journey’ of the patient during the perioperative pathway.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"12 ","pages":"Article 101713"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534865","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":"Fowler’s syndrome—Patient led phenotyping of 265 patients","authors":"Emily R. Cox ,&nbsp;J.N. Panicker ,&nbsp;D. Coombe ,&nbsp;C. Selai ,&nbsp;D. Ellis ,&nbsp;J. Stone ,&nbsp;I. Hoeritzauer","doi":"10.1016/j.cont.2024.101710","DOIUrl":"10.1016/j.cont.2024.101710","url":null,"abstract":"<div><h3>Aims:</h3><div>To better understand Fowler’s syndrome from a patient perspective.</div></div><div><h3>Methods:</h3><div>The survey was created by the Fowler’s syndrome UK charity(FSUK, registered charity number 1196903), and advertised to patients with a diagnosis of Fowler’s syndrome via social media from December 2021 to March 2022.</div></div><div><h3>Results:</h3><div>Of 265 participants, 187 (70%) were aged between 15–30 years. Patients self-reported Fowler’s syndrome. Medical notes were not obtained. However, 195 (74%) were diagnosed by either urethral sphincter EMG or urethral pressure profile suggesting a representative sample, with few differences in those not reporting those investigations. 183 (69%) experienced complete urinary retention. Over 75% reported pain in either their bladder, urethra or pelvis. 224 (84%) used catheters to manage symptoms and 80% were taking opiates for pain. Sacral neuromodulation was offered to 75% of patients and found useful by 27% of these patients. Urethral sphincter or detrusor botulinum toxin, pain management, or physiotherapy were offered to between 32%–61% of patients and found beneficial in less than a third of those undertaking them. Over 50% rated impact on life overall as ‘severe’. Over 80% required help with ADLs on their worst day. 200 (75%) reported being told that their symptoms were due to anxiety, “imaginary” or “all in their head”.</div></div><div><h3>Conclusions:</h3><div>This is the largest cross-sectional study of women with Fowler’s syndrome. Fowler’s syndrome severely affected quality of life in &gt;50%. Current management options available were recorded as beneficial in fewer than a third of participants. The majority of participants felt unsupported by medical professionals.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"12 ","pages":"Article 101710"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434307","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":"Comparison of pelvic floor morphometry in supine and standing in women with and without pelvic organ prolapse: A cross-sectional exploratory study","authors":"Lori B. Forner ,&nbsp;Marie-Pierre Cyr ,&nbsp;Emma M. Beckman ,&nbsp;Paul W. Hodges ,&nbsp;Michelle D. Smith","doi":"10.1016/j.cont.2024.101708","DOIUrl":"10.1016/j.cont.2024.101708","url":null,"abstract":"<div><h3>Introduction:</h3><div>Intra-abdominal pressure (IAP) and gravity may both challenge pelvic organ support and contribute to the development or worsening of pelvic organ prolapse (POP). This study aimed to assess whether pelvic floor morphometry differs between supine and standing positions in women with and without POP, at rest and with elevated IAP, and to compare the change in measures from the supine to standing position between groups.</div></div><div><h3>Methods:</h3><div>Thirty premenopausal vaginally parous women with (<span><math><mrow><mi>n</mi><mo>=</mo><mn>15</mn></mrow></math></span>) and without (<span><math><mrow><mi>n</mi><mo>=</mo><mn>15</mn></mrow></math></span>) POP were included. Transperineal ultrasound was used to assess pelvic floor morphometry (bladder neck [BN], rectal ampulla [RA], levator plate angle [LPA], anorectal angle [ARA], levator anteroposterior distance [LAP], and levator hiatal area [LHA]) in supine and standing, at rest and bearing down. Measures were compared between positions (supine and standing) and groups (women with and without POP).</div></div><div><h3>Results:</h3><div>At rest, BN and RA were lower and LPA was smaller in standing than supine for all participants (all <span><math><mrow><mi>p</mi><mo>&lt;</mo><mn>0</mn><mo>.</mo><mn>04</mn></mrow></math></span>), and LHA and LAP distance were greater in standing than supine for women with POP (<span><math><mrow><mi>p</mi><mo>&lt;</mo><mn>0</mn><mo>.</mo><mn>001</mn></mrow></math></span>). In standing rest, BN and RA were lower and LHA was greater in women with than without POP (<span><math><mrow><mi>p</mi><mo>&lt;</mo><mn>0</mn><mo>.</mo><mn>001</mn></mrow></math></span>). There were no differences between women with and without POP in these measures in supine (all <span><math><mrow><mi>p</mi><mo>&gt;</mo><mn>0</mn><mo>.</mo><mn>23</mn></mrow></math></span>). ARA was greater in women with POP than without POP in both positions at rest (<span><math><mrow><mi>p</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>002</mn></mrow></math></span>). During bearing down, BN and RA were lower, ARA and LPA were smaller, and LHA and LAP distance were larger in standing than in supine for all participants (all <span><math><mrow><mi>p</mi><mo>&lt;</mo><mn>0</mn><mo>.</mo><mn>023</mn></mrow></math></span>). In bearing down in both positions, BN and RA were lower and ARA and LHA were greater in women with than without POP (all <span><math><mrow><mi>p</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>013</mn></mrow></math></span>).</div></div><div><h3>Conclusion:</h3><div>Our findings indicate lower pelvic floor support in women with POP compared to women without POP that is evident during bearing down in supine, and at rest and during bearing down in standing. These findings underscore the utility of transperineal ultrasound to assess pelvic floor morphometry in standing to guide management of women with POP.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"12 ","pages":"Article 101708"},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534864","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":"Testosterone and 5 Alpha Reductase Inhibitor (5ARI) in Benign Prostatic Hyperplasia (BPH): A historical perspective","authors":"Ananias C. Diokno ,&nbsp;Avaneesh Kunta ,&nbsp;Ryan Bowen","doi":"10.1016/j.cont.2024.101711","DOIUrl":"10.1016/j.cont.2024.101711","url":null,"abstract":"<div><div>This paper provides a review of the historical and scientific evolution of testosterone and 5ARI research. It chronicles the evolution from early empirical practices like castration, through the formal discovery of testosterone in the 20th century, to the eventual synthesis of testosterone and identification of Leydig cells. Testosterone’s crucial role in male development and its influence on the development and maturation process of the prostate gland are also presented. The introduction of 5ARIs in the 1990s, such as finasteride, marked a significant advancement in managing BPH by reducing dihydrotestosterone (DHT) levels. The controversy regarding the therapeutic use of 5ARIs is discussed, given concerns about their association with high-grade prostate cancer and other systemic risks. Likewise, emerging evidence challenges the traditional view that testosterone exacerbates prostate conditions, suggesting that testosterone replacement therapy (TRT) may improve symptoms of low testosterone without increasing BPH symptoms, prostate cancer (PCa), or cardiovascular risk. Several new studies are discussed suggesting that low or declining testosterone level could be a risk factor for prostate tumorigenesis. This review emphasizes the need for continued research on Testosterone and 5ARI to further define their role in men’s health.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"12 ","pages":"Article 101711"},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434308","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":"History of clinical applications of desmopressin","authors":"Lennox R. Ksido ,&nbsp;Cassandra V. Heaney ,&nbsp;Thomas F. Monaghan ,&nbsp;Jeffrey P. Weiss","doi":"10.1016/j.cont.2024.101709","DOIUrl":"10.1016/j.cont.2024.101709","url":null,"abstract":"<div><div>Desmopressin is a synthetic analog of the endogenous peptide hormone arginine vasopressin, or antidiuretic hormone. The drug was initially developed in 1967 with the intention of creating a molecule that could treat central diabetes insipidus, a condition characterized by a deficiency of ADH and results in the production of large volumes of dilute urine (Zaoral et al., 1967). In the years since, therapeutic use of desmopressin has expanded beyond central diabetes insipidus to include the treatment of many other conditions, notably nocturnal polyuria in children with enuresis (bed wetting), adult nocturia, congenital bleeding disorders, and more. The purpose of the present narrative review is to recount the history of desmopressin, review its key therapeutic indications, and discuss important pharmacologic and pharmacokinetic considerations of this medication.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"12 ","pages":"Article 101709"},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428424","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":"13 - Pilot Feasibility Study of a Mobile App Supporting Self-Management of Fecal Incontinence","authors":"D Bliss ,&nbsp;R Holly ,&nbsp;O Gurvich ,&nbsp;J Konstan ,&nbsp;R Johnson ,&nbsp;J McCormick ,&nbsp;M Muehlbauer ,&nbsp;J Dominique ,&nbsp;E Jennings ,&nbsp;M Benbenek ,&nbsp;M Conway ,&nbsp;A Weinberger","doi":"10.1016/j.cont.2024.101355","DOIUrl":"10.1016/j.cont.2024.101355","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"12 ","pages":"Article 101355"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416468","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":"49 - POST PARTUM PELVIC FLOOR DYSFUNCTIONS: IS IT A MATTER OF LANGUAGE BARRIER?","authors":"S Bosio ,&nbsp;S Perossini ,&nbsp;S Manodoro ,&nbsp;E Nicoli ,&nbsp;A Tangi ,&nbsp;G Bonaccorso ,&nbsp;A Boccuti ,&nbsp;G Bonelli ,&nbsp;O Caruso","doi":"10.1016/j.cont.2024.101391","DOIUrl":"10.1016/j.cont.2024.101391","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"12 ","pages":"Article 101391"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426229","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":"51 - Pelvic floor muscle function in early postpartum period and perineal injury- is there a difference?","authors":"A Krawczyk ,&nbsp;D Sys ,&nbsp;J Szymański ,&nbsp;D Lipa ,&nbsp;W Bojanowska ,&nbsp;K Kwiatkowska-Tuszyńska ,&nbsp;M Starzec-Proserpio","doi":"10.1016/j.cont.2024.101393","DOIUrl":"10.1016/j.cont.2024.101393","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"12 ","pages":"Article 101393"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426231","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}