Continence (Amsterdam, Netherlands)最新文献

{"title":"Does the presence of Fowler's syndrome predicts successful long-term outcome of sacral nerve stimulation in women with non-obstructive urinary retention?","authors":"Mohammed Bassil Ismail , Wameedh Qays Abdullhussein","doi":"10.1016/j.cont.2025.101919","DOIUrl":"10.1016/j.cont.2025.101919","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 101919"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632065","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":"2025-09-01","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":"Management of bladder outlet obstruction after stress urinary incontinence surgery in women: Results of a North American Survey among surgeons","authors":"Andry Perrin ,&nbsp;Lysanne Campeau ,&nbsp;Jas Singh ,&nbsp;Jacques Corcos","doi":"10.1016/j.cont.2025.102277","DOIUrl":"10.1016/j.cont.2025.102277","url":null,"abstract":"<div><h3>Introduction</h3><div>To gather expert opinion and describe trends in the management of early and prolonged bladder outlet obstruction following stress urinary incontinence surgery.</div></div><div><h3>Methods</h3><div>Expert physicians and members of the Society of Urodynamics, Female Pelvic Medicine &amp; Urogenital Reconstruction (SUFU), were queried by means of an online survey regarding the management of bladder outlet obstruction following stress urinary incontinence surgery.</div></div><div><h3>Results</h3><div>Sixty surgeons answered the questionnaire (9 %). Most responders performed &gt;20 sling procedures per year, and 15 % of them were autologous fascial pubovaginal slings. The estimated prevalence of complete postoperative urinary retention was 3 %. The prevalence of post-void residual volume ≥200 ml, was estimated around 8 %. Of those presenting with post-void residual ≥200 ml, 35 % were symptomatic. For a inability to void 48 h after synthetic mid-urethral sling insertion, most responders would observe for a week before planning an incision of the sling. In the case of post-void residual ≥200 ml, the trend of the majority would be observation. In patient in inability to void 48 h following autologous fascial pubovaginal sling procedure, most participants would offer observation, as well as if the patient presented with post-void residual ≥200 ml.</div></div><div><h3>Conclusions</h3><div>According to expert opinion, although we could highlight some trends in the management of bladder outlet obstruction associated with urinary retention following the surgical management of female stress urinary incontinence, particularly with regards to observation, there was no consensus on the management in terms of method or timing of surgical revision.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 102277"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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":"2025-09-01","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":"Global insights into overactive bladder management: A survey of physician preferences and practices","authors":"Omer Anis ,&nbsp;Mikolaj Przydacz ,&nbsp;Tyler Trump ,&nbsp;Saar Anis ,&nbsp;Howard B. Goldman","doi":"10.1016/j.cont.2025.101913","DOIUrl":"10.1016/j.cont.2025.101913","url":null,"abstract":"<div><h3>Introduction</h3><div>Overactive bladder syndrome (OAB) is a prevalent condition characterized by urinary urgency, frequency, and nocturia, significantly affecting quality of life. Despite advancements in treatment options, physician practices and preferences for managing OAB vary widely, especially between different specialties. This study aims to evaluate the current global trends, preferences, and barriers regarding the selection and use of available third-line therapies for OAB, with a focus on which treatments are most commonly available and preferred in clinical practice.</div></div><div><h3>Methods:</h3><div>This cross-sectional survey aimed to gather insights into physicians’ practices and opinions regarding OAB management. A 17-item questionnaire was developed and distributed electronically to members of the International Continence Society (ICS). The survey, conducted from April to July 2024, collected anonymous responses from 201 physicians. Data analysis included descriptive statistics, chi-square tests, and ANOVA using R software.</div></div><div><h3>Results:</h3><div>A total of 201 physicians responded, 60.7% of whom had completed fellowship training in relevant specialties. Among third line therapies, botulinum toxin injections and sacral neuromodulation (SNM) were the most favored treatments, with 46.2% and 29.9% of respondents rating them highly favorable, respectively. Urogynecologists from obstetrics and gynecology (OB-GYN) specialties were less likely to favor posterior tibial nerve stimulation (PTNS) compared to their urology-trained counterparts (p&lt;0.001). Fellowship training significantly impacted the timing of follow-ups, with fellowship-trained physicians more likely to see patients at 4 weeks post-treatment. Key barriers to advanced therapies included patient resistance to implantable devices (65.8%) and limited neuromodulation training (27.9%).</div></div><div><h3>Conclusions:</h3><div>The management of OAB varies significantly across specialties, with notable differences in treatment preferences and barriers. While botulinum toxin and SNM remain popular choices, the availability of newer therapies such as implantable tibial nerve stimulation remains limited. Understanding these trends can inform future research and clinical guidelines aimed at improving OAB management and addressing barriers to advanced therapies.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 101913"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587459","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":"Development, usability, and randomized pilot feasibility study of a mobile application prototype supporting self-management of accidental bowel leakage.","authors":"Donna Z Bliss, Olga V Gurvich, Joseph A Konstan, Ryanne Johnson, Jeannine McCormick, Marshall Muehlbauer, Dominique Jamison, Emma Jennings, Mary Benbenek, Molly Conway, Alexandra Weinberger, Casey Kirchschlager, Holly E Richter","doi":"10.1016/j.cont.2025.102276","DOIUrl":"https://doi.org/10.1016/j.cont.2025.102276","url":null,"abstract":"<p><strong>Aims: </strong>Patients need support in managing conservative interventions for fecal incontinence (FI). To address this need, a three-phased study aimed to develop and test the usability of a mobile application prototype (App-p) supporting patient self-management of FI and examine the feasibility of conducting a randomized controlled pilot study of App-p use.</p><p><strong>Methods: </strong>Phase 1: The App-p was developed. Phase 2: App-p usability was tested. Phase 3: In a pilot feasibility study, patients with FI from an American continence/urogynecology practice were randomly assigned 1:1 to a usual care control group (UCC-Group) or usual care and App-p use group (APP-Group) and followed for five weeks. Study activities for both groups were completion of electronic data forms at baseline and five weeks and, at five weeks, a call with their clinician and an interview. Descriptive quantitative and qualitative analyses were conducted.</p><p><strong>Results: </strong>The I'M ABLe App-p described 11 conservative interventions for FI, each with a journal for self-reporting intervention performance. App-p usability was very good (System Usability Score = 72 (12.5) (mean (SD)). Twenty eligible participants were randomized as planned. All study activities were completed by 60 % (6/10) of the UCC-Group and 80 % (8/10) of the APP-Group. All journals were completed by 80 % (8/10) of the APP-Group versus 30 % (3/10) of the UCC-Group. The APP-Group accessed the App-p 27 (5-45) days (median (range)), describing it as easy-to-use, convenient, and increasing self-management accountability. One UCC-Group participant and two APP-Group participants withdrew.</p><p><strong>Conclusion: </strong>Results show feasibility of conducting a randomized controlled study using the App-p and support its further development.</p>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12652371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643581","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":"Challenges associated with using continence management products: Qualitative study set in India, Papua New Guinea and Romania","authors":"Cathy Murphy ,&nbsp;Lucie Pannell ,&nbsp;Ritu Ghosh ,&nbsp;Sureshkumar Kamalakannan ,&nbsp;Vennila Palanivelu ,&nbsp;Almah Kuambu ,&nbsp;Ben Zuvani ,&nbsp;George Stefan ,&nbsp;Iuliana Mesesan","doi":"10.1016/j.cont.2025.101918","DOIUrl":"10.1016/j.cont.2025.101918","url":null,"abstract":"<div><h3>Background</h3><div>Effectively managing urine and faecal leakage is essential to maintain quality of life for people living with incontinence. Most people affected by long-term incontinence use continence management products (purchased or homemade). These products can have both positive and negative consequences. Globally, people living in lower and middle income settings often do not have access to products or only very limited options, but availability is increasing. Understanding the challenges of product use is important to support product decision making. The aim of this study was to identify and describe challenges associated with using continence management products for adults and young people living with incontinence in India, Papua New Guinea and Romania.</div></div><div><h3>Methods</h3><div>We used a qualitative exploratory design and participatory action research approach in this study. Data were collected using semi-structured interviews with 63 people (continence product user n = 42, parent/carer n = 21) who took part in a total of 54 interviews in India, Papua New Guinea and Romania. Secondary analysis of the data was undertaken using a framework approach to address the study aim.</div></div><div><h3>Results</h3><div>Participants used products namely, indwelling urinary catheters, disposable absorbent products and homemade products (e.g. bottles or blankets). Experiences varied widely and depended on individual characteristics and circumstances. Four themes were used to categorise the key challenges associated with continence product use (i. Physical side-effects, ii. Cost and impact on access, iii. Engagement in day-to-day activities and iv. Psychological and social effects). The large majority of participants reported one or more negative consequences of use, with skin damage, infection, embarrassment, smell, difficulties using or disposing of the products and cost dominating, varying by product type. Some challenges were relatively minor, but others (such as wounds or needing to move out of their home) were potentially life changing.</div></div><div><h3>Conclusion</h3><div>Most participants reported an overall benefit from using products, but many also experienced significant challenges. Some did not appear to be using an appropriate product to meet their needs or were using products incorrectly (e.g. not changing them frequently enough). Ensuring a range of products to meet individual needs will help mitigate against unintended harms. To optimise the benefits of product use, policy makers and service providers seeking to improve continence product provision should consider local and individual contexts, and ensure personnel are trained to support product selection and correct fit and usage.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 101918"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ICS teaching module: Urodynamic testing for patients with post radical prostatectomy urinary incontinence","authors":"Carlos Arturo Levi D'Ancona ,&nbsp;Tufan Tarcan ,&nbsp;Stefania Musco ,&nbsp;Arthur Degani Ottaiano ,&nbsp;Peter F.W.M. Rosier","doi":"10.1016/j.cont.2025.102275","DOIUrl":"10.1016/j.cont.2025.102275","url":null,"abstract":"<div><h3>Aim</h3><div>To present the body of evidence on the practice of assessment and diagnosis of lower urinary tract dysfunction (LUTD) in post radical prostatectomy urinary incontinence (PRP-UI). This serves as a scientific background overview for a presentation made available on the International Continence Society (ICS) website.</div></div><div><h3>Methods</h3><div>ICS-Teaching module prepared by an ad-hoc working group instituted by the ICS Urodynamics Committee using an expert literature review focusing on guidelines and clinical practice and consensus formation by the members of the working group. Finally, the content was reviewed by the core members of the ICS Urodynamics and Standardisation Steering Committees.</div></div><div><h3>Results</h3><div>In addition to non-invasive initial assessment of PRP-UI, clinical practice guidelines state that a specialist (urologist-) assessment includes performing or considering invasive urodynamics to evaluate LUT functions before surgical treatment. We explain the practical elements and consequences of this.</div></div><div><h3>Conclusions</h3><div>This module provides expert guidance on the diagnosis of dysfunction in patients with signs and symptoms of PRP-UI. The coexistence of (other) LUTD with UI is plausibly relevant to management selection, although prospective evidence for this is understudied. Standard urodynamic techniques can be used but should in certain cases be adapted and supplemented for the testing of patients with PRP-UI.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"15 ","pages":"Article 102275"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"85 - Sharing a Best Practice for the use of intermittent catheterization in management of Urinary Retention due to benign prostatic hyperplasia","authors":"Eugenia Fragalà ,&nbsp;Alberto Feruzzi ,&nbsp;Valerio Vagnoni ,&nbsp;Giulia Guidotti ,&nbsp;Giovanni Sernaglia ,&nbsp;Maria Grazia Conti ,&nbsp;Samanta Fornia ,&nbsp;Giacomo Saraceni ,&nbsp;Rocco Francesco Delle Fave ,&nbsp;Marco Guerra ,&nbsp;Alexia Vici ,&nbsp;Mara Bacchiani ,&nbsp;Roberta Gunelli","doi":"10.1016/j.cont.2025.101851","DOIUrl":"10.1016/j.cont.2025.101851","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"14 ","pages":"Article 101851"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364655","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":"16 - Clean intermittent self catheterization in male patients with BOO and AUR might reintroduce spontaneous micturition: A prospective study","authors":"Damiano Graziani,&nbsp;Antonio Luigi Pastore,&nbsp;Antonio Carbone,&nbsp;Yazan Al Salhi,&nbsp;Andrea Fuschi,&nbsp;Paolo Pietro Suraci,&nbsp;Manfredi Bruno Sequi,&nbsp;Alice Antonioni,&nbsp;Onofrio Antonio Rera,&nbsp;Fabio Maria Valenzi,&nbsp;Giorgio Martino,&nbsp;Giuseppe Candita,&nbsp;Gianfrancesco Filippo,&nbsp;Paolo Benanti,&nbsp;Luca Erra,&nbsp;Giovanni Di Gregorio,&nbsp;Hila Rogozinski,&nbsp;Salvatore Viola,&nbsp;Gaia Vivarelli","doi":"10.1016/j.cont.2025.101783","DOIUrl":"10.1016/j.cont.2025.101783","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"14 ","pages":"Article 101783"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365373","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}