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Aims Terms used in the field of chronic pelvic pain (CPP) are poorly defined and often confusing. An International Continence Society (ICS) Standard for Terminology in chronic pelvic pain syndromes (CPPS) has been developed with the aim of improving diagnosis and treatment of patients affected by chronic pelvic pain syndromes. The standard aims to facilitate research, enhance therapy development and support healthcare delivery, for healthcare providers, and patients. This document looks at the whole person and all the domains (organ systems) in a systematic way. Methods A dedicated working group (WG) was instituted by the ICS Standardisation Steering Committee according to published procedures. The WG extracted information from existing relevant guidelines, consensus documents, and scientific publications. Medline and other databases were searched in relation to each chronic pelvic pain domain from 1980 to 2014. Existing ICS Standards for terminology were utilized where appropriate to ensure transparency, accessibility, flexibility, and evolution. Consensus was based on majority agreement. Results The multidisciplinary CPPS Standard reports updated consensus terminology in nine domains; lower urinary tract, female genital, male genital, gastrointestinal, musculoskeletal, neurological aspects, psychological aspects, sexual aspects, and comorbidities. Each is described in terms of symptoms, signs and further evaluation. Conclusion The document presents preferred terms and definitions for symptoms, signs, and evaluation (diagnostic work-up) of female and male patients with chronic pelvic pain syndromes, serving as a platform for ongoing development in this field. Neurourol. Urodynam. 36:984-1008, 2017. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Abstract: Small cell carcinoma (SCC) of the prostate is a high-grade malignant neoplasm with neuroendocrine differentiation and accounts for only 0.5–2% of all prostate cancers. From 2005 to 2010, there were a total of three cases of SCC at our hospital. The disease onset age was 61, 74, and 84 years, respectively. Initial presentations include urinary difficulty, bone pain, and gross hematuria. One patient had mixed tumors of both SCC and adenocarcinoma, and two had prior adenocarcinomas that recurred as SCC. The diagnosis of SCC was all made via transurethral resection. Two patients died of their diseases 7 and 15 months after diagnosis, and one survived for more than 65 months. The serum prostate specific antigen (PSA) was 1660 ng/mL, 72.8 ng/mL, and 35.7 ng/mL before definitive diagnosis. Notably, the only surviving patient was diagnosed with SCC after the transurethral resection of prostate because of the presence of lower urinary tract symptoms. The serum PSA prior to the operation was 0.11 ng/mL, and he received chemotherapy with 5 courses of cisplatin and VP-16. Palliative transurethral resection of the prostate (TURP) not only solved the obstructive symptoms of voiding but helped in removing the prostate tissue, which might have the SCC component in patients with prostate adenocarcinoma under androgen deprivation therapy. [Copyright &y& Elsevier]

The treatment of overactive bladder (OAB) has evolved over the past 20 years to include a number of behavioral, pharmacological, and minimally invasive treatments. After behavioral therapy, pharmacological therapy with antimuscarinics remains the mainstay of treatment. Despite this, a large number of patients will 'fail' or be unsatisfied with drugs therapy. It would be extremely helpful to patients and clinicians to be able to predict who those patients are. However, there are a number of barriers. First and foremost are defining 'success' and 'failure' and this can vary dramatically from one patient to another. Endpoints other than the traditional variables used in clinical trials may be more effective in evaluating treatments and helping to predict outcomes. Along similar lines, there are various definitions for OAB that is 'refractory' to conventional treatments and this term needs clarification. In many cases, response to therapy may be affected by factors such as comorbidities, metabolism of drugs, concurrent therapies, etc. These factors are sometimes obvious and sometimes not, and for a variety of reasons it can be quite difficult to predict or determine their effect on outcome. Finally, many patients with OAB include have mixed (stress and urgency) symptoms. It is important to sort out the OAB component of mixed symptoms and mixed urinary incontinence (MUI) when determining effects of therapy. Neurourol. Urodynam. 29:652-657, 2010. © 2010 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Objectives: The published data feature little information pertaining to the psychological status of patients with dysfunctional voiding. We conducted this study to evaluate the psychological profile of female patients afflicted with dysfunctional voiding. Methods: A total of 32 women with dysfunctional voiding completed an American Urological Association symptom index review, and a structured interview relating to depression (Hamilton Rating Scale for Depression), and anxiety symptoms (Hamilton Rating Scale for Anxiety). A group of 31 women who had no lower urinary tract symptoms served as controls. The anxiety and depression symptoms were compared between the dysfunctional voiding patients and asymptomatic controls. Results: The mean patient age was 48.3 years. The mean total American Urological Association symptoms score was 20.3. The mean Hamilton Rating Scale for Depression score was 16.9, with 3.1%, 6.3%, and 50.0% patients revealing mild, mild to moderate, and moderate to severe depression symptoms, respectively. The mean Hamilton Rating Scale for Anxiety score was 21.2, with 21.9% and 34.4% patients having mild to moderate and moderate to severe symptoms of anxiety, respectively. For the controls, the mean Hamilton Rating Scale for Depression score was 4.3 and the mean Hamilton Rating Scale for Anxiety score was 4.8. Patients with dysfunctional voiding had a significantly greater degree of depression and anxiety than was the case for the controls. Conclusions: The results of this study have shown that women with dysfunctional voiding experience a greater degree of depression and anxiety compared with asymptomatic controls. Evaluation of the psychological profile is important for multidisciplinary management of the dysfunctional voiding in women. [Copyright &y& Elsevier]

Objective To determine the significance of tumour grade in predicting disease progression in stage Ta transitional cell carcinoma (TCC) of the urinary bladder. Patients and methods From August 1975 to January 1991, 140 patients (121 men and 19 women, mean age 64.2 years, range 30-83) with stage Ta TCC of the urinary bladder were treated at the Veterans General Hospital-Taipei by transurethral resection and post-operative adjuvant intravesical chemotherapy. There were 48 patients (34%) with grade 1, 78 patients (56%) with grade 2 and 14 patients (10%) with grade 3 tumours. Disease progression and muscle invasion were assessed during a mean follow-up of 74.3 months and related to grade, urine cytology and the number and location of tumours. Results A total of 10 patients (7%) had tumour recurrence which invaded the muscle, of whom one had grade 1, six had grade 2 and three had grade 3 tumours. The patient with a grade 1 tumour developed muscle invasion within 16 months of surgery. The mean interval to the development of muscle invasion was 49.2 months in patients with grade 2 and 39.4 months with grade 3 tumour. In patients with stage Ta TCC, a grade 3 tumour was more likely to progress to muscle invasion (21%) than was a grade 1 (2.1%; P<0.05) or grade 2 (7.7%; P<0.05) tumour. One patient with a grade 2 and one patient with grade 3 tumour developed distant metastases without muscle invasion. Overall, the disease progression rate was 8.6% (12/140) in stage Ta TCC. Disease progression was more common with grade 3 (28.5%) than with grade 2 (9.0%; P<0.05) and grade 1 (2.1%; P<0.05) tumours. Conclusion Tumour grade may be used to predict disease progression after resection of stage Ta urinary bladder cancer. A higher grade of tumour was associated with a higher incidence of disease progression. [ABSTRACT FROM AUTHOR]