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To determine risk factors for urinary retention (UR) after robot-assisted radical cystectomy (RALC) with orthotopic neobladder diversion. A total of 269 patients who underwent RALC with orthotopic neobladder diversion from 2008 to 2019 at seven tertiary hospitals were retrospectively analyzed. There were 68 patients who had UR (UR arm) and 201 patients who did not have UR (no-UR arm). UR was defined as voiding dysfunction without catheterization or more than 100 mL of residual urine after voiding. Preoperative demographics, perioperative factors, pathology outcomes, and postoperative complications of UR and no-UR arms were compared and predictors of UR were identified. Among demographic factors, only gender proportion showed a difference, with male proportion being significantly lower in the UR arm than in the no-UR arm (81% vs 92%, p = 0.010). For perioperative outcomes, anastomosis site stricture (27% vs 11%, p = 0.003) and length of hospital stays (23 days vs. 19 days, p = 0.001) were significantly higher in the UR arm than in the no-UR arm. In multiple logistic regression analysis, female (OR 3.32, 95% CI: 1.43–7.72) and body mass index (BMI) (OR 1.10, 95% CI 1.00–1.20) were UR predictors. UR after RALC with orthotopic neobladder diversion is significantly increased in females. Multiple logistic regression analysis identified female and BMI elevation as UR predictors. [ABSTRACT FROM AUTHOR]

Objectives • Cystitis, inflammation of the bladder due to urinary tract infection, and Urethral stricture, narrowing of the urethra that obstructs the urine flow are conditions often aligned with the Ayurvedic concept of Mutraghata (urinary obstruction). This case report aims to evaluate the effectiveness of an Ayurvedic treatment protocol, including Udwartana (powder massage), Virechana (purgation), and Uttara Basti (enema) (urethral douche) on the parameters of Uroflowmetry. Methodology • A patient diagnosed with cystitis and urethral stricture underwent a series of Panchakarma (biopurificatory) procedures. The protocol included Udwartana (powder massage), Avagaha Swedana (sitz bath), Virechana (purgation), Niruha Basti (enema) (decoction enema), Uttara Basti (enema) (urethral douche) using medicated decoctions and oils on alternate days. Post-discharge, the patient continued oral Ayurvedic medications at home. Uroflowmetry was employed to assess treatment effectiveness before and after the intervention. Results • Marked improvements were observed in Uroflowmetry parameters, including maximum flow rate, average flow rate, and voiding time along with a reduction in symptoms such as frequent urination, burning sensation during micturition, reduced flow, and the patient reported an enhanced quality of life, with better performances in daily activities. These improvements were sustained during the 60- day follow-up period. Conclusion • A combination of modified Uttara Basti (transurethral douche) and other panchakarma procedures, plus oral Ayurvedic medications was effective in relieving the symptoms of urethral stricture and improving Uroflowmetry parameters with sustained results during the 60-day follow-up period. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to analyze the sleep patterns of patients with nocturnal enuresis (NE) using a wearable brain-wave-sensing device. Materials and Methods: We prospectively analyzed 10 of the 14 patients who visited the hospital for NE between August 2023 and July 2024 and agreed to participate in the study. Four patients were excluded owing to pairing errors and loss to follow-up. Participants were instructed to maintain a frequency volume chart for 1 week and sleep while wearing MUSE-S™, a wearable brainwave detection device. We monitored the arousal threshold state based on sleep patterns when NE occurred in all patients. Results: The median age of the patients was 8.7 years (interquartile range, 7.0-10.6), and 4 patients (40.0%) were male. In all participants, non-rapid eye movement (NREM) deep sleep was the dominant stage in the early part of sleep, whereas NREM light sleep was dominant in the middle part. The arousal threshold was high in the early part of sleep and decreased toward the end. A poor response to enuretic alarms was observed when NE occurred during the NREM deep-dominant period. In contrast, a good response was observed when NE occurred during the NREM light-dominant period. Conclusions: Differences in sleep stages influence the arousal threshold more than individual characteristics. To effectively manage the NE, focusing on the timing of urination is important in the latter part of the sleep period. [ABSTRACT FROM AUTHOR]

Background: This study aims to externally validate a clinical mathematical model designed to predict urine output (UOP) during the initial post-operative period in pediatric patients who underwent cardiac surgery with cardiopulmonary bypass (CPB). Methods: Children aged 0–18 years admitted to the pediatric cardiac intensive care unit at Cleveland Clinic Children's from April 2018 to April 2023, who underwent cardiac surgery with CPB were included. Patients were excluded if they had pre-operative kidney failure requiring kidney replacement therapy (KRT), re-operation or extracorporeal membrane oxygenation or KRT requirement within the first 32 post-operative hours or had indwelling urinary catheter for fewer than the initial 32 post-operative hours, or had vasoactive-inotrope score of 0, or those with missing data in the electronic health records. Results: A total of 213 encounters were analyzed; median age (days): 172 (IQR 25–75th%: 51–1655), weight (kg): 6.1 (IQR 25–75th%: 3.8–15.5), median UOP ml/kg/hr in the first 32 post-operative hours: 2.59 (IQR 25–75th%: 1.93–3.26) and post-operative 30-day mortality: 1, (0.4%). The mathematical model achieved the following metrics in the entire dataset: mean absolute error (95th% Confidence Interval (CI)): 0.70 (0.67–0.73), median absolute error (95th% CI): 0.54 (0.52–0.56), mean squared error (95th% CI): 0.97 (0.89–1.05), root mean squared error (95th% CI): 0.99 (0.95–1.03) and R2 Score (95th% CI): 0.29 (0.24–0.34). Conclusions: This study provides encouraging external validation results of a mathematical model predicting post-operative UOP in pediatric cardiac surgery patients. Further multicenter studies must explore its broader applicability. [ABSTRACT FROM AUTHOR]

This study critically examines the impact of urination posture on bladder health and overall urinary function, focusing on three primary postures: standing, sitting, and squatting. Each posture is analyzed for its physiological implications, including bladder emptying efficiency, post-void residual volume, and pelvic muscle strain. The merits and demerits of each posture are discussed in relation to gender, age, and specific health conditions, such as prostate enlargement and lower urinary tract symptoms (LUTS). Scientific evidence highlights the sitting posture as the most beneficial overall, promoting complete bladder emptying, reducing residual urine, and supporting pelvic health. While standing offers convenience, particularly for men, it can contribute to incomplete bladder emptying and increase the risk of urinary tract infections (UTIs) and other complications. Squatting, although highly effective in promoting urinary and bowel function, may not be practical or accessible for all individuals. The findings suggest that sitting, particularly for individuals with bladder or prostate conditions, is the optimal posture for long-term urinary health. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pediatric lower urinary tract symptoms (LUTS) are a set of common childhood problems. Community‐level interventions that target behavioral change among children with LUTS can improve symptoms outside of the clinic environment. Parents, navigating the home and school environments, are key in supporting healthy bladder behaviors. Thus, we asked parents about their perceptions and barriers related to pediatric bladder health. METHODS: English‐speaking parents (n = 30) of children ages 5‐10 years with and without LUTS were interviewed. Transcripts were coded iteratively by two independent coders using deductive and inductive approaches that emphasized consensus coding and peer debriefing. RESULTS: Ninety‐three percent of participants were women, 50% were 30‐39 years old, and 60% held a graduate degree. Parents identified school‐, classroom‐, and child‐based barriers to bladder health. These included the bathroom environment, restrictive policies for bathroom use, and anxiety on how and when to use the bathroom. CONCLUSIONS: Addressing school‐, classroom‐, and child‐based barriers is necessary to promote healthy bladder habits among children in the school environment and beyond. Recommended school‐based interventions include bathroom use and sanitation policies that support students' voiding needs, teachers' professional development, and school readiness initiatives. Limitations include participation of English‐speaking parents only. [ABSTRACT FROM AUTHOR]

Background • Pelvic congestion syndrome (PCS), also known as ovarian vein syndrome, is one of the key causes of chronic pelvic pain. The present study combined pelvic floor myofascial manipulation, uterine conditioning, and improved Kegel exercise for the treatment of a PCS patient with pelvic inclination to provide a reference for clinical therapy. Case description • A 29-year-old female was admitted to our hospital on 20th April 2023, with the main complaint being repeated lower abdominal and lumbosacral pain with frequent urination (urine volume < 200 ml/time), external genital itching accompanied by increased secretion for more than 5 years. The patient was treated with pelvic floor myofascial manipulation, uterine conditioning, and improved Kegel exercise 6 times. Pelvic magnetic resonance imaging (MRI) examination, pelvic X-ray examination, overall posture assessment, and related functional status were observed and evaluated. Conclusions • After comprehensive pelvic floor rehabilitation treatment containing pelvic floor myofascial manipulation, uterine conditioning, and improved Kegel training, the symptoms and signs of the patient were significantly improved, and the effect was obvious. [ABSTRACT FROM AUTHOR]

Context: Different individuals within a group can form strong links through auditory, visual, and tactile senses. Temporarily separating sheep into subflocks, although not involving complete social isolation of individuals, can be stressful, especially when ewes are separated from lambs. Aims: This study aimed to explore the effects of 1-h temporary ewe–lamb sensory separations on stress-related behaviours during separation, as well as its effect on stress-related hormones of ewes. Methods: Small-tailed Han ewes were randomly assigned to the following four groups (six each): the auditory + visual + tactile separation (A + V + T group), visual + tactile separation (V + T group), tactile separation (T group), and the control (C group). Then, the ewes were separated from their lambs for 1 h on Postnatal Days 14, 21, 28, 35 and 42. Ewe behaviours during the separations were observed using focal animal-sampling methods. Key results: Results showed that the separated ewes (A + V + T, V + T, and T groups) spent more time looking and exploring and less time lying (P < 0.05). Ewes showed more exploring behaviour in T group (P < 0.05). Ewes that gave birth to two lambs showed more urinating behaviour (P < 0.05). There was no significant difference in the level of stress-related hormones in ewes among the four different separation-method groups (A + V + T, V + T, T, and C groups). Conclusions: One hour ewe-lamb sensory separation affected the stress related behaviours of Small-tailed Han ewes during separation, but it did not cause differences in stress-related hormones in ewes after the separation. Ewes showed increased exploring or urinating behaviour when they were separated through lack of tactile contact only with lambs, or when ewes give birth to two lambs. Implications: Ewes temporarily separated from their lambs are less stressed if they are unable to hear or see the lambs, thereby improving ewe welfare. These effects appear more pronounced in ewes with multiple lambs and provides new perspectives for further studies on the effect of litter size on ewe-lamb bonding. Ewes and lambs are often temporarily separated during daily management. This study showed 1 h temporarily ewe-lamb sensory separation affected stress-related behaviours of Small-tailed Han ewes. The ewes showed more exploring or urinating behaviour when separated through lack of tactile contact only with lambs. It suggests that when ewes are temporarily separated from their lambs, avoiding the ewes hearing and seeing the lambs may partially reduce their stress response, thereby improving ewe welfare. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Our study aimed to assess the efficacy and durability of holmium laser enucleation of the prostate (HoLEP) in managing acute urinary retention (AUR), neurogenic chronic urinary retention (NCUR), and non-neurogenic chronic urinary retention (NNCUR). We also sought to compare outcomes in patients with preoperative urinary retention (UR) to those without. METHODS: We conducted a retrospective analysis using prospectively gathered data from men who underwent HoLEP at our institution between October 2017 and July 2022. Patient demographics and outcome measures were recorded, including indications for the procedure, median urinary volume drained, or median postvoid residual urine volume (PVR) before catheterization or HoLEP. Chronic urinary retention (CUR) was defined as PVR >300 mL in males able to void; and initial catheter drainage >1000 mL in males unable to void, in the absence of pain. NCUR and NNCUR were differentiated based on the presence of any significant illness or injury with a neurologic impact on the bladder. All patients had postoperative followup visits at one, three, six, and 12 months. Our evaluation included the International Prostate Symptom Score (IPSS), quality of life (QoL) assessment, maximum urinary flow rate (Qmax), PVR, and catheter-free status. RESULTS: Three hundred sixty-eight males who underwent HoLEP were included in our study. The UR group consisted of 189 patients (70 AUR, 42 NCUR, and 77 NNCUR), and the lower urinary tract symptoms (LUTS) group was comprised of 179 individuals. There were no statistically significant differences between the NCUR and NNCUR subgroups regarding demographics and outcomes. At 12 months postoperative, the AUR group had a higher catheter-free rate than the CUR group (p=0.04), and other outcome variables were comparable between the two cohorts. The UR group had a significantly lower QoL score at one month (p=0.01) and a significantly lower IPSS score at one and 12 months (p=0.034 and p=0.018, respectively) than the LUTS cohort. During all followup visits, the UR group had a significantly higher PVR than the LUTS cohort. The successful first trial of void (TOV) rate for the UR and LUTS groups was 81% and 83.2%, respectively. At 12 months postoperative, the catheter-free rate for the UR and LUTS cohorts was 96.3% and 99.4%, respectively. [ABSTRACT FROM AUTHOR]

Background: Distal renal tubular acidosis (dRTA) is a condition characterized by the impaired ability to secrete hydrogen ions from the distal tubule. In pediatric patients, common clinical features of dRTA include excessive urine production (polyuria), frequent nighttime urination (nocturia), poor growth and weight gain (failure to thrive), difficulty with bowel movements (constipation), abnormal breathing, and the presence of kidney stones (nephrolithiasis). While urinary tract infections (UTIs) are frequently associated with dRTA, renal failure is uncommon and seldom reported in children. Case Presentation: A 10-year-old girl was referred for the evaluation due to a progressive loss of gross motor milestones over a period of 3 years. She also experienced an acute episode of paralysis and was found to have bilateral medullary nephrocalcinosis (right staghorn calculus) accompanied by moderate renal failure and a UTI. Her development in other areas was appropriate for her age. Importantly, there was a history suggestive of excessive urine production (polyuria), increased thirst (polydipsia), and frequent nighttime urination (nocturia). Physical examination revealed proximal myopathy, characterized by a waddling gait and a positive Gower's sign, as well as diminished reflexes and muscle tone in the lower limbs. Laboratory tests indicated the presence of sepsis (total leukocyte count – 26,660, CRP-174.29) and elevated renal parameters (serum creatinine – 4.27) along with active urinary abnormalities. Urine culture and sensitivity testing showed significant growth of Escherichia coli (>100,000 CFU). A computed tomography scan of the kidneys, ureters, and bladder revealed a staghorn calculus on the right side, as well as bilateral medullary nephrocalcinosis and swollen kidneys. The patient was diagnosed with dRTA based on several factors, including hypokalemic hyperchloremic metabolic acidosis with a normal anion gap, high urine pH, borderline hypercalciuria, presence of medullary nephrocalcinosis, and after ruling out other potential differential diagnoses. Following treatment for the UTI and sepsis, as well as standard treatment for dRTA, the child exhibited symptomatic improvement. Her creatinine levels returned to 0.8 mg/dL, and the septic markers declined to normal levels. To further investigate the cause of the initial decline in renal function in addition to the UTI, a renal biopsy was performed. Conclusion: This case report emphasizes the significance of including medullary nephrocalcinosis and renal tubular acidosis in the list of potential diagnoses for patients presenting with progressive gross motor developmental regression, acute flaccid paralysis, and proximal myopathy. Timely identification of these conditions can help avoid unnecessary and expensive investigations, while also facilitating prompt clinical recovery in affected children. Early diagnosis plays a crucial role in guiding appropriate management strategies and improving patient outcomes. [ABSTRACT FROM AUTHOR]

To clarify the efficacy of saw palmetto extract (SPE) (Lalilab Incorporated, NC, USA), a phytotherapeutic agent, in rats, its pharmacological effects on urodynamic parameters, bladder contractility and autonomic receptors were investigated. The urodynamic parameters, bladder contractile responses, and muscarinic receptors were measured by a cystometric method, organ-bath methods, and specific binding of [N-methyl-3H]scopolamine chloride (pH]NMS), respectively. Orally administered SPE (160 mg/kg) in rats significantly increased the micturition interval and decreased the frequency of micturition. SPE (0.1 mg/mL) significantly attenuated the contraction of isolated rat bladder induced by electrical field stimulation (EFS) and acetylcholine. SPE (20-600 jxg/mL) inhibited specific [3H]NMS binding in the rat bladder in a concentration dependent manner. These results indicate that SPE improves the detrusor overactivity in rats by antagonizing bladder muscarinic receptors. Therefore, SPE may be a potential beneficial agent for improving lower urinary tract symptoms in subjects wi1h lower urinary tract symptoms (LUTS). [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to investigate the number of potential LUTS patients among Japanese women. Methods The subjects were women that were registered on "Go106", a subject recruitment site operated by ORTHOMEDICO Inc., and were friends with "Go106" account in LINE. We investigated their age, presence of urinary problems, frequency of hospital visits, and Core Lower Urinary Tract Symptom Score (CLSS) with a web-based questionnaire. Results The number of respondents was 1372, of which the effective response rate was 89.3%. In this survey, we divided the respondents into three groups: "No urinary problems; group 1," "Have urinary problems but do not consult a doctor; group 2," and "Have urinary problems and consult a doctor; group 3." And within each group, the respondents were further divided into, total, those aged 40 or above and those aged under 40. We investigated the lower urinary tract symptoms in each group. Among all respondents, 540 were from group 1, 671 were from group 2, and 14 were from group 3. In all the groups, the most troubling symptom was "Leakage of urine when coughing, sneezing, or exercising." Conclusions The percentage of the population who had problems with urination but did not consult a doctor was the largest, and about 40% of women aged under 40 were identified to have urinary problems. [ABSTRACT FROM AUTHOR]

PeeBuddy, the first portable urination device for Indian women, has been around for close to seven years; still, it is struggling to break the taboo of serving as a portable urination device for Indian women treated as a taboo product in India. It has been hard to convince the Indian populous at large. Although Bajaj had done tremendous work over the years, much remained to be done. The critical task is to position PeeBuddy, such that Indian women should understand the purpose of the product, a brand, without hurting their sentiments. Bajaj knows that convincing Indian women and shifting them to any urination device required a shift in their mindset, which was hard to achieve. [ABSTRACT FROM AUTHOR]

Urine leakage volume is an important indicator reflecting the severity of incontinence in patients. Currently, there are limited smart diapers capable of continuous dynamic monitoring of urine volume. This study developed two types of urine volume sensors, resistive and capacitive, which were integrated with traditional diapers to assess urine leakage levels: mild leakage (0–5 mL), moderate leakage (6–12 mL), and severe leakage (above 12 mL). Three patterns of resistive urine volume sensors were designed, and the results showed that the A pattern could accurately determine urine volume and frequency levels. Additionally, three electrode spacing designs were tested for the capacitive urine volume sensors. The results indicated that the sensor with a 1 cm electrode spacing could determine the urine volume range, with each 1 mL increase in urine causing a capacitance rise of approximately 1.5–1.8 pF, with an error of about ± 0.5 mL per increment. Both resistive and capacitive methods showed high accuracy in monitoring urine volume and frequency. This study validated the feasibility of smart flexible fabric sensors in detecting urine volume and frequency, providing a potential solution for better assessing and managing the condition of incontinence patients. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Materials and Methods Results Conclusions Nocturia impairs the quality of life in patients with type 2 diabetes mellitus. Although sodium glucose co‐transporter 2 inhibitors (SGLT2i) such as tofogliflozin increase urine volume, their impact on nocturia, in conjunction with dietary salt restriction, is less clear.This multicenter, open‐label, randomized, parallel‐group trial included 80 subjects with type 2 diabetes and nocturia. The patients were divided into two groups: one receiving tofogliflozin, the shortest half‐life, without salt restriction, and the other receiving both tofogliflozin and dietary salt restriction. The primary endpoint was nocturia frequency at 12 weeks. The secondary outcomes included changes in daytime urination frequency, urine volume, and home blood pressure.At 12 weeks, there were no significant differences in nocturia changes between both groups. Nocturia frequency did not change in the tofogliflozin without salt restriction group from 1.5 ± 0.8 to 1.3 ± 1.1 times per night (P = 0.297), and significantly decreased from 1.6 ± 1.0 to 1.3 ± 0.7 times per night in the tofogliflozin and dietary salt restriction group (P = 0.049). There was a trend toward increased urine volume and frequency during the daytime in the group with salt restriction, indicating a time‐shift effect of the short half‐life tofogliflozin and salt restriction on urinary time.The frequency of nocturia after tofogliflozin did not increase. Tofogliflozin reduced nocturia when combined with salt restriction. Furthermore, daytime urine volume and frequency showed an increasing trend, suggesting a shift in urine production to daytime hours due to the short half‐life of tofogliflozin. Dietary modifications can enhance the therapeutic benefits of tofogliflozin in managing nocturia in people with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background: Lower urinary tract symptoms (LUTSs) are a common complaint in adult and elderly men with bladder outlet obstruction, and have a considerable impact on their quality of life. Symptoms affect storage, voiding and post micturition stages. Among the latter, a feeling of incomplete emptying is one of the most bothersome for the patients; a condition that in turn contributes to affect urinary urgency, nocturia and frequency. Common recommendations include self-management practices (e.g., control of fluid intake, double-voiding and distraction techniques) to relieve patients' symptoms, whose effectiveness, however, is under debate. Methods: In this report we describe two pioneering procedures to favor bladder residual content voiding in people complaining of LUTS disorders. The first is based on motor imagery and the second on the use of odors. The beneficial effects of Mental imagery techniques on various tasks (e.g., in the treatment of several pathological conditions or as valid mnemonics aids have a long tradition and have received consistently experimental support. Thus, a patient (a 68-year-old Caucasian man) complaining of LUTS was trained to use a motor imagery technique (building up a visual image comprising the bladder, the detrusor muscle and the urethra, and to imagine the detrusor muscle contracting and the flow of urine expelled) for 90 days and two odors (coffee and a lavender scented cleanser) for 10 days, as a trigger for micturition. He was asked to record—immediately after the first morning micturition—the time interval between the first (free) and the second (cued) micturition. Results: Reported data suggest the efficacy of motor imagery in favoring the bladder residual urine voiding in a few minutes (M = 4.75 min.) compared to the control condition, i.e., the baseline of the patient (M = 79.5 min.), while no differences between the odor-based procedures (M 1st odorant = 70.6 min.; M 2nd odorant = 71.1 min) and the latter were observed. Conclusions: A procedure based on an imagery technique may, therefore, be of general value—as a suggested protocol—and accordingly can be applicable to clinical settings. An olfactory bladder control hypothesis cannot, however, be ruled out and is discussed as a promising future line of research. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of urethral catheterization on the accuracy of EMG uroflowmetry in children with non-neurogenic voiding disorders during pressure-flow (PF) studies compared to the non-invasive EMG uroflowmetry test. Methods: A retrospective study of children undergoing a urodynamic evaluation at our institution between 8/2018 and 7/2022 was employed. Urination curves and pelvic floor muscle activity were compared between PF studies and non-invasive EMG uroflowmetry test. The non-invasive test was selected as the standard benchmark. Results: 104 children were tested, with 34 children (33%) being able to urinate only in a non-invasive EMG uroflowmetry. The percentage of boys unable to urinate with a catheter was significantly higher than girls (54% vs. 13%, p-value < 0.001). In 70 children, a normal bell-shaped urination curve was found in 13 compared to 33 children in the PF studies and non-invasive uroflowmetry, respectively. PF studies demonstrated a specificity of 39% (95% CI 23–57) and a positive predictive value (PPV) of 61% (95% CI 53–67) in finding non-bell-shaped curves. Relaxation of pelvic muscles was found in 21 (30%) as opposed to 39 (55%) of children in invasive and non-invasive EMG uroflowmetry, respectively (p-value = 0.5). Conclusion: The accuracy of PF studies in children, primarily in boys, compared to the non-invasive uroflowmetry, was poor. This may pose potential errors in diagnosis and subsequent treatment. We recommend completing a non-invasive EMG uroflowmetry in cases where the child refused to urinate, or pathology was found, requiring a modification in treatment. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effect of blood urea nitrogen (N) breeding value (BUNBV) on the concentration of urinary N (UN) and urinary urea N (UUN) of Hereford heifers. Thirty two heifers with divergent BUNBV: 16 low (BUNBV – 1.95 to −0.58, liveweight 208 ± 4.4 kg and age 303 ± 16.7 d; LBUN) and 16 high (BUNBV 0.32–1.91, liveweight 204 ± 4.8 kg and age 302 ± 7.9 d; HBUN) were studied over a 14-day period during which they were fed lucerne silage. Individual urine, faecal, and blood spot samples were collected in the morning (0900 h) and afternoon (1400 h) on four non-consecutive days during the second experimental week. Intakes of dry matter and N, and liveweight were similar across treatments. Positive relationships existed between BUNBV and UN (R2 =  0.51; P < 0.001), and BUNBV and UUN (R2 =  0.57; P < 0.001). One unit increase in BUNBV increased heifer UN by 0.60 ± 0.254 g/L and UUN by 0.54 ± 0.221 g/L across both sampling times (AM and PM). This suggests that breeding for low BUN may reduce the environmental impact of pastoral beef production systems. However, further research is needed to compare N balance and urination behaviours of beef heifers divergent in BUNBV. [ABSTRACT FROM AUTHOR]

Some cichlid fishes release urine‐containing chemical cues that lower aggression in their opponents. Bioassays to identify the aggression‐modulating pheromone include assessing the effect of urine fractions on the behavior towards a mirror image or in interactions with another male. However, many of these methods can be time‐consuming and require many fish. The objective of the present study was to assess the behavior of male Mozambique tilapia (Oreochromis mossambicus) towards male urine using two methods with the intent of simplifying the bioassays: aggression towards a mirror image (mirror assay) and real opponents in which the urogenital papilla was tied using surgical silk to prevent urination. The results confirm the aggression‐reducing effect of dominant male urine in both experimental approaches. Ten minutes of biting or 15 min of tail‐beating behaviors in the mirror assay, or 5 min of opercular expansion or 15 min of lateral display in interactions with real opponents were necessary to detect a statistically significant reduction in aggressive behavior towards dominant male urine. We also found that males with subordinate status had lower latency to initiate aggressive behaviors towards the mirror than dominants in the same condition, even though fish had been isolated for 1 week. However, no such differences in latency were found in the real opponent assay. We conclude that 5 min of opercular expansion behavior in real opponent fights or 10 min of biting behavior in the mirror assay are the shortest times necessary to test aggressive behavior in urine fractions in bioassay‐guided identification of pheromones. [ABSTRACT FROM AUTHOR]

The Giant Anteater (Myrmecophaga tridactyla), facing threats from habitat degradation and hunting, remains a species of enigmatic behavior. This study analyzed camera trap data collected over 7700 camera trap nights in 49 stations near marked trees in Southern Guyana. A total of 883 Giant Anteater sightings were recorded, categorized into solitary adults (797), females with offspring (70), solitary juveniles (8), and paired adults (6). Meticulous observations documented various behaviors, distinguishing chemical (sniffing) and visual (scratching, climbing, hugging, rubbing) tree-marking from non-tree-marking behaviors (foraging, self-scratching, rolling, urinating/defecating). For solitary individual, a PCA revealed an inverse correlation between ignoring and sniffing (explaining 33.64 % of PC1), suggesting individuals engage in one behavior per observation. We observed an inverse correlation between hug/scratch/rub and climb (20.75 % of PC2). A weighted PCA assessing correlations by social categories, distinguishing marking behaviors from ignoring the tree (explaining 95.6 % of PC1). Scratching trees without climbing or hugging occurred from 3 pm to 1 am, with climbing most frequent between 8 and 10 pm. These behaviors were common during peak anteater sightings, peaking in May, with fewer observations in September. Overall, Giant Anteaters exhibit tree-marking behaviors, including scratching, climbing, and hugging and that a primary purpose for this behavior is communication. [ABSTRACT FROM AUTHOR]

Objectives: To investigate roles of brain carbon monoxide (CO), an endogenous gasotransmitter, in regulation of the rat micturition reflex. Methods: In urethane‐anesthetized (0.8 g/kg, ip) male rats, evaluation of urodynamic parameters was started 1 h before intracerebroventricular administration of CORM‐3 (CO donor) or ZnPP (non‐selective inhibitor of heme oxygenase, a CO producing enzyme) and continued for 2 h after the administration. We also investigated effects of centrally pretreated SR95531 (GABAA receptor antagonist) or SCH50911 (GABAB receptor antagonist) on the CORM‐3‐induced response. Results: CORM‐3 significantly prolonged intercontraction intervals (ICIs) without changing maximal voiding pressure (MVP), while ZnPP significantly shortened ICI and reduced single‐voided volume and bladder capacity without affecting MVP, post‐voided residual volume, or voiding efficiency. The ZnPP‐induced ICI shortening was reversed by CORM‐3. The CORM‐3‐induced ICI prolongation was significantly attenuated by centrally pretreated SR95531 or SCH50911, respectively. Conclusions: Brain CO can suppress the rat micturition reflex through brain γ‐aminobutyric acid (GABA) receptors. [ABSTRACT FROM AUTHOR]

Purpose: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are primarily preferred in patients with type 2 diabetes. The purpose of this paper was to elucidate the effects of SGLT-2 inhibitor use on patients' voiding habits, sleep, and quality of life. Methods: Our study involved patients with type 2 diabetes who had an SGLT2 inhibitor added to their current treatment. The frequency of day-night urination, lower urinary tract symptoms, sleep and quality of life were assessed both prior to initiation of the treatment and during subsequent 1st and 3rd months. Results: The study included 38 women and 34 men. At the third month after SGLT-2 inhibitor had been added, there was a significant decrease in HbA1c, triglyceride and microalbumin levels (p<0.05). There was no increase in voiding frequency (day/night) and there was no difference in the evaluation of lower urinary tract symptoms, but voiding volumes increased in uroflowmetry. When the short form-36 (SF-36) scale was examined, there was a significant improvement in physical function, one of the sub-parameters (p = 0.01). The factor affecting this most, was the improvement in HbA1c. Conclusion: This paper suggests that SGLT-2 inhibitors don't increase voiding frequency and don't cause an increase in lower urinary tract symptoms. [ABSTRACT FROM AUTHOR]

Pelvic fracture is a serious injury, which has a profound impact on sexual function due to concurrent nervous and urethral injuries. In this case report, we describe a 29-year-old single man who had retrograde ejaculation as a result of a pelvic fracture-related posterior urethral stricture. The patient wanted to improve his ejaculatory ability after experiencing urethral stricture for 8 years and retrograde ejaculation for 3 years following the pelvic fracture. We precisely located and measured the patient's urethral stricture using a retrograde urethrogram, and we used transrectal color Doppler ultrasound to track the patient's ejaculation process in real time. Next, we used urethral balloon dilatation to relieve the urethral stricture. Urinary obstruction symptoms have completely resolved, and the patient was able to urinate without any obstructions. Meanwhile, the real-time transrectal color Doppler ultrasound result showed that some semen might ejaculate externally by passing through the initial stricture area, while some semen continued to flow retrogradely into the bladder. [ABSTRACT FROM AUTHOR]

Flexible pressure sensors are lightweight and highly sensitive, making them suitable for use in small portable devices to achieve precise measurements of tiny forces. This article introduces a low-cost and easy-fabrication strategy for piezoresistive flexible pressure sensors. By embedding silver nanowires into a polydimethylsiloxane layer with micro-pyramids on its surface, a flexible pressure sensor is created that can detect low pressure (17.3 Pa) with fast response (<20 ms) and high sensitivity (69.6 mA kPa−1). Furthermore, the pressure sensor exhibits a sensitive and stable response to a small amount of water flowing on its surface. On this basis, the flexible pressure sensor is innovatively combined with a micro-rotor to fabricate a novel urinary flow-rate meter (uroflowmeter), and results from a simulated human urination experiment show that the uroflowmeter accurately captured all the essential shape characteristics that were present in the pump-simulated urination curves. Looking ahead, this research provides a new reference for using flexible pressure sensors in urinary flow-rate monitoring. ARTICLE HIGHLIGHTS: • A flexible pressure sensor is presented based on a micro-pyramid array and silver nanowires and with low detection limit, high sensitivity, and fast response. • The sensor responds accurately and stably to human pulse signals and rapidly changing cyclic loads. • The sensor can accurately and sensitively detect dynamic water flow passing over its upper surface, and the uroflowmeter designed using it has considerably high detection accuracy. [ABSTRACT FROM AUTHOR]

The study aims to evaluate the impact of family synchronized empowerment education on the sense of shame and quality of life in patients discharged with catheters following radical surgery for cervical cancer. The data of 92 patients who underwent radical cervical cancer surgery and were discharged with urinary catheters from October 2022 to October 2023 were retrospectively retrieved and assessed. Patients who had surgery from October 2022 to April 2023 comprised the control group, while those who had surgery from May 2023 to October 2023 formed the observation group, with 46 patients in each group. The control group received conventional health education, while the observation group received family synchronized empowerment education. The Social Influence Scale (SIS), Family Assessment Device (FAD), and Quality of Life Questionnaire-C30 (QLQ-C30) were used to assess patients’ sense of shame, family function and quality of life. Data on self-urination cases, urinary retention, catheter reset and urinary tract infection were collected during follow-up visits. The results showed that those from the observation group had statistically significant improvements in SIS score, FAD score, functional domain of QLQ-C30, symptom domain, six symptom scores, and overall health status score compared to the control group (p < 0.05). In addition, the observation group also had better outcomes in self-urination (p < 0.05), urine retention incidence, catheter reset rate, and urinary infection incidence (p < 0.05). Thus, family synchronized empowerment education may effectively reduce the sense of shame, enhance the quality of life for patients discharged with catheters and facilitate early catheter removal and resumption of self-urination. [ABSTRACT FROM AUTHOR]

In this paper, a new artificial detrusor system is proposed to achieve continuous control over the urination process and realize the normal voiding process of human (NVPH). The system is powered by a wireless power transfer (WPT) module, controlled by a control module and actuated by a shape memory alloy (SMA) spring. The design method of the SMA springs is proposed. Two control strategies are proposed to achieve NVPH. The first strategy is an open-loop control strategy based on the result of finite element analysis (FEM) simulation results and calculation of the derived system governing equations. The second strategy is a closed-loop control strategy based on the collection of feedback data and algorithmic processing. Both strategies are verified by experiments. The results show that the proposed system is feasible and both strategies can achieve NVPH. It can provide reference and guidance for the design of artificial detrusor system and formulation of control strategies. [ABSTRACT FROM AUTHOR]

Aim: This study utilized latent profile analysis to investigate care needs subgroups among older adults with urinary incontinence. Methods: The "Elderly Urinary Incontinence Care Needs Inventory" surveyed 510 participants in two Guangzhou City hospitals from July 2022 to June 2023. Latent profile analysis created a classification model, and variance and correlation analysis assessed influencing factors. Results: A total of 510 older adults with urinary incontinence participated. The standardized total care needs score was 78.77 ± 5.03, with variations across dimensions: social participation needs scored (71.16 ± 10.32), daily life care needs (78.80 ± 5.51), medical care needs (77.33 ± 12.17), psychological comfort needs (76.97 ± 6.51) and health education needs scored highest (82.67 ± 6.77). Three distinct profiles emerged: "medium," "high SPN‐PCN" and "high DLCN‐MCN‐HEN". The majority belonged to the "high SPN‐PCN" profile. Significant correlations were found with age, education, leaks and frequency of micturitions. Conclusion: Research findings showed the existence of three distinct categories, with a notable majority of participants belonging to the "high SPN‐PCN" group. The significance of having these classes identified lies in the move away from a one‐size‐fits‐all approach to a more nuanced understanding of care needs. Customized nursing interventions can be devised based on specific factors, such as age, education level, urinary incontinence‐related symptoms and potential category. For instance, for the "high SPN‐PCN" group, our nursing strategy can encompass heightened psychological support and expanded opportunities for social engagement.Furthermore, in the training and education of healthcare professionals, recognizing and meeting the needs of each potential category of older adults might require more attention. Geriatr Gerontol Int 2024; 24: 758–765. [ABSTRACT FROM AUTHOR]

Introduction: The bladder diary (BD) is a widely used diagnostic instrument. Its correct completion is essential for obtaining a reliable clinical impression. Previous studies reported problems with correctly completing the BD. This qualitative study investigated whether an animated fill-in instruction improves comprehension compared with a textual fill-in instruction. Material and methods: Adults assessed either a BD with the regular textual fill-in instruction (TBD) or a BD with an animated fill-in instruction (ABD). The thinking-aloud method and interviews were used. Predefined items were scored. Results: ABD participants had a better understanding of the BD than the TBD participants, especially participants with low levels of education. They scored better in naming micturition, fluid intake, incontinence and urge. Non-native speakers appreciated the visual support. Conclusion: Textual fill-in instructions for bladder diaries are difficult to understand for participants of all education levels because of terminology and layout. Animated fill-in instructions improve comprehension and completion quality and provide more reliable information. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to compare holmium laser enucleation of the prostate (HoLEP) outcomes in patients with and without neurologic diseases (ND). Methods: A prospectively maintained database of patients undergoing HoLEP from January 2021 to April 2022 was reviewed. The following NDs were included: diabetes-related neuropathy/neurogenic bladder, Parkinson’s disease, dementia, cerebrovascular accident, multiple sclerosis, traumatic brain injury, transient ischemic attack, brain/spinal tumors, myasthenia gravis, spinal cord injury, and other. Statistical analysis was performed using t-tests, Chi-squared, and binomial tests (p<0.05). Results: A total of 118 ND patients were identified with 135 different neurologic diseases. ND patients were more likely to have indwelling catheters (57% vs. 39%, p=0.012) and urinary tract infections (UTIs) preoperatively (32% vs. 19%, p=0.002). Postoperatively, ND patients were more likely to fail initial trial of void (20% vs. 8.1%, p<0.001) and experience an episode of acute urinary retention (16% vs. 8.5%, p=0.024). Within 90 days postoperative, the overall complication rate was higher in the ND group (26% vs. 13%, p=0.001). Within the ND group, 30/118 (25%) had ≥1 UTI within 90 days preoperative, which decreased to 10/118 (8.7%) 90 days postoperative (p<0.001). At last followup (mean 6.7 months [ND] vs. 5.4 months [nonND], p=0.03), four patients (4.4%) in the ND group required persistent catheter/clean intermittent catheterization compared to none in the non-ND group (p=0.002). Conclusions: Patients with ND undergoing HoLEP are more likely to experience postoperative retention and higher complication rates compared to non-ND patients. While UTI rates are higher in this population, HoLEP significantly reduced three-month UTI and catheterization rates. [ABSTRACT FROM AUTHOR]

To evaluate the possible impact of patients' sacral ratios (SRs) on response to biofeedback (BF) therapy in pediatric patients with lower urinary tract dysfunction (LUTD). In this retrospective cohort conducted from 2016 to 2018 in our tertiary medical center, we included the medical records of all pediatric patients with LUTD who were nominated for BF due to having abnormal uroflowmetry patterns and simultaneous increase in electromyography (EMG) activity. Ten sessions of weekly animated BF were performed for each patient. All patients underwent a complete urological evaluation, uroflowmetry with simultaneous EMG and post-void residual measurement before and after treatment. SRs were calculated based on plain anteroposterior lumbosacral radiographs. Patients were then divided into normal SR (≥0.74) and low SR (<0.74) and outcomes were compared between them. Of the total 86 patients included in our study, 48 (55.8%) had a normal SR (≥0.74), while 38 (44.2%) had a low SR (<0.74). Our data revealed that BF therapy significantly improved maximum and average urinary flow rates, urine volume, daytime urinary incontinence, enuresis, urinary urgency and constipation; irrespective of the patients' SRs (all P < 0.001). Our between-groups analyses showed that after the completion of BF, the SR ≥ 0.74 group had significantly higher maximum urinary flow rate (mean difference [95%CI]: 7.7 [5.4, 10.0], P < 0.001) (Figure) and urine volume (mean difference [95%CI]: 49.9 [19.5, 80.4], P = 0.002) and significantly lower diurnal urinary incontinence (4.2% vs. 21.1%, P = 0.020), enuresis (4.2% vs. 18.4%, P = 0.040) and constipation (2.1% vs. 23.7%, P = 0.004) compared to the SR < 0.74 group. SR has been proposed as a reliable indicator of bony pelvis growth and subsequent lumbosacral neurodevelopment. Additionally, larger SR values are associated with better postoperative sphincter function in children with urological and anorectal malformations. Our results demonstrated that after completion of BF, the normal SR group had a significantly better improvement of some of the uroflowmetry indicators and LUTD-associated symptoms compared to the low SR group. Our findings implied that although BF therapy is an efficient treatment for children with LUTD, irrespective of their sacral development; children with enhanced sacral development may benefit from better clinical response, especially in terms of LUTD-associated symptoms. [ABSTRACT FROM AUTHOR]

Objectives: The vagina has an important role in transmission of 3 opposite striated pelvic muscle forces acting against pelvic ligaments to close urethra distally and at bladder neck. The same muscle forces stretch vagina to support the urothelial stretch receptors to prevent them activating the micturition reflex at low bladder volumes, and to open the urethra prior to micturition. Striated muscles have a limited contractile force. The hypothesis the weight of the intraabdominal contents on the vaginal membrane adds additional weight for the striated pelvic muscles to move when they tension the vagina to close the urethra for continence, open it for evacuation and prevent urothelial stretch receptors from activating micturition prematurely (interpreted as urgency). Materials and Methods: To test if a binary musculo-elastic model of bladder control can explain significant cure/improvement of lower urinary tract symptoms following weight loss after bariatric surgery. Results: The results for improvement of stress urinary incontinence (SUI), overactive bladder syndrome (OAB) and mixed symptoms were consistent with the concept of an extra intraabdominal intestinal load on the vagina membrane which prevented the 3 opposite striated muscle forces stretching the vagina sufficiently to close the urethra (SUI) and/or prevent excessive afferent impulses from the urothelial stretch receptors activating micturition prematurely (OAB). Conclusion: Removing the burden of intestinal contents on the vagina restored several different areas of incontinence, SUI, mixed incontinence, urgency (OAB) seemingly validates the hypothesis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Urinary incontinence (UI) consists of involuntary leakage of urine during the storage phase of urination. Methods: An anonymous survey was given to Spanish and Italian veterinarians about canine UI treated cases, diagnosis, treatment, follow-up, and professional interest. Results and discussion: Most veterinarians treated =3 cases/quarter, resulting in the percentage of incontinence males being lower than that of females (1-4% vs 0-24%). The percentage of spayed incontinent females was lower in Spain (0-24%) than in Italy (75-100%). Most diagnoses were based on a diagnostic algorithm (Spain: 88.7%; Italy: 65.3%); patient report and history, blood work, urinalysis and abdominal ultrasound. Urethral/bladder pressure measurement was unusual (Spain: 0.2%; Italy: 2.4%). In Spain, radiology with contrast medium and CT urography (26.3% and 34.4%, respectively) were more frequent than in Italy (11.6% and 22.7%, respectively). When suspecting urethral sphincter mechanism incompetence pharmacological trial (Spain: 93.2%; Italy: 78.9%). The first-choice medical treatment was Phenylpropanolamine, followed by Ephedrine and Deslorelin. When pharmacotherapy failed, the most frequent option was drug change, followed by increased drug dosage/frequency of administration, surgical therapy and colposuspension. A review was completed after the first week of treatment followed by periodic reviews. Most of the respondents participated in continuing education only if UI occurred in their everyday practice (Spain: 63.0%; Italy: 55.4%) and about 30% responders did it regardless of the number of UI cases treated (Spain: 30.5%; Italy: 37.4%). Conclusion: Some recommendations in clinical practice were made. UI can be underestimated by owners; therefore, a complete history should be obtained by veterinarians. Veterinarians should carefully evaluate if spaying is advisable considering it could increase UI risk. A step-by-step approach is recommended and a specific diagnostic-therapeutic algorithm for UI in dogs is provided. Conservative approaches (regular exercise, weight loss in overweight dogs and observing an "incontinence diary" to identify abnormal patterns of urination) are advisable. [ABSTRACT FROM AUTHOR]

Background: Exposure to antigens is crucial for child immune system development, aiding disease prevention and promoting infant health. Some common food antigen proteins are found in human breast milk. However, it is unclear whether gluten antigens linked to celiac disease (CD) are transmitted through breast milk, potentially impacting the development of the infant's immune system. Objective: This study aimed to analyze the passage of gluten immunogenic peptides (GIP) into human breast milk. We evaluated the dynamics of GIP secretion after lactating mothers adopted a controlled gluten-rich diet. Methods: We prospectively enrolled 96 non-CD and 23 CD lactating mothers, assessing total proteins and casein in breast milk, and GIP levels in breast milk and urine. Subsequently, a longitudinal study was conducted in a subgroup of 12 non-CD lactating mothers who adopted a controlled gluten-rich diet. GIP levels in breast milk and urine samples were assayed by multiple sample collections over 96 hours. Results: Analysis of a single sample revealed that 24% of non-CD lactating mothers on a regular unrestricted diet tested positive for GIP in breast milk, and 90% tested positive in urine, with significantly lower concentrations in breast milk. Nevertheless, on a controlled gluten-rich diet and the collection of multiple samples, GIP were detected in 75% and 100% of non-CD participants in breast milk and urine, respectively. The transfer dynamics in breast milk samples were long-enduring and GIP secretion persisted from 0 to 72 h. In contrast, GIP secretion in urine samples was limited to the first 24 h, with inter-individual variations. In the cohort of CD mothers, 82.6% and 87% tested negative for GIP in breast milk and urine, respectively. Conclusions: This study definitively established the presence of GIP in breast milk, with substantial inter-individual variations in secretion dynamics. Our findings provide insights into distinct GIP kinetics observed in sequentially collected breast milk and urine samples, suggesting differential gluten metabolism patterns depending on the organ or system involved. Future research is essential to understand whether GIP functions as sensitizing or tolerogenic agents in the immune system of breastfed infants. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Bladder exstrophy-epispadias complex is a rare condition that necessitates numerous surgical procedures during a patient's youth to achieve adequate urine storage and continence. This study aimed to identify the specific needs and functional challenges faced by adults who underwent pediatric bladder exstrophy reconstructions and assess the management of these issues in an adult population. METHODS: A retrospective chart review was conducted for all bladder exstrophy complex patients who underwent surgery at a young age and were subsequently referred to our center between 2005 and 2020. Inclusion criteria included patients with cloacal or classical bladder exstrophy older than 18 years. We recorded the reasons for referral, management of contemporary complaints, types of past and present urinary reconstructions, and their current functional status. RESULTS: The study included 38 patients. The primary reasons for referral were incontinence (39%) and catheterization difficulties (24%). Management typically involved partial or complete surgical revision of their urinary reservoir, occasionally combined with a bladder neck procedure. Ultimately, only three patients continued to experience incontinence, while none reported catheterization issues after undergoing treatment at our center. Long-term exstrophy-related reconstruction complications included urinary tract infections (39%), stones (29%), stenosis (24%), fistulas (13%), chronic renal disease (16%), metabolic abnormalities (3%), and cancer (3%). CONCLUSIONS: Adults who have previously undergone bladder exstrophy reconstruction exhibit a wide range of urologic reconstructions. Their needs often revolve around continence and catheterization concerns. Most patients with satisfactory functional outcomes perform self-catheterization through a continent cutaneous channel and have either a continent pouch or an augmented bladder. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the feasibility of the 3-day micturition diary for children with enuresis. We included 53 such children (March 2020-December 2021), who kept a urination diary and filled out a questionnaire. The data were retrospectively analyzed; the differences in completion rate, sensitivity, and specificity between the urination diaries recorded for 3 and 7 days were compared; and factors affecting the completion of the urination diary were assessed. Compared with the 7-day micturition diary, the 3-day micturition diary is easier to complete; the data tend to be more credible; and its application in children with enuresis is feasible. [ABSTRACT FROM AUTHOR]

Aim: After spinal cord injuries (SCIs), patients may develop either detrusor-sphincter dyssynergia (DSD) or urinary incontinence, depending on the level of the spinal injury. DSD and incontinence reflect the loss of coordinated neural control among the detrusor muscle, which increases bladder pressure to facilitate urination, and urethral sphincters and pelvic floor muscles, which control the bladder outlet to restrict or permit bladder emptying. Transcutaneous magnetic stimulation (TMS) applied to the spinal cord after SCI reduced DSD and incontinence. We defined, within a mathematical model, the minimum neuronal elements necessary to replicate neurogenic dysfunction of the bladder after a SCI and incorporated into this model the minimum additional neurophysiological features sufficient to replicate the improvements in bladder function associated with lumbar TMS of the spine in patients with SCI. Methods: We created a computational model of the neural circuit of micturition based on Hodgkin-Huxley equations that replicated normal bladder function. We added interneurons and increased network complexity to reproduce dysfunctional micturition after SCI, and we increased the density and complexity of interactions of both inhibitory and excitatory lumbar spinal interneurons responsive to TMS to provide a more diverse set of spinal responses to intrinsic and extrinsic activation of spinal interneurons that remains after SCI. Results: The model reproduced the re-emergence of a spinal voiding reflex after SCI. When we investigated the effect of monophasic and biphasic TMS at two frequencies applied at or below T10, the model replicated the improved coordination between detrusor and external urethral sphincter activity that has been observed clinically: low-frequency TMS (1 Hz) within the model normalized control of voiding after SCI, whereas high-frequency TMS (30 Hz) enhanced urine storage. Conclusion: Neuroplasticity and increased complexity of interactions among lumbar interneurons, beyond what is necessary to simulate normal bladder function, must be present in order to replicate the effects of SCI on control of micturition, and both neuronal and network modifications of lumbar interneurons are essential to understand the mechanisms whereby TMS reduced bladder dysfunction after SCI. Author summary: We developed a computer model using Hodgkin-Huxley representations of spinal interneurons to simulate normal bladder control, dysfunctional control of micturition after SCI, and clinically observed bladder responses to transcutaneous magnetic stimulation (TMS) of the lumbar spine. We incorporated an infantile spinal voiding reflex by adding lumbar interneurons to make a spinal voiding reflex possible and modified descending control of these neurons to inhibit the infantile reflex in normal adults. After SCI, the descending inhibition of the spinal voiding reflex is lost, and the spinal voiding reflex re-emerges. To make the lumbar spine response to TMS, it was necessary to add two excitatory interneurons and one inhibitory neuron in the lumbar spine: these neurons manifested frequency-specific responses to TMS. Based on the dynamical properties of the inhibitory and excitatory neurons responding to TMS, low frequency TMS (1 Hz) permitted the action of the re-emergent spinal voiding reflex to coordinate bladder contraction and urethral relaxation so that effective bladder emptying was re-established during TMS. Higher frequency TMS contracted the urethral sphincter and prevented simulated leaking and incontinence. Greater lumbar interneuronal complexity, consistent with animal experiments, is required to simulate bladder responses to SCI and TMS. [ABSTRACT FROM AUTHOR]

Objective To investigate the effectiveness, safety and economy of Qianliexin capsule in the treatment of chronic prostatitis using multi-center and real world research method for providing the guidance for clinical application. Methods A total of 3 399 patients with chronic prostatitis were enrolled from 22 centers across the country. The patients received Qianliexin capsule alone or in addition to their conventional treatment. NIH-CPSI scores were observed and recorded before and after treatment, and change s in total re sponse rate, score halving rate, symptom disappe arance rate and single symptom score we re analyzed. Adverse reactions were observed and abnormal rate of liver and kidney function (ALT/AST/Cr), as well as cost-effectiveness ratio and incremental cost-effectivene ss ratio during treatment cycle were recorded. Results After treatment, the total NIH-CPSI score decreased compared with that before treatment, and the total effective rate was 89.79%, the difference was statistically significant (P <0.001). The overall halving rate of pain or discomfort symptom score was 76.21%, and the overall halving rate of urination symptom score was 78.26%. The overall disappearance rate of pain or discomfort symptom score was 23.36%, and the overall disappearance rate of urination symptom score was 21.77%. The incidence of adverse reactions was 0.47%, and the frequency was rare. No serious adverse reactions were found. In the economic evaluation, the cost-effectiveness ratio of Qianliexin capsule used alone (3.42 yuan/%) was the smallest. Conclusion Qianliexin capsule can significantly improve the pain and discomfort symptoms and urination symptoms of chronic prostatitis patients in real medical scenes, with good safety and high economy. [ABSTRACT FROM AUTHOR]

The Quality of Life Assessment in Spina bifida for Teenagers (QUALAS-T) is a tool used to evaluate health-related quality of life (HRQOL) in adolescents with spina bifida (SB). The purpose of this study was to translate the QUALAS-T into Korean and validate its Korean version (QUALAS-T-K). Translation and validation processes were carried out in accordance with a specified protocol, including forward and back translation, a content validity study, and a main study. The tool's reliability was evaluated based on its internal consistency and stability. Factor analysis was conducted, and convergent validity was confirmed using the KIDSCREEN-27. Of the 59 participants, 35 had lipomyelomeningoceles. Confirmatory factor analysis confirmed that QUALAS-T-K had the same structure as QUALAS-T. The QUALAS-T-K showed excellent internal consistency (α: 0.872–0.893, ω: 0.875–0.885), test–retest reliability (ICC:0.84–0.92), and weak to strong correlations with the KIDSCREEN-27. The QUALAS-T-K, developed by reflecting on the characteristics of SB and considering the applicability of Korean cultural characteristics and clinical practice, is a convenient and reliable tool with excellent internal consistency and stability. This could be a useful tool in clinical and research settings for HRQOL evaluation of adolescents with SB. Optimizing health-related quality of life (HRQOL) is one of the goals of individuals with spina bifida (SB), and HRQOL measures that reflect the condition specificity of SB should be performed. The QUAlity of Life Assessment in Spina bifida for Teenagers (QUALAS-T), developed in the USA, is a self-reported HRQOL questionnaire used in research and clinical practice for adolescents with SB. This study revealed that the QUALAS-T, translated into Korean, is a valid, convenient, and reliable tool. The Korean version of the QUALAS-T is a useful tool that can be used in clinical and research settings to optimize HRQOL in adolescents with SB. [ABSTRACT FROM AUTHOR]

Micturition serves an essential physiological function that allows the body to eliminate metabolic wastes and maintain water-electrolyte balance. The urine spot assay (VSA), as a simple and economical assay, has been widely used in the study of micturition behavior in rodents. However, the traditional VSA method relies on manual judgment, introduces subjective errors, faces difficulty in obtaining appearance time of each urine spot, and struggles with quantitative analysis of overlapping spots. To address these challenges, we developed a deep learning-based approach for the automatic identification and segmentation of urine spots. Our system employs a target detection network to efficiently detect each urine spot and utilizes an instance segmentation network to achieve precise segmentation of overlapping urine spots. Compared with the traditional VSA method, our system achieves automated detection of urine spot area of micturition in rodents, greatly reducing subjective errors. It accurately determines the urination time of each spot and effectively quantifies the overlapping spots. This study enables high-throughput and precise urine spot detection, providing important technical support for the analysis of urination behavior and the study of the neural mechanism underlying urination. [ABSTRACT FROM AUTHOR]

Hypereosinophilic syndrome is a myeloproliferative disorder that is distinguished with the presence of eosinophilia, which is an absolute eosinophil level of more than 1500/µL for no less than 6 months, no recognized cause for eosinophilia, and clear organ involvement characteristics. But, in some cases where patients require therapy to decrease eosinophil counts due to severe symptoms, a lower time period of hypereosinophilic is also admissible. In this case series, we have included three cases in which first case presented with the features of diarrhea, nausea, and decreased appetite who underwent colonoscopy and was diagnosed as a case of eosinophilic colitis. The second patient was a female came with abdominal pain and burning micturition, who was having eosinophilia on blood count examination and was diagnosed as a case of eosinophilic cystitis. Third case was young female who was diagnosed as eosinophilic endocarditis on two-dimensional echocardiography having dyspnea and rash and high eosinophil count on blood smear. All the three patients were started on steroids, who recovered well with medication and were discharged for follow-up after 7 days with complete blood count. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted infections (STIs) increase gradually and have become a public health problem in the world. UU, CT, NG, and MG are four common STI pathogens. Our retrospective study analyzed the clinical situation and the laboratory data of patients infected with the four pathogens. The prevalence of the four pathogens, detected in urine and genital tract secretion, was studied in Hangzhou, China. Methods: A total of 3,168 male and female patients were randomly selected from February 2023 to February 2024. Urine and genital secretions were collected, and four STI pathogens were controlled for detection. Data were collected from the hospital’s electronic medical records, and SPSS 25.0 software was used to perform a statistical analysis. Results: Among 3,168 patients, a total of 1,527 were detected as positive, and the positive rate was 48.20%. The age of patients ranged from 13 - 98 years, with an average age of 45.6. The total of patients consisted of 2,191 males and 977 females, which had a significant difference (p < 0.05). Specimens were mainly collected from the Department of Dermatovenerology, Urological Surgery, Obstetrics and Gynecology, and so on. The positive rate was statistically different between male and female patients (p < 0.05). Single infection performed a main role and accounted for 79.57% of all of the positive patients. In the d 20 age group, the positive rate was the highest and was as high as 77.65%. In detail, single infection caused by UU dominated, especially in the 21 - 30 age group. Double infection caused by UU and CT and triple infection caused by UU, CT, and NG were the majority, both especially in the 21 - 30 age group. There were significant differences in the positive rates in the different age groups and in the four pathogens (p < 0.05). Quadruple infection was very rare and had only been detected in one patient. Conclusions: The prevalence of the four pathogens in Hangzhou was different from other regions. More male than female patients, more single than multiple infections, and more single and multiple infections occurring in young people were the features in Hangzhou. The study would provide reference for prevention, diagnosis, and treatment of STI. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Purpose Through their biological clocks, organisms on this rotating planet can coordinate physiological processes according to the time of the day. However, the prevalence of circadian rhythm disorders has increased in modern society with the growing number of shift workers, elevating the risk of various diseases. In this study, we employed a mouse model to investigate the effects of urinary rhythm disturbances resulting from dietary changes commonly experienced by night shift workers. Methods We established 3 groups based on feeding time and the use of restricted feeding: ad libitum, daytime, and early nighttime feeding. We then examined the urinary rhythm in each group. In addition to the bladder rhythm, we investigated changes in mRNA patterns within the tissues constituting the bladder. Additionally, we assessed the urination rhythm in Per1 and Per2 double-knockout mice and evaluated whether the injection of antioxidants modified the impact of mealtime shift on urination rhythm in wild-type mice. Results Our study revealed that a shift in mealtime significantly impacted the circadian patterns of water intake and urinary excretion. In Per2::Luc knock-in mouse bladders cultured ex vivo, this shift increased the amplitude of Per2 oscillation and delayed its acrophases by several hours. Daily supplementation with antioxidants did not influence the mealtime shift-induced changes in circadian patterns of water intake and urinary excretion, nor did it affect the modified Per2 oscillation patterns in the cultured bladder. However, in aged mice, antioxidants partially restored the urinary rhythm. Conclusions A shift in mealtime meaningfully impacted the urination rhythm in mice, regardless of the presence of circadian clock genes.

BACKGROUND: The dysfunction of bladder function caused by spinal cord injury is a difficult point in clinical treatment and a hot spot in research. Repairing the injured spinal cord and remodeling the bladder micturition reflex pathway are the fundamental treatment methods. OBJECTIVE: To summarize the reconstruction of the bladder innervation pathway after spinal cord transection injury and its related influencing factors. METHODS: The relevant literature concerning the reconstruction of bladder micturition reflex, neurogenic bladder and urinary reflex and spinal cord repair was retrieved on CNKI, WanFang Data, PubMed and Web of Science. Chinese and English search terms were “neurogenic bladder; spinal cord injury; micturition reflex; spinal cord repair”. RESULTS AND CONCLUSION: In the process of reconstructing the bladder micturition reflex, there are many factors involved, including the repair and reconstruction of the injured spinal cord, the remodeling of micturition center, the changes of bladder tissue and substances and hormones in and out of the body. In this process, there are mainly the following problems: (1) As a complex process, there are many sites involved in the reconstruction of the micturition reflex, so the main sites of action can be selected for in-depth study, so as to break through the doubts existing in the reconstruction of the micturition reflex pathway. (2) The mechanism of the normal micturition reflex is complex. After spinal cord transection injury, whether the central nucleus mass controlling or participating in the micturition reflex is compensated and the corresponding compensatory mechanism needs to be further investigated. (3) Information communication between the center and the bladder is interrupted after spinal cord transection injury. Whether there is a direct information connection between the center and the bladder remains to be further investigated. (4) The relationship between reconstructing micturition reflex and body fluid after spinal cord transection injury needs further study. In the reconstruction of the bladder micturition reflex, the key treatment is to promote spinal cord repair, nerve reflex reconstruction, substance metabolism and bladder tissue structure adjustment through intervention. Chinese medicine and Western medicine have their methods. [ABSTRACT FROM AUTHOR]