522 results on '"urodynamic"'
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2. Anorectal manometry and urodynamics in children with spina bifida: can we predict the colonic dysmotility from bladder dysfunction?
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Anadolulu, Ali İhsan, Erdoğan, Ragibe Büşra, Canmemiş, Arzu, Özel, Şeyhmus Kerem, and Durakbaşa, Çiğdem Ulukaya
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SPINA bifida ,BLADDER diseases ,CHILD patients ,NEUROGENIC bladder ,TREATMENT effectiveness - Abstract
Introduction: Spina bifida is a condition that impacts the development of the neural tube leading to urological and gastrointestinal symptoms. Both systems are influenced together due to their shared innervation and embryological origin. Despite its impact on health and well-being there has been limited research on the relationship between manometry results and urodynamic tests, in this patient population. The aim of this study was to delineate the association of neurogenic bladder/bowel dysfunction with anorectal manometry and urodynamics. Materials and methods: Urodynamics and anorectal manometry were used to analyse the neurogenic bowel and bladder dysfunctions in 29 paediatric patients with spina bifida. Those children who had previous anorectal surgical interventions were excluded from the study. Patients were grouped according to the level of spinal defect to lower or upper defect. In this study, parameters such as bladder compliance, postvoid residual volume, detrusor activity, anorectal pressures, and rectal compliance were considered. Group comparison tests were performed using standardized paediatric protocols for data analysis as well as correlation tests. A p-value less than 0.05 was considered significant at all levels. Results: A total of 29 patients with spina bifida were identified. Of these, 14 were male and 15 were female. Bladder function differed among the patients in the lower defect (LD, n:18) and upper defect (UD, n:11) groups. LD group exhibited lower bladder volumes (175.45 ± 106.19 mL) compared to the UD group (266.83 ± 102.54 mL, p < 0.05). All LD and 72.7% of UD had detrusor sphincter dyssynergia. There was positive correlation between functional bladder parameters and bowel dysfunction, such as rectoanal inhibitory reflex (RAIR) and maximum filling pressures of the bladder (rho = 0.569, p < 0.05). There was also a significant correlation between rectal compliance and bladder volumes. Conclusions: Association of neurogenic bowel and bladder dysfunction is a complex issue which requires personalized approach for managing the consequences. In children with neurogenic bladder dysfunction increased RAIR activity may be a sign for colonic dysmotility of neurogenic origin. This study may also pave the way for delineation of the mechanism under the generation of RAIR which is thought to be only intrinsic in origin. To optimize treatment modalities, full assessment with anorectal manometry and urodynamic studies should be done in patients with spina bifida. Clinical trial registration: This study was not performed on volunteer patients. Clinical study enrolment is not required as this study was obtained from urodynamics and anorectal manometry performed in patients with neurogenic bladder/bowel and during clinical follow-up. Highlights: What is currently known about this topic?: Spina bifida involves neuroembryological development that affects shared sacral innervations, causing bladder and bowel dysfunctions. What new information is contained in this article?: This research work reveals how anorectal manometry is related to urodynamic findings in children with spina bifida hence proposes individualized treatment choices for the purpose of better clinical outcome. [ABSTRACT FROM AUTHOR] more...
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- 2024
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3. Early bladder dysfunction after vesicovaginal fistula repair: A prospective comparative analysis of transvaginal, open, and laparoscopic abdominal approaches.
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Anand, Madhur, Kumar, Manoj, Jain, Mayank, Gupta, Amber, Kumar, Abhijeet, Singh, Bhupendra Pal, Singh, Vishwajeet, and Goel, Apul
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VESICOVAGINAL fistula ,BLADDER diseases ,URINARY organs ,POSTOPERATIVE period ,LAPAROSCOPIC surgery - Abstract
Introduction: We aim to compare the clinical and urodynamic profile of lower urinary tract symptoms (LUTS) in patients undergoing laparoscopic, open transabdominal, and laparoscopic transabdominal vesicovaginal fistulae (VVF) repair at 3 months of repair, that is, in early postoperative period. Materials and Methods: Fifty‐one consecutive patients with endoscopically confirmed VVF were enrolled in our study over 2 years. Malignant fistulae, radiation‐induced, and complex fistulae were excluded after cross‐sectional imaging. All patients underwent a postoperative assessment for the success of the repair. Then at 3 months, they completed the American Urological Association Symptom Score questionnaire and underwent a dual channel pressure‐flow urodynamic study. The results of transvaginal, laparoscopic, and open transabdominal repairs were compared. Results: All patients belonged to the Indian Caucasian race. The mean age was 35.43 ± 6.63 years. Thirty‐two patients had supratrigonal and 19 had trigonal fistulae. Laparoscopic transabdominal repair was done in 15 patients, open transabdominal repair in 22 patients, and transvaginal repair in 14 patients. Forty‐six patients reported some LUTS at a median follow‐up of 5.83 ± 2.37 months postoperatively. Only 18 (35.2%) of these patients had moderate to severe symptoms The postoperative bladder dysfunction rates in open transabdominal, transvaginal and laparoscopic transabdominal groups were 36.4%, 28.6%, and 20%, respectively. Twenty‐seven patients (52.9%) had some urodynamic abnormality, that is, small capacity (5), high voiding pressures (14), genuine stress incontinence (3), and poor compliance (3). Bladder capacity was a significant predictor of bladder dysfunction in our patients. Conclusions: In our study, all three surgical approaches were associated with bladder dysfunction, however, it was the least in the laparoscopic transabdominal approach. Postoperative bladder capacity is a significant predictor of bladder dysfunction. [ABSTRACT FROM AUTHOR] more...
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- 2024
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4. Anorectal manometry and urodynamics in children with spina bifida: can we predict the colonic dysmotility from bladder dysfunction?
- Author
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Ali İhsan Anadolulu, Ragibe Büşra Erdoğan, Arzu Canmemiş, Şeyhmus Kerem Özel, and Çiğdem Ulukaya Durakbaşa
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Spina bifida ,Anorectal manometry ,Urodynamic ,Neurogenic bladder ,Neurogenic bowel ,Children ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Introduction Spina bifida is a condition that impacts the development of the neural tube leading to urological and gastrointestinal symptoms. Both systems are influenced together due to their shared innervation and embryological origin. Despite its impact on health and well-being there has been limited research on the relationship between manometry results and urodynamic tests, in this patient population. The aim of this study was to delineate the association of neurogenic bladder/bowel dysfunction with anorectal manometry and urodynamics. Materials and methods Urodynamics and anorectal manometry were used to analyse the neurogenic bowel and bladder dysfunctions in 29 paediatric patients with spina bifida. Those children who had previous anorectal surgical interventions were excluded from the study. Patients were grouped according to the level of spinal defect to lower or upper defect. In this study, parameters such as bladder compliance, postvoid residual volume, detrusor activity, anorectal pressures, and rectal compliance were considered. Group comparison tests were performed using standardized paediatric protocols for data analysis as well as correlation tests. A p-value less than 0.05 was considered significant at all levels. Results A total of 29 patients with spina bifida were identified. Of these, 14 were male and 15 were female. Bladder function differed among the patients in the lower defect (LD, n:18) and upper defect (UD, n:11) groups. LD group exhibited lower bladder volumes (175.45 ± 106.19 mL) compared to the UD group (266.83 ± 102.54 mL, p more...
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- 2024
- Full Text
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5. A comparative study between EMG uroflowmetry with and without a catheter in children
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Shayel Bercovich, Roy Morag, Bezalel Sivan, and David Ben Meir
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Urodynamic ,EMG-flow ,Voiding curves ,Validity ,Lower urinary tract symptoms ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract 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 more...
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- 2024
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6. Evaluation of Peri-Operative Outcomes after Prostatic Urethral Lift with Emphasis on Urodynamic Changes, Symptom Improvement and Sexual Function.
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Lombardo, Riccardo, Santarelli, Valerio, Turchi, Beatrice, Santoro, Giuseppe, Guercio, Alessandro, Franco, Antonio, Secco, Silvia, Dell'Oglio, Paolo, Galfano, Antonio, Olivero, Alberto, Pastore, Antonio Luigi, Al Salhi, Yazan, Fuschi, Andrea, Nacchia, Antonio, Tema, Giorgia, Fegiz, Alessandra, Fusco, Ferdinando, Cini, Riccardo, Cicione, Antonio, and Tubaro, Andrea more...
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BENIGN prostatic hyperplasia , *BLADDER obstruction , *URINARY organs , *PROSTATE , *CYSTOSCOPY - Abstract
Background and Aims: The aim of our study is to evaluate the possible urodynamic effect of prostatic urethral lift (PUL) in patients with lower urinary tract symptoms due to benign prostatic hyperplasia. Methods: A consecutive series of patients undergoing PUL placement were consecutively enrolled in two centers. Inclusion criteria: ≥50 years of age, benign prostatic obstruction (BPO), international prostate symptom score (IPSS) ≥ 13, prostate volume ≤ 60 mL, and no middle prostate lobe. All patients were evaluated using a detailed clinical history, a validated questionnaire, flexible cystoscopy, and pressure flow studies (PFS) at baseline. PFS were performed at 6 months to evaluate the urodynamic effect of PUL. Results: Overall, 20 patients with a median age of 63 were enrolled. At six months, statistically significant improvements in terms of median Qmax (11.5 vs. 8.5; p < 0.05) and median IPSS (16 vs. 10.5; p < 0.05) were recorded, and sexual function was maintained. All urodynamic parameters improved at 6 months, and significance was reached for all values except for PdetQmax. Finally, Schäfer's class improved from a median of III to a median of II. More specifically, 16/20 presented an improvement in the Schäfer class, and 12/20 patients presented a BOOI < 20 at 6 months. Conclusions: PUL represents an effective treatment in patients with LUTS due to BPH and improves bladder outlet obstruction without any effect on sexual function. [ABSTRACT FROM AUTHOR] more...
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- 2024
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7. Female sexual dysfunctions in multiple sclerosis patients with lower urinary tract symptoms: an Italian case-control study.
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Balsamo, Raffaele, Crocetto, Felice, Barone, Biagio, Fusco, Ferdinando, Arcaniolo, Davide, Costantini, Elisabetta, Illiano, Ester, Amicuzi, Ugo, Torella, Marco, Ranavolo, Raffaele, Quattrone, Carmelo, Sio, Marco De, and Tammaro, Simone more...
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MANN Whitney U Test ,FISHER exact test ,DEMYELINATION ,URINARY organs ,YOUNG adults - Abstract
Background Multiple sclerosis (MS) is a recurrent, autoimmune, and inflammatory demyelinating chronic disease that typically manifests in young adulthood and exerts adverse effects on sexual functions. Aim The study evaluated the prevalence of sexual dysfunctions (SDs) and the relationship with neurological disability, depression, and lower urinary tract symptoms (LUTS) in a cohort of MS female patients, comparing these results with those of healthy women. Methods From January 2023 to January 2024, consecutive premenopausal female patients with MS, were recruited and the examination included urinalysis, ultrasonography and a urodynamic test according to the International Continence Society standard. Outcomes Descriptive statistics were reported as mean and standard deviation for continuous variables (analyzed by independent samples Mann-Whitney U test and independent samples Kruskal-Wallis test) while categorical variables were reported as frequency and percentage (analyzed by chi-square test with Fisher's exact test). Results Female Sexual Function Index (FSFI) total score and all FSFI subscales scores were significantly lower in patients with MS vs healthy control subjects (P <.001); FSFI total scores and all FSFI subscale scores were statistically significantly lower in patients with MS with an International Prostate Symptom Score ≥20 (P <.001) and considering a cutoff for Beck Depression Inventory–II score ≥17, depression was present in 61% (n = 47 of 77) of patients with MS and completely absent in the control group. Clinical Translation The knowledge that SDs are a common problem in MS and in other chronic illnesses can alleviate the feeling of stigma and talking openly of sexual problems can be helpful for the patients and so the doctor-patient relationship can be reinforced. Strengths and Limitations The sample was drawn from a single center, and larger multicenter studies that include both genders are needed to obtain strong results. Conclusion Our findings confirm the idea of a polygenic and multifactorial etiology of female SDs in MS. Therefore, women with MS should be evaluated in terms of SDs during follow-ups. [ABSTRACT FROM AUTHOR] more...
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- 2024
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8. A comparative study between EMG uroflowmetry with and without a catheter in children.
- Author
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Bercovich, Shayel, Morag, Roy, Sivan, Bezalel, and Ben Meir, David
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PELVIC floor ,DIAGNOSTIC errors ,URINARY organs ,URINATION ,CATHETERS - Abstract
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] more...
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- 2024
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9. The effect of aromatherapy during urodynamic testing on patients anxiety and cortisol levels: A randomized controlled trial.
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Kettas Dolek, Elife and Altun Ugras, Gülay
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DIASTOLIC blood pressure ,SYSTOLIC blood pressure ,OXYGEN saturation ,RANDOMIZED controlled trials ,HEART beat - Abstract
Background: During urodynamic testing (UT), patients may experience emotions such as embarrassment, discomfort, irritability, and tension, which can cause anxiety. Aromatherapy is a complementary and alternative treatment that may be employed in clinical settings to alleviate patients' anxiety before invasive procedures. Objectives: The aim of this study was to determine the effect of aromatherapy on patients' anxiety and cortisol levels during UT. Materials and Methods: The sample of this single‐center, prospective, two‐armed, randomized controlled clinical study consisted of 98 patients undergoing UT. Patients were randomly assigned to the intervention group (n = 49) and the control group (n = 49). The anxiety level was assessed using the state‐trait anxiety inventory (STAI), and measured with physiological responses to anxiety, such as changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), and cortisol levels, pre and post‐UT. Aromatherapy was applied to the intervention group starting 5 min before UT and continuing throughout the testing. The control group received routine treatment and care. Data were analyzed using Pearson's χ2, dependent samples t‐tests, and independent samples t‐tests. Results: In the study, post‐UT anxiety in the intervention group was significantly lower than in the control group (p < 0.001), while SpO2 was higher (p = 0.021). In the study group, post‐UT anxiety (p < 0.001), HR (p = 0.000), and cortisol levels (p = 0.005) decreased compared to pre‐UT, whereas in the control group, anxiety (p < 0.001) and HR (p = 0.000) decreased, and SBP (p = 0.010) and RR (p = 0.004) increased. Conclusions: Aromatherapy during UT positively influenced both the psychological and physiological responses to anxiety. [ABSTRACT FROM AUTHOR] more...
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- 2024
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10. Urodynamic Changes Following Fewer Injection Sites of Intravesical Botulinum Toxin in Idiopathic Detrusor Overactivity: A Double-Blinded Prospective Randomized Clinical Trial
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Soleimanifard, Niloofar, Nayeri, Reza Kaffash, Moghimian, Mehran, Tayebi, Sona, and Emami, Maryam
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- 2025
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11. Tight Filum Terminale
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Rjoub, Ahmad, Daraghma, Motaz, Demaidi, Yazan, AlAli, Khaled Fares, editor, and Hashim, Hashim Talib, editor
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- 2024
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12. 补中益气汤联合生物反馈电刺激对中老年女性 轻中度压力性尿失禁的改善效果.
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黄克岭, 王 伟, 孙新光, and 温英武
- Abstract
OBJECTIVE: To probe into the improvement effects of Buzhong Yiqi decoction combined with biofeedback electrical stimulation on mild to moderate stress urinary incontinence in middle-aged and elderly women. METHODS: A total of 132 middle-aged and elderly women with mild to moderate stress urinary incontinence admitted into the hospital from May 2021 to Mar. 2023 were divided into control group and combination group via random number table method, with 66 cases in each group. The control group was treated with mild to moderate stress urinary incontinence, the combination group was given Buzhong Yiqi decoction based on the control group. After 8 weeks of continuous treatment, the clinical efficacy, the scores of incontinence questionnaire short form ( ICI-Q-SF) and incontinence quality of life scale ( I-QOL ), results of 1h urine pad test, urodynamic indicators and surface myoelectricity of pelvic floor muscle before and after treatment were compared between two groups, and the incidences of adverse drug reactions were recorded. RESULTS: The total effective rate of the combination group was 95. 45% (63 / 66), higher than 80. 30% (53 / 66) of the control group, with statistically significant difference ( P < 0. 05). After treatment, the ICI-Q-SF scores, volumes and frequencies of urine leakage with 1 h, residual urine volumes, muscle voltages in pre-resting stage and post-resting stage of both groups were lower than those before treatment; the I-QOL score, bladder compliance, maximum urinary flow rate and maximum urethral closure pressure, muscle voltages in fast muscle (type Ⅱ muscle fibers) stage and slow muscle (type Ⅰ muscle fibers) stage of both groups were higher than those before treatment, with statistically significant differences (P<0. 05). After treatment, the ICI-Q-SF score, 1 h volumes and frequencies of urine leakage, residual urine volumes, muscle voltages in pre-resting stage and post-resting stage of the combination group were lower than those of the control group; the I-QOL score, bladder compliance, maximum urinary flow rate and maximum urethral closure pressure, muscle voltages in fast muscle (type Ⅱ muscle fibers) stage and slow muscle (type Ⅰ muscle fibers) stage of the combination group were higher than those of the control group, with statistically significant differences (P<0. 05). No adverse drug reactions occurred in either group during treatment. CONCLUSIONS: For middle-aged and elderly female patients with mild to moderate stress urinary incontinence, the treatment effects of Buzhong Yiqi decoction combined with biofeedback electrical stimulation is significant, which can improve patients’ incontinence status, quality of life, urodynamic parameters and pelvic floor muscle function, with good safety. [ABSTRACT FROM AUTHOR] more...
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- 2024
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13. The use of urodynamic to assess the mechanism of incontinence in patients with Yang-Monti based catheterizable cutaneous stomas
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M. Abdelwadood, Eman H. Ibrahim, Tamer A. Abouelgreed, Yasser M. Haggag, Mohamed M. Yassin, Mohamed A. Elhelaly, El-Sayed I. El-Agamy, Basem Fathi, Salma F. Abdelkader, Sameh S. Ali, Naglaa M. Aboelsoud, Nasser Ramadan, Mohamed Sobhy, and Tarek Gharib more...
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Incontinence ,urodynamic ,urinary diversion ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Objective: To analyze the static and dynamic urodynamic parameters of reservoirs and continent conduits in continent cutaneous urinary diversion with catheterizable stoma. Materials and methods: 76 patients had augmented ileocystoplasty or continent urinary diversion with catheterizable urinary stoma based on Mitrofanoff principle and Yang-Monti procedure using subserous tunnel as continence mechanism. They were followed up for at least 6 months post-operatively for continence through stoma and divided into two groups (continents vs non-continent) according to stomal continence. Both groups had urodynamic assessment performed via the stoma to assess reservoir capacity, pressure and contractions, efferent limb functional length, reservoir overactivity, static and dynamic maximal closure pressures and leak point pressure. Results: Continence rate was 87%. Continent group included 66 patients and incontinent group included 10 patients. In both groups at rest, the reservoir pressure after filling did not exceed 25 cm H2O. During peristaltic contraction, the pressure did not exceed 30 cm H2O and the duct remained continent. After Valsalva maneuver, the reservoir pressure increased up to 34 (+ 7.4) cm H2O and leakage occur in 10 patients (13%). Reservoir (wall) overactivity was recorded in 54 patients, with insignificant rise in intraluminal pressure during the contractions. In both groups, the efferent tract closing pressure was always higher than the reservoir pressure. The mean of maximal closing pressure at Valsalva was 82.5 (+ 4.18) cm H2O in the continent group and 61.66 (+ 8.16) cm H2O in the incontinent group. The mean functional length of the conduit was 4.95 + 1.62 in the continent group and 2.80 + 1.50 cm in the incontinent group. Conclusions: Urodynamic evaluation of continent catheterizable cutaneous stoma after Yang-Monti procedure has a practical significance. Functional length of the conduit seems to be the most influential factor for continence reflecting static & dynamic maximal closure pressure. Higher conduit closing pressure is associated with better continence. Contractions of the pouch and peristaltic contraction of the conduit has no effect on continence mechanism. more...
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- 2024
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14. Neurogenic dysfunction of the lower urinary tract in infectious and inflammatory diseases of the spine: is there a correlation with clinical and radiological variants of myelopathy? Preliminary result of the analysis of a single-center cohort
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Aleksandr I. Gorbunov, Mikhail A. Mushkin, Diana A. Kaumova, Alexandr N. Muraviev, Andrey I. Gorelov, Nadezhda V. Orlova, and Anna A. Gorelova
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infectious spondylitis ,neurogenic lower urinary tract dysfunction ,urodynamic ,Surgery ,RD1-811 - Abstract
Objective. To study the relationship between clinical and radiation variants of myelopathy and types of the neurogenic dysfunction of the lower urinary tract in patients with infectious spondylitis. Material and Methods. A single-center cohort observational study was conducted with the analysis of medical records and a prospective examination of 20 patients with infectious spondylitis complicated by neurogenic dysfunction of the lower urinary tract. Results. Infectious spondylitis can be complicated by the development of various urodynamic disorders, including neurogenic detrusor hyperactivity (30 %), its combination with detrusor-sphincter dissinergia (30 %) and a decrease in detrusor contractility (40 %). In 50 % of patients, an urodynamic examination revealed an increase in detrusor pressure of more than 40 cm water. There was no connection between the development of any type of lower urinary tract dysfunction and MRI types of myelopathy according to Vendatam, as well as between the level of spinal cord compression and the severity of neurological disorders according to AIS. Conclusion. The results of the study do not confirm the existence of a relationship between the various characteristics of myelopathy in infectious spondylitis and the results of urodynamic examination. The limitation of the reliability of the results is the small number of observations. Studies with a larger sample are required to assess the relationship between the clinical and radiation characteristics of myelopathy and variants of neurogenic dysfunction of the lower urinary tract in patients with infectious spondylitis. more...
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- 2023
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15. The role of gel-infused translabial ultrasound as a new modality in evaluation of female urethral stricture.
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Mahmoudnejad, Nastaran, Abrishami, Alireza, Sharifiaghdas, Farzaneh, Borabadi, Ramin, Dadpour, Mehdi, Nayebzade, Amirhossein, and Khazaei, Mehdi
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URETHRA stricture ,URETHROSCOPY ,ULTRASONIC imaging ,URODYNAMICS ,FIBROSIS - Abstract
Introduction To investigate the role of trans-labial ultrasound study in detection of female urethral stenosis (FUS) compared to former cysto-urethroscopy as the currently available definitive diagnostic modality. Material and methods In this cross-sectional study, 60 consecutive patients with bladder outlet obstruction diagnosed by clinical symptoms and urodynamic study, were included from 2019 to 2022. For additional assessment, all these patients underwent gel-Infused trans-labial ultrasound (GITLUS) and cystourethroscopy. Trans-labial real-time ultrasonography was performed following the insertion of 20 ml steady stream viscous jelly into the urethral meatus to assess the length of the urethra and exact location and length of the probable narrowing, as well as the presence of peri-urethral fibrosis (PUF). Results In GITLUS evaluation, urethral stricture was found in 27 patients. Mean urethral length and stricture length were 35.63 ±4.78 and 17.04 ±10.59, respectively. All these stenosis were confirmed via cysto-urethroscopy. PUF was found in 20 of 27 patients. In cysto-urethroscopy, urethral stricture was confirmed in 40 patients: 13 in urethral meatus and 27 in other parts or pan-urethra. GITLUS could not reveal urethral stricture in 13 patients with meatal stenosis, confirmed with cystoscopy. GITLUS detected FUS less accurately when it involves pure distal urethra compared to other parts of urethra or pan-urethral stenosis (p value = 0.002). Conclusions GITLUS is a safe, non-invasive, and valuable technique for detecting FUS. The location and the length of the stricture and probable peri-urethral fibrosis can be identified by this method. However, in meatal or pure short-length distal urethral strictures, this method should be used with caution. [ABSTRACT FROM AUTHOR] more...
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- 2024
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16. Clinical and urodynamics outcomes in pediatric primary bladder diverticula: a comparative study.
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Karaaslan, Birgül and Kuzdan, Mehmet O.
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URINARY tract infections ,URODYNAMICS ,DIVERTICULOSIS ,VESICO-ureteral reflux ,BLADDER diseases - Abstract
Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU 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.) more...
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- 2024
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17. ICS‐SUFU standard: Theory, terms, and recommendations for pressure‐flow studies performance, analysis, and reporting. Part 1: Background theory and practice.
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Rosier, Peter F. W. M., Valdevenito, Juan P., Smith, Phillip, Sinha, Sanjay, Speich, John, and Gammie, Andrew
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PERFORMANCE theory ,THEORY-practice relationship ,URINATION disorders - Abstract
Aims: The working group (WG) initiated by the International Continence Society Standardization Steering Committee and supported by the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction has revised the (1997) ICS Standard for pressure flow studies. Methods: Based on the ICS standard for developing evidence‐based standards, the WG developed this new ICS standard in the period from May 2020 to December 2022. A draft was posted on the ICS website in January 2023 to facilitate public discussion and the comments received have been incorporated into this final release. Results: The WG summarizes the theory and recommends the practice and the terms used for the diagnosis of voiding dysfunction for adult female and male patients without relevant neurological abnormalities, in part 1 of this standard. The WG has also recommended standard principles and parameters for objective and continuous grading of urethral resistance and detrusor voiding contraction on the basis of pressure flow studies in part 2. The recommendations for practice in this part have also the aim to increase the understanding of the physiology as well as the psychology of voiding. The potential effects of the laboratory situation of the test on the voiding as well as the role of the urodynamicist in this regard are discussed. The WG has recommended to use for diagnosis only the voidings that are considered representative by the patient. Conclusion: A pressure flow study is the gold standard to assess voiding function and to quantify dysfunction. This part of the standard explains the clinical background, gives recommendations for the execution of a pressure flow study and lists relevant terms, parameters, and units of measurements. [ABSTRACT FROM AUTHOR] more...
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- 2023
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18. ICS‐SUFU standard: Theory, terms, and recommendations for pressure‐flow studies performance, analysis, and reporting. Part 2: Analysis of PFS, reporting, and diagnosis.
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Rosier, Peter F. W. M., Gammie, Andrew, Valdevenito, Juan Pablo, Speich, John, Smith, Phillip, and Sinha, Sanjay
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URINATION disorders ,PATIENTS ,BLADDER obstruction ,PERFORMANCE theory ,MEDICAL quality control ,TECHNICAL reports - Abstract
Aims: The Working Group (WG), initiated by the International Continence Society (ICS) Standardisation Steering Committee and supported by the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction, has revised the ICS Standard for pressure‐flow studies of 1997. Methods: Based on the ICS standard for developing evidence‐based standards, the WG developed this new ICS standard in the period from May 2020 to December 2022. A draft was posted on the ICS website in December 2022 to facilitate public discussion and the comments received have been incorporated into this final release. Results: The WG has recommended analysis principles for the diagnosis of voiding dysfunction for adult men and women without relevant neurological abnormalities. New standard terms and parameters for objective and continuous grading of urethral resistance (UR), bladder outflow obstruction (BOO) and detrusor voiding contraction (DVC) are introduced in this part 2 of the standard. The WG has summarized the theory and recommendations for the practice of pressure‐flow study (PFS) for patients in part 1. A pressure‐flow plot is recommended for the diagnosis of every patient, in addition to time‐based graphs. Voided percentage and post void residual volume should always be included in PFS analysis and diagnosis. Only parameters that represent the ratio or subtraction of pressure and synchronous flow are recommended to quantify UR and only parameters that combine pressure and flow in a product or sum are recommended to quantify DVC. The ICS BOO index and the ICS detrusor contraction index are introduced in this part 2 as the standard. The WG has suggested clinical PFS dysfunction classes for male and female patients. A pressure‐flow scatter graph including every patient's pdet at maximum flow (pdetQmax) with maximum flow rate (Qmax) point should be included in all scientific reports considering voiding dysfunction. Conclusion: PFS is the gold standard used to objectively assess voiding function. Quantifying the dysfunction and grading of abnormalities are standardized for adult males and females. [ABSTRACT FROM AUTHOR] more...
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- 2023
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19. Overactive bladder and multiple sclerosis in the University Hospital of Oujda
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Anouar El Moudane, Kaoutar Chhita, Ahmed Jdaini, Abdessamad Motaouakil, Yassine Mebrouk, and Ali Barki
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Neurogenic lower urinary tract dysfunction ,Multiples sclerosis ,Quality of life ,OAB ,Urodynamic ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Multiple sclerosis (MS) is the most frequent autoimmune neurological disease in the young population. Vesico-sphincter disorders are frequent in the course of the disease; it has been reported that 90% of MS patients will develop a lower urinary tract disorder within 18 years of the diagnosis. Methods The aim of this study is to identify the frequency, severity, diagnosis, and treatment of overactive bladder (OAB) in MS patients at the Mohammed VI hospital university in Oujda-Morocco. It is a cross-sectional study. The population was collected in neurology department of Mohammed VI hospital university in Oujda-Morocco. The population cohort consisted of patients diagnosed with multiple sclerosis, which were invited to the urology department where they underwent urinary screening and completed a form of questions regarding the frequency and severity of OAB and its influence on quality of life. Result In our study, the mean age of the patients was 43 years, and our sample was composed of 48% males and 52% females, and the most frequent lower urinary tract symptom was urgency (57%), followed by urinary frequency (29%) and urge incontinence (14%). The recurrent-remittent form was the most frequent (62%), followed by the primary progressive form (24%) and the secondary progressive recurrent form (14%). Among the patients, 33% presented a mild symptomatology, 48% moderate, and 19% severe. In this study, it was found that the intensity of urinary symptoms and the MS disability score were positively correlated with quality of life and disease duration. Conclusion The urgency was the major symptom of the lower urinary tract, and the MS disability score and the severity of OAB were associated with the quality of life of the patients. The urological evaluation of patients with multiple sclerosis should be performed routinely to identify OAB and to treat this condition appropriately. more...
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- 2023
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20. Nocturia in female patients: Current clinical features, treatment patterns and outcomes at a tertiary referral centre.
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Drangsholt, Siri, Peyronnet, Benoit, Arcila-Ruiz, Maria, Sussman, Rachael, Palmerola, Ricardo, Pape, Dominique, Rosenblum, Nirit, Nitti, Victor, and Brucker, Benjamin
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Nocturia ,desmopressin ,female ,urodynamic ,voiding diary - Abstract
Objective: To report the current clinical features, treatment patterns and outcomes of female patients who were seen at a tertiary referral centre with a primary diagnosis of nocturia, and to assess the predictive factors of therapeutic management failure. Patients and methods: A retrospective chart review of all new female patients seen in a single-centre functional urology practice with the diagnosis of nocturia was performed. Up to three visits within a 12-month period from the time of presenting were reviewed. The primary endpoint was patient-reported improvement assessed at each follow-up visit and the change in the number of nocturia episodes. Results: In all, 239 female patients were included for analysis. The prevalence of nocturnal polyuria, reduced bladder capacity, and global polyuria were 75%, 40.2%, and 18.1%, respectively. Within the first two visits, 72.7% of patients had started a treatment beyond behavioural therapies. Anticholinergics were the most commonly initiated treatment (47.2% of patients). At the latest considered visit, 80 patients reported improvement in nocturia (45.5%) and there was a mean - 0.8 decrease in the number of nocturia episodes from 4 to 3.2, which was statistically significant (P more...
- Published
- 2019
21. Comparison of adjustable and nonadjustable single-incision mini-slings in the treatment of female stress urinary incontinence: An initial experience with 30 cases
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Ching-Chung Liang, Sherry Yueh-Hsia Chiu, and Wu-Chiao Hsieh
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Mid-urethral sling ,Mini-slings ,Single-incision ,Urinary incontinence ,Urodynamic ,Gynecology and obstetrics ,RG1-991 - Abstract
Objective: Several single-incision mini-slings (SIMSs) have been developed to minimize the potential complications associated with retropubic or transobturator mid-urethral slings. However, few studies compared the efficacy of different types of SIMS. This study compared the outcomes of an adjustable SIMS (Ajust) with a nonadjustable SIMS (Solyx) in the treatment of urodynamic stress incontinence (USI) over postoperative follow-up of 12 months. Materials and methods: In this study, the surgical outcomes of the first 30 patients receiving Ajust and the first 30 patients undergoing Solyx at a university hospital were reviewed retrospectively, all of whom were diagnosed with USI without coexistent pelvic organ prolapse. Preoperative and postoperative examinations included structured urogynecological questionnaires, 1-hour pad tests, and complete urodynamic testing. Patient demographics, urodynamic parameters, and 12-months surgical outcomes were compared between the Ajust and Solyx groups. Results: There were no significant differences between the Ajust and Solyx groups in terms of subjective cure rate (93.3% vs 90.0%), objective cure rate (89.3% vs 89.3%), and de novo urgency or urge urinary incontinence (13.3% vs 16.7%) 12 months after surgery. Postoperatively, both Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7 scores were significantly improved in the Ajust and Solyx groups. In comparison with preoperative data, postoperative urodynamic results revealed a significant decrease in maximal urethral closure pressure in the Ajust group (n = 28) and a significant increase in residual urine in the Solyx group (n = 28). However, significant differences were not observed in the postoperative pad test and urodynamic data between the Ajust and Solyx groups, and no major complications occurred in either group. Conclusions: In this paper describing the preliminary experience of 30 patients, both adjustable and nonadjustable SIMS performed by an experienced surgeon were safe and effective in correcting USI at 12-month postoperative follow-up. more...
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- 2022
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22. Risk factors for upper urinary tract deterioration in adult patients with spina bifida.
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Haudebert, Camille, Hascoet, Juliette, Samson, Emmanuelle, Jezequel, Magali, Voiry, Caroline, Brochard, Charlène, Richard, Claire, Kerdraon, Jacques, Siproudhis, Laurent, Manunta, Andréa, and Peyronnet, Benoit more...
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- *
URINARY organs , *SPINA bifida , *KIDNEY failure , *CLINICAL deterioration , *NEUROGENIC bladder , *KIDNEY physiology , *URODYNAMICS - Abstract
Purpose: Neurogenic bladder associated with spina bifida disease remains a major cause for mortality or morbidity due to kidney damages. However, we currently do not know which urodynamic findings are associated with an higher risk of upper tract damages in spina bifida patients. The objective of the present study was to evaluate urodynamic findings associated with functional kidney failure and/or with morphological kidney damages. Methods: A large single-center restrospective study was conducted in our national referral center for spina bifida patients using our patients' files. All urodynamics curves were assessed by the same examinator. Functional and/or morphological evaluation of the upper urinary tract were done at the same moment as the urodynamic exam (between 1 week before and 1 month after). Kidney function was assessed using creatinine serum levels or 24 h urinary creatinine levels (creatinine clearance) for walking patients, or with the 24 h urinary creatinine level for wheelchair‐users. Results: We included 262 spina bifida patients in this study. Fifty-five patients had a poor bladder compliance (21.4%) and 88 of them had detrusor overactivity (33.6%). Twenty patients had a stage 2 kidney failure (eGFR < 60 ml/min) and 81 patients out of 254 (30.9%) had an abnormal morphological examination. There were three urodynamic findings significantly associated with UUTD: bladder compliance (OR = 0.18; p = 0.007), Pdetmax (OR = 14.7; p = 0.003) and detrusor overactivity (OR = 1.84; p = 0.03). Conclusion: In this large series of spina bifida patients, maximum detrusor pressure and bladder compliance are the main urodynamic findings determinants of UUTD risk. [ABSTRACT FROM AUTHOR] more...
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- 2023
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23. Straining to void at preoperative urodynamic study as a risk factor for prolapse recurrence after surgery.
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Mancarella, Matteo, Pautasso, Stefano, Novara, Lorenzo, Piat, Francesca Chiadò, Testa, Francesco, Arrunategui, Valeria Gomez, Sgro, Luca Giuseppe, and Biglia, Nicoletta
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- *
CYSTOMETRY , *COLPORRHAPHY , *PELVIC organ prolapse , *VAGINAL hysterectomy , *SURGERY - Abstract
Straining to void is the need to make a muscular effort in order to initiate, maintain or improve the urinary stream, through an increase in abdominal pressure. This pattern of bladder emptying is frequently observed in women with pelvic organ prolapse causing urinary obstruction, to overcome the increased resistance to urine flow. However, frequent increases in abdominal pressure are a risk factor for developing pelvic organ prolapse, and might play a role in its recurrence after surgery. The aim of this study was to investigate the role of straining identified at urodynamic study in prolapse recurrence after surgical repair. This was a retrospective study on women submitted to prolapse repair by vaginal hysterectomy with modified McCall culdoplasty and anterior colporraphy. All patients underwent a preoperative urodynamic evaluation including a pressure-flow study performed after prolapse reduction by means of a vaginal pessary; straining was defined by a simultaneous and similar increase in intravesical and abdominal pressures of at least 10 cmH 2 O over the baseline during bladder emptying, corresponding to intermittent peaks of urine flow. Patients were divided into two groups according to the presence or absence of straining, and they were compared for surgical results at 12 months and for the rate of anterior or central recurrence over time. Women with straining (n = 16), compared to women with normal voiding (n = 43), showed a higher risk of anterior recurrence over time at Kaplan-Meier curves, for both stage II (p = 0.02) and stage III prolapse (p = 0.02). No difference was seen for central recurrence during the follow up period. POP-Q staging at 12 months was similar for the two groups, except for the location of the Aa point which was significantly better for women without straining (−1.6 ± 0.1 cm vs −0.8 ± 0.3 cm, p = 0.03). Straining to void identified in preoperative urodynamic study seems to increase the risk of anterior recurrence after surgical repair of pelvic organ prolapse. [ABSTRACT FROM AUTHOR] more...
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- 2023
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24. Effect of Rectal Midazolam on Pain, Stress, and Cooperation of Patient during Urodynamic Test in Women: A Randomized Clinical Trial.
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Saberi, Narjes, Hayrabedian, Aygineh, Mazdak, Hamid, Hassannejad, Razieh, Zargham, Mahtab, Sichani, Mehrdad Mohammadi, Mirzaei, Mahboubeh, and Mohammadi Sichani, Mehrdad
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- *
PATIENT compliance , *CLINICAL trials , *MIDAZOLAM , *URINARY stress incontinence , *VISUAL analog scale , *VITAL signs , *BLOOD pressure , *ANIMAL sedation - Abstract
Purpose: The urodynamic study is an invasive test, and causes pain and stress in the patient. We have investigated the effect of rectal midazolam sedation on the pain, stress, and cooperation of women performing urodynamic study. Materials and Methods: At the present randomized clinical trial (RCT) from January to July of 2021 a total of 84 women were prospectively randomized to undergo urodynamic study with or without sedation. The primary outcome of interest was experienced pain during urodynamic study. In the intervention group, after monitoring baseline vital signs (heart rate, blood pressure, O2 saturation), sedation was done with rectal midazolam at a dose of 0.3 mg/kg (maximum 15 mg). Completing the procedure, after recovery from sedation patients were asked to fill a self-assessed visual analog pain scale (VAS, 0-10), 5-point visual stress scale (1-5) and, patient collaboration level during urodynamic study was evaluated by nurse with a researcher-made tool (0-3). In the control group test was performed in routine practice with no sedation. Baseline vital signs measured pre and intra-procedural time, as well as their experienced pain, stress, and cooperation levels were recorded. Results: 84 female cases were evaluated. In terms of comparison of changes in pre and intra-test physiologic parameters, results showed that there were no significant differences between the two groups for all physiologic parameters: SBP, DBP, PR, SpO2. Analysis of the pain score showed that it was lower in the intervention group, and there was a significant difference in pain score between the two groups (P =.024). While the stress and corporation scores were not reported statistically significant (P=.388 and P=.955, respectively).Conclusion: Sedation with rectal midazolam in adult women before UDS is safe and effective in reducing pain but is not effective in reducing stress and increasing cooperation. The amount of pain based on the visual analog pain scale is mild and although this method is safe, its use routinely is not recommended. [ABSTRACT FROM AUTHOR] more...- Published
- 2023
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25. Experimental study of extracellular vesicle-small intestine submucosa novel biological composite for urethral stricture repair and reconstruction.
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Wang, Dan, Zhu, Xiaojun, Siqin, Buhe, Ren, Chao, Chang, Ming, and Bai, Ligang
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- *
URETHRA stricture , *EXTRACELLULAR vesicles , *SMALL intestine , *PERACETIC acid , *ELECTRON microscopy , *URODYNAMICS - Abstract
Urethral stricture (US) is a common condition that considerably affects patients’ quality of life.This study aimed to explore the adoption value of the extracellular vesicle (EV)- small intestinal submucosa (SIS) complex in the repair of USs.EVs were extracted from healthy male New Zealand white rabbits, and SIS was prepared using peracetic acid (PAA) oxidation and decellularization. The morphology and particle size of the prepared EV-SIS complex were evaluated using electron microscopy and qNano nanoparticle analyzer, and the labeled proteins of EVs were detected using Western blot method. EV-SIS the complex was implanted in a rabbit model of US, and urodynamic parameters were assessed.The EV-SIS complex displayed a full morphology, intact membrane structure, and uniform particle size. The protein concentration of EVs in the complex was approximately 0.351 µg/µL, with a yield of approximately 1.86 µg/106 cells. The complex exhibited remarkable repair effects in the rabbit model of US, with bladder capacity, maximal urethral pressure, and minimal urethral pressure all markedly superior to those in the US group (
P < 0.05).The EV-SIS complex demonstrates potential clinical value in the repair of USs, improving urodynamic parameters, and offering a promising therapeutic option for patients with US. [ABSTRACT FROM AUTHOR] more...- Published
- 2025
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26. Revascularized Pyelo-Uretero-Cystoplasty in Patients with Chronic Bladder Outlet Obstruction Due to Ectopic Ureterocele: A Safe Surgical Technique with Superior Continence Outcomes
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Asal Hojjat, Shabnam Sabetkish, and Abdol-Mohammad Kajbafzadeh
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reconstructive surgical procedures ,ureterocele ,urinary reservoirs ,urodynamic ,blood supply ,Surgery ,RD1-811 - Abstract
Purpose To present the outcomes of revascularized pyeloureterocystoplasty with ureterocele unroofing in end stage bladder patients with duplex system and ureterocele. Methods Thirteen patients with obstruction of intrauterine outlet from an ectopic obstructive ureterocele were included. Fourteen units of duplex systems underwent upper pole partial nephrectomy in conjunction with augmentation revascularized pyeloureterocystoplaty and ureterocele unroofing. The anterior and lateral walls of the ureterocele were excised before cystoplasty, and the resultant edges of the posterior wall were sutured to the bladder epithelium. Anastomosis of the upper pole vein and artery to the inferior iliac artery and the common iliac vein was performed. Detubularization of the whole ureter was performed with exception of the intramural ureteric part that kept tubularized for ‘jet/turbulent’ occurrence. Five patients (control group) underwent pyeloureterocystoplasty without revascularization. Patients underwent several evaluations in long-term follow-up. Results Patients were all dry by day and night in our long-term follow-up. Urinary incontinence improved in patients with no need for re-augmentation technique. Vesicoureteral reflux subsided in all patients postoperatively except one, who was asymptomatic. After five years, median bladder capacity rose from 128.5 ml to 395 ml and bladder compliance showed significant improvement from 15 ml/cm H2O to 29 ml/cm H2O, in experimental group and remained stable for 24–36 months. Median bladder capacity did not rise significantly in control group. Conclusion Pyeloureterocystoplasty is an efficient choice in this type of patients, which may prevent the recurrence of hypocompliant bladders and prevent ischemia and subsequent fibrosis. more...
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- 2022
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27. Urodynamic Predictors for Voiding Recovery after Transurethral Resection of Prostate in Benign Prostatic Hyperplasia Patients with Significant Post-voiding Residual Urine.
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Mohamed, Mohamed Mostafa Idrees, Maarouf, Aref Mohamed, Sleem, Mohamed Mahmoud, and Elsayed, Ibrahem Ismail
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- *
BENIGN prostatic hyperplasia , *BLADDER obstruction , *URINE , *TRANSURETHRAL prostatectomy - Abstract
Background: Detrusor underactivity (DU) is a frequent clinical issue that is poorly understood. Both the diagnosis and the course of treatment are challenging and unpredictable. In men, DU and bladder outlet obstruction (BOO) frequently coexist. Prostatic surgery may enhance voiding efficiency (VE). Aim: To improve the outcome of transurethral resection of the prostate (TURP) by selecting Benign Prostatic Hyperplasia (BPH) patient with significant post-voiding residual urine who could benefit from surgery and could void normally after TURP. Patients and Methods: This is a clinical trial - single arm study included 24 male patients above 50 years old with BPH and significant postvoiding residual urine who underwent TURP. Urodynamic predictors were assessed. Results: There was significant difference between patients with good and poor outcomes regarding IPSS pre-operatively, Qmax, postvoid residual (PVR), Voiding Efficiency and BCI Conclusion: The success rate of prostatectomy was 83.3% and about 16.7% had poor outcomes. Patients with higher BCI had good prognosis. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
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28. Physiopathology of Underactive Bladder
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Cerruto, Maria Angela, Tafuri, Alessandro, Del Popolo, Giulio, Series Editor, Finazzi Agrò, Enrico, Series Editor, Soligo, Marco, Series Editor, Balzarro, Matteo, editor, and Li Marzi, Vincenzo, editor more...
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- 2021
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29. Posterior urethral valves: Role of prenatal diagnosis and long-term management of bladder function; a single center point of view and review of literature
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Chiara Pellegrino, Maria Luisa Capitanucci, Valentina Forlini, Antonio Zaccara, Federica Lena, Maria Laura Sollini, Enrico Castelli, and Giovanni Mosiello
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posterior urethral valves ,renal function ,bladder outlet obstruction ,bladder function ,pediatric ,urodynamic ,Pediatrics ,RJ1-570 - Abstract
Posterior Urethral Valves (PUV) are the most common cause of lower urinary tract obstruction. More severe forms are detected early in pregnancy (mainly type I), while other forms are usually discovered later in childhood when investigating lower urinary tract symptoms. Bladder dysfunction is common and is associated with urinary incontinence in about 55% (0%–72%). Despite the removal of the obstruction by urethral valve ablation, pathological changes of the urinary tract can occur with progressive bladder dysfunction, which can cause deterioration of the upper urinary tract as well. For this reason, all children with PUV require long-term follow-up, always until puberty, and in many cases life-long. Therefore, management of PUV is not only limited to obstruction relief, but prevention and treatment of bladder dysfunction, based on urodynamic observations, is paramount. During time, urodynamic patterns may change from detrusor overactivity to decreased compliance/small capacity bladder, to myogenic failure (valve bladder). In the past, an aggressive surgical approach was performed in all patients, and valve resection was considered an emergency procedure. With the development of fetal surgery, vesico-amniotic shunting has been performed as well. Due to improvements of prenatal ultrasound, the presence of PUV is usually already suspected during pregnancy, and subsequent treatment should be performed in high-volume centers, with a multidisciplinary, more conservative approach. This is considered to be more effective and safer. Primary valve ablation is performed after clinical stability and is no longer considered an emergency procedure after birth. During childhood, a multidisciplinary approach (pediatric urologist, nephrologist, urotherapist) is recommended as well in all patients, to improve toilet training, using an advanced urotherapy program with medical treatments and urodynamic evaluations. The aim of this paper is to present our single center experience over 30 years. more...
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- 2023
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30. Benign prostatic hyperplasia: Who will benefit from surgical intervention? A single center experience.
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Sharifiaghdas, Farzaneh, Khoiniha, Mohammad Reza, Basiri, Abbas, Bonakdar Hashemi, Milad, Borumandnia, Nasrin, and Dadpour, Mehdi
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- *
BENIGN prostatic hyperplasia , *CYSTOMETRY , *TRANSURETHRAL prostatectomy , *TREATMENT duration , *PROSTATE surgery , *PATIENT satisfaction , *URINARY organs - Abstract
Background: To evaluate the pre-operative factors affecting clinical response to prostate surgery in men with benign prostatic hyperplasia (BPH). Materials and methods: In this prospective cohort study, 172 patients who underwent surgical intervention for BPH (either as open prostatectomy (n = 78) or monopolar-trans-urethral resection of prostate (n = 94) from February 2017 to October 2019 were consecutively enrolled. Pre-operative conventional three-lumen urodynamic study and transabdominal sonography were performed for all patients to determine peak flow rate (Qmax), detrusor pressure at the peak flow rate (PdetQmax), post-void residual volume (PVR), presence of detrusor overactivity (DO), prostate volume and median lobe size, and bladder wall thickness with empty and full bladder. Uroflowmetry and cystoscopy were performed during follow-up, whenever indicated. Successful surgical outcome was defined as subjective satisfaction of the patient and a Qmax of more than 15 ml/s on post-operative uroflowmetry. Results: At 1-year follow-up, complete resolution of lower urinary tract syndrome (LUTS) was detected in 138 (80.2%) patients; however, 21 (12.2%) still had pure obstructive LUTS, 9 (5.2%) had pure storage LUTS, and 4 (2.3%) were still suffering from both storage and obstructive LUTS. After performing multivariable analysis, shorter duration of pre-operative medical treatment and higher pre-operative bladder contractility index (BCI) were found to be independent predictors of successful surgery (p = 0.012 and p < 0.001, respectively). Results of the ROC curve analysis showed that a preoperative BCI level more than 90.95 and pre-surgical medical treatment duration less than 14.45 months have the most specificity and sensitivity to predict the success of surgical outcome. We also observed that the probability of recovery decreased considerably over time following surgery. Conclusion: Shorter duration of pre-operative medical treatment and increased pre-operative BCI can independently predict favorable outcome of BPH surgery. These factors could be used for better patient management and appropriate planning and consultation before BPH surgery. [ABSTRACT FROM AUTHOR] more...
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- 2022
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31. Neurogenic Bladder in Cerebral Palsy: Upper Motor Neuron
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Truong, Hong, Bani Hani, Ahmad H., Miller, Freeman, Section editor, Bachrach, Steven J., Section editor, Miller, Freeman, editor, Bachrach, Steven, editor, Lennon, Nancy, editor, and O'Neil, Margaret E., editor more...
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- 2020
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32. Urodynamic Patterns and Prevalence of N-LUTDs in Suprapontine Lesions
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Fragalà, Eugenia, Soligo, Marco, Series Editor, Lamberti, Gianfranco, editor, Giraudo, Donatella, editor, and Musco, Stefania, editor
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- 2020
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33. Urodynamic changes following laparoscopic versus vaginal hysterectomy.
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Abouelgreed, Tamer, Saleh, Doaa, Abdelaal, Mohamed, Elatreisy, Adel, Elhelaly, Mohamed, El-Agamy, El-Sayed, Elgammal, Ahmed, and Moawad, Ashraf
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- *
VAGINAL hysterectomy , *LAPAROSCOPIC surgery , *BLADDER , *HYSTERECTOMY , *CYSTOMETRY - Abstract
Objective: To compare urodynamic changes before and after hysterectomy (laparoscopic vs. vaginal approach) for benign gynecological diseases. Patients and Methods: A total of 90 women with a mean age of 56.36-years were enrolled in this study between August 2019 and April 2021. They were divided into two equal groups (45 patients each). Group, I had a vaginal hysterectomy, and Group II had a laparoscopic hysterectomy. All patients were assessed clinically using ICIQ-FLUTS questionnaire and a urodynamic study before and six months after surgery. Results: Both vaginal and laparoscopic hysterectomy did not significantly change the maximum flow rate, voiding time, and average flow rate. The increase in residual urine volume in group I was not significant (p = 0.129), as was in Group II (p = 0.217). All the modifications, however, were within permissible limits. According to the cystometry result, volume at initial sensation rose in both groups after surgery, with no statistically significant difference (p = 0.364). After both forms of hysterectomy, maximum bladder capacity did not vary considerably. Preoperatively, all study participants exhibited no overactivity of the detrusor muscle; nevertheless, following surgery, overactivity was noted in 9 patients after vaginal hysterectomy compared to three patients after laparoscopic hysterectomy, and all the alterations were within a clinically acceptable range. In addition, the ICIQ-FLUTS score was not significantly different between the study groups. Conclusions: According to the urodynamic study, hysterectomy for benign uterine conditions, whether vaginal or laparoscopic, did not adversely affect urinary bladder function. [ABSTRACT FROM AUTHOR] more...
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- 2022
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34. Immunochemical and urodynamic outcomes after polypropylene mesh explant from the pelvic wall of rats.
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Lo, Tsia-Shu, Lin, Yi-Hao, Huang, Ting-Xuan, Chu, Hsiao-Chien, and Chen, Yi-Pin
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- *
SURGICAL meshes , *POLYPROPYLENE , *URINARY organs , *RATS - Abstract
Introduction and hypothesis: To analyze the immunochemical and urodynamic outcomes after partial versus complete excision of transvaginal polypropylene mesh (PPM) from pelvic walls of rats. Methods: Forty-eight female Sprague-Dawley (SD) rats were randomly distributed into seven groups: control, mesh total removal 60 days (M-T 60D), mesh total removal 180 days (M-T 180D), mesh partial removal 60 days (M-H 60D), mesh partial removal 180 days (M-H 180D), sham 60 days (Sham 60D), and sham 180 days (Sham 180D). In the mesh groups, PPM was inserted and partially (0.3 × 0.3 cm) or completely removed 30 days later. In the Sham group, the space between the vagina and bladder was dissected without placing or removing the synthetic mesh at day 1 and day 30 later. Urodynamic studies, immunochemical analysis, and Western blot were done at days 60 and 180. Results: The M-T 60D voiding pressure was significantly decreased compared to the Sham 60D and M-H 60D. The voiding interval of M-T 60D was significantly shorter than that of M-H 60D. In the M-T 60D and M-T 180D groups, the leak point pressure was significantly less than in their corresponding sham groups. IL-1 and TNF-α were significantly more intense in M-T 60D compared to M-H 60D and Sham 60D. NGF was significantly greater in M-T 60D compared to Sham 60D. There were no significant differences in MMP-2 and CD-31s throughout the group. Conclusion: Total mesh excision incites a host inflammatory response and transitory lower urinary tract dysfunction. Despite the good outcomes after total excision, the invasiveness and surgical risk associated with repeated procedures should not be underestimateded. [ABSTRACT FROM AUTHOR] more...
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- 2022
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35. Improvement of bladder function after bladder augmentation surgery: a report of 26 years of clinical experience.
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Trojan, Katharina C., Schneider, Joanna, Marco, Beatriz Bañuelos, Ciesla, Luise, Geppert, Tamara, Kaindl, Angela M., and Lingnau, Anja
- Abstract
Introduction: To assess the long-term effect of bladder augmentation surgery in patients with spina bifida and to identify risk factors for severe bladder dysfunction requiring bladder augmentation. Methods: A retrospective analysis was performed on 178 patients with spina bifida, 23 of them underwent bladder augmentation. Surgery outcome was evaluated according to urodynamic assessments at three follow-up time points per patient up to 120 months postoperatively. The results were compared to the preoperative situation and to the non-operated control group. Bladder function was evaluated using the modified Hostility score. To identify risk factors for bladder dysfunction requiring bladder augmentation, characteristics such as type of spina bifida, lesion level and therapy of bladder dysfunction were analyzed. Results: A high spinal lesion level is a risk factor for requiring bladder augmentation. In the BA group, significantly more thoracic lesions were found than NBA group, BA: 26.1%, NBA: 8.4% (p = 0.021). With bladder augmentation surgery, the modified Hostility score decreased from a preoperative median value of 4.3 ± 1.4 to 1.6 ± 1.0 at the third postoperative follow-up (FU3 = 61–120 months after surgery). In the reference group, the score of the last urological assessment was 2.0 ± 1.5. The age at which clean intermittent catheterization or anticholinergic medication started had no significant influence on the decision to perform bladder augmentation. Discussion/conclusion: Spina bifida patients with bladder augmentation had a significant improvement of the bladder function even at long-term follow-up. A high level of spinal lesion was a predisposing factor for requiring a bladder augmentation. [ABSTRACT FROM AUTHOR] more...
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- 2022
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36. Busting for Botox®: an analysis of rebooking methods and delay to reinjection of intravesical Botulinum toxin A.
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Kealey, Josh, Yao, Henry H., Cheng, Janice, O'Connell, Helen E., and Gani, Johan
- Abstract
The objective of this study was to determine if the method of rebooking intravesical Botulinum neurotoxin A injections for treatment of detrusor overactivity causes treatment delays. The records of patients diagnosed with urodynamically proven detrusor overactivity treated with Botox® between March 2005 and October 2018 were included in a retrospective multicentre case series. Rebooking method was categorised into: (i) patient-initiated rebooking methods, (ii) doctor-initiated rebooking methods and (iii) automatic rebooking. Primary outcome was the proportion of patients with delay in reinjection >1 month after cessation of effect. A total of 336 patients were included in this study and results showed that 180/336 underwent a second and 122/180 a third cycle of Botulinum neurotoxin A. Patient- reported efficacy ranged from 73--84%, urinary tract infection rate was 8--11% per cycle and de novo urinary retention rate was 8.2--16.1% per cycle. The method of rebooking was patient-initiated in 45% (n=68) of cases and doctor-initiated in 55% (n=83) for the second injection. The rate of delay to retreatment was not clinically significant between the two groups at 33% and 37%, respectively. For those who progressed to a third cycle, the method of rebooking was automated in 11% (n=12) of patients and doctor- or patient-initiated rebooking in 89% (n=97). Automatic rebooking method resulted in a significantly lower rate of delay to injection (8% vs 44%, p=0.026). Significant delays occur in the reinjection of intravesical Botulinum neurotoxin A for detrusor overactivity. These delays can be reduced by utilising an automatic rebooking method once dose and duration of effect are established. [ABSTRACT FROM AUTHOR] more...
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- 2022
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37. Acceptability and perceived value of urodynamics from the patient perspective: A narrative review.
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Serati, Maurizio, Braga, Andrea, Rosier, Peter F. W. M, de Wachter, Stefan, Uren, Alan, and Finazzi‐Agrò, Enrico
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PATIENTS' attitudes ,URODYNAMICS ,URINARY organs - Abstract
Background: The value and application of urodynamic evaluation (UDS) have been a controversial topic in recent years. Gaining robust data on the patient viewpoint in this area is important since, even when UDS findings do not change the management plan, the objective diagnostic information gained from UDS may be valued by patients. Moreover, insights from UDS may empower treating physicians to counsel patients more effectively and manage their expectations regarding treatment outcomes. Objective: This expert narrative review aims to analyze the findings of published studies in this area, looking at two topics in turn: (a) the tolerability and acceptability of the UDS procedure itself from the patient perspective and (b) patient perceptions of the clinical value of insights provided by UDS. Design, Setting, Participants, and Outcome Measurements: An evidence assessment was conducted using selected articles from the literature reporting data on patients' perspectives on the tolerability, acceptability, utility, and value of the urodynamic investigation. Results and Limitations: Although pain, discomfort, and infection risks are frequently used as a rationale to skip UDS when initial management fails, there is good evidence that, from the patients' perspective, the procedure is very well tolerated in most cases. There are only a few articles available that assess patient perceptions of the usefulness of UDS, but those that do exist appear to demonstrate that the insights gained from UDS are widely welcomed by patients in the interest of receiving a more tailored and personalized treatment approach. Conclusion: From the patient perspective, UDS appears to be a well‐accepted and well‐tolerated diagnostic tool in patients with lower urinary tract symptoms, particularly when an appropriate explanation is provided before the examination. Our review also highlights that patients value the objective information provided by UDS and that this outweighs the temporary invasiveness of the test. This information is particularly relevant in light of the relative lack of evidence in the literature about patient expectations of specialist care in functional urology, which may have hindered progress with quality of care. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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38. Clinical Correlation of Bladder Electron Microscopic Characteristics in Patients with Detrusor Underactivity of Various Etiologies.
- Author
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Jhang, Jia-Fong, Ho, Han-Chen, Jiang, Yuan-Hong, Hsu, Yung-Hsiang, and Kuo, Hann-Chorng
- Subjects
ELECTRON configuration ,NERVE endings ,CONNECTIVE tissues ,TIGHT junctions ,SMOOTH muscle ,RETENTION of urine ,DYSKINESIAS - Abstract
This study aimed to investigate the ultrastructural characteristics of the bladder of patients with detrusor underactivity (DU) of various etiologies. Twenty-five patients with DU and control subjects underwent urodynamic testing and transmission electron microscopic examination of bladder specimens. The epithelium, lamina propria, and muscle layers were analyzed separately. The DU bladders exhibited total epithelial denudation (52%). In the bladders with remaining epithelium, apical cell uroplakins (44.4%) and tight junction complexes (77.8%) were also noted. The lamina propria was characterized by loose extracellular connective tissue (48%) and a lack of nerve terminals (76%). Smooth muscle shrinkage and a loss of their regular spindle shape (91.6%) were also noted in the detrusor layer. Patients with DU with intact epithelial cell layers had significantly larger void volumes and maximal flow rates than those with mild or severe epithelial denudation. Patients with remaining nerve terminals in lamina propria had a stronger first sensation of filling and smaller residual urine volume than those without nerve terminals. The proportion of ultrastructural defects of the bladder was not significantly different among patients with DU of various etiologies and treatment outcomes. DU bladders were characterized by ultrastructural defects in the entire bladder, and the defects were correlated to clinical parameters. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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39. Effect of Preoperative Urodynamic Study on Urinary Outcomes after Transobturator Sling
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Pedro Rincon Cintra da Cruz, Aderivaldo Cabral Dias Filho, Gabriel Nardi Furtado, Rhaniellen Silva Ferreira, and Ceres Nunes Resende
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urinary incontinence ,urodynamic ,stress urinary incontinence ,transobturator suburethral tape ,propensity score ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Objective To evaluate whether performing preoperative urodynamic study influences postoperative urinary symptoms of women with stress urinary incontinence that underwent transobturator sling. Methods Retrospective analysis of patients treated for stress urinary incontinence by transobturator sling from August 2011 to October 2018. Predictor variables included preoperative urodynamic study, age, incontinence severity, body mass index, preoperative storage symptoms and previous anti-urinary incontinence procedure. Outcome variables were postoperative subjective continence status, storage symptoms and complications. Logistic regression after propensity score was employed to compare outcomes between patients who underwent or not pre-operative urodynamic study. Results The present study included 88 patients with an average follow-up of 269 days. Most patients (n = 52; 59.1%) described storage symptoms other than stress urinary incontinence, and 38 patients (43.2%) underwent preoperative urodynamic studies. Logistic regression after propensity score did not reveal an association between urinary continence outcomes and performance of preoperative urodynamic study (odds ratio 0.57; confidence interval [CI]: 0.11-2.49). Among women that did not undergo urodynamic study, there was a subjective improvement in urinary incontinence in 92% of the cases versus 87% in those that underwent urodynamic study (p = 0.461). Furthermore, postoperative storage symptoms were similar between women who did not undergo urodynamic study and those who underwent urodynamic study, 13.2% versus 18.4%, respectively (p = 0.753). Conclusion Preoperative urodynamic study had no impact on urinary incontinence cure outcomes as well as on urinary storage symptoms after the transobturator sling in women with stress urinary incontinence. more...
- Published
- 2021
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40. Importance of urodynamic evaluation of bladder function after secondary untethering in spina bifida patients: single center experience of 30 years
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Ciesla, Luise, Schneider, Joanna, Marco, Beatriz Bañuelos, Schulz, Matthias, Thomale, Ulrich-Wilhelm, Geppert, Tamara, Trojan, Katharina C., Kaindl, Angela M., and Lingnau, Anja
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- 2023
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41. The challenges in the diagnosis of detrusor underactivity in clinical practice: A mini-review
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Ahmed, Ahmed, Farhan, Bilal, Vernez, Simone, and Ghoniem, Gamal M
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Reproductive Medicine ,Biomedical and Clinical Sciences ,Urologic Diseases ,Renal and urogenital ,Detrusor underactivity ,Underactive bladder ,Urodynamic ,Bladder outlet obstruction ,Chronic urinary retention ,BCI ,bladder contractility index ,CUR ,chronic urinary retention ,DHIC ,detrusor hyperactivity with impaired contractility ,DO ,detrusor overactivity ,DU ,detrusor underactivity ,ICS ,International Continence Society ,LinPURR ,linear passive urethral resistance relation ,OAB ,overactive bladder ,PVR ,post-void residual urine ,Pdet@Qmax ,detrusor pressure at maximal flow ,Qmax ,maximum urinary flow rate ,UDS ,urodynamic study - Abstract
ObjectiveTo review the current definitions, terminology, epidemiology and aetiology of detrusor underactivity (DU), with specific attention to the diagnostic criteria in use. In addition, we address the relation and the overlap between DU and bladder outlet obstruction (BOO). In this mini-review, we hope to help identify DU patients and facilitate structured clinical evaluation and research.MethodsWe searched the English literature using ScienceDirect and PubMed for relevant articles. We used the following terms: 'detrusor underactivity', 'underactive bladder', 'post voiding residual', 'post micturition residual', 'acontractile bladder', 'detrusor failure', and 'detrusor areflexia'.ResultDU is one of the most common conditions causing lower urinary tract symptoms (LUTS). Unfortunately, it is also the most poorly understood bladder dysfunction with scant research. To our knowledge there is no clear definition and no non-invasive method to characterise this important clinical condition. DU may result from the normal ageing process; however, it has multiple aetiologies including neurogenic and myogenic dysfunction. In many cases the symptoms of DU are similar to those of BOO and it usually requires invasive urodynamic study (UDS) for diagnosis to differentiate the two diagnoses. A number of diagnostic tests may be used including: UDS testing, the Schafer pressure/flow nomogram, linear passive urethral resistance relation, Watts factor, and the bladder contractility index. Of these, UDS testing is the most practical as it determines both the maximum urinary flow rate and the pressure exerted by the detrusor muscle relative to the maximal flow of urine, allowing for precise characterisation of detrusor function.ConclusionCurrently, the diagnosis of DU is based on invasive urodynamic parameters as defined by the International Continence Society in 2002. There is no consensus for the definition of DU prior to 2002. As there is significant overlap between the symptoms of DU and BOO, it is difficult to diagnose DU clinically. more...
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- 2016
42. Revascularized Pyelo-Uretero-Cystoplasty in Patients with Chronic Bladder Outlet Obstruction Due to Ectopic Ureterocele: A Safe Surgical Technique with Superior Continence Outcomes.
- Author
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Hojjat, Asal, Sabetkish, Shabnam, and Kajbafzadeh, Abdol-Mohammad
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BLADDER obstruction ,OPERATIVE surgery ,ILIAC artery ,NEPHRECTOMY ,ILIAC vein ,VESICO-ureteral reflux - Abstract
To present the outcomes of revascularized pyeloureterocystoplasty with ureterocele unroofing in end stage bladder patients with duplex system and ureterocele. Thirteen patients with obstruction of intrauterine outlet from an ectopic obstructive ureterocele were included. Fourteen units of duplex systems underwent upper pole partial nephrectomy in conjunction with augmentation revascularized pyeloureterocystoplaty and ureterocele unroofing. The anterior and lateral walls of the ureterocele were excised before cystoplasty, and the resultant edges of the posterior wall were sutured to the bladder epithelium. Anastomosis of the upper pole vein and artery to the inferior iliac artery and the common iliac vein was performed. Detubularization of the whole ureter was performed with exception of the intramural ureteric part that kept tubularized for 'jet/turbulent' occurrence. Five patients (control group) underwent pyeloureterocystoplasty without revascularization. Patients underwent several evaluations in long-term follow-up. Patients were all dry by day and night in our long-term follow-up. Urinary incontinence improved in patients with no need for re-augmentation technique. Vesicoureteral reflux subsided in all patients postoperatively except one, who was asymptomatic. After five years, median bladder capacity rose from 128.5 ml to 395 ml and bladder compliance showed significant improvement from 15 ml/cm H
2 O to 29 ml/cm H2 O, in experimental group and remained stable for 24–36 months. Median bladder capacity did not rise significantly in control group. Pyeloureterocystoplasty is an efficient choice in this type of patients, which may prevent the recurrence of hypocompliant bladders and prevent ischemia and subsequent fibrosis. [ABSTRACT FROM AUTHOR] more...- Published
- 2022
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43. Lower Urinary Tract Dysfunction in Myasthenia Gravis: A Case Report and Literature Review.
- Author
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Pereira P, Coelho MM, Tizón S, and Freixo S
- Abstract
Lower urinary tract dysfunction often occurs after various neurological disorders and significantly impacts patients' quality of life. Studies on myasthenia gravis (MG) are scarce, and most of them are case reports associated with symptoms such as overactive bladder, incontinence, and urinary retention. The authors present the case of a 68-year-old female patient with a myasthenia gravis diagnosis, followed by Urogynecology Physical Medicine and Rehabilitation for stress urinary incontinence. A urodynamic study performed demonstrated intrinsic sphincter dysfunction with detrusor hypocontractility. She began functional rehabilitation of the pelvic floor without improvement, so she was advised to consider a possible surgical approach. This case report highlights the connection between MG and lower urinary tract dysfunction, underscoring the necessity for increased awareness and customized management strategies for affected patients., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Pereira et al.) more...
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- 2024
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44. Urodynamic Effects of Prostatic Urethral Lift Procedure for Male Voiding Lower Urinary Tract Symptoms.
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Muller, Berrend G., Martens, Frank M.J., Heesakkers, John P.F.A., and d'Ancona, Frank C.H.
- Subjects
- *
URINARY organs , *RETENTION of urine , *PROSTATE-specific antigen , *QUALITY of life , *BLADDER obstruction , *BENIGN prostatic hyperplasia , *CYSTOMETRY - Abstract
Aims: Primary objective is to investigate whether prostatic urethral lift (PUL) results in an improvement of urodynamic parameters that define bladder outlet obstruction (urethral resistance algorithm [urethral resistance factor (URA)], Schäfer grade, detrusor pressure at maximum flow [PdetQmax], and detrusor pressure at bladder opening [PdetOpen]). Materials and Methods: Twenty patients (main inclusion criteria: ≥50 years of age, benign prostatic obstruction (BPO), international prostate symptom score (IPSS) ≥13, prostate volume ≤60 mL, and no middle prostate lobe) were enrolled in the study and a PUL was performed. Patients underwent urodynamic investigation and filled out the IPSS and quality of life (QoL) before and after PUL. A paired t-test was used to analyze the results. Results: The mean age was 68 years (range 55–79), mean prostate volume (TRUS) was 45 mL (range 20–59), and mean prostate-specific antigen was 2.0 μg/L (0.2–4.4). IPSS of the 16 patients reduced significantly (from 22.20 to 14.47, p = 0.000). Qmax during pressure flow study improved significantly (from 4.5 to 7.2 mL/s, p = 0.001), no significant difference was found in Qmax during free uroflowmetry. There was no significant difference found in postvoiding residual. URA decreased significantly post-treatment (from 52 to 37 cmH2O, p = 0.000). The Schäfer obstruction plot decreased significantly (from 3.5 to 2.6, p = 0.022). Seven patients underwent Greenlight Laser Vaporization of the prostate after the PUL attributable to unsatisfactory results. Conclusions: PUL has desobstructive effects, but they seem clinically modest. The procedure improves urodynamic parameters as well as QoL in males with lower urinary tract symptoms based on BPO. However, the mechanism how PUL leads to a remarkable symptom relief remains unclear and cannot be explained by the desobstructive mechanisms we observed. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
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45. The Relationship Between Histological Changes and Urodynamic Parameters in Patients Undergoing Orthotopic Ileal Neobladder Surgery: A Case-Control Study.
- Author
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Kara, Burak Yavuz, Akdeniz, Ekrem, Yalçınkaya, Fatih, Önal, Binnur, and Altuğ, Mustafa Uğur
- Subjects
- *
CYSTECTOMY , *BLADDER , *CONFIDENCE intervals , *URINARY diversion , *INFLAMMATION , *URINATION , *CASE-control method , *TREATMENT effectiveness , *URODYNAMICS , *DESCRIPTIVE statistics , *PATIENT compliance , *ODDS ratio , *DATA analysis software , *ENDOSCOPY - Abstract
Objective: The relationship between histological changes and urodynamic findings emerging in neobladders (NBs) in a long term was not previously investigated. This study aimed to investigate the relationship between histological changes and urodynamic findings in the NB. Materials and Methods: Patients undergoing radical cystectomy and Studer NB were included in the study. Patients with follow-up times <48 months were assigned to group 1 (n = 5) and those with follow-up times >48 months in group 2 (n = 6). Metabolic, endoscopic, histologic, urodynamic, and continence parameters were evaluated after surgery. Results: No metabolic disorders or pathology was observed in the endoscopy of any patients. Histological evaluation revealed a decreased chronic inflammation and villus length severity over the years, with increased goblet cell numbers and fibrosis rates. Maximum reservoir capacity, compliance, and voiding pressure values for groups 1 and 2 were 418±42.1 and 401.33±67.8 mL, 15.65±2.7 and 18.54±4.98 mL/cm H2O, and 28.2±2.28 and 30.6±7.4 cm H2O, respectively. Maximum reservoir capacity was higher in group 1 than in group 2, whereas compliance and voiding pressure were lower, without significant differences (p = 0.84, p = 0.64, and p = 0.97; respectively). Conclusion: No effects were observed on urodynamıc parameters resulting from the development of long term histological changes in the NB. However, the NB appeared to adapt to its new function by gradually assuming a similar morphology to the urothelium, maintaining a sufficient capacity and compliance. Daytime continence was achieved at a rate of 90.9%, without metabolic pathology. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
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46. Urodynamic Parameters in Spinal Cord Injury-Induced Neurogenic Bladder Rats after Stem Cell Transplantation: A Narrative Review
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Nasrin Abolhasanpour, Sakineh Hajebrahimi, Abbas Ebrahimi-Kalan, Ahmad Mehdipour, and Hanieh Salehi-Pourmehr
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urodynamic ,spinal cord injuries ,urinary bladder ,neurogenic ,stem cell transplantation ,Medicine (General) ,R5-920 - Abstract
Neurogenic bladder (NGB) secondary to spinal cord injury (SCI) is accompanied with several complications such as urinary tract deterioration, urinary incontinence, and consequently lower quality of life (QoL), significant morbidities, and occasionally death. Current therapeutic methods have some side effects and there is no treatment for the upper urinary tract injuries. Stem cell therapy is a promising method for treating this condition. However, the best timing and the best route of its transplantation have not yet been determined. Animal models of SCI, especially in rats, are the most commonly used method for evaluating the efficacy of cell therapy in NGB improvement, and the most common assessment method is the urodynamic studies (UDS). However, there are variations in the range of UDS parameters among the published studies. The current review aimed to discuss the effect of stem cell transplantation on bladder dysfunction recovery based on urodynamic parameters after SCI in rats. For this purpose, the cell source, doses, the route of administration, and the complete UDS equipment and its parameters were summarized in SCI models in rats. In some urodynamic test results, to some extent, an improvement in the lower urinary system function was observed in each treatment group. However, this improvement was far from full functional recovery. The average cell dose was about 1 million cells in every injected site. In most studies, the stem cells (SCs) were transplanted 9 days after the injury using PE-50 and PE-60. Many researchers have recommended further experimental and clinical studies to confirm this treatment modality. more...
- Published
- 2020
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47. Interpretation of Tracings and Identification of Artifacts
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Vignoli, Giancarlo and Vignoli, Giancarlo
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- 2018
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48. A comparison of flow rate curve shape and video-urodynamic findings in women with lower urinary tract symptoms: can flow rate curve shape predict female bladder outflow obstruction or detrusor underactivity?
- Author
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Kocadag, Huriye, Toia, Bogdan, Axell, Richard, Yasmin, Habiba, Pakzad, Mahreen H., Hamid, Rizwan, Greenwell, Tamsin J., and Ockrim, Jeremy L.
- Subjects
- *
URINARY organs , *SYMPTOMS , *BLADDER obstruction , *DIAGNOSIS , *BLADDER cancer , *NEUROGENIC bladder ,URETHRAL obstruction - Abstract
Purpose: To establish the correlation between flow rate curve shape and video-urodynamic findings in women with lower urinary tract symptoms (LUTS). Methods: A retrospective review of consecutive women with LUTS who performed a free flow study immediately before undergoing video-urodynamic investigations over a 28-month period. Flow rate curve shape and video-urodynamic parameters were analysed. Free flow curves were defined into five categories: bell-shaped, prolonged, fluctuating, intermittent or plateau. Women who voided less than 150 ml on the free flow study were excluded from the analysis. Results: A total of 250 women with LUTS, with a mean age 48 years (range 18–83), were included. Bell-shaped tracings excluded obstruction in 89%. Prolonged flow rate curves diagnosed obstruction in 62% and detrusor underactivity in 8%. Fluctuating and intermittent flow rate curves were associated with urodynamic obstruction in 37 and 39%, respectively, and detrusor underactivity in 25 and 29%, respectively. A plateau flow rate curve was indicative of urodynamic obstruction in all three cases observed. Conclusion: Flow rate curve patterns can be suggestive of urodynamic diagnoses. Women without a prolonged void and bell-shaped traces had normal voiding urodynamics in 76% of cases, and the majority could be managed without invasive investigations. Patients with fluctuating and intermittent flow rate curves demonstrate a spectrum of urodynamic diagnoses with a third of cases having obstruction and a third of cases having detrusor underactivity. Plateau flow rate curve patterns are associated with urethral obstruction. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
- Full Text
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49. Clinical Correlation of Bladder Electron Microscopic Characteristics in Patients with Detrusor Underactivity of Various Etiologies
- Author
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Jia-Fong Jhang, Han-Chen Ho, Yuan-Hong Jiang, Yung-Hsiang Hsu, and Hann-Chorng Kuo
- Subjects
urodynamic ,urine retention ,pathogenesis ,treatment outcome ,Biology (General) ,QH301-705.5 - Abstract
This study aimed to investigate the ultrastructural characteristics of the bladder of patients with detrusor underactivity (DU) of various etiologies. Twenty-five patients with DU and control subjects underwent urodynamic testing and transmission electron microscopic examination of bladder specimens. The epithelium, lamina propria, and muscle layers were analyzed separately. The DU bladders exhibited total epithelial denudation (52%). In the bladders with remaining epithelium, apical cell uroplakins (44.4%) and tight junction complexes (77.8%) were also noted. The lamina propria was characterized by loose extracellular connective tissue (48%) and a lack of nerve terminals (76%). Smooth muscle shrinkage and a loss of their regular spindle shape (91.6%) were also noted in the detrusor layer. Patients with DU with intact epithelial cell layers had significantly larger void volumes and maximal flow rates than those with mild or severe epithelial denudation. Patients with remaining nerve terminals in lamina propria had a stronger first sensation of filling and smaller residual urine volume than those without nerve terminals. The proportion of ultrastructural defects of the bladder was not significantly different among patients with DU of various etiologies and treatment outcomes. DU bladders were characterized by ultrastructural defects in the entire bladder, and the defects were correlated to clinical parameters. more...
- Published
- 2022
- Full Text
- View/download PDF
50. Is pre-operative urodynamic bladder function the true predictor of outcome of male sling for post prostatectomy incontinence?
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Toia, Bogdan, Leung, Lap Yan, Saigal, Raveen, Solomon, Eskinder, Malde, Sachin, Taylor, Claire, Sahai, Arun, Hamid, Rizwan, Seth, Jai H., Sharma, Davendra, Greenwell, Tamsin J., and Ockrim, Jeremy L.
- Subjects
- *
SUBURETHRAL slings , *PROSTATECTOMY , *ARTIFICIAL sphincters , *FORECASTING , *BLADDER , *URINARY stress incontinence - Abstract
Purpose: To investigate pre-operative urodynamic parameters in male sling patients to ascertain whether this might better predict surgical outcomes and facilitate patient selection. Methods: We performed a retrospective, case notes and video-urodynamics, review of men who underwent AdVanceXP male sling in three London hospitals between 2012 and 2019. Urodynamics were performed in all centres, while retrograde leak point pressure (RLPP) was performed in one centre. Results: Successful outcome was seen in 99/130 (76%) of men who required one pad or less per day. The dry rate was 51%. Pad usage was linked to worse surgical outcomes, mean 2.6 (range 1–6.5) for success vs 3.6 (range 1–10) although the ranges were wide (p = 0.002). 24 h pad weight also reached statistical significance (p = 0.05), with a mean of 181 g for success group versus 475 g for the non-successful group. The incidence of DO in the non-successful group was significantly higher than in successful group (55% versus 29%, p = 0.0009). Bladder capacity less than 250 ml was also associated with worse outcomes (p = 0.003). Reduced compliance was not correlated with outcomes (31% for success groups vs 45% for non-successful group, p = 0.15). Preoperative RLPP was performed in 60/130 patients but did not independently reach statistical significance (p = 0.25). Conclusion: Urodynamic parameters related to bladder function—detrusor overactivity and reduced maximum cystometric capacity predict male sling outcomes and may help in patient selection for male sling (or sphincter) surgery; whereas urodynamic parameters of sphincter incompetency (RLPP) were not predictive. Further larger scale studies are required to confirm these findings. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
- Full Text
- View/download PDF
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