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https://www.readbyqxmd.com/read/29296045/current-pharmacological-and-surgical-treatment-of-underactive-bladder
#1
REVIEW
Yuan-Hong Jiang, Cheng-Ling Lee, Jia-Fong Jhang, Hann-Chorng Kuo
Underactive bladder (UAB) or detrusor underactivity (DU) is a common yet still poorly understood urological problem. In addition to true detrusor failure and neuropathy, the inhibitory effects of detrusor contraction by the striated urethral sphincter and the bladder neck through alpha-adrenergic activity may also play a role in the development of UAB or DU. Treatment of UAB or DU aims to reduce the postvoid residual (PVR) urine volume and increase voiding efficiency, either by spontaneous voiding or abdominal straining...
October 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29279882/new-therapeutic-directions-to-treat-underactive-bladder
#2
REVIEW
Toby C Chai, Tambudzai Kudze
Underactive bladder (UAB) is a term used to describe a constellation of symptoms that is perceived by patients suggesting bladder hypocontractility. Urodynamic measurement that suggest decreased contractility of the bladder is termed detrusor underactivity (DUA). Regulatory approved specific management options with clinically proven ability to increase bladder contractility do not currently exist. While DUA specific treatments presumably will focus on methods to increase efficiency of bladder emptying capability relying on augmenting the motor pathway in the micturition reflex, other approaches include methods to augment the sensory (afferent) contribution to the micturition reflex which could result in increased detrusor contractility...
December 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29279881/current-pharmacological-and-surgical-treatment-of-underactive-bladder
#3
REVIEW
Dae Kyung Kim
Generally accepted guidelines are not yet available on the management of underactive bladder (UAB). Although the natural history of UAB is still not fully understood, observation may be an acceptable management option in patients with tolerable lower urinary tract symptoms and little risk of upper urinary tract damage. If needed, scheduled and double voiding may be recommended as an effective and safe add-on therapy. Parasympathomimetics have been widely used for the management of UAB, but the evidence does not support clinical benefit...
December 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29279880/pathophysiology-of-the-underactive-bladder
#4
REVIEW
Naoki Aizawa, Yasuhiko Igawa
Underactive bladder (UAB), which has been described as a symptom complex suggestive of detrusor underactivity, is usually characterized by prolonged urination time with or without a sensation of incomplete bladder emptying, usually with hesitancy, reduced sensation on filling, and slow stream often with storage symptoms. Several causes such as aging, bladder outlet obstruction, diabetes mellitus, neurologic disorders, and nervous injury to the spinal cord, cauda equine, and peripheral pelvic nerve have been assumed to be responsible for the development of UAB...
December 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29279879/clinical-implications-of-underactive-bladder
#5
REVIEW
Kwang Jin Ko, Chung Un Lee, Kyu-Sung Lee
Underactive bladder (UAB) is a common urologic condition but a complex disease that causes troublesome lower urinary tract symptoms. Currently, management of UAB remains unsatisfactory. Also, many urological diseases can be combined with UAB. In these combined cases, the treatment results may be affected by UAB component. This review focuses on the clinical implications of UAB in patients with common urologic conditions, including bladder outlet obstruction, overactive bladder syndrome and stress urinary incontinence...
December 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29279878/epidemiology-of-underactive-bladder-common-but-underresearched
#6
REVIEW
Young Dong Yu, Seong Jin Jeong
Detrusor underactivity (DU) or underactive bladder is a common cause of lower urinary tract symptoms (LUTS), but it is still poorly understood and underresearched. Although there has been a proposed definition by International Continence Society in 2002, no widely accepted diagnostic criteria have been established for this entity in clinical practice. Therefore, it has been rare to identify community-based researches on the epidemiology of DU until now. Only certain studies have reported the prevalence of DU in community-dwelling cohorts with significant LUTS using arbitrary urodynamic criteria for DU and these investigations have indicated that DU accounts for 25%-48% and 12%-24% of elderly men and women, respectively...
December 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29279877/definition-and-symptoms-of-underactive-bladder
#7
REVIEW
Alan D Uren, Marcus J Drake
Underactive bladder (UAB) is a symptom syndrome reflecting the urodynamic observation of detrusor underactivity (DU), a voiding contraction of reduced strength and/or duration, leading to prolonged or incomplete bladder emptying. An International Continence Society Working Group has described UAB as characterised by a slow urinary stream, hesitancy and straining to void, with or without a feeling of incomplete bladder emptying and dribbling, often with storage symptoms. Since DU often coexists with bladder outlet obstruction, or storage dysfunction (detrusor overactivity or incontinence), the exact contribution of the DU to the presenting complaints can be difficult to establish...
December 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29279876/underactive-bladder
#8
EDITORIAL
Kyu-Sung Lee
No abstract text is available yet for this article.
December 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29277467/bladder-dysfunction-in-wolfram-syndrome-is-highly-prevalent-and-progresses-to-megacystis
#9
Ruth Wragg, Renuka P Dias, Timothy Barrett, Liam McCarthy
AIM: Wolfram syndrome is a rare genetic defect in WFS1 or WSF2(CISD2). It includes diabetes mellitus and insipidis, sensorineural deafness, optic atrophy, but not bladder dysfunction. However, this has appeared a common finding in our national referral clinic, and we sought to quantify this problem. METHODS: Data were collected from a multidisciplinary team managing all Wolfram patients in the UK. The following was analyzed: age, date of non-invasive urodynamics (NIU), symptoms, bladder capacity, voided volume, post-void residual and uroflow pattern...
November 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29273299/-self-intermittent-catheterization-and-urinary-retentions-in-parkinsonian-syndromes
#10
E Savard, A Declemy, V Coindreau, F Babany, C Chesnel, A Charlanes, F Le Breton, G Amarenco
INTRODUCTION: Lower urinary tract symptoms are common in Parkinson diseases, especially chronic urinary retention. In case of significant and symptomatic postvoid residual, a specific treatment is necessary in order to empty the bladder and nowadays the gold standard of such neurogenic bladder is based on self-intermittent-catheterizations, if possible at all. We carried out a retrospective study about feasibility and outcomes of self-intermittent-catheterizations in this population. METHODS: Retrospective study with qualitative and quantitative, clinical and instrumental (urodynamic) assessment, of lower urinary tract symptoms as urinary retention in extrapyramidal syndromes...
December 19, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/29249687/male-incontinence-the-etiology-or-basis-of-treatment
#11
REVIEW
Austin G Hester, Alexander Kretschmer, Gopal Badlani
CONTEXT: Elderly men are an increasing proportion of the aging population in the 21st century. Urinary incontinence reduces the quality of life and increases the burden of care for the aging population. OBJECTIVE: The primary objective of this review is to explore the etiopathology of common causes of incontinence in aging male patients. The focus is on the algorithm of the initial evaluation of these patients from both a primary care and a urologic standpoint. EVIDENCE ACQUISITION: A nonsystematic review of the literature was performed in September 2017...
December 14, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29203142/synthesis-and-evaluation-of-a-potent-well-balanced-ep2-ep3-dual-agonist
#12
Akihiro Kinoshita, Masato Higashino, Koji Yoshida, Yoshiyuki Aratani, Akito Kakuuchi, Keisuke Hanada, Hiroyuki Takeda, Atsushi Naganawa, Hidekazu Matsuya, Kazuyuki Ohmoto
A highly potent and well-balanced dual agonist for the EP2 and EP3 receptors is described. Optimization of the lead compound was accomplished in consideration of the relative agonist activity against each EP subtype receptor and the pharmacokinetic profile. As the result, 2-[(2-{(1R,2R)-2-[(1E,4S)-5-cyclopentyl-4-hydroxy-4-methyl-1-penten-1-yl]-5-oxocyclopentyl}eth-yl)thio]-1,3-thiazole-4-carboxylic acid (10) showed excellent potency (human EC50 EP2 = 1.1 nM, EP3 = 1.0 nM) with acceptable selectivity over the EP1 and EP4 subtypes (>2000-fold)...
November 24, 2017: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/29202586/pharmacological-treatments-available-for-the-management-of-underactive-bladder-in-neurological-conditions
#13
Seyedeh-Sanam Ladi-Seyedian, Behnam Nabavizadeh, Lida Sharifi-Rad, Abdol-Mohammad Kajbafzadeh
Underactive bladder (UAB) is a common cause of lower urinary tract dysfunction which has an increasing incidence with aging. It is characterized as an incompetent detrusor contraction with reduced strength and/or duration to completely empty the bladder. UAB is observed in both men and women. The exact definition, classification, and pathophysiological mechanism responsible for UAB is still debatable, however neurologic, myogenic, and iatrogenic causes are explained. The symptom complex related to UAB includes hesitancy, diminished sensation of bladder filling, a slow urinary stream, increased post-void residue, and etc...
December 5, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29201606/a-3d-printed-implantable-device-for-voiding-the-bladder-using-shape-memory-alloy-sma-actuators
#14
Faezeh Arab Hassani, Wendy Yen Xian Peh, Gil Gerald Lasam Gammad, Roshini Priya Mogan, Tze Kiat Ng, Tricia Li Chuen Kuo, Lay Guat Ng, Percy Luu, Shih-Cheng Yen, Chengkuo Lee
Underactive bladder or detrusor underactivity (DU) is defined as a reduction of contraction strength or duration of the bladder wall. Despite the serious healthcare implications of DU, there are limited solutions for affected individuals. A flexible 3D printed implantable device driven by shape memory alloys (SMA) actuators is presented here for the first time to physically contract the bladder to restore voluntary control of the bladder for individuals suffering from DU. This approach is used initially in benchtop experiments with a rubber balloon acting as a model for the rat bladder to verify its potential for voiding, and that the operating temperatures are safe for the eventual implantation of the device in a rat...
November 2017: Advanced Science (Weinheim, Baden-Wurttemberg, Germany)
https://www.readbyqxmd.com/read/29189291/effect-of-thoracic-epidural-ropivacaine-versus-bupivacaine-on-lower-urinary-tract-function-a-randomized-clinical-trial
#15
Stefan A Girsberger, Marc P Schneider, Lukas M Löffel, Fiona C Burkhard, Patrick Y Wuethrich
BACKGROUND: Thoracic epidural analgesia with bupivacaine resulted in clinically relevant postvoid residuals due to detrusor underactivity. This study aimed to compare the risk of bladder dysfunction with ropivacaine versus bupivacaine using postvoid residuals and maximum flow rates. Our hypothesis was that ropivacaine would result in lower postvoid residuals, because ropivacaine has been shown to have less effect on motor blockade. METHODS: In this single-center, parallel-group, randomized, double-blind superiority trial, 42 patients undergoing open renal surgery were equally allocated to receive epidural bupivacaine 0...
November 21, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29072046/diagnosis-and-clinical-evaluation-of-neurogenic-bladder
#16
Gerard Amarenco, Samer Sheikh Ismaël, Camille Chesnel, Audrey Charlanes, Frederique LE Breton
BACKGROUND: Neurologic diseases lead to urinary dysfunctions. AIM: The aim of this article is to present an overview of diagnosis and evaluation of neurogenic bladder with a special focus on urodynamic tests. CONCLUSION: Overactive bladder, with high detrusor pressure associated with detrusor sphincter dyssynergia, can lead to severe complications with renal failure, upper urinary tract dilatation and infectious complications. Underactive bladder with voiding dysfunction and urinary retention, is also a risk factor of urological alterations...
October 25, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29070575/saphenous-nerve-stimulation-normalizes-bladder-underactivity-induced-by-tibial-nerve-stimulation-in-cats
#17
Shun Li, Xing Li, Katherine Theisen, Jeffrey Browning, Bing Shen, Jicheng Wang, James R Roppolo, William C de Groat, Changfeng Tai
This study in α-chloralose anesthetized cats aimed at investigating the bladder responses to saphenous nerve stimulation (SNS). A urethral catheter was used to infuse the bladder with saline and to record changes in bladder pressure. With the bladder fully distended, SNS at 1 Hz frequency and an intensity slightly below the threshold (T) for inducing an observable motor response of the hindlimb muscles induced large amplitude (40-150 cmH2O) bladder contractions. Application of SNS (1 Hz, 2-4T) during cystometrograms (CMGs), when the bladder was slowly (1-3 ml/min) infused with saline, significantly (p<0...
October 25, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29046983/holmium-laser-enucleation-of-the-prostate-patient-selection-and-outcomes
#18
REVIEW
Joseph M Kuebker, Nicole L Miller
PURPOSE OF REVIEW: Holmium laser enucleation of the prostate (HoLEP) is a proven technique to alleviate bladder outlet obstruction (BOO) from benign prostatic hyperplasia (BPH). Herein, we review factors relevant to selecting patients who will benefit from this procedure and expected outcomes. RECENT FINDINGS: New randomized trials have validated the excellent outcomes achieved by HoLEP in the management of BOO from BPH. Its success has been reproduced in a diverse array of patients including those on anticoagulation, with detrusor underactivity/acontractility, prostate cancer, and in the retreatment setting...
October 19, 2017: Current Urology Reports
https://www.readbyqxmd.com/read/29024564/videourodynamic-factors-predictive-of-successful-onabotulinumtoxina-urethral-sphincter-injection-for-neurogenic-or-non-neurogenic-detrusor-underactivity
#19
Yuan-Hong Jiang, Jia-Fong Jhang, Sheng-Fu Chen, Hann-Chorng Kuo
OBJECTIVE: The aim of the present study was to analyze treatment outcomes and identify videourodynamic factors predictive of successful urethral onabotulinumtoxinA treatment of neurogenic and non-neurogenic detrusor underactivity (DU). METHODS: Patients with DU refractory to medical treatment were treated with injections totaling 100 U onabotulinumtoxinA into the urethral sphincter. Treatment outcomes were assessed 1 month after treatment using the Global Response Assessment...
October 11, 2017: Lower Urinary Tract Symptoms
https://www.readbyqxmd.com/read/28969876/review-of-underactive-bladder
#20
REVIEW
Yi-Huei Chang, Justin Ji-Yuen Siu, Po-Jen Hsiao, Chao-Hsiang Chang, Eric Chieh-Lung Chou
In clinical practice, many patients cannot empty their bladders within an acceptable duration. Common complaints include weak urinary stream and incomplete emptying, which may affect quality of life. Bladder emptying requires sufficient detrusor contractile power, velocity, and durability. The urodynamic term for inadequate detrusor contraction is detrusor underactivity (DU). Although this definition was provided by the ICS, it may not be clinically practical. Analogous to the relationship between overactive bladder (OAB) and detrusor overactivity (DO), the symptom complex caused by DU is termed underactive bladder (UAB)...
September 29, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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