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Detrusor overactivity

Cosimo De Nunzio, Fabrizio Presicce, Riccardo Lombardo, Simon Carter, Carlo Vicentini, Andrea Tubaro
AIMS: To evaluate the role of Bladder wall thickness (BWT) as a predictor of Detrusor overactivity (DO) in patients with Lower urinary tract symptoms (LUTS)/Benign prostatic enlargement without Bladder Outlet Obstruction. METHODS: From January 1996 to December 2000, each new patient, aged 45 years or older with LUTS, underwent standard diagnostic assessment, urodynamic studies (cystometry and pressure flow studies), and ultrasound measurements of the bladder wall thickness (BWT) in two centers...
October 24, 2016: Neurourology and Urodynamics
Maya Basu, Stergios K Doumouchtsis
AIMS: There is evidence of an association between voiding parameters and the presence of overactive bladder symptoms. The aim of this study was to evaluate whether there is any association between pressure flow study parameters and the degree of health related quality of life impairment in women with OAB symptoms. The null hypothesis is that there is no significant correlation between quality of life domain scores and pressure flow study parameters. METHODS: One hundred and sixty-seven consecutive women with overactive bladder symptoms underwent evaluation with a quality of life assessment plus filling and voiding cystometry...
October 24, 2016: Neurourology and Urodynamics
Ana Claudia Paradella, André Ferraz de Arruda Musegante, Carlos Roberto Brites
Intravesical botulinum toxin A (BoNTA) injection has been widely used for the treatment of detrusor overactivity in patients with neurogenic bladder due to spinal cord injury who do not respond to conventional treatment. There is no consensus about antibiotic prophylaxis for this procedure. We conducted a retrospective analysis of medical records of adult patients with spinal cord injury who underwent detrusor BoNTA injection between January of 2007 and December of 2013 in a rehabilitation hospital. Occurrence of symptomatic urinary tract infection (UTI) was assessed in 3 groups in accordance with their use of antibiotics (prophylactic dosage, 3 days, more than 3 days) for the treatment of asymptomatic bacteriuria...
October 17, 2016: Brazilian Journal of Infectious Diseases
F Sakakibara, K Takahama, M Nanri, E Sasaki
Patients with spinal cord injury (SCI) usually develop lower urinary tract dysfunctions, including detrusor overactivity which is also known to be a risk factor for upper urinary tract dysfunction. Antimuscarinic agents, such as propiverine, have been used clinically for the treatment of detrusor overactivity. Also, propiverine has been known to possess antagonistic activity against L-type Ca(2+) channels and transient receptor potential vanilloid subtype 1 (TRPV1), in addition to activity against muscarinic receptors...
September 2016: Drug Research
Lorenz Leitner, Matthias Walter, Ulla Sammer, Stephanie C Knüpfer, Ulrich Mehnert, Thomas M Kessler
OBJECTIVES: To evaluate whether urodynamic investigation (UDI), the gold standard to assess refractory lower urinary tract symptoms (LUTS), is appropriate to select healthy volunteers with apparent normal lower urinary tract function as control subjects for comparative studies. SUBJECTS AND METHODS: 42 healthy subjects (22 women, mean age 32±10 years; 20 men, mean age 37±12 years) without LUTS were included into this prospective single-centre cohort study. All subjects recorded a 3-day bladder diary, completed validated questionnaires regarding LUTS, and underwent neuro-urological assessment as well as free uroflowmetry...
2016: PloS One
Shirish Dattatraya Yande, Omkar Vinay Joglekar, Maya Joshi
INTRODUCTION: Role of urodynamics prior to surgery of stress urinary incontinence (SUI) is under constant debate. Demonstration of the presence of detrusor overactivity is the only aspect that has been emphasized in the literature so far. We believe that there are number of other factors which may influence the evaluation and in turn the choice of surgical management and prediction of outcome of treatment. They are as follows: (1) Presence of voiding inefficiency, (2) asymptomatic detrusor overactivity, (3) and severity of SUI...
July 2016: Journal of Mid-life Health
M Spilotros, S Malde, E Solomon, M Grewal, B M Mukhtar, M Pakzad, R Hamid, J L Ockrim, T J Greenwell
PURPOSE: To report the etiology, presenting symptoms and outcomes of the different treatments performed in female patients with recurrent urethral stricture. MATERIALS AND METHODS: Twenty-six patients with refractory LUTS were diagnosed with a urethral stricture. The symptoms, the treatment performed and the outcomes were prospectively recorded. Sixteen patients were treated with a urethroplasty using a buccal mucosal graft (BMG) in 14 cases (54 %) and a vaginal flap in 2 (8 %)...
October 4, 2016: World Journal of Urology
Wei-Chia Lee, You-Lin Tain, Kay L H Wu, Steve Leu, Julie Y H Chan
Maternal fructose exposure (MFE) programs the development of metabolic syndrome (MetS) in young adult offspring. Epidemiological data indicate that MetS may increase the risks of overactive bladder (OAB) symptoms. However, it remains unknown whether MFE programs MetS-associated bladder dysfunction in adult offspring. Using Sprague-Dawley rats, we investigated the effects of MFE during pregnancy and lactation on developmental programming of MetS-associated bladder dysfunction. In addition, next generation sequencing technology was used to identify potential transcripts involved in the programmed bladder dysfunction in adult male offspring to MFE...
October 5, 2016: Scientific Reports
Katherine Warren, Helena Burden, Paul Abrams
Overactive bladder is a common condition, which significantly affects people's quality of life. The use of anticholinergic medication has been the mainstay of managing overactive bladder when conservative measures are not enough. Many patients stop anticholinergic medication because of the side effects and more recently the concerns about the effect of an anticholinergic burden and the development of dementia have been studied. Activation of β3 adrenoceptors has been shown to relax the detrusor muscle and subsequently lead to the development of the first β3 adrenoceptor agonist...
October 2016: Therapeutic Advances in Drug Safety
Amit Batla, Natalie Tayim, Mahreen Pakzad, Jalesh N Panicker
Urogenital dysfunction is commonly reported in Parkinson's disease (PD), and history taking and a bladder diary form the cornerstone of evaluation. The assessment of lower urinary tract (LUT) symptoms include urinalysis, ultrasonography, and urodynamic studies and help to evaluate concomitant urological pathologies such as benign prostate enlargement. Antimuscarinic medications are the first line treatment for overactive bladder (OAB) symptoms and solifenacin has been specifically studied in PD. Antimuscarininc drugs may exacerbate PD-related constipation and xerostomia, and caution is advised when using these medications in individuals where cognitive impairment is suspected...
October 2016: Current Treatment Options in Neurology
Helene Dessort, Evelyne Castel-Lacanal, Xavier de Boissezon, Philippe Marque
OBJECTIVE: Intermittent self-catheterization is the gold standard for patients with central neurologic bladder. It allows to reduce all urinary tract complications and to improve the quality of life. The factors of good compliance are continence and autonomy regarding the introduction of the catheter. Nevertheless, self-catheterization can be difficult because of the usual shortcomings associated with bladder and sphincter disorders (motor, sensory…). We found only one study about one adaptive equipment to facilitate the gesture for monoplegic patients...
September 2016: Annals of Physical and Rehabilitation Medicine
Charles Fattal, Claire Anquetil, Samer Abdelhamid
OBJECTIVE: To compare quality of life (QoL) in patients with spinal cord injury who underwent overactive detrusor treatment by Botulinum Toxin (BT) versus augmentation cystoplasty (AC). MATERIALS/PATIENTS AND METHODS: Prospective and descriptive study. Patients with refractory overactive bladder due to SCI were treated by at least 2 successive injections of BT or by AC. QoL was assessed using Qualiveen-30 (Q30). Clinical data and urodynamic parameters were collected and compared...
September 2016: Annals of Physical and Rehabilitation Medicine
Charles Joussain, Mélanie Popoff, Véronique Phé, Alexia Even, Laetitia Falcou, Emmanuel Chartier-Kastler, Brigitte Schurch, Pierre Denys
OBJECTIVE: Intradetrusor injection of onabotulinum toxin A (IDIBA) is the third-line therapy for patients with neurogenic detrusor overactivity (NDO). There is few evidence of long-term efficacy but no study assessed reasons for failure or abandonment of IDIBA and CISC (clean intermittent self-catheterization) combined strategy. We aimed to assess its long-term outcome in NDO management, and analyze failure and discontinuation. MATERIALS/PATIENTS AND METHODS: We retrospectively reviewed medical records of patients admitted in our neurourology department between 2001 and 2013...
September 2016: Annals of Physical and Rehabilitation Medicine
Charles Joussain, Jonathan Levy, Audrey Charlanes, Alexia Even, Laetitia Falcou, Emmanuel Chartier-Kastler, Pierre Denys
OBJECTIVE: Hereditary spastic paraplegia (HSP) represents a clinically and genetically heterogeneous group of neurodegenerative diseases, with a worldwide estimated prevalence of 1.3/100,000 [1]. The "pure" form of HSP is a characterized by a progressive spastic paraplegia, often associated with lower urinary tract symptoms (LUTS) (72.4% to 77.6%) [2,3]. However, urologic complications are rarely reported. The aim of this study was to characterize clinical and urodynamic aspects of LUTS following HSP, and to describe treatment and urological complications of LUTS in a large series of HSP patients...
September 2016: Annals of Physical and Rehabilitation Medicine
Ryusei Yokokawa, Hironobu Akino, Hideaki Ito, Xinmin Zha, Osamu Yokoyama
AIMS: There are some reports that bladder C-fibers are partially involved in detrusor overactivity in patients with brain lesions. We investigated the contribution of bladder C-fiber to decreased bladder capacity in rats with cerebral infarction. METHODS: Cerebral infarction was induced under halothane anesthesia by left middle cerebral artery occlusion with 4-0 nylon thread in female Sprague-Dawley rats. Intramural amounts of ATP and prostaglandin E2 , in vivo and in vitro ATP, NGF, and prostaglandin E2 release from the distended bladder urothelium, and changes in mRNA expressions of sensor molecules and receptors were monitored 6 h after the occlusion...
September 27, 2016: Neurourology and Urodynamics
Rose Khavari, Christof Karmonik, Michael Shy, Sophie Fletcher, Timothy Boone
PURPOSE: Neurogenic Lower Urinary Tract Dysfunction (NLUTD) is common in multiple sclerosis (MS) patients with a significant impact on their quality of life. In this study, we seek to discover brain activity processes during the micturition cycle in female patients with MS and NLUTD. MATERIALS AND METHODS: We report brain activity via functional magnetic resonance imaging (fMRI) and simultaneous urodynamic testing (UDS) in twenty-three ambulatory female patients with MS...
September 21, 2016: Journal of Urology
Na N Guan, Karl Svennersten, Petra J de Verdier, N Peter Wiklund, Lars E Gustafsson
The proximal urethra and urinary bladder trigone play important roles in continence. We have previously shown that PGD2 is released from guinea pig bladder urothelium/suburothelium and can inhibit detrusor contractile responses. We presently wished to investigate PGD2 actions in guinea pig out-flow region and the distribution of DP1 /DP2 receptors. The effects of PGD2 on urothelium-intact trigone and proximal urethra contractility were studied in organ bath experiments. Expression of DP1 /DP2 receptor proteins was analysed by western blot...
September 23, 2016: Journal of Cellular and Molecular Medicine
Alexandriah Alas, Orawee Chinthakanan, Luis Espaillat, Leon Plowright, Vivian Aguilar, G Willy Davila
INTRODUCTION AND HYPOTHESIS: We aimed to evaluate the success of suburethral slings in women ≥70 years of age. METHODS: This was a retrospective cohort study of women who underwent suburethral sling placement. Subjects were separated into three groups: ≤50 years of age (group 1), 51 to 69 years of age (group 2), and ≥70 years of age (group 3). The primary aim was to evaluate success as defined by ≥ improved on a validated patient improvement satisfaction score and a negative postoperative standardized stress test...
September 15, 2016: International Urogynecology Journal
Naoki Wada, Hiromichi Iuchi, Masafumi Kita, Kazumi Hashizume, Seiji Matsumoto, Hidehiro Kakizaki
OBJECTIVES: To investigate urodynamic efficacy and safety of mirabegron add-on treatment with tamsulosin for Japanese male patients with overactive bladder (OAB). METHODS: A prospective study was conducted in 26 consecutive male patients with OAB who had been taking tamsulosin. OAB was diagnosed by overactive bladder symptom score (OABSS). Before and 8 weeks after mirabegron add-on treatment with preceding tamsulosin, we assessed OABSS, International Prostate Symptom Score (IPSS), free uroflowmetry (UFM), filling cystometry and pressure-flow study (PFS)...
September 2016: Lower Urinary Tract Symptoms
Lorenz Leitner, Ulla Sammer, Matthias Walter, Stephanie C Knüpfer, Marc P Schneider, Burkhardt Seifert, Jure Tornic, Ulrich Mehnert, Thomas M Kessler
Many of the patients undergoing intradetrusor onabotulinumtoxinA injections for refractory neurogenic detrusor overactivity (NDO) present with chronic bacteriuria. In these patients, antibiotic prophylaxis has been widely recommended since bacteriuria might impair treatment efficacy and cause urinary tract infections (UTI) but the evidence is limited. The aim of this study was to evaluate if an antibiotic prophylaxis is needed in patients with asymptomatic bacteriuria undergoing intradetrusor onabotulinumtoxinA injections...
2016: Scientific Reports
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