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Detrusor underactive

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https://www.readbyqxmd.com/read/29777585/potential-vascular-mechanisms-in-an-ex-vivo-functional-pig-bladder-model
#1
Uzoma A Anele, Paul H Ratz, Andrew F Colhoun, Sydney Roberts, Ryan Musselman, Randy A Vince, John E Speich, Adam P Klausner
AIMS: Chronic ischemia is a recognized factor in the pathophysiology of underactive bladder (UAB). Although relative ischemia (ie, low blood flow) is known to occur during filling, little is known regarding the pathophysiology that leads to UAB. Therefore, we developed an ex vivo functional porcine model to investigate the role of transient ischemia and whether autoregulation, a mechanism that maintains tissue oxygenation in certain vital organs, also exists in the bladder. METHODS: Using bladders from slaughtered pigs, we prepared an isolated perfused model where we studied the effects of bladder perfusion flow rate on perfusion pressure and tissue oxygenation during the filling phase...
May 19, 2018: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29776685/are-there-pharmacotherapeutic-options-for-underactive-bladder
#2
Nadir I Osman, Christopher R Chapple
Currently, underactive bladder, the symptom-based correlate of the urodynamic diagnosis of detrusor underactivity, has no effective drug treatments. Use of sympathomimetics, targeting cholinergic receptors, is not supported by current evidence. Several potential targets are the subject of ongoing investigation.
May 15, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29705282/is-urodynamics-necessary-when-assessing-a-patient-with-male-lower-urinary-tract-symptoms
#3
Marcus J Drake
Urodynamics can distinguish bladder outlet obstruction from detrusor underactivity. Clear identification of the mechanism of a man's voiding symptoms can help give the best chance of good outcome from surgery. Publication of results from the UPSTREAM study will help in establishing the exact place for urodynamic testing in male lower urinary tract symptoms.
April 25, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29704587/do-urodynamic-findings-other-than-outlet-obstruction-influence-the-decision-to-perform-a-transurethral-resection-of-prostate
#4
Blayne Welk, Patrick McGarry, Richard Baverstock, Kevin Carlson, Duane Hickling
AIMS: To determine if urodynamic findings other than high-pressure voiding influence the decision to perform a transurethral resection of prostate (TURP). METHODS: Four clinical scenarios were created featuring a healthy 65 year-old man. An electronic survey was distributed to members of the International Continence Society, and the Society for Urodynamics and Female Pelvic Medicine, & Urogenital Reconstruction. RESULTS: 86 urologists responded (median age was 45-54 years, 62% described their practice as academic)...
April 25, 2018: Urology
https://www.readbyqxmd.com/read/29701328/repeat-retropubic-suburethral-sling-procedure-is-effective-for-recurrent-female-stress-urinary-incontinence
#5
Hueih Ling Ong, Yuan-Hong Jiang, Hann-Chorng Kuo
OBJECTIVE: The aim of the present study was to investigate the effectiveness of repeat retropubic suburethral sling for recurrent stress urinary incontinence (SUI) in women. METHODS: A retrospective review was performed of 35 women with SUI who underwent repeat retropubic suburethral sling procedures between May 1994 and November 2014. Treatment outcome was assessed directly or by telephone interview. Sling position and urethral incompetence during straining and coughing after the procedure were evaluated...
April 27, 2018: Lower Urinary Tract Symptoms
https://www.readbyqxmd.com/read/29683886/a-modern-comparison-of-urodynamic-findings-in-diabetic-versus-nondiabetic-women
#6
Rena D Malik, Joshua A Cohn, Jessica Volsky, Sarah Garvey, Charles Chang, Gregory T Bales, Doreen E Chung
OBJECTIVES: Few contemporary studies exist regarding urodynamic (UDS) findings in patients with diabetes mellitus (DM), and data are conflicting. Our aim was to compare UDS findings in women with and without DM. METHODS: Data from female patients in a prospectively maintained UDS database (2010-2014) were reviewed. Studies were performed according to International Continence Society standards. Clinical data, presenting symptoms, and UDS findings were compared in women with and without DM, controlling for demographic and pertinent variables...
April 20, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29664135/clinical-outcomes-of-detrusor-underactivity-in-female-with-advanced-pelvic-organ-prolapse-following-vaginal-pelvic-reconstructive-surgery
#7
Tsia-Shu Lo, Sandy Chua, Ma Clarissa Uy-Patrimonio, Chuan C Kao, Chih H Lin
AIM: To determine the impact of vaginal pelvic reconstructive surgery (PRS) on detrusor underactivity (DU) patients having advanced pelvic organ prolapse (POP). METHODS: A retrospective study of patients who underwent PRS for advanced POP (POP-Q ≥ 3) with DU. Data regarding preoperative evaluation, surgical procedure, and post-operative management were collated. Patients were considered to have DU when detrusor pressure at maximum flow (Pdet Qmax ) was ≤10 cmH2 0 and peak flow rate (Qmax ) of ≤12 mL/s...
April 17, 2018: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29528972/the-role-of-urodynamics-in-the-surgical-management-of-benign-prostatic-obstruction
#8
Matthew G Crockett, Marcus J Drake
PURPOSE OF REVIEW: Benign prostatic obstruction (BPO) is a common cause of lower urinary tract symptoms (LUTS) in elderly men. However, such symptoms are often caused by primary detrusor overactivity or underactivity. Surgical management where BPO is absent or merely incidental has a lower chance of success, and exposes the patient to the potential complications of surgery. This review discusses the diagnostic challenges facing this common presentation. RECENT FINDINGS: Most evidence comes from small, historical prospective cohort studies...
May 2018: Current Opinion in Urology
https://www.readbyqxmd.com/read/29504988/clinical-and-urodynamic-characteristics-of-underactive-bladder-data-analysis-of-1726-cases-from-a-single-center
#9
Xing Li, Li-Min Liao, Guo-Qing Chen, Zhao-Xia Wang, Tian-Ji Lu, Han Deng
There have no universally accepted criteria and have been established for classification of underactive bladder (UAB) at present. Thus, the study described the comprehensive clinical and urodynamic characteristics of UAB in patients with lower urinary tract symptoms.A total of 1726 patients (1259 men and 467 women; 6-88 years old) who were admitted to our center with a diagnosis of UAB were included in this retrospective study. It was due to the type of rehabilitation hospital, so higher percentage of neurological patients were included...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29462145/videourodynamic-findings-of-lower-urinary-tract-dysfunctions-in-men-with-persistent-storage-lower-urinary-tract-symptoms-after-medical-treatment
#10
Yuan-Hong Jiang, Chung-Cheng Wang, Hann-Chorng Kuo
OBJECTIVE: To analyze the underlying lower urinary tract dysfunctions by video-urodynamic studies in men who have persistent storage symptoms after initial drug therapy for lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). METHODS: The medical records of 614 men ≥40 years of age with LUTS and an International Prostate Symptom Score of ≥8 were retrospectively analyzed. All patients had persistent storage symptoms after medical treatment for at least 6 months...
2018: PloS One
https://www.readbyqxmd.com/read/29385785/urothelial-dysfunction-and-chronic-inflammation-are-associated-with-increased-bladder-sensation-in-patients-with-chronic-renal-insufficiency
#11
Sheng-Fu Cheng, Yuan-Hong Jiang, Hann-Chorng Kuo
PURPOSE: Chronic kidney disease (CKD) or end-stage renal disease (ESRD) patients usually have lower urinary tract symptoms, such as frequency and urgency. Additionally, they frequently suffer from urinary tract infections. This study investigated dysfunction and chronic inflammation of the bladder urothelium in ESRD/CKD patients. METHODS: This study enrolled 27 patients with CKD (n=13) or ESRD (n=14) for urodynamic studies and bladder biopsies. Patients presented with detrusor underactivity (DU; n=8) or bladder oversensitivity (BO; n=19)...
January 2018: International Neurourology Journal
https://www.readbyqxmd.com/read/29379731/underactive-bladder-pathophysiology-and-clinical-significance
#12
REVIEW
Reem Aldamanhori, Nadir I Osman, Christopher R Chapple
Underactive bladder (UAB) is a voiding disorder which generates disabling lower urinary tract symptoms (LUTS) due to the inability to produce an effective voiding contraction sufficient to empty the bladder. The underlying abnormality, that is usually appreciated when performing urodynamic studies, has been defined by the International Continence Society (ICS) as detrusor underactivity (DUA). DUA is a common yet under-researched bladder dysfunction. The prevalence of DUA in different patient groups suggests that multiple aetiologies are implicated...
January 2018: Asian Journal of Urology
https://www.readbyqxmd.com/read/29361664/noninvasive-neurophysiological-mapping-of-the-lower-urinary-tract-in-adult-and-aging-rhesus-macaques
#13
Parag N Gad, Nelly Kokikian, Kari L Christe, V Reggie Edgerton, Leif A Havton
The lower urinary tract (LUT) may be activated by spinal cord stimulation, but the physiological mapping characteristics of LUT activation with noninvasive transcutaneous spinal cord stimulation (TSCS) are not known. The effects of aging on the contractile properties of the detrusor are also not well understood. Therefore, TSCS was applied over the T10 /T11 to L6 /L7 spinous processes in adult ( n = 6) and aged ( n = 9) female rhesus macaques. A combination of urodynamic studies and electromyography recordings of the external urethral sphincter (EUS), external anal sphincter (EAS), and pelvic floor muscles was performed...
April 1, 2018: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29357567/re-unravelling-detrusor-underactivity-development-of-a-bladder-outlet-resistance-bladder-contractility-nomogram-for-adult-male-patients-with-lower-urinary-tract-symptoms
#14
https://www.readbyqxmd.com/read/29356059/signs-and-symptoms-that-distinguish-detrusor-underactivity-from-mixed-detrusor-underactivity-and-bladder-outlet-obstruction-in-male-patients
#15
Andrew Gammie, Mathilde Kaper, Achim Steup, Satoshi Yoshida, Caroline Dorrepaal, Ton Kos, Paul Abrams
AIMS: This study aimed to identify signs and symptoms which show differences between men with detrusor underactivity (DU) compared to those with both DU and bladder outlet obstruction (BOO). METHODS: One thousand six hundred and twelve urodynamic tests on male patients were analyzed retrospectively. Signs and symptoms which showed a statistically significant difference between patients with DU alone and patients with both DU+BOO were identified. RESULTS: In the DU only group, considering only patients without a history of bladder outlet surgery, the number of daytime micturitions was lower, maximum voided volume on the bladder diary was higher, and slow stream was reported less often, whereas urinary tract infections were reported more often than for DU+BOO males...
January 22, 2018: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29296045/current-pharmacological-and-surgical-treatment-of-underactive-bladder
#16
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
#17
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
#18
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
#19
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/29279878/epidemiology-of-underactive-bladder-common-but-underresearched
#20
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
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