Adult Onset Nocturnal Enuresis: Identifying Causes, Cofactors and Impact on Quality of Life.

Objectives: The objectives of the present study were: (i) Evaluate common co-pathologies associated with, and potentially contributing to adult onset Nocturnal enuresis (NE) in a tertiary referral population; and (ii) quantify its impact on QoL with validated questionnaires.

Methods: Following Institutional Review Board approval, patients with adult onset NE were reviewed with history, physical examination, urodynamic studies, questionnaires: Overactive bladder questionnaire short-form (OAB-qSF), Urogenital Distress Inventory (UDI-6), AUA symptom score (AUA-SS) and Patient Global Impression scale (PGIS).

Results: Between 2004 and 2016, 45 NE patients (19 male, 26 female) were identified.

Urodynamics in the evaluation of the patient with multiple sclerosis: when are they helpful and how do we use them?

Multiple sclerosis (MS) is an autoimmune inflammatory disease that results in damage to the myelin sheaths of the nerves in the central nervous system. Urinary urgency, frequency, and urgency incontinence are the most common symptoms, occurring in 37% to 99% of patients. Voiding symptoms (hesitancy, feeling of incomplete bladder emptying, and occasionally urinary retention) are also common in this population, occurring in 34% to 79% of patients.

Long-term morbidity of Martius labial fat pad graft in vaginal reconstruction surgery.

Objective: To assess the long-term morbidity of Martius labial fat pad (MLFP) interposition in vaginal reconstruction procedures at a tertiary institution.

Materials And Methods: After institutional review board approval, medical records of consecutive women in a prospective surgical database requiring MLFP as part of their vaginal reconstruction were reviewed for demographics, indications for MLFP, complications, and outcomes, with minimum of 6 months follow-up. Three MLFP groups were compared as follows: (1) vesicovaginal fistula, (2) bladder outlet obstruction, and (3) others.

Long-term functional outcomes following nonradiated vesicovaginal repair.

Purpose: We investigated the long-term impact on bladder and sexual symptoms in women with prior vesicovaginal fistula repair, particularly those previously treated before referral.

Materials And Methods: After receiving institutional review board approval we reviewed the charts of women who underwent nonradiated vesicovaginal fistula repair for demographics, surgical approach (vaginal or abdominal) and functional outcomes with a minimum 6-month followup. Patients lost to followup were reached by a structured phone interview and/or mailed validated lower urinary tract questionnaires, including the UDI-6 (Urogenital Distress Inventory-6), IIQ-7 (Incontinence Impact Questionnaire-7) and FSFI (Female Sexual Function Index).

Renal deterioration in multiple sclerosis patients with neurovesical dysfunction.

Objectives: Our aims were to determine the prevalence of renal ultrasound (RUS) abnormalities over time in multiple sclerosis (MS) patients with lower urinary tract symptoms (LUTS).

Methods: Data were examined retrospectively from MS patients with LUTS, from 2000-2009. Study inclusion requirements were both baseline urodynamics (UD) and RUS data, with followup RUS at ≥ 12 months.

Management of two synthetic midurethral slings eroded into the urethral lumen.

Mesh complications, both erosions and extrusions, are becoming more common in the practice of urology. We present the case of a 58-year-old woman who presented with lower urinary tract symptoms (LUTS) and recurrent urinary tract symptoms following treatment for stress urinary incontinence and who was found to have two slings eroded into her urethral lumen. The slings were debulked in the urethra using the holmium laser, thereby avoiding a more complex urethral reconstruction.

Long term results after complication of "prophylactic" suburethral tape placement.

Introduction: To report the long term result following complications that arose after "prophylactic" placement of midurethral sling (MUS) during prolapse repair.

Materials And Methods: After institutional review board approval, the records of patients who presented with complications of prophylactic MUS and had a minimum 1 year follow up after repair of their complication were reviewed. Data collected included age, body mass index, operative note documenting primary procedure and type of prophylactic MUS, indication for prophylactic MUS, presenting complaint, duration and severity of symptoms since MUS placement, operative events if any, and outcomes after repair of the complication.

A surprisingly low prevalence of demonstrable stress urinary incontinence and pelvic organ prolapse in women with multiple sclerosis followed at a tertiary neurogenic bladder clinic.

Purpose: We report the prevalence of stress urinary incontinence and pelvic organ prolapse in patients with multiple sclerosis referred to a tertiary care neurogenic bladder clinic.

Materials And Methods: We queried an institutional review board approved neurogenic bladder database for urodynamic and demographic data on patients with multiple sclerosis followed for lower urinary tract symptoms in a 12-year period. Demographic information included multiple sclerosis classification, age at initial visit, body mass index, parity and pelvic examination findings.

When are urodynamics indicated in patients with stress urinary incontinence?

Despite technical and procedural advances in urodynamics over the past decade, the role of urodynamics in women with stress urinary incontinence (SUI) remains controversial. Many of these advancements have been the result of multicentric studies in the United States, such as the UITN and PFDN, which will be highlighted in this article. It appears to be the consensus that urodynamics may not be needed in pure stress incontinence.

Urodynamics: role in incontinence and prolapse: a urology perspective.

Changes in pelvic floor as well as urethral anatomy and function occur with aging, which can result in prolapse and urinary incontinence. Aside from the socially debilitating impact incontinence has on patient's lives, it significantly affects the health care systems economically. Rates of incontinence and pelvic organ prolapse (POP) in women of this age demographic is estimated to be 30% to 94%, and 1 in 8 women may require surgical repair for POP or incontinence by their eighth decade, with a reoperation rate of 30%.