Hereditary spastic paraplegias: When to expect bladder dysfunction a genetic and urodynamic study.

Background: The aim of this study was to characterize hereditary spastic paraplegias (HSP) patients' urodynamic profiles and development of bladder symptoms.

Methods: This is a multicentric retrospective study which included patients presenting with bladder disorders. We reviewed medical and urodynamic records in individuals with HSP and recorded age at onset of gait and bladder disorders, disability stage at the time of urodynamic assessment.

Association between frailty and detrusor overactivity with detrusor underactivity in older women.

Purpose: While detrusor overactivity (DO) with detrusor underactivity (DU) (DO-DU) has been described as typical of aging, the pathogenesis of DO-DU is highly multifactorial, and often thought to involve medical conditions beyond the urinary tract. We aimed to explore potential associations between idiopathic DO-DU and frailty in older women after accounting for age.

Methods: The design of the study is a cross-sectional single-center study, in an outpatient urodynamic unit specializing in geriatrics.

Long-term functional outcomes of artificial urinary sphincter (AMS 800™) implantation in women aged over 75 years and suffering from stress urinary incontinence caused by intrinsic sphincter deficiency.

Purpose: To assess the outcomes after artificial urinary sphincter (AUS) implantation in older women aged over 75 years.

Methods: A monocentric retrospective study included all non-neurological women aged over 75 years suffering from stress urinary incontinence (SUI) due to intrinsic sphincter deficiency and undergoing an AUS placement between 1991 and 2015. Early postoperative complications were reported according to Clavien-Dindo classification.

Detrusor contractility in post-menopausal women: Impact of ageing, complaint and urodynamic diagnosis.

Introduction: Detrusor contractility (DC) can have a considerable impact on the management oflower urinary tract symptoms (LUTS). However, it is currently impossible to predict, based on clinical data alone, which woman has an impaired DC. Our aim was to determine if DC, assessed by projected isovolumetric pressure-1 (PIP1) and VBN contractility parameter k, was associated with age, main complaint, and urodynamic diagnosis in a population of older women.

Nocturia in patients with cognitive dysfunction: a systematic review of the literature.

Background: The objective of this study is to evaluate current literature on the association between cognitive dysfunction and nocturia.

Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was conducted through MEDLINE, EMBASE and COCHRANE databases and completed in November 2019. Randomized and non-randomized studies were included if they assessed the association between cognitive dysfunction and nocturia in older participants with or without neurological diseases.

Predictive factors of adherence to urinary self-catheterization in older adults.

Aims: The primary aim is to explore the adherence predicting factors in clean intermittent self-catheterization (CISC) in patients aged over 65 years. The secondary aim is to assess whether in this population, the non-adherence risk is greater, compared with patients under 65.

Methods: All patients older than 65 that successfully learned CISC between January 2011 and January 2016 were included.

Comparison of bladder voiding efficiency in women when calculated from a free flow versus an intubated flow.

Objectives: To assess the reproducibility of bladder voiding efficiency (BVE, Void%) between free flow (FF) and intubated flow (IF) and to correlate BVE measurements with urinary incontinence (UI) complaints and urodynamic (UDS) findings in women.

Methods: UDS recordings of women referred for LUTD evaluation to our UDS center were reviewed. Each file included FF at arrival, filling cystometry, and IF.

Intermittent Self-catheterization in Older Adults: Predictors of Success for Technique Learning.

Purpose: The main goal of this retrospective study is to explore the predictors of success in learning clean intermittent self-catheterization (CISC) in patients over 65 years of age. The secondary goal is to assess whether in this population, the risk of failure to perform CISC is greater, compared with patients under 65 with similar pathologies.

Methods: All patients older than 65 consulting between January 2011 and January 2016 for learning CISC were included.

Detrusor after-contraction: a new insight.

Aims: Detrusor after-contractions (DAC) are non-common in adults. Both definition (nothing in ICS reports) and significance (artefact, link with detrusor overactivity (DO) or bladder outlet obstruction (BOO)) remain discussed. Our purpose was to carry out an analysis of the urodynamic parameters during voidings with DAC and, using the VBN model, to simulate pathophysiological conditions able to explain both voiding phase and DAC.

Functional outcomes of adjustable continence therapy (ACT™) balloons in women aged >80 years and suffering from stress urinary incontinence caused by intrinsic sphincter deficiency.

Objective: To determine the functional outcomes of adjustable continence therapy (ACT™) balloons in elderly women suffering from stress urinary incontinence (SUI) caused by intrinsic sphincter deficiency (ISD).

Material And Methods: A monocentric retrospective study included all non-neurological women aged >80 years who suffered from SUI due to ISD and undergoing ACT™ balloon placement between 2000 and 2013. Early post-operative complications were reported according to the Clavien-Dindo classification.

Contribution of behavioral and cognitive therapy to managing overactive bladder syndrome in women in the absence of contributive urodynamic diagnosis.

Overactive bladder (OAB) is a syndrome characterized by symptoms of urgency with or without incontinence, frequency, and nocturia. Pathophysiology of OAB is incompletely characterized. Therefore, there is great variability surrounding OAB evaluation.

Idiopathic and neurogenic detrusor overactivity: do the different patterns have urodynamic characteristics related to gender or neurological condition?

Objectives: To evaluate the urodynamic characteristics of the two patterns (phasic, P and terminal, T) of detrusor overactivity (DO) according to gender and neurological condition.

Materials And Methods: Urodynamic characteristics of DO were analysed in a population with proven urodynamic DO (127 women and 76 men, respectively with 48 and 43 neurological diseases (encephalic, incomplete medullar lesion or peripheral)). Phasic DO is characterized by phasic waves with or without leakage while terminal DO is defined by a single non-inhibited contraction resulting in incontinence.

Is a sequence of tests during urethral pressure profilometry correlated with symptoms assessment in women?

Introduction: Our purpose was, applying a strictly defined protocol for urethral profilometry, 1) to test the repeatability of same session rest maximum urethral closure pressure (MUCP) and 2) to search for correlation between women complaint and the changes in MUCP value (rest and dynamic tests).

Materials And Methods: A population of 140 consecutive women referred for evaluation of lower urinary tract dysfunction was stratified in 4 groups according with the urinary symptoms: stress, urge, mixed incontinence and continent and in each group in 3 age groups (young, middle age and old). The sequence of tests recorded in supine position was: urethral pressure profile at rest bladder empty, after bladder filling at 250 mL (reference test), stress profile, fatigability (before (rest) and after 10 successive strong coughs), then in standing position.

Decreased maximum flow rate during intubated flow is not only due to urethral catheter in situ.

Introduction And Hypothesis: We used the Valentini-Besson-Nelson (VBN) mathematical micturition model to analyze the potential obstructive effect of a 7-F transurethral catheter on the voiding process during intubated flow (IF) in women. Our hypothesis was that incomplete sphincter relaxation leads to residual sphincter pressure.

Methods: We reviewed a urodynamic database of women referred for evaluation of lower urinary tract dysfunction.

Phasic or terminal detrusor overactivity in women: age, urodynamic findings and sphincter behavior relationships.

Objectives: To search for relationships between phasic (P) and terminal (T) DO with age, urodynamic findings and sphincter behavior during involuntary detrusor contraction in woman.

Materials And Methods: Urodynamic studies (triple lumen catheter 7F, seated position) of 164 successive women referred for LUTS with diagnosis of DO were reviewed. Patients were stratified in 4 sub-groups: pre- (18-44 y), peri- (45-54 y), post-menopause (55-74 y) and oldest old (= 75 y).

Urodynamics in women from menopause to oldest age: what motive? What diagnosis?

Purpose: To analyze age-associated changes as a motive for urodynamics and urodynamic diagnosis in community-dwelling menopausal women and to discuss the role of menopause and ageing.

Materials And Methods: Four hundred and forty nine consecutive menopausal women referred for urodynamic evaluation of lower urinary tract (LUT) symptoms, met the inclusion criteria and were stratified into 3 age groups: 55-64 years (A), 65-74 years (B), and 75-93 years (C). Comprehensive assessment included previous medical history and clinical examination.

Rectus abdominis electromyography and MechanoMyoGraphy comparison for the detection of cough.

We recently developed a novel active implant for the treatment of severe stress urinary incontinence. This innovative medical device has been developed with the main purpose of reducing the mean urethral occlusive pressure of the current prosthesis. This goal is achieved by detecting circumstances implying either high or low intra-abdominal pressures by a single 3-axis accelerometer.

Urodynamics in a community-dwelling population of females 80 years or older. Which motive? Which diagnosis?

Purpose: To determine why community-dwelling women aged 80 years or over were referred for urodynamic evaluation despite their advanced age and which urodynamic diagnosis was made.

Materials And Methods: One hundred consecutive females (80-93 years) were referred to our urodynamics outpatient clinic for evaluation of lower urinary tract symptoms (LUTS) between 2005 and 2008. Clinical evaluation comprised of a previous history of LUTS, previous medical history of neurological disease or dementia, pelvic floor dysfunction or prior pelvic surgery.

Diagnosis and management of adult female stress urinary incontinence: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians.

Urinary incontinence is a frequent affliction in women and may be disabling and costly {LE1}. When consulting for urinary incontinence, it is recommended that circumstances, frequency and severity of leaks be specified {Grade B}. The cough test is recommended prior to surgery {Grade C}.

Analysis of rhythmic rectal contractions during filling cystometry in women.

Purpose: Rhythmic or random rectal contractions independent of bladder activity are frequently observed during cystometry and usually attributed either to a neurological disease, or to ageing. The aim of our study was to search for an association of rhythmic rectal contractions (RRCs) with a specific lower urinary tract symptom or/and an urodynamic diagnosis.

Materials And Methods: The population consisted of 534 consecutive women with lower urinary tract symptoms and without specific gastro-intestinal disease referred for urodynamics; 382 (non-ND) had no history of neurological disease and 152 (ND) a history of neurological disease.

Differences between the data from free flow and intubated flow in women with urinary incontinence. What do they mean?

Aims: To assess the effects of a urethral catheter on the urodynamic data extracted from uroflow in women, and to interpret the differences from free uroflow using the VBN mathematical micturition model.

Methods: Urodynamic data of 217 consecutive (June 2002 to December 2004) women with urinary incontinence and without neurological disease or more than grade 2 prolapse were reviewed. Inclusion criteria were to perform one free flow (FF) and one intubated flow (IF) (voided volumes of at least 100 ml and continuous flow curves).

[Sensory innervation of the bladder: clinical and therapeutic implications].

Sensory impulses derived from the bladder and urinary sphincter system play an important role in the control of detrusor-sphincter function. Conscious sensation is essential to ensure the storage phase and to allow micturition at a functionally and socially acceptable time. Adequate sensation of the lower urinary tract requires an intact urothelium--peripheral nervous system--spinal cord--brain stem--midbrain--sensory cortex axis.

Influence of temperature on urethra to bladder micturition reflex in the awake ewe.

Aims: The flow of fluid along the urethra is known to facilitate detrusor contraction during micturition. This reflex, previously described in awake ewes, helps to achieve complete bladder emptying. In anesthetized cats, another urethra to bladder reflex involving urethral cold receptors has been described.

[Functional consequences and complications of surgery for female stress urinary incontinence].

Objective: The functional consequences and complications of surgical treatment offemale stress urinary incontinence (SUI) are not systematically reported in clinical trials. The authors present a practical review of the results of the surgical techniques most frequently used for the treatment of SUI.

Materials And Methods: An exhaustive literature search concerning the various surgical techniques for female SUI, their results, and their complications, was performed using MEDLINE (1966-2003) and the PUBMED search engine.