Salvage perineal-retropubic AUS cuff in paraplegic patient with exstrophy-epispadias complex after previous cuff erosion at bladder neck.

Cuff erosion at the bladder neck of an implanted artificial urinary sphincter (AUS) needs complete explantation of the device. The subsequent scar tissues predispose to repeated cuff erosion, when another AUS is implanted with the cuff at a similar location. We describe a paraplegic patient with exstrophy-epispadias complex that suffered from an AUS cuff erosion at the bladder neck.

Efficacy and safety of mirabegron for the treatment of low compliance bladder resulting from sacral/infrasacral lesions: A prospective study.

Objective: To assess the efficacy and safety of mirabegron in patients with sacral/infrasacral lesions who have an acontractile detrusor and develop a low compliance bladder.

Methods: This prospective study included adult patients with acontractile detrusor as a result of sacral/infrasacral lesions who develop a low compliance bladder (compliance <20 mL/cmH O). All patients were asked to make a 48-h clean intermittent catheterization diary and underwent invasive urodynamics evaluation at the baseline, and were started on mirabegron 50 mg once daily.

Work-up for the neurourological patient.

A targeted history and physical examination are the mainstays for basic evaluation of neurourological patients. Urodynamics investigations are of paramount importance in providing information about the pressure situation in the lower urinary tract (LUT). Pressures are crucial not only for LUT but also for upper urinary tract function.

Frequency volume chart for the illiterate population: A simple solution.

Introduction: We aimed to assess the feasibility of a novel method of recording frequency volume chart (FVC) in adult patients who are either illiterate or are unable to make the required written record.

Materials And Methods: This prospective study included adult patients, in whom FVC was required as part of their urological evaluation, who were either illiterate or were not sufficiently literate to make the required written record. Three groups of people were involved in the study: (i) patient, (ii) nursing staff, and (iii) the investigator/coinvestigator.

Gains in health utility associated with urinary catheter innovations.

Purpose: To estimate gains in health utility for two different catheter features and a support service related to urinary catheters used for intermittent catheterization.

Patients And Methods: Two internet-based time trade-off (TTO) surveys were undertaken to value vignettes describing two innovative catheter features and a support service. The first TTO survey "Size and Service" included catheters with compact design and the availability of a support service for users; the second TTO survey "Phthalates" included avoidance of potentially harmful phthalates in the material of the catheters.

The impact of different scenarios for intermittent bladder catheterization on health state utilities: results from an internet-based time trade-off survey.

Aims: Intermittent catheterization (IC) is the gold standard for bladder management in patients with chronic urinary retention. Despite its medical benefits, IC users experience a negative impact on their quality of life (QoL). For health economics based decision making, this impact is normally measured using generic QoL measures (such as EQ-5D) that estimate a single utility score which can be used to calculate quality-adjusted life years (QALYs).

Neurogenic bowel dysfunction: Clinical management recommendations of the Neurologic Incontinence Committee of the Fifth International Consultation on Incontinence 2013.

Background: Evidence-based guidelines for the management of neurological disease and lower bowel dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance.

Aims: To update clinical management of neurogenic bowel dysfunction from the recommendations of the 4th ICI, 2009.

Neurogenic lower urinary tract dysfunction: Clinical management recommendations of the Neurologic Incontinence committee of the fifth International Consultation on Incontinence 2013.

Background: Evidence-based guidelines for the management of neurological disease and lower urinary tract dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance.

Aims: To update clinical management of neurogenic bladder dysfunction from the recommendations of the fourth ICI, 2009.

Management of LUTS in patients with dementia and associated disorders .

Aims: To systematically review the management of lower urinary tract symptoms (LUTS) in patients with dementia and associated disorders.

Methods: This systematic review was performed according to the PRISMA statement. Studies were identified by electronic search of Embase and Medline databases (last search August 2015) and by screening of reference lists and reviews.

Sexual dysfunction in patients with epilepsy.

Sexuality is an important and private aspect of life and sexuality and epilepsy have been intimately linked since ancient time. Disturbances of reproductive and sexual health are common in men and women with epilepsy. Multiple causes may lead to sexual dysfunction.

Follow-up of the neuro-urological patient: a systematic review.

Objectives: To systematically review the long-term urological follow-up strategies for patients with neurogenic lower urinary tract dysfunction (NLUTD), focusing on three main groups of neurological diseases: (i) spinal cord injuries, (ii) spinal dysraphism, and (iii) multiple sclerosis.

Patients And Methods: Data acquisition comprised electronic search on the Medical Literature Analysis and Retrieval System Online (MEDLINE) database and the EMBASE database in August 2014 to retrieve English language studies. MEDLINE and EMBASE search included the following medical subject heading (MeSH) terms: (i) neurogenic bladder and (ii) neurogenic bladder dysfunction.

Voiding dysfunction in women: How to manage it correctly.

Introduction: Of women aged >40 years, 6% have voiding dysfunction (VD), but the definition for VD in women with respect to detrusor underactivity (DU) and bladder outlet obstruction (BOO) is not yet clear. In this review we address the current literature to define the diagnosis and treatment of VD more accurately.

Methods: We used the PubMed database (1975-2012) and searched for original English-language studies using the keywords 'female voiding dysfunction', 'detrusor underactivity', 'acontractile detrusor' and 'bladder outlet obstruction and urinary retention in women'.

Factors implicated in pathogenesis of urinary tract infections in neurogenic bladders: some revered, few forgotten, others ignored.

Aims: To comprehensively review factors implicated in the pathogenesis of urinary tract infection in patients with neurogenic bladders, and to stimulate research, especially in the somewhat ignored and forgotten areas of this important clinical subject.

Methods: In addition to reviewing relevant articles on pubmed, some important articles from previous times which were not available online were also procured and reviewed.

Results: Intrinsic defence mechanisms including protective flora, anti-adherence mechanisms, urothelial, and immunological responses to bacterial binding and the blood supply to the urinary bladder may be impaired in patients with neurogenic bladders.

GAG layer replenishment therapy for chronic forms of cystitis with intravesical glycosaminoglycans--a review.

Aims: Glycosaminoglycan (GAG) layer replenishment is a cornerstone in the therapy of interstitial cystitis (IC). During the last years intravesical GAG layer replenishment has proven to be an effective treatment for overactive bladder (OAB), radiation cystitis, and recurrent urinary tract infections (UTIs).

Methods: Examination of different substances available for intravesical GAG replenishment and evaluation of the evidence for the treatment of the above-mentioned conditions.

What are the causes and consequences of bladder overdistension? ICI-RS 2011.

Aims: To report the outcome of the think tank on prolonged bladder overdistension from the 3rd ICI-RS meeting.

Methods: Prolonged bladder overdistension was discussed after acute urinary retention, its terminology, its prevalence, pathophysiology, and consequences, as well as prophylactic and therapeutic aspects.

Results: Acute prolonged bladder overdistension (ApBO) is a consequence of undetected or inadequately treated acute retention, and is mostly due to regional anesthesia, prolonged childbirth, or extensive surgery.

Constipation and LUTS - how do they affect each other?

Context: Urinary bladder and rectum share a common embryological origin. Their autonomic and somatic innervations have close similarities. Moreover, the close proximity of these two organ systems could suggest that dysfunction in one may influence, also mechanically, the function of the other.

Dose escalation improves therapeutic outcome: post hoc analysis of data from a 12-week, multicentre, double-blind, parallel-group trial of trospium chloride in patients with urinary urge incontinence.

Background: Flexible dosing of anticholinergics used for overactive bladder (OAB) treatment is a useful strategy in clinical practice for achieving a maximum effective and maximum tolerated level of therapeutic benefit. In this post hoc analysis we evaluated the efficacy and tolerability of trospium chloride treatment for urinary urge incontinence (UUI) with focus on flexible dosing.

Methods: The data came from a 12-week, randomised, double-blind, phase IIIb study in which 1658 patients with urinary frequency plus urge incontinence received trospium chloride 15 mg TID (n = 828) or 2.

Trospium chloride and oxybutynin hydrochloride in a german study of adults with urinary urge incontinence: results of a 12-week, multicenter, randomized, double-blind, parallel-group, flexible-dose noninferiority trial.

Objectives: The aims of this study were to determine whether oral trospium chloride is noninferior to oxy-butynin for urinary urge incontinence and to evaluate its efficacy, tolerability, and health-related quality of life parameters.

Methods: In this randomized, double-blind, active-controlled, parallel-group, multicenter, Phase IIIb trial conducted in Germany, male and female outpatients aged >or=18 years with documented urinary frequency (>or=8 micturitions/24 hours) plus urge incontinence (>or=5 episodes/week) were randomized to receive oral treatment with trospium chloride 15 mg TID or oxybutynin hydrochloride 2.5 mg TID for 12 weeks.

Efficacy, tolerability and safety of propiverine hydrochloride in comparison to oxybutynin in children with urge incontinence due to overactive bladder: Results of a multicentre observational cohort study.

Objective: To compare, in a retrospective observational cohort study, the efficacy, tolerability and safety of propiverine and oxybutynin in children with urge incontinence (UI) due to overactive bladder.

Patients And Methods: Medical records were scrutinized for children with UI. As a primary efficacy outcome variable the achievement of continence after treatment with variable doses of propiverine or oxybutynin was assessed.

Botulinum neurotoxin A for benign prostatic hyperplasia.

Purpose Of Review: The injection of botulinum neurotoxin A (BoNT-A) into the prostate represents an alternative, minimal invasive treatment for lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH), which gained the interest of urologists during the last years, although it is not yet licensed. The purpose of this review is to summarize the mechanisms through which BoNT-A could inhibit the progression of BPH and eliminate the lower urinary tract symptoms according to the findings of animal studies. Furthermore, we review clinical studies to report the efficacy and safety of intraprostatic BoNT-A injection according to various injection protocols.

Microbiological tined-lead examination: does prolonged sacral neuromodulation testing induce infection?

Objective: To investigate whether prolonged sacral neuromodulation (SNM) testing induces a substantial risk of infection because of the percutaneous passage of the extension wire.

Patients And Methods: A consecutive series of 20 patients with negative prolonged SNM testing for >or=14 days who underwent tined-lead explantation were prospectively evaluated. The explanted tined leads were sent for microbiological examination.

Nocturia: an Austrian study on the multifactorial etiology of this symptom.

Aims: To identify the different factors contributing to nocturia in a clinical setting.

Patients And Methods: Three hundred twenty-four patients (133 women, 191 men; mean age 63 years) were entered into this multi-institutional study. When presenting with nocturia we obtained detailed medical history and performed urine analysis, post-void residual volume and renal ultrasonography.

Failure of monotherapy in primary monosymptomatic enuresis: a combined desmopressin and propiverine treatment regimen improves efficacy outcomes.

Objective: To evaluate, in a prospective study, the combination of the antimuscarinic propiverine and the antidiuretic hormone-agonist desmopressin in children and adolescents not responsive to previous monotherapy, as in primary monosymptomatic enuresis (PME), combined treatments are considered a second-line approach after the failure of monotherapy.

Patients And Methods: The study included 122 children and adolescents (mean age 10.8 years, range 5-21) with PME and so far unresponsive to single or multiple monotherapy.