Systematic Evaluation of Lower Urinary Tract Sensations to Improve Management of LUTS: ICI-RS 2024.

Aims: Lower urinary tract (LUT) sensations form an essential part of diagnostic criteria for many LUT symptoms, additionally LUT sensations are used to evaluate the effectivity of therapeutic interventions. The accurate measurement of LUT sensations, however, is severely hampered by the subjective nature of these sensations.

Methods: This paper summarizes the discussions from the 2024 meeting of the International Consultation for Incontinence-Research Society (ICI-RS 2024) regarding systematic evaluations of LUT sensations and the design of more objective tools to measure these.

What do X-ray images of the bladder during video urodynamics show us in patients with spinal cord injury?

Study Design: Retrospective anonymized cohort study.

Objectives: To study X-ray images of video urodynamics (VUD) in patients with spinal cord injury (SCI).

Setting: Single-center study.

What is the clinical meaning of a negative bulbocavernosus reflex in spinal cord injury patients?

Study Design: This is a retrospective cohort study.

Objective: To highlight some issues about the clinical meaning of a negative bulbocavernosus reflex (BCR) in spinal cord injury (SCI) patients.

Settings: Research group University Antwerp Belgium.

Testing sensation of gently squeezing the testes has diagnostic value in spinal cord injury men.

Study Design: Retrospective cohort study.

Objectives: Determine the diagnostic value of testing the sensation of squeezing the testes.

Setting: Research group run by the University of Antwerp.

Bladder Pain Syndrome and Interstitial Cystitis Beyond Horizon: Reports from the Global Interstitial Cystitis/Bladder Pain Society (GIBS) Meeting 2019 Mumbai - India.

Purpose Of The Meeting: Bladder pain syndrome/interstitial cystitis is a prevalent but underserved disease. At the Global Interstitial Cystitis/Bladder Pain Syndrome Society (GIBS) meeting, the organization and participants were committed to delivering word-class expertise and collaboration in research and patient care. Under the umbrella of GIBS, leading research scholars from different backgrounds and specialties, as well as clinicians, from across the globe interested in the science and art of practice of Bladder Pain Syndrome (BPS)/Interstitial Cystitis (IC) were invited to deliberate on various dimensions of this disease.

Combining different evaluations of sensation to assess the afferent innervation of the lower urinary tract after SCI.

Study Design: Retrospective cohort study.

Objectives: To study a combination of three evaluations of sensation in the lower urinary tract (LUT) in patients with spinal cord injury (SCI).

Setting: University Antwerp Belgium, Unicenter study.

Hunner lesion disease differs in diagnosis, treatment and outcome from bladder pain syndrome: an ESSIC working group report.

There is confusion about the terms of bladder pain syndrome (BPS) and Interstitial Cystitis (IC). The European Society for the Study of IC (ESSIC) classified these according to objective findings [9]. One phenotype, Hunner lesion disease (HLD or ESSIC 3C) differs markedly from other presentations.

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.

Can intraurethral stimulation inhibit micturition reflex in normal female rats?

Objective: The study was designed to determine the effect of low frequency (2.5Hz) intraurethral electrical stimulation on bladder capacity and maximum voiding pressures.

Materials And Methods: The experiments were conducted in 15 virgin female Sprague-Dawley rats (220-250g).

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.

Inhibitory Effect and Possible Mechanism of Intraurethral Stimulation on Overactive Bladder in Female Rats.

Purpose: To investigate the inhibitory effect and possible mechanism of intraurethral stimulation on overactive bladder (OAB) induced by acetic acid irritation.

Methods: Cystometry was performed in 13 urethane-anesthetized female rats. Intravesical infusion of 0.

Approach to the male patient with lower urinary tract dysfunction.

History and physical examination are the cornerstones of evaluation of the male patient with lower urinary tract (LUT) symptoms and (suspected) neurologic disorder, both to diagnose the nervous system lesion, and to get insight into the type of LUT dysfunction (LUTD). Non-neurologic LUTD needs to be ruled out. Laboratory testing is necessary to diagnose urinary infection.

Cell-Based Therapies in Lower Urinary Tract Disorders.

Cell-based therapy for the bladder has its beginnings in the 1990s with the successful isolation and culture of bladder smooth muscle cells. Since then, several attempts have been made to artificially implant native cell types and stem cell-derived cells into damaged bladders in the form of single-cell injectables or as grafts seeded onto artificial extracellular matrix. We critically examined in the literature the types of cells and their probable role as an alternative to non-drug-based, non-bowel-based graft replacement therapy in disorders of the urinary bladder.

Exploring associations between lower urinary tract symptoms (LUTS) and gastrointestinal (GI) problems in women: a study in women with urological and GI problems vs a control population.

Objectives: To study the prevalence of self-reported lower urinary tract symptoms (LUTS) in women consulting a Gastroenterology clinic with complaints of functional constipation (FC), fecal incontinence (FI) or both, compared with a female control population. Also, to study the influence of FC, FI, or both on self-reported LUTS in women attending a Urology clinic.

Patients And Methods: We present a retrospective study of data collected through a validated self-administered bladder and bowel symptom questionnaire in a tertiary referral hospital from three different female populations: 104 controls, 159 gastroenterological patients and 410 urological patients.

Pelvic floor awareness and the positive effect of verbal instructions in 958 women early postdelivery.

Introduction And Hypothesis: It is uncertain how reliable a personal belief is about the ability to do pelvic floor muscle (PFM) contractions early postdelivery and how instructional feedback affects pelvic floor muscle contraction (PFMC) performance. We hypothesize that many women do not have a reliable idea about PFMC and that instructional feedback can help improve their control.

Methods: Prospective observational study in 958 women (median 30 years) early postdelivery PFMC was evaluated with visual observation: an inward movement of the perineum was accepted as sign of good contraction.

Pudendal and median nerve sensory perception threshold: a comparison between normative studies.

Background: For the evaluation of sensory innervation, normative data are necessary as a comparison.

Aims: To compare our current perception thresholds (CPTs) with normative data from other research.

Methods: Healthy volunteers were assessed for 2000, 250, and 5 Hz CPTs of the median and pudendal nerve and data were compared with other studies.

Urethral sensation: basic mechanisms and clinical expressions.

A prerequisite for conscious bladder control is adequate sensory input to the central nervous system, and it is well established that changes in sensory mechanisms can give rise to disturbances in bladder function. Impulses related to the desire to void are believed to course through the pelvic nerves, and those for sensation of a full bladder course through the pudendal nerves. The sense of imminent micturition most probably resides in the urethra, and the desire to void comes from stretching the bladder wall.

Onset of action of the β3-adrenoceptor agonist, mirabegron, in Phase II and III clinical trials in patients with overactive bladder.

Purpose: Long-term persistence with pharmacotherapy for overactive bladder (OAB) requires a drug with an early onset of action and good efficacy and tolerability profile. Although antimuscarinics improve OAB symptoms within 1-2 weeks of initiating treatment, adherence after 3 months is relatively poor due to bothersome side effects (e.g.

A phase II dose-ranging study of mirabegron in patients with overactive bladder.

Introduction And Hypothesis: Mirabegron is a potent and selective β3-adrenoceptor agonist that may represent an alternative treatment option in place of antimuscarinics for patients with overactive bladder.

Methods: Patients completed a single-blinded, 2-week placebo run-in period followed by 12 weeks of randomized (n = 928) double-blinded treatment with mirabegron oral controlled absorption system (OCAS) 25, 50, 100, or 200 mg once-daily (QD), placebo or tolterodine extended release (ER) 4 mg QD. The primary endpoint was change from baseline to end-of-treatment in mean number of micturition episodes/24 h.

Reproducibility of electrical sensory testing in lower urinary tract at weekly intervals in healthy volunteers and women with non-neurogenic detrusor overactivity.

Objective: To evaluate the reproducibility of a standardized technique of current perception threshold measurements with square wave and sine wave current, with monopolar and bipolar electrodes in a cohort of patients with overactive bladder (OAB) and healthy volunteers.

Methods: We enrolled 6 female nulliparous healthy volunteers and 11 female patients with OAB. Current perception threshold measurements of the bladder were performed using several techniques.

Contemporary management of the painful bladder: a systematic review.

Context: Different types of behavioural, dietary, interventional, pharmacologic, and surgical therapies have been used to treat painful bladder syndrome/interstitial cystitis (PBS/IC). Because of the paucity of randomised placebo-controlled studies on different treatments, an evidence-based management approach has not yet been developed.

Objective: To critically review and synthesize data from a wide range of current therapeutic approaches to PBS/IC, to quantify the effect size from randomised controlled trials (RCTs), and to reach clinical agreement on the efficacy of treatments for PBS/IC.

Tadalafil for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: pathophysiology and mechanism(s) of action.

Background: The PDE5 inhibitor tadalafil is investigation for the treatment of lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH). Several clinical studies of tadalafil and other PDE5 inhibitors have reported significant symptom reduction but limited urinary flow rate improvement. This manuscript reviews the published literature describing the pathophysiology of male LUTS, with an emphasis on mechanisms that may be modulated or improved by phosphodiesterase type 5 (PDE5) inhibition.

Lower bowel function in urinary incontinent women, urinary continent women and in controls.

Aims: The anorectum and the lower urinary tract (LUT) are closely related. Clinically, it is important for caregivers to identify the presence of concomitant pathology as early in the diagnostic process as possible. This study evaluates lower bowel symptoms (LBS) in women with different types of urinary incontinence (UI), and compares the outcome with continent women and with a female control group.