How to define failure of intradetrusor injections of botulinum toxin A for neurogenic detrusor overactivity.

Introduction: Neurogenic detrusor overactivity (NDO) has a major impact on patients' quality of life and can lead to upper urinary tract complications. Intradetrusor botulinum toxin type A injections are administered as second-line treatment to these patients following the failure of anticholinergic agents. The aim of the DETOX 2 study is to propose a consensus definition of the failure of intradetrusor botulinum toxin injections for NDO in patients presenting spinal cord injury, spina bifida, or multiple sclerosis (MS) with self-catheterization.

[Uroflowmetry: A follow-up tool for neurogenic bladder patients treated by transcutaneous tibial posterior stimulation?].

Objective: Neurogenic bladders can suffer from overactivity, underactivity or dyssynergia depending on the level of the initial lesion. These symptoms can lead to severe alterations of the upper urinary tract. One of the first-line treatments is the transcutaneous tibial posterior stimulation (TTNS), which was demonstrated to be efficient on urodynamics.

A new tool to investigate anorectal disorders in patients with multiple sclerosis: STAR-Q.

Background: Bowel symptoms are commonly experienced by patients with Multiple sclerosis (PwMS), but no specific questionnaire validated in this population allows a rigorous assessment.

Objective: Validation of a multidimensional questionnaire assessing bowel disorders in PwMS.

Methods: A prospective, multicenter study was conducted between April 2020 and April 2021.

Risk factors for upper urinary tract deterioration in adult patients with spina bifida.

Purpose: Neurogenic bladder associated with spina bifida disease remains a major cause for mortality or morbidity due to kidney damages. However, we currently do not know which urodynamic findings are associated with an higher risk of upper tract damages in spina bifida patients. The objective of the present study was to evaluate urodynamic findings associated with functional kidney failure and/or with morphological kidney damages.

Transanal irrigation is a better choice for bowel dysfunction in adults with Spina bifida: A randomised controlled trial.

Aim: To compare transanal irrigation with conservative bowel management for the treatment of bowel dysfunction in Spina bifida (SB) patients.

Methods: Patients with SB and bowel dysfunction were randomly assigned to receive either transanal irrigation or conservative bowel management. The effectiveness of the treatment was defined as a decrease of 4 points in the neurogenic bowel dysfunction (NBD) score at week 10.

French cross-cultural adaptation and validity of the Moorong Self-Efficacy scale: the MSES-FR, a measure of Self-Efficacy for French people with spinal cord injury.

Purpose: To adapt the Moorong Self-Efficacy Scale (MSES) in the French language and determine its psychometric proprieties.

Materials And Methods: After a back-translation process, an expert committee was solicited to develop the French Self Efficacy Scale, thanks to a Delphi method, regarding theoretical framework and concepts explored. A total of 201 patients with SCI were included to explore internal consistency, internal and external structure validity assessed with the General Self-Efficacy scale, MOS Health Survey Short-Form, Hospital Anxiety and Depression Scale, Way of Coping Check-list, Perceived Stress Scale, Social Support Questionnaire, Self-Esteem questionnaire, and Satisfaction With Life Scale.

Evaluation of safety and performance of the self balancing walking system Atalante in patients with complete motor spinal cord injury.

Study Design: Prospective, open label, observational.

Objectives: To present results of the first clinical study on a newly developed robotic exoskeleton (Atalante®, Wandercraft, Paris, France) that enables individuals with spinal cord injury (SCI) to perform ambulatory functions without technical aids.

Setting: Two sites specialized in SCI rehabilitation, France.

Assessment of sacral spinal excitability using stimulus-response curves of the bulbocavernosus reflex.

Objective: To analyze and quantify sacral spinal excitability through bulbocavernosus reflex (BCR) stimulus-response curves.

Methods: Thirty subjects with upper motor neuron lesions (UMN) and nine controls were included in this prospective, monocentric study. Sacral spinal excitability was assessed using stimulus-response curves of the BCR, modeled at different bladder filling volumes relative to the desire to void (as defined by the International Continence Society) during a cystometry.

Prospective multicentre observational study assessing the tolerance and perception of patients using the Liquick Base catheter with an Ergothan tip.

Introduction: Intermittent self-catheterisation has revolutionised the management of neurogenic bladder-sphincter dysfunctions. The Liquick Base catheter is characterised by a streamlined Ergothan tip. The purpose of this study is to assess the tolerance and perception of patients using this catheter.

[Urodynamics: All the nurse needs to know].

Urodynamic (UD) is an exam intended to explore the mechanisms underlying lower urinary tract symptoms (LUTS) or urinary incontinence (UI). It involves the measurement of bladder and sphincter pressures using uretrovesical and rectal catheters with pressure transducers, but also the measurement of urinary flow and bladder sensation during filling. UD is far from being systematic in the assessment of LUTS or UI and must seek to tackle a specific clinical or therapeutic question.

[Anal tone: Physiology, clinical and instrumental characteristics].

Introduction: The anal tone allows the maintenance of anorectal continence. Its regulation depends on spinal segmental mechanisms under supra-sacral control.

Material And Methods: A systematic review was performed using Medline database, according to PRISMA methodology, using following keywords anal tone ; anal sphincter ; anorectal function ; reflex ; digital rectal examination.

Pregnancy and Delivery in Women with Lower Urinary Tract Reconstruction: A National Multicenter Retrospective Study from the French-Speaking Neuro-Urology Study Group (GENULF) and the Neuro-Urology Committee of the French Association of Urology.

Purpose: Management of pregnancy and delivery in women with lower urinary tract reconstruction is challenging and the currently available literature is insufficient to guide clinical practice. We report pregnancy and delivery outcomes in this specific population.

Materials And Methods: We conducted a national multicenter retrospective study (16 centers) including 68 women with 96 deliveries between 1998 and 2019.

[Effects of attention and desire to void on sensory evoked cortical potentials following perineal stimulation].

Objective: Cortical somatosensory evoked potentials (SEP) are usually used to test the integrity of lemniscal pathways and thus provide arguments for the neurogenic etiology of sensory symptoms. For example, PES by perineal stimulation (SEP-P) has been shown to be altered in incontinence or neurogenic sexual dysfunction. We wanted to verify the integrity, structure and amplitude of far-field responses of PES-P in two conditions, the first without feeling the need to urinate (S0), the second with urgency (US).

Urinary biomarkers profiles in patients with neurogenic detrusor overactivity according to their neurological condition.

Objectives: The aim of this study was to investigate the disease-specific urinary levels variations of neurotrophins (NGF, BDNF), mediators of inflammation (TGFβ-1, PGE-2) and markers of extracellular matrix alterations (TIMP-2) in patients with multiple sclerosis (MS) spinal cord injury (SCI), or spina bifida (SB), and neurogenic detrusor overactivity (NDO).

Methods: A prospective single-center study was conducted between March 2015 and March 2017. Patients aged over 18 years old, with neurological disease, with a urodynamic diagnosis of NDO were included.

Urologic Disorders are Still the Leading Cause of In-hospital Death in Patients With Spina Bifida.

Objective: To assess and analyze the contemporary causes of in-hospital deaths of spina bifida patients.

Methods: It was a cross-sectional observational study of the longitudinal national cohort of all patients hospitalized in French public and private hospitals. We analyzed the data from the French hospital discharge database (Programme de Médicalisation des Systemes d'Information, PMSI) from 2009 to 2014.

Contrast-enhanced CT Texture Parameters as Predictive Markers of High-risk Urodynamic Features in Adult Patients with Spina Bifida.

Objective: To investigate computed tomography (CT) texture analysis of the bladder wall as a predictor of urodynamics findings in adult patient with spina bifida.

Methods: A single-center prospective trial was conducted from March 2015 to March 2017 including all consecutive adult spina bifida patients seen for urodynamic testing. A contrast-enhanced abdominal CT was systematically performed in all patients during the same visit.

Urinary TIMP-2 and MMP-2 are significantly associated with poor bladder compliance in adult patients with spina bifida.

Aims: To assess the predictive values of six urinary markers (nerve growth factor [NGF], brain-derived neurotrophic factor [BDNF], matrix metalloproteinase 2 [MMP-2], tissue inhibitor metalloproteinase 2 [TIMP-2], transformation growth factor β-1 [TGF-B1], and prostaglandin 2 [PGE2]) for adverse urodynamic features and for upper urinary tract damage in adult patients with spina bifida.

Materials And Methods: A single-center prospective trial was conducted from March 2015 to March 2017 including all consecutive adult patients with spina bifida seen for urodynamic testing. The urine was collected and stored at -80°C.

Diagnosis and treatment of urinary and sexual dysfunction in hereditary TTR amyloidosis.

Purpose: We aimed to review the current knowledge on the epidemiology, diagnosis, and management of urinary and sexual dysfunction in patients with TTR amyloidosis (ATTR).

Methods: We performed a review of the literature, screening for randomized controlled trials, prospective and retrospective series, position papers, and guidelines on urinary and sexual dysfunction in ATTR patients published in PubMed and Embase.

Results: Lower urinary tract dysfunction is present in up to 83% of patients with ATTR.

Determinants and prognostic value of post-operative maximum urethral closure pressure after artificial urinary sphincter in men.

Purpose: To evaluate the determinants and prognostic value of post-operative maximum urethral closure pressure (MUCP) after AUS implantation in male patients.

Methods: The charts of all male patients who had an AUS implantation between 2008 and 2018 at a single center were reviewed retrospectively for an exploratory study. A post-operative urethral profilometry was performed systematically as part of routine daily practice over the study period to assess the post-operative MUCP with the AUS consecutively closed (c-MUCP) and opened (o-MUCP).

Management of urethrocutaneous fistulae complicating sacral and perineal pressure ulcer in neurourological patients: A national multicenter study from the French-speaking Neuro-urology Study Group and the Neuro-urology committee of the French Association of Urology.

Purpose: To describe the epidemiologic characteristics of urethrocutaneous fistulae (UCF) in sacro-perineal pressure ulcer (SPPU) in neurourological patients and to assess outcomes after surgical urinary diversion.

Materials And Methods: Through the French-speaking Neurourology Study Group and Association of Urology network, a retrospective multicenter study in nine major urology and physical medicine and rehabilitation (PMR) units was conducted. All patients with SPPU associated with UCF between 2000 and 2016 were included.

[Use of botulinum toxin A in pelvic floor dysfunctions in the elderly: A review].

Introduction: The present article is the final report of a multi-disciplinary meeting supported by the GRAPPPA (group for research applied to pelvic floor dysfunctions in the elderly). The objective was to conduct a comprehensive review on the role of botulinum toxin A (BonTA) in the treatment of pelvic floor dysfunctions in the elderly.

Methods: The present article, written as a comprehensive review of the literature, combines data issued from the scientific literature with expert's opinions.

Risk of prolapse and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor using clean intermittent catheterization versus Valsalva voiding.

Aims: To assess the relative risks of pelvic organ prolapse (POP) and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor voiding with Valsalva versus those using clean-intermittent catheterization (CIC).

Methods: We conducted a retrospective analysis including all spina bifida patients with neurogenic acontractile detrusor with a minimum follow-up of 12 months. Patients were then divided in two groups according to their bladder management: voiding with Valsalva versus CIC.

Comparison of neurogenic lower urinary tract dysfunctions in open versus closed spinal dysraphism: A prospective cross-sectional study of 318 patients.

Aims: To compare the neurogenic lower urinary tract dysfunction (NLUTD) in patients with closed spinal dysraphism (CSD) versus patients with open spinal dysraphism (OSD) as well as their management patterns.

Methods: A prospective cross-sectional study was conducted between September 2007 and December 2015 including all spina bifida patients seen at the multidisciplinary French national referral center for spina bifida. NLUTD and its management were compared between the OSD and CSD groups.