Diagnoses and Treatment Recommendations-Interrater Reliability of Uroflowmetry in People with Multiple Sclerosis.

Background: Uroflowmetry (UF) is an established procedure in urology and is recommended before further investigations of neurogenic lower urinary tract dysfunction (NLUTD). Some authors even consider using UF instead of urodynamics (UD). Studies on the interrater reliability of UF regarding treatment recommendations are rare, and there are no relevant data on people with multiple sclerosis (PwMS).

[A review of intravesical treatment options in neuro-urology].

Neurogenic lower urinary tract dysfunction is caused by various disorders of the central and peripheral nervous system. This can result in several malfunctions of the storage and voiding phase, which are reflected in symptoms such as urgency, urinary incontinence, recurrent urinary tract infections and post-void residual urine. Reduced quality of life, impairment of the upper urinary tract, reduced employment opportunities and worsening of the symptoms of the underlying condition can be the consequences.

[Imaging of the pelvic floor : The urological perspective].

Background: Physiological pelvic floor function is essential for maintaining the appropriate storage and voiding function of the lower urinary tract. Disorders of pelvic floor function can consist of both hypofunction and hyperfunction and can result in urge symptoms, urinary incontinence, disorders of the micturition process, urinary retention, and chronic pelvic floor pain, as well as endangering the upper urinary tract. Thus, these disorders can be complex in their cause and effect.

Neurogenic Lower Urinary Tract Symptoms, Fatigue, and Depression-Are There Correlations in Persons with Multiple Sclerosis?

The symptoms of multiple sclerosis (MS) frequently include fatigue, depression, and neurogenic lower urinary tract symptoms (LUTS), causing severe burdens on affected individuals. The relationships between these symptoms have not been intensively researched and there are no studies on the detailed influence of the different neurogenic LUTS. We aimed to investigate the relationships between fatigue, depression, and neurogenic LUTS as recorded in bladder diaries by persons with MS.

Is the Standard Artificial Urinary Sphincter AMS 800 Still a Treatment Option for the Irradiated Male Patient Presenting with a Devastated Bladder Outlet?

Background: Circular urethral compression with an artificial sphincter allows control of voiding, even in patients with severe stress urinary incontinence, but it heightens the risk of urethral atrophy and erosion. This study of one of the largest populations of patients treated with radiotherapy investigates the additive effect of the post-radiogenic stricture of the membranous urethra/bladder neck on AMS 800 artificial urinary sphincter outcomes.

Methods: In a retrospective multicenter cohort study, we analyzed patients fitted with an AMS 800, comparing those who had received radiotherapy with patients presenting a devastated bladder outlet (stricture of the membranous urethra/bladder neck).

Urinary and Double Incontinence in Cognitively Impaired Patients: Impacts on Those Affected and Their Professional Caregivers.

Urinary or double incontinence in frail elderly people is common and leads to a reduction in quality of life and an increased burden on the patients' caregivers. Up to now, no special instrument has been available to assess the impact of incontinence on cognitively impaired patients and their professional caregivers. Thus, the outcomes of incontinence-specific medical and nursing interventions for cognitively impaired individuals are not measurable.

Neurogenic Lower Urinary Tract Dysfunction in Asymptomatic Patients with Multiple Sclerosis.

Neurogenic lower urinary tract dysfunction (NLUTD) in asymptomatic patients with MS has been described in preliminary studies, but specific investigations of this topic are rare. Many authors advise early diagnosis and treatment of NLUTD in patients with MS. In contrast, clinical practice and different guidelines recommend neuro-urological diagnostics only in the presence of symptoms.

Randomised Controlled Trials Assessing the Clinical Value of Urodynamic Studies: A Systematic Review and Meta-analysis.

Context: The role of urodynamic studies (UDSs) in the diagnosis of lower urinary tract symptoms (LUTS) is crucial. Although expert statements and guidelines underline their value for clinical decision-making in various clinical settings, the academic debate as to their impact on patient outcomes continues.

Objective: To summarise the evidence from all randomised controlled trials assessing the clinical usefulness of UDS in the management of LUTS.

Clinical Predictors of Neurogenic Lower Urinary Tract Dysfunction in Persons with Multiple Sclerosis.

Background: Multiple sclerosis patients often develop neurogenic lower urinary tract dysfunction with a potential risk of upper urinary tract damage. Diagnostic tools are urodynamics, bladder diary, uroflowmetry, and post-void residual, but recommendations for their use are controversial.

Objective: We aimed to identify clinical parameters indicative of neurogenic lower urinary tract dysfunction in multiple sclerosis patients.

Electrochemically activated solution as bladder irrigation-An individual curative trial in patients with neurogenic lower urinary tract dysfunction and recurrent urinary infections.

Aims: Driven by increasing awareness of antibiotic stewardship, especially in the vulnerable group of patients with neurogenic lower urinary tract dysfunction (NLUTD), whose frequent need for invasive interventions leads to a high incidence of recurrent urinary tract infections (rUTIs), the goal was to find an alternative to antibiotic treatment. Our intention was for the treatment to be locally administered and well-tolerated as well as to avoid the risk of antimicrobial resistance.

Methods: A retrospective analysis of 12 catheterized NLUTD patients was performed within the setting of an individual curative trial.

[Diagnostic testing of female urinary incontinence: dos and dont's].

Urinary incontinence causes significant limitations in quality of life and reduces mental and physical health. It is a widespread and chronic disease. About 200 million people are affected by urinary incontinence worldwide.

[Current aspects of neurogenic dysfunctions of the lower urinary tract in multiple sclerosis].

Background: In the clinical management of patients with multiple sclerosis (MS), the challenge is to make an early diagnosis and initiate adequate treatment of neurogenic disorders of the lower urinary tract (NLUTD). Various national guidelines provide practical recommendations which are sometimes discordant.

Objective: To develop a simple evidence-based algorithm for detecting NLUTD in patients with MS that could be taken as a principle for deriving therapeutic consequences.

Overactive bladder syndrome - focus onto detrusor overactivity.

Introduction And Hypothesis: To determine in patients with overactive bladder (OAB), urodynamic differences as well to compare the characteristics of patient's, with presence of detrusor overactivity on urodynamics with those with absence of detrusor overactivity.

Methods: Taking into account the urodynamic findings, the patients with OAB symptoms were categorized into one of two groups: group 1 (with detrusor overactivity) or group 2 (without detrusor overactivity), and comparative analyses for both groups were performed (epidemiological data, patient history, urodynamic criteria, bladder diaries, IC-OAB, IC-OABqol - questionnaires).

Results: There was a significant difference in age as well in the disease duration between group 1 and group 2.

Incontinence in frail elderly persons: Report of the 6th International Consultation on Incontinence.

Background: Evidence-based guidelines for the management of frail older persons with urinary incontinence are rare. Those produced by the International Consultation on Incontinence represent an authoritative set of recommendations spanning all aspects of management.

Aims: To summarize the available evidence relating to the management of urinary incontinence in frail older people published since the 5th International Consultation on Incontinence.

Incidence of urinary tract infection following initiation of intermittent catheterization among patients with recent spinal cord injury in Germany and the Netherlands.

To assess incidence of urinary tract infection (UTI) among patients with recent spinal cord injury (SCI) who initiated intermittent catheterization (IC). Retrospective chart review. Two European SCI rehabilitation centers.

Patient Selection in Surgical Centers of Expertise in the Treatment of Patients with Moderate to Severe Male Urinary Stress Incontinence.

Objective: To analyze decision-making in patients with male urinary incontinence (SUI) in centers of expertise. The artificial urinary sphincter (AUS) remains the gold standard for male patients with moderate to severe SUI but adjustable male slings are a minimally invasive treatment option with good results, hence without a high level of evidence regarding the optimal patient selection.

Materials And Methods: In total, 220 patients (88 AUS; 132 adjustable slings) were investigated from the DOMINO database that underwent surgery between 2010 and 2012 in 5 urological departments that offer adjustable sling systems as well as AUS systems for patients with moderate to severe urinary incontinence.

Fixed or adjustable sling in the treatment of male stress urinary incontinence: results from a large cohort study.

Background: Fixed and adjustable male slings for the treatment of male urinary stress incontinence became increasingly popular during the last decade. Although fixed slings are recommended for the treatment of mild to moderate stress urinary incontinence, there is still a lack of evidence regarding the precise indication for an adjustable male sling. Furthermore, there is still no evidence that one type of male sling is superior to another.

Should we routinely assess psychological morbidities in idiopathic lower urinary tract dysfunction: ICI-RS 2019?

Aims: Psychological morbidities play a major role in idiopathic lower urinary tract dysfunction (iLUTD). The aim of the Think Tank (TT) was to discuss the relevance of psychological morbidities in idiopathic LUTD over the life span, including overactive bladder (OAB) or dysfunctional voiding (DV) and methods of assessment.

Methods: The paper is based on a selective review of the literature and in-depth discussions, leading to research recommendations regarding the assessment of psychological morbidities in iLUTD on children and adults held during the TT of the International Consultation on Incontinence Research Society in 2019.

High/low-volume center experience predicts outcome of AMS 800 in male stress incontinence: Results of a large middle European multicenter case series.

Aim: To analyze the influence of implantation volume of artificial sphincters (AMS 800) on outcome in a large central European multicenter cohort study.

Methods: As part of the DOMINO (Debates on Male Incontinence) project, the surgical procedures and outcomes were retrospectively analyzed in a total of 473 patients who received an artificial sphincter (AMS 800) between 2010 and 2012. Clinics that implanted at least 10 AMS 800 per year were defined as high-volume centers.