Autonomic dysfunction and plasticity in micturition reflexes in human α-synuclein mice.

Although often overshadowed by the motor dysfunction associated with Parkinson's disease (PD), autonomic dysfunction including urinary bladder and bowel dysfunctions are often associated with PD and may precede motoric changes; such autonomic dysfunction may permit early detection and intervention. Lower urinary tract symptoms are common in PD patients and result in significant morbidity. This studies focus on nonmotor symptoms in PD using a transgenic mouse model with overexpression of human α-synuclein (hSNCA), the peptide found in high concentrations in Lewy body neuronal inclusions, the histopathologic hallmark of PD.

Algorithms for the management of overactive bladder.

Overactive bladder (OAB) is a highly prevalent and bothersome condition that hampers quality of life in men and women. Increased awareness of available treatment has led growing numbers of patients to seek medical attention in search of relief. Clinical algorithms for the management of OAB would enable physicians who treat these patients to deliver up-to-date, effective care in an expeditious fashion.

Preview of new drugs for overactive bladder and incontinence: darifenacin, solifenacin, trospium, and duloxetine.

This year, the US Food and Drug Administration will approve four new drugs indicated for the treatment of lower urinary tract dysfunction. Darifenacin, solifenacin, and trospium are antimuscarinic agents aimed at relieving the symptoms of overactive bladder and urge incontinence in men and women. Duloxetine will be the first drug approved for the treatment of female stress urinary incontinence.

Functional brain imaging and the bladder: new insights into cerebral control over micturition.

Mechanisms for cerebral control over the micturition process remain poorly elucidated. The knowledge is based largely on human pathophysiology and data derived from electrophysiologic testing in animals. Recent advances in dynamic functional brain imaging technologies including positron-emission tomography, single photon emission computed tomography, and functional magnetic resonance imaging have allowed new insights into how the human brain regulates this process.

Beyond collagen: injectable therapies for the treatment of female stress urinary incontinence in the new millennium.

Previous experience with GAX-collagen has shown that the endoscopic correction of female SUI is both possible and effective. It is clear, however, that durability remains a primary concern when implementing this approach to treatment. The availability of recently developed and newly emerging materials, carefully designed using the tenets and techniques of biotechnology and materials science, may provide solutions to some of the difficulties beleaguering this treatment option.

De novo urge syndrome and detrusor instability after anti-incontinence surgery: current concepts, evaluation, and treatment.

The onset of de novo irritative voiding symptoms after anti-incontinence surgery for stress urinary incontinence is troubling to both patient and physician alike. At present, mechanisms responsible for the development of these symptoms are incompletely elucidated. Although bladder outlet obstruction may certainly be a cause, correct diagnosis and treatment of this condition in its more insidious manifestation may be difficult.

Reconstitution of human corpus cavernosum smooth muscle in vitro and in vivo.

A large number of congenital and acquired abnormalities of the genitalia would benefit from the availability of transplantable, autologous corpus cavernosum tissue for use in reconstructive procedures. We describe the results of preliminary experiments designed to determine the feasibility of using cultured human corporal smooth muscle cells seeded onto biodegradable polymer scaffolds for the formation of corpus cavernosum smooth muscle in vitro and in vivo. Primary cultures of human corpus cavernosum smooth muscle cells were derived from operative biopsies obtained during penile prosthesis implantation.

Blood flow, pressure and compliance in the male human bladder.

Purpose: The regulation of human bladder blood flow during filling is poorly understood. We characterized changes in bladder blood flow with filling and examined the relationship of bladder compliance and blood flow.

Materials And Methods: A total of 17 awake male patients underwent saline cystometry followed by cystoscopy while under local anesthesia, during which a laser Doppler flow probe was placed into the posterior bladder wall detrusor.