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.

Use of a specific questionnaire and perineal electromyography to assess neuropathic pain after radical retropubic prostatectomy.

Objective: Prostate cancer is the most frequent cancer in men and radical retropubic prostatectomy (RRP) is one of the first-line treatment. However, RRP has some side effects and can lead to chronic perineal pain. The objective of the study was to determine in patients suffering from perineal pain after RRP the possibility of a neurogenic damage by means of a specific questionnaire dedicated to track down neuropathic pain.

Influence of the urine stream interruption exercise on micturition.

Objectives: To assess the effect of urine stream interruption exercise on micturition.

Methods: This study was conducted prospectively in female patients without urinary disorders. Two uroflowmetries were performed: one during a usual micturition and one during an exercise of urine stream interruption.

Predictive factors of adherence to urinary self-catheterization in older adults.

Aims: The primary aim is to explore the adherence predicting factors in clean intermittent self-catheterization (CISC) in patients aged over 65 years. The secondary aim is to assess whether in this population, the non-adherence risk is greater, compared with patients under 65.

Methods: All patients older than 65 that successfully learned CISC between January 2011 and January 2016 were included.

Specificity of Lower Urinary Tract Symptoms in Neuromyelitis Optica in Comparison With Multiple Sclerosis Patients.

Purpose: The aim of this study was to describe lower urinary tract symptoms in neuromyelitis optica (NMO), and to compare these data with urinary disorders observed in multiple sclerosis (MS) patients.

Methods: Retrospective study of data collected from January 1997 to July 2017 using the database from a Neuro-Urology Department of a university hospital. NMO and MS patients were matched for sex, age, and Expanded Disability Status Scale (EDSS).

Lower Urinary Tract Symptoms in Elderly Population With Multiple Sclerosis.

Purpose: The aim of this study is to compare the clinical and urodynamic characteristics of urinary disorders in multiple sclerosis (MS) patients in a geriatric population with a nongeriatric population.

Methods: This study was conducted retrospectively between 2010 and 2016. Each patient with MS aged 65 and older was matched with 2 patients with MS aged less than 65 in sex, form of MS, and Expended Disability Status Scale (EDSS).

Intermittent Self-catheterization in Older Adults: Predictors of Success for Technique Learning.

Purpose: The main goal of this retrospective study is to explore the predictors of success in learning clean intermittent self-catheterization (CISC) in patients over 65 years of age. The secondary goal is to assess whether in this population, the risk of failure to perform CISC is greater, compared with patients under 65 with similar pathologies.

Methods: All patients older than 65 consulting between January 2011 and January 2016 for learning CISC were included.

Influence of a distraction task on pelvic floor muscle contraction.

Aims: Attention may play a key role in the contraction of pelvic floor muscles in stressful situations, meaning that mental distraction may be involved in urinary incontinence.

Methods: Informed consent was obtained from 20 healthy volunteers. The electromyographic (EMG) activity of the external anal sphincter (EAS) was recorded during voluntary contraction elicited by local stimulation.

Posterior vaginal wall pull down maneuver: a clinical test to diagnose intrinsic sphincter deficiency in women suffering from genuine urinary stress incontinence.

Objectives: To assess the predictive value of a simple clinical test (posterior vaginal wall pull down maneuver) in the diagnosis of intrinsic sphincter deficiency.

Methods: The present prospective study included 62 women suffering from stress urinary incontinence. Every patient underwent a urogynecological examination including multichannel urodynamic testing (cystometry, urethral pressure profile, Valsalva Leak Point Pressure measurement) and a clinical examination including posterior vaginal wall pull down maneuver.

Pencil and paper test: a new tool to predict the ability of neurological patients to practice clean intermittent self-catheterization.

Purpose: We created and validated the new pencil and paper test, which allows assessment of the ability of patients with a neurological disorder to practice clean intermittent self-catheterization.

Materials And Methods: We developed a simple test including common gestures mimicking the usual maneuvers needed during clean intermittent self-catheterization, and involving the same cognitive and physical resources needed for this technique. We evaluated the test in 118 patients with a neurological condition.

Urine leakage related to physical fatigue in women with urinary stress incontinence.

Objective: To evaluate the frequency of urine leakage related to physical fatigue in women presenting with urinary stress incontinence using a specific questionnaire, and to assess its association with the Bristol Female Lower Urinary Tract Symptoms questionnaire and urodynamic findings.

Design: Prospective observational descriptive study.

Setting: University hospital (urodynamics laboratory).

Decrease in urethral pressure following repeated cough efforts: a new concept for pathophysiology of stress urinary incontinence.

Aims: To describe the decrease in maximum urethral closure pressure (MUCP) following repeated coughs in women with stress urinary incontinence (SUI).

Methods: MUCP was recorded at rest and after seven cough efforts in 70 women under age 40 referred for urodynamic investigation (47 women with SUI and 23 women without SUI).

Results: The intraclass correlation coefficient for repeatability was very good at 400 mL filling volume: 0.

Autonomic nervous system activity during bladder filling assessed by heart rate variability analysis in women with idiopathic overactive bladder syndrome or stress urinary incontinence.

Purpose: Idiopathic overactive bladder syndrome is a common disorder, especially in women. Of various pathophysiological factors several studies suggest a specific dysfunction of the autonomic nervous system. To verify this hypothesis we compared heart rate variability parameters, which provide an analysis of autonomic function, in women with idiopathic overactive bladder syndrome to those in a reference population of women with stress urinary incontinence.

External intercostal muscles and external anal sphincter electromyographic activity during coughing.

Few studies focused on concomitant electromyographic recordings of pelvic floor muscles and muscles involved in cough initiation. The objective of this study was to investigate the temporal course of external anal sphincter activation during coughing. Informed consent was obtained from ten healthy volunteers and ten women presenting with stress urinary incontinence (SUI).

Pelvic floor muscle activity during coughing: altered pattern in women with stress urinary incontinence.

Objectives: To assess the relationship between bladder pressure (BP) and pelvic floor muscle activity during coughing in women with stress urinary incontinence (SUI).

Methods: External anal sphincter integrated electromyographic activity (EAS-EMGi) was recorded in 21 women using pregelled surface electrodes. The relationship between BP and EAS-EMGi activity was assessed during four successive coughs at 0, 200, and 400 mL of filling.

Abnormal pelvic response to cough in women with stress urinary incontinence.

Aims: To assess how muscular fatigue deteriorates the modulation of pelvic contraction during increasing cough efforts. Furthermore, we investigated the correlation between the temporal course of pelvic floor activation during cough.

Methods: Informed consent was obtained from 20 women presenting with SUI and 6 continent women (overactive bladder syndrome [OAB]).

External anal sphincter contraction during cough: not a simple spinal reflex.

Aims: To assess whether the anal contraction during voluntary coughing is a simple spinal reflex-mediated activity or not. To address this question we studied the external intercostal (EIC) muscle activity and external anal sphincter (EAS) response to cough.

Materials And Methods: Electromyographic recordings were made from pre-gelled disposable surface electrodes.

Evidence of occult dysautonomia in Fowler's syndrome: alteration of cardiovascular autonomic function tests in female patients presenting with urinary retention.

Objective: To assess the hypothesis that an occult impairment of the autonomic system might represent one of the mechanisms of urinary disturbance in Fowler's syndrome (FS), in which the pathophysiology of urinary retention is the predominant feature.

Patients And Methods: We prospectively investigated 10 women (mean age 43.7 years) with FS, diagnosed by assessing both voiding-phase dysfunction (complete or incomplete retention with a residual urine volume of >150 mL, and a maximum flow rate of <15 mL/s), abnormalities of striated urethral sphincter electromyography (decelerating bursts and complex repetitive discharges), the presence of polycystic ovaries and absence of any apparent usual causes (obstructive, neurological diseases).

Cough anal reflex: strict relationship between intravesical pressure and pelvic floor muscle electromyographic activity during cough. Urodynamic and electrophysiological study.

Purpose: Cough and more generally abdominal strain determine a pelvic floor contraction which allows an increase in sphincter pressure to prevent leakage during stress. Many electrophysiological studies have demonstrated this reflex (formally cough anal reflex). We postulated that the perineal muscle contraction following cough is not a simple binary response but proportional to the intensity of the cough.

Using intercostal muscle EMG to quantify maternal expulsive efforts during vaginal delivery: a pilot study.

Aims: The expulsive forces of childbirth can be included among the many potential risk factors implicated in the subsequent development of stress urinary incontinence (SUI) in women. The objective of this study was to devise a non-invasive way to measure abdominal pushing that would accurately represent the expulsive forces during childbirth.

Methods: By means of intravesical and intrauterine manometry, and electromyography (EMG) of intercostal muscles, we quantified these forces in 21 women during vaginal delivery.

Dissociation between electrical and mechanical bulbocavernosus reflexes.

Aims: To record reflex motor responses, elicited by mechanical stimulation of the penis or clitoris, in each bulbocavernosus muscles and to compare left and right reflex pathways in normal subjects, then to compare electrical and mechanical responses in various neurological diseases.

Methods: Two groups of patients were studied: 22 patients without neurological disease considered as normal subjects; and 25 patients with neurological disease (three multiple sclerosis, six spina bifida, nine conus medullaris syndrome, three peripheral neuropathies, two lumbosacral lesions, one multisystem atrophy, and one syringomyelia). Electrical bulbocavernosus reflex (EBCR) was evoked by orthodromic stimulation of the dorsal nerve of the penis at the penile base or the clitoris.

Bulbocavernosus muscle responses after suprapubic stimulation: analysis and measurement of suprapubic bulbocavernosus reflex latency.

Our objective was to describe pelvic floor responses with measurement of reflex latency after suprapubic mechanical stimulation. Twenty-one patients without neurological disease were studied. They were 14 women and seven men.