Increasing of treatment efficiency in patients with neurogenic detrusor overactivity is an important medical and social problem. Its significance is determined not only by the high prevalence of neurogenic lower urinary tract dysfunctions, but also by the high risk of complications, among which an impaired renal function takes the leading place. Botulinum toxin therapy is considered as a second-line treatment and is carried out in case of insufficient efficacy, unsatisfactory tolerability or the presence of contraindications to anticholinergic therapy. Botulinum toxin therapy has been actively used in our country for more than 12 years. In 2022, abobotulinum toxin A (Dysport) was registered in the Russian Federation for the treatment of neurogenic detrusor overactivity. An overview of the results of clinical trials of Dysport, indicating its high efficacy and favorable safety profile, is presented in the article. The availability of botulinum toxin in the arsenal of a urologist, which has a high efficiency, opens up additional prospects for the treatment of patients with a neurourological profile.
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J Pediatr Urol
January 2025
Department of Women and Children's Health, School of Life Course Sciences, Kings College London, London, UK; Children's Bladder Service, Evelina London Children's Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Introduction: The Mirabegron-anticholinergic (MAC) combination has proven effective as a step-up strategy in managing paediatric neurogenic bladder following anticholinergic medication and botulinum toxin (BTX) therapy. This study assesses the long-term efficacy of MAC in children with neurogenic bladder.
Patients And Methods: A retrospective chart review was conducted from 2015 to 2023, including consecutive paediatric patients receiving Mirabegron (25/50 mg) with an anticholinergic agent (solifenacin 16, tolterodine 7, oxybutynin 7, trospium 1).
Int J Surg Case Rep
December 2024
Department of Urology, Faculty of Medicine, Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Introduction: Primary bladder neck obstruction (PBNO) is a rare but significant cause of BOO and LUTS in females, with unclear etiology involving theories of fibrotic narrowing, tissue hyperplasia, or muscle abnormalities. Due to nonspecific symptoms, PBNO diagnosis remains challenging, and optimal surgical treatment needs to be better defined.
Case Presentation: We report two cases of females in their 50s with recurrent urinary retention managed by indwelling catheters.
Neurourol Urodyn
December 2024
Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Introduction: Detrusor contractions can be classified as either volitional or involuntary. The latter are a hallmark of urge urinary incontinence. Understanding differences in neuroactivation associated with both types of contractions can help elucidate pathophysiology and therapeutic targets.
View Article and Find Full Text PDFArch Phys Med Rehabil
December 2024
Department of Rehabilitation, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China. Electronic address:
Objective: To assess the available evidence of non-invasive or minimally invasive neuromodulation therapies in improving urodynamic outcomes, voiding diaries, and quality of life in patients with neurogenic lower urinary tract dysfunction (NLUTD) after spinal cord injury (SCI).
Data Sources: A comprehensive search of 10 databases from inception until August 30, 2023 was conducted.
Study Selection: Randomized controlled trials (RCTs) assessing the effects of conventional treatment (CT) and CT combined with sham stimulation (SS), transcranial magnetic stimulation (TMS), sacral nerve magnetic stimulation (SNMS), TMS+SNMS, sacral pulsed electromagnetic field therapy (SPEMFT), sacral transcutaneous electrical nerve stimulation (STENS), sacral dermatomal transcutaneous electrical nerve stimulation (SDTENS), bladder & sacral transcutaneous electrical nerve stimulation (B&STENS), transcutaneous tibial nerve stimulation (TTNS), transcutaneous electrical acupoint stimulation (TEAS), pelvic floor electrical stimulation (PFES), or pelvic floor biofeedback therapy (PFBFBT) on postvoid residual volume (PVR), maximum cystometric capacity (MCC), number of voids per 24 h (V24), mean urine volume per micturition, (MUV), maximum urinary flow rate (Qmax), maximum detrusor pressure (MDP), maximum voiding volume (MVV), number of leakages per 24 h (L24), lower urinary tract symptoms (LUTS) score, and spinal cord injury-quality of life (SCI-QoL)score in patients with NLUTD after SCI were included.
J Pediatr Urol
December 2024
Department of Pediatric Urology, Göztepe Prof. Dr Süleyman Yalcin City Hospital, Istanbul, Turkey.
Introduction: In pediatric urology, urodynamic studies are considered the most reliable method for assessing the function of the lower urinary tract. These evaluations play a particularly important role in guiding treatment decisions for neurogenic bladder conditions.
Objective: The aim of this study is to assess the impact of artifacts on the interobserver and intraobserver agreement in the interpretation of pediatric urodynamic traces.
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