Urinary incontinence is a difficult condition that affects millions of people around the world. Recent research has opened the door to understanding the involvement of imbalance in the autonomic nervous system (ANS) as a cause of urge urinary incontinence (UUI) and has highlighted the therapeutic potential of targeting the sympathetic and parasympathetic pathways. This mini-review discusses current pharmacological and neuromodulation approaches that act on the ANS to restore bladder function. Future research should investigate the role of the ANS in bladder dysfunction and incontinence in more depth, and assess optimization of neuromodulation protocols and therapy combination to improve outcomes for patients with UUI. PATIENT SUMMARY: Our mini-review discusses dysfunction of the autonomic nervous system (ANS) as a possible cause of urge urinary incontinence. We describe treatments that could have an effect on incontinence by improving the balance of the ANS. Further research is needed to define the role of the ANS in tailoring treatment for individual patients.
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http://dx.doi.org/10.1016/j.euf.2025.02.015 | DOI Listing |
Am J Obstet Gynecol
March 2025
Social, Statistical, & Environmental Sciences, RTI International, Research Triangle Park, NC, United States.
Background: Prior studies have failed to demonstrate clinical or statistical difference in fecal incontinence (FI) symptom improvement with neuromodulation by percutaneous tibial nerve stimulation (PTNS) vs sham. The results of these studies may be indicative of a placebo or sham effect and led us to investigate possible genetic biomarkers of placebo response among women with FI.
Objective: To evaluate the relationship between response to PTNS or sham and genetic polymorphisms associated with placebo response in women with FI.
Rev Gaucha Enferm
March 2025
Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brasil.
Objective: To develop and validate the content of a behavioral therapy protocol aiming at improving urinary incontinence in elderly women.
Method: This is a methodological study to develop and validate the content of a protocol to be applied with elderly women with urinary incontinence. It was conducted in two phases: 1) development of the protocol based on a literature review, NANDA-I and NIC; 2) content validation through evaluation of the protocol by experts in a focus group.
J Robot Surg
March 2025
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333423, Taiwan.
To evaluate the effect of cystopexy on continence recovery after anterior-approach transperitoneal robot-assisted radical prostatectomy (RaRP). We retrospectively analyzed continence recovery of patients with prostate cancer receiving RaRP in a transperitoneal anterior-approach manner with or without cystopexy. Continence recovery is defined as complete intact continence without safety pad utility.
View Article and Find Full Text PDFWorld J Urol
March 2025
Department of Urology, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel-Aviv, 6423906, Israel.
Introduction: Transient stress urinary incontinence (SUI) after holmium laser enucleation of prostate (HoLEP) is commonly linked to intraoperative injury of the external urethral sphincter (EUS). We assessed the reliability of the post-HoLEP endoscopic appearance of the membranous urethra mucosa (MUM) in predicting post-HoLEP continence.
Methods: Forty HoLEPs were prospectively recorded by an artificial intelligence video platform capable of segmenting clips by surgical steps.
Neurogenic bladder (NB) is a group of bladder and/or urethral dysfunctions caused by neurological lesions, commonly seen in patients with lumbar spine diseases, manifesting as urinary storage and voiding dysfunction, significantly affecting patients' quality of life. Degenerative changes or trauma to the lumbar spine can lead to narrowing of the dural sac, compressing the sacral nerve roots, cauda equina or blood vessels, causing bladder dysfunction and leading to NB. Diagnostic methods for NB include history taking, physical examination and noninvasive and invasive tests, such as urodynamic testing and cystoscopy.
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