| 1. |
- Gladh, Gunilla, 1943-, et al.
(författare)
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Voiding pattern in healthy newborns
- 2000
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Ingår i: Neurourology and Urodynamics. - 0733-2467 .- 1520-6777. ; 19:2, s. 177-184
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Tidskriftsartikel (refereegranskat)abstract
- A 4-hour observation period has been used in infants to investigate suspected bladder dysfunction. The aim of the present study was to extend the usefulness of this protocol by establishing reference values for voiding frequency, intervals, volumes, and residual urine in healthy newborns. The study included 51 healthy newborns, 26 girls and 25 boys, aged 3 to 14 days. During a 4-hour period, all micturitions and residuals were recorded as well as feeding, sleeping, crying, and defecations. The observation was completed with the child undressed to observe the urinary stream during one void. Different provocation tests were tried to induce urinary leakage. All newborns voided with a stream, about once per hour, with a median volume of 23 mL. For each voiding parameter, there was a large inter- and intra-individual variability. Double voidings were common as well as sizable residual volumes. The diuresis was about six times higher than in healthy school children. The healthy newborns did not leak during provocation tests such as manual compression of the bladder.
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| 2. |
- Jiang, Chong-He
(författare)
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Modulation of the micturition reflex pathway by intravesical electrical stimulation : An experimental study in the rat
- 1998
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Ingår i: Neurourology and Urodynamics. - 0733-2467 .- 1520-6777. ; 17:5, s. 543-554
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Tidskriftsartikel (refereegranskat)abstract
- Intravesical electrical stimulation (IVES) is used clinically to improve bladder evacuation in patients with inadequate micturition contractions. The procedure involves field stimulation of A bladder mechanoreceptor afferents resulting in a prolonged enhancement of the micturition reflex. The aim of the present experimental study in the rat was to identify the site for this neuromodulation, whether it was due to sensitization of bladder mechanoreceptors, to enhancement of transmission in the central micturition reflex pathway, or to improved effectiveness of the peripheral motor system of the bladder. The experiments were performed on female rats, anesthetized by -chloralose. Multi-unit afferent or efferent activity was recorded from bladder pelvic nerve branches during repeated cystometries before and after IVES. The specific antagonist CPPene was used to block central glutaminergic receptors of NMDA type. Micturition threshold volume decreased significantly after IVES. The afferent threshold volume, peak response, and pressure sensitivity were unchanged as were the peak efferent activity and bladder contractility. There was no efferent activity until just before the micturition contraction. The IVES-induced decrease in micturition threshold was blocked by prior administration of the NMDA (N-methyl-D-aspartic acid) antagonist CPPene (3-(2-carboxypiperazin-4-yl)-1-propenyl-1-phosphonic acid). The findings indicate that the IVES-induced modulation of the micturition reflex is due to an enhanced excitatory synaptic transmission in the central micturition reflex pathway. The observed modulation may account for the clinical beneficial effect of IVES treatment.
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| 3. |
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| 4. |
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| 5. |
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| 6. |
- Andersson, Karl Erik, et al.
(författare)
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Are there relevant animal models to set research priorities in LUTD? ICI-RS 2019
- 2020
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 39:S3, s. 9-15
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Forskningsöversikt (refereegranskat)abstract
- Aim: To discuss animal models of lower urinary tract disorders (LUTD) and their translational impact. Methods: Report of discussions based on presented literature-search based reviews relevant for the purpose. Results: Animal models can be used to investigate fundamental biological mechanisms, but also as tools to elucidate aspects of the pathogenesis of disease and to provide early evidence of any safety risk. Several different models may be required to obtain information that can have a translational impact. The term “translational research” covers not only the process of directly transferring knowledge from basic sciences to human trials to produce new drugs, devices, and treatment options for patients (T1 type translation) but also the implementation of early clinical research findings (phases I-III) into practice to improve care for patients (T2 type). Direct transfer of animal data to T2 is rarely possible, and the process often does not continue after the first trials in humans (phase I). It should be emphasized that many preclinical observations do not have (and do not need to have) immediate translational impact. Conclusions: No single animal model can mimic the complexity of the human disease. Still, animal models can be useful for gaining information on LUT function in humans, for elucidating pathophysiological mechanisms, and for the definition of targets for future drugs to treat LUT disorders.
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| 7. |
- Andersson, Karl-Erik, et al.
(författare)
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Phosphodiesterases (PDEs) and PDE inhibitors for treatment of LUTS
- 2007
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 26:6, s. 928-933
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Tidskriftsartikel (refereegranskat)abstract
- Lower urinary tract (LUT) smooth muscle can be relaxed by drugs that increase intracellular concentrations of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). Both of these substances are degraded by phosphodiesterases (PDEs), which play a central role in the regulation of smooth muscle tone. The distribution and functional significance of PDE enzymes vary in different tissues of the LUT. Targeting specific PDE isoenzymes should thus allow organ selectivity. PDE 4 and 5 appear to predominate in the prostate, PDE 1 and 4 are thought to influence detrusor smooth muscle function, and PDE 5 may be functionally important in the urethra and vasculature. Studies on the use of PDE inhibitors to treat various LUT symptoms (LUTS), have yielded favorable results. Thus, positive effects of the PDE 5 inhibitors sildenafil and tadalafil on symptoms and quality of life in men with LUTS, erectile dysfunction, and BPH have also been demonstrated. These effects may be due to effects on cGMP signaling and/or modification of afferent input from bladder, urethral, and prostate tissue. This review gives an update on the distribution of PDEs in structures relevant for LUT function, and discusses how inhibition of these enzymes can contribute to beneficial effects on LUTS. Information for the review was obtained from searches of the PubMed database, and from the authors' files.
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| 8. |
- Aronsson, Patrik, 1983, et al.
(författare)
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A novel in situ urinary bladder model for studying afferent and efferent mechanisms in the micturition reflex in the rat.
- 2014
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Ingår i: Neurourology and urodynamics. - : Wiley. - 1520-6777 .- 0733-2467. ; 33:5, s. 550-557
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The search for new animal models to investigate both efferent and afferent levels of the micturition reflex, to better understand urinary dysfunctions, is of great importance. Therefore in this study we developed and characterized, by comparisons with a conventional whole bladder model, a novel in situ model. METHODS: The urinary bladder was carefully prepared and separated, via a midline incision, into two halves all the way to the urethra in pentobarbitone and medetomidine anesthetized male rats. The separated bladder halves (with no direct connection) were immobilized with ligatures to the underlying tissue. The tension could thereafter be recorded at one side, while the other half was occasionally stretched in order to evoke an afferent signal. Also, injections of ATP and methacholine and electric nerve stimulation were employed. RESULTS: Ipsilateral stretch of 30 and 50mN induced a force-dependent contractile response on the contralateral side. Moreover, electrical stimulation of efferent pelvic nerve fibers, and intravenous injections of methacholine and ATP, evoked dose-dependent contractions, resembling responses observed in the whole bladder model. Here, the threshold frequency at electrical stimulation of the efferent fibers was <2Hz and the maximum response appeared at 10-20Hz, while afferent stimulation had a threshold of 5-10Hz with the maximum response at 40Hz. CONCLUSIONS: In the current study we show that stimulation of afferents at one side of the bladder induces, via impulses from the central nervous system, contractions from the other side. This novel model enables quantitative comparisons of changes occurring within the micturition reflex arc in bladder disorders.
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| 9. |
- Ask, Per, et al.
(författare)
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A SHORT-TIME-DELAY URINARY FLOWMETER
- 1985
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 4:3, s. 247-256
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Tidskriftsartikel (refereegranskat)abstract
- A urinary flowmeter has been designed, using a quickly rotating disc and a balance principle. The flowmeter has a fast and accurate response to changing flows. The time delay of the flowmeter is less than about 0.25 s. The improved accuracy in recording urinary flow using the presented flowmeter should make it possible to extract more information from the detrusor pressure and urinary flow relations, relevant for assessing lower urinary tract function.
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| 10. |
- Ask, Per, et al.
(författare)
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PRESSURE MEASUREMENT TECHNIQUES IN URODYNAMIC INVESTIGATIONS
- 1990
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 9:1, s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- It is apparent that the use of accurate pressure measurement techniques is essential for the outcome of urodynamic investigations. The aim of this paper is to estimate the demands on urodynamic pressure measurements and to review the properties of various techniques used. For the infused catheter technique, the dynamic properties are very much dependent on the complicance of the infusion system. With optimal infusion, the bandwidth and the pressure rise rate seem to be sufficient for most applications. Intraluminal microtransducers have a high bandwidth, but a certain fiber optic transducer cannot accurately measure mechanical pressure in the collapsed urethra. The principal differences in measuring hydrostatic pressure between the infused catheter technique and microtransducers should be observed. Flexion artefacts are a problem when measuring urethral pressure profiles. Newly developed transducers may offer a solution to this problem.
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| 11. |
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| 12. |
- Asklund, Ina, et al.
(författare)
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Mobile app for treatment of stress urinary incontinence : a randomized controlled trial
- 2017
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Ingår i: Neurourology and Urodynamics. - : John Wiley & Sons. - 0733-2467 .- 1520-6777. ; 36:5, s. 1369-1376
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To evaluate the effect of a mobile app treatment for stress urinary incontinence (SUI) in women.METHODS: Randomized controlled trial, conducted 2013-2014 in Sweden. Community-dwelling adult women with ≥1 SUI episode/week recruited through our website and randomized to app treatment (n = 62) or control group (postponed treatment, n = 61). One participant from each group was lost to follow-up. Intervention was the mobile app Tät(®) with a treatment program focused on pelvic floor muscle training (PFMT), and information about SUI and lifestyle factors. Primary outcomes, 3 months after randomization: symptom severity (International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form [ICIQ-UI SF]); and condition-specific quality of life (ICIQ Lower Urinary Tract Symptoms Quality of Life [ICIQ-LUTSqol]).RESULTS: One hundred and twenty-three women were included (mean age 44.7), with moderate/severe SUI (97.5%, 120/123), mean ICIQ-UI SF score 11.1 (SD 2.8) and mean ICIQ-LUTSqol score 34.4 (SD 6.1) at baseline. At follow-up, the app group reported improvements in symptom severity (mean ICIQ-UI SF score reduction: 3.9, 95% confidence interval 3.0-4.7) and condition-specific quality of life (mean ICIQ-LUTSqol score reduction: 4.8, 3.4-6.2) and the groups were significantly different (mean ICIQ-UI SF score difference: -3.2, -4.3to -2.1; mean ICIQ-LUTSqol score difference: -4.6, -7.8 to -1.4). In the app group, 98.4% (60/61) performed PFMT at follow-up, and 41.0% (25/61) performed it daily.CONCLUSIONS: The mobile app treatment was effective for women with SUI and yielded clinically relevant improvements. This app may increase access to first-line treatment and adherence to PFMT.
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| 13. |
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| 14. |
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| 15. |
- Austin, Paul F., et al.
(författare)
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The standardization of terminology of lower urinary tract function in children and adolescents : Update report from the standardization committee of the International Children's Continence Society
- 2016
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 35:4, s. 471-481
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Tidskriftsartikel (refereegranskat)abstract
- AimThe impact of the original International Children's Continence Society (ICCS) terminology document on lower urinary tract (LUT) function resulted in the global establishment of uniformity and clarity in the characterization of LUT function and dysfunction in children across multiple healthcare disciplines. The present document serves as a stand-alone terminology update reflecting refinement and current advancement of knowledge on pediatric LUT function. MethodsA variety of worldwide experts from multiple disciplines within the ICCS leadership who care for children with LUT dysfunction were assembled as part of the standardization committee. A critical review of the previous ICCS terminology document and the current literature was performed. Additionally, contributions and feedback from the multidisciplinary ICCS membership were solicited. ResultsFollowing a review of the literature over the last 7 years, the ICCS experts assembled a new terminology document reflecting current understanding of bladder function and LUT dysfunction in children using the resources from the literature review, expert opinion and ICCS member feedback. ConclusionsThe present ICCS terminology document provides a current and consensus update to the evolving terminology and understanding of LUT function in children.
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| 16. |
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| 17. |
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| 18. |
- Burgu, Berk, et al.
(författare)
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Can the outcome of autoaugmentation omentocystoplasty be improved? Urodynamic, histological, and collagen content evaluation in sheep model.
- 2011
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Ingår i: Neurourology and urodynamics. - : Wiley. - 1520-6777 .- 0733-2467. ; 30:7, s. 1371-5
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Tidskriftsartikel (refereegranskat)abstract
- To compare histological and urodynamic outcome of the classical detrusorotomy with and without the aid of intravesical balloon distension. We also describe a new technique with multiple detrusor incisions instead of detrusorotomy.A total of 24 animals were included in the study. Three different techniques of autoaugmentation cystoplasty were applied to surgically reduced bladders of 14 sheep. Five sheep underwent surgical reduction of bladder capacity as control group and five sheep underwent sham operation. In Group DIB (detrusor incision with balloon), standard whole thickness incisions on bladder wall were performed and a silicon balloon was inflated intravesically postoperatively. Group DMB (detrusorotomy with balloon) and Group DM (detrusorotomy) underwent standard detrusorotomy. After measuring capacities and compliances, animals were sacrificed on 90th postoperative day. Bladders were histopathologically evaluated. Expression of vascular endothelial growth factor (VEGF), CD31, and microvessel density (MVD) was noted. Quantification of collagen subtypes was also performed.The mean capacity and compliance for Group DM and control were not significantly different and both were lower than other augmentation groups and sham. In Groups DMB and DM fibrosis was significantly increased. The VEGF expression was lower in Group DIB with respect to other augmentation groups whereas MVD was not significantly different. Measurement of total collagen and collagen subtypes revealed an increase in total collagen of groups DMB and DM when compared to other groups. Quantification of collagen subtypes demonstrated that types I and III were significantly increased in aforementioned groups.Autoaugmentation omentocystoplasty in sheep model does not result in a reliable increase in bladder capacity and compliance. Intravesical balloon inflation makes the achievement more pronounced and significantly increases the bladder capacity and compliance.
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| 19. |
- Carlsson Farrelly, Elisabeth, et al.
(författare)
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One treatment with onabotulinumtoxinA relieves symptoms of overactive bladder in patients refractory to one or more oral medications
- 2023
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Ingår i: Neurourology and Urodynamics. - : John Wiley & Sons. - 0733-2467 .- 1520-6777. ; 42:6, s. 1203-1213
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and Hypothesis: Patients with overactive bladder (OAB) often undergo prolonged treatment with one or more oral OAB medications. OnabotulinumtoxinA (onabotA), a type A botulinum toxin, may provide an appropriate alternative to oral treatments in patients intolerant of or refractory to one or more oral OAB medications. The GRACE study demonstrated real-world benefits of onabotA treatment for OAB in patients refractory to oral medications. This exploratory post hoc analysis of data from the GRACE study aims to determine if treatment history impacts benefit from treatment with onabotA.Methods: This is a subanalysis of the GRACE study, a prospective observational study (NCT02161159) that enrolled patients with symptomatic OAB inadequately managed by at least one oral OAB medication. Patients had a treatment history of one or more anticholinergics (AC) and/or β-3 adrenoreceptor agonists (β-3) for relief of OAB; results were stratified according to treatment history. Patients in this analysis elected to discontinue oral medications upon treatment with onabotA. Safety was followed for 12 months in all patients that received at least 1 dose of onabotA; efficacy was determined over a 12-week period.Results: Compared to baseline levels, significant reductions in urinary incontinence (UI), urgency, micturition, and nocturia were noted as early as 1 week and were sustained at 12 weeks, regardless of the type and number of oral medications taken before treatment with onabotA. At 12 weeks post-onabotA, the mean change from baseline UI episodes/day for those with a treatment history of only one AC was −2.4 (n = 43, p ≤ 0.001); more than one AC, −2.4 (n = 52, p ≤ 0.001); one β-3, −3.3 (n = 12, p < 0.05); at least one AC and at least one β-3, −3.2 (n = 56, p ≤ 0.001). Pad and liner use was significantly decreased at 12 weeks post-onabotA across all treatment history groups. Reductions in diaper pant use varied, with less of a reduction in patients with a treatment history of more than one AC compared to patients with a history of at least one AC and one β-3 (p < 0.05) or those with a history of only one AC (p < 0.05). Overall, a total of 253/288 of patients (88%) reported improvements on the treatment benefit scale 12 weeks after treatment with onabotA, regardless of type and number of prior oral medications. In the population of patients that received at least one dose of onabotA (N = 504), 57 adverse events were reported in 38 patients (7.5%); 9 were serious (1.8%). Urinary retention was reported in 5 patients (1.0%); 1 was severe (0.2%). Symptomatic urinary tract infection was reported in 2 patients (0.4%).Conclusions: In this exploratory post hoc analysis of real-world data from the GRACE study, there were few significant differences in outcomes based on the type and number of prior oral medications. Thus, patients who are refractory to one or more oral OAB medications may benefit from earlier treatment with onabotA.
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| 20. |
- Chakrabarty, Basu, et al.
(författare)
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Nitric oxide signaling pathways in the normal and pathological bladder: Do they provide new pharmacological pathways?—ICI-RS 2023
- 2023
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Ingår i: Neurourology and Urodynamics. - 0733-2467 .- 1520-6777.
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Forskningsöversikt (refereegranskat)abstract
- Aims: The nitric oxide (NO•)/soluble guanylate cyclase/cyclic-GMP (cGMP) signaling pathway is ubiquitous and regulates several functions in physiological systems as diverse as the vascular, nervous, and renal systems. However, its roles in determining normal and abnormal lower urinary tract functions are unclear. The aim was to identify potential therapeutic targets associated with this pathway to manage lower urinary tract functional disorders. Methods: This review summarizes a workshop held under the auspices of ICI-RS with a view to address these questions. Results: Four areas were addressed: NO• signaling to regulate neurotransmitter release to detrusor smooth muscle; its potential dual roles in alleviating and exacerbating inflammatory pathways; its ability to act as an antifibrotic mediator; and the control by nitrergic nerves of lower urinary tract vascular dynamics and the contractile performance of muscular regions of the bladder wall. Central to much of the discussion was the role of the NO• receptor, soluble guanylate cyclase (sGC) in regulating the generation of the enzyme product, the second messenger cGMP. The redox state of sGC is crucial in determining its enzymic activity and the role of a class of novel agents, sGC activators, to optimize activity and to potentially alleviate the consequences of lower urinary tract disorders was highlighted. In addition, the consequences of a functional relationship between nitrergic and sympathetic nerves to regulate vascular dynamics was discussed. Conclusions: Several potential NO•-dependent drug targets in the lower urinary tract were identified that provide the basis for future research and translation to clinical trials.
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| 21. |
- Chen, Hui, et al.
(författare)
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Repeat periods of electrical stimulation prolong the modulation of the micturition reflex in the rat
- 2018
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Ingår i: Neurourology and Urodynamics. - : WILEY. - 0733-2467 .- 1520-6777. ; 37:8, s. 2480-2486
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Tidskriftsartikel (refereegranskat)abstract
- AimsMethodsThe aim of this study was to determine if the duration of the micturition reflex modulation could be prolonged by repeated periods of afferent stimulation in the decorticated rat. Eighteen female Sprague-Dawley rats were used for the study, 10 for intravesical electrical stimulation (IVES), and 8 for Ano-genital pudendal afferents stimulation. Repeated constant flow cystometries were performed with body-warm saline (0.06-0.1mL/min) at about 10min interval. The selected afferents were stimulated continuously for 5min at maximal intensity. The same stimulation was repeated six times with a pause of 5min between the stimulations. The mean threshold volume of cystometries performed during one hour before and each hour after the stimulation were compared. ResultsConclusionsAfter six periods of IVES, the micturition threshold volume decreased to its lowest value (62% of control) during the first hour and remained at 80% 4h later (n=10, Pamp;lt;0.01). Ano-genital afferent stimulation produced a corresponding increase in the micturition threshold volume. The long-lasting poststimulation effect was again observed for more than 5h. During the first hour the mean threshold volume increased to 211% of controls and it remained at about this level for the entire observation period (n=8, Pamp;lt;0.01). Repeated short periods of stimulation prolonged the modulatory effect well beyond the stimulation period. The findings provide experimental evidence supporting the clinical application of IVES and ano-genital stimulation for treatment of neurogenic urinary bladder dysfunction.
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| 22. |
- Coyne, Karin S, et al.
(författare)
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Moving towards a comprehensive assessment of lower urinary tract symptoms (LUTS).
- 2012
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Ingår i: Neurourology and urodynamics. - : Wiley. - 1520-6777 .- 0733-2467. ; 31:4, s. 448-54
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the utility of the International Prostate Symptom Score (IPSS) and the LUTS Tool when assessing lower urinary tract symptoms (LUTS). Secondary objectives were to examine associations of LUTS and treatment seeking.
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| 23. |
- de Boer, T A, et al.
(författare)
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Pelvic organ prolapse and overactive bladder.
- 2010
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Ingår i: Neurourology and urodynamics. - : Wiley. - 1520-6777 .- 0733-2467. ; 29:1, s. 30-9
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Forskningsöversikt (refereegranskat)abstract
- AIMS: In this review we try to shed light on the following questions: *How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP? *Does the presence of OAB symptoms depend on the prolapsed compartment and/or stage of the prolapse? *What is the possible pathophysiology of OAB in POP? *Do OAB symptoms and DO change after conservative or surgical treatment of POP? METHODS: We searched on Medline and Embase for relevant studies. We only included studies in which actual data about OAB symptoms were available. All data for prolapse surgery were without the results of concomitant stress urinary incontinence (SUI) surgery. RESULTS: Community- and hospital-based studies showed that the prevalence of OAB symptoms was greater in patients with POP than without POP. No evidence was found for a relationship between the compartment or stage of the prolapse and the presence of OAB symptoms. All treatments for POP (surgery, pessaries) resulted in an improvement in OAB symptoms. It is unclear what predicts whether OAB symptoms disappear or not. When there is concomitant DO and POP, following POP surgery DO disappear in a proportion of the patients. Bladder outlet obstruction is likely to be the most important mechanism by which POP induces OAB symptoms and DO signs. However, several other mechanisms might also play a role. CONCLUSIONS: There are strong indications that there is a causal relationship between OAB and POP.
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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Ehrén, Ingrid, et al.
(författare)
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Cognitive challenges in persons with spina bifida : Bearing on urological dysfunctions?
- 2020
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Ingår i: Neurourology and Urodynamics. - : John Wiley & Sons. - 0733-2467 .- 1520-6777. ; 39:8, s. 2139-2145
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate if adult persons with spina bifida (SB) who have urinary tract complications have cognitive difficulties that can be identified by neuropsychological tests.METHODS: All individuals with SB ≥ 18 years of age registered at a regional outpatient clinic (n = 219) were invited, of which, 154 persons were included. Neuropsychological assessment of their cognitive status was performed with Wechsler Adult Intelligence Scale®-Fourth Edition: Coding, Block design, Arithmetic's, FAS (word generation), Rey Auditory Verbal Test for learning, and delayed recall 30 min. Bladder and bowel function were assessed with questions used by the Nordic Spinal Cord Injury Registry (NSCIR) in structured interviews, by questionnaires, and by chart reviews.RESULTS: Average neuropsychological test results for this SB population was shown to be approximately 1 SD under the median for the general population. The Coding test showed significantly lower test results as compared with the whole SB group in persons with urinary tract complications, especially urinary tract infections, reduced kidney function, dependent emptying of the bladder, and the bowel and accidental bowel leakage. The Arithmetic's test showed a significant difference between subgroups in all parameters except reduced kidney function whereas the other neuropsychological tests were significantly correlated with some but not all urological parameters.CONCLUSION: We propose neuropsychological testing with primarily two tests to find those persons with SB who, due to cognitive challenges, might need extra support to minimize urological complications.
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| 28. |
- Ehrén, Ingrid, et al.
(författare)
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Voiding conditions, renal and bowel function in a cohort of adults with spina bifida
- 2020
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 39:6, s. 1796-1802
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To map voiding patterns, degree of continence, use of drugs for voiding disorders, kidney function and surgical interventions but also the bowel function in a near-total regional cohort of adults with spina bifida aged more than or equal to 18 years.METHODS: All individuals more than or equal to 18 years of age with spina bifida registered at a regional outpatient clinic (n = 219) were invited to participate, of which 196 persons were included. Bladder and bowel function were assessed according to questions used by the Nordic Spinal Cord Injury Registry by structured interviews and questionnaires in combination with review of patient charts including kidney function.RESULTS: Twenty percent of the patients voided spontaneously. Fifty-four percent used clean intermittent catherization (CIC) and of these, 14% had also undergone augmentation of the bladder and/or implantation of an artificial sphincter or sling, 23% had undergone major urological surgery, and 3% had an indwelling catheter. Seventeen percent of patients voiding spontaneously or using CIC reported total continence but as many as 36% reported daily leakage. Anticholinergics was the most common drug, used by 21% in the total cohort. About 13% of the patients had a reduced kidney function but only 1.5% had end stage renal failure. Seventy-three percent had problems emptying the bowel and 18% experienced fecal leakage weekly or even daily.CONCLUSION: We found a large variation in problems with bladder and bowel function in this adult group of persons with spina bifida. A structured customized program for follow-up seems necessary to optimize their health status in these areas.
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| 29. |
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| 31. |
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| 32. |
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| 33. |
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| 34. |
- Fraser, Matthew O., et al.
(författare)
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Best practices for cystometric evaluation of lower urinary tract function in muriform rodents
- 2020
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 39:6, s. 1868-1884
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Rodent cystometry has provided valuable insights into the impact of the disease, injury, and aging on the cellular and molecular pathways, neurologic processes, and biomechanics of lower urinary tract function. The purpose of this white paper is to highlight the benefits and shortcomings of different experimental methods and strategies and to provide guidance on the proper interpretation of results. Methods: Literature search, selection of articles, and conclusions based on discussions among a panel of workers in the field. Results: A range of cystometric tests and techniques used to explore biological phenomena relevant to the lower urinary tract are described, the advantages and disadvantages of various experimental conditions are discussed, and guidance on the practical aspects of experimental execution and proper interpretation of results are provided. Conclusions: Cystometric evaluation of rodents comprises an extensive collection of functional tests that can be performed under a variety of experimental conditions. Decisions regarding which approaches to choose should be determined by the specific questions to be addressed and implementation of the test should follow standardized procedures.
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| 35. |
- Frederiksen, Hans, et al.
(författare)
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Nerve induced responses and force-velocity relations of regenerated detrusor muscle after subtotal cystectomy in the rat.
- 2004
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 23:2, s. 159-165
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To study the pharmacological and mechanical properties of newly developed detrusor muscle after subtotal cystectomy, to explore if the regenerated detrusor has characteristics similar to the normal bladder base, from which it regenerated, or to the normal bladder body which it replaces. METHODS: Partial cystectomy was performed in female rats. Fifteen weeks later, detrusor strips were cut from supratrigonal and equatorial segments. Unoperated rats served as controls. Responses to field stimulation were obtained in the absence and presence of scopolamine, prazosin, and P2X1 blockade. Dose-response curves were obtained for carbachol, alpha,beta-methylene-ATP, and phenylephrine. Force-velocity data were obtained on maximally activated chemically skinned preparations. RESULTS: Maximal contractile response to field stimulation was 60% of that to high-K+ with no difference between strips from control and cystectomy bladders. Prazosin had no effect. Scopolamine decreased maximal response of supratrigonal strips to 62 +/- 6 (controls) and 61 +/- 4% (operated) of that without blocker. For equatorial strips the decrease was to 81 +/- 5 (controls) and 58 +/- 8% (operated). Frequency-response relations were obtained during blockade with scopolamine, alpha,beta-methylene-ATP, and prazosin. Supratrigonal strips showed a pronounced additional inhibition up to 40 Hz. Equatorial strips from controls were completely inhibited at all frequencies. Equatorial strips from operated bladders were inhibited up to 20 Hz but not at 40 and 60 Hz. Carbachol EC(50) values were similar in all groups. Maximum response to phenylephrine was 10-20% of high-K+ response. Maximal shortening velocity (Vmax) was similar in control supratrigonal and equatorial strips, but was significantly lower in the operated bladders. CONCLUSIONS: (1): A regional difference exists in pharmacological properties of control detrusor, with a considerable contractile response to stimulation remaining in the supratrigonal muscle after simultaneous cholinergic, adrenergic, and purinergic blockade. (2): The new detrusor was functionally well innervated with no supersensitivity to muscarinic stimulation. (3): The newly formed bladder body had pharmacological properties specific for the supratrigonal segment from which it had developed. (4): There was no regional difference in force-velocity characteristics of the control detrusor. (5): The lowered Vmax in the newly formed bladder might thus be related to growth and regeneration of muscle cells.
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| 36. |
- Frederiksen, Hans, et al.
(författare)
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Regeneration of detrusor muscle after subtotal cystectomy in the rat; effects on contractile proteins and bladder mechanics.
- 2001
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 20:6, s. 685-697
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to determine to what extent adult rats can produce new contracting bladder muscle and to see if such newly formed bladder tissue possesses characteristic mechanical properties or whether the ability to recover mechanically is so pronounced that the prehistory of the bladder is unimportant. Subtotal cystectomy was performed in adult female rats, leading to a pronounced decrease in total bladder weight. At 10 weeks, bladder weight had normalized. The histological appearance of such bladders was similar to that of the controls. Active and passive length-tension relations for the detrusor muscle were determined in controls and up to 10 weeks after surgery. Immediately after surgery active and passive forces showed a leftward shift and maximum active force decreased markedly. With time the length-tension curves shifted back to normal, but a decreased active force still remained at 10 weeks. Detrusor actin concentration and detrusor myosin/actin ratio were unaffected by the subtotal cystectomy. Intermediate filament protein/actin ratio showed a significant but transitory increase. We conclude that there is a remarkable recovery of detrusor muscle function after subtotal cystectomy, leading to a normalization of optimum length for active force and a net synthesis of contractile and cytoskeletal proteins. The ability to produce active force does, however, not fully recover.
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| 37. |
- Fry, Christopher Henry, et al.
(författare)
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New targets for overactive bladder—ICI-RS 2109
- 2020
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 39:S3, s. 113-121
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Forskningsöversikt (refereegranskat)abstract
- Aim: To review evidence for novel drug targets that can manage overactive bladder (OAB) symptoms. Methods: A think tank considered evidence from the literature and their own research experience to propose new drug targets in the urinary bladder to characterize their use to treat OAB. Results: Five classes of agents or cellular pathways were considered. (a) Cyclic nucleotide–dependent (cyclic adenosine monophosphate and cyclic guanosine monophosphate) pathways that modulate adenosine triphosphate release from motor nerves and urothelium. (b) Novel targets for β3 agonists, including the bladder wall vasculature and muscularis mucosa. (c) Several TRP channels (TRPV1, TRPV4, TRPA1, and TRPM4) and their modulators in affecting detrusor overactivity. (d) Small conductance Ca2+-activated K+ channels and their influence on spontaneous contractions. (e) Antifibrosis agents that act to modulate directly or indirectly the TGF-β pathway—the canonical fibrosis pathway. Conclusions: The specificity of action remains a consideration if particular classes of agents can be considered for future development as receptors or pathways that mediate actions of the above mentioned potential agents are distributed among most organ systems. The tasks are to determine more detail of the pathological changes that occur in the OAB and how the specificity of potential drugs may be directed to bladder pathological changes. An important conclusion was that the storage, not the voiding, phase in the micturition cycle should be investigated and potential targets lie in the whole range of tissue in the bladder wall and not just detrusor.
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| 38. |
- Fuellhase, Claudius, et al.
(författare)
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Spinal neuronal cannabinoid receptors mediate urodynamic effects of systemic fatty acid amide hydrolase (FAAH) inhibition in rats
- 2016
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Ingår i: Neurourology and Urodynamics. - : WILEY-BLACKWELL. - 0733-2467 .- 1520-6777. ; 35:4, s. 464-470
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Tidskriftsartikel (refereegranskat)abstract
- AimsTo test if urodynamic effects from systemic Fatty Acid Amide Hydrolase (FAAH) inhibition involve sacral spinal cannabinoid type 1 (CB1) or type 2 (CB2) receptors. MethodsMale rats with or without partial urethral obstruction were used for cystometry or immunohistochemistry. Urodynamic effects of intravenous (IV) 0.3mg/kg Oleoyl Ethyl Amide (OEtA; FAAH inhibitor), and intrathecal (IT) 5g rimonabant (CB1 antagonist) or 5g SR144528 (CB2 antagonist) were studied in awake rats. ResultsAfter administration of rimonabant or SR144528, non-obstructed rats with normal bladder function developed bladder overactivity (BO), which was counteracted by OEtA. OEtA also counteracted BO in obstructed rats. SR144528 did not affect bladder function in obstructed rats but counteracted the urodynamic effects of OEtA. Surprisingly, rimonabant (and AM251, another CB1 antagonist) reduced BO in obstructed rats, whereafter OEtA produced no additional urodynamic effects. CB1 expression increased in the sacral spinal cord of obstructed rats whereas no changes were observed for CB2 or FAAH. ConclusionsUrodynamic effects of systemic FAAH inhibition involve activities at spinal neuronal CB1 and CB2 receptors in normal and obstructed rats. Endogenous spinal CB receptor ligands seem to regulate normal micturition and BO. Altered spinal CB receptor functions may be involved in the pathogenesis of obstruction-induced BO. Neurourol. Urodynam. 35:464-470, 2016. (c) 2015 Wiley Periodicals, Inc.
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| 39. |
- Gandaglia, G., et al.
(författare)
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The fatty acid amide hydrolase inhibitor oleoyl ethyl amide counteracts bladder overactivity in female rats
- 2014
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Ingår i: Neurourology and Urodynamics. - : John Wiley & Sons. - 0733-2467 .- 1520-6777. ; 33:8, s. 1251-1258
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Tidskriftsartikel (refereegranskat)abstract
- AIMS:To study micturition and bladder overactivity in female rats after chronic treatment with the fatty acid amide hydrolase (FAAH) inhibitor oleoyl ethyl amide (OEtA).METHODS:Sprague-Dawley rats received daily subcutaneous injections of OEtA (0.3 mg/kg), or vehicle for 2 weeks. Cystometries, organ bath studies, Western blot, and immunofluorescence were then used. Expressions of FAAH, cannabinoid 1 and 2 receptors (CB1 and CB2), mitogen-activated protein kinase (MAPK), vesicular acetyl choline-transporter protein (VAChT), and calcitonin gene-related peptide (CGRP) were evaluated.RESULTS:At baseline, OEtA-treated rats had higher values (P < 0.05) of micturition intervals (MI) and volumes (MV), bladder capacity (BC), threshold pressure, and flow pressure than vehicle controls. Intravesical PGE2 reduced MI, MV, and BC, and increased basal pressure and the area under the curve in all rats. However, these urodynamic parameters were altered less by intravesical PGE2 in OEtA-treated rats (P < 0.05 vs. vehicle controls). Compared to vehicle controls, detrusor from OEtA-treated rats had larger contractions to carbachol at 10-0.1 µM, but no difference in Emax was recorded. FAAH, CB1, CB2, VAChT, or CGRP was similarly expressed in bladders from all rats. In separate experiments, intravesical OEtA increased mucosal expression of phosphorylated MAPK.CONCLUSIONS:Chronic FAAH inhibition altered sensory urodynamic parameters and reduced bladder overactivity. Even if it cannot be excluded that OEtA may act on central nervous sensory pathways to contribute to these effects, the presence of FAAH and CB receptors in the bladder and activation of intracellular signals for CB receptors by intravesical OEtA suggest a local role for FAAH in micturition control. Neurourol. Urodynam
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| 40. |
- Gladh, Gunilla, 1943-
(författare)
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Effect of thoughtful preparation on the catheterization of children undergoing investigative studies
- 2003
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 22:1, s. 58-61
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Tidskriftsartikel (refereegranskat)abstract
- Aims:To evaluate an anesthetic sedation free method of transurethral catheterization in children.Methods:The child and his or her parents are thoroughly prepared for the procedure by means of written and oral child-adapted information and practical instructions. To evaluate this routine, a simple questionnaire was given to 115 consecutive children undergoing transurethral catheterization.Results:The questionnaire was returned by 99 children (86%). Most children and parents (95) found the preparation“good”or“very good”and tolerated the catheterization procedure well. Only six children reported the catheterization to be“very painful”(without requiring that the procedure was terminated). Complications, such as urgency, smarting pain during voidings, or both, after withdrawal of the catheter, occurred in 12 children and urinary tract infections in 3. Unexpectedly, girls were affected more often than boys.Conclusions:Careful preparation of children and their parents allows the great majority of diagnostic studies that require urethral catheterization to be accomplished without anesthesia. Neurourol. Urodynam. 22:58–61, 2003. © 2003 Wiley-Liss, Inc.
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| 41. |
- Gladh, Gunilla, 1943-, et al.
(författare)
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Intravesical electrical stimulation in the treatment of micturition dysfunction in children
- 2003
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 22:3, s. 233-242
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Tidskriftsartikel (refereegranskat)abstract
- Aims To evaluate the results of intravesical electrical stimulation (IVES) in an open prospective study to treat underactive detrusor in children. The treatment was offered as an alternative to clean intermittent catheterization (CIC).Methods Forty-four children were included, 21 girls and 3 boys (6–16 years, md 10) with idiopathic, 9 girls and 11 boys (4–18 years; md 13) with neurogenic underactive detrusor. IVES was given by a catheter electrode in the bladder (cathode) with the anode attached to the suprapubic abdominal skin. Continuous stimulation at 20 or 25 Hz was delivered by battery powered stimulators giving unipolar square-wave pulses (0,2 or 0,7 ms). Stimulation intensity was adjusted individually according to the acceptance of the child (12–64 mA). IVES was initially given at the clinic but 18 children had additional treatment at home. Effect of treatment was monitored by micturiton/incontinence diary, reports of bladder sensation, recordings of urinary flow, residual volume and frequency of urinary tract infections.Results The IVES-treatment was completed by 39/44 children. Long term normalization of the voiding (md 2,5 years follow up) was obtained for 20/24 children with idiopathic problems (83%) and 8/20 with neurogenic problems (40%). Another four had much improved bladder function. The neurogenic group required more stimulation sessions than the idiopathic group. Of those on CIC, 11/15 who completed IVES could discontinue the catheterization. The frequency of urinary tract infections and incontinence decreased significantly (P < 0.01).Conclusions It is concluded that IVES is a promising method to treat the underactive detrusor in children.
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| 42. |
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| 43. |
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| 44. |
- Hashim, Hashim, et al.
(författare)
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Desmopressin, as a "Designer-Drug," in the Treatment of Overactive Bladder Syndrome
- 2009
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 28:1, s. 40-46
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This study looked at whether oral desmopressin, by decreasing kidney urine production, would prolong bladder filling-time thereby increasing the time to reach maximum capacity, thus reducing overactive bladder (OAB) symptoms, and providing an alternative method of treatment to OAB sufferers. Methods: An investigator-initiated, 2-week, multi-national, multi-centre, "proof-of-concept," phase IIb, double-blind, placebo-controlled, prospective, randomized, cross-over study was conducted using 0.2 mg of oral desmopressin in adults suffering with OAB. Patients were included in the trial period if they had >= 4 voids in the first 8-hr of the day after rising, excluding the first morning void. The primary endpoint was evaluation of effectiveness of desmopressin in increasing the time to the first OAB symptom episodes during the first 8-hr following treatment. Results: Time to first void was 8-min later on the drug than on placebo (P = 0.27). However, the drug led to one less void (3.2 vs. 4.2) in the same period (P < 0.001). There was an increase in the time to first urgency episode with a decrease in the number of urgency episodes in the drug days compared to placebo (P < 0.003). There was a subjective improvement in frequency and urgency and overall quality-of-life as measured by the ICIQ-OAB. Twenty-seven people reported adverse events which were all mild, headache being the commonest and no hyponatremia was recorded. Conclusions: Antidiuresis, using oral desmopressin tablets, is a novel, feasible and safe (short-term basis) method of treatment for adults with OAB, and could be considered in the armamentarium of drugs available for the treatment of OAB. Neurourol. Urodynam. 28:40-46, 2009. (C) 2008 Wiley-Liss, Inc.
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| 45. |
- Hedlund, Petter
(författare)
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Cannabinoids and the Endocannabinoid System in Lower Urinary Tract Function and Dysfunction
- 2014
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Ingår i: Neurourology and Urodynamics. - : Wiley-Blackwell. - 0733-2467 .- 1520-6777. ; 33:1, s. 46-53
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Tidskriftsartikel (refereegranskat)abstract
- AimsTo review knowledge on cannabinoids and the endocannabinoid system in lower urinary tract function and dysfunction. MethodsReview of MEDLINE using defined search terms, and manual analysis. Articles published in English were included. Results and DiscussionComponents of the endocannabinoid systemcannabinoid (CB) receptor types 1 and 2, anandamide, and fatty acid amide hydrolase (FAAH), which degrades anandamide and related fatty-acid amideshave been located to lower urinary tract tissues of mice, rats, monkeys, and humans. Studies have located CB receptors in urothelium and sensory nerves and FAAH in the urothelium. CB receptor- and FAAH-related activities have also been reported in the lumbosacral spinal cord. Data on supraspinal CB functions in relation to micturition are lacking. Cannabinoids are reported to reduce sensory activity of isolated tissues, cause antihyperalgesia in animal studies of bladder inflammation, affect urodynamics parameters reflecting sensory functions in animals models, and appear to have effects on storage symptoms in humans. FAAH inhibitors have affected sensory bladder functions and reduced bladder overactivity in rat models. Cannabinoids may modify nerve-mediated functions of isolated lower urinary tract tissues. ConclusionsEvidence suggests components of the endocannabinoid system are involved in regulation of bladder function, possibly at several levels of the micturition pathway. It is unclear if either CB receptor has a dominant role in modification of sensory signals or if differences exist at peripheral and central nervous sites. Amplification of endocannabinoid activity by FAAH inhibitors may be an attractive drug target in specific pathways involved in LUTS.
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| 46. |
- Ishizuka, O, et al.
(författare)
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Role of supraspinal serotonin receptors for micturition in normal conscious rats
- 2002
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 21:3, s. 225-230
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Tidskriftsartikel (refereegranskat)abstract
- Serotonin (5-HT) receptors are widely distributed in the central nervous system, including several areas involved in the control of micturition reflex pathways. However, the roles of the different subtypes of 5-HT receptors are not well known. We studied in normal, conscious rats, the effects on the cystometrogram of intracerebroventricular (i.c.v.) administration of 5-HT, 8-hydroxy-2-(di-N-propylaminotetralin) (8-OH-DPAT; agonist at 5-HT1A receptors), alpha-methol-5-hydroxytryptamine maleate (agonist at 5-HT2 receptors), 2-methyl-5-hydroxytryptamine hydrochloride (agonist at 5-HT3 receptors), and 1-(4-amino-5-chloro-2methoxyphenyl)-3-(1-n-butyl-4piperidinyl)-1-propano ne hydrochloride (RS67506; agonist at 5-HT4 receptors). Female Sprague-Dawley rats, weighing approximately 230 g, were used. A polyethylene catheter was inserted into the bladder through the dome for cystometric investigations. For administration of drugs, a catheter was implanted into the right cerebral ventricle. Three days after implantation of the bladder catheter, continuous cystometry was performed. Administration of 5-HT (6 nmol/kg i.c.v.), 8-OH-DPAT (6 nmol/kg), alpha-methyl-5-hydroxytryptamine maleate (6 nmol/kg), or RS67506 hydrochloride (6 nmol/kg) significantly (P < 0.05) increased micturition pressure and decreased bladder capacity and micturition volume. The effects increased in a dose-dependent manner (18, 60 nmol/kg). Intracerebroventricular administration of 2-methyl-5-hydroxytryptamine hydrochloride (60 nmol/kg) caused no change in the cystometric parameters. The results suggest that in normal conscious rats, at the supraspinal level, 5-HT (via 5-HT1A, 5-HT2, and 5-HT4 receptors) can enhance the micturition reflex induced by bladder filling. Whether this means that 5-HT1A, 5-HT2, and 5-HT4 receptors can be targets for drugs meant for treatment of bladder hyperactivity, should be explored. (C) 2002Wiley-Liss, Inc.
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| 47. |
- Jiang, Chonghe, et al.
(författare)
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Gating of the Micturition Reflex by Tonic Activation of Bladder Cold Receptors in the Cat
- 2009
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Ingår i: NEUROUROLOGY AND URODYNAMICS. - : Wiley. - 0733-2467 .- 1520-6777. ; 28:6, s. 555-560
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To determine whether C afferents can modify the gating of the A delta micturition reflex in order to identify the neuronal site of interaction of the two afferent systems. Methods: Adult female cats, anaesthetized with a.-chloralose, had their bladder and urethra catherized through a slit in the proximal urethra. Micturition threshold volume was assessed by cystometry and bladder efferent activity recorded simultaneously. The bladder was filled at a slow rate (1.2-3.5 ml/min) with either body-warm saline (control) or menthol solution (0.06 mM) or by cold saline (4 degrees C). Results: Of 14 trial sessions in 5 animals, the threshold volume of the A delta micturition reflex was consistently reduced by menthol infusions from a control median (md) value of 16.8 to 10.2 ml (P andlt; 0.01). The threshold pressure was also somewhat decreased from and 0.7 to 0.5 kPa (P andlt; 0.05), while the peak pressure or pressure slope did no differ in two situations. Similar results were obtained with slow cold infusions into the bladder (nine sessions in three animals). The threshold volume decreased from and 19.8 to 17.4 ml (P andlt; 0.05). The bladder reflex response to slow menthol or cold infusions had the typical features of an A delta micturition reflex in that the efferent activity was largely abolished by the bladder A delta mechanoreceptor unloading. Conclusions: Gradual tonic activation of bladder cold receptors lowers the threshold volume of the ordinary A delta micturition, pointing to a segmental spinal mechanism for the gating of the micturition reflex. Neurourol. Urodyrzam. 28:555-560, 2009.
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| 48. |
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| 49. |
- Khullar, Vik, et al.
(författare)
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The relationship between BMI and urinary incontinence subgroups: Results from EpiLUTS.
- 2014
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Ingår i: Neurourology and urodynamics. - : Wiley. - 1520-6777 .- 0733-2467. ; 33:4, s. 392-399
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To evaluate the relationship between body mass index (BMI) and urinary incontinence (UI) in adults ≥40 from the United States, United Kingdom, and Sweden. METHODS: This was a secondary analysis of EpiLUTS-a population-representative, cross-sectional, Internet-based survey conducted to assess the prevalence and HRQL impact of urinary symptoms. UI was evaluated by the LUTS Tool and categorized by subgroups: no UI, urgency urinary incontinence (UUI), stress urinary incontinence (SUI), mixed urinary incontinence (MUI) (UUI+SUI), UUI+other UI (OI), SUI+OI, and OI. Descriptive statistics were used. Logistic regressions examined the relationship of BMI to UI controlling for demographics and comorbid conditions. RESULTS: Response rate was 59%; 10,070 men and 13,178 women were included. Significant differences in BMI were found across UI subgroups. Obesity rates were highest among those with MUI (men and women), SUI+OI (women), UUI and UUI+OI (men). Logistic regressions of each UI subgroup showed that BMI≥30 (obese) was associated with UI in general and MUI (women) and UUI+OI (men). Among women, being obese increased the odds of having SUI and SUI+OI. Women with BMI 25-29.9 (overweight) were more likely to have UI in general and SUI with and without other incontinence (SUI, MUI, and SUI+OI). Being overweight was unrelated to any form of UI in men. CONCLUSIONS: Results were consistent with prior research showing BMI is associated with higher risk of UI. These findings indicate substantial differences in obesity by gender and UI subtype, suggesting different mechanisms for UI other than purely mechanical stress on the bladder. Neurourol. Urodynam. 9999:1-8, 2013. © 2013 Wiley Periodicals, Inc.
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| 50. |
- Kirby, Michael G, et al.
(författare)
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Overactive bladder: Is there a link to the metabolic syndrome in men?
- 2010
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Ingår i: Neurourology and urodynamics. - : Wiley. - 1520-6777 .- 0733-2467. ; 29:8, s. 1360-4
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Tidskriftsartikel (refereegranskat)abstract
- It is becoming increasingly clear that a variety of metabolic, cardiovascular, and endocrine factors contribute to male pelvic health. In particular, a growing body of evidence suggests a relationship between lower urinary tract symptoms, benign prostatic hyperplasia, overactive bladder, erectile dysfunction, and the metabolic syndrome. This article explores these relationships, focusing on the role of the autonomic nervous system and hyperinsulinemia, together with their implications for urological practice.
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