| 111. |
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| 112. |
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| 113. |
- Fry, Christopher H., et al.
(författare)
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Fibrosis and the bladder, implications for function ICI-RS 2017
- 2018
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467. ; 37, s. 7-12
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Most benign bladder pathologies are associated with an increase of extracellular matrix (ECM—fibrosis) and may progress from formation of stiffer matrix to a more compliant structure. The aims were to summarize current knowledge of the origins of bladder fibrosis and consequences in bladder function. Methods: A meeting at the International Consultation on Incontinence Research Society 2017 congress discussed the above aims and considered paradigms to reduce the extent of fibrosis. Discussants based their arguments on the basis of their own expertise, supplemented by review of the literature through PubMed. Proposals for future work were derived from the discussion. Results: Altered urodynamic compliance when ECM deposition is increased is mirrored by changes in the elastic modulus of isolated tissue, whether compliance is decreased or increased. No changes to compliance or fibrosis have been reported after botulinum toxin injections. Several paracrine and autocrine agents increase ECM deposition, the role of TGF-β was particularly emphasized. None of these agents has a net long-term effect on detrusor contractility and the reduction of contractile performance with increased ECM is due solely to a loss of detrusor mass. Several strategies to reduce fibrosis were described, ranging from potential therapeutic roles for vitamin-D or endostatin, manipulation of intracellular pathways that mediate myofibroblast differentiation and the potential role of the anti-fibrotic hormone relaxin. An understanding of epigenetic regulation of ECM deposition was also considered. Conclusions: The conclusion that reduced bladder contractile function with increased fibrosis is due largely to the replacement of detrusor with ECM offers a way forward for future research to consider approaches that will restore bladder function by reducing ECM deposition.
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| 114. |
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| 115. |
- Kanai, A., et al.
(författare)
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New therapeutic targets to prevent benign prostatic enlargement and symptomatic progression to benign prostatic obstruction-ICI-RS 2023
- 2023
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Ingår i: Neurourology and Urodynamics. - 0733-2467.
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Tidskriftsartikel (refereegranskat)abstract
- AimsBenign prostatic enlargement (BPE) can impact lower urinary tract function due to its potential progression to benign prostatic obstruction (BPO). Treatment options include removal of the obstruction by surgery or through use of therapeutics designed to slow growth or reduce tissue stress imposed by muscular stromal components. Inflammation and development of fibrosis can also raise intrinsic tissue stress within the gland, further impacting obstruction. Outflow tract obstruction can also impact emission and ejaculation if the obstruction persists.MethodsThis review summarizes an ICI-RS think tank considering novel drug treatments that might address BPO caused by progressive development of BPE, as well as manage decompensation changes to bladder function.ResultsTopics included recent advances in our understanding of pathological changes occurring to the prostate and other lower urinary tract tissues during progressive development of BPE, and how prevention or reversal might benefit from the identification of novel drug targets. These included contractile properties of prostatic tissues, the impact of BPE and its effects on bladder function, the deposition of intramural fibrotic tissue with protracted BPO, the role of inflammation in the development of BPE and its progression to BPO. In particular, we discussed current therapeutic options for treating BPE/BPO, and new therapeutic targets, what they treat and their advantage over current medications.ConclusionSeveral new drug targets were identified, including soluble guanylate cyclase (sGC), the receptor for nitric oxide (NO center dot), and sGC activators that promotes sGC-mediated cGMP production when sGC is inactivated and unresponsive to NO center dot.
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| 116. |
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| 117. |
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| 118. |
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| 119. |
- Radziszewski, P., et al.
(författare)
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Exogenously Administered Bombesin and Gastrin Releasing Peptide Contract the Female Rat Urethra In Vivo and In Vitro
- 2011
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467. ; 30:7, s. 1388-1391
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bombesin (BOM) and gastrin releasing peptide (GRP) have been located to the lower urinary tract (LUT). However, there is a paucity of data demonstrating the impact of these endogenous peptides. Objectives: The aim of the present study was to investigate the contractile actions of BOM and GRP on the female rat urethra in vitro and in vivo. Female Sprague-Dawley rats (n = 37) weighing approximately 225 g were used. Intraurethral pressure was recorded by a catheter placed at the maximum pressure zone corresponding to the intrinsic urethral sphincter. Measurements: In vitro, changes in intraurethral pressure was conducted on perfused intact urethral/bladder preparations and are expressed as percentages of sphincteric intraurethral pressure achieved with noradrenaline. In vivo, changes in intraurethral pressure was conducted in anesthetized subjects and compared with the baseline intraurethral pressure and sham controls. Results: In vitro, the increase in intraurethral pressure induced by BOM was 23.6 +/- 3.2 cmH(2)O, exceeding the pressure evoked with NA by 9.6 cmH(2)O or 174.4% whereas GRP induced a maximum pressure of 10.7 +/- 1.6 cmH(2)O, an increase of 2.2 +/- 0.5 cmH(2)O or 82.9% (P < 0.05) of the NA evoked pressure. In vivo, the mean baseline pressure was 22.9 +/- 1.4 cmH(2)O. The intraurethral pressure evoked by BOM was 50.6 +/- 6.3 cmH(2)O (P < 0.05), and for GRP, the evoked intraurethral pressure was 56.2 +/- 13.4 cmH(2)O (P < 0.05). Conclusions: The present data suggest that both BOM and GRP may contribute to the control of continence by their contractile action on the sphincters of the LUT outflow region. Neurourol. Urodynam. 30:1388-1391, 2011. (C) 2011 Wiley-Liss, Inc.
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| 120. |
- Schafer, Werner, et al.
(författare)
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Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies
- 2002
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Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467. ; 21:3, s. 261-274
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Tidskriftsartikel (refereegranskat)abstract
- This is the first report of the International Continence Society (ICS) on the development of comprehensive guidelines for Good Urodynamic Practice for the measurement, quality control, and documentation of urodynamic investigations in both clinical and research environments. This report focuses on the most common urodynamics examinations; uroflowmetry, pressure recording during filling cystometry, and combined pressure-flow studies. The basic aspects of good urodynamic practice are discussed and a strategy for urodynamic measurement, equipment set-up and configuration, signal testing, plausibility controls, pattern recognition, and artifact correction are proposed. The problems of data analysis are mentioned only when they are relevant in the judgment of data quality. In general, recommendations are made for one specific technique. This does not imply that this technique is the only one possible. Rather, it means that this technique is well-established, and gives good results when used with the suggested standards of good urodynamic practice.
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