| 1. |
- Burgu, Berk, et al.
(författare)
-
Can the outcome of autoaugmentation omentocystoplasty be improved? Urodynamic, histological, and collagen content evaluation in sheep model.
- 2011
-
Ingår i: Neurourology and urodynamics. - : Wiley. - 1520-6777 .- 0733-2467. ; 30:7, s. 1371-5
-
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.
|
|
| 2. |
- Weinhold, Philipp, et al.
(författare)
-
Transient receptor potential a1 (TRPA1) agonists inhibit contractions of the isolated human ureter
- 2018
-
Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 37:2, s. 600-608
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: Mechanoafferent and peristaltic mechanisms of the human ureter involve transient receptor potential V1 (TRPV1)- and purinoceptor-mediated functions. Hydrogen sulphide, an endogenous TRPA1 ligand, is linked to inhibitory neurotransmission of the pig ureter. No information is available on TRPA1 activity in the human ureter. We therefore examined the distribution and function of TRPA1 in the human ureter. Methods: Expression of TRPA1 in human ureter tissue was studied by Western blot and immunofluorescence. The TRPA1 distribution was compared to TRPV1, calcitonin gene related peptide (CGRP), tyrosine hydroxylase (TH), and vimentin. Effects of the TRPA1 agonists allyl isothiocyanate (AI), cinnamaldehyde (CA), sodium hydrogen sulfide (NaHS), and capsaicin (TRPV1 agonist) on human ureter preparations were studied in organ baths. Results: By Western blot, bands were detected at the expected molecular weight for TRPA1. TRPA1- and TRPV1-immunoreactivities were located on CGRP-positive nerves, but not on TH-positive nerves. TRPA1 was also located in vimentin-positive interstitial cells. In functional experiments, neither of the TRPA1-agonists (1-100 μM) had any direct effects on ureter tension (baseline/potassium-induced contractions). However, CA, AI, NaHS, and capsaicin (10 μM) decreased (P < 0.01-0.05) tetrodotoxin-sensitive electrically induced (2,4,8,16,32 Hz) contractions. Inhibitory activities were 50-61% (CA), 30-56% (AI), 30-40% (NaHS), and 37-67% (Capsaicin). Conclusions: In the human ureter, TRPA1 is located to sensory nerves and interstitial cells. TRPA1 agonists inhibited electrically induced contractions but had no direct effect on smooth muscle tension of the human ureter. A role for TRPA1 in modulating neurotransmission and possibly peristalsis of the human ureter is proposed.
|
|
| 3. |
- Ehrén, Ingrid, et al.
(författare)
-
Voiding conditions, renal and bowel function in a cohort of adults with spina bifida
- 2020
-
Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 39:6, s. 1796-1802
-
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.
|
|
| 4. |
- Aronsson, Patrik, 1983, et al.
(författare)
-
A novel in situ urinary bladder model for studying afferent and efferent mechanisms in the micturition reflex in the rat.
- 2014
-
Ingår i: Neurourology and urodynamics. - : Wiley. - 1520-6777 .- 0733-2467. ; 33:5, s. 550-557
-
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.
|
|
| 5. |
- Gandaglia, G., et al.
(författare)
-
The fatty acid amide hydrolase inhibitor oleoyl ethyl amide counteracts bladder overactivity in female rats
- 2014
-
Ingår i: Neurourology and Urodynamics. - : John Wiley & Sons. - 0733-2467 .- 1520-6777. ; 33:8, s. 1251-1258
-
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
|
|
| 6. |
|
|
| 7. |
- Austin, Paul F., et al.
(författare)
-
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
-
Ingår i: Neurourology and Urodynamics. - : Wiley. - 0733-2467 .- 1520-6777. ; 35:4, s. 471-481
-
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.
|
|
| 8. |
- Carlsson Farrelly, Elisabeth, et al.
(författare)
-
One treatment with onabotulinumtoxinA relieves symptoms of overactive bladder in patients refractory to one or more oral medications
- 2023
-
Ingår i: Neurourology and Urodynamics. - : John Wiley & Sons. - 0733-2467 .- 1520-6777. ; 42:6, s. 1203-1213
-
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.
|
|
| 9. |
- Ehrén, Ingrid, et al.
(författare)
-
Cognitive challenges in persons with spina bifida : Bearing on urological dysfunctions?
- 2020
-
Ingår i: Neurourology and Urodynamics. - : John Wiley & Sons. - 0733-2467 .- 1520-6777. ; 39:8, s. 2139-2145
-
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.
|
|
| 10. |
- Khullar, Vik, et al.
(författare)
-
The relationship between BMI and urinary incontinence subgroups: Results from EpiLUTS.
- 2014
-
Ingår i: Neurourology and urodynamics. - : Wiley. - 1520-6777 .- 0733-2467. ; 33:4, s. 392-399
-
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.
|
|
