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英文中文

Role of videourodynamics, imaging, and cystoscopy in patients with recurrent urinary tract infections: Should we throw in the kitchen sink? 视频动力、成像和膀胱镜检查在复发性尿路感染患者中的作用：我们是否应该把厨房水槽扔进去？

Continence Reports

Pub Date : 2024-11-08 DOI: 10.1016/j.contre.2024.100073

G. Chan , F. Davidovic , J. Gani

Purpose:

Recurrent urinary tract infection (rUTI) remains a common outpatient problem with discordance and paucity of evidence for management. This study aims to evaluate the role of videourodynamics (VUD), additional imaging, and cystoscopy in the complete workup of these patients.

Materials and Methods:

A retrospective review was performed on 1421 consecutive patients referred for physician performed VUD. After exclusion criteria, 170 patients were included. Ethics approval was obtained, followed by data collection, and analysis of demographics, symptoms, cystoscopy results, imaging, and VUD parameters. Statistical analyses were performed with IBM SPSS Statistics Version 28. Statistical significance was defined by an alpha level of P

\leq 0.05

Results:

Overall, 117/170 (69%) had identifiable causes of rUTI identified on VUD. There was a statistically significant difference (p<0.001) in identifying a cause in those with voiding symptoms (93/114

=

82%) compared to those without (24/56

=

43%). Gender was not predictive of an identifiable cause on VUD (

p = 0.47

). Neither was a neurogenic history (

p = 0.11

), diabetes (

p = 0.97

), or age (

p = 0.89

). Additional imaging was not diagnostic for rUTI cause. No malignancy was identified on imaging or cystoscopy.

Conclusion:

In patients with rUTI, VUD may be an important investigative step to find a possible underlying cause, but it is a scarce resource. As VUD has a higher detection rate in patients with voiding symptoms, by first screening for these patients on history, VUD can be used judiciously. Cystoscopy and additional imaging were not as helpful in identifying a target treatment plan for rUTI, when a VUD had already been done.

目的：复发性尿路感染（rUTI）仍是一个常见的门诊问题，其治疗方法不统一且缺乏证据。本研究旨在评估视频动力疗法（VUD）、附加影像学检查和膀胱镜检查在这些患者的全面检查中的作用。根据排除标准，共纳入 170 名患者。该研究获得了伦理批准，随后进行了数据收集，并对人口统计学、症状、膀胱镜检查结果、影像学和 VUD 参数进行了分析。统计分析采用 IBM SPSS 统计 28 版进行。结果：总体而言，有 117/170 人（69%）在 VUD 上发现了可确定的 rUTI 病因。与无排尿症状者（24/56 = 43%）相比，有排尿症状者（93/114 = 82%）在确定病因方面存在显著差异（P<0.001）。性别并不能预测 VUD 的病因（p=0.47）。神经源性病史（p=0.11）、糖尿病（p=0.97）或年龄（p=0.89）也不能预测。其他影像学检查不能诊断 rUTI 病因。结论：对于 rUTI 患者，VUD 可能是寻找可能潜在病因的重要检查步骤，但它是一种稀缺资源。由于VUD在有排尿症状的患者中检出率较高，因此首先根据病史对这些患者进行筛查，可以明智地使用VUD。如果已经进行了 VUD 检查，那么膀胱镜检查和其他影像学检查对于确定 rUTI 的目标治疗方案并没有那么有帮助。

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引用次数: 0

Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysis 人工尿道括约肌与男性吊带治疗男性尿失禁的安全性和有效性：系统回顾和荟萃分析

Continence Reports

Pub Date : 2024-11-08 DOI: 10.1016/j.contre.2024.100070

Bagrat Grigoryan , George Kasyan , Roman Shapovalenko , Dmitry Pushkar

Background and objective:

Male stress urinary incontinence (UI) remains a serious problem associated with a significant quality of life reduction. The aim of this study is to determine the safety and effectiveness of artificial urinary sphincter (AUS) and male slings (MS) for stress UI in men.

Evidence acquisition:

Inclusion criteria: randomized/non-randomized trials evaluating adult men with stress UI. Exclusion criteria: repeated SUI surgery, combined conservative interventions and pharmacological treatment. The electronic databases were searched up to January 2024. The systematic review was conducted according to PICO framework and PRISMA 2020 guidelines and was registered in PROSPERO. The risk of bias was evaluated using the tools recommended by the Cochrane Society.

Evidence synthesis:

Thirteen clinical trials were included in the systematic review, and 11 in the meta-analysis. There was no statistically significant difference in the improvement rate between AUS and MS (RR

=

0.93, 95% CI: [0.85, 1.02], p

=

0.13). MS showed statistically significant fewer infectious complication (RR

=

3.26, 95% CI: [1.97, 5.39], p<0.00001), device explantation (RR

=

3.29, 95% CI: [2.46, 4.41], p<0.00001), surgical revision (RR

=

2.27, 95% CI: [1.60, 3.20], p<0.00001), urinary retention (RR

=

0.04, 95% CI: [0.01, 0.07], p

=

0.004) rates and operation time (RR

=

0.93, 95% CI: [0.85, 1.02], p

=

0.13) compared with AUS.

Conclusion:

AUS demonstrates a comparable improvement level to MS. The operation time, infectious complication, device explantation, urinary retention, and surgical revision rates were lower in MS. More randomized and prospective studies with long-term follow-up will further increase confidence in the choice between AUS and MS for male UI treatment.

背景和目的：男性压力性尿失禁（UI）仍然是一个严重的问题，会严重降低生活质量。本研究旨在确定人工尿道括约肌（AUS）和男性吊带（MS）治疗男性压力性尿失禁的安全性和有效性。证据获取：纳入标准：评估成年男性压力性尿失禁的随机/非随机试验。排除标准：重复 SUI 手术、联合保守干预和药物治疗。对电子数据库的检索截止到2024年1月。该系统性综述根据PICO框架和PRISMA 2020指南进行，并在PROSPERO中进行了注册。证据综述：13项临床试验被纳入系统综述，11项被纳入荟萃分析。AUS和MS的改善率在统计学上没有明显差异（RR=0.93，95% CI：[0.85，1.02]，P= 0.13）。MS 的感染性并发症（RR = 3.26，95% CI：[1.97, 5.39]，p<0.00001）、装置拆卸（RR = 3.29，95% CI：[2.46, 4.41]，p<0.00001）、手术翻修（RR = 2.27，95% CI：[1.60, 3.20]，p<0.00001）、尿潴留（RR = 0.04，95% CI：[0.01，0.07]，p = 0.004）率和手术时间（RR = 0.93，95% CI：[0.85，1.02]，p = 0.13）与 AUS 相比。结论：AUS的改善程度与MS相当，但MS的手术时间、感染并发症、装置拆卸、尿潴留和手术翻修率更低。更多长期随访的随机和前瞻性研究将进一步增强在男性尿失禁治疗中选择AUS和MS的信心。

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引用次数: 0

Successful management of high urogenital sinus in an adult female: Case report 成功治疗一名成年女性的高位尿道窦：病例报告

Continence Reports

Pub Date : 2024-10-26 DOI: 10.1016/j.contre.2024.100068

Gamal Ghoniem , Nardeen Magdy Samaan , Mohamed Samir , Muhammed A. Moukhtar Hammad , Ashraf G. Fahmy

This case report presents the successful management of high urogenital sinus (UGS) in a 21-year-old female using a modified Anterior Sagittal Transrectal Approach (ASTRA). The patient, with a history of painful cyclic hematuria and delayed menarche, was initially misdiagnosed with a transverse vaginal septum. Diagnostic clarity was achieved through cystourethroscopy, revealing a single external meatal opening indicative of UGS. The modified ASTRA technique, including a rectum-sparing approach, was employed to correct the anomaly. Preoperative administration of leuprolide acetate helped reduce the risk of postoperative infections and complications. Postoperative care included serial vaginal dilatations to prevent stenosis, resulting in no complications or need for further surgical interventions at 12-month follow-up. This case highlights the importance of a multidisciplinary approach and the potential of the modified ASTRA technique in managing high UGS in adult patients. Further research to validate these findings in a larger cohort could be difficult because of rarity to miss the diagnosis in adult females.

本病例报告介绍了采用改良前矢状经直肠入路（ASTRA）成功治疗一名 21 岁女性高位泌尿生殖窦（UGS）的病例。该患者有疼痛性周期性血尿和月经初潮延迟病史，最初被误诊为阴道横隔。通过膀胱尿道镜检查，诊断结果清晰明了，发现单个外部肉腔开口，表明存在 UGS。手术采用了改良的ASTRA技术，包括直肠切除术，以矫正异常。术前服用醋酸亮丙瑞林有助于降低术后感染和并发症的风险。术后护理包括连续阴道扩张以防止狭窄，结果在12个月的随访中没有出现并发症，也不需要进一步的手术治疗。该病例强调了多学科方法的重要性，以及改良 ASTRA 技术在治疗成人高 UGS 方面的潜力。由于成年女性漏诊的罕见性，因此很难在更大的群体中进一步研究验证这些发现。

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引用次数: 0

History of urodynamics. Its origins, development and implication for urology as a specialty in Europe and the USA 尿动力学的历史。其起源、发展及其对欧洲和美国泌尿外科专业的影响

Continence Reports

Pub Date : 2024-10-18 DOI: 10.1016/j.contre.2024.100069

Friedrich H. Moll , Thorsten Halling , Werner Schäfer

The field of urodynamics playes a major role in the development of urology as a specialty. It was the corner stone in functional thinking and a major point in establishing a science of its own, because physiological aspects payed the major role in generating new theories. This was in contrast to surgery. Within this field of medicine it needs up to the 1970th and 1980th establishing a functional view on aspects of treating diseases at all. Up to this time here, knife had the first place.

A part of this topic regarding aspects of the German speaking countries had just been published Moll F. Halling T Geschichte der Urodynamik in: Schultz-Lampel, D., Goepel, M., Hampel, C. (eds) Urodynamik. Springer, Berlin, Heidelberg. 2022 pp 3-22 https://doi.org/10.1007/978-3-662-59066-9_1 p 2-22.

Moll, F. 2001 Historische Anmerkungen zur Entwicklung der Neuro-Urologie in: Nissen G., Badura F. (Hrsg) Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde, Band 7. Königshausen und Neumann Würzburg 2001.

尿动力学领域在泌尿外科这一专业的发展中扮演着重要角色。它是功能性思维的基石，也是建立一门自己的科学的关键点，因为生理方面在产生新理论方面发挥着重要作用。这与外科形成了鲜明对比。在这一医学领域，直到 20 世纪 70 年代和 80 年代，才在治疗疾病的各个方面建立起功能性观点。在这之前，外科手术一直占据着第一位。在德语国家，这一主题的一部分刚刚发表在《Moll F. Halling T Geschichte der Urodynamik》一书中：Schultz-Lampel, D., Goepel, M., Hampel, C. (eds) Urodynamik.Springer, Berlin, Heidelberg.2022 pp 3-22 https://doi.org/10.1007/978-3-662-59066-9_1 p 2-22.Moll, F. 2001 Historische Anmerkungen zur Entwicklung der Neuro-Urologie in：Nissen G., Badura F. (Hrsg) Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde, Band 7.Königshausen und Neumann Würzburg 2001。

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引用次数: 0

Erratum to: “Can recurrent UTIs in women be cured? Review article” [Cont. Rep. 5 (2023) 100021] 勘误："女性复发性尿毒症可以治愈吗？评论文章" [Cont. Rep. 5 (2023) 100021]

Continence Reports

Pub Date : 2024-10-15 DOI: 10.1016/j.contre.2024.100067

Valeerat Swatesutipun

引用次数: 0

Erratum to “Lower Urinary Tract Symptoms (LUTS) and COVID-19” [Cont. Rep. 9 (2024) 100044] 对 "下尿路症状（LUTS）与 COVID-19" 的勘误 [Cont. Rep. 9 (2024) 100044]

Continence Reports

Pub Date : 2024-10-04 DOI: 10.1016/j.contre.2024.100066

Sona Tayebi , Mohammad Sajjad Rahnama’i , Ashkan Shafigh , Hanieh Salehi-Pourmehr , Hadi Mostafaei , Ehsan Sepehran , Sakineh Hajebrahimi

引用次数: 0

Underweight, dementia, and not being completely independent in bowel management are risk factors for urinary incontinence among older people 体重过轻、痴呆和不能完全独立排便是老年人尿失禁的风险因素

Continence Reports

Pub Date : 2024-09-18 DOI: 10.1016/j.contre.2024.100065

Takeshi Okinami , Tsubasa Ohno , Nobuyuki Nishikawa

Background:

Despite the known relationship between frailty and urinary incontinence, the components of frailty that are important in managing urinary incontinence remain unclear.

Objectives:

This study aimed to investigate physical factors that influenced urinary incontinence.

Methods:

This prospective observational study included patients admitted to the rehabilitation ward of our hospital from July 2020 to June 2022. Patients’ data were collected during the week before their discharge. Patients who needed diaper changes because of urine contamination were defined as incontinent and others as continent. Univariate and multivariate analyses were used to analyze differences between the two groups by age, sex, medical history, body mass index, serum albumin levels, Mini-Mental State Examination scores, Functional Independence Measure motor items (excluding bladder management), grip strength, gait speed, lower limb muscle strength, posture when seated on the toilet, residual urine volume, medication for lower urinary tract symptoms, and polypharmacy.

Results:

Of 121 patients, 104 (38 men, 66 women) were included in our analyses. Patients’ median age was 81 years (range 56–101 years). The risk factors for urinary incontinence identified in the multivariate analysis were: history of dementia (odds ratio [OR] 19.80, 95% confidence interval [CI]: 2.31–170.00;

p

= 0.00646), body mass index < 18.5 kg/m² (OR 7.09, 95% CI: 1.36–36.90;

p

= 0.0201), and non-completely independent bowel management (OR 7.19, 95% CI: 1.29–40.16;

p

= 0.0245).

Conclusions:

We concluded that dementia, low body mass index, and non-completely independent bowel management are associated with urinary incontinence among older people.

背景：尽管虚弱与尿失禁之间的关系已众所周知，但在处理尿失禁过程中，虚弱的重要组成部分仍不明确。收集患者出院前一周的数据。因尿液污染而需要更换尿布的患者定义为大小便失禁，其他患者定义为无尿。采用单变量和多变量分析方法，根据年龄、性别、病史、体重指数、血清白蛋白水平、迷你精神状态检查评分、功能独立性测量运动项目（不包括膀胱管理）、握力、步态速度、下肢肌力、如厕坐姿、残余尿量、下尿路症状用药和多重用药等因素分析两组患者之间的差异。患者的中位年龄为 81 岁（56-101 岁）。多变量分析确定的尿失禁风险因素包括：痴呆症病史（几率比 [OR] 19.80，95% 置信区间 [CI]：2.31-170.00；P = 0.00646）、体重指数 < 18.5 kg/m2（OR 7.09，95% CI：1.36-36.90；P = 0.结论：我们得出结论，痴呆、低体重指数和非完全独立的肠道管理与老年人尿失禁有关。

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引用次数: 0

Diagnosis and treatment of nocturnal enuresis throughout the ages 历代夜间遗尿症的诊断和治疗

Continence Reports

Pub Date : 2024-09-07 DOI: 10.1016/j.contre.2024.100064

Pieter Dik , Mohammad Sajjad Rahnama’i

Nocturnal enuresis is associated with discomfort and it can lead to serious disturbed family life, bullying and low self esteem. Throughout the ages therapies for bedwetting were tried varying from drinking wine with shaved down testicle of a hare, flogging with nettles, cold showers, injections with strychnine, application of metal devices and electrical pulses until eventually the discovery of the pad and bell alarm was made. More about bedwetting was understood not earlier than in the past 50 years. Counselling, targeted medication and alarm clock training improved outcome and prognosis. New therapies are being developed such as innovative alarm clocks and medication. Still 10% of girls and 18% of boys suffer from bedwetting around the age of 6 years and this will not change much because genetic factors are the most important cause of nocturnal enuresis.

夜间遗尿会让人感到不适，严重时还会导致家庭生活混乱、受欺负和自卑。古往今来，人们尝试过各种治疗尿床的方法，包括用剃下的野兔睾丸喝酒、用荨麻鞭打、冷水淋浴、注射马钱子碱、使用金属装置和电脉冲，直到最终发现尿垫和尿铃报警器。在过去的 50 年里，人们对尿床有了更多的了解。咨询、针对性药物和闹钟训练改善了治疗效果和预后。目前正在开发新的疗法，如创新的闹钟和药物。目前，仍有 10% 的女孩和 18% 的男孩在 6 岁左右尿床，这种情况不会有太大改变，因为遗传因素是导致夜间遗尿的最重要原因。

引用次数: 0

The medical management of lower urinary tract symptoms during the nineteenth century 十九世纪下尿路症状的医学治疗

Continence Reports

Pub Date : 2024-09-03 DOI: 10.1016/j.contre.2024.100062

Srusthti Bhat , Jonathan Charles Goddard

Medical management and lifestyle changes rather than surgical interventions, are used for many urological problems. This was also the case in the past. The use of herbal medication for urinary symptoms in the nineteenth century is reviewed as well as the acceptance of herbal medicine at that time. The place of conservative therapy is studied in context of the global management of lower urinary tract symptoms during the nineteenth century. During this time period, lower urinary tract symptoms were still mainly managed with herbal treatments, despite the advances in science and chemistry; anything resembling a modern pharmacopeia postdated the nineteenth century.

许多泌尿系统疾病都采用药物治疗和改变生活方式的方法，而不是手术治疗。过去的情况也是如此。本文回顾了十九世纪使用草药治疗泌尿系统症状的情况，以及当时人们对草药的接受程度。从十九世纪全球下尿路症状治疗的角度研究了保守疗法的地位。在这一时期，尽管科学和化学取得了进步，但下尿路症状仍主要采用草药治疗；任何类似现代药典的东西都是十九世纪以后的东西。

引用次数: 0

The history of prosthetic devices for postprostatectomy incontinence 前列腺切除术后尿失禁修复装置的历史

Continence Reports

Pub Date : 2024-09-02 DOI: 10.1016/j.contre.2024.100063

Juliusz J. Szczesniewski , David E. Díaz , Miguel Virseda-Chamorro , Giordano Polisini , Enrico Ammirati , Alessandro Giammò

Urinary incontinence has been studied since the Egyptian era of the second millennium BCE. Throughout history, several devices have been developed to address this condition. The prevalence of stress incontinence has increased with the surgical treatment of prostatectomy. Since 1947, numerous devices have been developed for the treatment of this condition. We performed a narrative literature review conducted through PubMed and Google Scholar, aimed at creating a chronological outline of devices developed for managing post-prostatectomy urinary incontinence. The first known compression device introduced in 1910 evolved into advanced systems like the AMS 800 artificial urinary sphincter, key milestones in device technology and surgical techniques. Nowadays, several new devices have been developed, each incorporating an innovative solution. In addition, a new artificial sphincter also had been advanced. The incorporation of electronic sphincter control systems seems to be the next innovation. Through continuous innovation, the field has advanced from basic solutions to sophisticated, customized treatments, providing hope and enhancing the quality of life for affected individuals. The evolution of these devices not only marks a journey through history but also illustrates a future where technological advancements continue to play a pivotal role in stress incontinence after prostatectomy.

自公元前两千年的埃及时代起，人们就开始对尿失禁进行研究。在整个历史长河中，人们开发了多种设备来解决这一问题。随着前列腺切除手术的开展，压力性尿失禁的发病率也随之增加。自 1947 年以来，已开发出许多用于治疗这种情况的装置。我们通过 PubMed 和 Google Scholar 进行了一次叙述性文献综述，旨在按时间顺序勾勒出为治疗前列腺切除术后尿失禁而开发的设备的轮廓。从 1910 年推出的第一个压缩装置发展到 AMS 800 人工尿道括约肌等先进系统，这是装置技术和手术技术的重要里程碑。如今，又开发出了几种新设备，每种设备都采用了创新的解决方案。此外，新型人工括约肌也已取得进展。电子括约肌控制系统的加入似乎是下一个创新。通过不断创新，该领域已从基本解决方案发展到复杂的定制治疗方法，为患者带来了希望，并提高了他们的生活质量。这些设备的演变不仅标志着一段历史进程，同时也展示了技术进步在前列腺切除术后压力性尿失禁方面继续发挥关键作用的未来。

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