Cervical myelopathy (CM) and lumbar canal stenosis (LCS) are common degenerative spinal diseases among the elderly, and the major associated complaints include lower urinary tract symptoms (LUTS). The aim of this study was to investigate subjective and objective urological parameters of patients undergoing decompression surgery for CM and LCS.
Methods
We retrospectively reviewed patients who underwent evaluation by the International Prostate Symptom Score (IPSS) and uroflowmetry before decompression surgery for CM and LCS. Patients with comorbidities that can affect LUTS were excluded. Postoperative changes were evaluated in patients followed up within 1 month.
Results
Among referrals to urological consultations for LUTS, 231 patients were evaluated preoperatively. Moderate-severe urinary symptoms (IPSS ≥ 8) were present in 59.8% of 92 CM patients and 64.0% of 139 LCS patients. Poor voiding patterns defined as maximum urinary flow rate <12 mL/s or postvoid residual volume >100 mL were identified in 26.1% of CM and 25.2% of LCS. While IPSS did not associate with disease severity, poor voiders presented with worse Japanese Orthopedic Association scores. Moreover, poor voiders suffered for a longer period of time from orthopedic symptoms due to LCS. In followed-up patients (CM, n = 32; LCS, n = 47), total IPSS, storage subscores, and voiding subscores were significantly improved after surgery, as was voiding time from uroflowmetry.
Conclusions
This study demonstrated high prevalence of lower urinary tract dysfunction of CM and LCS as well as short-term effectiveness of decompression surgery. These results would encourage urologists to consider an orthopedic consultation when lower urinary tract dysfunction is identified in patients with degenerative spinal diseases.
目的颈椎病(CM)和腰椎管狭窄症(LCS)是老年人常见的退行性脊柱疾病，主要的相关症状包括下尿路症状(LUTS)。本研究的目的是探讨CM和LCS减压手术患者的主客观泌尿学参数。方法回顾性分析CM和LCS减压手术前接受国际前列腺症状评分(IPSS)和尿流测量评估的患者。排除了可能影响LUTS的合并症患者。术后1个月内随访观察患者术后变化。结果在LUTS泌尿科会诊的转诊患者中，231例患者术前接受了评估。92例CM患者中有59.8%出现中重度泌尿系统症状(IPSS≥8)，139例LCS患者中有64.0%出现中重度泌尿系统症状。26.1%的CM患者和25.2%的LCS患者存在排尿不良模式，定义为最大尿流量≤12 mL/s或排尿后残余容量≤100 mL。虽然IPSS与疾病严重程度无关，但较差的患者表现出较差的日本骨科协会评分。此外，由于LCS，贫穷的提供者遭受矫形症状的时间更长。随访患者(CM, n = 32;LCS (n = 47)、总IPSS、储存亚评分和排尿亚评分在手术后显著改善，尿流测量的排尿时间也显著改善。结论CM和LCS患者下尿路功能障碍发生率高，减压手术短期有效。这些结果将鼓励泌尿科医生考虑在退行性脊柱疾病患者中发现下尿路功能障碍时进行骨科会诊。
{"title":"Neurogenic lower urinary tract dysfunction in association with severity of degenerative spinal diseases: Short-term outcomes of decompression surgery","authors":"Shingo Kimura, Shunichi Takyu, Naoki Kawamorita, Takashige Namima, Naoki Morozumi, Akihiro Ito","doi":"10.1111/luts.12444","DOIUrl":"10.1111/luts.12444","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Cervical myelopathy (CM) and lumbar canal stenosis (LCS) are common degenerative spinal diseases among the elderly, and the major associated complaints include lower urinary tract symptoms (LUTS). The aim of this study was to investigate subjective and objective urological parameters of patients undergoing decompression surgery for CM and LCS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed patients who underwent evaluation by the International Prostate Symptom Score (IPSS) and uroflowmetry before decompression surgery for CM and LCS. Patients with comorbidities that can affect LUTS were excluded. Postoperative changes were evaluated in patients followed up within 1 month.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among referrals to urological consultations for LUTS, 231 patients were evaluated preoperatively. Moderate-severe urinary symptoms (IPSS ≥ 8) were present in 59.8% of 92 CM patients and 64.0% of 139 LCS patients. Poor voiding patterns defined as maximum urinary flow rate <12 mL/s or postvoid residual volume >100 mL were identified in 26.1% of CM and 25.2% of LCS. While IPSS did not associate with disease severity, poor voiders presented with worse Japanese Orthopedic Association scores. Moreover, poor voiders suffered for a longer period of time from orthopedic symptoms due to LCS. In followed-up patients (CM, n = 32; LCS, n = 47), total IPSS, storage subscores, and voiding subscores were significantly improved after surgery, as was voiding time from uroflowmetry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrated high prevalence of lower urinary tract dysfunction of CM and LCS as well as short-term effectiveness of decompression surgery. These results would encourage urologists to consider an orthopedic consultation when lower urinary tract dysfunction is identified in patients with degenerative spinal diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"14 5","pages":"346-357"},"PeriodicalIF":1.3,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73730299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Efstathios Papaefstathiou, Maria Papaioannou, Eirini Papaefstathiou, Aikaterini Apostolopoulou, Apostolos Apostolidis
Objective
Urinary bladder ischemia has been implicated in the pathogenesis of lower urinary tract symptoms (LUTS). However, research regarding urinary molecular markers for diagnosis and prognosis of pelvic ischemia is still premature, hindering further implementation in clinical practice. The aim of this study is to systematically appraise biomarkers associated with bladder ischemia detected in urine.
Methods
We performed a systematic review of PubMed/Medline, Embase, Web of Science, and the Cochrane Library in October 2021 according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. A subsequent reference search of retrieved articles was also performed. The identified reports were reviewed according to Systematic Review Center for Laboratory Animal Experimentation's risk-of-bias tool for animal studies.
Results
Eight publications were selected for this analysis. The included reports used 8-hydroxy-2′-deoxyguanosine (8-OHdG) (in eight studies) as urinary marker of bladder ischemia. The pooled mean difference for urinary 8-OHdG levels between study and control groups was 13.73 ng/mg creatinine (95% CI, 9.79-17.67; P < .001; I2 = 69%) for rat studies and 3.71 ng/mg creatinine (95% CI, 2.91-4.51; P < .001; I2 = 94%) for rabbit studies. The result remained statistically significant favoring the control group independent of the type of intervention used to achieve bladder ischemia. Regarding secondary outcomes, mean voided volume and micturition interval were significantly lower in the ischemia group.
Conclusion
The lack of human randomized controlled trials is a major limitation. 8-OHdG is a urinary biomarker to be investigated in future studies for diagnosis and prognosis of LUTS in patients with vascular injury or bladder outlet obstruction.
{"title":"Do we have enough evidence to propose a urinary biomarker of bladder ischemia? A systematic review and meta-analysis","authors":"Efstathios Papaefstathiou, Maria Papaioannou, Eirini Papaefstathiou, Aikaterini Apostolopoulou, Apostolos Apostolidis","doi":"10.1111/luts.12443","DOIUrl":"10.1111/luts.12443","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Urinary bladder ischemia has been implicated in the pathogenesis of lower urinary tract symptoms (LUTS). However, research regarding urinary molecular markers for diagnosis and prognosis of pelvic ischemia is still premature, hindering further implementation in clinical practice. The aim of this study is to systematically appraise biomarkers associated with bladder ischemia detected in urine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a systematic review of PubMed/Medline, Embase, Web of Science, and the Cochrane Library in October 2021 according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. A subsequent reference search of retrieved articles was also performed. The identified reports were reviewed according to Systematic Review Center for Laboratory Animal Experimentation's risk-of-bias tool for animal studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight publications were selected for this analysis. The included reports used 8-hydroxy-2′-deoxyguanosine (8-OHdG) (in eight studies) as urinary marker of bladder ischemia. The pooled mean difference for urinary 8-OHdG levels between study and control groups was 13.73 ng/mg creatinine (95% CI, 9.79-17.67; <i>P</i> < .001; <i>I</i><sup>2</sup> = 69%) for rat studies and 3.71 ng/mg creatinine (95% CI, 2.91-4.51; <i>P</i> < .001; <i>I</i><sup>2</sup> = 94%) for rabbit studies. The result remained statistically significant favoring the control group independent of the type of intervention used to achieve bladder ischemia. Regarding secondary outcomes, mean voided volume and micturition interval were significantly lower in the ischemia group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The lack of human randomized controlled trials is a major limitation. 8-OHdG is a urinary biomarker to be investigated in future studies for diagnosis and prognosis of LUTS in patients with vascular injury or bladder outlet obstruction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"14 5","pages":"308-317"},"PeriodicalIF":1.3,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82473381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. A. Abelleyra Lastoria, N. Raison, A. Aydın, Shamim Khan, P. Dasgupta, K. Ahmed
The purpose of this review was to summarize and compare the efficacy among surgical interventions in terms of symptomatic relief in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). The review protocol was published on PROSPERO. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) 2020 checklist was followed. Following database search, a narrative synthesis was performed. Data pertaining symptom scores, pain levels, and voiding frequency following surgery were summarized by calculating percentage change in these parameters. Multiple surgical treatments were identified. These included injections of hyaluronic acid (HA), botulinum toxin A (Botox A), triamcinolone, resiniferatoxin (RTX), platelet‐rich plasma, and 50% dimethyl sulfoxide (DMSO) solution, neuromodulation, hydrodistension (HD), resection/fulguration of Hunner lesions, resection of ilioinguinal and iliohypogastric nerves, reconstructive surgery, and cystectomy. This review found no evidence suggesting that HD and RTX injections can ameliorate IC/BPS symptoms. Current evidence suggests that sacral neuromodulation, cystectomy, and transurethral resection/fulguration of Hunner lesions could lead to symptomatic relief in IC/BPS. Further research into the efficacy of Botox A, triamcinolone, 50% DMSO solution, and HA instillations is required. However, the best treatment options cannot be reliably stated due to the low level of evidence of the studies identified. Further research should report outcomes for Hunner‐type IC and BPS separately given their differing histopathological characteristics. Performing high‐quality randomized controlled trials could be hindered by the low prevalence of the condition and a small proportion of patients progressing to surgery.
{"title":"Comparing surgical interventions for interstitial cystitis: A systematic review","authors":"D. A. Abelleyra Lastoria, N. Raison, A. Aydın, Shamim Khan, P. Dasgupta, K. Ahmed","doi":"10.1111/luts.12441","DOIUrl":"https://doi.org/10.1111/luts.12441","url":null,"abstract":"The purpose of this review was to summarize and compare the efficacy among surgical interventions in terms of symptomatic relief in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). The review protocol was published on PROSPERO. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) 2020 checklist was followed. Following database search, a narrative synthesis was performed. Data pertaining symptom scores, pain levels, and voiding frequency following surgery were summarized by calculating percentage change in these parameters. Multiple surgical treatments were identified. These included injections of hyaluronic acid (HA), botulinum toxin A (Botox A), triamcinolone, resiniferatoxin (RTX), platelet‐rich plasma, and 50% dimethyl sulfoxide (DMSO) solution, neuromodulation, hydrodistension (HD), resection/fulguration of Hunner lesions, resection of ilioinguinal and iliohypogastric nerves, reconstructive surgery, and cystectomy. This review found no evidence suggesting that HD and RTX injections can ameliorate IC/BPS symptoms. Current evidence suggests that sacral neuromodulation, cystectomy, and transurethral resection/fulguration of Hunner lesions could lead to symptomatic relief in IC/BPS. Further research into the efficacy of Botox A, triamcinolone, 50% DMSO solution, and HA instillations is required. However, the best treatment options cannot be reliably stated due to the low level of evidence of the studies identified. Further research should report outcomes for Hunner‐type IC and BPS separately given their differing histopathological characteristics. Performing high‐quality randomized controlled trials could be hindered by the low prevalence of the condition and a small proportion of patients progressing to surgery.","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"67 1","pages":"218 - 241"},"PeriodicalIF":1.3,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81103841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammet İrfan Dönmez, Mehmet Serkan Özkent, Mustafa Bilal Hamarat, Mehmet Kocalar
Objective
To evaluate if voiding through the zipper or voiding pants down would make any difference with regard to uroflowmetry parameters and postvoiding residual urine (PVR) volumes in healthy males with no lower urinary tract symptoms (LUTS).
Methods
Healthy males over 18 years of age with no LUTS were prospectively evaluated using a uroflowmetry test. Each individual was asked to void through the zipper (group 1) and pants down (group 2) at different times. The uroflowmetry test was repeated if the voided volume did not exceed 150 mL. Uroflowmetry results such as voided volume, maximum flow rate (Qmax), average flow rate (Qave), and duration of voiding were noted. PVR volume was assessed using ultrasonography. Electromyography was not used. Data are shown as mean ± standard deviation. For statistical analysis, a paired t test was used to analyze parametric parameters.
Results
A total of 44 males were enrolled. The median age of the individuals was 24 (range 18-44 years). There were no statistically significant differences between the two measurements in terms of voided volume (307 ± 121 mL vs 325 ± 145 mL, P = .365) and duration of voiding (25 ± 11 s vs 23.8 ± 11.6 s, P = .526). However, there were statistically significant differences in Qmax (26.6 ± 6.7 mL/s vs 30.0 ± 8.2 mL/s, P = .001), Qave (14.4 ± 3.6 mL/s vs 16.2 ± 5.1 mL/s, P = .009), and PVR volumes (23.9 ± 19.4 mL vs 3.9 ± 9.6 mL, P = .0001).
Conclusion
Voiding pants down shows higher flow rates and lower PVR than voiding through the zipper in individuals with no LUTS. Future studies with a larger number of individuals (including those with LUTS) and a broader age range cohort are required for solid conclusions.
目的评价无下尿路症状(LUTS)的健康男性，通过拉链排尿或尿裤排尿对尿流仪参数和排尿后残尿量的影响。方法对18岁以上无LUTS的健康男性采用尿流法进行前瞻性评价。每个人都被要求在不同的时间脱下拉链(第一组)和裤子(第二组)。如果尿量不超过150ml，则重复尿流测定。记录尿流测量结果，如排尿量、最大流量(Qmax)、平均流量(Qave)、排尿时间等。超声检查PVR体积。未使用肌电图。数据以平均值±标准差表示。统计分析采用配对t检验分析参数参数。结果共入组44例男性。患者年龄中位数为24岁(18-44岁)。两种方法在排尿量(307±121 mL vs 325±145 mL, P = .365)和排尿时间(25±11 s vs 23.8±11.6 s, P = .526)方面差异无统计学意义。Qmax(26.6±6.7 mL/s vs 30.0±8.2 mL/s, P = 0.001)、Qave(14.4±3.6 mL/s vs 16.2±5.1 mL/s, P = 0.009)、PVR容积(23.9±19.4 mL vs 3.9±9.6 mL, P = 0.0001)差异有统计学意义。结论在无LUTS的人群中，尿裤排尿比拉链排尿流速高，PVR低。未来的研究需要更多的个体(包括LUTS患者)和更广泛的年龄范围队列来得出可靠的结论。
{"title":"Through the zipper or pants down: Does it change uroflowmetry parameters in healthy males?","authors":"Muhammet İrfan Dönmez, Mehmet Serkan Özkent, Mustafa Bilal Hamarat, Mehmet Kocalar","doi":"10.1111/luts.12442","DOIUrl":"10.1111/luts.12442","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate if voiding through the zipper or voiding pants down would make any difference with regard to uroflowmetry parameters and postvoiding residual urine (PVR) volumes in healthy males with no lower urinary tract symptoms (LUTS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Healthy males over 18 years of age with no LUTS were prospectively evaluated using a uroflowmetry test. Each individual was asked to void through the zipper (group 1) and pants down (group 2) at different times. The uroflowmetry test was repeated if the voided volume did not exceed 150 mL. Uroflowmetry results such as voided volume, maximum flow rate (Qmax), average flow rate (Qave), and duration of voiding were noted. PVR volume was assessed using ultrasonography. Electromyography was not used. Data are shown as mean ± standard deviation. For statistical analysis, a paired <i>t</i> test was used to analyze parametric parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 44 males were enrolled. The median age of the individuals was 24 (range 18-44 years). There were no statistically significant differences between the two measurements in terms of voided volume (307 ± 121 mL vs 325 ± 145 mL, <i>P</i> = .365) and duration of voiding (25 ± 11 s vs 23.8 ± 11.6 s, <i>P</i> = .526). However, there were statistically significant differences in Qmax (26.6 ± 6.7 mL/s vs 30.0 ± 8.2 mL/s, <i>P</i> = .001), Qave (14.4 ± 3.6 mL/s vs 16.2 ± 5.1 mL/s, <i>P</i> = .009), and PVR volumes (23.9 ± 19.4 mL vs 3.9 ± 9.6 mL, <i>P</i> = .0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Voiding pants down shows higher flow rates and lower PVR than voiding through the zipper in individuals with no LUTS. Future studies with a larger number of individuals (including those with LUTS) and a broader age range cohort are required for solid conclusions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"14 5","pages":"341-345"},"PeriodicalIF":1.3,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80192434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vesicouterine fistula (VUF) is the rarest form of genitourinary fistulas. As lower-segment cesarean section becomes a more common mode of delivery, they have become the leading cause of VUF formation. We present four VUF patients with varied symptoms such as menouria, amenorrhea, with or without urinary incontinence. We diagnosed all of our cases through cystoscopy in conjunction with methylene blue dye test or hysteroscopy.
Outcome
We successfully repaired VUF in three open surgery instances and one laparoscopic case. To diagnose VUF, cystoscopy and hysteroscopy are still the gold standard. An expert surgeon's open or laparoscopic repair is effective and safe. The patients no longer experienced incontinence, cyclical hematuria (menouria), discomfort, or sexual dysfunction.
Conclusion
Cystoscopy and hysteroscopy remain the gold standard tool in diagnosing VUF. Open or laparoscopic repair performed by an experienced surgeon is an effective and safe technique with a successful outcome.
{"title":"Rare cases of vesicouterine fistula","authors":"Maulidina Medika Rahmita, Arry Rodjani, Irfan Wahyudi, Fina Widia","doi":"10.1111/luts.12440","DOIUrl":"10.1111/luts.12440","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Case</h3>\u0000 \u0000 <p>Vesicouterine fistula (VUF) is the rarest form of genitourinary fistulas. As lower-segment cesarean section becomes a more common mode of delivery, they have become the leading cause of VUF formation. We present four VUF patients with varied symptoms such as menouria, amenorrhea, with or without urinary incontinence. We diagnosed all of our cases through cystoscopy in conjunction with methylene blue dye test or hysteroscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcome</h3>\u0000 \u0000 <p>We successfully repaired VUF in three open surgery instances and one laparoscopic case. To diagnose VUF, cystoscopy and hysteroscopy are still the gold standard. An expert surgeon's open or laparoscopic repair is effective and safe. The patients no longer experienced incontinence, cyclical hematuria (menouria), discomfort, or sexual dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Cystoscopy and hysteroscopy remain the gold standard tool in diagnosing VUF. Open or laparoscopic repair performed by an experienced surgeon is an effective and safe technique with a successful outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"14 5","pages":"401-404"},"PeriodicalIF":1.3,"publicationDate":"2022-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81473002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabete de Souza Pereira, Ana Paula de Lima Ferreira, Milene de Oliveira Almeida, Cinthia Silva Barbosa, Gleyce de Melo Falcão Monteiro, Leila Barbosa, Andrea Lemos
Objective
To determine the prevalence and factors associated with urinary incontinence (UI) in female crossfitters.
Methods
This is a cross-sectional study. Data were collected using assessment forms: Knowledge, Attitude and Practice survey for young female athletes; Incontinence Severity Index; and International Consultation on Incontinence Questionnaire for UI. Descriptive analysis was conducted to obtain absolute and relative frequencies, means and 95% confidence intervals (95% CI). Multivariate analysis was carried out to determine the association between UI and sociodemographic, gynecological-obstetric, and anthropometric variables, associated morbidities, previous history and physical activity.
Results
Prevalence of UI, in the 189 included volunteers, was 38.6% and the most frequent type was stress UI (69.9%). A total of 72.6% of incontinent women reported urine loss during CrossFit training. Knowledge (53.4%) and attitude (86.2%) regarding UI were generally adequate, while prevention, management and treatment were inadequate (96.3%). The predominant characteristics of UI were frequency of once a week or less (74.0%), in small amounts (86.3%), mild intensity (57.5%) and slight impact on quality of life (64.3%). In multivariate analysis, no variable was significantly associated with UI.
Conclusions
The prevalence of UI in female crossfitters was 38.6%. The factors investigated did not contribute to the development of UI.
{"title":"Prevalence and factors associated with urinary incontinence in female crossfitters: A cross-sectional study","authors":"Elizabete de Souza Pereira, Ana Paula de Lima Ferreira, Milene de Oliveira Almeida, Cinthia Silva Barbosa, Gleyce de Melo Falcão Monteiro, Leila Barbosa, Andrea Lemos","doi":"10.1111/luts.12437","DOIUrl":"10.1111/luts.12437","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the prevalence and factors associated with urinary incontinence (UI) in female crossfitters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a cross-sectional study. Data were collected using assessment forms: Knowledge, Attitude and Practice survey for young female athletes; Incontinence Severity Index; and International Consultation on Incontinence Questionnaire for UI. Descriptive analysis was conducted to obtain absolute and relative frequencies, means and 95% confidence intervals (95% CI). Multivariate analysis was carried out to determine the association between UI and sociodemographic, gynecological-obstetric, and anthropometric variables, associated morbidities, previous history and physical activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prevalence of UI, in the 189 included volunteers, was 38.6% and the most frequent type was stress UI (69.9%). A total of 72.6% of incontinent women reported urine loss during CrossFit training. Knowledge (53.4%) and attitude (86.2%) regarding UI were generally adequate, while prevention, management and treatment were inadequate (96.3%). The predominant characteristics of UI were frequency of once a week or less (74.0%), in small amounts (86.3%), mild intensity (57.5%) and slight impact on quality of life (64.3%). In multivariate analysis, no variable was significantly associated with UI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of UI in female crossfitters was 38.6%. The factors investigated did not contribute to the development of UI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"14 4","pages":"281-288"},"PeriodicalIF":1.3,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40314227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cheng-Han Tsai, Yu-Hua Fan, Alex T. L. Lin, William J. Huang
Objectives
Postoperative persistence of storage symptoms after transurethral resection of the prostate (TURP) is bothersome, and evidence of its cause is sparse. We sought to analyze risk factors for using antimuscarinics or beta-3 agonists after TURP in benign prostatic hyperplasia (BPH) patients.
Methods
BPH patients who underwent TURP and were followed up for >6 months after surgery were retrospectively enrolled. Postoperative pharmacotherapy for storage symptoms was defined as the prescription of antimuscarinics or beta-3 agonists within 3 months after TURP for >3 months. Preoperative and perioperative variables were evaluated for their effect on the postoperative prescription of antimuscarinics or beta-3 agonists.
Results
Of the 376 patients, 45 (12.0%) received postoperative pharmacotherapy for storage symptoms. Patients who underwent bipolar TURP were significantly more likely to receive postoperative pharmacotherapy than those who underwent monopolar TURP (15.7% vs 6.9%; P = 0.01). Significantly more patients with intravesical prostatic protrusions >1 cm used postoperative pharmacotherapy than those with protrusions of ≤1 cm (14.4% vs 5.2% respectively; P = 0.02). Multivariate logistic regression analysis revealed age >75 years (odds ratio [OR] 3.04; 95% CI 1.29-7.16; P = 0.011), intravesical prostatic protrusion >1 cm (OR, 3.48; 95% CI, 1.32-9.15; P = 0.012), and bipolar transurethral resection (OR 4.25; 95% CI 1.53-11.80; P = 0.005) as significant risk factors for postoperative pharmacotherapy.
Conclusions
Advanced age, intravesical prostatic protrusion, and bipolar TURP were significantly associated with postoperative pharmacotherapy for storage symptoms after TURP in BPH patients. Therefore, patients with these risk factors might be informed about the risk of postoperative storage symptoms that may require medications after TURP.
目的经尿道前列腺切除术(TURP)后积液症状的持续存在是令人烦恼的，其原因的证据很少。我们试图分析在良性前列腺增生(BPH)患者行TURP后使用抗毒蕈素或β -3激动剂的危险因素。方法回顾性分析行TURP治疗的前列腺增生患者，术后随访6个月。术后储存症状的药物治疗定义为在TURP术后3个月内使用抗毒蕈素或β -3激动剂治疗3个月。评估术前和围手术期变量对术后抗毒蕈素或β -3激动剂处方的影响。结果376例患者中，45例(12.0%)接受了术后药物治疗。双相TURP患者接受术后药物治疗的可能性明显高于单极TURP患者(15.7% vs 6.9%;p = 0.01)。膀胱内前列腺突出1 cm的患者术后使用药物治疗的比例明显高于膀胱内前列腺突出≤1 cm的患者(14.4% vs 5.2%;p = 0.02)。多因素logistic回归分析显示年龄75岁(优势比[OR] 3.04;95% ci 1.29-7.16;P = 0.011)，膀胱内前列腺突出1 cm (OR, 3.48;95% ci, 1.32-9.15;P = 0.012)，双极经尿道切除(OR 4.25;95% ci 1.53-11.80;P = 0.005)为术后药物治疗的重要危险因素。结论老年、膀胱内前列腺突出和双极TURP与前列腺增生患者TURP术后药物治疗与储存症状显著相关。因此，有这些危险因素的患者可能被告知TURP术后可能需要药物治疗的储存症状的风险。
{"title":"Risk factors for pharmacotherapy for storage symptoms after transurethral resection of the prostate in patients with benign prostatic hyperplasia","authors":"Cheng-Han Tsai, Yu-Hua Fan, Alex T. L. Lin, William J. Huang","doi":"10.1111/luts.12438","DOIUrl":"10.1111/luts.12438","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Postoperative persistence of storage symptoms after transurethral resection of the prostate (TURP) is bothersome, and evidence of its cause is sparse. We sought to analyze risk factors for using antimuscarinics or beta-3 agonists after TURP in benign prostatic hyperplasia (BPH) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>BPH patients who underwent TURP and were followed up for >6 months after surgery were retrospectively enrolled. Postoperative pharmacotherapy for storage symptoms was defined as the prescription of antimuscarinics or beta-3 agonists within 3 months after TURP for >3 months. Preoperative and perioperative variables were evaluated for their effect on the postoperative prescription of antimuscarinics or beta-3 agonists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 376 patients, 45 (12.0%) received postoperative pharmacotherapy for storage symptoms. Patients who underwent bipolar TURP were significantly more likely to receive postoperative pharmacotherapy than those who underwent monopolar TURP (15.7% vs 6.9%; <i>P</i> = 0.01). Significantly more patients with intravesical prostatic protrusions >1 cm used postoperative pharmacotherapy than those with protrusions of ≤1 cm (14.4% vs 5.2% respectively; <i>P</i> = 0.02). Multivariate logistic regression analysis revealed age >75 years (odds ratio [OR] 3.04; 95% CI 1.29-7.16; <i>P</i> = 0.011), intravesical prostatic protrusion >1 cm (OR, 3.48; 95% CI, 1.32-9.15; <i>P</i> = 0.012), and bipolar transurethral resection (OR 4.25; 95% CI 1.53-11.80; <i>P</i> = 0.005) as significant risk factors for postoperative pharmacotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Advanced age, intravesical prostatic protrusion, and bipolar TURP were significantly associated with postoperative pharmacotherapy for storage symptoms after TURP in BPH patients. Therefore, patients with these risk factors might be informed about the risk of postoperative storage symptoms that may require medications after TURP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"14 5","pages":"329-333"},"PeriodicalIF":1.3,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40311400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diagnosis of Hunner-type interstitial cystitis (HIC) relies on the ability to identify Hunner lesions endoscopically, which can lead to storage symptom misdiagnosis. Here, we examined serum biomarkers for HIC and verified their utility.
Methods
Based on the previous definition of the Japanese guidelines, which did not distinguish HIC and non-HIC diseases, we searched for serum biomarkers in 25 patients with interstitial cystitis (IC) and 25 control participants using metabolomics during 2013–2014. In 2019, we conducted a validation study in HIC and control groups. Serum samples were analyzed using liquid chromatography–tandem mass spectrometry, and candidate biomarker concentrations were compared between the groups using Mann–Whitney test.
Results
Metabolomics targeted 678 metabolites and revealed that the levels of 14 lysolipids, seven γ-glutamyl amino acids, and two monoacylglycerols were significantly different between the IC and control groups. The following metabolites were selected from each metabolite category as candidates: 1-linoleoylglycerophosphocholine (1-linoleloyl-GPC [18:2]), γ-glutamylisoleucine (γ-Glu-Ile), and 1-arachidonylglycerol (1-AG). The serum concentrations of 1-linoleoyl-GPC (18:2) in the HIC and control groups were 27 920 ± 6261 and 40 360 ± 1514 ng/mL (P = 0.0003), respectively. The serum concentrations of γ-Glu-Ile and 1-AG were not significantly different between the groups. When the cut-off value of 1-linoleoyl-GPC (18:2) was set at 28 400 ng/mL, the sensitivity and specificity were 68% and 84%, respectively.
Conclusions
Serum 1-linoleoyl-GPC (18:2) is a candidate diagnostic biomarker for HIC. Additional studies on whether this biomarker can distinguish HIC from other diseases with high urination frequency are required for its clinical use.
{"title":"Identification of diagnostic serum biomarkers for Hunner-type interstitial cystitis","authors":"Kazumasa Torimoto, Tomohiro Ueda, Masato Kasahara, Akihide Hirayama, Chie Matsushita, Yoshihiro Matsumoto, Daisuke Gotoh, Yasushi Nakai, Makito Miyake, Katsuya Aoki, Kiyohide Fujimoto","doi":"10.1111/luts.12439","DOIUrl":"10.1111/luts.12439","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Diagnosis of Hunner-type interstitial cystitis (HIC) relies on the ability to identify Hunner lesions endoscopically, which can lead to storage symptom misdiagnosis. Here, we examined serum biomarkers for HIC and verified their utility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on the previous definition of the Japanese guidelines, which did not distinguish HIC and non-HIC diseases, we searched for serum biomarkers in 25 patients with interstitial cystitis (IC) and 25 control participants using metabolomics during 2013–2014. In 2019, we conducted a validation study in HIC and control groups. Serum samples were analyzed using liquid chromatography–tandem mass spectrometry, and candidate biomarker concentrations were compared between the groups using Mann–Whitney test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Metabolomics targeted 678 metabolites and revealed that the levels of 14 lysolipids, seven γ-glutamyl amino acids, and two monoacylglycerols were significantly different between the IC and control groups. The following metabolites were selected from each metabolite category as candidates: 1-linoleoylglycerophosphocholine (1-linoleloyl-GPC [18:2]), γ-glutamylisoleucine (γ-Glu-Ile), and 1-arachidonylglycerol (1-AG). The serum concentrations of 1-linoleoyl-GPC (18:2) in the HIC and control groups were 27 920 ± 6261 and 40 360 ± 1514 ng/mL (<i>P</i> = 0.0003), respectively. The serum concentrations of γ-Glu-Ile and 1-AG were not significantly different between the groups. When the cut-off value of 1-linoleoyl-GPC (18:2) was set at 28 400 ng/mL, the sensitivity and specificity were 68% and 84%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serum 1-linoleoyl-GPC (18:2) is a candidate diagnostic biomarker for HIC. Additional studies on whether this biomarker can distinguish HIC from other diseases with high urination frequency are required for its clinical use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"14 5","pages":"334-340"},"PeriodicalIF":1.3,"publicationDate":"2022-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74429867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Since the declaration of COVID‐19 as a pandemic, other unexpected symptoms related to the infection besides the respiratory system have been reported. Although a few case reports have revealed that adult patients with COVID‐19 also complained of urinary frequency and nocturia, the exact pathophysiology is still unclear. In this case series, we present three children aged 14 to 17 years with urodynamically proven lower urinary tract dysfunction (LUTD) following COVID‐19.
{"title":"Urodynamically proven lower urinary tract dysfunction in children after COVID‐19: A case series","authors":"I. Selvi, M. Dönmez, O. Ziylan, T. Oktar","doi":"10.1111/luts.12436","DOIUrl":"https://doi.org/10.1111/luts.12436","url":null,"abstract":"Since the declaration of COVID‐19 as a pandemic, other unexpected symptoms related to the infection besides the respiratory system have been reported. Although a few case reports have revealed that adult patients with COVID‐19 also complained of urinary frequency and nocturia, the exact pathophysiology is still unclear. In this case series, we present three children aged 14 to 17 years with urodynamically proven lower urinary tract dysfunction (LUTD) following COVID‐19.","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"46 1","pages":"301 - 304"},"PeriodicalIF":1.3,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82945915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01Epub Date: 2021-10-21DOI: 10.1111/luts.12413
Shizuo Yamada, Yoshihisa Kato
Objective: Transient receptor potential vanilloid subtype 1 (TRPV1) may play a significant role in the pathophysiology of the bladder. The present study investigated the effects of the herbal product, saw palmetto extract (SPE) on TRPV1-mediated Ca2+ influx and specific [3 H]resiniferatoxin ([3 H]RTX) binding to TRPV1 in HEK293 cells expressing TRPV1 (HEK293VR11 cells).
Methods: Ca2+ influx induced by and the direct binding activity of TRPV1 were measured using a method with Fura 2-AM, a cytoplasmic calcium indicator, and a radioligand binding assay using a [3 H]RTX, respectively.
Results: SPE did not markedly affect Ca2+ influx in HEK293VR11 cells; however, it significantly inhibited capsaicin-induced increases in Ca2+ influx in these cells. The specific binding of [3 H]RTX in HEK293VR11 cells was saturable with Kd value of 120 ± 7 pM and Bmax of 1.07 ± 0.10 fmol/mg protein, and was inhibited by low concentrations of non-labeled RTX with Ki of 60.1 ± 7.6 nM. These results confirmed the pharmacological specificity of specific binding sites of [3 H]RTX to TRPV1 in HEK293VR11 cells. SPE inhibited the specific binding of [3 H]RTX in a concentration-dependent manner, with Ki of 24.2 ± 1.4 μg/mL.
Conclusions: The present study demonstrated for the first time, that SPE inhibited capsaicin-induced Ca2+ influx with binding to TRPV1 in HEL293VR11 cells. These results will contribute to a more detailed understanding of the pharmacological effects of SPE on urinary dysfunction.
{"title":"Effects of saw palmetto extract on the vanilloid receptor TRPV1.","authors":"Shizuo Yamada, Yoshihisa Kato","doi":"10.1111/luts.12413","DOIUrl":"https://doi.org/10.1111/luts.12413","url":null,"abstract":"<p><strong>Objective: </strong>Transient receptor potential vanilloid subtype 1 (TRPV1) may play a significant role in the pathophysiology of the bladder. The present study investigated the effects of the herbal product, saw palmetto extract (SPE) on TRPV1-mediated Ca<sup>2+</sup> influx and specific [<sup>3</sup> H]resiniferatoxin ([<sup>3</sup> H]RTX) binding to TRPV1 in HEK293 cells expressing TRPV1 (HEK293VR11 cells).</p><p><strong>Methods: </strong>Ca<sup>2+</sup> influx induced by and the direct binding activity of TRPV1 were measured using a method with Fura 2-AM, a cytoplasmic calcium indicator, and a radioligand binding assay using a [<sup>3</sup> H]RTX, respectively.</p><p><strong>Results: </strong>SPE did not markedly affect Ca<sup>2+</sup> influx in HEK293VR11 cells; however, it significantly inhibited capsaicin-induced increases in Ca<sup>2+</sup> influx in these cells. The specific binding of [<sup>3</sup> H]RTX in HEK293VR11 cells was saturable with K<sub>d</sub> value of 120 ± 7 pM and B<sub>max</sub> of 1.07 ± 0.10 fmol/mg protein, and was inhibited by low concentrations of non-labeled RTX with K<sub>i</sub> of 60.1 ± 7.6 nM. These results confirmed the pharmacological specificity of specific binding sites of [<sup>3</sup> H]RTX to TRPV1 in HEK293VR11 cells. SPE inhibited the specific binding of [<sup>3</sup> H]RTX in a concentration-dependent manner, with K<sub>i</sub> of 24.2 ± 1.4 μg/mL.</p><p><strong>Conclusions: </strong>The present study demonstrated for the first time, that SPE inhibited capsaicin-induced Ca<sup>2+</sup> influx with binding to TRPV1 in HEL293VR11 cells. These results will contribute to a more detailed understanding of the pharmacological effects of SPE on urinary dysfunction.</p>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"14 2","pages":"117-121"},"PeriodicalIF":1.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39536461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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