Continence (Amsterdam, Netherlands)最新文献

{"title":"Efficacy of percutaneous tibial nerve stimulation in pediatric bladder dysfunction: A systematic review and meta-analysis","authors":"Rayhan Adji Harimurthi,&nbsp;Fina Widia,&nbsp;Gerhard Reinaldi Situmorang,&nbsp;Harrina Erlianti Rahardjo,&nbsp;Irfan Wahyudi,&nbsp;Arry Rodjani,&nbsp;Putu Angga Risky Raharja","doi":"10.1016/j.cont.2026.102316","DOIUrl":"10.1016/j.cont.2026.102316","url":null,"abstract":"<div><h3>Introduction</h3><div>Lower urinary tract symptoms (LUTS) impair quality of life in children. Percutaneous tibial nerve stimulation (PTNS), a non-invasive neuromodulation treatment has shown promise in the adult population. However, its efficacy in children has yet to be thoroughly investigated.</div></div><div><h3>Method</h3><div>A PRISMA-compliant systematic review and meta-analysis was conducted to evaluate the efficacy of percutaneous tibial nerve stimulation (PTNS) in children with neurogenic and non-neurogenic lower urinary tract dysfunction (LUTD). Relevant studies published up to March 2025 were identified through searches of the Cochrane Library, Scopus, PubMed, and Google Scholar databases. Eligible studies included experimental and observational designs that assessed urinary symptoms, urodynamic outcomes, or treatment response in participants aged 18 years or younger. Data extraction was performed independently by two reviewers, and risk of bias was assessed using ROBINS-I for non-randomized studies and ROB 2 for randomized controlled trials. A random-effects model was applied for the meta-analysis.</div></div><div><h3>Results</h3><div>Twelve studies (including four RCTs) were included. Nine studies reporting lower urinary tract symptoms showed significant reductions in daytime incontinence (RR 0.45; 95 % CI 0.36–0.56; I² = 68 %), frequency (RR 0.42; 95 % CI 0.30–0.59; I² = 74 %), urgency (RR 0.39; 95 % CI 0.29–0.53; I² = 58 %), and nocturnal enuresis (RR 0.39; 95 % CI 0.21–0.73; I² = 60 %), with an overall pooled RR of 0.43 (95 % CI 0.34–0.55; I² = 63 %). Five studies reported maximum voided volume (MVV), demonstrating significant increases in within-group analyses (MD 40.36 mL; 95 % CI 17.63–63.10; I² = 76 %) and between-group comparisons (MD 34.05 mL; 95 % CI 5.53–62.76; I² = 77 %), for an overall pooled MD of 35.95 mL (95 % CI 21.88–50.03; I² = 84 %). Other urodynamic variables (Qmax, Qave, PVR, cystometric capacity, Pdetmax, pressure–flow indices) were heterogeneously reported and synthesised narratively; where available, signals favored improved storage function. Subtype effects for MNE vs NMNE were described narratively due to limited, non-uniform reporting.</div></div><div><h3>Conclusion</h3><div>Tibial nerve stimulation is associated with clinically meaningful improvement in core paediatric LUTS and a pooled increase in MVV, with a favourable safety profile. Benefits appear clearest in non-neurogenic phenotypes, while enuresis shows short-term gains with uncertain durability without maintenance. This review refines the evidence base by pairing symptom effects with urodynamic context and highlights priorities for future trials: ICCS-aligned endpoints, standardized and quantitative urodynamics, phenotype stratification (including MNE vs NMNE), and prospective evaluation of maintenance protocols.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102316"},"PeriodicalIF":1.2,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and pilot testing of the ICIQ-S-UDS – A questionnaire for assessing and auditing the patient satisfaction and value of urodynamics","authors":"Kathryn Jones ,&nbsp;Alan Uren ,&nbsp;Preksha Kuppanda ,&nbsp;Megan Pardoe ,&nbsp;Paul Abrams ,&nbsp;Hashim Hashim ,&nbsp;Laura Thomas ,&nbsp;Andrew Gammie ,&nbsp;Nikki Cotterill","doi":"10.1016/j.cont.2026.102313","DOIUrl":"10.1016/j.cont.2026.102313","url":null,"abstract":"<div><h3>Background</h3><div>Urodynamics (UDS) is an investigative procedure used to evaluate bladder symptoms. The International Consultation on Incontinence (ICIQ) Urodynamics-Satisfaction questionnaire, developed in 2004, measured patient satisfaction with UDS.</div></div><div><h3>Aim</h3><div>To develop new items assessing the perceived ‘value’ of UDS to the patient and to refine and validate the existing questionnaire items on patient ‘satisfaction’.</div></div><div><h3>Methods</h3><div>New items were developed, and the original questionnaire was updated using a modified Delphi process with clinical experts, followed by refinement through patient cognitive interviews. The resulting developmental questionnaire was pilot tested to assess its measurement properties.</div></div><div><h3>Results</h3><div>The final 16-item ICIQ-S-UDS, comprising 11 ‘satisfaction’ items, 5 ‘value’ items and two free-text fields, was developed following feedback from an 11-member expert panel and four rounds of cognitive interviews with 12 patients. In the pilot phase, 98 completed the questionnaire and 57 completed the test-retest administration. Internal consistency was α = 0.69 for the ‘satisfaction’ items and α = 0.63 for the ‘value’ items. Exploratory factor analysis was not conducted due to low response variability and borderline Cronbach’s alpha values. Test-retest reliability for most items demonstrated moderate agreement or higher (kappa, κ ≥ 0.41), although 95 % confidence intervals were wide.</div></div><div><h3>Conclusion</h3><div>The ICIQ-S-UDS can be recommended as a survey tool suitable for auditing and evaluating UDS clinical practice and patient care. However, further evidence from larger and more diverse patient samples are needed to support its use as a robust measurement scale.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102313"},"PeriodicalIF":1.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening tools to identify a neurogenic cause for pelvic organ dysfunction: A scoping review","authors":"Katie Webb ,&nbsp;Imogen Pateman ,&nbsp;Jason Mallabone ,&nbsp;Sophie Prudence ,&nbsp;Tabitha Pridham ,&nbsp;Jessica Pun ,&nbsp;Caroline M. Alexander ,&nbsp;Gemma Clunie ,&nbsp;Marcus J. Drake","doi":"10.1016/j.cont.2025.102312","DOIUrl":"10.1016/j.cont.2025.102312","url":null,"abstract":"<div><h3>Background</h3><div>Pelvic organ dysfunction can be an early sign of neurological disease, potentially preceding recognition of the underlying neurogenic mechanism. Screening tools are widely used in healthcare to aid early detection. Many tools exist for assessing pelvic organ symptoms, but it is unclear if any are designed to identify whether neurological disease is causing pelvic organ symptoms, nor whether there may be a potential neurogenic basis for such symptoms in the absence of prior neurological diagnosis.</div></div><div><h3>Objective</h3><div>To identify assessment and diagnostic tools used to evaluate pelvic organ symptoms in neurological disease and determine their intended purposes, including whether any are designed to evaluate likelihood of neurogenic basis.</div></div><div><h3>Methods</h3><div>A scoping review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) scoping review guidance. Searches of MEDLINE, CINAHL, and Embase databases included terms such as “assessment and screening tools,” “neurological conditions,” and “pelvic organ dysfunction.”</div></div><div><h3>Results</h3><div>From 1600 papers screened, 513 were included. Across these, 212 different tools were identified, covering a wide variety of uses. However, none were specifically developed to screen for a neurogenic cause of pelvic organ symptoms in patients with or without a prior neurological diagnosis.</div></div><div><h3>Conclusions</h3><div>There are currently no tools designed to establish neurogenic mechanisms underlying pelvic organ symptoms. For undiagnosed individuals, this type of tool would trigger prompt neurology review, potentially improving prognosis. Developing a screening tool focused on detecting neurogenic origins could support earlier recognition and management of many neurological conditions associated with pelvic organ dysfunction.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102312"},"PeriodicalIF":1.2,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent urgency-activated, transcutaneous tibial nerve stimulation: Feasibility and urodynamic effects in overactive bladder","authors":"Javier A. Muñoz ,&nbsp;John PFA. Heesakkers ,&nbsp;Diego Leiva ,&nbsp;Joaquín O. García ,&nbsp;Pablo A. Gálvez","doi":"10.1016/j.cont.2025.102310","DOIUrl":"10.1016/j.cont.2025.102310","url":null,"abstract":"<div><div>This short report extends our previous proof-of-concept on intermittent, urgency-activated transcutaneous tibial nerve stimulation (TTNS) during invasive cystometry. Twenty-one adults with overactive bladder and detrusor overactivity underwent consecutive baseline and urgency-activated TTNS cystometries, with stimulation manually triggered at each onset of urgency. Compared with baseline, TTNS increased maximum cystometric capacity by 79 mL and reduced maximum detrusor pressure by 26 cmH₂O, with marked reductions in involuntary detrusor contractions and urgency urinary incontinence episodes. Overall, 85.7 % of participants met predefined response criteria, including complete suppression of detrusor overactivity in 71.4 % (Criterion A) and partial response in 14.3 % (Criterion B). Exploratory clustering identified three response patterns: a robust global response (capacity and pressure), a moderate balanced response, and a pressure-dominant response with limited capacity change. These findings confirm feasibility but derive from a modest, single-arm physiological study; larger sham-controlled trials are required to validate these patterns and clarify clinical relevance.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102310"},"PeriodicalIF":1.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The bladder trigone: A sensory organ?","authors":"Karl-Erik Andersson ,&nbsp;Anthony Kanai ,&nbsp;Bengt Uvelius","doi":"10.1016/j.cont.2025.102309","DOIUrl":"10.1016/j.cont.2025.102309","url":null,"abstract":"<div><div>The bladder trigone is a distinct anatomical and functional subregion of the urinary bladder, defined by its triangular configuration between the ureteral orifices and the internal urethral orifice. Although traditionally less studied compared to the bladder dome and detrusor body, recent morphological, molecular, and transcriptomic analyses reveal that the trigone is highly specialized. Understanding the trigone's role in sensory signaling, urinary continence, and pathophysiological conditions such as bladder pain syndrome and vesicoureteral reflux provides a basis for developing therapeutic approaches to treat disorders involving this structure.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102309"},"PeriodicalIF":1.2,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors of clinical success for treatment of urgency urinary incontinence using implantable tibial neuromodulation","authors":"Harry J. Kendall ,&nbsp;Roger R. Dmochowski ,&nbsp;John P.F.A. Heesakkers","doi":"10.1016/j.cont.2025.102308","DOIUrl":"10.1016/j.cont.2025.102308","url":null,"abstract":"<div><h3>Introduction</h3><div>Implantable tibial Neuromodulation (iTNM) is an emerging therapy for overactive bladder (OAB). In the Revi® system (BlueWind Medical), the implanted electrode is activated through an external wearable. This study aims to identify characteristics tied to a positive clinical response.</div></div><div><h3>Methods</h3><div>The OASIS Study was a prospective, multicentre, single arm trial, evaluating Revi in adult females with urgency urinary incontinence. Baseline characteristics and voiding diaries at 1, 3, 6, 9, and 12months were analyzed. Multivariate logistic regression identified predictors of response, with significance set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>A total of 151 participants were implanted, with 135–146 providing voiding diaries throughout 12 months of follow-up. The overall success rate at 12 months was 82 %. Prior use of OAB medication was a positive predictor of success at 6, 9 and 12 months (OR; 3.31, 5.14, 4.51, respectively). Larger leg circumference (&gt;23 cm) predicted lower odds of success at 3 months (OR 0.16) and 6 months (OR 0.28). BMI &gt;30 kg/m² was negatively associated with success at 9- and 12-months (OR 0.30 and OR 0.29, respectively). Presence of large leaks reduced odds of success at all timepoints, except for 12 months (OR range 0.15–0.5). Baseline quality of life was associated with success, though not linearly.</div></div><div><h3>Conclusion</h3><div>Most female participants benefited from the Revi System treatment. Larger leg circumference and higher BMI predicted lower success at early and later timepoints, respectively. Large leaks were modestly associated with poorer outcomes. Recent OAB medication use predicted better treatment response.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102308"},"PeriodicalIF":1.2,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment: LUTD in rare pediatric neurological conditions: A joint report by the neurourology promotion committee and children and young adults committee","authors":"Cagri Akin Sekerci ,&nbsp;Selcuk Yucel ,&nbsp;Tufan Tarcan","doi":"10.1016/j.cont.2025.102301","DOIUrl":"10.1016/j.cont.2025.102301","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"16 ","pages":"Article 102301"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary and fecal incontinence following childbirth","authors":"Ian Milsom,&nbsp;Maria Gyhagen","doi":"10.1016/j.cont.2025.102306","DOIUrl":"10.1016/j.cont.2025.102306","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102306"},"PeriodicalIF":1.2,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed-methods scoping review on bladder self-care practices in women with and without lower urinary tract symptoms","authors":"Jean F. Wyman ,&nbsp;Kristine M.C. Talley ,&nbsp;Melanie Meister ,&nbsp;Diane K. Newman ,&nbsp;Amy M. Claussen ,&nbsp;Julia Geynisman-Tan ,&nbsp;Deepa Camega ,&nbsp;Jeni Hebert-Beirne ,&nbsp;Lisa Kane Low ,&nbsp;Ann Stapleton","doi":"10.1016/j.cont.2025.102300","DOIUrl":"10.1016/j.cont.2025.102300","url":null,"abstract":"<div><div>This scoping review synthesized literature on women's bladder self-care practices by: 1) describing study characteristics; 2) identifying questionnaires used to assess self-care; and 3) summarizing behaviors relevant to bladder health. Five databases and reference lists were searched through April 2025 for qualitative, quantitative, and mixed-methods studies. Ninety-seven studies were included, identifying 107 behaviors grouped into four domains: Toileting and Bladder Management, Personal Care and Hygiene Practices, Lifestyle and Behavioral Strategies, and Therapeutic Interventions. Most studies focused on women with urinary symptoms, with few population-based samples. No comprehensive, validated questionnaire assessing the full scope of bladder self-care was identified. Women engage in diverse behaviors that may influence bladder health. A validated, multidimensional questionnaire is needed to assess these behaviors, identify risk and protective factors, and guide preventive interventions.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102300"},"PeriodicalIF":1.2,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing access to incontinence products in Low- and middle-income countries","authors":"Muhidin Adan Abdulla","doi":"10.1016/j.cont.2025.102305","DOIUrl":"10.1016/j.cont.2025.102305","url":null,"abstract":"","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"17 ","pages":"Article 102305"},"PeriodicalIF":1.2,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}