Recurrent Urinary Tract Infections and Asymptomatic Bacteriuria in Adults
AbstractPurpose of reviewOur goal was to summarize recent evidence regarding recurrent urinary tract infections and asymptomatic bacteriuria in different adult populations.Recent findingsSeveral research groups are focused on the description of resident bacterial flora in the bladder and urinary dysbiosis in the microbiome era. Even the definitions might change in light of these discoveries. However, the role of urinary microbiome and bacterial interference has still to be determined.SummarySystematic treatment of asymptomatic bacteriuria is not recommended and even classic indications such as asymptomatic bacteriuria in p...
Source: Current Bladder Dysfunction Reports - December 1, 2021 Category: Urology & Nephrology Source Type: research

Role of Surgery in Bladder Pain Syndrome
AbstractPurpose of ReviewBladder pain syndrome is a clinical condition with many aspects to its presentation and numerous suggested treatments, many of which remain controversial. Reconstructive surgery should only be considered when all the conservative options have been exhausted and only after careful counselling. The purpose of this review is to demonstrate the current evidence in the surgical management of this disease, preparatory to which we have reviewed the surgical aspects.Recent FindingsFor medical treatment, the evidence base is of poor quality and based on case series. Nevertheless, in carefully selected patie...
Source: Current Bladder Dysfunction Reports - November 15, 2021 Category: Urology & Nephrology Source Type: research

Evidence for the Appropriate Use of Telemedicine in Female Pelvic Medicine and Reconstructive Surgery
AbstractPurpose of ReviewTo summarize the available literature regarding telehealth interventions in the management of pelvic floor disorders.Recent FindingsMost Female Pelvic Medicine and Reconstructive Surgery (FPMRS) patients own and feel comfortable operating the technology required to participate in telehealth interventions and would be willing to interact remotely with their providers. Telehealth may be an appropriate and effective tool for patient education about bladder and pelvic physiology and pathophysiology, remote pelvic floor muscle strengthening when in-person physical therapy is not accessible, overactive b...
Source: Current Bladder Dysfunction Reports - November 3, 2021 Category: Urology & Nephrology Source Type: research

Optimizing Lead Placement in Sacral Neuromodulation
AbstractPurpose of reviewSacral neuromodulation remains an effective therapy for multiple conditions and both the technology and implant techniques have evolved over more than two decades. Understanding of the ideal conditions for testing and administration of the therapy continue to progress as well, though considerable controversy still exists. This review seeks to clarify the current knowledge and opinion surrounding types of neuromodulation testing, what constitutes an optimized lead and best practices for maximizing therapeutic success.Recent findingsThere are distinct advantages and disadvantages to each method of sa...
Source: Current Bladder Dysfunction Reports - July 28, 2021 Category: Urology & Nephrology Source Type: research

Questionnaires to Evaluate Lower Urinary Tract Symptoms in Men and Women
AbstractPurpose of ReviewTo discuss the current state of questionnaires evaluating lower urinary tract symptoms (LUTS) in men and women.Recent FindingsThere exist numerous validated patient-reported outcome questionnaires that evaluate a variety of LUTS in men and women. Existing questionnaires tend to cover specific domains and populations, with variable scoring systems and limited applications. There has been a general lack of a standardized validated instrument to assess the spectrum of LUTS across both men and women. In recent years, the development of a standardized broad-spectrum symptom index by the Lower Urinary Tr...
Source: Current Bladder Dysfunction Reports - June 25, 2021 Category: Urology & Nephrology Source Type: research

Understanding the FDA Device Approval Process in FPMRS
AbstractPurpose of ReviewThis review will provide an understanding of the FDA device approval process, particularly with respect to medical devices used in female pelvic medicine and reconstructive surgery.Recent FindingsBringing a novel medical device to the market through the FDA regulatory process can be broken down into four steps: device classification, selecting and preparing premarket-submission regulatory pathways, FDA review of premarket-submissions, and postmarket regulatory controls.SummaryWhile the FDA regulatory process can be daunting, physicians and surgeons have the responsibility toward unmet needs of pati...
Source: Current Bladder Dysfunction Reports - June 22, 2021 Category: Urology & Nephrology Source Type: research

Neuroanatomy of Bladder Pain
AbstractPurpose of ReviewIn this review, we summarize the most recent literature on neurobiology of bladder pain in a systematic fashion starting with end organ, peripheral nervous system, the spinal cord, and ending with the brain. Special attention is dedicated to pain processing in patients with spinal cord injury.Recent FindingsChronic bladder pain is not an isolated entity and is in fact a result of a complex interaction between the end organ, surrounding structures, and peripheral and central nervous system. The afferent fibers collecting the information from the bladder urothelium and mucosa are a very diverse popul...
Source: Current Bladder Dysfunction Reports - June 15, 2021 Category: Urology & Nephrology Source Type: research

Cannabinoid Therapy in Female Pelvic Medicine and Reconstructive Surgery: Current Evidence and Future Directions
AbstractPurpose of ReviewIn this review, we examine the current literature regarding the use of cannabinoids in several areas of female pelvic medicine and reconstructive surgery (FPMRS) including overactive bladder, interstitial cystitis/bladder pain syndrome, and chronic pelvic pain.Recent FindingsAnimal models support the role of the endocannabinoid system in the pathophysiology of these disorders and several drug targets have been identified. However, clinical studies remain limited. Palmitoylethanolamine (PEA) is emerging as a possible therapy for pain in this context.SummaryThere is currently insufficient evidence to...
Source: Current Bladder Dysfunction Reports - May 31, 2021 Category: Urology & Nephrology Source Type: research

Contemporary Review of MRI in Benign Genitourinary Pelvic Medicine: What Every Urologist Should Know
AbstractPurpose of ReviewHerein we report a systematic review of literature to identify the contemporary focus areas of magnetic resonance imaging (MRI) use in benign Urology and present the highest yield results.Recent FindingsMRI, specifically upright MRI, in combination with proper instructions and repeated Valsalva maneuvers, allows for more objective assessment of pelvic organ prolapse (POP) staging. The lack of standardization of reference lines and points used in MRI evaluation of POP is a key limitation. Evaluation of prostate artery embolization (PAE) as an effective treatment for benign prostatic hyperplasia (BPH...
Source: Current Bladder Dysfunction Reports - May 31, 2021 Category: Urology & Nephrology Source Type: research

Urinary Tract Infection in the Neurogenic Bladder: an Update of Surgical and Non-surgical Management
AbstractPurpose of ReviewThis review explores the current literature surrounding non-surgical and surgical management strategies for urinary tract infections (UTIs) in adult patients with neurogenic lower urinary tract dysfunction. UTIs in patients with neurogenic bladders (NB) are recurrent and lifelong contributors to morbidity and mortality. Diagnosis and treatment of UTIs in this patient population are significantly more challenging and require thoughtful clinical decision-making. Topics such as risk factors, diagnosis, nonoperative treatment strategies, and surgical management will be discussed.Recent FindingsCurrent ...
Source: Current Bladder Dysfunction Reports - May 29, 2021 Category: Urology & Nephrology Source Type: research

Current Bladder Dysfunction Reports Thulium Laser Prostatectomy
AbstractPurpose of ReviewThe purpose of this review is to summarize the literature on safety and efficacy of minimally invasive thulium laser procedures for benign prostatic hypertrophy (BPH).Recent FindingsRecent studies have confirmed long-term safety and efficacy of thulium laser prostatectomy. There has been recent literature published from around the world confirming safety and efficacy in treatment of large prostates, obese patients, and in patients taking oral anticoagulation. Newer thulium laser systems use a wavelength of 1.9 μm instead of 2 μm. Thus far, no clinical differences have been seen in outcomes of...
Source: Current Bladder Dysfunction Reports - April 24, 2021 Category: Urology & Nephrology Source Type: research

The Importance of Quality Assurance and Quality Improvement in Low- and Middle-Income Settings
AbstractPurpose of ReviewThis review will discuss the importance of quality improvement in low- and middle-income settings as well as several potential barriers to these measures.Recent FindingsThere is substantial potential for growth in the field of quality improvement in low-resource settings. The extent of quality improvement (QI) research in low-resource settings is limited but expanding.SummaryPatient harm that is attributable to the costs of poor quality is a significant factor in all practice settings but is arguably of greater impact in limited-resource settings. Due to the recognized human, physical, and technolo...
Source: Current Bladder Dysfunction Reports - March 5, 2021 Category: Urology & Nephrology Source Type: research

Neurogenic Bowel in the Pediatric Patient —Management from Childhood to Adulthood
AbstractPurpose of ReviewThe current literature on neurogenic bowel will be addressed with a specific focus on spina bifida population. Topics will include bowel management, clinical care pathways, variation in care, quantification of dysfunction, and quality of life outcomes.Recent FindingsThere have been several recent studies that retrospectively review the outcomes from a national spina bifida registry as well as ongoing work regarding the development and validation of quality of life (QOL) instruments for the neurogenic populations. These studies have highlighted the significance of any fecal incontinence and its nega...
Source: Current Bladder Dysfunction Reports - January 23, 2021 Category: Urology & Nephrology Source Type: research

Intravesical Therapy for BPS/IC
AbstractPurpose of ReviewThis manuscript gives a recent overview of intravesical treatments in patients with bladder pain syndrome/interstitial cystitis (BPS/IC). The newest data on GAG replenishment therapy, intravesical local anaesthetics, DMSO, botulinum toxin, experimental drugs, and ways of application are discussed.Recent FindingsThe literature data show symptomatic therapeutic successes in a limited number of patients with most treatments discussed here. The heterogeneity of BPS/IC, the absence of clear knowledge of the cause in each patient, the different phenotypes included in the same research sample, the variabi...
Source: Current Bladder Dysfunction Reports - January 11, 2021 Category: Urology & Nephrology Source Type: research

Biomarkers for Bladder Pain Syndrome/Interstitial Cystitis
AbstractPurpose of ReviewIn this manuscript, the literature published in the past 5  years about BPS/IC biomarkers was reviewed. Topics include BPS/IC biomarkers, the classical BPS/IC diagnostic, clinical outcomes as a new concept of BPS/IC phenotyping biomarkers, BPS/IC urinary biomarkers, BPS/IC bladder tissue biomarkers and BPS/IC biomarkers outside the bladder.Recent FindingsThe importance of patients ’ phenotyping and sub-grouping emerged as a way of finding new BPS/IC biomarkers and treatment. Also, the use of non-invasive methodologies and of artificial intelligence approaches has been gaining momentum in...
Source: Current Bladder Dysfunction Reports - January 8, 2021 Category: Urology & Nephrology Source Type: research

Sexual Health in the Neurogenic Patient
AbstractPurpose of ReviewIn this review, the current literature addressing sexual health in common neurologic conditions will be summarized. Conditions discussed include stroke, multiple sclerosis, spinal cord injury, and spina bifida.Recent FindingsThere is an increasing awareness of sexual dysfunction in patients with neurologic injury and of the role of sexual therapy in improving quality of life.SummarySexual health in a neurogenic patient is dependent upon a variety of factors. Determining the most influential sources of sexual dysfunction is important for providing effective treatment. (Source: Current Bladder Dysfunction Reports)
Source: Current Bladder Dysfunction Reports - December 9, 2020 Category: Urology & Nephrology Source Type: research

Cranberry Products for the Prevention of Catheter-Associated Urinary Tract Infections
AbstractPurpose of ReviewIn this review, we examine the current literature regarding the use of cranberry and other complimentary methods for the prevention of catheter-associated urinary tract infections (CAUTIs).Recent FindingsSome studies have suggested cranberry products may have a positive effect in reducing the incidence of CAUTIs in patients with normal bladder function receiving short-term catheterization, while other studies have failed to show the benefits of cranberry products for the reduction of CAUTIs.SummaryWhile there is some data suggesting cranberry-derived products may reduce CAUTIs in specific patient p...
Source: Current Bladder Dysfunction Reports - December 7, 2020 Category: Urology & Nephrology Source Type: research

The Role of Organizations like IVUmed in Developing Centers of Excellence
AbstractPurposeAs healthcare disparity gaps continue to grow across the globe, so too are the efforts aimed at addressing them. Here we review the most common platforms currently used in global health and advantages and disadvantages of each. We highlight international organizations that have prioritized health system strengthening and long-term sustainability and apply the lessons learned from these endeavors to propose mechanisms for developing centers of excellence in low- and middle-income countries.SummaryHealth system strengthening must be prioritized in international urologic endeavors. Without recognizing this as a...
Source: Current Bladder Dysfunction Reports - December 2, 2020 Category: Urology & Nephrology Source Type: research

Management of Pelvic Floor Disorders in Young Women
AbstractPurpose of ReviewThis review is meant to guide female pelvic medicine providers on treatment of pelvic floor disorders in the relatively uncommon population of younger women.Recent FindingsPresented herein are recent data on pelvic floor muscle training in the postpartum period to help with prevention of pelvic floor disorders as well as surgical outcomes in younger women.SummaryAlthough new evidence is available on prevention and treatment for younger patients, more RCTs and cohort studies are needed. (Source: Current Bladder Dysfunction Reports)
Source: Current Bladder Dysfunction Reports - November 26, 2020 Category: Urology & Nephrology Source Type: research

Treatment of Overactive Bladder in the Frail Patient
AbstractPurpose of ReviewTo understand how frailty interacts with overactive bladder. To explore how frailty should be considered when devising an individualized treatment plan for OAB patients.Recent FindingsFrailty can be assessed in the outpatient office without undue burden. The urology community is increasingly aware of the importance of evaluating a patient for frailty and including this assessment in treatment algorithms. Frailty should be considered when treating OAB patients, since frail OAB patients are more susceptible to the potential deleterious consequences of medical therapy, onabotulinumtoxinA therapy, and ...
Source: Current Bladder Dysfunction Reports - November 25, 2020 Category: Urology & Nephrology Source Type: research

Review of Current Neurogenic Bladder Best Practices and International Guidelines
AbstractPurpose of ReviewCurrent guidelines for neurogenic bladder (NGB) contain contrasting recommendations in several areas. In this review, the current literature published over the last 5  years will be critically evaluated.Recent FindingsA number of novel techniques and therapeutic agents have been introduced in the past 5  years or are currently under investigation. Current guidelines do not take these into account. Mirabegron, electromotive onabotulinumtoxin, hydrogel onabotulinumtoxin, progress in neuromodulation (laparoscopic lead implantation, utility in acute and incomplete spinal cord injury (SCI), tr...
Source: Current Bladder Dysfunction Reports - November 17, 2020 Category: Urology & Nephrology Source Type: research

The Evidence For and Against Prostate-Reducing Procedures for Men with Neurogenic Bladder
AbstractPurpose of ReviewThe evaluation of anatomic bladder outlet obstruction due to benign prostatic hyperplasia in patients with neurogenic bladder dysfunction can be a challenging and complex process for urologists. Lower urinary tract symptoms are non-specific, and the attribution of symptoms to underlying neurologic disease may result in withholding potentially beneficial therapies and procedures from patients with benign prostatic hyperplasia. Conversely, the underlying neurologic disorder may have profound effects on lower urinary tract symptoms and quality of life and must be considered in patient management decis...
Source: Current Bladder Dysfunction Reports - November 14, 2020 Category: Urology & Nephrology Source Type: research

Antibiotic Prophylaxis in Pelvic Floor Surgery
AbstractPurpose of ReviewThe goal of this review is to summarize the current recommendations and evidence for the use of antibiotic prophylaxis in pelvic floor surgery. We provide a historical perspective on antimicrobial prophylaxis, review bacteria associated with pelvic floor surgery by site, and current antimicrobial prophylaxis recommendations from the American Urological Association (AUA) and American College of Obstetrics and Gynecology (ACOG).Recent FindingsACOG published updated recommendations for perioperative prophylaxis in June 2018 and the AUA in June 2019. There has been a complete de-emphasis on the use of ...
Source: Current Bladder Dysfunction Reports - November 13, 2020 Category: Urology & Nephrology Source Type: research

The Necessity of Postoperative Bladder Training by Intermittent Clamping: a Urologist ’s View
AbstractPurpose of ReviewThe aim of the study is to evaluate the feasibility of postoperative bladder training by intermittent clamping.Recent FindingsUrinary catheterization is a common technique in clinical practice. However, there is no consensus on its management prior to the removal of the indwelling catheter in postoperative situations.SummaryThis review illustrates that bladder training by intermittent clamping prior to the removal of urinary catheters is not necessary. Additionally, intermittent clamping of urinary catheter might carry the risk of complications such as prolonging urinary catheter retention, urinary...
Source: Current Bladder Dysfunction Reports - November 13, 2020 Category: Urology & Nephrology Source Type: research

The Current Status of Global Urology
AbstractPurpose of ReviewEverybody will be aware of the inequality in the provision of healthcare across the planet, but relatively few people will be aware of the scale of the problem. In this article, we will summarize what is known about the problem, what is being done to address the deficiencies and an argument will be made for a more collaborative approach.Recent FindingsThere has traditionally been sparse data on the outcomes of surgical humanitarian missions. Recent studies assessing the effects of planned mission trips have revealed widely varying complication rates. There continues to be little published on long-t...
Source: Current Bladder Dysfunction Reports - November 11, 2020 Category: Urology & Nephrology Source Type: research

The Role of Pelvic Neurophysiology Testing in the Assessment of Patients with Voiding Dysfunction
AbstractPurpose of ReviewThe role of pelvic neurophysiology testing in the evaluation of patients with lower urinary tract (LUT) symptoms is explored in this review.Recent FindingsDifferent neurophysiology tests such as sphincter EMG and pudendal somatosensory evoked potentials are useful in evaluating the sacral somatic afferent and efferent innervation. S2 and S3 dermatomal evoked potentials assess individual sacral roots and are feasible to perform using standard neurophysiology machines.SummaryThe innervation of the LUT has a substantial contribution from splanchnic and somatic nerves arising from the sacral segments. ...
Source: Current Bladder Dysfunction Reports - November 9, 2020 Category: Urology & Nephrology Source Type: research

Simulation Training in Endo-urology: a New Opportunity for Training in Senegal
AbstractPurpose of ReviewTeaching of surgery has long relied on live practice. The advent of endo-urology and laparoscopy have favored the development of simulation. The purpose of this study was to evaluate the role of simulation in the development of a center of excellence center in Senegal.Recent FindingsSimulation has become the standard for surgical training students in Europe and the USA, allowing for a better and faster learning. The routine practice of minimally invasive surgery in urology along with a high number of residents should favor the use of simulation in this setting.SummaryThe experts achieved a higher p...
Source: Current Bladder Dysfunction Reports - November 6, 2020 Category: Urology & Nephrology Source Type: research

Contemporary Landmark Trials Update in the Management of Idiopathic Overactive Bladder
AbstractPurpose of ReviewThe landmark trials evaluating the different lines of treatment for overactive bladder (OAB) were reviewed to provide a summary of the most recent advances in behavioral, medical, and surgical management of OAB in the last 5 to 10  years.Recent FindingsClinical trials for the treatment of OAB have evaluated the efficacy and effectiveness of different combinations of medical management, surgical management, and conservative therapies in quality of life improvement in these patients. All three lines of therapy include safe and effective treatment options that can be used as monotherapy or in com...
Source: Current Bladder Dysfunction Reports - November 6, 2020 Category: Urology & Nephrology Source Type: research

Assessing In Vivo Bladder Urothelial Hyper-Permeability: Preclinical and Clinical Implications
AbstractPurpose of ReviewTo provide an update on the detection and evaluation of bladder hyper-permeability related to interstitial cystitis/painful bladder syndrome (IC/PBS) and inflammatory bowel disorders (e.g., inflammatory bowel syndrome).Recent FindingsWe developed a contrast-enhanced magnetic resonance imaging (CE-MRI) approach to assess in vivo bladder hyper-permeability by instilling a MRI contrast agent, Gd-DTPA (gadolinium diethylenetriamine pentaacetic acid), by intravesical injection through a catheter into the bladder. Molecular-targeted MRI (mt-MRI) was also used to assess in vivo bladder hyper-permeability-...
Source: Current Bladder Dysfunction Reports - November 4, 2020 Category: Urology & Nephrology Source Type: research

Vesicoureteral Reflux: Special Considerations and Specific Populations
AbstractPurpose of ReviewThis review will hopefully serve as a brief update on the current approaches to vesicoureteral reflux (VUR) within the context of historical approaches to this disorder and dispelling some of the myths surrounding its treatment. There is also greater focus on certain populations with VUR that may (or may not) be at particular risk.Recent FindingsDespite several large studies showing the benefit of antibiotic prophylaxis in preventing infections in VUR, there continues to be conflicting results in smaller scale studies or in regard to renal scarring that prevent its accepted use universally. Some of...
Source: Current Bladder Dysfunction Reports - November 4, 2020 Category: Urology & Nephrology Source Type: research

Management of Chronic Bacteriuria in Neurogenic Bladders
AbstractPurpose of the ReviewLower urinary tract dysfunction is a major cause of morbidity in patients with neurogenic conditions. One of the significant issues in this group is urinary tract infections. In this review, the causes of bacteriuria along with the symptoms, diagnosis, prevention and treatment options will be discussed.Recent FindingsAs in other areas of neuro-urology there is a lack of randomized controlled trials in this field. Most of the evidence is from retrospective cohort studies. Nonetheless, there are a number of guidelines and consensus statements from international organizations to standardize the tr...
Source: Current Bladder Dysfunction Reports - November 3, 2020 Category: Urology & Nephrology Source Type: research

Cost-Effectiveness and Economic Benefits of Volunteerism
AbstractPurpose of ReviewSurgical pathology is very common, but access to even basic care is not universal. Volunteers, either individually or as part of a larger organization, have arisen to fill this gap. As volunteerism is ubiquitous, true audits of cost-effectiveness are equally as rare. We explore the economic benefits of volunteerism as well as potential metrics by which its cost-effectiveness may be assessed.Recent FindingsThere are a number of models after which a volunteer program may be structured —from the individual volunteer visiting a particular center to the establishment of self-sustaining units which...
Source: Current Bladder Dysfunction Reports - October 30, 2020 Category: Urology & Nephrology Source Type: research

Vaginal Yeast Infection
AbstractPurpose of ReviewThis review includes a detailed overview of the vaginal yeast infection based on current literature available, addressing etiology, epidemiology, risk factors, and pathophysiology, as well as clinical presentation, burden, diagnostic, and treatment strategies.Recent FindingsThere are multiple meta-analyses, systematic reviews, randomized control trials, and critical reviews recently published that have advanced the understanding of pathophysiology and answered questions regarding global burden, prevention, and treatment in a systematic way.SummaryIn the recent years, important work has been made to...
Source: Current Bladder Dysfunction Reports - October 28, 2020 Category: Urology & Nephrology Source Type: research

Urinary Tract Infection and Pelvic Organ Prolapse —an Association that Needs Further Clarification
AbstractPurpose of ReviewThis review will summarize the latest evidence regarding an association between urinary tract infection and pelvic organ prolapse. Topics include pelvic organ prolapse, urinary tract infection, surgical and conservative interventions for pelvic organ prolapse, and the risk for urinary tract infection, catheterizations, and prophylaxis for urinary tract infection and pelvic organ prolapse.Recent FindingsAlthough no studies were found regarding mechanistic factors for the association between UTI and POP, or with the degree/severity of prolapse with the risk for UTI, this review adds critical informat...
Source: Current Bladder Dysfunction Reports - October 25, 2020 Category: Urology & Nephrology Source Type: research

Hydatid Disease of the Urinary Bladder: a Review
AbstractPurpose of ReviewWe sought to discuss the current literature on the hydatid disease of the bladder. We will shed light on history and physical findings, successful diagnostic work ups, and the various treatment options.Recent FindingsCurrently, the literature on hydatid disease of the bladder is primarily case studies with limited number of patients. While hydatid disease is prevalent in endemic areas, hydatid disease of the bladder is rare and presents after years of cyst enlargement and subsequent symptoms.SummaryClinical manifestations usually depend on the site and size of the cysts; however, patients can prese...
Source: Current Bladder Dysfunction Reports - October 24, 2020 Category: Urology & Nephrology Source Type: research

Managing Sphincter Deficiency Stress Urinary Incontinence in the Neurogenic Patient: Diagnosis and Management Strategies
AbstractPurpose of ReviewIn this review, we present the current literature on the diagnosis and management of stress urinary incontinence induced by sphincter deficiency associated with neurogenic lower urinary tract dysfunction.Recent FindingsBecause sphincter deficiency stress urinary incontinence is not a common condition, there are no guidelines or large-scale clinical studies that focus on the diagnosis and management of this condition. Although there is consensus that urodynamic investigation is the only method to assess the function of the lower urinary tract, there is no established urodynamic criteria to diagnose ...
Source: Current Bladder Dysfunction Reports - October 24, 2020 Category: Urology & Nephrology Source Type: research

Urodynamics for the “Failed” Midurethral Sling
AbstractPurpose of ReviewThe goal of this paper is to provide the reader with three distinct definitions of midurethral sling failure and provide guidance on the work up and management of each definition.Recent FindingsThe definition of sling failure should include not only patients with recurrent and persistent stress urinary incontinence but also those with de novo voiding symptoms and overactive bladder as a result of their midurethral sling. Urodynamics are less commonly performed for the straightforward patient with stress urinary incontinence prior to a midurethral sling. However, there is evidence that urodynamics s...
Source: Current Bladder Dysfunction Reports - September 13, 2020 Category: Urology & Nephrology Source Type: research

Addressing Sphincter Dysfunction in the Female with Neurogenic Lower Urinary Tract Dysfunction
AbstractPurpose of ReviewNeurogenic sphincter dysfunction in females will be discussed with reference to both foundational and contemporary research with an emphasis on tools for urologic management. The article will focus on both conservative and surgical options for patients broadly characterized with underactive or overactive sphincter dysfunction.Recent FindingsThere is limited recently published prospective data to guide management; however, there exist several insightful retrospective studies to guide practice.SummaryThe bulk of literature for the management of sphincter dysfunction for this complex patient populatio...
Source: Current Bladder Dysfunction Reports - August 2, 2020 Category: Urology & Nephrology Source Type: research

Current State of Fetal Intervention for Obstructive Uropathy –Focus on Bladder
AbstractPurpose of the ReviewThe authors present an overview of the mostly formative and latest literature on the current fetal management of lower urinary tract obstruction (LUTO) and postnatal renal outcome with a special focus on the bladder.Recent FindingsSince the PLUTO trial [1] in 2013, only a few retrospective studies have been published which compared fetal cystoscopy with the placement of a vesicoamniotic shunt (VAS) and showed that both interventions are superior to conservative management because they improve the 6  months survival rates in severe LUTO. In contrast, only fetal cystoscopy provides a trend o...
Source: Current Bladder Dysfunction Reports - July 17, 2020 Category: Urology & Nephrology Source Type: research

Phenotypes of BPS/IC
AbstractPurpose of ReviewThe aim of this review is to summarise the latest research related to different phenotypes of BPS/IC, addressing the evidence for current well-defined phenotypes as well as identifying novel potential phenotypes and highlighting areas for future study.Recent FindingsTwo distinct phenotypes of BPS/IC are well-recognised: Hunner ’s lesion disease and non-Hunner’s lesion BPS/IC. Recent studies have shown these phenotypes exhibit distinct clinical, pathological and cystoscopic features, and targeted treatment to Hunner’s lesions can prove effective. Recent studies have also identified...
Source: Current Bladder Dysfunction Reports - July 16, 2020 Category: Urology & Nephrology Source Type: research

Healthcare Disparities in the Treatment of Pelvic Floor Disorders
AbstractPurpose of ReviewPelvic floor disorders (PFD) include urinary incontinence, pelvic organ prolapse, fecal incontinence and other storage and emptying abnormalities. These disorders are common among women and are significantly undertreated. Healthcare disparities may partly explain this phenomenon.Recent FindingsDisparities in the treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence can be stratified by race, age, and socioeconomic status. Race is often closely intertwined with socioeconomic status, access to care, and mistrust of healthcare providers. Overall, the etiology of disparities ...
Source: Current Bladder Dysfunction Reports - July 13, 2020 Category: Urology & Nephrology Source Type: research

Benefits of an International Volunteer Experience in Residency Training
AbstractPurpose of ReviewIn this article, we review the literature describing the benefit of international surgical volunteerism on resident training.Recent FindingsReview of recent data demonstrates a resident benefit by decreasing burnout and improving clinical skill, cost-containment strategies, and personal and professional development. There is also a demonstrable benefit to institutions by way of improved resident recruitment and additional philanthropic funding sources. Finally, benefits to healthcare systems have been documented by way of “reverse innovation” and increased healthcare worker productivity...
Source: Current Bladder Dysfunction Reports - July 5, 2020 Category: Urology & Nephrology Source Type: research

Systemic Therapy for Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC): Systematic Review of Published Trials in the Last 5 Years
AbstractPurpose of ReviewSystemic drug therapy licensed and present in worldwide guidelines for bladder pain syndrome/interstitial cystitis (BPS/IC) has been relatively stable for the last years. This systematic review aims to assess trials enrolling BPS/IC patients, published in the last 5  years. The authors abided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement to define retrieved trials. The keywords used in the search were “interstitial cystitis”, “bladder pain syndrome” and “trial”. Five additional papers were added: three published...
Source: Current Bladder Dysfunction Reports - June 26, 2020 Category: Urology & Nephrology Source Type: research

Understanding and Redefining the Role of Urodynamics in Pelvic Floor Disorders
AbstractPurpose of ReviewThe goal of this study is to review current literature regarding the role of urodynamic studies (UDS) in evaluation of non-neurogenic patients with pelvic floor disorders of stress urinary incontinence (SUI), pelvic organ prolapse (POP), voiding dysfunction, and interstitial cystitis/bladder pain syndrome (IC/BPS).Recent FindingsRates of pre-operative UDS have decreased among women with SUI. Guidelines suggest UDS is not required for index SUI patients opting for surgical treatments. Non-index SUI patients are candidates for UDS testing if such objective information will better clarify symptomology...
Source: Current Bladder Dysfunction Reports - June 23, 2020 Category: Urology & Nephrology Source Type: research

Pudendal neuromodulation for pelvic pain
AbstractPurpose of ReviewCurrent literature regarding the role of neuromodulation for the treatment of pelvic pain will be addressed with a focus on pudendal neuromodulation. The mechanism of action for pudendal nerve stimulation and technique for pudendal neuromodulation will be reviewed. Literature regarding the efficacy of neuromodulation for the treatment of pelvic pain will be summarized.Recent FindingsMultiple studies have demonstrated efficacy of various modalities of neuromodulation in the treatment of chronic pelvic pain.SummaryNeuromodulation may be an effective treatment option for the treatment of chronic pelvi...
Source: Current Bladder Dysfunction Reports - June 10, 2020 Category: Urology & Nephrology Source Type: research

Complementary and Alternative Medicine for the Management of Interstitial Cystitis/Bladder Pain Syndrome: a Recent Update
AbstractPurpose of ReviewInterstitial cystitis and/or bladder pain syndrome (IC/BPS) affect many women in the USA and management of IC/BPS can be challenging for the providers. In addition to conventional treatment options outlined by the American Urologic Association (AUA) guidelines, many complementary and alternative medicines (CAM) have been gaining popularity. Our study aims to review recent publications on CAM and management of IC/BPS.Recent FindingOur literature search included all studies that addressed complementary or alternative methods of treating IC/BPS patients from the last 5  years. We have identified ...
Source: Current Bladder Dysfunction Reports - June 10, 2020 Category: Urology & Nephrology Source Type: research

Complications of Pediatric Bladder Reconstruction in the Adult Patient
AbstractPurpose of ReviewBladder augmentation and associated reconstructive procedures are a surgical option for patients with urologic congenital anomalies and neuropathic bladder with the goal of improving continence and reducing the risk of upper tract deterioration. Despite these benefits, augmentation also portends several short- and long-term potential complications. The goal of this chapter is to discuss these complications and review the current literature on this topic.Recent FindingsMetabolic abnormalities, including acid-base disorders and their sequelae, occur in 5 –15% of patients with bladder augmentati...
Source: Current Bladder Dysfunction Reports - June 7, 2020 Category: Urology & Nephrology Source Type: research

Initial Experience of Pediatric Urology Consortium in Taking Care of Children with Bladder Exstrophy: the Search for the Holy Grail
AbstractPurpose of ReviewThe bladder exstrophy-epispadias complex is a very rare and complex spectrum of congenital anomalies. The holy grail of treatment for BEEC is volitional voiding with preservation of the upper tracts and patient satisfaction. The development of a collaboration can increase the exposure and experience for a panel of surgeons to better improve the care of babies with this anomaly, both in the surgical correction and in the pre- and post-operative care.Recent FindingsThe reported outcomes after exstrophy repair vary widely due to different approaches to closure as well as the variable outcome measures ...
Source: Current Bladder Dysfunction Reports - June 5, 2020 Category: Urology & Nephrology Source Type: research

The Role of Urodynamic Testing Prior to Third-Line OAB Therapy
AbstractPurpose of ReviewThis review outlines current guidelines and evidence for the use of urodynamic testing prior to the initiation of third-line overactive bladder (OAB) treatment options.Recent FindingsOAB currently affects many patients with a significant impact on quality of life as well as health care resources. Treatment algorithms proceed from least to most invasive in an attempt to ameliorate symptoms, namely, urgency, frequency, and urgency incontinence. The current third-line OAB management strategies include percutaneous tibial nerve stimulation (PTNS), sacral nerve stimulation (SNS), and onabotulinumtoxinA ...
Source: Current Bladder Dysfunction Reports - June 5, 2020 Category: Urology & Nephrology Source Type: research

Sacral Neuromodulation in the Management of Bladder Pain Syndrome/Interstitial Cystitis
AbstractPurpose of ReviewIn this review, the current literature available about sacral neuromodulation (SNM) in the management of bladder pain syndrome/interstitial cystitis (BPS/IC) will be addressed.Recent FindingsSNM has emerged in recent years as a minimally invasive option of management for refractory BPS/IC patients that otherwise should undergo reconstructive procedures. Although not approved by the FDA for this specific group of patients, the available data show a favourable response in both objective and subjective variables with a long-lasting effect. The implantation rate after the test phase is greater with the...
Source: Current Bladder Dysfunction Reports - June 4, 2020 Category: Urology & Nephrology Source Type: research