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 6, 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 27, 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 24, 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 11, 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 11, 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 8, 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 6, 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 6, 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 5, 2020 Category: Urology & Nephrology Source Type: research

WATER II Trial (Aquablation)
AbstractPurpose of ReviewThis review discusses the role of aquablation therapy for the treatment of benign prostatic hyperplasia in those with prostate volumes between 80 and 150  mL (WATER II trial).Recent FindingsAquablation therapy reduced International Prostate Symptoms Scores, improved urinary flow rate, and preserved ejaculatory function in the majority of sexually active patients. Other advantages include faster operative times and a shorter learning curve. Adverse events were low and predominantly centered around bleeding risk.SummaryAquablation therapy is effective and safe in the surgical management of large...
Source: Current Bladder Dysfunction Reports - June 5, 2020 Category: Urology & Nephrology Source Type: research

Impact of Frailty on the Treatment of Pelvic Floor Disorders
AbstractPurpose of ReviewFrailty is highly prevalent with increasing age and contributes to adverse health outcomes. Prior to medical and surgical intervention for the treatment of pelvic floor disorders (PFD), a comprehensive evaluation is necessary to evaluate frailty. Beyond a standard assessment, the care of frail patients requires consideration of additional factors including functional ability, cognitive impairment, and the role of caregivers. In this article, we review the current literature on PFD, specifically urinary and fecal incontinence and pelvic organ prolapse, in frail individuals and highlight the risks an...
Source: Current Bladder Dysfunction Reports - June 4, 2020 Category: Urology & Nephrology Source Type: research

Optimizing Neuromodulation Testing —Who, When, and How?
AbstractPurpose of ReviewWe review the current literature pertaining to recommendations for selecting appropriate patients and performing a test phase for sacral neuromodulation.Recent FindingsCurrent literature reveals that this therapy can be successfully offered to patients with mild and severe forms of refractory overactive bladder, wet or dry. It can also be offered to elderly patients and patients with concurrent fecal incontinence, even in the setting of a known history of obstetric anal sphincter injury. Patients with non-obstructive urinary retention should be carefully selected with other etiologies ruled out, an...
Source: Current Bladder Dysfunction Reports - June 3, 2020 Category: Urology & Nephrology Source Type: research

Immunomodulatory Therapies for Interstitial Cystitis/Bladder Pain Syndrome
AbstractPurpose of ReviewInterstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic, debilitating condition of unknown etiology characterized by persistent pain perceived to be related to the urinary bladder and lower urinary tract symptoms. Evidence shows that immunological inflammatory responses underlie the pathophysiology of IC/BPS with Hunner lesions but not that of IC/BPS without Hunner lesions. Here, we review the current understanding of the immunological inflammatory nature of IC/BPS with Hunner lesions and the clinical outcomes of immunomodulatory therapies.Recent FindingsOpen trials show that steroids imp...
Source: Current Bladder Dysfunction Reports - May 29, 2020 Category: Urology & Nephrology Source Type: research

Predicting Upper Urinary Tract Risk in the Neurogenic Bladder Patient
AbstractPurpose of ReviewIn this review, we explore if risk factors for developing renal deterioration can be identified in a timely fashion, thereby preventing or delaying the progression of renal injury in the neurogenic bladder patient.Recent FindingsHistorically detrusor leak point pressure (DLPP)>  40 cm H2O has been used to identify risk of upper urinary tract dysfunction (UUTD). Recent studies suggest that DLPP should not be the only decision-making parameter to predict the risk of UUTD and that patients with DLPP>  20 cm H2O should be followed closely for upper tract assessment. Furthe...
Source: Current Bladder Dysfunction Reports - May 21, 2020 Category: Urology & Nephrology Source Type: research

A Review of Enhanced Recovery Protocols in Pelvic Surgery
AbstractPurpose of ReviewTo evaluate recent literature relevant to the review and appraisal of enhanced recovery protocol after pelvic surgery.Recent FindingsSeveral protocols have recently been implemented and published that utilize aspects of guidelines published by the Enhanced Recovery After Surgery (ERAS) Society. These studies have added to the body of literature confirming the efficacy of enhanced recovery protocols.SummaryWhile evidence exists and is commonly cited for individual interventions, in recent years, there has been an increase in the study of novel protocols for enhanced recovery. These studies show that...
Source: Current Bladder Dysfunction Reports - May 17, 2020 Category: Urology & Nephrology Source Type: research

Is Urinary Retention Following Extravesical Ureteral Reimplantation Still a Concern?
AbstractPurpose of ReviewTransient urinary retention is a known complication of bilateral extravesical ureteral reimplantations. Recent studies have shown that the robotic-assisted bilateral extravesical reimplantation may have lower transient urinary retention rates than previously reported for the open approach. The purpose of this review is to compare urinary retention incidence in patients undergoing open versus robotic-assisted extravesical reimplantations.Recent FindingsIn some of the larger series, open bilateral extravesical ureteral reimplantation was noted to have a temporary urinary retention rate of 4 –15...
Source: Current Bladder Dysfunction Reports - May 12, 2020 Category: Urology & Nephrology Source Type: research

Vaginal Mesh Survivorship
The objective is to propo se the concept of vaginal mesh survivorship, examine which aspects of the cancer survivorship framework are applicable to patients with vaginal mesh complications, and apply these accordingly.Recent findingsA literature review of vaginal mesh complications was performed to identify the current state of care received by patients and patient-reported outcomes. Subcategories from the cancer survivorship framework were compared with the current care of women with vaginal mesh complications. Areas of improvement and gaps in research were identified.SummaryNearly all domains of the cancer survivorship f...
Source: Current Bladder Dysfunction Reports - May 11, 2020 Category: Urology & Nephrology Source Type: research

Valve Bladder Syndrome Associated with Posterior Urethral Valves: Natural History, Work-up, and Management
AbstractPurpose of ReviewThis review focuses on the diagnosis, evaluation, and management of valve bladder syndrome (VBS) following initial treatment of posterior urethral valves (PUV). Based on current literature, we discuss the effect of PUV management in VBS and investigate the role of medications, catherization, surgery, and novel interventions.Recent FindingsThe current initial management of PUV involves valve ablation. Cutaneous urinary diversions are secondary options based on patient characteristics, PUV severity, and response to catheter drainage. VBS can independently occur as a consequence of PUV due to reduced ...
Source: Current Bladder Dysfunction Reports - May 2, 2020 Category: Urology & Nephrology Source Type: research

Opioid Use in Urologic Practice
AbstractPurpose of ReviewThe opioid epidemic has become a major public health crisis over the last two decades. The opioid-related deaths and economic costs have increased dramatically since opioid analgesics started to be prescribed regularly to help control cancer- and non-cancer-related pain in the late twentieth century. As a result of the worsening opioid crisis, various guidelines and government regulations have recently been implemented to cope with this opioid problem as it affects all fields of medicine, urology included. Many conditions in urology involve chronic pain medication, including neurogenic bladder. Thi...
Source: Current Bladder Dysfunction Reports - April 29, 2020 Category: Urology & Nephrology Source Type: research

Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors
AbstractPurpose of ReviewThe epidemiology of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) is continuously evolving with an increasing life span and the prevalence of metabolic diseases, including obesity, diabetes, cardiovascular disease, and hypertension. As a result, there is a substantial financial strain on health care.Recent FindingsRecent studies and clinical trials have strengthened the relationship of known risk factors of BPH and LUTS. These include metabolic syndrome, diabetes, obesity, hypertension, and elevated serum dihydrotestosterone. Excessive consumption of red meat, saturated...
Source: Current Bladder Dysfunction Reports - February 26, 2020 Category: Urology & Nephrology Source Type: research

Cognition, Emotion, and the Bladder: Psychosocial Factors in Bladder Pain Syndrome and Interstitial Cystitis (BPS/IC)
AbstractPurpose of ReviewTo review findings from empirical studies assessing the role of psychosocial factors in bladder pain syndrome and interstitial cystitis (BPS/IC).Recent FindingsThere is a high rate of psychosocial comorbidity in BPS/IC, including elevated levels of anxiety and depression. Recent studies assessing the role of illness perceptions in BPS/IC relate poorer illness perceptions to more unhelpful illness coping patterns. Conversely, positive illness perceptions including self-efficacy in illness management are associated with more adaptive coping behaviors such as exercising and acceptance. New research is...
Source: Current Bladder Dysfunction Reports - January 31, 2020 Category: Urology & Nephrology Source Type: research

Prevention of Stress Urinary Incontinence in Women
AbstractPurpose of ReviewLower urinary tract dysfunction (LUTD), including stress urinary incontinence (SUI), is increasingly recognized as a public health issue due to the prevalence, individual burden, and societal impact. Women are disproportionately affected by UI and are exposed to unique events that affect LUT function including higher rates of LUT infection, childbirth, pelvic floor anatomic changes, and hormonal milieu. The majority of LUTD research and clinical practice has focused on treatment of the most affected subset of women, but there are millions of women living with urinary incontinence that do not seek a...
Source: Current Bladder Dysfunction Reports - January 30, 2020 Category: Urology & Nephrology Source Type: research

Underactive Bladder and Bladder Outlet Procedures in Women
AbstractPurpose of ReviewThis review outlines current options for women suffering from both stress urinary incontinence (SUI) and underactive bladder (UAB). This is often a challenging patient population; however, many treatment options are available including behavioral, pharmacologic, and surgical. Therapies can be divided into those specifically targeting either the bladder or the bladder outlet.Recent FindingsFor patients with SUI and UAB, several clinical trials have helped to formulate current guidelines. Also, a number of novel techniques and therapeutic agents are currently under investigation. Current surgical tre...
Source: Current Bladder Dysfunction Reports - January 30, 2020 Category: Urology & Nephrology Source Type: research

Overactive Bladder in Women: an Update for Primary Care Physicians
AbstractPurpose of ReviewOveractive bladder (OAB) is a widely prevalent urinary condition affecting women of all ages, with increasing incidence in advancing age. A primary care provider is likely to encounter a significant proportion of women experiencing lower urinary tract symptoms (LUTS). This review serves primary care physicians as a thorough reference for a common condition causing LUTS in women.Recent FindingsMost emerging data addressing overactive bladder relates to the different treatment modalities available. The side effect profile of antimuscarinic drugs remains an ongoing concern among OAB patients, especial...
Source: Current Bladder Dysfunction Reports - January 13, 2020 Category: Urology & Nephrology Source Type: research

OAB and IC/BPS: Two Conditions or a Continuum of One?
AbstractPurpose of ReviewOveractive bladder (OAB) and interstitial cystitis/bladder pain syndrome (IC/BPS) are defined as syndromes consisting of “urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence” and “an unpleasant sensation perceived to be related to the urinary bladder, associated with lower urinary tract symptoms,” respectively. Distinguishing between the two diagnoses ca n be challenging and although OAB and IC/BPS are traditionally considered separate conditions, more evidence is emerging to suggest a continuum between the symptoms. T...
Source: Current Bladder Dysfunction Reports - January 13, 2020 Category: Urology & Nephrology Source Type: research

Colpocleisis for Advanced Pelvic Organ Prolapse
AbstractPurpose of ReviewThe purpose of this review is to consolidate and present the most recent literature on colpocleisis in the treatment of pelvic organ prolapse.Recent FindingsSince its origin in the 1800s, the techniques for colpocleisis have remain largely unchanged. We will review the peri-operative considerations for a patient undergoing an obliterative procedure, specifically focusing on the potential concern for uterine pathology. There are no universally accepted guidelines for endometrial evaluation in the asymptomatic post-menopausal patient, yet the majority of providers prefer to perform some type of pre-o...
Source: Current Bladder Dysfunction Reports - January 8, 2020 Category: Urology & Nephrology Source Type: research

Update on the Pathophysiology of Interstitial Cystitis /Bladder Pain Syndrome
AbstractPurpose of ReviewInterstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic, potentially debilitating condition characterized by lower urinary tract symptoms and pain perceived to be related to the bladder. The etiology of IC/BPS has been rigorously studied for more than a century, but remains unknown. IC/BPS comprises a wide variety of clinical phenotypes with different potential etiologies. Recently, the importance of IC/BPS subtyping has become recognized. In this review, we revisit current hypotheses on IC/BPS pathophysiology and discuss the most likely causes of IC/BPS according to current research.Rece...
Source: Current Bladder Dysfunction Reports - January 6, 2020 Category: Urology & Nephrology Source Type: research

Voiding Dysfunction After Neobladder Urinary Diversion
AbstractPurpose of ReviewRadical cystectomy and urinary diversion remains the gold standard treatment for patients with high risk or muscle invasive bladder cancer. Despite the fact that a majority of patients are eligible for orthotopic neobladder, over 85% of patients receive incontinent urinary diversions, primarily over concerns for complications or postoperative voiding dysfunction. In this review, we explore the incidence, etiology, and treatment of voiding dysfunction after orthotopic neobladder creation in male and female patients.Recent FindingsVoiding dysfunction after orthotopic neobladder consists of urinary in...
Source: Current Bladder Dysfunction Reports - January 6, 2020 Category: Urology & Nephrology Source Type: research

Treatment of Refractory Urinary Urgency, Frequency, and Incontinence in Pregnancy
AbstractPurpose of ReviewThe prevalence of urinary symptoms such as urgency, frequency, and urge incontinence is high in pregnancy and often becomes more bothersome further in pregnancy. First-line treatment often includes behavioral modifications such as avoidance of caffeine and timed voiding. Treating incontinence refractory to these first-line measures poses a challenge to the clinician given the concern for fetal harm, miscarriage, and preterm labor from current treatment modalities. The purpose of this review article is to summarize the most up-to-date literature of second- and third-line treatment options for urge i...
Source: Current Bladder Dysfunction Reports - December 18, 2019 Category: Urology & Nephrology Source Type: research

Recent Developments in Imaging in BPS/IC
AbstractPurpose of reviewIn this review, the current literature of imaging of bladder pain syndrome and interstitial cystitis (BPS/IC) will be addressed. Topics include BPS/IC, cystoscopy, computed tomography, and magnetic resonance image (MRI).Recent findingsThere are no randomized clinical trials on imaging of BPS/IC. Recently, contrast-enhanced MRI could detect the brain alterations and the changes in bladder permeability, and detection of the latter is enhanced by intravesical injection of contrast agents.SummaryMRI could advance the understanding of pathological changes in the brain and the bladder of BPS/IC patients....
Source: Current Bladder Dysfunction Reports - December 14, 2019 Category: Urology & Nephrology Source Type: research

Consequences of Pelvic Radiotherapy on Urinary Function in Women
The objective of this review is to critically evaluate recent literature on the urinary complications following pelvic radiation for malignancy in women.Recent FindingsLower urinary tract symptoms (LUTS) manifest in a significant population of women post-radiation with confirmed objective findings on urodynamic evaluation. Other serious consequences such as fistula, hemorrhagic cystitis, and strictures are less common but can be significant.SummaryThe sequelae of radiation on the female lower urinary tract can range from mild symptoms to those requiring major surgical intervention. Therefore, post-radiotherapy patients mus...
Source: Current Bladder Dysfunction Reports - December 5, 2019 Category: Urology & Nephrology Source Type: research

Post-Prostatectomy Incontinence: an Update on Current Management
AbstractPurpose of ReviewTo review the most recent literature on the treatment of post-prostatectomy incontinence.Recent FindingsNew technology and implementation of surgical devices have resulted in a myriad of treatment options for men suffering post-prostatectomy incontinence. However, many of these have widely varied results.SummaryThe treatment of post-prostatectomy incontinence is consistent and continues to expand with more devices being introduced in the market. However, optimization of patient outcomes and determination of which devices work best will be required. To date, there are few randomized controlled trial...
Source: Current Bladder Dysfunction Reports - December 4, 2019 Category: Urology & Nephrology Source Type: research

Central Nervous System Changes in Pelvic Inflammation/Pain Patients
AbstractPurpose of ReviewCentralized pain syndromes (CPS), including chronic pelvic pain (CPP) syndrome, are significant public health problems with prevalence more than diabetes, cancer, or cardiovascular disease. A variety of pathologies are linked with CPP syndrome; however, pain often continues without the presence of pathology, or when an underlying pelvic disease is found, the extent and severity of pain are disproportionate. Although this is not a systematic review, we performed a detailed literature search to identify relevant papers and to provide the available evidence for central changes in association with CPP ...
Source: Current Bladder Dysfunction Reports - December 2, 2019 Category: Urology & Nephrology Source Type: research

Nocturia: Evaluation and Management
AbstractPurpose of ReviewNocturia, defined as waking to pass urine during the main sleep period, is among the most common and bothersome lower urinary tract symptoms. In this review, the current literature as it pertains to the etiology, evaluation, and management of nocturia is addressed.Recent FindingsOver the past decade, there has been increased interest in nocturia as a specific lower urinary tract symptom, with efforts made to improve understanding of underlying mechanisms and consequences. Several publications now classify nocturia according to underlying cause (such as nocturnal polyuria), in that what was a previo...
Source: Current Bladder Dysfunction Reports - November 28, 2019 Category: Urology & Nephrology Source Type: research

Detrusor Underactivity and Underactive Bladder in Women: What Is New?
AbstractPurpose of ReviewDetrusor underactivity (DU) and its symptom-based correlation, the underactive bladder (UAB), are common problems encountered in urological practice. Whilst DU has been defined for many years, only recently has UAB received a formal definition and there is now accumulating literature based on this condition. In this article, we reviewed the recent literature on the aetiology, pathogenesis, diagnosis and management of DU/UAB in women.Recent FindingsDetrusor underactivity is diagnosed on urodynamic studies but there still remains a lack of widely recognised and accepted diagnostic criteria. Commencin...
Source: Current Bladder Dysfunction Reports - November 27, 2019 Category: Urology & Nephrology Source Type: research

Advances in Pharmacotherapy for the Treatment of Overactive Bladder
AbstractPurpose of ReviewTo present the current literature on the pharmacologic management of overactive bladder, including combination therapies, agents still in clinical development, and special considerations related to individuals with cognitive decline, frailty and cardiovascular risk.Recent FindingsCombination therapy is shown to be more effective than monotherapy, without additional side effects. Preliminary studies on novel treatment methods, including new medications, as well as novel use of established medications, demonstrate improved efficacy with a favorable side effect profile. Investigation into new target p...
Source: Current Bladder Dysfunction Reports - November 25, 2019 Category: Urology & Nephrology Source Type: research

The Role of Local Hormone Replacement in Overactive Bladder
AbstractPurpose of ReviewOveractive bladder (OAB) is a common and distressing condition which is known to increase with age and to have a significant effect on quality of life (QoL). Whilst OAB is a symptomatic diagnosis, many patients will require basic investigations prior to initiating the appropriate management. This paper will explore the prevalence and pathophysiology of OAB as well as diagnosis and management of the condition.Recent FindingsThere is increasing evidence that local oestrogen therapy may be beneficial in the management of postmenopausal women with OAB, either when used alone or as combination therapy w...
Source: Current Bladder Dysfunction Reports - November 25, 2019 Category: Urology & Nephrology Source Type: research

The Bladder is Not Sterile: an Update on the Urinary Microbiome
AbstractPurpose of ReviewThe article discusses (1) techniques used to study bacterial urinary microbiota; (2) existence of non-bacterial urinary microbiota; (3) associations between changes in urinary microbiota and various benign lower urinary tract disorders.Recent FindingsUrine harbors a diverse microbial community that resides within it. A multitude of studies have identified differences in these communities associated with urologic conditions, suggesting that microbial communities may maintain normal bladder homeostasis. Technological advances in analytic approaches have improved our understanding of the urinary micro...
Source: Current Bladder Dysfunction Reports - November 15, 2019 Category: Urology & Nephrology Source Type: research

Dilemmas in Management of the Geriatric Bladder
AbstractPurpose of ReviewIn this article, we will review current dilemmas regarding evaluation and management of the geriatric bladder incorporating concepts of normal changes of aging as well as common lower urinary tract dysfunction.Recent FindingsIncreasing age leads to functional changes in essentially all organ systems including the genitourinary system. Understanding the natural changes with age of the bladder as well as the signs and symptoms of pathologic conditions is paramount to diagnosis and treatment of urologic conditions in the geriatric population.SummaryThere are several conundrums in the diagnosis and eva...
Source: Current Bladder Dysfunction Reports - November 13, 2019 Category: Urology & Nephrology Source Type: research

Classification, Characterization, and Sub-Grouping of Interstitial Cystitis
AbstractPurpose of ReviewInterstitial cystitis (IC) and IC-related conditions such as painful bladder syndrome (PBS), bladder pain syndrome (BPS), and hypersensitive bladder (HSB) have a similar symptomatic profile but probably different etiologies. A reasonable classification of these diseases/conditions is mandatory for clinical and investigational progress. We reviewed definition of current terminology and recent research evidence regarding IC and related conditions to propose a sensible classification system.Recent FindingsThe condition with Hunner lesions (Hunner type IC: HIC) is obviously distinct from other categori...
Source: Current Bladder Dysfunction Reports - November 11, 2019 Category: Urology & Nephrology Source Type: research

Pharmacotherapy for Interstitial Cystitis/Bladder Pain Syndrome
AbstractPurpose of ReviewCurrent literature regarding pharmacotherapy treatment strategies available for the management of interstitial cystitis/bladder pain syndrome (IC/BPS) will be addressed including oral, transdermal, and intravesical therapies. Pharmacotherapies with emerging data will be addressed, but the focus is on those treatments described by the AUA guidelines for IC/BPS.Recent FindingsWhile multiple pharmacotherapy options for the management of IC/BPS exist, the evidence for most medical therapies is not strong and frequently yields mixed results. It has been over two decades since a new medication has gained...
Source: Current Bladder Dysfunction Reports - November 6, 2019 Category: Urology & Nephrology Source Type: research

Is Vaginal Laser Effective for Overactive Bladder? Results of a Systematic Review
AbstractPurpose of ReviewThe aim of this review is to determine the efficacy of laser treatment in overactive bladder (OAB) syndrome in women.Recent FindingsIn international literature, there are few studies focusing on OAB symptoms. The proposed treatments included thulium laser, fractional CO2 laser and Erbium:YAG laser.SummaryAlthough the analysed studies are not RCTs, the results show the efficacy of laser treatment in OAB symptoms, also compared to conventional medical and surgical treatments. However, these tests must be implemented with RCTs and with large patient samples. (Source: Current Bladder Dysfunction Reports)
Source: Current Bladder Dysfunction Reports - November 6, 2019 Category: Urology & Nephrology Source Type: research

Rectourethral Fistula —Review of Current Practices, Developments, and Outcomes
AbstractPurpose of ReviewRectourethral fistula (RUF) is an uncommon pathology associated with a significant deterioration in quality of life. It can result from a variety of etiologies and frequently occurs in medically complex patients. Due to the involvement of both the urinary and fecal systems, there are a number of treatment considerations. The literature surrounding management of this condition is quite varied due to these factors.Recent FindingsRecent literature on the field consists primarily of single institution case series, though there is a recently published multi-center cohort study with a relatively larger s...
Source: Current Bladder Dysfunction Reports - November 6, 2019 Category: Urology & Nephrology Source Type: research

Pharmaceutical Options for Stress Urinary Incontinence
AbstractPurpose of ReviewWe review the currently available pharmaceutical options for SUI.Recent FindingsPharmaceutical options for SUI are either drugs that manipulate hormones or those that impact neurotransmitter levels. Local estrogen replenishment has been associated with improved OAB symptoms in postmenopausal women, but its impact on SUI is unclear. Subjective improvement may be noted, while objective outcome indices are typically unchanged. There is weak evidence to suggest that any adrenergic agonist is better than placebo in improving objective incontinence measures. Both alpha- and beta-adrenergic agonists are a...
Source: Current Bladder Dysfunction Reports - October 28, 2019 Category: Urology & Nephrology Source Type: research

Combination Therapy for Bladder Dysfunction in Patients with Neurogenic Detrusor Overactivity
AbstractPurpose of ReviewNeurogenic bladder is a common condition and top health priority present in 20 –70% of patients with neurologic diseases including multiple sclerosis (MS), Parkinson’s disease (PD), spinal cord injury (SCI), and cerebrovascular accidents (CVA). Current gold-standard medications for overactive bladder (OAB), such as anti-muscarinics, have undesirable side effects, or have l imited data in neurogenic patients. Combining therapy for urinary urge incontinence (UUI) has shown the potential to increase efficacy while maintaining or improving tolerability of treatment. Our objective was to rev...
Source: Current Bladder Dysfunction Reports - October 28, 2019 Category: Urology & Nephrology Source Type: research

Hormone Replacement for Pelvic Floor Disorders
AbstractPurpose of ReviewThe purpose of this review article is to summarize the recent literature regarding the effect of hormone replacement therapy on pelvic floor disorders and its role as a preventative or treatment option.Recent FindingsThe recent evidence describing the effect of hormone replacement therapy on pelvic floor disorders is mainly limited to cohort studies, systematic reviews, and secondary analysis of randomized controlled trials such as the Women ’s Health Initiative and Nurses’ Health Study. There are few quality randomized controlled trials, especially within the last 5 years on this ...
Source: Current Bladder Dysfunction Reports - October 26, 2019 Category: Urology & Nephrology Source Type: research

Radiation Cystitis: a Contemporary Review
AbstractPurpose of ReviewThere is not a universally agreed upon treatment algorithm for radiation cystitis. The goal of this review will be to discuss numerous options available to the provider at various points in treatment and the literature supporting its use.Recent FindingsThere are various degrees of presentation, with milder forms that can be managed as outpatient and more serious forms requiring inpatient admission. There are a myriad of treatment options, including intravesical instillations, ablative procedures, systemic therapies, hyperbaric oxygen therapy, arterial embolization, and urinary diversion. If these m...
Source: Current Bladder Dysfunction Reports - October 26, 2019 Category: Urology & Nephrology Source Type: research

Vesicourethral Anastomotic Stenosis after Prostate Cancer Treatment
AbstractPurpose of ReviewTo describe the epidemiology, pathogenesis, and management of vesicourethral anastomotic stenosis after prostate cancer treatment.Recent FindingsInjectable scar modulating agents administered at the time of direct visual internal urethrotomy of vesicourethral anastomotic stenoses have been shown to improve endoscopic treatment outcomes. Trials are ongoing to find the optimal agent and delivery system. Novel tissue engineering techniques are in development and hold promise.SummaryVesicourethral anastomotic stenosis after the treatment of prostate cancer is a challenging complication for patients and...
Source: Current Bladder Dysfunction Reports - October 25, 2019 Category: Urology & Nephrology Source Type: research

Overactive Bladder in Diabetes Mellitus
AbstractPurpose of ReviewTo explore the current literature regarding the epidemiology, pathophysiology, diagnosis, and management of overactive bladder in diabetic patients.Recent FindingsOveractive bladder is a syndrome complex of urinary urgency, often accompanied by frequency and nocturia. Several studies have established the relationship between diabetes mellitus and bladder dysfunction. However, there is limited literature available to evaluate the prevalence of overactive bladder in this population and to guide clinical practice. The introduction of medications such as mirabegron and minimally invasive techniques suc...
Source: Current Bladder Dysfunction Reports - October 22, 2019 Category: Urology & Nephrology Source Type: research

Management of Overactive Bladder in the Young Man
AbstractPurpose of ReviewIn this review, the current literature regarding idiopathic overactive bladder (OAB) in the young male will be discussed. We will also share the unique experience of providers at a single military institution in treating this specific patient population and their recommendations based on the unique etiologies, comorbidities, and treatment response and adherence.Recent FindingsDespite several studies addressing idiopathic OAB and providing the basis for existing guidelines, none offer guidance on how this syndrome affects a younger male population in whom OAB is less likely to be due to an obstructi...
Source: Current Bladder Dysfunction Reports - August 10, 2019 Category: Urology & Nephrology Source Type: research