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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), transrecta...
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 combina...
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 the...
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