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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 of be...
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 new potenti...
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.Summary...
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 before 2015, due to the add...
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 stud...
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 augmentation a...
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