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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 10, 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 5, 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 5, 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 5, 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 27, 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 review and ...
Source: Current Bladder Dysfunction Reports - October 27, 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 topic. The d...
Source: Current Bladder Dysfunction Reports - October 25, 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 25, 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 24, 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 21, 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 9, 2019 Category: Urology & Nephrology Source Type: research

Rectourethral Fistula: Operative Technique and Outcomes
AbstractPurpose of ReviewRectourethral fistula (RUF) is an infrequent yet distressing pathology that can lead to significant complications for patients. Its management has been debated over the years and physicians have yet to reach a consensus on RUF treatment. In this review, we outline the status of the current literature on RUF from the initial diagnosis to the outcomes, complications, and surgical techniques available for RUF repair.Recent FindingsHigher rates of success are achieved on the first surgical attempt. Therefore, when deciding which surgical procedure to use, it is of vital importance to consider both pati...
Source: Current Bladder Dysfunction Reports - July 16, 2019 Category: Urology & Nephrology Source Type: research

Management of Overactive Bladder After Treatment of Bladder Outlet Obstruction
AbstractPurpose of ReviewTo discuss the epidemiology and pathophysiology of overactive bladder (OAB) after bladder outlet surgery (BOS), review the prognostic factors associated with persistent OAB, and present evaluation and management strategies.Recent FindingsA randomized trial of preoperative urodynamics in male lower urinary tract symptoms is underway; however, high-level evidence for management of persistent OAB after BOS is lacking.SummaryIdentification of prognostic factors for persistent OAB symptoms is important for counseling patients before BOS; however, the data guiding such counseling are limited. In general,...
Source: Current Bladder Dysfunction Reports - July 16, 2019 Category: Urology & Nephrology Source Type: research

Urinary Retention Following Non-urologic Surgery
AbstractPurpose of ReviewTo evaluate the literature assessing postoperative urinary retention (POUR) after non-urologic surgeries, including risk factors, as well as short- and long-term consequences.Recent FindingsPOUR is multifactorial; however, several risk factors, such as male sex, advanced age, and preexisting lower urinary tract symptoms are well established. Procedures that do not involve damage to the urinary or nervous system are rarely associated with long-term consequences, as opposed to colorectal surgery in which long-term voiding dysfunction may be experienced. Improved surgical technique may improve results...
Source: Current Bladder Dysfunction Reports - July 15, 2019 Category: Urology & Nephrology Source Type: research

Historical and Current Concepts Regarding Urodynamics in Multiple Sclerosis Patients
AbstractPurpose of ReviewIn this review, current literature on management of neurogenic bladder in patients with multiple sclerosis (MS) is summarized. Topics include a review of MS, a brief overview of general treatment options, the effects of MS may manifest on lower urinary tract symptoms (LUTS), and clinical assessment of these patients. The utility of urodynamic evaluation in this patient population and the use of antibiotic prophylaxis in patients with MS on immunomodulatory medications are reviewed.Recent FindingsUnlike neurogenic bladder in spinal cord patients, lower urinary tract dysfunction in MS patients rarely...
Source: Current Bladder Dysfunction Reports - July 12, 2019 Category: Urology & Nephrology Source Type: research