Etiology and Evaluation of Female Urethral Strictures
AbstractPurpose of ReviewThis goal of this review is to summarize the current literature on the diagnosis and evaluation of female urethral stricture.Recent FindingsFemale urethral stricture is a rare condition, which can present with a wide variety of symptoms, including both obstructive and irritative voiding symptoms, pain, or infection. Initial evaluation with post-void residual and uroflowmetry are good screening tests but are unable to diagnose stricture. Diagnosis often requires more than one modality, most commonly cystoscopy and voiding cystourethrogram, with or without urodynamics. Ultrasound is a newer diagnosti...
Source: Current Bladder Dysfunction Reports - January 11, 2022 Category: Urology & Nephrology Source Type: research

Psychosocial Factors in Neurogenic Lower Urinary Tract Dysfunction: Implications for Multidisciplinary Care
AbstractPurpose of ReviewTo review the literature regarding the role of psychological and social factors in neurogenic lower urinary tract dysfunction (NLUTD).Recent FindingsNeurogenic lower urinary tract dysfunction significantly affects psychological and psychosocial domains. There is a high level of comorbidity between psychological distress, anxiety, and depression in both patients with NLUTD and their caregivers. Psychological comorbidity can affect outcomes broadly. In addition, managing NLUTD and its effects can impact social, sexual, caregiver, and patient –provider relationships and quality of life. There is som...
Source: Current Bladder Dysfunction Reports - January 4, 2022 Category: Urology & Nephrology Source Type: research

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 thu...
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