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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

Intravesical Therapy for BPS/IC
AbstractPurpose of ReviewThis manuscript gives a recent overview of intravesical treatments in patients with bladder pain syndrome/interstitial cystitis (BPS/IC). The newest data on GAG replenishment therapy, intravesical local anaesthetics, DMSO, botulinum toxin, experimental drugs, and ways of application are discussed.Recent FindingsThe literature data show symptomatic therapeutic successes in a limited number of patients with most treatments discussed here. The heterogeneity of BPS/IC, the absence of clear knowledge of the cause in each patient, the different phenotypes included in the same research sample, the variabi...
Source: Current Bladder Dysfunction Reports - January 11, 2021 Category: Urology & Nephrology Source Type: research

Biomarkers for Bladder Pain Syndrome/Interstitial Cystitis
AbstractPurpose of ReviewIn this manuscript, the literature published in the past 5  years about BPS/IC biomarkers was reviewed. Topics include BPS/IC biomarkers, the classical BPS/IC diagnostic, clinical outcomes as a new concept of BPS/IC phenotyping biomarkers, BPS/IC urinary biomarkers, BPS/IC bladder tissue biomarkers and BPS/IC biomarkers outside the bladder.Recent FindingsThe importance of patients ’ phenotyping and sub-grouping emerged as a way of finding new BPS/IC biomarkers and treatment. Also, the use of non-invasive methodologies and of artificial intelligence approaches has been gaining momentum in BPS/IC ...
Source: Current Bladder Dysfunction Reports - January 8, 2021 Category: Urology & Nephrology Source Type: research

Sexual Health in the Neurogenic Patient
AbstractPurpose of ReviewIn this review, the current literature addressing sexual health in common neurologic conditions will be summarized. Conditions discussed include stroke, multiple sclerosis, spinal cord injury, and spina bifida.Recent FindingsThere is an increasing awareness of sexual dysfunction in patients with neurologic injury and of the role of sexual therapy in improving quality of life.SummarySexual health in a neurogenic patient is dependent upon a variety of factors. Determining the most influential sources of sexual dysfunction is important for providing effective treatment. (Source: Current Bladder Dysfunction Reports)
Source: Current Bladder Dysfunction Reports - December 9, 2020 Category: Urology & Nephrology Source Type: research

Cranberry Products for the Prevention of Catheter-Associated Urinary Tract Infections
AbstractPurpose of ReviewIn this review, we examine the current literature regarding the use of cranberry and other complimentary methods for the prevention of catheter-associated urinary tract infections (CAUTIs).Recent FindingsSome studies have suggested cranberry products may have a positive effect in reducing the incidence of CAUTIs in patients with normal bladder function receiving short-term catheterization, while other studies have failed to show the benefits of cranberry products for the reduction of CAUTIs.SummaryWhile there is some data suggesting cranberry-derived products may reduce CAUTIs in specific patient p...
Source: Current Bladder Dysfunction Reports - December 7, 2020 Category: Urology & Nephrology Source Type: research

The Role of Organizations like IVUmed in Developing Centers of Excellence
AbstractPurposeAs healthcare disparity gaps continue to grow across the globe, so too are the efforts aimed at addressing them. Here we review the most common platforms currently used in global health and advantages and disadvantages of each. We highlight international organizations that have prioritized health system strengthening and long-term sustainability and apply the lessons learned from these endeavors to propose mechanisms for developing centers of excellence in low- and middle-income countries.SummaryHealth system strengthening must be prioritized in international urologic endeavors. Without recognizing this as a...
Source: Current Bladder Dysfunction Reports - December 2, 2020 Category: Urology & Nephrology Source Type: research

Management of Pelvic Floor Disorders in Young Women
AbstractPurpose of ReviewThis review is meant to guide female pelvic medicine providers on treatment of pelvic floor disorders in the relatively uncommon population of younger women.Recent FindingsPresented herein are recent data on pelvic floor muscle training in the postpartum period to help with prevention of pelvic floor disorders as well as surgical outcomes in younger women.SummaryAlthough new evidence is available on prevention and treatment for younger patients, more RCTs and cohort studies are needed. (Source: Current Bladder Dysfunction Reports)
Source: Current Bladder Dysfunction Reports - November 26, 2020 Category: Urology & Nephrology Source Type: research

Treatment of Overactive Bladder in the Frail Patient
AbstractPurpose of ReviewTo understand how frailty interacts with overactive bladder. To explore how frailty should be considered when devising an individualized treatment plan for OAB patients.Recent FindingsFrailty can be assessed in the outpatient office without undue burden. The urology community is increasingly aware of the importance of evaluating a patient for frailty and including this assessment in treatment algorithms. Frailty should be considered when treating OAB patients, since frail OAB patients are more susceptible to the potential deleterious consequences of medical therapy, onabotulinumtoxinA therapy, and ...
Source: Current Bladder Dysfunction Reports - November 25, 2020 Category: Urology & Nephrology Source Type: research