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Ralf Böthig,1 Burkhard Domurath,2 Johannes Kutzenberger,3 Jörn Bremer,4 Ines Kurze,5 Albert Kaufmann,6 Jana Pretzer,7 Jens-Peter Klask,8 Birgitt Kowald,9 Christian Tiburtius,1 Klaus Golka,10 Sven Hirschfeld,11 Roland Thietje11 1Department of Neuro-Urology, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, Hamburg, Germany; 2Centre for Neuro-Urology, Kliniken Beelitz, Neurologische Rehabilitationsklinik, Beelitz-Heilstätten, Germany; 3Department of Neuro-Urology, Kliniken Hartenstein UKR, Bad Wildungen, Germany; 4Centre for Spinal Cord Injuries, BDH-Klinik Greifswald, Greifswald, Germany; 5Centre for Spinal Cord Injuries, Department of Paraplegiology and Neuro-Urology, Zentralklinik Bad Berka, Bad Berka, Germany; 6Department of Neuro-Urology, Kliniken Maria Hilf GmbH, Mönchengladbach, Germany; 7Department of Urology and Neuro-Urology, BG Trauma Hospital Berlin, Berlin, Germany; 8BG Trauma Hospital Duisburg, Duisburg, Germany; 9Biomechanical Laboratory, BG Klinikum Hamburg, Hamburg, Germany; 10Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund(IfADo), Dortmund, Germany; 11Centre for Spinal Cord Injuries, BG Klinikum Hamburg, Hamburg, GermanyCorrespondence: Ralf BöthigDepartment of Neuro-Urology, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, Bergedorfer Str. 10, Hamburg 21033, GermanyTel +49 40 7306 2608Fax +49 40 7306 2621Email r.boethig@bgk-hamburg.dePurpose: For successful long-term rehabilitation of patients with neurogenic lower urinary tract dysfunction (NLUTD), it is necessary to define the objective requirement for urological aids based on a scientifically validated basis.Methods: This was a cross-sectional multicenter study, based on a questionnaire. Data concerning bladder management and daily consumption of urological appliances for patients with NLUTD in a community setting were collected through a standardized survey.Results: Seven hundred and sixty-seven records were analyzed: 543 males, 221 females (N/A = 3). Patients using intermittent catheterization (n= 608) required 5.06 (mean) single-use catheters per day. Out of them, 94 (15.5%) required additional pads (mean: 2.29 per day), 34 patients (5.6%) additionally used pants (mean: 2.55 per day) and 46 patients (7.6%) utilized condom catheters (mean: 3.81 per day) between catheterizations. Among all, 126 patients (16.4%) used pads (mean: 5.03 per day), and 51 patients (6.6%) used pants (mean: 3.03 per day). Women needed both pads (p

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Study design:Cross-sectional study.Objective:To evaluate the long-term effect of the sacral anterior root stimulator (SARS) on neurogenic bowel dysfunction in a large, well defined spinal cord injury (SCI) cohort.Setting:Department of Neuro-Urology, Bad Wildungen, Germany.Methods:Subjects undergone surgery at for SARS-SDAF (sacral deafferentation) between September 1986 and July 2011 (n=587) answered a questionnaire. In total, 277 SARS subjects were available for the baseline (recall) and follow-up comparison.Results:Median age was 49 years (range: 19-80), time from SCI to surgery was 10 years (range: 0-49) and from surgery to follow-up 13 (range: 1-25). Of the responders 73% used SARS for bowel emptying. On visual analog scale (VAS) ranging from 0-10 (best), satisfaction with SARS was 10. Baseline and follow-up comparison showed a decline in the median VAS score 0-10 (worst) for bowel symptoms from 6 (range: 4-8) to 4 (range: 2-6), P<0.0001; median neurogenic bowel dysfunction score from 17 (range: 11-2) to 11 (range: 9-15), P<0.0001; median St Marks score from 4 (range: 0-7) to 4 (range: 0-5), P=0.01; and median Cleveland constipation score from 7 (range: 6-10) to 6 (range: 4-8), P<0.0001. Use of suppositories, digital evacuation and mini enema and subjects totally dependent on assistance during defecation were significantly lower after SARS.Conclusions:The SARS has the potential to be one of the few treatment methods targeting multiple organ dysfunctions following SCI. [ABSTRACT FROM AUTHOR]

Objective:To evaluate the performance of a new 30-cm-long, telescoping male intermittent catheter (SpeediCath Compact Male; Coloplast A/S, Humlebæk, Denmark) in urinary bladder emptying, safety and subject acceptance vs a standard-length male intermittent catheter (SpeediCath).Materials and methods:In a prospective, randomized, multicenter, crossover non-inferiority study, 37 male intermittent catheter users self-catheterized three times with the test catheter on one test day and three times with the standard-length male (reference) catheter on another test day. Residual urine (RU) volume in the bladder after catheterization was measured by ultrasound. Safety was assessed in the entire study period in terms of adverse events (AEs) and adverse device events (ADEs). Subjects evaluated their experience, sensation, disposal, bleeding and discomfort with the test and reference catheters and final catheter preference.Results:SpeediCath Compact Male did not differ from the reference catheter in terms of performance (bladder emptying). The upper confidence limit of the mean difference between absolute RU volumes for the test and reference catheter groups did not exceed a pre-established non-inferiority limit of 20 ml, thereby showing the test catheter's non-inferiority to the reference catheter (that is, no worse at bladder emptying). The only AE/ADE reported was one instance of mild urethral burning for 30 min after catheterization, which was judged possibly related to the test catheter but resolved quickly.Conclusions:The SpeediCath Compact Male catheter is as efficient as a conventional intermittent catheter (SpeediCath) at emptying the bladder with the additional benefit of being more discreet and easier to use. [ABSTRACT FROM AUTHOR]

Background Assessment of efficacy and safety of propiverine (prop.; Mictonetten™) and oxybutynin (oxy.) in children with neurogenic detrusor overactivity (NDO) aged 1 – 18 years. Materials and methods In a comparative cohort study 255 children with NDO (199 myelomeningocele (MMC), 46 spinal cord injury), were treated with anticholinergics for 2.5 years on average at 14 centers and were evaluated retrospectively. 127/255 children were allocated to prop., 128/255 to oxy.; median age at diagnosis and treatment initiation were 2.08 and 7.18 (prop.) vs. 3.37 and 7.98 (oxy) years, respectively. Results Primary efficacy outcome, max. detrusor pressure at micturition, was on average reduced to a significantly larger extent in the prop. than in the oxy. group. Correspondingly, clinically relevant reductions of detrusor pressure (below 40 cm H20 or reduction by > 50%) resulted significantly more often in the prop. than in the oxy. group (74% vs. 50%). Urodynamic results are in agreement with clinical findings (tab. 1). Both propiverine and oxybutynin demonstrated a resolution or downgrading of vesico-uretero-renal reflux (tab. 2). Propiverine was better tolerated than oxybutynin (9.40 vs. 17.46% adverse events), in those children suffering from MMC significantly better. Conclusion Comparative studies of efficacy and tolerability of anticholinergics in NDO of children were missing so far. This cohort study demonstrates a more effective reduction of the max. detrusor pressure at micturition with prop. in comparison to oxy. Prop. was better tolerated than oxy. Urodynamic effects are correlated with improvement of reflux, indicating possibly more favourable long-term outcomes of the upper urinary tract [ABSTRACT FROM AUTHOR]