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Objectives Methods Results Conclusions Lower urinary tract symptoms (LUTS) are prevalent among women, affecting not only their physical well‐being but also their quality of working life. This study aimed to assess the relationship between psychosocial factors at work and LUTS among working women. Additionally, we sought to investigate whether women with psychosocial risk factors at work reported reduced quality of life (QOL) and a higher degree of productivity loss from absenteeism and presenteeism.An online survey was conducted to collect the demographic characteristics, occupational risk factors, and LUTS among employed Korean women. Shift work, weekly working hours, occupational stress, and emotional labor were surveyed as psychosocial risk factors at work. The association between psychosocial risk factors and LUTS was assessed using adjusted logistic regression. The relationships between psychosocial risk factors and LUTS‐related outcomes, such as were examined using a generalized linear model.Of the 1057 participants, 260 (24.6%) and 294 (27.81%) had overactive bladder and urinary incontinence, respectively. Job stress, emotional labor, and night‐shift work are significantly associated with a higher prevalence of LUTS, which reduce workers' QOL and labor productivity through absenteeism and presenteeism due to urination symptoms.Psychosocial factors at work, particularly job stress, emotional labor, and night‐shift work, were significantly associated with a higher prevalence of LUTS, leading to reduced QOL and labor productivity due to urination symptoms. [ABSTRACT FROM AUTHOR]

Objective Methods Search Strategy Data Collection and Analysis Conclusions This integrative review identified studies that reported the prevalence of physiotherapeutic interventions for urinary incontinence among postpartum women.This is an integrative literature review study. We used the integrative literature review framework proposed by Whittemore and Knafl to search for relevant literature.The search strategy for electronic databases was developed from the research question and definitions of key concepts, assisted by the librarian. Databases that were searched include Google Scholar, Medline (PubMed), CINAHL, and the Joanna Briggs Institute databases. Both qualitative and quantitative studies that met the inclusion criteria were included. We used the CASP tool to assess the quality of selected papers.The included articles were thematically analyzed. Thirty‐six papers met the inclusion criteria for the review. Six themes emerged from the analysis: prevalence of postpartum UI; risk factors for postpartum UI; antenatal pelvic floor muscle training; conservative treatment and quality of life; experiences of postpartum women with UI; and possible coping strategies adopted by women. Most of the articles were quantitative studies (80.5%); 16.6% were qualitative and 2.7% adopted mixed methods.Urinary incontinence is common in postpartum women. Antenatal pelvic floor muscle training is protective against postpartum UI and should be the first‐line treatment option. [ABSTRACT FROM AUTHOR]

Background: Effects of neutering on bitch health have been reported, and are suggested to relate to bitch age at the time of neutering for some diseases. However, variation between published studies in terms of study populations and methodologies makes comparison and consolidation of the evidence difficult. Objective: A scoping review was designed to systematically search the available literature to identify and chart the evidence on the effect of neutering timing in relation to puberty on five health outcomes: atopy, developmental orthopaedic disease (DOD), neoplasia, obesity and urogenital disease. Design: A protocol was registered, and literature searches were conducted in CAB Abstracts, Medline and Web of Science. Studies were reviewed against inclusion criteria. Data on study and population characteristics and health outcomes were charted for the final included studies. Results: A total of 1,145 publications were reviewed across all five searches; 33 were retained for inclusion and charting. Only six of the 33 studies categorised the timing of surgical neutering as prepubertal or post-pubertal; one investigating mammary neoplasia and the other five, urogenital disease, commonly urinary incontinence. No studies were identified that examined the impacts of neutering bitches before or after puberty on atopy, DOD or obesity. One study considered bitches that were pre or post-pubertal at the time of the first treatment with deslorelin acetate for oestrus suppression and 26 examined the effects on health related to age, rather than pubertal status, at neutering. Conclusion: This scoping review suggests that robust evidence to support veterinarians, those working with dogs and dog owners when discussing the timing of neutering relative to puberty does not yet exist. The impact of neutering before or after puberty on atopy, DOD, neoplasia, obesity and urogenital disease in female domesticated dogs remains unclear. [ABSTRACT FROM AUTHOR]

Background: Men frequently underestimate the significance of urinary incontinence and fail to disclose their condition owing to embarrassment and the associated social stigma. Therefore, successful incontinence management with absorbent products helps individuals cope with the emotional and social challenges arising from incontinence, including visible urine leakage, frequent urination, unpleasant odours, and isolation. Aim: To assess the most essential performance features of the newly developed MoliCare Premium Men Pad. Methods: Computer-assisted personal interviews were conducted to obtain the opinions and satisfaction levels of 69 male users with incontinence in Germany regarding different performance characteristics of the newly designed MoliCare Premium Men Pad after using the product. Findings: All performance characteristics of the new MoliCare Premium Men Pad design received positive ratings from all interviewees. Notably, 90% of participants were 'highly satisfied' and 'satisfied' with the new MoliCare design. Conclusions: The new MoliCare SkinGuard absorbent core technology, anti-leakage guards, and well-engineered product design provide protection, discretion, and comfort to individuals with incontinence. The newly developed MoliCare Premium Men Pad is specifically tailored to meet the primary needs of male pad users and help them maintain a normal lifestyle. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence is frequent in the general population and affects men and women of all ages. UI carries an unsuspected load on the healthcare system. To investigate whether urinary incontinence is associated with all-cause, cardiovascular disease (CVD) and cancer mortality among US adults. Methods: The analyzed data was collected from the 2007–2016 National Health and Nutrition Examination Survey (NHANES) data. A total of 25,182 US participants with complete information about follow-up information and urinary incontinence (UI) were included in this cohort study. Univariate Cox regression analyses, the UpSet plot, multivariate Cox regression analysis, subgroup analysis of all-cause mortality, and Kaplan-Meier survival curve were employed to support the research objectives. Results: A total of 25,182 participants had a mean age of 49.8 ± 17.8 years, with 49.3% of them being male and 50.7% of them being female. In the unadjusted model, we found that the risk of all-cause mortality increased by 12% (95% CI 1.03–1.22, P = 0.008), the risk of CVD mortality increased by 21% (95% CI 1.07–1.36, P = 0.002), and the risk of Cancer mortality increased by 8% (95% CI 0.95–1.22, P = 0.243) among individuals with urinary incontinence. After adjusting for multiple variables, we found that the risk of all-cause mortality in patients with urinary incontinence decreased by 1% (95% CI 0.9–1.09), but this decrease was statistically insignificant (P = 0.868), and the risk of Cancer mortality decreased by 3% (95% CI 0.84–1.12, P = 0.686). The association between urinary incontinence and mortality risk were stable in stratified analyses. Conclusions: In our study, we found that urinary incontinence itself is an independent risk factor for death. The association between urinary incontinence and mortality became less significant after adjusting for covariates, this is a common occurrence in statistical analysis. Future research, with larger sample sizes and more robust study designs, is needed to further elucidate the complex relationship between urinary incontinence and mortality risk. [ABSTRACT FROM AUTHOR]

ObjectivesDesignResultsConclusionWe examined the association of urinary incontinence (UI) with physical, mental, and social health among older Korean Americans living in subsidized senior housing.Data were obtained from surveys conducted in 2023 with older Korean Americans residing in subsidized senior housing in the Los Angeles area (n = 313). UI was measured using a question about the frequency of involuntary urine loss. Physical, mental, and social health risks were assessed with a single item for self-rated health (fair/poor rating), the Patient Health Questionnaire−9 (probable depression), and the Lubben Social Network Scale−6 (isolation from family and friends).Over half of the sample reported UI, with 46.3% experiencing it infrequently (i.e. seldom) and 10.3% frequently (i.e. sometimes or often). UI was significantly associated with physical and mental health indicators; the odds of reporting fair or poor health and having probable depression were 1.94–7.32 times higher among those with either infrequent or frequent UI compared to those without UI. While family isolation was not associated with UI, the odds of being isolated from friends were 2.85 times greater among those with frequent UI compared to those without UI.Our findings confirm the adverse impact of UI on physical and mental health and highlight its unique role in social health. UI-associated social isolation was significant only in relationships with friends, providing new insights into the distinction between isolation from family and friends. These findings enhance our understanding of the health risks associated with UI and inform strategies for health management and promotion within the senior housing context. [ABSTRACT FROM AUTHOR]

Background: The standard artificial urinary sphincter (AUS) is an implantable device for the treatment of urinary incontinence by applying a pressure loading around the urethra through an inflatable cuff, often inducing no‐physiological stimulation up to tissue degenerative phenomena. A novel in silico approach is proposed to fill the gap of the traditional procedures by providing tools to quantitatively assess AUS reliability and performance based on AUS‐urethra interaction. Methods: The approach requires the development of 3D numerical models of AUS and urethra, and experimental investigations to define their mechanical behaviors. Computational analyses are performed to simulate the urethral lumen occlusion by AUS inflation under different pressures, and the lumen opening by applying an intraluminal pressure progressively increased under the AUS action (Abaqus Explicit solver). The AUS reliability is evaluated in terms of tissue stimulation by the mechanical fields potentially responsible for vasoconstriction and tissue damage, while the performance by the intraluminal pressure that causes the lumen opening for a specific occlusive pressure, showing the maximum urethral pressure for which continence is guaranteed. Results: The present study implemented the procedure considering the gold standard AMS 800 and a novel patented AUS. Results provided the comparison between two sphincteric devices and the evaluation of the influence of different building materials and geometrical features on the AUS functionality. Conclusions: The approach was developed for the AUS, but it could be adapted also to artificial sphincters for the treatment of other anatomical dysfunctions, widening the analyzable device configurations and reducing experimental and ethical efforts. [ABSTRACT FROM AUTHOR]

Background: We detail our approach and experience with a hybrid version of the endopelvic hood-sparing (HS) robot-assisted radical prostatectomy (RARP) using the da Vinci robotic platform. Materials and Methods: We retrospectively reviewed the records of 200 patients who underwent RARP by a single surgeon. Patients were propensity-matched into three cohorts depending on biopsy and prostatectomy Gleason Grade Groups: traditional retropubic (RP) (n = 80), retzius-sparing (RS) (n = 40), and HS (n = 80). Patient characteristics and oncologic and functional outcomes were examined. Zero pads per day defined return of continence. Erections suitable for penetrative intercourse with/without medications defined return of sexual function. Results: Patient characteristics were similar between cohorts excluding prostate-specific antigen levels (p = 0.014), which were significantly lower in the RS cohort (7.1 ± 5.3 ng/mL) compared with RP (9.2 ± 9.3 ng/mL) and HS (8.8 ± 8.9 ng/mL). Clinically significant positive margin rates were significantly higher (p = 0.046) in the RS cohort (32.5%) compared with RP (17.5%) and HS (13.9%). Biochemical recurrence and metastasis rates were similar between all cohorts. Median time to continence was significantly lower for RS and HS-RARP (p < 0.001) compared with RP-RARP at 1.3, 1.6, and 5.4 months, respectively. Median time to return of sexual function was significantly lower for RS and HS-RARP (p < 0.001) compared with RP-RARP at 4.0, 7.7, and 15.1 months, respectively. Conclusions: Our hybrid HS-RARP approach provides functional outcomes similar to RS-RARP with the early oncologic control of traditional RP-RARP. [ABSTRACT FROM AUTHOR]

Background: Stress urinary incontinence (SUI) is a widespread and frustrating condition that affects millions of people worldwide, with severe consequences on patients' quality of life and health care systems' costs. Currently, the most severe cases of SUI are treated using implanted (and rather invasive) extraurethral artificial sphincters. The authors propose an innovative, minimally invasive endourethral device for the treatment of SUI. Methods: Ten patients with SUI were enrolled in three Italian centers and underwent device implantation. After 10, 30, 60, and 90 days, correct device position was confirmed by ultrasonography. Improvements in continence and quality of life were evaluated through a 24-hour pad-test, an International Consultation on Incontinence Questionnarie-Short Form (ICI-Q) and a custom checklist. The device was explanted after 90 days. Results: The proposed device was successfully implanted and explanted in 8 out of 10 patients. The results of the pad-test, ICI-Q, and custom checklist demonstrated remarkable improvements in continence (median improvement: 82% with respect to the initial condition) and quality of life (mean reduction of the impact of urine losses on the quality of life: 61%). No major pain or discomfort was reported. Conclusions: The results demonstrate the efficacy of the proposed endourethral artificial sphincter in addressing SUI. The proposed device was successfully implanted and explanted in a short time (∼10 minutes) without intrinsic side effects and without triggering pain or discomfort. [ABSTRACT FROM AUTHOR]

Idiopathic normal pressure hydrocephalus (iNPH) is a disease characterized by gait disturbance, cognitive impairment, and urinary incontinence. For those patients who do not respond to shunt surgery, it lacks objective radiologic findings for the diagnosis of shunt malfunction. Here we aimed to evaluate whether the Evans index and callosal angle change during a prospective long-term follow-up of patients with iNPH submitted to shunt surgery. Clinical (NPH Japanese Scale) and radiologic (Evans index and callosal angle) data were collected pre- and postoperatively (3, 6, 12 and months) in 19 patients with iNPH. Imaging tests were evaluated by the same neuroradiologist during the follow-up. Patients had lower scores on the NPH Japanese Scale over time (P < 0.001). There was no significant difference among Evans index values during the follow-up (P = 0.24). Preoperative average callosal angle was 72 ± 15, which increased to 91 ± 18 in 6 months (P = 0.003). In this sample, patients with iNPH submitted to a programmable valve shunt had an increase in callosal angle concomitant to neurologic improvement. The Evans index did not change during follow-up. [ABSTRACT FROM AUTHOR]

Idiopathic normal pressure hydrocephalus (iNPH) typically presents with gait disturbances, cognitive decline, and urinary incontinence. Symptomatic improvement generally occurs following shunt placement, but limited evidence exists on the quality of life (QOL) metrics in iNPH. Therefore, we conducted a prospective study of the effect of shunt placement on QOL in iNPH patients, using Quality of Life in Neurologic Disorders (Neuro-QOL) metrics. Eligible patients underwent shunt placement after evidence of symptomatic improvement following temporary cerebrospinal fluid diversion via inpatient lumbar drain trial. Patients were administered short- and long-form Neuro-QOL assessments prior to shunt placement and at 6-month and 1-year postoperative timepoints to evaluate lower extremity mobility, cognitive function, and social roles and activities participation. Changes in QOL measures were analyzed using a repeated-measures linear mixed effects model. There were 48 patients with a mean age of 75.4 ± 6.3 years. Average short-form mobility scores improved by 3.9 points (14.6%) at 6-month follow-up and by 6.2 points (23.2%) at 1-year follow-up compared with preoperative baseline (P = 0.027 and P = 0.0002, respectively). Short-form cognition scores increased by 5.2 points (22.4%) at 6 months and 10.9 points (47.0%) at 1 year postoperatively (P = 0.007 and P < 0.0001, respectively). On long-form assessment, social roles and activity participation scores improved by 29.3 points (23.4%) at 6 months and 31.6 points (25.2%) at 1 year after surgery compared to baseline (P = 0.028 and P = 0.02, respectively). Our findings demonstrate that shunt placement leads to improved QOL in iNPH patients across multiple domains. Significant improvements in mobility, cognition, and social roles and activity participation are realized within the first 6 months and are sustained on 1-year follow-up. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence and severity of pelvic floor disorders (PFD), and the associations between treatment type and PFD, and cancer stage and PFD in patients before and after hysterectomy for gynaecological cancer; and the changes in outcomes over time. Design: Longitudinal cohort study. Setting: Gynaecological oncology outpatient clinics. Population: Patients undergoing hysterectomy for endometrial, uterine, ovarian or cervical cancer. Methods: Participants were assessed before, and 6 weeks and 3 months after hysterectomy. Changes over time were analysed using generalised estimating equations or linear mixed models. Associations were analysed using logistic regression models and analyses of variance. Main outcome measures: Incontinence Severity Index, Pelvic Floor Distress Inventory‐short form (PFDI‐20), Female Sexual Function Index. Results: Of 277 eligible patients, 126 participated. Prevalence rates of PFD were high before (urinary incontinence [UI] 66%, faecal incontinence [FI] 12%, sexual inactivity 73%) and after (UI 59%, FI 14%, sexual inactivity 58%) hysterectomy. Receiving adjuvant therapy led to moderate‐to‐very severe UI 3 months after surgery compared with surgery only (odds ratio 4.98, 95% CI 1.63–15.18). There was no association between treatment type and other PFD, or cancer stage and any PFD. Conclusion: Prevalence of PFD was high before and after hysterectomy for gynaecological cancer. Moderate‐to‐very‐severe UI was associated with adjuvant therapy. [ABSTRACT FROM AUTHOR]

Objective: To investigate how reproductive history was associated with urinary incontinence in midlife. Design: A follow‐up study. Setting: Denmark. Population: A total of 39 977 mothers who participated in the Maternal Follow up (2013–2014) in the Danish National Birth Cohort. National registries provided their reproductive history. Methods: How parity, mode of birth and obstetric tears associated with urinary incontinence were estimated with adjusted odds ratios (OR) and 95% CI using logistic regression. Main outcome measures: Self‐reported urinary incontinence including subtypes stress, urge and mixed urinary incontinence. Results: At an average age of 44 years, the prevalence of any urinary incontinence was 32% (21% stress, 2% urge, and 8% mixed urinary incontinence). Women with two births more often had urinary incontinence than women with one birth (OR 1.20, 95% CI 1.10–1.31). Compared with women with only spontaneous births, a history of only caesarean sections was associated with much lower odds of urinary incontinence (OR 0.39, 95% CI 0.35–0.42) and a history of instrumental births with slightly lower odds (OR 0.92, 95% CI 0.86–0.98). Compared with no tear/first‐degree tear as the largest tear, episiotomy was associated with less urinary incontinence (OR 0.91, 95% CI 0.86–0.97) whereas third/fourth‐degree tears were associated with more (OR 1.14, 95% CI 1.04–1.25). Findings were mainly explained by similar associations with stress and mixed urinary incontinence. Conclusions: Vaginal birth was associated with a higher risk of long‐term urinary incontinence, but our results indicate that this risk may be reduced by shortening the second stage of birth. [ABSTRACT FROM AUTHOR]

Background: Mixed urinary incontinence (MUI) has always represented a major therapeutic challenge and the management of this type of incontinence is often complicated by uncertain outcomes. Surgical options include interventions targeting both stress urinary incontinence (SUI) and urge urinary incontinence (UUI), although there are no international published guidelines that dictate whether it is better to start with surgical management to address the SUI or UUI component after the failure of conservative treatment. The aim of the present study is to evaluate the effectiveness of the Macroplastique (MPQ) procedure on overactive bladder (OAB) symptoms in women with MUI with a minimum follow-up of 1 year. Methods: A retrospective analysis of prospectively collected data was performed in two tertiary reference centers. We enrolled all women complaining of symptoms of SUI and OAB, dry or wet, with a urodynamically confirmed diagnosis of MUI [urodynamic stress incontinence (USI) with detrusor overactivity (DO)], who took a previous ineffective antimuscarinic treatment and underwent the MPQ procedure. We considered as objectively cured women who did not leak urine during the stress test and with a 1 h pad-test negative, while International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF), ICIQ-OAB, Patient Global Impression of Improvement (PGI-I) scale, and a Visual Analogue Scale (VAS) were used to assess subjective outcomes. Results: A total of forty-six patients who met the inclusion criteria and who underwent the MPQ procedure were considered for the analysis. At the 1-year mark of follow-up, 72% of patients were objectively cured at stress test and 65% were objectively cured at pad-test, while 72% of women declared themselves subjectively cured. OAB symptoms significantly improved after MPQ and a complete resolution of OAB was recorded in 35% of patients. Conclusions: This study demonstrated that MPQ is a safe and effective option for the treatment of female MUI. Furthermore, MPQ significantly improves the symptoms of OAB and is able to completely cure this condition in a relevant percentage of women with MUI when pharmacological treatment fails. [ABSTRACT FROM AUTHOR]

Background: The association between surgical performance ratings and clinical outcomes in robotic surgery is poorly understood. Additionally, no studies have reported on the relationship between the surgeon's initial case-skill evaluation and the learning curve in robot-assisted surgery. We evaluated whether an objective surgical technique evaluation score for initial robot-assisted radical prostatectomy (RARP) was associated with clinical outcomes and surgeons' learning curves. Methods: Six surgeons who were trained in and started to perform RARP at our institution were included. Anonymized, unedited videos of each surgeon's 10th RARP case were evaluated by three reviewers, using modified Objective Structured Assessment of Technical Skill (OSATS) scores. We then divided the surgeons into two groups on the basis of these OSATS scores. We retrospectively compared the clinical outcomes and learning curves of the console time of the two groups for consecutive RARPs, performed from March 2018 to July 2023. Results: We analyzed 258 RARPs (43 cases/surgeon), including 129 cases performed by high-OSATS score surgeons (18.2–19.3 points) and 129 cases performed by low-OSATS score surgeons (11.9–16.0 points). Overall, the high-OSATS score group had significantly shorter operation and console times than the low-OSATS score group did (both P < 0.01) and their patients' rate of continence recovery by 3 months post-RARP was significantly higher (P = 0.03). However, complications, blood loss, and positive margins did not differ between the groups (P = 0.08, P = 0.51, and P = 0.90, respectively). The high-OSATS score group had a significantly shorter console time than the low-OSATS score group did after the 11–20 cases. Conclusions: The OSATS score in early RARP cases can predict subsequent surgical outcomes and surgeons' learning curves. [ABSTRACT FROM AUTHOR]

Aim: Caregivers in home care settings may experience significant physical, emotional, and financial burdens in providing toileting assistance. However, few studies have evaluated these three aspects of caregiver burden. Therefore, this study aimed to clarify the physical, emotional, and financial burdens of toileting assistance and examine the factors associated with each burden. Methods: A self‐administered postal questionnaire was distributed to 405 family caregivers of older adults receiving home care and subsidies for incontinence products in Japan in 2019. Family caregivers answered questions about toileting assistance, the perceived physical, emotional, and financial burdens of providing toileting assistance at home, and the urinary/fecal symptoms of older adults. Results: Of the 242 family caregivers who reported each burden, 213 (88%) had experienced at least one physical, emotional, or financial burden. The prevalence of physical, emotional, and financial burdens was 77.3%, 78.1%, and 70.7%, respectively. Approximately 60% of respondents reported experiencing all three burdens. Physical burden was associated with spouses acting as primary caregivers, nocturia, fecal incontinence, and the odor of urine/feces from toileting assistance. Emotional burden was associated with nighttime assistance, urinary/fecal leakage from absorbent incontinence products, and the odor of urine/feces. Financial burden was associated with frequent assistance, disposal costs of absorbent incontinence products, and the degree of toileting assistance. Conclusions: The results revealed a high prevalence of the three burdens of toileting assistance among family caregivers, suggesting the need to assess these burdens. Furthermore, they suggested the importance of providing guidance to family members, which may help reduce these burdens. [ABSTRACT FROM AUTHOR]

Introduction: Pelvic floor muscle training (PFMT) for urinary incontinence (UI) is recommended in combination with biofeedback to visualize pelvic floor muscles. The focus is on non‐invasive hand‐held ultrasound (US) measurement methods for PFMT, which can be performed at home. Recently, self‐performed US measurements in which the patient applies the US to themself have gradually spreading. This study aimed to develop an educational program for the biofeedback method using self‐performed US and to evaluate its feasibility. Methods: This study was an observational study. The ADDIE model (Analysis, Design, Development, Implementation, and Evaluation) was utilized to create an e‐learning program for women aged ≥40 years with UI. Participants self‐performed bladder US via e‐learning, using a hand‐held US device with a convex probe. The primary outcome was the number of times the bladder area was successfully extracted using an existing automatic bladder area extraction system. The secondary outcome was the total score of the technical evaluation of the self‐performed US, which was evaluated across three proficiency levels. Descriptive statistics were conducted for participant characteristics, presenting categorical variables as percentages and continuous variables as means ± SD. Results: We included 11 participants with a mean age of 56.2 years. Nine participants were able to record US videos, and two were unable to record bladder videos. Regarding the technical evaluation scores, all participants scored ≥80%; four had perfect scores. Conclusions: This study showed that transabdominal self‐performed bladder US can be performed in 81.8% of women with UI in their 40–60s by using an e‐learning program. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to elucidate the clinical characteristics and predictors of long‐term postoperative urinary incontinence (PUI) after robot‐assisted radical prostatectomy (RARP). Methods: This study included patients who underwent RARP at our institution and were stratified into PUI (≥1 pad/day) and continence (0 pad/day) groups at 60 months after RARP. A propensity score‐matched analysis with multiple preoperative urinary status (Expanded Prostate Cancer Index Composite urinary subdomains, total International Prostate Symptom Score (IPSS), and IPSS‐quality of life scores) was performed to match preoperative urinary status in these groups. Serial changes in urinary status and treatment satisfaction preoperatively and until 60 months after RARP were compared, and predictors of long‐term PUI were assessed using multivariate logistic regression analysis. Results: A total of 228 patients were included in the PUI and continence groups (114 patients each). Although no significant difference in preoperative urinary status was observed between the two groups, the postoperative urinary status significantly worsened overall in the PUI group than in the continence group. Treatment satisfaction was also significantly lower in the PUI group than in the continence group from 12 to 60 months postoperatively. Multivariate logistic regression analysis revealed that age (≥70 years) and biochemical recurrence (BCR) were significant predictors of the long‐term PUI group (p < 0.05). Conclusions: Patients with long‐term PUI had poor overall postoperative urinary status and lower treatment satisfaction than the continence group. Considering the age and risk of BCR is important for predicting long‐term PUI when performing RARP. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Generative artificial intelligence (AI) has proven to be a powerful tool with increasing applications in clinical care and medical education. ChatGPT has performed adequately on many specialty certification and knowledge assessment exams. The objective of this study was to assess the performance of ChatGPT 4 on a multiple-choice exam meant to simulate the Canadian urology board exam. METHODS: Graduating urology residents representing all Canadian training programs gather yearly for a mock exam that simulates their upcoming board-certifying exam. The exam consists of written multiple-choice questions (MCQs) and an oral objective structured clinical examination (OSCE). The 2022 exam was taken by 29 graduating residents and was administered to ChatGPT 4. RESULTS: ChatGPT 4 scored 46% on the MCQ exam, whereas the mean and median scores of graduating urology residents were 62.6%, and 62.7%, respectively. This would place ChatGPT's score 1.8 standard deviations from the median. The percentile rank of ChatGPT would be in the sixth percentile. ChatGPT scores on different topics of the exam were as follows: oncology 35%, andrology/benign prostatic hyperplasia 62%, physiology/anatomy 67%, incontinence/female urology 23%, infections 71%, urolithiasis 57%, and trauma/reconstruction 17%, with ChatGPT 4's oncology performance being significantly below that of postgraduate year 5 residents. CONCLUSIONS: ChatGPT 4 underperforms on an MCQ exam meant to simulate the Canadian board exam. Ongoing assessments of the capability of generative AI is needed as these models evolve and are trained on additional urology content. [ABSTRACT FROM AUTHOR]

To analyze the frequency of new urologic visits and urologic diagnoses in patients prescribed sodium-glucose co-transporter-2 inhibitors (SGLT-2is). Records from a multi-state health system between 2014 and 2022 were reviewed to identify patients referred for outpatient urology evaluation within 2 years of diabetes medication prescription. Patients were stratified by the prescription of SGLT-2is or another diabetes medication. Frequency of urology visits within 1-year, urologic diagnoses, and prescriptions to treat lower urinary tract symptoms (LUTS) were compared. Patients were stratified by whether they had achieved HbA1c goal (≥7% or <7%) following treatment as well as by sex. Multivariable logistic regression was performed to determine if SGLT-2 use independently predicted outcomes of interest. 163,827 patients met inclusion criteria. Use of SGLT-2is was associated with a higher frequency of early urologic referral, balanitis/balanoposthitis, overactive bladder, urinary frequency, urgency, and need for LUTS medications in males with HbA1c ≥7%. Females on SGLT-2is with HbA1c ≥7% also had higher rates of urinary incontinence. In those with HbA1c <7%, only balanitis/balanoposthitis and urinary incontinence were higher in the SGLT-2i cohorts for males and females, respectively. Multivariable analysis found SGLT-2i use as predictive of early urology referral, balanitis/balanoposthitis, urinary urgency, frequency, overactive bladder, and need for LUTS medications in males. Multivariable analysis of females demonstrated similar results. SGLT-2is may lead to worse urologic outcomes and increased utilization of urologic care relative to other diabetic medications. Future studies are necessary to identify which patients are at highest risk of adverse urologic outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Hysterectomy has been suggested to increase the risk of urinary incontinence (UI), although evidence is controversial. In our population‐based cohort study, we aimed to assess the independent effect of hysterectomy on the risk of de novo UI. Material and Methods: This is a population‐based cohort study on the women of the Northern Finland Birth Cohort 1966 (n = 5889). We identified all hysterectomies among the cohort (n = 461) using the national Care Register for Health Care and classified them according to surgical approach into laparoscopic (n = 247), vaginal (n = 107), and abdominal hysterectomies (n = 107). Women without hysterectomy formed the reference group (n = 3495). All women with UI diagnoses and operations were identified in the register, and women with preoperative UI diagnosis (n = 36) were excluded from the analysis to assess de novo UI. Data on potential confounding factors were collected from registers and the cohort questionnaire. Incidences of different UI subtypes and UI operations were compared between the hysterectomy and the reference groups, and further disaggregated by different hysterectomy approaches. Logistic regression models were used to analyze the association between hysterectomy and UI, with adjustments for several UI‐related covariates. Results: We found no significant difference in the incidence of UI diagnoses or the rate of subsequent UI operations between the hysterectomy and the reference groups (24 [5.6%] vs. 166 [4.7%], p = 0.416 and 14 [3.3%] vs. 87 [2.5%], p = 0.323). Hysterectomy was not significantly associated with the risk of any subtype of UI (overall UI: OR 1.20, 95% CI 0.77–1.86; stress UI (SUI): OR 1.51, 95% CI 0.89–2.55; other UI: OR 0.80, 95% CI 0.36–1.74). After adjusting for preoperative pelvic organ prolapse (POP) diagnoses, the risk was decreased (overall UI: OR 0.54, 95% CI 0.32–0.90; other than SUI: OR 0.40, 95% CI 0.17–0.95). Regarding different hysterectomy approaches, the risks of overall UI and SUI were significantly increased in vaginal, but not in laparoscopic or abdominal hysterectomy. However, adjusting for preoperative POP diagnosis abolished these risks. Conclusions: Hysterectomy is not an independent risk factor for de novo UI. Instead, underlying POP appears to be a significant risk factor for the incidence of UI after hysterectomy. [ABSTRACT FROM AUTHOR]

• Calculated person-year incidence of urinary incontinence in hypertensive female patients. • The incidence rates of UI in hypertensive women were significantly higher than that in normotensive women. • Hypertension was an independent risk factor for new-onset UI and SUI in Chinese adult women. To determine the incidence of UI (urinary incontinence) and its subtypes in hypertensive women and examine the association between hypertension and new-onset UI. We conducted a cohort study on women aged ≥20 years in six regions of China. This cohort study was carried out from 2014 to 2016 at baseline, with follow-up completed in 2018. Information on sociodemographic characteristics, physiological and health behaviours were collected. We calculated the standardized person-year incidence of UI in hypertensive women, and used logistic regression to evaluate the association between hypertension and UI and its subtypes. The standardized incidence of UI, stress UI (SUI), urgency UI (UUI), and mixed UI (MUI) in hypertensive women was 32.2, 21.9, 4.1, and 6.1 per 1000 person-years. Compared with normotensive women, the unadjusted and adjusted OR (odd ratio) for UI in hypertensive women was 2.62 (95 % confidence interval [CI], 2.16–3.18) and 1.70 (95 % CI, 1.14–2.53), respectively; The unadjusted and adjusted OR for SUI in women with hypertension was 2.44 (95 % CI, 1.92–3.09) and 2.60 (95 % CI, 1.68–4.04), respectively; The unadjusted and adjusted OR for UUI in women with hypertension was 2.80 (95 % CI, 1.79–4.37) and 0.54 (95 % CI, 0.13–3.66), respectively; The unadjusted and adjusted OR for MUI in women with hypertension was 2.49 (95 % CI, 1.92–3.09) and 0.60 (95 % CI, 0.19–1.91), respectively. The incidence of UI in hypertensive women was 32.2/1000 person-years. Hypertension was an independent risk factor for new-onset UI and SUI in Chinese adult women. [ABSTRACT FROM AUTHOR]

• UI can be disabling and is often difficult to treat effectively. • Current treatments for refractory UI are mostly invasive and uncomfortable. • Introducing the concept of a novel, non-invasive catheter device for managing UI. • The device aims to improve patient outcomes with real-time monitoring and tailored care. Urinary incontinence, characterized by the involuntary leakage of urine, significantly impacts millions globally, affecting their quality of life, social interactions, and psychological well-being. Traditional diagnostic methods and treatments often fall short, especially for refractory urinary incontinence, due to their invasive nature and limited scope for continuous, real-time assessment. This narrative review critically examines current approaches to diagnosing and managing urinary incontinence, highlights significant gaps in practice, and underscores the urgent need for innovative solutions. We explore the evolution of diagnostic and treatment modalities and introduce a preliminary method involving a conceptual catheter device that promises to shift toward non-invasive, real-time monitoring and management. This review synthesizes prevailing research and provides a visionary outlook on how emerging technologies could revolutionize urinary incontinence care, offering a future of personalized, patient-centered strategies. Our discussion extends to the limitations of conventional urodynamic studies, which are often uncomfortable and fail to capture the dynamic nature of urinary incontinence in everyday settings. The proposed preliminary method features an advanced, smart-device solution integrating sensors and artificial intelligence to offer precise, real-time insights into bladder activity. This device, still in the conceptual stages, has the potential to transform the landscape of urinary incontinence management by enhancing diagnostic accuracy and therapeutic efficacy. By bridging the gap between current limitations and future possibilities, this paper aims to inspire ongoing innovation and research in the field of urogynecology. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the application of a rehabilitation management protocol for urinary incontinence after robot-assisted laparoscopic prostatectomy (RALP). Methods: We conducted a retrospective cohort study of 114 patients who underwent RALP between August 2021 and November 2021 as the control group and a prospective analysis of 114 patients who underwent RALP between May 2022 and August 2022 as the experimental group. The rehabilitation management protocol focused on preoperative stage, postoperative care, day of catheter removal, 1 month postoperative, 3 months postoperative, 6 months postoperative, and 12 months or more postoperative. Results: The 24-h pad test was significantly lower in the experimental group compared with the control group at 2 and 6 months after RALP (both P < 0.01). The scores of the international consultation on incontinence questionnaire-short form (ICIQ-SF) in the experimental group were significantly lower than those in the control group at 1 month after RALP (P < 0.01).The scores of quality of life in the experimental group were significantly higher than those of the control group at 1, 2, and 6 months after RALP (all P < 0.01).The scores of Broome Pelvic Muscle Self-efficacy Scale (BPMSES) were lower than those of the control group at 1, 2, 3, and 6 months after RALP (all P < 0.01). Conclusion: The application of the rehabilitation management protocol had significant beneficial effects on urinary functions and quality of life in patients with prostate cancer after RALP. [ABSTRACT FROM AUTHOR]

Background: The purpose was to investigate the frequency of lower urinary tract symptoms (LUTS) and lower urinary tract dysfunction (LUTD) in Duchenne muscular dystrophy (DMD) and the relationship between these symptoms and independence and quality of life (QoL). Methods: The cross-sectional study included children aged 5–18 years and diagnosed with DMD and their families. Data were collected using the Dysfunctional Voiding and Incontinence Scoring System (DVISS), the Barthel Index, and the Pediatric Quality of Life™ 3.0 Neuromuscular Module (PedsQL-NMM). Results: The study was completed with 45 children with DMD. LUTS was found in 86.66% and LUTD was found in 44.44%. The most common symptom was holding maneuvers (62.22%). Other common symptoms were urinary urgency (55.55%), daytime urinary incontinence (46.66%), and enuresis (31.11%). There was a significant correlation of the DVISS with the level of independence and QoL (p < 0.05). Moreover, higher LUTS score was associated with lower Barthel and PedsQL-NMM scores. Conclusion: LUTS is a neglected condition, although it is frequently seen in children with DMD. Clinical trial registration: NCT05464446 [ABSTRACT FROM AUTHOR]

The impact of ageing on the body and its association with skin harm and frailty in relation to multimorbidity, comorbidity and polypharmacy is clearly described in the literature. The ageing population globally brings with it the challenge for healthcare professionals of managing individuals with increasingly complex and inter-related needs. This article considers ageing skin and skin tears within the context of frailty as a syndrome. It discusses what frailty is understood to be, how to recognise and assess for it, and how to consider risk and prevention of harm to the skin of the ageing person with frailty. [ABSTRACT FROM AUTHOR]

Among the conditions underlying childhood daytime incontinence the most frequent is overactive bladder (OAB). Parasacral transcutaneous electrical nerve stimulation (parasacral TENS) is a promising therapy for OAB treatment in children; however, there is no standard treatment protocol. To evaluate the immediate and continued effects of parasacral TENS monotherapy in children with OAB. 57 children at mean age 10.8 years diagnosed with OAB at a single centre were prospectively enrolled from 2013 to 2018. The inclusion criterion was typical OAB symptoms. The treatment results were evaluated based on objective measurements from bladder diaries, 48 h frequency/volume (48 h F/V) charts, and uroflowmetry. The parasacral TENS treatment lasted for 4 months, twice daily, with 1 h sessions. Results were evaluated at three time points: 2 months of therapy, 4 months (end of active therapy), and 10 months (6 months after cessation of therapy). After 4 months of parasacral TENS treatment, the number of days with daytime incontinence decreased from 7.23 to 3.94/14 days (p < 0.05), nocturnal enuresis decreased from 6.81 to 3.77/14 days (p < 0.05), and urgency episodes from 7.36 to 3.58 in 14 days (p < 0.05). Treatment effects remained stable 6 months after therapy cessation regarding days with daytime incontinence (from 3.94 [immediately after treatment] to 3.28 in 14 days [6 months after treatment cessation]), nocturnal enuresis (from 3.77 to 2.91 in 14 days), and urgency episodes (from 3.58 to 2.12 in 14 days) (p < 0.05). Complete response after 6 months of therapy was observed in 32% of patients with daytime incontinence, 35% with nocturnal enuresis, and 50% with urgency episodes. A recent systematic review of parasacral TENS in children with OAB included only two studies with a follow up of 6 months or longer after treatment cessation; therefore, little is known about the continued effects of parasacral TENS. High rates of complete symptom remission were reported in studies where only subjective symptoms were evaluated. Results of our study reveal that the positive effect of treatment persist. The strengths of the present study include its prospective design, large sample size, and uniform standard urotherapy performed prior to TENS. The use of parasacral TENS in children with OAB is effective and results in a significant reduction in daytime incontinence, nocturnal enuresis, and urgency episodes. A longer treatment duration of 4 months leads to more improvement and the effects remain stable 6 months after treatment cessation. Summary Table Treatment results regarding daytime incontinence, nocturnal enuresis, and urgency episodes. Summary Table Initial evaluation before treatment After 4 months of pTENS After 6 months of pTENS cessation p Days daytime incontinence/14 days 7.23∗ 3.94∗∗ 3.28∗∗∗ ∗vs∗∗p < 0.05 ∗vs∗∗∗p < 0.05 ∗∗vs∗∗∗.ns Days with nocturnal enuresis/14 days 6.81# 3.77## 2.91####vs##p < 0.05 #vs###p < 0.05 ##vs###.ns Days with urgency episodes/14 days 7.36& 3.58&& 2.12&&&&vs&& p < 0.05 &vs&&&p < 0.05 &&vs&&&p < 0.05 Abbreviations: pTENS, parasacral transcutaneous electrical nerve stimulation. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to evaluate the predictive clinical and operative risk factors for urinary incontinence (UI) rates following thulium fiber enucleation of benign prostate hyperplasia (ThuFLEP). Materials and methods: We conducted a retrospective cohort review of a prospectively maintained database for patients who underwent ThuFLEP between 2021 and 2023 in our university clinic performed by a single surgeon with high experience (more than 3000 endoscopic enucleation). To perform the operation, we used a thulium fiber laser Fiberlase U3 (IRE Polus ltd, Fryazino, Russia) with operating modes of 1.5 J and 40 Hz 60 W. Postoperative UI rates and risk factors following ThuFLEP were assessed for three follow-up intervals (up to 1 months, from 1 to 3 months and after 3 months post-ThuFLEP). Statistical analysis was conducted using univariate and multivariate logistic regression. Results: Out of total 578 patients who underwent ThuFLEP, the study included 381 patients with full information about continence status. Long-term UI (more than 3 months) were found only in 1.6% cases with 0.8% for stress UI, 0.3% for urge UI and 0.5% for mixed UI. Univariate logistic regression analysis has shown that higher total laser energy (OR = 1.009; 95% CI = 1.001–1.018; p = 0.036) and enucleation technique (OR = 0.272; 95% CI = 0.113–0.656; p = 0.004 in favor of En-bloc ThuFLEP) were associated with UI overall, while at multivariable analysis only En-bloc ThuFLEP was protective factor for UI (OR = 0.302; 95%CI = 0.123–0.739; p = 0.009). For short-term UI (less than 1 months) early sphincter release was found as protective factor at both uni- and multivariate analysis compare to longer UI. Conclusion: Short-term UI up to 3 months following ThuFLEP is associated with early sphincter release, while overall UI rates are related with enucleation technique (preferable En-bloc) and total laser energy (preferable lower energy). The surgeon should take all these risk factors into account before choosing the technique of BPH surgical treatment. [ABSTRACT FROM AUTHOR]

Back ground: Urinary Incontinence is also called leaky bladder/ sometimes involves a strong, uncontrollable urge to urinate. Life style of daily passengers includes hurry, anxiety and stress to catch the train to travel long distances for education or occupation purpose. Many people may feel discomfort to use washroom more frequently. Objectives: To assess prevalence of urinary incontinence and socio-demographic profile and risk factors of daily passengers in Prakasam district suffering with urinary incontinence, who travelled in trains during study period. Methodology: A Cross sectional observational study conducted among 160 daily passengers from August 1st to September 30th 2021 in Ongole, Prakasam district, Andhra Pradesh. A pretested semi structured questionnaire is used to assess socio demographic profile and risk factors of urinary incontinence among study participants. Questionnaire for urinary incontinence for diagnosis [QUID] is applied for diagnosing urinary incontinence among study participants. Simple random technique was applied to choose study participants. Results: Prevalence of Urinary Incontinence was 29.66%. Almost half of the study participants (47.2%) mentioned the urinary continence when they had cough or sneezing. Mean age of study participants was 21.7 years and ranged between 17 to 76 years. Pearson correlation test revealed a strong significant positive correlation between QUID Urge score and QUID stress score. (r = 0.40, p < 0.01). Conclusion: Urinary incontinence significantly high in the age group > 30 when compared to others. At the same time urinary incontinence significantly high among study participants having smoking history. People who had high stress score had high prevalence of urinary incontinence. [ABSTRACT FROM AUTHOR]

Objective This study seeks to explore the effects of pelvic floor muscle exercises on urinary incontinence and leisure time in women diagnosed with multiple sclerosis (MS). Materials & Methods A quasi-experimental design was utilized in this study. The research included 15 women with MS at stages 7 or lower on the expanded disability status scale, selected conveniently to form the intervention group. This group underwent a structured pelvic floor muscle exercise program. Pre-test and post-test assessments were conducted using the international consultation on incontinence questionnaire-urinary incontinence short form, the leisure activities questionnaire and the fatigue severity scale. The impact of the intervention was analyzed using the Wilcoxon test. Results The results demonstrated a significant reduction in urinary incontinence (P=0.007) and increased leisure activities (P=0.003) among women with MS who engaged in pelvic floor muscle exercises. However, these exercises did not significantly affect the participants' fatigue levels. Conclusion The study suggests pelvic floor exercises can effectively decrease urinary incontinence and enhance leisure activities in women with MS. These findings emphasize the importance of incorporating targeted exercises into the care of this patient population, providing valuable insights for healthcare professionals and individuals aiming to enhance their quality of life (QoL). Further research and integration of pelvic floor exercises into comprehensive care strategies are recommended to optimize the well-being of women with MS. [ABSTRACT FROM AUTHOR]

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Objective: The purpose of the study was to verify the psychometric properties of the Bengali-translated Incontinence Severity Index (ISI) questionnaire. Materials and methods: A test–retest data collection method was conducted with 47 respondents using the Bengali-translated ISI questionnaire. Results: The mean age of the respondents was 41.4 years; standard deviation (S.D.) ± 9.90. Most of the women were suffering with moderate severity of urinary incontinence 48.9% (n = 23). The present study determined that Bengali-translated ISI questionnaire was valid and reliable. In addition, present study reflected on the content validity of the Bengali version of ISI questionnaire was 1 > 0.75; internal consistency α = 0.80 and intra-class correlation (ICC) = 0.86 respectively. Conclusion: The Bengali version of ISI questionnaire is valid and reliable measurement tool to extent the severity of urinary incontinence in the cultural context of Bangladesh. [ABSTRACT FROM AUTHOR]

Urine leakage volume is an important indicator reflecting the severity of incontinence in patients. Currently, there are limited smart diapers capable of continuous dynamic monitoring of urine volume. This study developed two types of urine volume sensors, resistive and capacitive, which were integrated with traditional diapers to assess urine leakage levels: mild leakage (0–5 mL), moderate leakage (6–12 mL), and severe leakage (above 12 mL). Three patterns of resistive urine volume sensors were designed, and the results showed that the A pattern could accurately determine urine volume and frequency levels. Additionally, three electrode spacing designs were tested for the capacitive urine volume sensors. The results indicated that the sensor with a 1 cm electrode spacing could determine the urine volume range, with each 1 mL increase in urine causing a capacitance rise of approximately 1.5–1.8 pF, with an error of about ± 0.5 mL per increment. Both resistive and capacitive methods showed high accuracy in monitoring urine volume and frequency. This study validated the feasibility of smart flexible fabric sensors in detecting urine volume and frequency, providing a potential solution for better assessing and managing the condition of incontinence patients. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence (UI) is the most prevalent pelvic floor disorder following treatment for gynaecological cancer with a distressing impact on quality-of-life in survivors. Physiotherapist-supervised pelvic floor muscle (PFM) training is recommended as the first-line intervention for UI in community-dwelling women. However, it is not known if this intervention is effective in women following treatment for gynaecological cancer, nor whether PFM training can be delivered entirely remotely. The primary aim of this study is to investigate if a telehealth-delivered PFM training program incorporating a novel biofeedback device reduces UI compared with usual care, following gynaecological cancer. Methods: This is a pragmatic, two-arm parallel-group, stratified superiority randomised controlled trial recruiting 72 participants (ACTRN12622000580774). Recruitment sites include gynaecology-oncology outpatient clinics, supplemented by advertisements through community foundations/social media/care groups. Participants must have completed primary cancer treatment at least 6 months prior or adjuvant therapy at least 3 months prior, for Stage I, II or III uterine, cervical, fallopian tube, primary peritoneal or ovarian cancer or borderline ovarian tumour, and have UI occurring at least weekly. Participants randomised to the usual care group will receive bladder and bowel advice handouts and one audio telehealth physiotherapist consultation to answer any queries about the handouts. Participants randomised to the intervention group will receive the same handouts plus eight video telehealth physiotherapist consultations for PFM training with a biofeedback device (femfit®), alongside a home-based program over 16 weeks. The primary outcome measure is a patient-reported outcome of UI frequency, amount and interference with everyday life (measured using the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form), immediately post-intervention compared with baseline. Secondary outcomes include quality-of-life measures, bother of pelvic floor symptoms, leakage episodes, use of continence pads and global impression of change. We will also investigate if the intervention improves intra-vaginal resting and squeeze pressure in women in the intervention arm, using data from the biofeedback device. Discussion: If clinical effectiveness of telehealth-delivered physiotherapist-supervised PFM training, supplemented with home biofeedback is shown, this will allow this therapy to enter pathways of care, and provide an evidence-based option for treatment of post-cancer UI not currently available. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), ID 12622000580774. Registered 20 April 2022. [ABSTRACT FROM AUTHOR]

Background and objective: Localized prostate cancer treatment aims to balance cancer control with preserving urinary and erectile function. While focal ablative therapies have emerged, their uncertain prognosis prompts exploration of partial prostatectomy. We systematically reviewed its efficacy as a primary treatment, particularly in low-to-intermediate-risk patients. Methods: Our review comprehensively analyzed existing studies on partial prostatectomy for localized cancer. We focused on patient selection, surgical techniques, and postoperative outcomes, emphasizing tumor control, continence, and erectile function. Studies involving multiparametric MRI and targeted biopsies for candidate selection were included. Key findings and limitations: Partial prostatectomy, encompassing various techniques, demonstrates promising short-term outcomes in tumor control and functional preservation. Preoperative imaging and biopsy aid in candidate selection. However, longer-term data on cancer recurrence are limited, warranting further investigation. Heterogeneity among studies and the lack of standardized follow-up protocols are notable limitations. Conclusions and clinical implications: Partial prostatectomy offers a minimally invasive and effective treatment option for localized prostate cancer, particularly in selected patients. Preoperative imaging and biopsy play crucial roles in patient selection, while standardized follow-up protocols are needed to assess long-term outcomes. Future research should focus on elucidating its precise role and optimizing patient selection criteria, contributing to improved prostate cancer management strategies. Advancing practice: Partial prostatectomy is explored for localized prostate cancer treatment, aiming to balance cancer control with preserving function. Short-term outcomes are promising, but long-term data on recurrence are lacking. Further research is needed to optimize patient selection and standardize follow-up protocols. Patient summary: Treating localized prostate cancer aims to manage cancer effectively while preserving urinary and erectile function. Partial prostatectomy, targeting the tumor while preserving the gland, shows promising outcomes in low-to-intermediate-risk patients. Preoperative imaging and standardized monitoring are vital. Longer-term follow-up is crucial for understanding its role in prostate cancer treatment. [ABSTRACT FROM AUTHOR]

Background: Robot-assisted radical prostatectomy (RARP) is a preferred minimally invasive surgical treatment for prostate cancer. The number of elderly patients and those with cardiovascular and/or cerebrovascular issues undergoing surgery is increasing, and many of them are taking antithrombotic (AT) agents. However, the effect of AT agents on postoperative urinary recovery has not been adequately studied. In this study, we analyzed the differences in the postoperative recovery of urinary continence and oncological outcomes in patients undergoing RARP for localized prostate cancer between AT agent adherents and non-adherents. Methods: A total of 394 patients who underwent conventional anterior RARP between February 2015 and February 2021 were categorized into two groups: those taking oral AT agents (AT group) and the control group. Urinary continence recovery, complications, and oncological outcomes were compared between the groups. A Cox proportional hazards analysis was performed to identify clinical factors that affect urinary continence recovery. Results: The background data and bleeding complications did not differ significantly between the groups. The recovery of continence was significantly poorer in the AT group in terms of complete pad free (HR: 0.53 [95% CI: 0.39–0.71]) and use of ≤ 1 safety pad (HR: 0.74 [95% CI: 0.59–0.94]). The rate of anastomotic leakage on cystography was significantly higher in the AT group (20.9% vs. 6.7%). A univariate analysis revealed that taking antithrombotic agents, higher prostate-specific antigen levels, and a more advanced clinical stage were associated with a poor urinary continence recovery; a multivariate analysis showed that taking AT agents was an independent factor negatively associated with urinary continence recovery. There was no significant difference between the groups in the positive surgical margin rate (19.0% vs. 23.8%) or the biochemical-recurrence-free rate. Conclusion: Taking oral AT agents may be associated with poor urinary continence recovery after RARP. [ABSTRACT FROM AUTHOR]

AbstractWomen Veterans constitute a distinctive cohort whose exposure to military service can contribute to development of bladder conditions, such as urinary incontinence (UI), as they age. Behavioral therapies are recommended as first-line treatment for incontinence, yet many VA Medical Centers do not have staff trained to administer them. The purpose of this research study was to conduct a qualitative program evaluation of MyHealtheBladder, a mobile telehealth version of an evidence-based eight‐week behavioral treatment program designed for women Veterans with incontinence. MyHealtheBladder uses mobile telehealth technology to teach pelvic floor muscle exercises, bladder control strategies, fluid management, risk factor reduction, and self‐monitoring. Eighteen women Veterans who completed a pilot study of MyHealtheBladder participated in semi-structured telephone interviews exploring their experience with the program. A directed content analysis was conducted of the transcribed interview data. Participants described ease of accessing MyHealtheBladder using smart phones and other mobile devices, emphasizing the flexibility of using the program at home, work, or while traveling. Most participants described program content as understandable, relevant, and easy to follow. They discussed how the program increased knowledge of UI, promoted consistency in practicing behavioral therapy, strengthened pelvic floor muscles, reduced urine leakage, and improved psychosocial wellbeing. Suggestions for improvement included more interaction with staff, more individualized tailoring of content to UI type, incorporating in-person clinic visits, and including supplementary material. Participants uniformly endorsed the program and recommended it for other women Veterans, as well as for those in active duty to prevent or treat UI earlier in the life course. [ABSTRACT FROM AUTHOR]

Urinary tract infections (UTIs) pose a substantial burden on global healthcare systems. When unraveling the complex pathophysiology of UTIs, bladder models are used to understand complex and multifaceted interactions between different components within the system. This review aimed to bridge the gap between in vitro and in vivo experimental bladder models towards UTI research. We reviewed clinical, animal, and analytical studies and patents from 1959 to the end of 2023. Both in vivo and in vitro models offer unique benefits and drawbacks in understanding UTIs. In vitro models provide controlled environments for studying specific aspects of UTI biology and testing potential treatments, while in vivo models offer insights into how UTIs manifest and progress within living organisms. Thus, both types of models are leading to the development of more effective diagnostic tools and therapeutic interventions against UTIs. Moreover, advanced methodologies involving three-dimensional bladder organoids have also been used to study bladder biology, model bladder-related disorders, and explore new treatments for bladder cancers, UTIs, and urinary incontinence. Narrowing the distance between fundamental scientific research and practical medical applications, these pioneering models hold the key to unlocking new avenues for the development of personalized diagnostics, precision medicine, and ultimately, the alleviation of UTI-related morbidity worldwide. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence (UI) is a prevalent, health-threatening condition that causes isolation and psychological strain, leading to significant personal distress. The connection between the triglyceride glucose body mass index (TyG-BMI) and UI remains elusive. The purpose of the current research was to investigate any possible relationships between raised TyG-BMI levels and a higher likelihood of UI. Methods: For a thorough examination, adults 20 years and older with UI were included in cross-sectional research using the data obtained from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018. Our investigation centred on three of the significant varieties of UI: Urgent Urinary Incontinence (UUI), Mixed Urinary Incontinence (MUI), and Stress Urinary Incontinence (SUI), employing weighted multivariate logistic regression models for an in-depth evaluation. The TyG-BMI, a possible biomarker, was arranged in increasing order among participants and then assessed with a trend test (P for trend). Moreover, this investigation delved into the non-linear relationships using advanced smoothed curve fitting techniques. Meticulous subgroup analyses were executed to verify the uniformity of the UI and TyG-BMI relationship across diverse demographic groups. Results: A thorough investigation was conducted with 18,751 subjects to analyze the prevalence and types of UI, showing that 23.59% of individuals suffered from SUI, 19.42% from UUI, and 9.32% from MUI. Considering all possible confounding variables, Multivariate logistic regression analysis showed a substantial relationship between elevated TyG-BMI values and a greater likelihood across all UI categories. Specifically, stratifying the TyG-BMI into quartiles revealed a pronounced positive correlation in the top quartile relative to the bottom, reflected in increased odds ratios for SUI, UUI, and MUI (SUI: OR = 2.36, 95% CI 2.03–2.78, P < 0.0001; UUI: OR = 1.86, 95% CI 1.65–2.09, P < 0.0001; MUI: OR = 2.07, 95% CI 1.71–2.51, P < 0.0001). Conclusions: Among US adults, an association has been observed wherein increased TyG-BMI values correlate with a higher chance of UI. This suggests that TyG-BMI might be a helpful marker for identifying individuals at risk of UI, providing novel insights into its assessment and management. [ABSTRACT FROM AUTHOR]

Background/Objectives: Obesity is a growing global health concern, which increases the risk of various diseases and has seen a rising prevalence over time. The global prevalence of obesity among adults has doubled over time. Obesity significantly impacts health by increasing the risk of a range of severe medical conditions. Cardiovascular diseases, such as heart attacks and strokes, are more prevalent in individuals with obesity due to factors like high blood pressure and abnormal cholesterol levels. This systematic review and meta-analysis sought to establish the effectiveness of bariatric surgery in treating infertility in women. Methods: This systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A broad electronic search was conducted through PubMed, Web Science, and Medline databases for studies published between April 2017 and October 2023. The search strategy used the following terms: bariatric surgery, metabolic surgery, bariatric surgical procedures, stomach stapling, infertility, and fertility issues. The data were analyzed using the Revman version 5.1.2 software. Results: The results of the study show that despite the heterogeneity found in the studies, irregular menstrual cycles were found to reduce significantly in patients who underwent bariatric surgery (p = 0.01), with an RR of 0.22, at a 95% CI (0.06, 0.74). With regards to infertility, the results indicate that bariatric surgery reduced the level of infertility among the patients significantly (p = 0.00001), with an RR of 0.55, at a 95% CI (0.45, 0.68). Further, the results show bariatric surgery reduced rate of miscarriages among patients (p = 0.01), with an RR of 0.51, at a 95% CI (0.30, 0.86). Moreover, bariatric surgery reduced the level of congenital malfunction, but the effect was not statistically significant (p = 0.16), with an RR of 0.39, at a 95% CI (0.10, 1.45). However, the overall effect of bariatric surgery on treating infertility was found to be significantly effective (p = 0.0001), with an RR of 0.54, at a 95% CI (0.43, 0.68). This implies that bariatric surgery helps in weight loss, which improves ovulatory dysfunction and irregular menstruation while boosting spontaneous conception. Conclusions: This study found that bariatric surgery helps infertile women of a reproductive age to lose weight, which improves ovulatory dysfunction and irregular menstruation while boosting spontaneous conception. On the other hand, the study noted that after bariatric surgery, spontaneous conception can occur because of a decreased rate of miscarriage, increased fertility, reduced levels of congenital malfunction, and the restoration of regular menstrual cycles. Therefore, this study highlights the need to offer adequate preconception care and counselling to women who are about to be pregnant, both before and after bariatric surgery. Further, based on the fact that this study focused on general bariatric surgery, future research should focus on specific types of bariatric surgery to establish the most effective type of bariatric surgery in treating infertility in women. [ABSTRACT FROM AUTHOR]

Urinary incontinence after robotic-assisted radical prostatectomy (RARP) has been associated with older age, a longer operative time, a higher BMI, a short membranous urethral length and preoperative erectile function. The authors sought to assess the association between the neuromuscular characteristics and postoperative urinary incontinence. Methods: RARP specimens from 29 men who underwent bilateral nerve sparing were reanalyzed. Urinary incontinence was evaluated using the International Consultation on Incontinence Questionnaire—Short Form (ICIQ-SF) at 6 weeks post surgery and last follow-up. Linear and logistic regression analyses were performed to assess neuromuscular characteristics and incontinence. Results: At the 1-year follow-up, 11 patients (38%) reported severe incontinence (>12 ICIQ-SF score). The median number of peripheral nerves observed at the base and apex in the specimens was 52 (IQR 13–139) and 59 (IQR: 28–129), respectively. Ganglia were present in 19 patients (65%) at the base and 12 patients (41%) at the apex. Additionally, the median proportional area of detrusor smooth muscle fibers at the base was 0.54 (IQR 0.31–1), while the median proportional area of striated muscle fibers at the apex was 0.13 (IQR 0.08–0.24). No statistically significant associations were found. Conclusions: Histologic neuromuscular characteristics were not associated with postoperative urinary incontinence. Enhanced intraoperative evaluation and larger-scale studies may prove useful for the prediction of postprostatectomy incontinence. [ABSTRACT FROM AUTHOR]

Background: The ASCAPE project aims to improve the health-related quality of life of cancer patients using artificial intelligence (AI)-driven solutions. The current study employs a comprehensive dataset to evaluate sleep and urinary incontinence, thus enabling the development of personalized interventions. Methods: This study focuses on prostate cancer patients eligible for curative treatment with surgery. Forty-two participants were enrolled following their diagnosis and were followed up at baseline and 3, 6, 9, and 12 months after surgical treatment. The data collection process involved a combination of standardized questionnaires and wearable devices, providing a holistic view of patients' QoL and health outcomes. The dataset is systematically organized and stored in a centralized database, with advanced statistical and AI techniques being employed to reveal correlations, patterns, and predictive markers that can ultimately lead to implementing personalized intervention strategies, ultimately enhancing patient QoL outcomes. Results: The correlation analysis between sleep quality and urinary symptoms post-surgery revealed a moderate positive correlation between baseline insomnia and baseline urinary symptoms (r = 0.407, p = 0.011), a positive correlation between baseline insomnia and urinary symptoms at 3 months (r = 0.321, p = 0.049), and significant correlations between insomnia at 12 months and urinary symptoms at 3 months (r = 0.396, p = 0.014) and at 6 months (r = 0.384, p = 0.017). Furthermore, modeling the relationship between baseline insomnia and baseline urinary symptoms showed that baseline insomnia is significantly associated with baseline urinary symptoms (coef = 0.222, p = 0.036). Conclusions: The investigation of sleep quality and urinary incontinence via data analysis through the ASCAPE project suggests that better sleep quality could improve urinary disorders. [ABSTRACT FROM AUTHOR]

Introduction: The primary objective of this study was to evaluate the impact of vaginal uterosacral plication on urge symptoms and quality of life in a cohort of patients with uterosacral ligament insufficiency and urge symptoms. Methods: A total of 40 female patients were included in the study, and their posterior fornix was supported with gauze to simulate the surgical procedure. Uterosacral plication was applied to patients who experienced a decrease in urinary incontinence, nocturia, a sense of urgency, and a decrease in urge urinary incontinence symptoms or complete recovery. Images of the bladder, bladder neck, urethra, and symphysis pubis were obtained preoperatively and 1 year postoperatively. POP-Q staging was also performed, and patients completed the Overactive Bladder Evaluation Form (OAB-V8) and the Incontinence Impact Questionnaire Short Form (ICIQ-SF). Results: Results from the OAB-V8 questionnaire showed that postoperative nocturia scores improved by 72.1% compared to preoperative scores, and the need to urinate at night and waking up scores improved by 68.3%. The mean bladder neck thickness and the mean detrusor thickness were significantly decreased from 10 to 9.2 (p < 0.0001) and from 8.7 to 6.4 (p < 0.0001), respectively. The ICIQ-SF questionnaire scores showed a 68.4% improvement in urinary incontinence affecting daily life after the operation. Conclusion: This study adds to the clinical evidence that uterosacral ligament support improves symptoms of overactive bladder syndromes, including urgency and nocturia. The use of pelvic floor ultrasound and the apical tamponade test is important in patient selection for the correct indication. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the efficacy and safety following treatment with Bulkamid for stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (MUI). Methods: We retrospectively analyzed data of women diagnosed with SUI or stress-predominant MUI who underwent Bulkamid periurethral injection between November 2020 and January 2023 and completed 12 months of follow-up. The primary outcome of the study was to assess patient satisfaction, which was measured on a four-point scale, ranging from cured to worse, and through validated questionaries such as the International Consultation on Incontinence Questionnaire-short Form (ICIQ-UI SF) and Contilife Quality of Life questionnaire. Results: Of the 70 patients included, 41 (59%) had MUI with predominant stress incontinence. Median age was 59 years (IQR 47–75), with a median BMI of 25 (18–40) and a median number of pregnancies of 2 (0–4). Forty-seven (67%) procedures were performed under sedation and 23 (33%) under local anesthesia. Forty-three (69%) women reported feeling cured or improved at 12 months follow-up and among them, 25 (40%) reported feeling cured. A total of 16 (23%) patients were subsequently treated, in detail 11 (16%) patients underwent MUS positioning, and 5 (7%) had an additional injection of Bulkamid. ICIQ and Contilife QoL showed a significant improvement at 1, 3, 6, and 12 months (all p < 0.001). Conclusions: Bulkamid injections are an effective and safe treatment option for women with SUI or stress-predominant MUI, providing good outcomes at 12 months. [ABSTRACT FROM AUTHOR]

Scientific treatments for postpartum urinary incontinence, including pelvic floor muscle exercises (such as Kegel exercises) and infrared therapy, can effectively improve pelvic floor and urethral function, thus enhancing quality of life. However, clinical research on the combined use of these interventions for postpartum urinary incontinence is limited. To investigate the combining efficacy of pelvic floor muscle exercises with infrared physiotherapy on postpartum urinary incontinence. Clinical information of 102 patients with postpartum urinary incontinence (June 2021–June 2022) were collected and analyzed. Patients were randomly divided into control (conventional intervention) and observation (pelvic floor muscle exercises combined with infrared physiotherapy) groups, with 52 and 50 cases respectively. We compared pelvic floor muscle strength, urodynamic indicators, leakage volume, quality of life, and overall clinical efficacy between the two groups. Before intervention, both groups had similar pelvic floor function scores and urodynamic indicators. Post-intervention, the pelvic floor function scores in the observation group were significantly lower than control. The urodynamic indicator levels of the observation group were markedly higher than control after 2 months of intervention. Leakage volume was similar before intervention, while the observation group had significantly lower volumes after 1 and 2 months of intervention. Quality of life scores were similar initially, but after 2 months, the observation group scored higher. The observation group showed notably better pelvic floor rehabilitation at 2 months post-intervention. Combining pelvic floor muscle exercise with infrared physiotherapy has been shown to be a highly effective approach in enhancing pelvic floor muscle strength and improving the quality of life for postpartum women experiencing urinary incontinence. This combined therapy also demonstrates positive effects on urodynamic indicators, reducing leakage volume, and facilitating pelvic floor rehabilitation. [ABSTRACT FROM AUTHOR]