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Lower urinary tract dysfunction (LUTD) increases with aging. Ensuing symptoms including incontinence greatly impact quality of life, isolation, depression, and nursing home admission. The aging bladder is hypothesized to be central to this decline, however, it remains difficult to pinpoint a singular strong driver of aging‐related bladder dysfunction. Many molecular and cellular changes occur with aging, contributing to decreased resilience to internal and external stressors, affecting urinary control and exacerbating LUTD. In this study, we examined whether cellular senescence, a cell fate involved in the etiology of most aging diseases, contributes to LUTD. We found that umbrella cells (UCs), luminal barrier uroepithelial cells in the bladder, show senescence features over the mouse lifespan. These polyploid UCs exhibit high cyclin D1 staining, previously reported to mediate tetraploidy‐induced senescence in vitro. These senescent UCs were not eliminated by the senolytic combination of Dasatinib and Quercetin. We also tested the effect of a high‐fat diet (HFD) and senescent cell transplantation on bladder function and showed that both models induce cystometric changes similar to natural aging in mice, with no effect of senolytics on HFD‐induced changes. These findings illustrate the heterogeneity of cellular senescence in varied tissues, while also providing potential insights into the origin of urothelial cancer. We conclude that senescence of bladder uroepithelial cells plays a role in normal physiology, namely in their role as barrier cells, helping promote uroepithelial integrity and impermeability and maintaining the urine‐blood barrier. [ABSTRACT FROM AUTHOR]

Objective: The objective of our study was to assess the efficacy of Rezum, a minimally invasive surgical treatment, for patients with lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) in real‐world clinical practice at a single institution in Japan. Materials and Methods: We conducted a prospective study involving 100 patients who underwent the Rezum procedure between October 2022 and February 2024. We analyzed patient backgrounds that are compliant with Japanese regulations and assessed descriptive outcomes such as symptom scores, peak flow in uroflowmetry, post‐void residual (PVR) volume, and prostate volume (PVol). These data were collected at 1 and/or 3 months postoperatively. Results: On average, 4.7 water vapor injections were administered during the Rezum procedures, with a mean operative time of 6.3 min. Patients experienced significant relief in symptoms, with reductions of 55% in International Prostate Symptom Score, 53% in quality of life score, and 30% in Overactive Bladder Symptom Score. There was also a significant decrease in mean PVR volume (50% reduction) and PVol (27% reduction). Among the subgroup of 23 pre‐interventional catheter‐dependent patients, 91% achieved catheter independence. Conclusion: Our single‐center analysis demonstrates that Rezum is an effective and safe minimally invasive therapeutic option for patients with BPH. This promising novel technique can be particularly beneficial for patients at an augmented risk of bleeding or those considered high risk for anesthesia. [ABSTRACT FROM AUTHOR]

Introduction: Sexual dysfunction affects a couple's relationship and quality of life of the patient and the partner irrespective of age. In Lower urinary tract symptoms (LUTS) with benign prostatic hyperplasia (BPH), sexual dysfunction is highly prevalent. This study aims to evaluate prevalence of sexual dysfunction in patients having LUTS with BPH and effect of various treatment on it. Materials and methods: The study is hospital based prospective cross-sectional study. Total 106 patients were included in this study. Fifty-six patients underwent medical treatment and 50 patients underwent transurethral resection of prostate (TURP) according to lower urinary tract symptom score along with grades of prostate. We measured prevalence of lower urinary tract symptoms, erectile dysfunction (ED), ejaculatory dysfunction (EJD).We compared the pre and post treatment ED, EJD scores in both medical and TURP group. Result: In our study, 11 (10.4%) patients had very mild ED, 12 (11.3%) had mild ED, 54 (50.9%) had moderate ED and 23 (21.7%) had severe ED. In our study, 11 (10.4%) patients had very mild EJD, 7 (6.6%) had mild EJD, 28 (26.4%) had moderate EJD and 2 (1.9%) had severe EJD. In medical group, ED pre-treatment versus ED post treatment was statistically significant (p = 0.0046), treatment of LUTS improves ED. EJD pre-treatment versus EJD post treatment was not statistically significant (p = 0.8368), treatment of LUTS associated with deterioration of EJD. In TURP group association of ED pre-treatment versus ED post treatment was statistically significant (p = 0.0319). Post TURP patients shows improvement in ED Association of EJD pre-treatment versus EJD post-treatment was statistically significant (p = 0.03000). Post TURP EJD deteriorate. Conclusion: We concluded that the severity of sexual dysfunction correlates with severity of LUTS. Ejaculatory function deteriorates after treatment of TURP compared to medical. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the technical feasibility, safety, and patency results of a simultaneous surgical approach to repair urethral stricture and treat benign prostatic enlargement endoscopically in a highly selected group of patients at a tertiary referral center. We hypothesize that this is technically feasible, safe, and does not affect urethroplasty outcomes. Methods: A retrospective review of adult men who underwent simultaneous urethroplasty and endoscopic prostatic surgery between May 2017 and May 2024 at our institution was conducted. Patients with strictures < 15 French and prostates with adverse prognostic features of response to medical treatment were included. The primary outcome was technical feasibility and safety. The secondary outcome was stricture-free survival. Results: Twenty men were treated during the study period. The median length of the urethral stricture was 3.0 cm (IQR 2.0–5.0), and the median size of the prostate was 95.0 cc (IQR 63.3–128.3). All patients were treated successfully with a median operative time of 194.5 min (IQR 180.0–246.8), and no procedures required conversion to a staged procedure or open prostatectomy. There were seven Clavien–Dindo I–II complications and one Clavien–Dindo IIIb complication (hematuria requiring endoscopic clot evacuation). At 22 months follow-up, two cases of urethral re-stricture were diagnosed, with one case requiring redo urethroplasty, though none had previous major complications. Conclusion: The combination of urethroplasty and endoscopic surgery for benign prostatic enlargement at the same stage appears to be technically viable and safe, and it does not compromise medium-term urethral patency results in a carefully selected group of patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pediatric lower urinary tract symptoms (LUTS) are a set of common childhood problems. Community‐level interventions that target behavioral change among children with LUTS can improve symptoms outside of the clinic environment. Parents, navigating the home and school environments, are key in supporting healthy bladder behaviors. Thus, we asked parents about their perceptions and barriers related to pediatric bladder health. METHODS: English‐speaking parents (n = 30) of children ages 5‐10 years with and without LUTS were interviewed. Transcripts were coded iteratively by two independent coders using deductive and inductive approaches that emphasized consensus coding and peer debriefing. RESULTS: Ninety‐three percent of participants were women, 50% were 30‐39 years old, and 60% held a graduate degree. Parents identified school‐, classroom‐, and child‐based barriers to bladder health. These included the bathroom environment, restrictive policies for bathroom use, and anxiety on how and when to use the bathroom. CONCLUSIONS: Addressing school‐, classroom‐, and child‐based barriers is necessary to promote healthy bladder habits among children in the school environment and beyond. Recommended school‐based interventions include bathroom use and sanitation policies that support students' voiding needs, teachers' professional development, and school readiness initiatives. Limitations include participation of English‐speaking parents only. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: Urodynamics (UDS) assesses voiding dysfunction using intravesical, vaginal, or rectal catheters, which can be distressing. This study was aimed at utilizing mindfulness to reduce anxiety and pain in patients undergoing UDS. Methods: A single-institution randomized controlled trial was conducted on 60 patients who underwent UDS. Patients were assigned to a mindfulness group (n = 30) or a control group (n = 30). Before UDS testing, all patients completed validated questionnaires assessing lower urinary tract symptoms (Urogenital Distress Inventory 6, UDI-6), anxiety (State-Trait Anxiety Inventory 6, STAI-6), and pain (Visual Analog Scale, VAS). The mindfulness group listened to a mindfulness audio prompt before UDS. All patients received standardized UDS education before UDS testing in a calm environment. After UDS testing, all patients completed validated UDS-perception questionnaires, STAI-6, Likert scale, and VAS surveys. Statistical analysis was performed using paired t tests, independent t tests, Wilcoxon, and Chi-squared tests. Results: Both groups had similar demographics, history of prior UDS, anxiety, and baseline UDI-6 and STAI-6. Post-UDS, anxiety scores decreased in both groups, with the mindfulness group reporting significant improvement in "calmness" (mean 1.7, SD = 0.84) compared with the control group (mean 2.3, SD = 1.0, p < 0.05). The mindfulness group reported increased relaxation whereas the control group reported decreased relaxation post-UDS. Patients in both groups without a history of UDS had a significant improvement in total anxiety compared with those with a history of UDS. Conclusion: Mindfulness meditation may improve calmness and relaxation for patients undergoing UDS. [ABSTRACT FROM AUTHOR]

Background Multiple sclerosis (MS) is a recurrent, autoimmune, and inflammatory demyelinating chronic disease that typically manifests in young adulthood and exerts adverse effects on sexual functions. Aim The study evaluated the prevalence of sexual dysfunctions (SDs) and the relationship with neurological disability, depression, and lower urinary tract symptoms (LUTS) in a cohort of MS female patients, comparing these results with those of healthy women. Methods From January 2023 to January 2024, consecutive premenopausal female patients with MS, were recruited and the examination included urinalysis, ultrasonography and a urodynamic test according to the International Continence Society standard. Outcomes Descriptive statistics were reported as mean and standard deviation for continuous variables (analyzed by independent samples Mann-Whitney U test and independent samples Kruskal-Wallis test) while categorical variables were reported as frequency and percentage (analyzed by chi-square test with Fisher's exact test). Results Female Sexual Function Index (FSFI) total score and all FSFI subscales scores were significantly lower in patients with MS vs healthy control subjects (P <.001); FSFI total scores and all FSFI subscale scores were statistically significantly lower in patients with MS with an International Prostate Symptom Score ≥20 (P <.001) and considering a cutoff for Beck Depression Inventory–II score ≥17, depression was present in 61% (n = 47 of 77) of patients with MS and completely absent in the control group. Clinical Translation The knowledge that SDs are a common problem in MS and in other chronic illnesses can alleviate the feeling of stigma and talking openly of sexual problems can be helpful for the patients and so the doctor-patient relationship can be reinforced. Strengths and Limitations The sample was drawn from a single center, and larger multicenter studies that include both genders are needed to obtain strong results. Conclusion Our findings confirm the idea of a polygenic and multifactorial etiology of female SDs in MS. Therefore, women with MS should be evaluated in terms of SDs during follow-ups. [ABSTRACT FROM AUTHOR]

Background: Interviewer-assisted administration of International Prostate Symptoms Score (IPSS) and Internal Index of Erectile Function-5 (IIEF-5) questionnaires in men with lower urinary tract symptoms (LUTS) due to benign prostate enlargement (BPE) may generate inconsistent outcomes. Objectives: To assess the correlation between the scores from interviewer-assisted administration of the IPSS questionnaire and the IIEF-5 questionnaire in men with uncomplicated LUTS due to BPE. Materials and Methods: The IPPS and the IIEF-5 questionnaires were administered with interviewer assistance to a cross-section of men presenting to the hospital with symptoms of LUTS due to uncomplicated BPE. The demographics were ascertained, and the association between IPPS and IIEF-5 scores was determined using linear correlation. Results: There were 211 participants in 18 months with a mean age of 66.5 ± 9.5years. The mean prostate volume, prostate-specific antigen, peak flow rate, and post-void residual volume were 55.2 ± 10.1 mL, 3.1 ± 0.7 ng/mL, 20.8 ± 8.2 mL/s, and 38.1 ± 21.5 mL, respectively. One hundred and eighty-six participants (88.2%) attained post-primary level of formal education. Moderate LUTS was reported in 51.7% (n = 109), while severe LUTS was reported in 10.4% (n = 22) participants. The mean storage LUTS (sLUTS) score was 6.25 ± 2.84, the mean voiding LUTS (vLUTS) score was 4.27 ± 4.56, and the mean IPSS was 10.38 ± 6.44. The mean IIEF-5 score was 15.17 ± 6.09. There was a poor correlation between IIEF-5 and sLUTS (Spearman rho –0.02; P = 0.77), vLUTS (Spearman rho –0.058; P = 0.403), IPSS scores (Spearman rho –0.048; P = 0.49), as well as with quality of life (QoL) preferences (F 1.722; P = 0.117). Conclusions: Interviewer-assisted IIEF-5 scores do not relate with sLUTS, vLUTS IPSS, and QoL due to LUTS, as is the case with reports on self-administered IIEF-5 scores.

Abstract Introduction and Objectives Voiding dysfunction remains a common side effect postprostate biopsy leading to significant morbidity. Alpha blockers have emerged as a potential therapeutic option to mitigate this risk, with various centres already incorporating its use in practice. Despite this, the literature regarding its efficacy remains inconclusive. Hence, a systematic review was performed to quantify the effect of perioperative alpha blockers on prostate biopsy‐related voiding function. Methods A systematic search in MEDLINE, Embase and PubMed between January 1989 and July 2023 was performed to identify relevant articles. Two independent reviewers independently screened abstracts, full texts and performed data extraction. Data including International Prostate Symptom Scores (IPSS), voiding flow rates (Qmax), postvoid residuals (PVR), rates of acute urinary retention (AUR) and quality of life (QoL) scores were extracted. Results were combined in an inverse variance random effects meta‐analysis. Results A total 808 patients from six randomised controlled trials (RCTs) comparing alpha blockers to controls were included. All articles excluded patients with pre‐existing voiding dysfunction. Pooled outcomes demonstrated statistically significant differences favouring alpha blocker usage in all objective and subjective measures including IPSS (mean difference 4.21, 95% confidence interval [CI] 2.58–5.84, p

Introduction and Hypothesis: Women with vulvovaginal or genital pain more commonly experience interstitial cystitis/bladder pain syndrome (IC/BPS) and urinary tract infections. However, the relationship between genital pain and bladder health is lacking. Methods: Women in the Prevention of Lower Urinary Tract Symptoms Consortium's RISE FOR HEALTH population-based study answered questions about bladder health globally, and across nine bladder health domains of holding, efficacy, social–occupation, physical activity, intimacy, travel, emotion, perception, and freedom. Bladder function was assessed across six indices including urinary frequency, sensation, continence, comfort, emptying, and dysbiosis (e.g., urinary tract infections). Participants were grouped by no pain beyond transitory events (i.e., minor headaches, toothaches, or sprains), nongenital-related pain only, and any genital pain using a validated pain diagram. Mean adjusted scores and indices were compared using general linear modelling. Results: Of 1,973 eligible women, 250 (12.7%) reported genital pain, 609 (30.9%) reported nongenital pain only, and 1,114 (56.5%) reported no pain. Women with any genital pain had lower (worse) adjusted mean scores across all bladder health scales (BHS; BHS global adjusted mean 47.5; 95% CI 40.8–54.1), compared with those with nongenital pain only (53.7; 95% CI 47.6–59.8), and no pain (59.3; 95% CI 53.3–65.4). Similarly, adjusted mean total Bladder Functional Index scores were lower for those with genital pain (63.1; 95% CI 58.4–67.9) compared with nongenital pain (72.1; 95% CI 67.7–76.5) and no pain (77.4; 95% CI 73.0–81.8). Conclusions: Heightened awareness of the relationship between genital pain and bladder health should prompt clinicians caring for women with genital pain to assess bladder health and function. [ABSTRACT FROM AUTHOR]

Background: Machine learning algorithms as a research tool, including traditional machine learning and deep learning, are increasingly applied to the field of urodynamics. However, no studies have evaluated how to select appropriate algorithm models for different urodynamic research tasks. Methods: We undertook a narrative review evaluating how the published literature reports the applications of machine learning in urodynamics. We searched PubMed up to December 2023, limited to the English language. We selected the following search terms: artificial intelligence, machine learning, deep learning, urodynamics, and lower urinary tract symptoms. We identified three domains for assessment in advance of commencing the review. These were the applications of urodynamic studies examination, applications of diagnoses of dysfunction related to urodynamics, and applications of prognosis prediction. Results: The machine learning algorithm applied in the field of urodynamics can be mainly divided into three aspects, which are urodynamic examination, diagnosis of urinary tract dysfunction and prediction of the efficacy of various treatment methods. Most of these studies were single‐center retrospective studies, lacking external validation, requiring further validation of model generalization ability, and insufficient sample size. The relevant research in this field is still in the preliminary exploration stage; there are few high‐quality multi‐center clinical studies, and the performance of various models still needs to be further optimized, and there is still a distance from clinical application. Conclusions: At present, there is no research to summarize and analyze the machine learning algorithms applied in the field of urodynamics. The purpose of this review is to summarize and classify the machine learning algorithms applied in this field and to guide researchers to select the appropriate algorithm model for different task requirements to achieve the best results. [ABSTRACT FROM AUTHOR]

Introduction: The primary objective of this investigation is to explore the impact of ejaculation on urinary flow rates in men experiencing lower urinary tract symptoms. Materials and Methods: This study involved the enrollment of 55 male patients who presented with lower urinary tract symptoms. An assessment encompassed components, including medical history, questionnaires related to sexual activity and lower urinary tract symptoms, bladder diary, physical examination, urinalysis, urine culture, ultrasound examination and measurements of serum prostate‐specific antigen, free flow uroflowmetry, and post‐void residual urine volume. All participants were instructed to abstain from ejaculation for 3 days before undergoing uroflowmetry (UF1). Subsequently, they were required to ejaculate. Subsequent uroflowmetry assessments were conducted at 2 to 4 h (UF2) and 48 to 50 h (UF3) after ejaculation. No further ejaculations were permitted during this timeframe. Results: The patients had a mean age of 50.97 ± 1.47 years. Statistically significant differences were observed in the mean values of Qmax and corrected Qmax (cQmax) between UF1 and UF2 measurements (p < 0.05). These differences were only in patients with benign prostatic enlargement (BPE) (p < 0.05). Furthermore, the number of patients with Qmax <15 mL/s showed a statistically significant difference between UF1 and UF2 measurements, specifically in the BPE group (p = 0.016). Conclusions: In this study, we have observed a significant and temporary increase in the Qmax following ejaculation, particularly among patients with BPE. This indicates that ejaculation can potentially complicate the interpretation of uroflowmetry results. Therefore, further research is necessary to gain a more comprehensive understanding of this phenomenon. [ABSTRACT FROM AUTHOR]

Purpose: Prostatic urethral lift has been an effective ejaculation sparing treatment for benign prostatic hypertrophy. The aim of this study was to evaluate the effect on male semen parameters. Methods: Between July 2014 and January 2022, 20 young men with urinary symptoms of BPH, unresponsive to drug treatment and motivated to preserve ejaculation for eventual paternity, underwent UroLift. Semen analysis was performed before and 6 month after surgery with evaluation of pH, volume, sperm concentration, total motility, vitality and morphology according to WHO 2011. All underwent digital rectal examination, transrectal prostate ultrasound to measure prostate volume, PSA, uroflowmetry, cystoscopy and urodynamics test if necessary. Objective and subjective urinary function was scheduled at 1, 3, 6, 12 month than yearly with UFM, IPSS, IIEF-5, and MSHQ-EjD-SF. Results: At a mean follow-up of 36 month (range 12 to 63), no retroejaculation or changes in seminal parameters occurred. Mean age was 44.5 (range 36.5 to 48) years. Mean operative time was 15 (range 10 to 20) min and 2.5 (range 2 to 4) implants per patients were used. At 6 month there were no difference in terms of total sperm count, volume, pH, motility, vitality, morphology, liquefaction, leucocytes (p = 0.9; p = 0.8; p = 0.7; p = 1; p = 1; p = 1; p = 0,2; p = 0.5). At last, Q-max increased by 64.4% (p = 0.001), post-void residual volume decreased by 66.6% (p = 0.016), and IPSS decreased by 60% (p < 0.001). IIEF and MSHQ-EjD-SF were preserved (p = 0.14, p = 0.4). Conclusions: UroLift appears safe technique to correct LUTS from BPH in young men desirous to preserve seminal analysis. [ABSTRACT FROM AUTHOR]

Objective/background: Benign prostatic hyperplasia (BPH) is increasing substantial burden on health care systems. Men with high body mass index (BMI) have bigger prostate volumes (PV) with subsequent increase in lower urinary tract symptoms (LUTS) than men with normal BMI. The purpose of this research was to investigate the correlation between Obesity and PV in patients with BPH. Method: The study included 560 patients (50–80 years) with BPH. Weight and height measured to calculate BMI. TRUS was used to measure PV. Patient demographics such as IPSS score and prostate specific antigen (PSA) were also noted. Results: Patients in the study had a mean age of 65.3 ± 9.45 years and the mean BMI was 23.97 ± 4.89 kg/m2. The mean PV of each BMI group were 37.45 ± 0.81, 57.89 ± 1.52 and 77.94 ± 2.17 (ml) for normal, overweight and obese groups, respectively, and the average PV score was 57.76 ± 1.50 ml. The mean PSA score was 3.26 ± 0.94 (ng/dl) with a range of 0.6–10.4. There was significant correlation between BMI and PV (p = 0.001) as well as between BMI with PSA and IPSS (p = 0.02, 0.001, respectively). Conclusion: The results showing strong correlation between BMI and PV also BMI with PSA and IPSS. Therefore reducing weight may lead to a lower prostate volume in the elderly stage, making LUTS less noticeable and improving quality of life. [ABSTRACT FROM AUTHOR]

Background: Bladder diaries represent a fundamental component in the assessment of patients presenting with lower urinary tract symptoms. Nevertheless, their importance often remains underappreciated and undervalued within clinical practice. This paper aims to conduct a comprehensive review of the existing literature concerning the utility of bladder diaries, underscore the criticality of their precision, elucidate the factors contributing to noncompliance with bladder diary completion, and investigate potential strategies for enhancing patient compliance. Materials and Methods: A review of the English‐language scientific literature available in the domains of Medline, Embase, Emcare, Midirs, and Cinahl was conducted. This was supplemented by discussion at the International Consultation on Incontinence Research Society Proposal session to define knowledge and identify gaps in knowledge surrounding the utility of bladder diaries. The existing evidence and outcome of the relevant discussion held in the meeting are presented. Results: Bladder diaries (BD) serve to characterize the nature and severity of storage lower urinary tract symptoms (LUTS) and provide an objective record of an individual's urination patterns. They aid in the refinement and customization of treatment strategies based on the clinical responses documented in the diary, optimizing treatment outcomes. Notably, both BD and urodynamic studies (UDS) play complementary yet distinct roles in LUTS evaluation. BD offers a more comprehensive and accessible approach to assessing specific storage LUTS, particularly due to their affordability and widespread availability, especially in resource‐limited settings. Nevertheless, the absence of a standardized BD format across global healthcare systems presents a significant challenge. Despite being recognized as reliable, noninvasive, validated, and cost‐effective tools for evaluating patients with LUTS, the implementation and completion of BD have proven to be complex. The introduction of automated bladder diaries heralds an era of precise, real‐time data collection, potentially enhancing the patient–clinician relationship. Completion of bladder diaries depends on an array of individual, social, and healthcare‐specific factors. Compliance with bladder diary completion could be enhanced with clear instructions, patient education, regular follow‐ups and positive re‐enforcement. This study has identified four critical areas for future research: Addressing healthcare disparities between affluent and developing nations, enhancing the current functionality and effectiveness of bladder diaries, exploring the feasibility of incorporating bladder diaries into the treatment and education process and improving the quality and functionality of existing bladder diaries. Conclusion: Bladder diaries play a pivotal role in the evaluation and management of patients with LUTS, providing a holistic perspective. When their complete potential is harnessed, they have the capacity to revolutionize the paradigm of LUTS management, ushering in a patient‐centered era of care. [ABSTRACT FROM AUTHOR]

Objectives: A large‐scale nationwide epidemiological survey of lower urinary tract symptoms (LUTS) was conducted via the Internet in 2023 to clarify the current prevalence of LUTS and evaluate its impact on daily life in Japan. Methods: The survey was conducted among individuals aged 20–99 years old who had anonymously registered with a Japanese online research company. The survey consisted of 48 questions related to LUTS and daily life. Results: A total of 6210 participants (3088 females and 3122 males), who were selected by probability sampling based on the composition of the Japanese population (age range: 20–99), were recruited. The overall prevalence of LUTS was 77.9% among the subjects aged ≥20 and 82.5% among those aged ≥40. The prevalence of LUTS differed between the sexes and trends toward significant increases in prevalence with age were seen for almost all LUTS. Furthermore, the prevalence of overactive bladder (OAB) was 11.9% among the subjects aged ≥20 and 13.8% among those aged ≥40. This study also showed that LUTS negatively affected daily life. However, the percentage of subjects who visited a physician to receive treatment for LUTS was low, including for participants with a history of treatment for LUTS, although this increased with age. Conclusion: The prevalence of LUTS, including OAB, increased with age and negatively affected daily life. However, since the percentage of patients who visit a physician to receive treatment for LUTS remains low, further educational activities regarding LUTS are necessary. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the effect of severe acute respiratory syndrome-coronavirus-2 infection on lower urinary tract function using validated questionnaires in patients with patients. Materials and Methods: This descriptive cross-sectional study was conducted according to the inclusion and exclusion criteria on 709 patients with Coronavirus disease-2019 (COVID-19) on an outpatient basis from September 2020 to May 2021 in Kerman’s health centers. After signing the consent form and completing the demographic information, the International Consultation on Incontinence Questionnaire male Lower Urinary Tract Symptoms Modules and International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms questionnaires were completed. Finally, the data were analyzed using the SPSS version 26 software. Results: Patients with COVID-19 (n=709) (365 questionnaires related to women and 344 questionnaires related to men) were examined on an outpatient basis. In general, 42.2% of women and 45.6% of men with COVID-19 had nocturia. The frequency of urination per day was higher than normal in 23% of women and 40.4% of men. In addition, 15% of women complained of a sense of urinary urgency while urinating, and 13.7% and 20% of men complained of straining and hesitancy in urinating, respectively. Similar to the males, the common symptoms in women were nocturia and increased daily frequency. In addition, with increasing age, lower urinary tract symptoms (LUTS) became common in COVID-19 patients. Conclusion: The results of our investigation imply that people with COVID-19 may acquire or experience de novo LUTS, particularly storage symptoms. All symptoms were more in people over 50 years old than in those younger. COVID-19 infection should be investigated in any patient presenting with LUTS during the current pandemic. Further research is needed to clarify the exact pathophysiology of this correlation.

Objective: We aimed to investigate the effect of severe acute respiratory syndrome-coronavirus-2 infection on lower urinary tract function using validated questionnaires in patients with patients. Materials and Methods: This descriptive cross-sectional study was conducted according to the inclusion and exclusion criteria on 709 patients with Coronavirus disease-2019 (COVID-19) on an outpatient basis from September 2020 to May 2021 in Kerman's health centers. After signing the consent form and completing the demographic information, the International Consultation on Incontinence Questionnaire male Lower Urinary Tract Symptoms Modules and International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms questionnaires were completed. Finally, the data were analyzed using the SPSS version 26 software. Results: Patients with COVID-19 (n=709) (365 questionnaires related to women and 344 questionnaires related to men) were examined on an outpatient basis. In general, 42.2% of women and 45.6% of men with COVID-19 had nocturia. The frequency of urination per day was higher than normal in 23% of women and 40.4% of men. In addition, 15% of women complained of a sense of urinary urgency while urinating, and 13.7% and 20% of men complained of straining and hesitancy in urinating, respectively. Similar to the males, the common symptoms in women were nocturia and increased daily frequency. In addition, with increasing age, lower urinary tract symptoms (LUTS) became common in COVID-19 patients. Conclusion: The results of our investigation imply that people with COVID-19 may acquire or experience de novo LUTS, particularly storage symptoms. All symptoms were more in people over 50 years old than in those younger. COVID-19 infection should be investigated in any patient presenting with LUTS during the current pandemic. Further research is needed to clarify the exact pathophysiology of this correlation. [ABSTRACT FROM AUTHOR]

Background: Nocturnal enuresis is generally considered a children's condition, yet it may persist 1%–2% in adolescence and early adulthood. Refractory patients often demand follow‐up by multidisciplinary teams, which is only restricted to some of the expert tertiary centers. However, there are no standardized transition programs/guidelines when follow‐up must be passed from pediatric to adult healthcare providers. Aim, Materials & Methods: To investigate this issue, we conducted a literature search on enuresis transition, which resulted in no articles. We, therefore, proceeded in a rescue search strategy: we explored papers on transition programs of conditions that may be related and/or complicated by enuresis, nocturia, or other urinary symptoms (chronic diseases, CKD, bladder dysfunction, kidney transplant, neurogenic bladder). Results: These programs emphasize the need for a multidisciplinary approach, a transition coordinator, and the importance of patient and parent participation, practices that could be adopted in enuresis. The lack of continuity in enuresis follow‐up was highlighted when we investigated who was conducting research and publishing on enuresis and nocturia. Pediatric disciplines (50%) are mostly involved in children's studies, and urologists in the adult ones (37%). Discussion: We propose a stepwise approach for the transition of children with enuresis from pediatric to adult care, depending on the clinical subtype: from refractory patients who demand more complex, multidisciplinary care and would benefit from a transition coordinator up to children/young adults cured of enuresis but who persist in having or present lower urinary tract symptoms (LUTS)/nocturia later on. In any case, the transition process should be initiated early at the age of 12–14 years, with adequate information to the patient and parents regarding relapses or LUTS/nocturia occurrence and of the future treating general practitioner on the enuresis characteristics and comorbidities of the patient. [ABSTRACT FROM AUTHOR]

Objectives: To study the possible association between (sexual) abuse and lower urinary tract symptoms (LUTS) in men and women. To study the differences in this association between men and women, and between the timing of the abuse. Subjects and Methods: A Dutch observational population‐based cross‐sectional study was used, based on self‐administered questionnaires. Respondents were included if they had answered all questions about abuse and LUTS. Logistic regression was used to analyse the data. Results: Included were 558 men and 790 women, of whom 29% and 37%, respectively, reported a history of one of more types of abuse. Abuse was significantly associated with LUTS in both men (odds ratio [OR] 1.7; 1.2–2.5) and women (OR 1.4; 1.1–2.1). This association, testing by two‐way interaction, was significantly stronger in men. No association was found between childhood abuse or adulthood abuse and LUTS, in men or women. The association of sexual abuse with LUTS was significant in both men (2.7; 1.4–5.2) and in women (1.5; 1.1–2.2), and this association (testing by two‐way interaction) was significantly much stronger in men. Conclusion: In men more than in women, a history of any type of abuse is associated with LUTS, regardless of whether the abuse occurred during childhood or adulthood. In both sexes, a history of sexual abuse is also associated with experiencing LUTS, with a much stronger association in men than in women. Patients, in particular male patients, presenting with LUTS should therefore be asked about sexual abuse in the past. [ABSTRACT FROM AUTHOR]

Objective: Comparison of the efficacy and safety of Rezūm therapy and bipolar transurethral resection of prostate (B‐TURP) for the management of benign prostatic hyperplasia (BPH) of 50–120 g size. Methods: One hundred patients with BPH who met the inclusion criteria were included and split into two equal groups to undergo Rezūm therapy or B‐TURP. The two groups were compared for efficacy using international prostate symptom score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), operative time, catheter time, hospital stay, post‐void residual urine (PVR), prostate‐specific antigen (PSA), and residual prostate size and safety using the incidence of complications. Results: Rezūm significantly ameliorated IPSS from the baseline score by 55.3%, QoL by 50%, Qmax by 62.5%, International Index of Erectile Function (IIEF) by 7.1%, PVR by 50%, residual prostate size by 28.1% and PSA by 42% at 2 years. Meanwhile, the improvement in B‐TURP was significantly higher than Rezūm group, Rezūm therapy had a significantly shorter duration of operative time and hospital stay. Also, it had fewer complications in comparison with B‐TURP. Conclusions: Rezūm is a minimally invasive procedure that provides significantly improved symptomatic relief of BPH and quality of life with preservation of erectile and ejaculatory functions. However, it is not as effective as B‐TURP. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to assess the presence of overactive bladder syndrome (OAB), academic stress, and their impact on quality of life (QoL) of healthy university students. Methods: A cross-sectional study recruited university students from different academic streams, between January 2021 to December 2021. Demographics, overactive bladder-validated 8 questionnaire (OAB-V8), International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQ-OAB) questionnaire, and Perception of Academic Stress (PAS) scale were collected. The correlation between the variables was assessed using the Social Sciences Statistical Package (SPSS) version 21. Results: Three hundred and 89 people met the inclusion criteria. There were 241 (62%) females, and 248 (63.8%) of the students were under the age of 22. Four academic streams were included: Engineering 96 (24.7%), Humanities 121 (31.1%), Medicine 85 (21.8%) and Nursing 87 (22.4%). OAB was found among 103 (26%) students. The mean OAB-V8 score was 5.8 ± 6.6. The mean PAS scale was 53.9 ± 9.4. The mean ICIQ-OAB score was 1.5 (0–9). Male gender 62 (60%), smoking 42 (40.8%), academic stream (Humanity 40 (38.8%)) and year (third and fourth-year students 34 (33%) and 33 (32%), respectively) have a statistically significant positive correlation with OAB (p < 0.001). Humanity stream (mean rank 169.2) and junior students (first and second years with mean rank of 174 and 177), respectively, had high level of academic stress and low PAS scale. There is a weak but statistically significant inverse correlation between OAB and the PAS scale (r = −0.211) (p < 0.001). Conclusion: OAB is prevalent among healthy university students and is directly related to academic stress. Both OAB and academic stress have impact on quality of life. We hope this study will help to raise awareness of OAB among university students to early identify and treat such a condition, avoiding unnecessary bother among healthy university students. [ABSTRACT FROM AUTHOR]

Objectives: Patients following renal transplantation (RTX) may experience nocturia exacerbation due to polyuria and reduced bladder capacity, thereby impacting the specific quality of life (QOL) associated with nocturia. The present study aims to investigate factors associated with the deterioration of nocturia‐specific QOL in RTX patients. Methods: The study cohort comprised 59 consecutive patients who had undergone successful RTX. Nocturia‐related QOL questionnaires (N‐QOL) were employed to evaluate the specific QOL related to nocturia. The Bother/Concern and Sleep/Energy domains of the N‐QOL were also assessed. The primary outcome measure was to explore factors related to the aggravation of nocturia‐specific QOL in patients post‐RTX. Results: The mean nocturia frequency post‐RTX was 1.3 ± 1.0. Univariate and multivariate analyses revealed a significant reduction in the Bother/Concern domain score associated with increased nocturia (p =.042). Aging significantly decreased the total N‐QOL score and the Sleep/Energy domain score (p =.001 and.0002, respectively). Prolonged duration after RTX significantly reduced the scores of both the Sleep/Energy domain and the Bother/Concern domain (p =.018 and.037, respectively). However, the duration of dialysis prior to RTX was not significantly associated with the total score or subdomains of N‐QOL. Conclusions: Nocturia‐specific QOL affected not only the nocturia itself, but also aging and the prolonged duration after RTX. Thus, comprehensive approaches to the RTX patients were needed to improve the Nocturia‐specific QOL in RTX patients. [ABSTRACT FROM AUTHOR]

Purpose: Patients with suspected UTIs are categorized into 3 clinical phenotypes based on current guidelines: no UTI, asymptomatic bacteriuria (ASB), or UTI. However, all patients may not fit neatly into these groups. Our objective was to characterize clinical presentations of patients who receive urine tests using the "continuum of UTI" approach. Materials and Methods: This was a retrospective cohort study of a random sample of adult noncatheterized inpatient and emergency department encounters with paired urinalysis and urine cultures from 5 hospitals in 3 states between January 01, 2017, and December 31, 2019. Trained abstractors collected clinical (eg, symptom) and demographic data. A focus group discussion with multidisciplinary experts was conducted to define the continuum of UTI, a 5-level classification scheme that includes 2 new categories: lower urinary tract symptoms/other urologic symptoms and bacteriuria of unclear significance. The newly defined continuum of UTI categories were compared to the current UTI classification scheme. Results: Of 220,531 encounters, 3392 randomly selected encounters were reviewed. Based on the current classification scheme, 32.1% (n = 704) had ASB and 53% (n = 1614) did not have a UTI. When applying the continuum of UTI categories, 68% of patients (n = 478) with ASB were reclassified as bacteriuria of unclear significance and 29% of patients (n = 467) with "no UTI" were reclassified to lower urinary tract symptoms/other urologic symptoms. Conclusions: Our data suggest the need to reframe our conceptual model of UTI vs ASB to reflect the full spectrum of clinical presentations, acknowledge the diagnostic uncertainty faced by frontline clinicians, and promote a nuanced approach to diagnosis and management of UTIs. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is increasing in the pediatric population and, as in adults, symptoms vary among patients. In children the first manifestations can sometimes overlap with acute neurological symptoms. Urological symptoms have not been much studied in childhood. We shared our experience with MS urological manifestation in children. Methods: This article is a retrospective evaluation of all children with MS, according to the Krupp criteria, who also present with urological symptoms. We collected demographic and clinical history, the MR localization of demyelinating lesions, urological symptoms, and exams. Results: We report on six MS pediatric cases with urological manifestation. Urinary symptoms, characterized by urinary incontinence in five patients and urinary retention in one patient, appeared in a different time frame from MS diagnosis. Urodynamic exams showed both overactive and underactive bladder patterns. Treatment was defined according to lower urinary tract dysfunction, using clean intermittent catheterization, oxybutynin, and intradetrusor Onabotulinum Toxin-A injection. A low acceptance rate of invasive evaluation and urological management was observed. Conclusions: The MS diagnosis was traumatic for all our patients. We believe it is important to address urological care in young people from the time of diagnosis for prompt management; it could be useful to include a pediatric urologist in multidisciplinary teams. [ABSTRACT FROM AUTHOR]

Introduction and hypotheses: The International Continence Society recommends the International Consultation on Incontinence Questionnaire-Bladder Diary (ICIQ-BD) for the assessment, management, and monitoring of lower urinary tract symptoms (LUTS). Translation, cross-cultural adaptation and validation will establish a valid and reliable tool for Brazilian women with LUTS. Methods: A cross-sectional study involving 101 women was carried out at the Urogynecology Outpatient Clinic in Belo Horizonte, Brazil, between August 2020 and April 2022. The process of cross-cultural adaptation and validation was executed following the ICIQ Group's protocol. Reviewed by an expert committee, the first pre-test was followed by subsequent adaptations, resulting in a second adapted version that underwent expert revisions. A second pretest was conducted, followed by cross-cultural adaptation and construct validation. Finally, the International Consultation on Incontinence Questionnaire-Bladder Diary-Brazilian Portuguese Version (ICIQ-BD-Br) underwent a validation process. Results: Construct validity (IVC >0.78) and internal consistency were satisfactory (α-Cronbach coefficient 0.87–0.94). The following adjustments were made: a specific field was created to document sleep and wake times, and a printed score ranging from 0 to 4 was included in the bladder sensation column. Test–retest reliability ranged from fair to excellent for all analyzed items (Spearman correlation: 0.64–0.95). Criterion validity analysis indicated slight agreement for one of the four symptoms analyzed (nocturia k=0.32). The final version was approved by the ICIQ Group. Conclusions: The ICIQ-BD-Br has been adapted for use in Brazilian Portuguese and has exhibited robust construct validity and reliability for Brazilian women with LUTS. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the importance of the post-void residual (PVR) ratio (PVR ratio) in achieving a favorable trifecta outcome for patients suffering from lower urinary tract symptoms and benign prostatic enlargement (LUTS-BPE) who undergo transurethral resection of the prostate (TURP). Starting from 2015, a series of patients with LUTS-BPE who underwent TURP were included in a forward-looking study. These patients were assessed using the international prostate symptom score (IPSS) screening tool, uroflowmetry, and a transrectal ultrasound to measure prostate volume (TRUS). Both the PVR urine volume and the PVR ratio (PVR-R), which is the PVR as a percentage of total bladder volume (voided volume + PVR), were measured. The assessment of outcomes was based on the trifecta favorable outcome, defined as meeting all of the following criteria: (1) absence of perioperative complications, (2) a postoperative IPSS of less than eight, and (3) a postoperative maximum urinary flow rate (Qmax) greater than 15 mL/s. A total of 143 patients were included, with a median age of 70 years (interquartile range 65–73). Of these, 58% (83/143) achieved a positive trifecta outcome. Upon conducting a multivariate analysis, both IPSS and Qmax were identified as predictors of a positive trifecta outcome, whereas the PVR-R did not prove to be an independent predictor. In summary, it was found that preoperative IPSS and Qmax are indicative of a trifecta outcome following TURP, whereas PVR-R is not. [ABSTRACT FROM AUTHOR]

Cowper's syringocele is a cystic dilation of the bulbourethral duct or gland. This rare pathology has historically been diagnosed in the pediatric population, with recent literature reporting an increased incidence in adults. Attempts have been made to classify Cowper's syringoceles by their appearance on imaging and endoscopy, however a simpler classification of unobstructed versus obstructed may be of more utility in directing management. Herein, we present a novel case of a Cowper's syringocele developed in adulthood that supports the suspicion for underdiagnosis, as well as one proposed mechanism of acquired etiology of Cowper's syringoceles involving incomplete or intermittent obstruction secondary to the application of external force of the leading to asymptomatic cystic dilation. [ABSTRACT FROM AUTHOR]

Methods for reducing power consumption in circuits of finite state machines (FSMs) are discussed in this review. The review outlines the main approaches to solving this problem that have been developed over the last 40 years. The main sources of power dissipation in CMOS circuits are shown; the static and dynamic components of this phenomenon are analyzed. The power consumption saving can be achieved by using coarse-grained methods common to all digital systems. These methods are based on voltage or/and clock frequency scaling. The review shows the main structural diagrams generated by the use of these methods when optimizing the power characteristics of FSM circuits. Also, there are various known fine-grained methods taking into account the specifics of both FSMs and logic elements used. Three groups of the fine-grained methods targeting FPGA-based FSM circuits are analyzed. These groups include clock gating, state assignment, and replacing look-up table (LUT) elements by embedded memory blocks (EMBs). The clock gating involves a separate or joint use of such approaches as the (1) decomposition of FSM inputs and (2) disabling FSM inputs. The aim of the power-saving state assignment is to reduce the switching activity of a resulting FSM circuit. The replacement of LUTs by EMBs allows a reduction in the power consumption due to a decrease in the number of FSM circuit elements and their interconnections. We hope that the review will help experts to use known methods and develop new ones for reducing power consumption. We think that a good knowledge and understanding of existing methods of reducing power consumption is a prerequisite for the development of new, more effective methods to solve this very important problem. Although the methods considered are mainly aimed at FPGA-based FSMs, they can be modified, if necessary, and used for the power consumption optimization of FSM circuits implemented with other logic elements. [ABSTRACT FROM AUTHOR]

Background: Numerous studies demonstrated the risk factors for urological complications in patients with diabetes before sodium–glucose co-transporter 2 inhibitor (SGLT2i) became commercially available. This study aimed to comprehensively investigate urological characteristics in patients with type 2 diabetes (T2DM) after SGLT2i became commercially available. Methods: We examined 63 outpatients with T2DM suspected of bacteriuria based on urinary sediment examinations. Urine cultures were performed, and lower urinary tract symptoms (LUTS) were assessed via questionnaires. Patients with bacteriuria were assessed using ultrasonography to measure post-void residual volume (PVR). Utilizing demographic and laboratory data, a random forest algorithm predicted LUTS, bacteriuria, and symptomatic bacteriuria (SB). Results: Thirty-two patients had LUTS and 31 had bacteriuria. High-density lipoprotein cholesterol level was crucial in predicting LUTS, while age was crucial in predicting bacteriuria. In predicting SB among patients with bacteriuria, creatinine level and estimated glomerular filtration rate were crucial. Our models had high predictive accuracy for LUTS (area under the curve [AUC] = 0.846), followed by bacteriuria (AUC = 0.770) and SB (AUC = 0.938) in receiver operating characteristic curve analysis. These predictors were previously reported as risk factors for urological complications. Although SGLT2i use was not an important predictor in our study, all SGLT2i users with bacteriuria had SB and exhibited higher PVR compared to non-SGLT2i users with bacteriuria. Conclusion: This study's random forest model highlighted distinct essential predictors for each urological condition. The predictors were consistent before and after SGLT2i became commercially available. [ABSTRACT FROM AUTHOR]

Aim:: Pudendal nerve stimulation (PNS) is a promising neuromodulation option. While sacral neuromodulation (SNM) and posterior tibial nerve stimulation (PTNS) are established third-line treatments for lower urinary tract dysfunction (LUTS), the pudendal nerve offers potential advantages that merit systematic review. The review aims to evaluate the safety, technical feasibility, and clinical efficacy of PNS for the treatment of urinary incontinence. Methods:: The review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and reported in accordance with the PRISMA guidelines. PubMed, Embase, and Cochrane Central were searched for studies on PNS, without time or language restriction. The final search date was 12th June 2024. Results:: Of 3,020 records screened, 14 studies were included. Two randomised crossover designs and 12 observational studies included a total of 292 patients, predominantly female (n=198; 68%). Safety data were reported by eight studies with a total of 24 adverse events reported in 199 patients (12.1%). These included infections (n=3; 1.5%), lead displacements (n=5, 2.5%) and unwanted stimulation effects including pain (n=10; 5.0%). All studies reported technical outcomes with varying results depending on approach. Operative duration ranged from 20-130min and conversion from percutaneous nerve evaluation to implant varied from 30%–100%. Seven studies included measures of clinical efficacy for LUTS and showed a reduction of 2.92 (5.57 to 2.65) in mean daily incontinence episodes (95% CI: 1.52 to 4.31), alongside improvements in voiding volumes and frequencies. Four studies reported physiological data, with increases in bladder capacity (factor 1.5-2) and effect on undesired detrusor contractions (UDC). Where directly compared, PNS demonstrated comparable or better outcomes than SNM in symptom reduction. Conclusion:: PNS appears to be a safe and technically feasible therapy. Clinical outcome data suggest beneficial effects in several LUTS populations including urinary incontinence.

Introduction and hypothesis: The genitourinary syndrome of menopause (GSM), apart from symptoms related to vulvovaginal atrophy (VVA), also consists of lower urinary tract symptoms (LUTS). Based on the common embryological origin of the genital and lower urinary system, the presence of estrogen receptors, and the high prevalence of VVA and LUTS in the menopausal population, the two conditions can coexist. This study is aimed at investigating the prevalence and risk factors of LUTS in a sample of Greek peri- and postmenopausal women. Methods: Four hundred and fifty (450) women, aged 40–70 years, attending three outpatient gynecology clinics for routine examination, completed a structured interview and responded to a validated questionnaire (International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms, ICIQ-FLUTS). Results: Urinary urgency or frequency affected 51.6% and dysuria 43.6% of the participants. Mild urgency or frequency was described by 25.6%, moderate by 14.4%, and severe by 11.6% of the women. Mild dysuria was reported by 26.26%, moderate by 5.8%, and severe by 11.6%. Age, weight, BMI, and number of pregnancies and abortions correlated with a higher ICIQ-FLUTS score. Women with moderate/severe symptoms of VVA, such as irritation, a burning sensation, and pruritus of the vulva or vagina, had a higher ICIQ-FLUTS score than women without such symptoms (beta coefficient 2.42, CI 1.204, 3.635, p < 0.001). Conclusions: Lower urinary tract symptoms are very common among peri- and postmenopausal women and are linked to symptoms of VVA. Our data support the need for prompt evaluation of women transitioning to menopause, as these symptoms compromise the quality of life. [ABSTRACT FROM AUTHOR]

Purpose of Review: Eosinophilic cystitis is a rare condition of unknown etiology. However, many factors can trigger such pathology, its symptoms may mimic many other clinical situations. In this article, the author is aiming to illustrate and summarize the up-to-date evidence about this disorder. Recent Findings: The latest published evidence about eosinophilic cystitis was reviewed and data about different triggers was collected. Different treatment modalities ranging from medications such as steroids to surgical interventions were mentioned in this review. Summary: There are different recommended treatments owing to different stages of presentation and underlying cause. Antibiotics, antihistamine, and steroids can be used in conjunction with stopping the trigger. Some literature suggested surgical intervention might be required for refractory cases. [ABSTRACT FROM AUTHOR]

Purpose of Review: In this review, we evaluate the potential of visual questionnaires for lower urinary tract symptoms (LUTS) as a clinically viable alternative to written questionnaires, aiming for improved accuracy and user-friendliness. Recent Findings: Several visual questionnaires, including VPSS, modified VPSS, SVPI, VASUS, LUTS-V, and DRIPSS, have been developed and validated for the assessment of male LUTS through predominantly quantitative studies, with a limited number of qualitative studies. Summary: Visual questionnaires demonstrate comparable efficacy to the written questionnaires, particularly proving their superiority in the less educated populations. However, inherent shortcomings and the lack of well-designed randomized controlled trials delay the integration of visual questionnaires into standard practice. The search for better alternatives continues. [ABSTRACT FROM AUTHOR]

Background and Objectives: The significant prevalence of Lower Urinary Tract Symptoms (LUTS), erectile dysfunction (ED), and associated adverse effects calls for increased attention in primary care settings. In Greece, there is a lack of sufficient data for LUTS and ED screening in primary care. Therefore, the aim of our study was to estimate the prevalence of LUTS and ED, identify associated risk factors, and evaluate their impact on quality of life among adult primary healthcare users aged 40 years and older in Crete, Greece. Materials and Methods: A cross-sectional study was conducted to explore the prevalence of LUTS and ED in 1746 primary health care users visiting rural primary health care practices in Crete, Greece. Participants underwent a comprehensive evaluation including demographic parameters, screening for LUTS utilizing the validated International Prostate Symptoms Score (IPSS) questionnaire and for ED using the International Index of Erectile Function (IIEF-5), in males, and for urinary incontinence in women with the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF). Participants with a prior diagnosis of LUTS or ED were excluded (n = 183). Results: Out of 536 participants finally included (n = 1746 screened), 32% of males and 36% of females exhibited moderate to severe LUTS. Following adjustments, we identified advanced age, retirement, and the presence of diabetes type 2 as factors associated with the occurrence of LUTS in men. Patients with LUTS also had a substantially increased likelihood of experiencing ED. Moreover, it was observed that women with hypertension or diabetes type 2 and lower education levels face an increased likelihood of developing LUTS, which adversely affects their quality of life. Conclusions: In conclusion, the findings of this study reveal a high occurrence of LUTS and ED in adults aged 40 years and older who utilize primary healthcare services, with a negative impact on their quality of life. [ABSTRACT FROM AUTHOR]

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Introduction: Ureteral stents are widely used throughout urologic surgery, most commonly following ureteroscope (URS) procedures. This systematic review aims to assess the current evidence concerning stent on string (SOS) placed after URS and compare it with stents without strings (SWOSs). Methods: A systematic review was conducted on several databases using the preferred reporting items for systematic review and meta-analysis (PRISMA) methodology for studies in English language, for patients of all age groups, who had an SOS after URS for stone disease. Results: Of 1210 records identified, a total of 22 studies (20 adult and 2 pediatric studies) were included, with a total of 8382 patients. Of these, 3427 (40.9%) had SOSs inserted and 434 (11%) were in the pediatric age group. Our results show that SOS provides several advantages, and compared with SWOS, they were in situ for less time, with no difference in complications such as urinary tract infection or urinary symptoms. Furthermore, significant cost savings, less pain on removal, and high rates of safe home removal were reported in SOS, with >90% patients reporting that they would be happy to remove their SOSs at home. However, a small risk of stent dislodgment must be considered when making decisions regarding SOS placement after URS. Conclusion: SOS provides an excellent option after URS, especially in those patients with no intraoperative complication, and their placement is done as a routine insertion based on surgeon preference. These stents reduce dwell time, pain, cost, risks, and suffering involved from prolonged stenting, and majority of patients are happy to remove it themselves at home. Although their use seems to be still restricted in the current endourology practices, they are likely to become the new gold standard for routine URS in future, with more shared decision making and patient-reported outcome measures coming into the mainstream. [ABSTRACT FROM AUTHOR]

Objective: To obtain the prevalence of lower urinary tract symptoms (LUTS) in young female population in tertiary care centre. Method: We conducted a descriptive and analytic study with ques tionnaire based data collection. All subjects were interviewed using conventional method and International Consultation on Incontinence Questionnaire (ICIQ) Female LUTS form in the urology outpatient department, SMS medical college and hospital, Jaipur (India). Result: Total 1278 patients enrolled in study. Using the well-structured questionnaire using ICIQ-FLUTS form, the prevalence of LUTS was 78.01% while conventional method having only 35.8%. This result revealed that LUTS is a common condition among young Indian female population with vaginal delivery as the common risk factor. Conclusion: Screening for LUTS using a structured questionnaire identified a significantly higher prevalence of LUTS than the conventional method. The ICIQ-FLUTS form is a robust questionnaire that can be recommended for use in epidemiological research as well as routine clinical practice. [ABSTRACT FROM AUTHOR]

Non-muscle invasive bladder cancer (NMIBC) accounts for ~70-75% of total bladder cancer tumors and requires effective early intervention to avert progression. The cornerstone of high-risk NMIBC treatment involves trans-urethral resection of the tumor followed by intravesical Bacillus Calmette-Guerin (BCG) immunotherapy. However, BCG therapy is commonly accompanied by significant lower urinary tract symptoms (LUTS) including urinary urgency, urinary frequency, dysuria, and pelvic pain which can undermine treatment adherence and clinical outcomes. Despite this burden, the mechanisms underlying the development of BCG-induced LUTS have yet to be characterized. This review provides a unique perspective on the mechanisms thought to be responsible for the development of BCG-induced LUTS by focussing on the sensory nerves responsible for bladder sensory transduction. This review focuses on how the physiological response to BCG, including inflammation, urothelial permeability, and direct interactions between BCG and sensory nerves could drive bladder afferent sensitization leading to the development of LUTS. Additionally, this review provides an up-to-date summary of the latest clinical data exploring interventions to relieve BCG-induced LUTS, including therapeutic targeting of bladder contractions, inflammation, increased bladder permeability, and direct inhibition of bladder sensory signaling. Addressing the clinical burden of BCG-induced LUTS holds significant potential to enhance patient quality of life, treatment compliance, and overall outcomes in NMIBC management. However, the lack of knowledge on the pathophysiological mechanisms that drive BCG-induced LUTS has limited the development of novel and efficacious therapeutic options. Further research is urgently required to unravel the mechanisms that drive BCG-induced LUTS. [ABSTRACT FROM AUTHOR]

Objectives: To describe the contemporary evolution of day‐case bladder outflow obstruction (BOO) surgery in England and to profile day‐case BOO surgery practices across England in terms of the types of operation performed and their safety profiles. Materials and Methods: This was a retrospective observational analysis of Hospital Episode Statistics and UK Office for National Statistics data. All 111 043 recorded operations across 117 hospital trusts over 66 months, from 1 January 2017 to 30 June 2022, were obtained. Operations were identified as one of: transurethral resection of prostate (TURP); laser ablation or enucleation; vapour therapy; prostatic urethral lift (PUL); or bladder neck incision. Monthly day‐case rate trends were plotted across the study period. Descriptive data, day‐case rates and 30‐day hospital readmissions were analysed for each operation type. Multilevel regression modelling with mixed effects was performed to determine whether day‐case surgery was associated with higher 30‐day hospital readmissions. Results: Day‐case patients were younger, with fewer comorbidities. Time series analysis showed a linear day‐case rate increase from 8.3% (January 2017) to 21.0% (June 2022). Day‐case rates improved for 92/117 trusts in 2021/2022 compared with 2017. Three of the six trusts with the highest day‐case rates performed predominantly day‐case TURP, and the other three laser surgery. Nationally, PUL and vapour surgery had the highest day‐case rates (80.9% and 38.1%). Most inpatient operations were TURP. Multilevel regression modelling found reduced odds of 30‐day readmission after day‐case BOO surgery (all operations pooled), no difference for day‐case vs inpatient TURP, and reduced odds following day‐case LASER operations. Conclusions: The day‐case rates for BOO surgery have linearly increased. Minimally invasive surgical technologies are commonly performed as day cases, whereas high day‐case rates for TURP and for laser ablation operations are seen in a minority of hospitals. Day‐case pathways to treat BOO can be safely developed irrespective of operative modality. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this American Urological Association (AUA) Guideline amendment is to provide a useful reference on the effective evidence-based management of male lower urinary tract symptoms secondary/attributed to BPH (LUTS/BPH). Materials and Methods: The Minnesota Evidence Review Team searched Ovid MEDLINE, the Cochrane Library, and the Agency for Healthcare Research and Quality (AHRQ) database to identify studies relevant to the management of BPH. The guideline was updated in 2023 to capture eligible literature published between September 2020 and October 2022. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions. Results: The BPH amendment resulted in changes to statements/supporting text on combination therapy, photoselective vaporization of the prostate (PVP), water vapor thermal therapy (WVTT), laser enucleation, and prostate artery embolization (PAE). A new statement on temporary implanted prostatic devices (TIPD) was added. In addition, statements on transurethral needle ablation (TUNA) and transurethral microwave thermotherapy (TUMT) were removed and information regarding these legacy technologies was added to the background section. References and the accompanying treatment algorithms were updated to align with the updated text. Conclusion: This guideline seeks to improve clinicians' ability to evaluate and treat patients with BPH/LUTS based on currently available evidence. Future studies will be essential to further support these statements to improve patient care. [ABSTRACT FROM AUTHOR]

Background: The aim of the current study is to measure the prevalence and the potential role of International Prostate Symptom Score (IPSS) score as a predictor of obstructive sleep apnea syndrome (OSAS) in male experienced lower urinary tract symptoms (LUTS). Methods: A cross‐sectional web‐based Italian survey was administered via Google Forms between July 17 and October 31, 2022. The urinary functioning was measured through the IPSS questionnaire. Specifically, we considered symptoms occurring more than "about half the time" (score ≥ 3) as bothering symptoms. Multivariable logistic regression models (LRMs) adjusting for age, body mass index (BMI), International Index of Erectile Function‐5, IPSS, and hypertension were fitted to predict OSAS in the cohort of men responding to the survey and experiencing LUTS. Results: Overall, 58 (24.4%) patients had a confirmed diagnosis of OSAS. The overall median IPSS was 5 (inter quartile range [IQR]: 3–8), respectively. According to IPSS items, 24 (10%), 44 (18.4%), 12 (5%), 12 (5%), 12 (5%), 11 (4.6%), 63 (26.4%) patients exhibit incomplete bladder emptying, urinary frequency, intermittency, urgency, weak stream, straining, nocturia with a score ≥ 3, respectively. After multivariable LRMs predicting the developing OSAS, age (odds ratio [OR]: 1.09, p < 0.001), BMI (OR:1.12, p < 0.001) and IPSS total score (OR:1.08, p = 0.02) were independent predicting factors. Conclusion: This analysis revealed that the IPSS total score, age, and BMI are independent predictors of OSAS in males. In this context, the use of IPSS in daily practice could be helpful in assessing the LUTS presence and in supporting physicians to identify a hidden sleep apnea condition. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate whether pathways involving transient receptor potential ankyrin 1 (TRPA1) channels in the urinary bladder mediate the bladder overactivity elicited by exposure to a low temperature in rats. Methods: At postnatal week 10, female Sprague–Dawley (SD) rats were intraperitoneally injected with the TRPA1 channel antagonist, HC030031, at room temperature (RT) and subsequently exposed to low temperature (LT). Bladder specimens treated with HC030031 were evaluated for contractions through cumulative addition of the TRPA1 channel agonist trans‐cinnamaldehyde. Two days before cystometric investigation, small interfering RNA (siRNA) targeting TRPA1 was transfected into urinary bladders. Then, cystometric investigations were performed on rats subjected to TRPA1 siRNA transfection at both RT and LT. Expression of TRPA1 channels in the urinary bladder was assessed through immunohistochemistry and real‐time reverse transcription‐polymerase chain reaction. Results: At RT, micturition patterns were unaffected by HC030031 treatment. However, upon exposure to LT, rats treated with HC030031 exhibited a reduction of LT‐elicited bladder overactivity, as evidenced by inhibited decreases in voiding interval, micturition volume, and bladder capacity. Additionally, HC030031 inhibited trans‐cinnamaldehyde‐induced contractions. Immunohistochemical analysis showed the presence of TRPA1 channels in the urinary bladder. Notably, rats with TRPA1 siRNA‐transfected bladders could partially inhibit bladder overactivity during LT exposure. Conclusions: These findings indicate that pathways involving TRPA1 channels expressed in the urinary bladder could mediate the LT‐elicited bladder overactivity. [ABSTRACT FROM AUTHOR]

Introduction: "Corona virus-induced disease (COVID-19)" is a highly infectious respiratory disease caused by the coronavirus (SARS-COV-2). In addition to respiratory symptoms, the infected people also experience urological symptoms such as renal impairment and lower urinary tract symptoms (LUTS), which include frequency, urgency, loin pain, pyuria, and hematuria. Infertility and urolithiasis have also been detected in some patients. Objectives: To evaluate the effect of the coronavirus on the urinary system and its consequences on the affected patients. Methods: A prospective case series study was conducted in Mosul City, Iraq. One hundred COVID-19 patients, after a positive PCR result, confirmed their infection with the coronavirus, were evaluated clinically and sent for urine analysis and a renal function test. Results: Among the 100 patients studied, more males (56%) than females (44%) were affected by COVID-19. Patients in the 51-60 age range have the highest incidence of urinary symptoms, with loin pain being the most common symptom (52%) and frequency coming in second (51%). Regarding urine analysis, pus cells, RBCs, and protein were observed in 48, 24, and 24%, respectively. Renal function tests were abnormal in 55% of infected patients. Conclusion: The impact of the coronavirus on the urinary system differs from one patient to another. Patients who are elderly are severely affected, and urinary manifestations appear to be more prominent in this age group. Moreover, acute kidney injury may happen in some individuals, particularly those who are hospitalized, and the lower urinary tract infection may be accompanied by fever, dehydration, or a prolonged homestay. [ABSTRACT FROM AUTHOR]