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Objective: To compare prostate artery embolisation (PAE) to the combination of tamsulosin and dutasteride therapy as a potential first‐line therapy for obstructive benign prostatic hyperplasia (BPH) in treatment‐naïve patients in the 'Prostate Embolisation AS first‐line therapY compAred to meDication in treatment naïVe men with prostAte eNlargement, a randomised ControllEd trial' (P‐EASY ADVANCE). Patients and Methods: A total of 39 men with enlarged prostates, moderate–severe lower urinary tract symptoms (LUTS) and obstructed/equivocal urodynamic studies (UDS), and who had no prior treatment for BPH, were randomised to receive either combined medical therapy with tamsulosin and dutasteride (medication) or PAE. Follow‐up UDS, International Prostate Symptom Score (IPSS), uroflowmetry and ultrasound were performed at short‐ to medium‐term intervals following interventions and compared to baseline. Results: The medication and PAE treatment groups had similar baseline characteristics, including prostate volumes (87.8 and 85.4 mL respectively), maximum urinary flow rate (Qmax; 6.5 and 6.6 mL/s, respectively), IPSS (19.5 and 21, respectively) and obstructed UDS (79% and 74%, respectively). Both interventions improved voiding and bladder outflow obstruction from baseline, with more patients unobstructed after PAE (63%) compared to medication (28%) (P = 0.03). PAE patients had significantly greater reductions in prostate size (P < 0.001), incomplete emptying (P = 0.002), total IPSS (P = 0.032), Qmax (P = 0.006) and quality of life (P = 0.001). Altered ejaculation, erectile dysfunction and nausea were more common in the medication group. Conclusion: Prostate artery embolisation was more effective than combined medical therapy at reducing urinary obstruction, decreasing prostate volume and improving LUTS in patients with BPH who had not previously been treated. This is the first randomised control study to compare PAE and combined medical therapy in exclusively treatment‐naïve patients and raises the potential of PAE as an alternative early treatment option for BPH. Further randomised comparative trials are planned to further validate the role of PAE in mitigating obstructive BPH. [ABSTRACT FROM AUTHOR]

Introduction: Nocturnal lower urinary tract symptoms are common in geriatric rehabilitation inpatients but have not been well described. The aim of this study was to compare patient characteristics stratified by self-reported nocturia severity in geriatric rehabilitation inpatients. Methods: The REStORing health of acutely unwell adulTs (RESORT) is an observational, longitudinal, prospective inception cohort of geriatric rehabilitation inpatients who underwent a Comprehensive Geriatric Assessment (CGA) at admission and discharge. Nocturia was captured by item 7 of the American Urology Association Symptom Score (AUASS) and dichotomised as ≤1 void and >1 void at night as per the International Continence Society definition. Differences in demographic, functional, and medical characteristics of the inpatients with and without nocturia >1 were compared. Results: Overall, 641 inpatients completed the nocturia item (mean age 82.6 [SD 7.7] years, 59.9% female). Nocturia occurred >once per night in 57.4%; mean number of episodes was 1.96 (SD 1.38), ranging from 0 to 5. There was no change in nocturia severity between admission and discharge. Daily urinary incontinence, urinary urgency, and comorbid illness were independently associated with multiple nocturia episodes. A history of falls within the last year, difficulty climbing stairs pre-admission, higher faecal incontinence score, impaired quality of life domains, higher levels of anxiety and depression were significantly more common in inpatients with multiple episodes of nocturia compared to no or only one episode of nocturia. Conclusion: Lower urinary tract symptoms, poor functional status and frailty markers were associated with repeated episodes of nocturia. Targeted intervention may reduce the severity of nocturia, with potential to improve sleep quality, impact therapeutic gains and influence discharge destination. [ABSTRACT FROM AUTHOR]

Infravesical obstruction (IO) is a common urological condition in young boys. Patients may present with various signs and symptoms at different ages, with severity depending to a large extent on the degree of obstruction. Consensus concerning accurate and objective modalities to diagnose IO and to differentiate between an anatomical or functional cause is still lacking. This study aimed to reach consensus on the diagnostic determinants that are important to assess the likelihood of anatomical IO in boys and differentiate between an anatomical or functional cause. A Delphi method was used to establish a list of diagnostic determinants that can be utilized in order to diagnose anatomical IO in boys. An international and interdisciplinary panel of experts was recruited to reach consensus using three sequential rounds of electronic questionnaires. Data were collected using the online survey platform Qualtrics. Rounds one and two were used to define diagnostic determinants. Round three was used to stratify key determinants according to age. All rounds received a response rate of 100%. In round one, consensus was achieved on 44 of a total 79 items. In round two, consensus was achieved on 19 of a total 51 items. Round three identified a variation in key determinants per age group. To create an effective tool for assessing IO in boys, key determinants identified in this study will need to be validated in a prospective clinical trial. Due to a large number of determinants and sections, this will not be a trivial task. In addition, since a Delphi study is based on expert opinion, any consensus achieved remains subjective. Diagnostic determinants identified in this study will need to be validated using prospective clinical data. Artificial Intelligence provides techniques for uncovering complex associations that cannot easily be reduced to equations. It may therefore play a pivotal role in the future development of robust IO risk assessment tools. An international group of experts agreed that a risk assessment tool for IO in boys would be beneficial for both clinical practice and research purposes. Using a Delphi study methodology, consensus was reached on a set of diagnostic determinants that were considered important to assess the likelihood of IO and differentiate between an anatomical or functional cause. This study paves the way for further research on IO in boys. Eventually this could lead to an accurate and standardized assessment tool for IO. [ABSTRACT FROM AUTHOR]

Non-Hodgkin's lymphoma are neoplasms derived from T cells and B cells and their precursors in the lymphoid system with higher susceptibility in involvement of extra-nodal sites. Predominant ureteric involvement is an unusual presentation. We present a case of diffuse large B-cell lymphoma with secondary involvement of ureter who had symptoms of urinary tract infection in absence of positive urine culture, non-responsive to broad spectrum antibiotics and masquerading pyogenic infection leading to pyelonephritis with ureteritis. Radiological examination revealed mass like soft tissue thickening of ureter extending from renal pelvis throughout the length of ureter. FNAC as well as biopsy from the periureteric thickening revealed lymphomatous involvement of ureter. The following case report provides insight on differentials and varied symptoms of lymphomatous involvement of ureter.

Background: Lower urinary tract symptoms (LUTS) and dysfunction can be a significant complication of functional constipation (FC), especially in children. The relationship arises due to the close anatomical and functional connections between the bladder, bowel, and pelvic floor muscles. Aim: The study aimed to investigate the presence of LUTS and the lower urinary tract dysfunction (LUTD). among children with FC. Patients and methods: A cross-sectional descriptive study was carried out on children aged 4–10 years at the pediatric gastroenterology clinic of Alexandria University Children's Hospital with an established diagnosis of FC according to Rome IV criteria. Age-adapted Agachan score was used to quantify the severity of FC. The Arabic version of the dysfunctional voiding symptom score (DVSS) was used to investigate the presence of LUTD. Results: The study was conducted on 105 children (54 boys, 51 girls), 50.5% of the patients had positive DVSS scores; 62.3% were girls and 37.7% were boys with statistically significant positive DVSS in girls. Most patients had moderate to severe scores by using the age-adapted Agachan score. Multivariate logistic regression analysis was used to determine the independent predictors of bladder bowel dysfunction in patients with chronic FC. The independent predictors were dysuria, decreased voiding frequency, urgency, daytime incontinence, and female sex. History of bright red blood in the stools and the presence of anal fissures during the perianal examination were more common with bladder and bowel dysfunction patients than FC alone (P =0.011 and 0.027, respectively). The prognostic performance of age-adapted Agachan score to predict the positivity of DVSS score was found statistically significant. Conclusion: Both LUTS and LUTD were correlated positively with FC, a crucial finding that necessitates the awareness of this finding. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate lower urinary tract symptoms (LUTS) and bowel disorders in a population of young subjects with autism spectrum disorder (ADS) by a national survey and to assess the relationship between the occurrence, frequency, and type of LUTS and the severity of behavioral and neuropsychiatric characteristics. Materials and methods: A survey on LUTS and bowel disorders in the ASD population was sent by mail and social media through the main Italian Associations of ASD between February and September 2022. The correlation between LUTS and ASD severity was also assessed. Results: The survey was completed by 502 subjects with a mean age of 16.6 years ± 10 years: male participants were 413 (mean age: 16.5 years ± 9.8 years), while female participants 89 (mean age: 17.2 years ± 10.9 years). ADS severity was found low in 29.9%, moderate in 27.1%, and severe in 43%. LUTS were reported by 77.1%, storage symptoms in 51.4%, and voiding symptoms in 60.6%. Urinary incontinence was reported by 12.5%. Enuresis was reported by 14.3% (72/502) of the respondents: primary enuresis in 70.8% (51/72), secondary in the remaining. Pads were used by 40 subjects with a median of 2.9 pads/day (range, 0-8). A toilet training program was performed by 61 of the respondents, with satisfactory results in 40/61 (65.6%). A significant correlation was found between greater ASD severity and higher LUTS rates. The mean VAS score on the impact of LUTS on family relationships was 2 ± 2.9. Regular bowel function was reported by 57.4% (288/502) of the respondents, while increased daily defecations were present in 11.2% (56/502), constipation in 31.5% (158/502), and fecal incontinence in 7.9% (40/502). Conclusion: This survey demonstrated that LUTS are very common in the young ASD population and that the prevalence of urinary symptoms is related to higher severity of the ASD condition. Bowel disorders are often associated with urinary symptoms and dysfunctions. Urologists should be aware of the frequent occurrence of urological disorders and symptoms in individuals with ASD and should be involved in their clinical management in a multidisciplinary team that cares for these people. [ABSTRACT FROM AUTHOR]

IntroductionTo evaluate lower urinary tract symptoms (LUTS) and bowel disorders in a population of young subjects with autism spectrum disorder (ADS) by a national survey and to assess the relationship between the occurrence, frequency, and type of LUTS and the severity of behavioral and neuropsychiatric characteristics.Materials and methodsA survey on LUTS and bowel disorders in the ASD population was sent by mail and social media through the main Italian Associations of ASD between February and September 2022. The correlation between LUTS and ASD severity was also assessed.ResultsThe survey was completed by 502 subjects with a mean age of 16.6 years ± 10 years: male participants were 413 (mean age: 16.5 years ± 9.8 years), while female participants 89 (mean age: 17.2 years ± 10.9 years). ADS severity was found low in 29.9%, moderate in 27.1%, and severe in 43%. LUTS were reported by 77.1%, storage symptoms in 51.4%, and voiding symptoms in 60.6%. Urinary incontinence was reported by 12.5%. Enuresis was reported by 14.3% (72/502) of the respondents: primary enuresis in 70.8% (51/72), secondary in the remaining. Pads were used by 40 subjects with a median of 2.9 pads/day (range, 0–8). A toilet training program was performed by 61 of the respondents, with satisfactory results in 40/61 (65.6%). A significant correlation was found between greater ASD severity and higher LUTS rates. The mean VAS score on the impact of LUTS on family relationships was 2 ± 2.9. Regular bowel function was reported by 57.4% (288/502) of the respondents, while increased daily defecations were present in 11.2% (56/502), constipation in 31.5% (158/502), and fecal incontinence in 7.9% (40/502).ConclusionThis survey demonstrated that LUTS are very common in the young ASD population and that the prevalence of urinary symptoms is related to higher severity of the ASD condition. Bowel disorders are often associated with urinary symptoms and dysfunctions. Urologists should be aware of the frequent occurrence of urological disorders and symptoms in individuals with ASD and should be involved in their clinical management in a multidisciplinary team that cares for these people.

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

Pelvic floor muscle atrophy and collagen loss in connective tissue due to declining estrogen production in women as they age may underlie the increasing prevalence of urge and stress incontinence. Estrogen therapy can correct the deficiency of estrogen receptors in genitourinary structures after menopause, but estrogen is not suitable for all women. A series of retrospective studies showed that urinary symptoms improved in women with overactive bladder syndrome who were receiving ospemifene for vulvovaginal atrophy (VVA), a component of genitourinary syndrome of menopause. Two case studies presented in this article support the findings. The woman in case 1 was 76 years old, had a 4-year history of urinary incontinence (UI), and several risk factors for urinary symptoms. During 15 months’ treatment with ospemifene for VVA, her urinary symptoms also improved as evidenced by a reduction (from four/day to one/day) in sanitary pad requirements to manage leakage. The patient in case 2 had predominantly moderate-to-severe VVA and mild mixed UI. During 6 months’ treatment with ospemifene, she experienced marked improvement in VVA symptoms, including normalization of vaginal pH and disappearance of dyspareunia, accompanied by a decrease in urinary symptoms, which allowed her to resume a normal exercise program.

Non-Hodgkin's lymphoma are neoplasms derived from T cells and B cells and their precursors in the lymphoid system with higher susceptibility in involvement of extra-nodal sites. Predominant ureteric involvement is an unusual presentation. We present a case of diffuse large B-cell lymphoma with secondary involvement of ureter who had symptoms of urinary tract infection in absence of positive urine culture, non-responsive to broad spectrum antibiotics and masquerading pyogenic infection leading to pyelonephritis with ureteritis. Radiological examination revealed mass like soft tissue thickening of ureter extending from renal pelvis throughout the length of ureter. FNAC as well as biopsy from the periureteric thickening revealed lymphomatous involvement of ureter. The following case report provides insight on differentials and varied symptoms of lymphomatous involvement of ureter., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

The purpose of this survey was to assess the prevalence of genital and urinary tract symptoms among Japanese women with declining estrogen levels. A health-related questionnaire survey was conducted among women in their 40s or older to inquire about their genital, intercourse-related, and urinary symptoms and concern over their symptoms. Of the consecutive 10,000 respondents recruited, 4488 (44.9%) reported having symptoms: 3546 (79.0%) expressed concern over their symptoms. Furthermore, 2173 women (21.7%) had incontinence, 1999 (20.0%) had urinary frequency, 1648 (16.5%) had itching, and 1560 (15.6%) reported odor; these were followed by looseness, dryness, and burning. Of the 2518 (25.2%) sexually active women, 518 (20.6%) reported having dyspareunia and more reported having urinary symptoms than genital symptoms. Of the symptomatic respondents, 33.1% had genital symptoms alone, 28.4% had urinary symptoms alone, and 38.4% had both. More sexually active women had genital symptoms, while more sexually inactive women had urinary symptoms. Genital and urinary symptoms were shown to be common and coexist in a considerable proportion of the respondents, highlighting the pathology of genitourinary syndrome of menopause. Again, dyspareunia and lower urinary tract symptoms were shown to be quite common among postmenopausal women. [ABSTRACT FROM AUTHOR]

Objective: To determine the incidence of Lower Urinary Tract Symptoms (LUTS) among patients visiting the gynaecology Outpatients Department (OPD) of Shalamar Hospital. Material & Methods: A cross sectional study was performed and 300 patients were recruited. Patients aged 40 to 60 years, visiting the Gynaecology OPD at Shalamar Hospital, Lahore were enrolled from 1st February 2018 to 30th September 2018. The participants were categorized in to two sets: Premenopausal (n=187) and Post-Menopausal (n=113). They were asked to fill the international Consultation and Incontinence Questionnaire-Short Form (ICIQ-UI Short Form). Results: Increased urinary frequency was found to be the most commonly reported symptoms (48%).Stress incontinence and urge incontinence were reported by 58% subjects amongst postmenopausal category and 42% in the premenopausal category. Presence of LUTS was observed to be directly proportional with age. Conclusion: A high incidence of LUTS was observed among patients visiting gynaecology OPD of Shalamar Hospital, Lahore. Risk factors of LUTS and incontinence, like obesity and multiparity were frequency reported. Further studies are required to understand the magnitude of this problem in general population of Pakistan.

Transperineal prostate microwave thermoablation (TPMT) has been established as a safe means of treating benign prostatic hyperplasia (BPH); however, its effectiveness in addressing BPH-related lower urinary tract symptoms (LUTS) remains unexplored. This case study aims to evaluate the efficacy of TPMT in LUTS attributed to BPH. An 84-year-old man with LUTS due to BPH-induced bladder outlet obstruction, unresponsive to previous medical treatments, and failed prostate artery embolization, underwent TPMT. Three coaxial needles were positioned at the midline, right, and left sides of the hypertrophic transitional zone of the prostate. Microwave energy, with parameters determined using liver data and targeted ablation area, was applied at 2,450 MHz in continuous mode. The tissue temperature was monitored using bilateral thermocouple sensors. The patient exhibited no changes in defecation rhythm, abdominal discomfort, or anorectal pain. Temporary postoperative hematuria was promptly resolved through saline irrigation within 6 hours, and hematological evaluations showed normal results. Significant clinical improvements were observed (e.g., prostate volume, prostate-specific antigen levels) accompanied by an increase in peak flow rate. Thus, TPMT appears to be a promising intervention for bladder outlet stenosis and LUTS induced by BPH.

Working conditions that impair sufficient water intake have been associated with kidney problems such as kidney stones, urinary symptoms and chronic kidney disease (CKD). Higher prevalence of these morbidities was linked to occupations that do not facilitate worker access to drinking water and toilets, as well as people who perform activities in a hot environment. In this mini-review, we aim to describe and interpret available evidence in the areas of occupation, hydration and kidney health. This review explores examples of documented kidney health problems affecting professions ranging from astronauts and teachers in developed countries to rural workers in low-income settings living in water-restricted or hot environments. [ABSTRACT FROM AUTHOR]

Aim and Background: A separate chapter of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) distributed in 2013 has been allocated to Obsessive-compulsive disorder (OCD). It is defined as unwanted, repeated, and obtrusive beliefs, images, thoughts, and anxiety or repetitive mental behaviors and actions. Clinical evaluation of patients with OCD has revealed their complaints regarding urology symptoms. Therefore, it has been theorized that OCD is correlated with urology symptoms such as urination frequency. Methods and Materials: This study was conducted on 100 patients with OCD referred to the OCD Clinic affiliated to Isfahan University of Medical Sciences, Iran, in 12013. In order to determine the severity of the disorder, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used. The Hospital Anxiety and Depression Scale (HADS) was used for the assessment of the degree of anxiety and depression. In addition, the Lower Urinary Tract Symptoms-Questionnaire (LUTS-Q) and a 25-item checklist were used for the evaluation of urinary symptoms. The data were analyzed using Student's t-distribution, one way ANOVA, chi-square test, and the Pearson coefficient in SPSS. Findings: The average of urinary symptoms score was 11 ± 6.8 and ranged from 0 to 27. There was a direct correlation between urinary symptoms and OCD symptoms (P = 0.022). Moreover, there was direct correlation between anxiety and depression score and urinary symptoms (P < 0.001). On the other hand, there was a direct correlation between the Y-BOCS score and anxiety and depression score (P = 0.049). Conclusions: In more than half of the participants, OCD was accompanied with urinary symptoms. In addition, 74% of patients had anxiety and depression disorder. Thus, these disorders require attention in the evaluation and treatment of patients with OCD and must be considered in their treatment interventions.

Introduction: Endoscopic enucleation of the prostate (EEP) has been recognized as a viable treatment modality for men with benign prostatic hyperplasia (BPH). The aim of our study was to compare the efficacy and functional outcomes of three different techniques of EEP, including monopolar enucleation (MEP), holmium laser enucleation of the prostate (HoLEP), and thulium laser enucleation of the prostate (ThuLEP). Methods: The study consisted of a retrospective comparison of pre- and postoperative parameters in men undergoing three types of EEP: MEP, HoLEP, and ThuLEP. Functional parameters were evaluated before and 6 months after surgery, which included the International Prostate Symptom Score, maximum flow rate, postvoid residual volume, prostate volume, and sodium levels of all patients. Results: A total of 551 men with the mean age of 67.1 years were included in the study. Of these, MEP was performed on 95 patients, HoLEP was performed on 254 patients, and ThuLEP on 202 patients. The mean mass of morcellated tissue obtained during the three techniques did not differ significantly (p > 0.05). Mean procedure times of ThuLEP and HoLEP were shorter than MEP demonstrating 72, 76, and 86 minutes, respectively (p < 0.01). The mean catheterization time following laser EEPs was shorter than MEP as shown by 1.3, 1.3, and 3.8 days, respectively (p < 0.01). Hospital stay times of HoLEP and ThuLEP were shorter than MEP demonstrated by 3.3, 3.4, and 6.9 days, respectively (p < 0.01). Patients after MEP had significant decrease in postoperative hemoglobin and sodium levels. All the groups showed statistically significant improvement in the aforementioned parameters following treatment. Conclusions: Both techniques of laser enucleation proved to be efficacious in the management of BPH. MEP of the prostate seems to be a highly promising addition to the list of enucleation techniques and was determined to be an effective and acceptable procedure, despite a higher complication rate. [ABSTRACT FROM AUTHOR]

Purpose We investigated changes in the levels of adenosine triphosphate and nitric oxide in the urothelium of men with detrusor underactivity and benign prostatic hyperplasia. Materials and Methods We prospectively enrolled in study 30 men who planned to undergo surgical treatment for benign prostatic hyperplasia. The 15 patients with a bladder contractility index less than 100 were assigned to the detrusor underactivity group while the 15 with a bladder contractility index more than 100 were assigned to the no detrusor underactivity group. Bladder mucosal specimens were collected at surgical prostate resection, and adenosine triphosphate and endothelial nitric oxide synthase were analyzed in these specimens. The levels of adenosine triphosphate and endothelial nitric oxide synthase were compared between the 2 groups. The correlation of urodynamic parameters with adenosine triphosphate and endothelial nitric oxide synthase was assessed in all patients. Results Mean ± SEM endothelial nitric oxide synthase did not significantly differ between the detrusor underactivity and no underactivity groups (3.393 ± 0.969 vs 1.941 ± 0.377 IU/ml, p = 0.247). However, the mean level of adenosine triphosphate in the detrusor underactivity group was significantly lower than in the no detrusor underactivity group (1.289 ± 0.320 vs 9.262 ± 3.285 pmol, p = 0.011). In addition, in all patients adenosine triphosphate positively correlated with the bladder contractility index (r = 0.478, p = 0.018) and with detrusor pressure on maximal flow (r = 0.411, p = 0.046). Conclusions Adenosine triphosphate was significantly decreased in the urothelium in men with detrusor underactivity and benign prostatic hyperplasia, reflecting the change in detrusor function. [ABSTRACT FROM AUTHOR]

Introduction HTLV-I associated tropical spastic paraparesis (TSP) and HTLV-I associated myelopathy (HAM) is an endemic disease in Caribbean Island. Bladder-sphincter dysfunctions are almost present. The objectives of the study are to describe clinic and urodynamic characteristics of voiding disorders in Martiniquan population, evaluate if there is a relationship between motor and urinary handicap, and evaluate prognosis factors of urologic complications. Methods Retrospective study of 60 patients suffering from HAM/TSP. Clinical, urodynamic datas, scale of urinary and motor handicap (Urinary Symptom Profile [USP] questionnaire and Osame Score) were collected. Results Storage symptoms were the most frequent (75%) whatever type of detrusor activity. Detrusor overactivity was the most frequent disorder (68.3%). Bladder compliance was normal in half percent of the cases. Urethral activity was increased in 47% of the cases. Detrusor sphincter dysynergia was found in 78% of the cases, post-void residual in 58% of cases. Sixty five percent of the patients present at least one urologic complication (morphologic and/or infectious) but there was no correlation with motor enablement ( P = 0.3097), neither urodynamic study ( P = 0.432 for detrusor overactivity, P = 0.107 for detrusor underactivity, P = 0.058 for high urethral activity, P = 0.893 for detrusor sphincter dysynergia, P = 0.850 for post-void residual volume), neither with evolution duration of HAM/TSP ( P = 0.348). USP score was not in correlation with Osame score ( P = 0.07). Conclusion Urologic symptoms are not always in relationship with urodynamic study: a systematic urodynamic study is necessary to evaluate HAM/TSP neurogenic bladder. No clinic or urodynamic criterias are predictive of urologic complications. These patients need a close follow up. Neurourol. Urodynam. 36:449-452, 2017. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to examine the efficacy and safety of intravesical Bacillus Calmette-Guerin (BCG) in the treatment of refractory interstitial cystitis (IC). Materials and Methods: Thirteen patients with refractory IC were enrolled in the study. They were scheduled to receive 6 weekly courses of treatment with intravesical BCG. Variables including the frequency, nocturia, urgency, pelvic pain, dyspareunia, dysuria, IC symptom index, IC problem index, and average voided volume were assessed every 6 months after the BCG therapy. Results: Thirteen patients received the complete course of intravesical BCG therapy. Twenty-four months after the treatment a mean improvement of 51.9% was seen in frequency (P = .001), 43.2% in nocturia (P = .002), 28.7% in urgency (P = .004), 43.1% in pelvic pain (P = .001), 58.3% in dyspareunia (P = .003), 6.5% in dysuria (P = .16), 57.7% in the O’Leary-Sant IC symptom index (P = .001), and 61.8% in the O’Leary-Sant IC problem index (P = .001) scores. A significant improvement was seen in the mean average voided volume at the 24th follow-up month (89.5%; P = .001). Conclusion: Intravesical BCG is a relatively effective treatment in patients with refractory IC. Its efficacy seems to be modest and lasts for at least 24 months in majority of the patients. It is also safe and well tolerated.

Purpose: Ureteral stents are frequently associated with side effects. Most patients suffer from storage lower urinary tract symptoms (LUTS). Storage LUTS are commonly attributed to the irritation of the trigone, smooth muscle spasm or a combination of factors. The relationship between microbial ureteral stent colonization (MUSC) and de novo or worsening storage LUTS has not been investigated yet. Methods: Five hundred ninety-one polyurethane ureteral stents from 275 male and 153 female patients were prospectively evaluated. The removed stents were sonicated to dislodge adherent microorganisms. Urine flow cytometry was performed to detect pyuria. A standardized urinary symptom questionnaire was given to all patients. Results: Thirty-five per cent of male and 28% of female cases showed de novo or worsened storage LUTS. MUSC was more common in patients with storage LUTS compared to patients without storage LUTS (men: 26 vs. 13%, respectively, P < 0.05; women: 63 vs. 48%, respectively, P = 0.13). Pyuria was significantly more common in patients with storage LUTS compared to patients without storage LUTS (men: 55 vs. 40%, respectively, P < 0.05; women: 70 vs. 45%, respectively, P < 0.05). No significant correlation was observed between the detected genera of microorganisms and storage LUTS. Conclusions: Our data show a significant association between MUSC- and stent-related de novo experienced or worsened storage LUTS in men. The incidence of MUSC is most common in both female and male patients with storage LUTS and accompanying pyuria. In these patients, a combination of antibiotics and anti-inflammatory drugs may be regarded as treatment option. [ABSTRACT FROM AUTHOR]

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

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

Objective:Abdominal obesity and type 2 diabetes mellitus are associated with erectile and urinary dysfunction in men. The extent to which sexual function and lower urinary tract symptoms (LUTSs) are improved by weight loss remains unclear.Subjects:We compared the effects of 8 weeks of a low-calorie diet using meal replacements (Kicstart) on insulin sensitivity, plasma testosterone levels, erectile function (measured by the five-item version of the International Index of Erectile Function, IIEF-5), sexual desire (measured by the Sexual Desire Inventory, SDI) and LUTS (measured by the International Prostate Symptom Score, IPSS), in abdominally obese (body mass index 30 kg m−2, waist circumference (WC) 102 cm) men (mean age 49.7 years) with uncomplicated diet or oral hypoglycemic-treated type 2 diabetes mellitus (n=19) or without type 2 diabetes mellitus (n=25), with a control group of nondiabetic men (n=26) with similar body mass index and WC.Results:Weight loss of ∼10% was significantly associated with increased insulin sensitivity, plasma testosterone levels, IIEF-5 and SDI scores, as well as reduced WC and IPSS scores, in diabetic as well as nondiabetic men. The degree of weight loss was significantly associated with improvements in plasma testosterone levels (r=−0.34), erectile function (r=−0.26) and LUTS (r=0.65). Reduction in LUTS was significantly associated with increased plasma testosterone (r=−0.35), erectile function (r=−0.42) and sexual desire (r=−0.40).Conclusions:Diet-induced weight loss significantly and rapidly improves sexual function, and reduces LUTS, in obese middle-aged men with or without diabetes. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To identify self-reported urogynaecological dysfunctions in women treated by radical hysterectomy, and predict risk factors. Methods: A survey using questionnaires. Questionnaires were mailed to 396 patients. Results: Symptoms of urinary incontinence and urinary retention were reported by more than one-third, respectively. One-third of the patients reported cystitis and dysuria. However, 78% of the women did not consider their symptoms as a problem. Analyses identified body mass index, at least one delivery, pre-operative urinary incontinence, and pulmonary disease as predictors for development of post-operative urinary incontinence. Predictive variables for urinary retention symptoms were age, cystitis and/or dysuria, previous rupture of the anal sphincter, fetal weight at delivery ≥4000g, sensation of vaginal dryness, and pre-operative urinary retention symptoms. Considering post-operative cystitis and/or dysuria, fetal weight ≥4000g, sensation of vaginal dryness, cystitis and/or dysuria before the operation, and physical activity were predictive variables. Conclusions: Patients can be informed and advised about possible urinary tract symptoms. Special attention in the pre- and post-operative period can be paid to a subgroup of patients at high risk of later urogynaecological problems. [Copyright &y& Elsevier]

Many urologists have a high regard for the usefulness of transurethral microwave therapy (TUMT) in treating patients with lower urinary tract symptoms caused by benign prostatic hyperplasia. This therapy has been examined clinically in many centers throughout the world. The rationale for its effect on symptoms is unlike many of the other so-called minimally invasive treatment modalities. The improvement in symptoms and voiding function is greater with transurethral microwave thermotherapy than with drug therapy, and the associated morbidity is low. It also offers greater versatility than drug therapy, allowing patients with severe baseline symptoms and small prostates to be treated successfully. In addition, there has been an evolution in the technology of TUMT from low-energy to high-energy application indicating that this technique has a future in the treatment of lower urinary tract symptoms. [Copyright &y& Elsevier]

To estimate the effect of nocturia on quality of life (QoL) and to assess the associated effects of sleep problems. Nocturia may lead to sleep insufficiency and consequently to a decrease in mental and physical health. Patients who consult a doctor for nocturia should thus be treated adequately. In addition, it is worthwhile for doctors to routinely check if patients who contact them for sleep problems also have nocturia. [ABSTRACT FROM AUTHOR]

Background: Constipation and lower urinary tract symptoms (LUTS) very frequently occur in the elderly, and several reports have suggested that dysfunction in either one of these systems may affect the other. Most studies correlating rectal and bladder dysfunction, however, have been carried out in children or young women. Objective: To examine the effect of alleviating constipation on LUTS in the elderly. Methods: Fifty-two patients aged 65–89 (mean 72 ± 13) years with chronic constipation and LUTS participated in this prospective cohort study. Before treatment of constipation was initiated and on their monthly visits, patients completed a questionnaire regarding their constipation pattern, urinary symptoms, sexual function and mood, and underwent urinalysis. Urinary tract anatomy and residual urine were evaluated by abdominal ultrasound at the commencement and completion of the study. Patients were followed up for 4 months. Results: Treatment of constipation increased the number of weekly defecations from 1.5 ± 0.9 to 4.7 ± 1.2 (p < 0.001). Patients spent less time on the toilet (25 ± 2.1 versus 63 ± 1.9 min, p < 0.0001). Fewer patients reported urgency (16 versus 34, p < 0.001), frequency (25 versus 47, p < 0.001) and burning sensation during urination (6 versus 17, p < 0.05). There was improvement in the scoring of urgency, frequency and burning sensation (from a baseline of 52 to 126, 131 and 95, respectively, p < 0.001). Urinary stream disturbances improved in 32 of the 52 patients (p < 0.001). Residual urine volume decreased from 85 ± 39.5 to 30 ± 22.56 ml (p < 0.001). There was also a significant decrease in the number of patients with bacteriurial events (5 versus 17, p < 0.001), and an improvement in sexual activity and mood (p < 0.05). Conclusions: Our data demonstrated that medical relief of constipation significantly improves LUTS in the elderly which, in turn, improves the patient’s mood, sexual activity and quality of life.Copyright © 2001 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Thulium laser vapo-enucleation of the prostate is the latest addition to the arsenal of minimally invasive therapies available for the surgical treatment of lower urinary tract symptoms secondary to benign prostate hyperplasia. The potential advantages include smoother vaporisation, a clearer visual field and the option of both continuous-wave and pulsed modes, which also potentiate the haemostatic properties of this endoscopic method. Short-term results show that it yields significant improvements in both subjective and objective outcomes, with a strong safety profile. Large-scale randomised studies with a longer follow-up are warranted to determine the durability of this laser procedure. [ABSTRACT FROM AUTHOR]

A self-administered questionnaire assessing female lower urinary tract symptoms and their impact on quality of life is described and validated, on 56 females in six participating departments. The patients answered two identical questionnaires on separate occasions before treatment. Test-retest reliability of the questionnaire, correlation between the symptoms and their troublesomeness, and the reproducibility of this correlation were assessed. The percentage of mistakes in answers to each of the questions varied from 1.8% to 49.1%, mainly owing to missing answers in the item groups: appliances, sexual function and social activities. Test-retest showed a repeat frequency of 50.0%-91.0% for symptoms and 44.6%-82.1% for trouble. A highly significant positive correlation was found between symptoms and trouble, which was most pronounced for questions concerning pain and incontinence. This correlation was consistent within time. The primary validation of this questionnaire is good. Its relevance as a basis for medical priority and clinical decision making remains to be investigated. [ABSTRACT FROM AUTHOR]

Background: An advisory board concluded that a new, comprehensive overactive bladder (OAB) patient-reported outcome (PRO) measure should be developed in accordance with regulatory guidelines. The OAB-Bladder Assessment Tool (OAB-BAT) was developed with qualitative input from OAB patients and experts to measure symptoms, bother, impacts, and satisfaction with treatment., Objective: Psychometric evaluation of the OAB-BAT assessing PRO OAB symptoms, bother, and impacts during a 7-d recall period., Design, Setting, and Participants: Psychometric testing was conducted for a 28-d observational study of 170 OAB patients. Eligibility criteria included clinician-confirmed OAB diagnosis with at least eight micturitions per day., Outcome Measurements and Statistical Analysis: Assessments included the OAB-BAT, a 7-d bladder diary, and co-validating OAB PROs. Analysis included classical and modern test theories. A scoring algorithm was developed and psychometric properties were assessed., Results and Limitations: The majority of participants were women (72.4%) with moderate OAB symptom severity (53.5%). More than one-third of participants (34.1%) were incontinent. Responses were well balanced across bother and impact items, while symptom frequency items showed sparse responses. Analysis supported an eight-item unidimensional model based on bother and impacts. No items performed differently by gender or continence status. The OAB-BAT showed internal consistency (ω=0.918), retest reliability (two-way random intraclass correlation coefficient=0.81), and convergent validity with the OAB-q (r>0.4). Known groups showed the expected trend. Comparisons between OAB-BAT scores and components of the bladder diary showed a moderate effect size (r>0.4)., Conclusions: The eight-item OAB-BAT with 7-d recall is valid and reliable as an OAB PRO measure. Structural modeling, balanced with content validity considerations, produced robust scores. The OAB-BAT is a useful addition to the clinical assessment of patients, designed to complement the use of bladder diaries for monitoring OAB outcomes, in clinical trial and clinical practice environments. Future studies will need to assess the treatment satisfaction items in a larger sample of patients receiving OAB treatment., Patient Summary: We tested a questionnaire designed to assess overactive bladder (OAB) symptoms, bother, satisfaction, and impacts by asking patients to complete it on a weekly basis. We found that the questionnaire accurately captures the symptoms and impacts that are most important to patients with OAB. We conclude that the questionnaire could be a useful instrument and, after further assessment in clinical practice and research, a possible alternative to a bladder diary in measuring OAB outcomes., (Copyright © 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Objective: To investigate the effect of Linshu Decoction (LSD) combined with levofloxacin in the treatment of lower urinary tract symptoms in patients with type ⅢA prostatitis., Methods: We randomly divided 124 type ⅢA prostatitis patients with lower urinary tract symptoms into an experimental and a control group, the former treated orally with LSD (1 dose bid) combined with levofloxacin tablets (0.1 g bid), and the latter with levofloxacin tablets only (0.1g bid). Before and after 4 weeks of medication, we obtained the NIH-CPSI, Traditional Chinese Medicine symptoms (TCM) scores, white blood cell (WBC) count in EPS and the results of uroflowmetry from the patients and compared them between the two groups., Results: Finally 115 of the patients were included in this study. After 4 weeks of treatment, the patients of the experimental group, compared with the controls, showed significantly decreased NIH-CPSI (14.57 ± 3.87 vs 20.12 ± 3.45, P < 0.05), TCM scores (6.35 ± 1.27 vs 10.72 ± 1.72, P < 0.05) and WBC count in EPS (［7.35 ± 4.52］ vs ［9.87 ± 5.87］ n/HP, P < 0.05). In comparison with baseline, the maximum urinary flow rate (Qmax) and average urinary flow rate (Qave) were increased in both of the two groups after medication, with statistically significant difference only in the experimental group (P < 0.05)., Conclusions: Linshu Decoction combined with levofloxacin is more effective than levofloxacin alone in the treatment of lower urinary tract symptoms in patients with type ⅢA prostatitis.

Endometrial cancer is the most common gynecologic malignancy. The mainstay of treatment for endometrial cancer is total hysterectomy with bilateral salpingo-oophorectomy. Radiation and chemotherapy accompanied with progestins can also play a significant role in treatment. Lower urinary tract symptoms (LUTS) following therapy for endometrial cancer are an extremely difficult and challenging condition that deteriorates patients' quality of life. Current literature remains rather scarce regarding LUTS after therapy for endometrial cancer. This review aimed to investigate the incidence of LUTS in endometrial cancer treatment., (Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background: No published study, to our knowledge, has systematically reviewed the prevalence estimates of lower urinary tract symptoms (LUTSs) and LUTS types in the general multiple sclerosis (MS) population. Therefore, a systematic review and a meta-analysis were conducted to determine the totality of literature investigating the prevalence of LUTSs and LUTS types in the general MS population according to International Continence Society definitions., Methods: Various electronic databases were searched between January 4, 2018, and February 12, 2018. This review included observational studies involving adults (18 years or older) with a confirmed diagnosis of MS recruited from the general MS population using self-report and/or objective outcome measures for LUTSs., Results: Twelve studies were included in the meta-analysis. The results showed that LUTSs were prevalent in people with MS, with a pooled prevalence of 68.41% using self-report and 63.95% using the objective measure of urodynamics. When considering LUTS types, urinary frequency was the predominant symptom, with a pooled prevalence estimate of 73.45%, followed by urgency assessed using self-report measures at 63.87%. Detrusor overactivity was found to be the most prevalent urodynamic symptom, with a pooled prevalence estimate of 42.9%, followed by detrusor sphincter dyssynergia at 35.44%., Conclusions: This systematic review revealed that LUTSs are highly prevalent in MS. There is a need for improvement in the conduct and reporting of prevalence studies of LUTSs in MS and for the use of validated self-report outcome measures to enable pooling of data in the future., Competing Interests: Dr Coote has disclosed a relationship with Novartis (fees for non-CME/CE services received directly from a commercial interest [contractor to deliver telerehabilitation as part of patient support program]). The other authors declare no conflicts of interest., (© 2020 Consortium of Multiple Sclerosis Centers.)

Objectives: To investigate whether caffeine intake is associated with urinary incontinence (UI) among Japanese adults., Methods: A total of 683 men and 298 women aged 40 to 75 years were recruited from the community in middle and southern Japan. A validated food frequency questionnaire was administered face-to-face to obtain information on dietary intake and habitual beverage consumption. Urinary incontinence status was ascertained using the International Consultation on Incontinence Questionnaire-Short Form., Results: Mean daily caffeine intake was found to be similar between incontinent subjects (men 120 mg, women 94 mg) and others without the condition (men 106 mg, women 103 mg), p=0.33 for men and p=0.44 for women. The slight increases in risk of UI at the highest level of caffeine intake were not significant after adjusting for confounding factors. The adjusted odds ratios (95% confidence interval) were 1.36 (0.65 to 2.88) and 1.12 (0.57 to 2.22) for men and women, respectively., Conclusions: No association was evident between caffeine intake and UI in middle-aged and older Japanese adults. Further studies are required to confirm the effect of caffeine in the prevention of UI.