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British Medical Journal Feb 1952
Topics: Humans; Urination; Urination Disorders
PubMed: 14896155
DOI: 10.1136/bmj.1.4754.372 -
World Journal of Urology Dec 2009Since urgency is key to the overactive bladder syndrome, we have reviewed the mechanisms underlying how bladder filling and urgency are sensed, what causes urgency and... (Review)
Review
INTRODUCTION
Since urgency is key to the overactive bladder syndrome, we have reviewed the mechanisms underlying how bladder filling and urgency are sensed, what causes urgency and how this relates to medical therapy.
MATERIALS AND METHODS
Review of published literature.
RESULTS
As urgency can only be assessed in cognitively intact humans, mechanistic studies of urgency often rely on proxy or surrogate parameters, such as detrusor overactivity, but these may not necessarily be reliable. There is an increasing evidence base to suggest that the sensation of ‘urgency’ differs from the normal physiological urge to void upon bladder filling. While the relative roles of alterations in afferent processes, central nervous processing, efferent mechanisms and in intrinsic bladder smooth muscle function remain unclear, and not necessarily mutually exclusive, several lines of evidence support an important role for the latter.
CONCLUSIONS
A better understanding of urgency and its causes may help to develop more effective treatments for voiding dysfunction.
Topics: Humans; Muscarinic Antagonists; Urinary Bladder; Urinary Bladder, Overactive; Urination Disorders
PubMed: 19588154
DOI: 10.1007/s00345-009-0446-5 -
British Medical Journal Feb 1956
Topics: Diabetes Complications; Diabetes Mellitus; Humans; Urination Disorders; Urologic Diseases
PubMed: 13284347
DOI: 10.1136/bmj.1.4964.433 -
Postgraduate Medical Journal Sep 2000
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Medicine; Middle Aged; Outpatient Clinics, Hospital; Specialization; Urination Disorders; Urology
PubMed: 11032533
DOI: 10.1136/pmj.76.899.596a -
Pediatric Nephrology (Berlin, Germany) Mar 2018In Dysfunctional voiding, failure of the external sphincter-pelvic floor complex to relax during micturition results in bladder outflow obstruction with a spectrum of... (Review)
Review
In Dysfunctional voiding, failure of the external sphincter-pelvic floor complex to relax during micturition results in bladder outflow obstruction with a spectrum of presentation from more benign lower urinary tract dysfunction including recurrent urinary tract infections, to significant upper tract pathology and end-stage renal failure. There is no underlying neurological or anatomical cause and the condition is postulated to be a largely learnt behavior. Diagnosis relies on non-invasive urodynamics and in particular uroflowmetry, plus or minus EMG, which is also used in biofeedback, the mainstay of treatment. The etiology, presentation, diagnosis, and treatment with particular emphasis on non-invasive urodynamics are covered.
Topics: Adrenergic alpha-Antagonists; Biofeedback, Psychology; Botulinum Toxins, Type A; Child; Humans; Transcutaneous Electric Nerve Stimulation; Urinary Bladder; Urinary Catheterization; Urination; Urination Disorders; Urodynamics
PubMed: 28567611
DOI: 10.1007/s00467-017-3679-3 -
Annals of Physical and Rehabilitation... 2014
Topics: Cognitive Behavioral Therapy; Female; Humans; Urinary Bladder, Overactive; Urination Disorders
PubMed: 24954497
DOI: 10.1016/j.rehab.2014.05.001 -
Urologia Internationalis 2010Botulinum neurotoxin (BoNT) is probably the most potent biological toxin that can affect humans. Since its discovery by Justinus Kerner, BoNT has seen use in a wide... (Review)
Review
INTRODUCTION
Botulinum neurotoxin (BoNT) is probably the most potent biological toxin that can affect humans. Since its discovery by Justinus Kerner, BoNT has seen use in a wide range of cosmetic and non-cosmetic conditions such as cervical dystonia, cerebral palsy, migraines and hyperhidrosis. We tried to trace its history from its inception to its recent urological applications.
MATERIALS AND METHODS
Historical articles about botulinum toxin were reviewed and a Medline search was performed for its urological utility. We hereby present a brief review of historical aspects of BoNT and its applications in urology.
RESULTS
In 1793, the first known outbreak of botulism occurred due to 'spoiled' sausage in Wildebad, Germany. The German physician and poet Justinus Kerner published the first accurate description of the clinical symptoms of botulism (sausage poison). He was also the first to mention its potential therapeutic applications. In urology, BoNT has been used in bladder and urethral lesions with varying degree of success. Recently, BoNT applications were explained for prostatic disorders. BoNT applications in urology are in the treatment of detrusor external sphincter dyssynergia, detrusor overactivity, detrusor underactivity, spastic conditions of the urethral sphincter, chronic prostate pain, interstitial cystitis, non-fibrotic bladder outflow obstruction (including benign prostatic hyperplasia) and acute urinary retention in women.
CONCLUSION
Justinus Kerner is the godfather of botulism research. The role of BoNT in urology has evolved exponentially and it is widely used as an adjuvant in voiding dysfunction. In the future, its utility will broaden and guide the urologist in managing various urological disorders.
Topics: Botulinum Toxins; Botulism; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; History, Ancient; Humans; Treatment Outcome; Urethra; Urinary Bladder; Urinary Bladder, Overactive; Urinary Retention; Urination Disorders; Urology
PubMed: 20664247
DOI: 10.1159/000317517 -
European Review For Medical and... Apr 2016The neurogenic dysfunctions of the detrusor and the sphincter are caused by either a known congenital defect of the nervous system or by acquired damage to the nervous... (Review)
Review
The neurogenic dysfunctions of the detrusor and the sphincter are caused by either a known congenital defect of the nervous system or by acquired damage to the nervous system. In patients with idiopathic bladder dysfunctions neurological examinations fail to reveal any pathology in the nervous system. The treatment strategy for the patient with detrusor-sphincter dysfunction should be based on a comprehensive functional and morphological evaluation. Clean Intermittent Catheterization is mandatory if voiding is ineffective. Reduced bladder capacity related to detrusor overactivity and decreased bladder walls compliance is successfully managed conservatively with oral anticholinergics. Conservative treatment prevents complications in the majority of patients. However, despite proper conservative treatment, some patients still develop complications. We propose our own practical classification of complications characteristic for the bladder and sphincter dysfunctions: 1. Urinary tract infections; 2. Urolithiasis; 3. Anatomic changes in the lower urinary tract; 4. Anatomic changes in the upper urinary tract; 5. Functional disturbances of kidneys parenchyma; 6. Urinary incontinence. Proposed practical classification of complications of bladder and sphincter dysfunctions is clear and simple. This classification can be used both in children with neurogenic and non-neurogenic dysfunctions. It is helpful in planning follow-up procedures and evaluation of treatment results.
Topics: Child; Humans; Male; Treatment Outcome; Urinary Bladder, Neurogenic; Urination Disorders
PubMed: 27097940
DOI: No ID Found -
The Journal of Urology Apr 2021Benign prostatic hyperplasia is one of the most common conditions seen by a general urologist. Validated questionnaires provide insight into patient symptoms, however...
PURPOSE
Benign prostatic hyperplasia is one of the most common conditions seen by a general urologist. Validated questionnaires provide insight into patient symptoms, however office based uroflow devices are limited by the variability of voiding behavior. Using a home uroflow device, we assessed individual voiding variability, temporal distribution of voiding parameters and the impact of age on voiding.
MATERIALS AND METHODS
Between April 2019 and June 2020, 19,824 unique voiding profiles were captured using the Stream Dx Uroflowmeter and retrospectively analyzed. Age and number of voids were summarized by mean±standard deviation. We used mixed effects models to compare average values and intrapatient variability of voiding parameters to time of day and age. The coefficient of variation was used to assess intrapatient variability.
RESULTS
A total of 637 patients were identified with 625 meeting inclusion criteria, producing 19,824 voids. Mean age was 67 (±10.2) years old, and each patient provided on average 5 (±3.3) voids a day through 7 days. Average intrapatient voiding parameters showed notable variability, where the coefficient of variation for maximum flow was 27.6% (95% CI 26.6-28.6). Early morning voids were associated with higher volume and lower number of voids. As age progressed, voiding profiles worsened in a linear fashion. Afternoon and evening voids were associated with reduced intrapatient variability relative to early morning voids.
CONCLUSIONS
Assessment of 19,824 uroflows using an accurate and precise home uroflow device demonstrates that an individual's voiding parameters vary greatly from day to day, throughout the day, and worsen with age. Multiple measurements performed at home provides a more realistic assessment of true voiding behavior by capturing individual voiding variability and can help urologists make better decisions in patient care.
Topics: Aged; Humans; Male; Prostatic Hyperplasia; Retrospective Studies; Self Care; Urination Disorders; Urodynamics
PubMed: 33259269
DOI: 10.1097/JU.0000000000001504 -
Texas Heart Institute Journal Apr 2015
Topics: Clinical Competence; Humans; Medical History Taking; Medical Records; Urination Disorders
PubMed: 25873817
DOI: 10.14503/THIJ-14-4910