DOCSLIB.ORG

Underactive Bladder; Review of Progress and Impact from the International CURE-UAB Initiative

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Underactive Bladder; Review of Progress and Impact from the International CURE-UAB Initiative INTERNATIONAL NEUROUROLOGY JOURNAL INTERNATIONAL INJ pISSN 2093-4777 eISSN 2093-6931 Review Article Int Neurourol J 2020;24(1):3-11 NEU INTERNATIONAL RO UROLOGY JOURNAL https://doi.org/10.5213/inj.2040010.005 pISSN 2093-4777 · eISSN 2093-6931 Volume 19 | Number 2 June 2015 Volume pages 131-210 Official Journal of Korean Continence Society / Korean Society of Urological Research / The Korean Children’s Continence and Enuresis Society / The Korean Association of Urogenital Tract Infection and Inflammation einj.org Mobile Web Underactive Bladder; Review of Progress and Impact From the International CURE-UAB Initiative Michael B. Chancellor, Sarah N. Bartolone, Laura E. Lamb, Elijah Ward, Bernadette M.M. Zwaans, Ananias Diokno Department of Urology, Beaumont Health System, Royal Oak, MI, USA There is a significant need for research and understanding of underactive bladder (UAB). The International Congress of Uro- logic Research and Education on Aging UnderActive Bladder (CURE-UAB) was organized by Doctors Michael Chancellor and Ananias Diokno in order to address these concerns. CURE-UAB was supported, in part, by the US National Institute of Aging and National Institute of Diabetes Digestive and Kidney. Since 2014, there have been 5 successful CURE-UAB con- gresses. They have brought together diverse stakeholders in the UAB field to identify areas of major scientific challenge and initiated a call to action among the medical community. In this review, we will highlight current and novel treatments under development for UAB and the progress and impact from the CURE-UAB initiative. Keywords: Underactive urinary bladder; Overactive urinary bladder; Urodynamics; Sarcopenia; Aging • Fund/Grant Support: Funding support was in parts sponsored by the NIA, NIDDK (R13AG047010) and the Aikens Center for Neurourology Research at Beaumont Health System (Royal Oak, MI, USA). • Conflict of Interest: Michael B Chancellor is one of the inventors of the autologous muscle-derived cell process and has received royalty pay- ments for the stem cell process and payments for consulting from Cook MyoSite. Except for that, no potential conflict of interest relevant to this article was reported. INTRODUCTION ued to improve, there are still no effective treatments for patients with this converse condition. UAB symptoms can include strain- Underactive bladder (UAB) is a complex constellation of symp- ing, incomplete bladder emptying, hesitancy, frequent urination, toms with few treatment options that can significantly diminish or leakage due to overflow incontinence. UAB can be caused by the quality-of-life (QoL) of those affected. Many UAB patients myogenic and neurogenic conditions, as well as aging and medi- feel helpless when they cannot void or are unable to adequately cation side effects. empty their bladder. UAB is prevalent, underdiagnosed, and The current management of UAB treatment for urinary re- represents an unmet medical need in elderly and other popula- tention is clean intermittent catheterization (CIC) or indwelling tions [1]. There are no outcome-validated effective therapeutics catheters to empty the bladder [3]. However, complications and for UAB and research on promising candidates has slowed due adverse effects can arise, especially during long-term use. Cur- to a lack of consensus and understanding regarding its diagno- rent research and treatment under consideration for UAB are sis and treatment [2]. described in detail in previous summary papers from Congress While treatments for overactive bladder (OAB) have contin- of Urologic Research and Education on Aging UnderActive Corresponding author: Michael B. Chancellor https://orcid.org/0000-0001-9480-8972 This is an Open Access article distributed under the terms of the Cre- Department of Urology, Beaumont Health System, 3811 West 13 Mile Road, Royal ative Commons Attribution Non-Commercial License (https://creative- Oak, MI 48073, USA commons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distri- E-mail: [email protected] bution, and reproduction in any medium, provided the original work is properly cited. Submitted: January 11, 2020 / Accepted after revision: January 29, 2020 Copyright © 2020 Korean Continence Society www.einj.org INJ Chancellor, et al. • CURE-UAB Bladder (CURE-UAB) [4,5]. to the international congresses. The UAB Foundation is a pa- tient advocacy group dedicated to encouraging, supporting, and THE INTERNATIONAL CURE-UAB monitoring action on the implementation of evidence-based ef- forts to promote global action on UAB. The UAB Foundation The purpose of the CURE-UAB conference series was to gather focuses on involving key stakeholders and representing UAB diverse stakeholders from multiple disciplines and backgrounds patients and their family and friends who care deeply about this together to address the unmet needs of UAB research and care. underrepresented disease. American Urological Association The first CURE-UAB, sponsored by the National Institute on (AUA), GUS, and SUNA are professional organizations for cli- Aging (NIA), National Institute of Diabetes and Digestive and nicians and researchers in the urology fields. Kidney Diseases (NIDDK), Aikens Center for Neurourology Research at Beaumont Health System, and The Underactive RETURN ON INVESTMENT OF THE Bladder Foundation was held in February 2014 in Washington, INTERNATIONAL COLLABORATIVE CURE-UAB DC. The second international meeting was December 2015 in GRANT Denver, CO; the third meeting was held in March 2017 in Washington, DC; the fourth meeting was held in November The United States National Institutes of Health (NIH) R13 2018 in Honolulu, HI; and the fifth meeting was held in De- grant mechanism supports high-quality scientific conferences cember 2019 in East Lansing, MI. to promote unmet medical needs, awareness, and engage public and private stakeholders. Starting in 2014, the NIA and NIDDK Public, Academic and Industry Stakeholders funded the R13 (R13AG047010) grant entitled CURE-UAB to CURE-UAB has received support from the following academic bring stakeholders together to educate and promote awareness and public stakeholders: The Aikens Center for Neurourology on the topic of UAB. We hereby report metric of the impact of Research, American Urological Association, Underactive Blad- this R13 on the medical and scientific community. der Foundation (https://www.underactivebladder.org), Geriatric A review of the impact on science, public awareness, and re- Urology Society (GUS), and Society of Urology Nursing Associ- search advances were completed by comparing publications ation (SUNA). Additional support and cosponsorships from and grants from the time-period prior to the 2014 R13 award public, academic and industry stakeholders significantly added and the 5 years since R13 funding. 18 70 60 700 16 No. of grants No. of grants No. of publications 60 50 No. of publications 600 14 publications of No. publications of No. UAB 50 OAB 500 12 40 10 40 400 30 8 30 300 No. of grants of No. 6 grants of No. 20 20 200 4 10 2 10 100 0 0 0 0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Year CURE-UAB A Year CURE-UAB B Fig. 1. The number of publications and grants on underactive bladder (UAB, A) and overactive bladder (OAB, B) over time (shown is 1998 to 2019). The CURE-UAB conference series started in 2014 and ended in 2019 (yellow box and shading). Publication count (UAB: orange line, right y-axis; OAB: blue line, right y-axis) is from PubMed.gov search of "underactive bladder" or “overactive blad- der” on 12/17/19. Prior to 1998, there are only 38 publications total for underactive bladder, with the earliest one from 1980. Grant count (UAB: blue bars, left y-axis; OAB: green bars, left y-axis) is from Grantome.com search of "underactive bladder” or “overactive bladder” on 12/17/19. There were no grants on UAB reported before 2007. CURE-UAB, Congress of Urologic Research and Educa- tion on Aging UnderActive Bladder. 4 www.einj.org Int Neurourol J March 31, 2020 Chancellor, et al. • CURE-UAB INJ Impact on Science with axonal degeneration demonstrated in unobstructed, aging To determine the impact on science, PubMed was searched for human bladders [3,5]. the terms OAB and UAB from 1998 to 2019 (Fig. 1). In the 5 The long-term effects of UAB may lead to significant compli- years prior to CURE-UAB (2009-2013), there were 2,391 OAB cations. Urine left behind in the bladder can lead to urinary tract and 35 UAB references in PubMed. In the 5 years after the first infections (UTIs) which, if become chronic, can lead to kidney CURE-UAB meeting (2015–2019), there were 2,698 OAB and damage and blood infections. In severe cases, urine left behind 204 UAB papers. OAB publications increased by 13% over the in the bladder can build up to a level that causes reflux up the 5-year period while UAB increased by 483%. ureters and may also cause kidney damage. Additionally, sedi- ments can accumulate in the bladder, forming bladder stones. Impact on Research UAB patients using catheters to empty their bladders also Prior to CURE-UAB, there was never a program announce- can face long-term medical difficulties, including inflammation ment specific for this disease. After the start of the CURE-UAB and discomfort, the potential for injury, and an increased risk series, the NIH issued UAB program announcements in 2015 of bacterial infection. For many individuals, the use of catheters (PA 15-049, 050, 051) and reissued in 2018 (PA-18-570, 571 can also be a cause for embarrassment and can negatively im- and 572: Underactive Bladder and Detrusor Activity in Aging). pact their work and home life. For older patients, it can have a We then further determined the impact of the CURE-UAB se- major impact on QoL.
Load more

Recommended publications
  • Underactive Bladder - an Underestimated Entity
    Journal of Mind and Medical Sciences Volume 7 Issue 1 Article 5 2020 Underactive bladder - an underestimated entity Spinu Arsenie Dan CAROL DAVILA UNIVERSITY OF MEDICINE AND PHARMACY, BUCHAREST, ROMANIA Ovidiu Gabriel Bratu CAROL DAVILA UNIVERSITY OF MEDICINE AND PHARMACY, BUCHAREST, ROMANIA Dragos Radu Marcu CAROL DAVILA UNIVERSITY OF MEDICINE AND PHARMACY, BUCHAREST, ROMANIA Adina Elena Stanciu INSTITUTE OF ONCOLOGY BUCHAREST, DEPARTMENT OF CARCINOGENESIS AND MOLECULAR BIOLOGY, BUCHAREST, ROMANIA Florentina Gherghiceanu CAROL DAVILA UNIVERSITY OF MEDICINE AND PHARMACY, BUCHAREST, ROMANIA See next page for additional authors Follow this and additional works at: https://scholar.valpo.edu/jmms Part of the Psychiatry Commons, and the Urology Commons Recommended Citation Dan, Spinu Arsenie; Bratu, Ovidiu Gabriel; Marcu, Dragos Radu; Stanciu, Adina Elena; Gherghiceanu, Florentina; Ionita-Radu, Florentina; Bungau, Simona; Stanescu, Ana Maria Alexandra; and Mischianu, Dan (2020) "Underactive bladder - an underestimated entity," Journal of Mind and Medical Sciences: Vol. 7 : Iss. 1 , Article 5. DOI: 10.22543/7674.71.P2328 Available at: https://scholar.valpo.edu/jmms/vol7/iss1/5 This Review Article is brought to you for free and open access by ValpoScholar. It has been accepted for inclusion in Journal of Mind and Medical Sciences by an authorized administrator of ValpoScholar. For more information, please contact a ValpoScholar staff member at [email protected]. Underactive bladder - an underestimated entity Authors Spinu Arsenie Dan, Ovidiu
    [Show full text]
  • Inflow™ Urinary Prosthesis FDA De Novo Approval No
    Evidence Dossier: inFlow™ Urinary Prosthesis FDA De Novo Approval No. DEN130044 For Women with Permanent Urinary Retention Resulting from Impaired Detrusor Contractility (IDC) of Neurologic Origin This medical technology dossier has been prepared per NAMCP format – Last revised September 4, 2018 Medical Reviewers As board-certified urologists with both academic and clinical expertise in voiding dysfunction, we have reviewed the Medical Technology Dossier for the inFlow Urinary Prosthesis and conclude that based on moderate quality, moderate certainty evidence the benefits of the InFlow Urinary Prosthesis outweigh the risks and it should be a recommended medical option for women with chronic urinary retention. Our determination of this Dossier’s quality of evidence is based on American Urological Association Guidelines Concerning Level of Certainty and Evidence Strength, summarized on the next page. Michael B. Chancellor, M.D. Roger R. Dmochowski, M.D. Director of Aikens Neurourology Research Center in the Professor at the Department of Urology, Vice Chair of the Dept. of Urology, Oakland University William Beaumont Department of Surgical Sciences at Vanderbilt University School of Medicine, Royal Oak, MI - Fellowship in in Nashville and Clinical Assistant Professor in Surgery at Neurourology and Female Urology the Uniformed Services University of the Health Sciences in Bethesda, Maryland Israel Franco, M.D., FACS, FAAP Michael S. Ingber, M.D. Clinical Professor of Urology; Director of Yale-New Director of Urogynecology and General Urology at Morris Haven Children’s Bladder and Continence Program; Urology, Denville NJ - Fellow in Female Pelvic Medicine Director of Yale Medicine Pediatric Bladder & and Reconstructive Surgery/Urogynecology, Glickman Continence Program Urological and Kidney Institute Karny Jacoby, M.D.
    [Show full text]
  • Understanding Neurogenic Bladder Supported by an Unrestricted Educational Grant from Hollister Incorporated
    Understanding Neurogenic Bladder Supported by an unrestricted educational grant from Hollister Incorporated. Hollister Incorporated is not responsible for the content of this booklet. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific medical advice or highly technical questions should consult his or her own physician. Table of Contents The Healthy Urinary System ..................................5 Bladder Problems ..........................................9 • Neurogenic Bladder Disorder ............................9 • Urinary Tract Infections ...............................10 • Urinary Incontinence .................................11 Diagnosing Bladder Disorders ................................12 Management and Treatment .................................13 • Medications ........................................13 • Fluids .............................................13 • Catheters ..........................................14 Intermittent Catheterization ..................................14 Choosing Your Intermittent Catheter ...........................17 Frequently Asked Questions .................................20 Glossary of Terms .........................................24 Support Networks ................................... Back Cover If you have just been diagnosed with a neurogenic bladder or are taking care of someone with a bladder disorder, you may find yourself learning new skills and making many decisions. You may feel overwhelmed by the information
    [Show full text]
  • Definition and Symptoms of Underactive Bladder
    Review Article Investig Clin Urol Posted online 2017.11.13 Posted online 2017.11.13 pISSN 2466-0493 • eISSN 2466-054X Definition and symptoms of underactive bladder Alan D. Uren1, Marcus J. Drake2 1Bristol Urological Institute, Southmead Hospital, Bristol, 2University of Bristol, Bristol, UK Underactive bladder (UAB) is a symptom syndrome reflecting the urodynamic observation of detrusor underactivity (DU), a void- ing contraction of reduced strength and/or duration, leading to prolonged or incomplete bladder emptying. An International Con- tinence Society Working Group has described UAB as characterised by a slow urinary stream, hesitancy and straining to void, with or without a feeling of incomplete bladder emptying and dribbling, often with storage symptoms. Since DU often coexists with bladder outlet obstruction, or storage dysfunction (detrusor overactivity or incontinence), the exact contribution of the DU to the presenting complaints can be difficult to establish. The presence of voiding and post voiding lower urinary tract symptoms (LUTS) is implicitly expected in UAB, but a reduced sensation of fullness is reported by some patients, and storage LUTS are also an impor- tant factor in many affected patients. These may result from a postvoid residual, but often they do not. The storage LUTS are often the key driver in leading the patient to seek healthcare input. Nocturia is particularly common and bothersome, but what the role of DU is in all the range of influences on nocturia has not been established. Qualitative research has established a broad impact on everyday life as a result of these symptoms. In general, people appear to manage the voiding LUTS relatively well, but the storage LUTS may be problematic.
    [Show full text]
  • Current Pharmacological and Surgical Treatment of Underactive Bladder Yuan‑Hong Jiang, Cheng‑Ling Lee, Jia‑Fong Jhang, Hann‑Chorng Kuo*
    [Downloaded free from http://www.tcmjmed.com on Friday, December 15, 2017, IP: 10.2.4.97] Tzu Chi Medical Journal 2017; 29(4): 187-191 Review Article Current pharmacological and surgical treatment of underactive bladder Yuan‑Hong Jiang, Cheng‑Ling Lee, Jia‑Fong Jhang, Hann‑Chorng Kuo* Department of Urology, Buddhist Tzu Chi General Hospital and Abstract Tzu Chi University, Hualien, Underactive bladder (UAB) or detrusor underactivity (DU) is a common yet still poorly Taiwan understood urological problem. In addition to true detrusor failure and neuropathy, the inhibitory effects of detrusor contraction by the striated urethral sphincter and the bladder neck through alpha-adrenergic activity may also play a role in the development of UAB or DU. Treatment of UAB or DU aims to reduce the postvoid residual (PVR) urine volume and increase voiding efficiency, either by spontaneous voiding or abdominal straining. Pharmacotherapy with parasympathomimetics or cholinesterase inhibitors might be tried, and benefits can be achieved in combination with alpha-blockers. Bladder outlet surgeries, including urethral onabotulinumtoxinA injection, transurethral incision of the bladder neck, and transurethral incision or resection of the prostate can effectively improve voiding efficiency and decrease the PVR in most patients with DU. The mechanisms have not been well elucidated. It is likely that ablation of the bladder neck or prostatic urethra might not only decrease bladder outlet resistance but also abolish the sympathetic hyperactivity which inhibits detrusor contractility in patients with idiopathic UAB or DU. Received : 18-May-2017 Keywords: Bladder function, Detrusor underactivity, Medical treatment, Urinary Revised : 14-Jun-2017 Accepted : 15-Jun-2017 retention Introduction is usually recommended.
    [Show full text]
  • Epidemiology of Underactive Bladder: Common but Underresearched
    Review Article Investig Clin Urol 2017;58 Suppl 2:S68-74. https://doi.org/10.4111/icu.2017.58.S2.S68 pISSN 2466-0493 • eISSN 2466-054X Epidemiology of underactive bladder: Common but underresearched Young Dong Yu, Seong Jin Jeong Department of Urology, Seoul National University Bundang Hospital, Seoul National University School of Medicine, Seongnam, Korea Detrusor underactivity (DU) or underactive bladder is a common cause of lower urinary tract symptoms (LUTS), but it is still poorly understood and underresearched. Although there has been a proposed definition by International Continence Society in 2002, no widely accepted diagnostic criteria have been established for this entity in clinical practice. Therefore, it has been rare to identify community-based researches on the epidemiology of DU until now. Only certain studies have reported the prevalence of DU in community-dwelling cohorts with significant LUTS using arbitrary urodynamic criteria for DU and these investigations have in- dicated that DU accounts for 25%–48% and 12%–24% of elderly men and women, respectively. However, these prevalence data based on the urodynamic definition apparently are limited in their extrapolation to the general population. Despite the clinical ambiguity of DU, its clinical effects on quality of life are quite significant, especially in the elderly population. An overall and proper comprehension of epidemiologic studies of DU may be crucial for better insight into DU, relevant decision making, and a more reasonable allocation of health resources. Therefore, researchers should find clues to the solution for the clinical diagnosis of this specific condition of LUTS from contemporary epidemiologic studies and try to develop a possible definition of ‘clinical’ DU from further studies.
    [Show full text]
  • A Patient's Guide to Underactive Bladder
    A Patient’s Guide to Underactive Bladder | 1 About the Authors Margie O’Leary, R.N., MSN, MSCN Clinical Supervisor Department of Neurology UPMC Multiple Sclerosis Clinic University of Pittsburgh School of Medicine Pittsburgh, PA USA Janet Okonski, B.S. Research Administrator Department of Urology University of Pittsburgh School of Medicine Pittsburgh, PA USA Michael B. Chancellor, M.D. Professor, Department of Urology Director, Aikens Research Center Oakland University William Beaumont School of Medicine Rochester, MI, USA Director of Neurourology Program Beaumont Health System Royal Oak, MI, USA | 2 Preface There are researchers, physicians, nurses and many other health care professionals in the world dedicated to finding both causes and effective treatments for those who experience symptoms of underactive bladder (UAB). The first international meeting to identify and discuss UAB was held in February 2014, with the second scheduled for December 2015. A special issue of the International Urology and Nephrology, Volume 46, Supplement 1, pages 1-46, was published as a result of the first meeting in Washington DC. This issue discusses this disease definition, clinical guidelines, therapeutic directions, and suitable animal models to allow accurate testing of potential therapeutic candidates for UAB. Additional professional material and videos remain available online. Another major outcome of the international meeting was the National Institute of Health’s Program Announcement that encourages new grant applications focusing on UAB. Furthermore, the need for greater patient education was identified and this is the inspiration for this handbook. Bladder symptoms can control one’s life. Though no cause or cure has yet been identified, the authors hope that this book will provide helpful information to those who suffer with UAB, their families, significant others and their caregivers.
    [Show full text]
  • (ICS) Report on the Terminology for Adult Male Lower Urinary Tract and Pelvic Floor Symptoms and Dysfunction
    Received: 4 November 2018 | Accepted: 7 November 2018 DOI: 10.1002/nau.23897 REVIEW ARTICLE The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction Carlos D’Ancona1 | Bernard Haylen2 | Matthias Oelke3 | Luis Abranches-Monteiro4 | Edwin Arnold5 | Howard Goldman6 | Rizwan Hamid7 | Yukio Homma8 | Tom Marcelissen9 | Kevin Rademakers9 | Alexis Schizas10 | Ajay Singla11 | Irela Soto12 | Vincent Tse13 | Stefan de Wachter14 | Sender Herschorn15 | On behalf of the Standardisation Steering Committee ICS and the ICS Working Group on Terminology for Male Lower Urinary Tract & Pelvic Floor Symptoms and Dysfunction 1 Universidade Estadual de Campinas, São Paulo, Brazil Introduction: In the development of terminology of the lower urinary tract, due to its 2 University of New South Wales, Sydney, increasing complexity, the terminology for male lower urinary tract and pelvic floor Australia symptoms and dysfunction needs to be updated using a male-specific approach and 3 St. Antonius Hospital, Gronau, Germany via a clinically-based consensus report. 4 Hospital Beatriz Ângelo Loures, Lisbon, Methods: This report combines the input of members of the Standardisation Portugal Committee of the International Continence Society (ICS) in a Working Group with 5 University of Otago, Christchurch, New Zealand recognized experts in the field, assisted by many external referees. Appropriate core 6 Cleveland Clinic, Cleveland, Ohio clinical categories and a subclassification were developed to give a numeric coding to 7 University College Hospitals, London, each definition. An extensive process of 22 rounds of internal and external review was United Kingdom developed to exhaustively examine each definition, with decision-making by 8 Japanese Red Cross Medical Centre, collective opinion (consensus).
    [Show full text]
  • The Standardization of Terminology of Lower Urinary Tract
    Neurourology and Urodynamics The Standardization of Terminology of Lower Urinary Tract Function in Children and Adolescents: Update Report From the Standardization Committee of the International Children’s Continence Society Paul F. Austin,1* Stuart B. Bauer,2 Wendy Bower,3 Janet Chase,4 Israel Franco,5 Piet Hoebeke,6 Søren Rittig,3 Johan Vande Walle,6 Alexander von Gontard,7 Anne Wright,8 Stephen S. Yang,9,10 and Tryggve Neveus 11 1From the Division of Urology, Washington University in St. Louis, St. Louis Childrens Hospital, St. Louis, Missouri 2Department of Urology, Childrens Hospital, Harvard Medical School, Boston, Massachusetts 3Pediatrics (Nephrology Section), Skejby University Hospital, Aarhus, Denmark 4The Childrens Centre, Cabrini Hospital, Melbourne, Australia 5New York Medical College, Valhalla, New York 6Pediatric Urology and Nephrology, Gent University Hospital, Ghent, Belgium 7Department of Child and Adolescent Psychiatry, Saarland University Hospital, Germany 8Pediatrics, Evelina Childrens Hospital, St. Thomas Hospital, London, England 9Division of Urology, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei, Taiwan 10School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan 11Department of Womens and Childrens Health, Section of Paediatric Nephrology, Uppsala University, Uppsala, Sweden Aim: The impact of the original International Children’s Continence Society (ICCS) terminology document on lower urinary tract (LUT) function resulted in the global establishment of uniformity and clarity in the characterization of LUT function and dysfunction in children across multiple healthcare disciplines. The present document serves as a stand- alone terminology update reflecting refinement and current advancement of knowledge on pediatric LUT function. Methods: A variety of worldwide experts from multiple disciplines within the ICCS leadership who care for children with LUT dysfunction were assembled as part of the standardization committee.
    [Show full text]
  • Bladder Management Following Spinal Cord Injury
    Bladder Management Following Spinal Cord Injury Jane TC Hsieh MSc Amanda McIntyre MSc Jerome Iruthayarajah BSc Eldon Loh MD FRCPC Karen Ethans MD FRCPC Swati Mehta PhD (c) Dalton Wolfe PhD Robert Teasell MD FRCPC www.scireproject.com Version 5.0 Key Points Detrusor External Sphincter Dyssynergia Therapy: Enhancing Bladder Volumes Pharmacologically Anticholinergic Therapy for SCI-Related Detrusor Overactivity Propiverine, oxybutynin, tolterodine and trospium chloride are efficacious anticholinergic agents for the treatment of SCI neurogenic bladder. Treatment with two of oxybutynin, tolterodine or trospium may be effective for the treatment of SCI neurogenic bladder in those not previously responding to one of these medications. Tolterodine, propiverine (particularly the extended-release formula), or transdermal application of oxybutinin likely result in less dry mouth but are similarly efficacious to oral oxybutynin in terms of improving neurogenic detrusor overactivity. Cisapride is not an effective treatment for hyperreflexic bladders in individuals with SCI. Toxin Therapy for SCI-Related Destrusor Overactivity Onabotulinum toxin type A injections into the detrusor muscle improve neurogenic destrusor overactivity and urge incontinence; it may also reduce destrusor contractility. Vanillanoid compounds such as capsaicin or resiniferatoxin increase maximum bladder capacity, and decreases urinary frequency, leakages, and pressure in neurogenic detrusor overactivity. Intravesical capsaicin instillation in bladders of individuals with SCI does not increase the rate of common bladder cancers after 5 years of use. Nociceptin/orphanin phenylalanine glutamine, a nociceptin orphan peptide receptor agonist, may be considered for the treatment of neurogenic bladder in SCI. Intravesical Instillations for SCI-Related Detrusor Overactivity Both propantheline and oxybutynin intravesical instillations improve cystometric parameters in patients with SCI and neuropathic bladder, but propantheline provides superior improvement in more parameters.
    [Show full text]
  • Pathophysiology and Animal Modeling of Underactive Bladder Phillip P
    University of Connecticut OpenCommons@UConn UCHC Articles - Research University of Connecticut Health Center Research 9-2014 Pathophysiology and Animal Modeling of Underactive Bladder Phillip P. Smith University of Connecticut School of Medicine and Dentistry George A. Kuchel University of Connecticut School of Medicine and Dentistry Follow this and additional works at: https://opencommons.uconn.edu/uchcres_articles Part of the Medicine and Health Sciences Commons Recommended Citation Smith, Phillip P. and Kuchel, George A., "Pathophysiology and Animal Modeling of Underactive Bladder" (2014). UCHC Articles - Research. 271. https://opencommons.uconn.edu/uchcres_articles/271 HHS Public Access Author manuscript Author Manuscript Author ManuscriptInt Urol Author Manuscript Nephrol. Author Author Manuscript manuscript; available in PMC 2015 June 16. Published in final edited form as: Int Urol Nephrol. 2014 September ; 46(0 1): S11–S21. doi:10.1007/s11255-014-0808-9. Pathophysiology and animal modeling of underactive bladder Pradeep Tyagi, Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA Phillip P. Smith, Department of Surgery, University of Connecticut Health Center, Farmington, CT, USA. UConn Center on Aging, University of Connecticut Health Center, Farmington, CT, USA George A. Kuchel, UConn Center on Aging, University of Connecticut Health Center, Farmington, CT, USA William C. de Groat, Department of Pharmacology, University of Pittsburgh, Pittsburgh, PA, USA Lori A. Birder, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Christopher J. Chermansky, Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA Rosalyn M. Adam, Department of Urology, Boston Children’s Hospital, Boston, MA, USA. Department of Surgery, Harvard Medical School, Boston, MA, USA Vincent Tse, Department of Urology, Concord Hospital, University of Sydney, Concord, NSW, Australia Michael B.
    [Show full text]
  • Detrusor Underactivity: Detection and Diagnosis Workshop Chair: Gommert Van Koeveringe, Netherlands 20 October 2014 09:00 - 12:00
    W7: Detrusor underactivity: detection and diagnosis Workshop Chair: Gommert van Koeveringe, Netherlands 20 October 2014 09:00 - 12:00 Start End Topic Speakers 09:00 09:20 Detrusor underactivity, a new condition for known Christopher Chapple symptomatology? 09:20 09:40 Detrusor underactivity and aging Gommert van Koeveringe 09:40 10:00 Male patients with detrusor underactivity Matthias Oelke 10:00 10:20 Female patients with detrusor underactivity Gommert van Koeveringe 10:20 10:30 Questions All 10:30 11:00 Break None 11:00 11:20 How can we find selective parameter combinations? Kevin Rademakers 11:20 11:40 Which approach is necessary to detect patients at Matthias Oelke risk? 11:40 12:00 What are future steps necessary to confirm the Christopher Chapple condition, develop therapy, and follow up after Matthias Oelke treatment? Kevin Rademakers Gommert van Koeveringe Aims of course/workshop Detrusor underactivity has gained increasing scientific and clinical interest since it became obvious that a substantial number of female or male patients suffer from this bladder condition. The key speakers of this workshop are intensively involved in new research initiatives within this unexplored field. They will present and discuss the known facts concerning the diagnosis of detrusor underactivity. Which invasive or non-invasive tools to assess contractility are currently available? How can we differentiate detrusor underactivity from bladder outlet obstruction? How do we define the patients with detrusor underactivity and what are differences in assessment of male and female patients? Handout W7 Detrusor underactivity: detection and diagnosis Monday 20th October 2014 09:00-12:00 Chair: Gommert van Koeveringe, Netherlands Speakers: Christopher Chapple, United Kingdom Matthias Oelke, Germany Kevin Rademakers, Netherlands Aims & Objectives: Detrusor underactivity has gained increasing scientific and clinical interest since it became obvious that a substantial number of female or male patients suffer from this bladder condition.
    [Show full text]