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Significance of preoperatively observed detrusor overactivity as a predictor of continence status early after robot-assisted radical prostatectomy

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Asian Journal of Andrology 2014年第6期16卷 869-872页

作者： Akihiro Yanagiuchi Hideaki Miyake Kazushi Tanaka Masato Fujisawa Division of Urology Kobe University Graduate School of Medicine 7-5-1 Kusunoki-Cho Chuo-Ku Kobe Japan.

Several recent studies have reported the involvement of bladder dysfunction in the delayed recovery of urinary continence following radical prostatectomy （RP）. The objective of this study was to investigate the significance of detrusor overactivity （DO） as a predictor of the early continence status following robot-assisted RP （RARP）. This study included 84 consecutive patients with prostate cancer undergoing RARP. Urodynamic studies, including filling cystometry, pressure flow study, electromyogram of the external urethral sphincter and urethral pressure profile, were performed in these patients before surgery. Urinary continence was defined as the use of either no or one pad per day as a precaution only. DO was preoperatively observed in 30 patients （35.7%）, and 55 （65.5%） and 34 （40.5%） were judged to be incontinent 1 and 3 months after RARP, respectively. At both 1 and 3 months after RARP, the incidences of incontinence in patients with DO were significantly higher than in those without DO. Of several demographic and urodynamic parameters, univariate analyses identified DO and maximal urethral closure pressure （MUCP） as significant predictors of the continence status at both 1 and 3 months after RARP. Furthermore, DO and MUCP appeared to be independently associated with the continence at both I and 3 months after RARP on multivariate analysis. These findings suggest that preoperatively observed DO could be a significant predictor of urinary incontinence early after RARP; therefore, it is recommended to perform urodynamic studies for patients who are scheduled to undergo RARP in order to comprehensively evaluate their preoperative vesicourethral functions.

关键词： detrusor overactivity robot-assisted radical prostatectomy urinary incontinence

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Long-term follow-up of intravesical abobotulinumtoxinA (Dysport®) injections in women with idiopathic detrusor overactivity

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Asian Journal of Urology 2024年第1期11卷 93-98页

作者： Mohammad Sajjad Rahnama'i Amin Bagheri Elham Jahantabi Hanieh Salehi-Pourmehr Hadi Mostafaei Brigitte Schurch Aida Javan Balegh Marand Sakineh Hajebrahimi Department of Urology St.Elisabeth-Tweesteden Hospital Tilburgthe Netherlands Research Center for Evidence-based Medicine Iranian EBM Centre:A Joanna Briggs Institute(JBI)Center of ExcellenceTabriz University of Medical SciencesTabrizIran Urology Department Faculty of MedicineTabriz University of Medical SciencesTabrizIran Department of Urology Comprehensive Cancer CenterMedical University of ViennaViennaAustria Service de Neuroréhabilitation CHUVLausanneSwitzerland Society of Urological Research and Education(SURE) Heerlenthe Netherlands

Objective:Only a few numbers of studies have been published on the use of abobotulinumtoxinA(Dysport®)in idiopathic detrusor overactivity(IDO).This study reported the long-term follow-up of women with IDO who were treated with intravesical Dysport®***:Two hundred and thirty-six patients with IDO who had failed first-line conservative and antimuscarinic therapy received 500-900 units of Dysport®between April 2014 and July *** patients were followed up for 5 years after their initial injection and interviewed on the ***:A total of 236 women with IDO aged from 18 years to 84 years(mean±standard deviation:49.6±15.9 years)were included in our *** median follow-up time for patients was 36.5(range:10-70)months,and the median recovery time after injection was 18.5(range:0-70)months.A total of 83(35.2%)patients stated that they had subjective improvement of their symptoms whereas 84(35.6%)patients did not report any improvement in *** initial International Consultation on Incontinence Questionnaire Overactive Bladder mean score was 6.9(standard deviation 3.4).There was a positive association between the median recovery time and the components of the International Consultation on Incontinence Questionnaire Overactive Bladder ***:In a sub-population of overactive bladder patients with IDO who have failed first-line therapy,a single intravesical Dysport®injection can resolve patient symptoms completely or reduce the symptoms to an acceptable level that can be controlled with antimuscarinics or re-injection on demands.

关键词： AbobotulinumtoxinA Dysport Intravesical ldiopathic detrusor overactivity

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Multiple factors related to detrusor overactivity in Chinese patients with benign prostate hyperplasia

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Chinese Medical Journal 2012年第21期125卷 3778-3781页

作者： LIU Ning MAN Li-bo HE Feng HUANG Guang-lin WANG Hai L1 Gui-zhong WANG Jian-wei LUYan-wei Department of Urology Beijing Jishuitan Hospitai Beijing 100035 China Department of StatisticsBeijing Jishuitan Hospital Beijing 100035 China

Background detrusor overactivity （DO） is a known cause of lower urinary tract symptoms and occurs in 50%-75% of benign prostate hyperplasia （BPH） patients. We sought to investigate the clinical and urodynamic fact... 详细信息

关键词： urodynamics detrusor overactivity benign prostatic hyperplasia bladder outlet obstruction

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Electroacupuncture at points Baliao and Huiyang (BL35) for post-stroke detrusor overactivity

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Neural Regeneration Research 2013年第18期8卷 1663-1672页

作者： Yan Liu Luran Liu Xiaomin Wang Department of Urinary Surgery Fourth Hospital of Harbin Medical University Department of Neurology Fourth Hospital of Harbin Medical University

Acupuncture is used extensively in China for the treatment of stroke and other neurological disorders. The National Institutes of Health recommends acupuncture as an adjunctive therapy for stroke recovery. This study included patients with post-stroke detrusor overactivity who were treated in the Department of Neurology, Fourth Hospital of Harbin Medical University, China. Subjects received either electroacupuncture or sham electroacupuncture at points Baliao [including bilateral Shangliao （BL31）, bilateral Ciliao （BL32）, bilateral Zhongliao （BL33）, and bilateral Xialiao （BL34）] and Huiyang （BL35）. Our results showed that electroacupuncture significantly improved cystometric capacity and bladder compliance, decreased detrusor leak point pressure, ameliorated lower urinary tract symptoms, and decreased the risk of upper urinary tract damage. These findings indicate that electroacupuncture at points Bafiao and Huiyang is an effective treatment for post-stroke detrusor overactivity.

关键词： neural regeneration acupuncture and moxibustion stroke urodynamics detrusor overactivity rehabilitation grants-supported paper neuroregeneration

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Pioneering drugs for overactive bladder and detrusor overactivity: Ongoing research and future directions

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World Journal of Obstetrics and Gynecology 2015年第2期4卷 24-39页

作者： Emilio Sacco Salvatore Recupero Riccardo Bientinesi Giuseppe Palermo Daniele D'Agostino Diego Currò Pierfrancesco Bassi Urologic Clinic Department of Surgical Sciences "Agostino Gemelli" Hospital Catholic University Medical School 00168 Rome Italy Institute of Pharmacology Catholic University Medical School 00168 Rome Italy

The ongoing research on pioneering drug candidates for the overactive bladder （OAB） aimed to overcome the limitations of currently licensed pharmacotherapies, such as antimuscarinics, β3-adrenergic agents, and botulinum neurotoxin, has been reviewed performing a systematic literature review and web search. The review covers the exploratory agents alternative to available medications for OAB and that may ultimately prove to be therapeutically useful in the future mana-gement of OAB patients based on preclinical and early clinical data. It emerges that many alternative pharmacological strategies have been discovered or are under investigation in disease-oriented studies. Several potential therapeutics are known for years but still fnd obstacles to pass the clinical stages of development, while other completely novel compounds, targeting new pharmacological targets, have been recently discovered and show potential to translate into clinical therapeutic agents for idiopathic and neurogenic OAB syndrome. The global scenario of investigational drugs for OAB gives promise for the development of innovative thera-peutics that may ultimately prove effective as first, combined or second-line treatments within a realistic timescale of ten years.

关键词： detrusor overactivity Drug therapy Lower urinary tract symptoms Overactive bladder Urinary incontinence

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Combined detrusor and External Urethral Sphincter BTX-A Injections for detrusor overactivity and detrusor External Sphincter Dyssynergia Secondary to Spinal Cord Injury

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Open Journal of Urology 2021年第2期11卷 45-51页

作者： Maping Huang Heyi Zhen Tianhai Huang Xiaoyi Yang Qiuling Liu Qingqing Li Hui Chen Department of Urology Guangdong Provincial Work Injury Rehabilitation Hospital Guangzhou China Department of Traumatic Brain Injury Rehabilitation Guangdong Province Work Injury Rehabilitation Hospital Guangzhou China

Objective: To evaluate the efficacy and safety of Combined detrusor and external urethral sphincter BTX-A injections for detrusor overactivity (DO) and detrusor external sphincter dyssynergia (DESD) secondary to spinal cord injury. Study Design: Prospective study. Methods: The study was carried out in 18 SCI patients with detrusor overactivity (DO) and detrusor external sphincter dyssynergia (DESD) receiving Combined detrusor and external urethral sphincter BTX-A injections treatment. Contain 200 U botulinum toxin intradetrusor and 100 U external urethral sphincter injections. The effective outcomes included maximum detrusor pressure at first DO and DESD (PdetmaxDO-DESD), volume at first DO and DESD (VDO-DESD), maximum urethral closure pressure (MUCP), and Incontinence-Specific Quality-of-Life Instrument (I-QoL). Adverse events were recorded. Results: All patients experienced a significant mean reduction in PdetmaxDO-DESD (50.75%), maximum urethral closure pressure (26.34%) and a significant mean increase in VDO-DESD (63.00%) 12-weeks post-injection. Significant (p Conclusion: Combined detrusor and external urethral sphincter BTX-A injections is a good choice for patients with DO and DESD secondary to spinal cord injury. It could not only protect the upper urinary tract but also improve quality of life.

关键词： detrusor overactivity detrusor External Sphincter Dyssynergia BTX-A Spinal Cord Injury

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Initial Experience with Mirabegron for the Treatment of Neurogenic Lower Urinary Tract Dysfunction

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Open Journal of Urology 2021年第8期11卷 305-311页

作者： Heyi Zhen Tianhai Huang Xiaoyi Yang Qiuling Liu Qingqing Li Maping Huang Hui Chen Department of Traumatic Brain Injury Rehabilitation Guangdong Province Work Injury Rehabilitation Hospital Guangzhou China Department of Urology Guangdong Provincial Work Injury Rehabilitation Hospital Guangzhou China

Background: Though anticholinergic drugs are considered the standard treatment for neurogenic detrusor overactivity, it is far from an ideal tool, because of their adverse effects such as Constipation or not respond sufficiently for a substantial proportion of patients. Recently mirabegron has become a commonly used overactive bladder medication in the general population, but few studies about mirabegron for the treatment of neurogenic detrusor overactivity. Objective: To evaluate the efficacy and safety of mirabegron for the treatment of neurogenic lower urinary tract dysfunction. Study Design: Prospective study. Methods: This prospective study included 13 adult patients with neurogenic lower urinary tract dysfunction as a result of spinal cord injury. All patients receiving mirabegron treatment (50 mg once daily) at least 6 weeks. The effective outcomes included the mean urine volume per catheterization, urinary incontinence episodes and Incontinence Specific Quality of Life Instrument. We monitored the blood pressure and heart rate to assess the cardiovascular safety, other adverse events were also recorded. Results: A total of 13 patients were included. After 6 weeks of treatment, all patients experienced a significant increase in the mean volume of per catheterization from 238.46 ± 65.43 ml to 327.69 ± 59.04 ml (p = 0.001). There is a significant reduction in the volume of urine leakage (463.85 ± 247.98 ml VS 180.00 ± 190.96 ml, p = 0.003) and incontinence episodes per 24 h (4.46 ± 2.03 VS 1.92 ± 1.50, p = 0.001). Significant improvement in mean Incontinence Specific Quality of Life Instrument was also found (p = 0.001). No patients reported dry mouth during the study, and the cardiovascular safety were acceptable. Conclusion: Mirabegron is safe and effective in the treatment of neurogenic lower urinary tract dysfunction. It might be a good choice for reducing

关键词： Neurogenic Lower Urinary Tract Mirabegron detrusor overactivity Spinal Cord Injury

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Beyond prostate, beyond surgery and beyond urology: The “3Bs” of managing non-neurogenic male lower urinary tract symptoms

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Asian Journal of Urology 2019年第2期6卷 169-173页

作者： Qixiang Song Paul Abrams Yinghao Sun Department of Urology Changhai HospitalSecond Military Medical UniversityShanghaiChina Bristol Urological Institute Southmead HospitalBristolUK

Lower urinary tract symptoms(LUTS),consisting storage,voiding and postmicturition symptoms,is a comprehensive definition involving symptoms that may occur due to several *** of simply focusing on the enlarged prostate,more attention has to be paid to the entire urinary tract as well as multiple system ***,prostate surgery alone does not necessarily provide adequate management and cross-disciplinary collaborations are sometimes *** on current literature,this paper proposes the“3Bs”concept for managing non-neurogenic male LUTS,namely,“beyond prostate”,“beyond surgery”and“beyond urology”.The clinical application of the“3Bs”enables urologists to carry out integrated,individualized and precise medical care for each non-neurogenic male LUTS patient.

关键词： Male Lower urinary tract symptoms Benign prostatic hyperplasia Benign prostatic obstruction detrusor overactivity detrusor underactivity Prostate surgery Comorbidities

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