- Thulium laser enucleation of the prostate (ThuLEP): Results, complications, and risk factors in 139 consecutive cases. [Journal Article]
- AJArab J Urol 2018; 16(4):411-416
- CONCLUSIONS: ThuLEP is safe and reproducible. Whilst it significantly reduces intraoperative bleeding as compared to transurethral resection of the prostate, operating time and perioperative heparin prophylaxis may still lead to a Hb drop and constitute a risk factor for postoperative bleeding. Therefore, a potential risk of deep vein thrombosis requiring heparin prophylaxis should be carefully considered and balanced with the expected clinical benefit of the operation.
- The first Iraqi experience in sacral neuromodulation for patients with lower urinary tract dysfunction. [Journal Article]
- AJArab J Urol 2018; 16(4):391-396
- CONCLUSIONS: SNM offers a good and durable solution for some functional bladder problems, if patients are well selected. There may also be additional extra-urinary benefits that contribute to improvements in QoL. SNM was well tolerated by our patients with an encouraging response rate, especially in psychologically stable patients with idiopathic dysfunctions.
- Investigating neurogenic bowel in experimental spinal cord injury: where to begin? [Review]
- NRNeural Regen Res 2019; 14(2):222-226
- The devastating losses following traumatic spinal cord injury (SCI) encompass the motor, sensory and autonomic nervous systems. Neurogenic bowel is a slow transit colonic dysfunction marked by consti...
The devastating losses following traumatic spinal cord injury (SCI) encompass the motor, sensory and autonomic nervous systems. Neurogenic bowel is a slow transit colonic dysfunction marked by constipation, rectal evacuation difficulties, decreased anorectal sensation, fecal incontinence or some combination thereof. Furthermore, neurogenic bowel is one of the most prevalent comorbidities of SCI and is recognized by afflicted individuals and caregivers as a lifelong physical and psychological challenge that profoundly affects quality of life. The restoration of post-injury control of movement has received considerable scientific scrutiny yet the daily necessity of voiding the bowel and bladder remains critically under-investigated. Subsequently, physicians and caregivers are rarely presented with consistent, evidence-based strategies to successfully address the consequences of dysregulated voiding reflexes. Neurogenic bowel is commonly believed to result from the interruption of the supraspinal control of the spinal autonomic circuits regulating the colon. In this mini-review, we discuss the clinical challenges presented by neurogenic bowel and emerging pre-clinical evidence that is revealing that SCI also initiates functional remodeling of the colonic wall concurrent with a decrease in local enteric neurons. Since the enteric input to the colonic smooth muscle is the final common pathway for functional contractions of the colon, changes to the neuromuscular interface must first be understood in order to maximize the efficacy of therapeutic interventions targeting colonic dysfunction following SCI.
- Surveillance urodynamics for neurogenic lower urinary tract dysfunction: A systematic review. [Review]
- CUCan Urol Assoc J 2018 Dec 03
- CONCLUSIONS: Evidence supporting optimal surveillance for NLUTD is lacking. Level 2b-4 evidence suggests that sUDS is likely to modify patient treatment and often demonstrates findings that modify treatment in the absence of symptoms or imaging changes.
- Should We Always Use Antibiotics after Urodynamic Studies in High-Risk Patients? [Journal Article]
- BRBiomed Res Int 2018; 2018:1607425
- CONCLUSIONS: Prophylaxis of UTI with a phytodrug (Canephron N) may be considered a good alternative to antibiotic prophylaxis use after UDS in high-risk female patients.
- [Botulinumtoxin for bladder disorders]. [Journal Article]
- FNFortschr Neurol Psychiatr 2018 Dec 03
- An overactive neurogenic detrusor and an non-neurogenic overactive bladder both exhibit symptoms such as urgency and frequency, both with and without urinary incontinence, and are often accompanied b...
An overactive neurogenic detrusor and an non-neurogenic overactive bladder both exhibit symptoms such as urgency and frequency, both with and without urinary incontinence, and are often accompanied by nocturia. OnabotulinumtoxinA-Detrusorinjection has become well established as a second line therapy in cases where anticholinergic medication has failed. The procedure can be performed under general or local anesthesia, in both in- and outpatient settings. The side effects of the procedure are primarily urinary tract infections and - especially in neurogenic bladder patients - urinary retention. This article focuses on the approved indications and summarizes the current scientific data.
- Bowel management in children with spina bifida. [Journal Article]
- JPJ Pediatr Rehabil Med 2018 Nov 19
- Spina bifida is a birth defect that commonly causes bowel and bladder dysfunction in children with a significant negative impact on quality of life and emotional wellbeing. Fecal continence improves ...
Spina bifida is a birth defect that commonly causes bowel and bladder dysfunction in children with a significant negative impact on quality of life and emotional wellbeing. Fecal continence improves satisfaction and the quality of life of both children and their caretakers. Bowel management in children with spina bifida is hampered by limited controlled studies and variable practice within different institutions and subspecialists. The goals of a successful bowel management program in children with spina bifida consist of predictable bowel movements, social continence, and eventual independence. Treatment options range from conservative interventions such as diets and oral laxatives that modify stool consistency and transit, to trans-anal irrigations and antegrade continence enemas that facilitate predictable recto-sigmoid emptying and provide a greater degree of independence. In children, the treatment approach should be implemented in the context of the child's developmental age in order to allow for optimum social integration with their age-appropriate peers. We present a review of a stepwise approach to bowel management in children with spina bifida and the challenges related to the proposed treatment options.
- Effect of Early Sacral Neuromodulation on Bladder Function in a Rat Model of Incomplete Spinal Cord Injury Due to Focal Contusion. [Journal Article]
- NNeuromodulation 2018 Dec 02
- CONCLUSIONS: Our results provide experimental evidence that early SNM treatment may prevent or diminish bladder dysfunctions (e.g., detrusor overactivity, abnormal micturition reflex) in a clinical condition of incomplete SCI.
- Feasibility of using a novel non-invasive ambulatory tibial nerve stimulation device for the home-based treatment of overactive bladder symptoms. [Journal Article]
- TATransl Androl Urol 2018; 7(6):912-919
- CONCLUSIONS: This novel ambulatory transcutaneous TNS (TTNS) device is safe and acceptable for use in patients reporting OAB symptoms as a form of home-based neuromodulation. A larger study however is required to confirm clinical efficacy.
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- Lower urinary tract symptoms treatment constraints assessment (LUTS-TCA): a new tool for a global evaluation of neurogenic bladder treatments. [Journal Article]
- WJWorld J Urol 2018 Dec 04
- CONCLUSIONS: LUTS TCA is the first validated tool to assess constraints of urinary treatment and has excellent psychometric properties.