- [How to evaluate BPH-related SBAUs in clinical practice and research?] [Journal Article]
- PUProg Urol 2018 Sep 13
- CONCLUSIONS: A number of systematic investigations into the evaluation of a man with LUTS/BPH include interrogation, clinical examination with rectal examination, urinalysis, flowmeter and post-micturition residual volume. The voiding catalog is necessary to understand the mechanism of a nocturia. PSA has a triple potential of interest: evaluation of the risk of progression, evaluation of the prostatic volume and diagnosis of a cancer of the prostate. Creatinine is needed only when chronic retention is observed and before surgery. Urethrocystoscopy is essential in case of hematuria, suspicion of stenosis of the urethra or bladder tumor. Ultrasound for evaluation of prostate volume is essential before surgery, and may be helpful in guiding the decision to prescribe a 5 alpha reductase inhibitor. No non-invasive technique has proven its possible substitution for pressure flow studies when indicated. When a researcher is considering evaluating a surgical or instrumental treatment for BPH, preoperative, perioperative and follow-up parameters are expected from readers to get a fair idea of the technique being evaluated. LEVEL OF EVIDENCE 5: Consensus d'experts.
- Long-term outcome of MR-guided Focused Ultrasound Treatment and Laparoscopic Myomectomy for Symptomatic Uterine Fibroids. [Journal Article]
- AJAm J Obstet Gynecol 2018 Sep 11
- CONCLUSIONS: Satisfaction with long-term outcome and rate of reinterventions following MRgFUS treatment or laparoscopic myomectomy for uterine fibroids was comparable. Further larger randomized trials are needed to confirm these findings.
- The relationship between oxidative stress and lower urinary tract symptoms: Results from the community health survey in Japan. [Journal Article]
- BIBJU Int 2018 Sep 14
- CONCLUSIONS: AGE levels were significantly associated with nocturia > 1. Further research is necessary to clarify a possible causal relationship between oxidative stress and nocturia. This article is protected by copyright. All rights reserved.
- Recurrent Urinary Tract Infections in Females and the Overlap with Overactive Bladder. [Review]
- CUCurr Urol Rep 2018 Sep 13; 19(11):94
- There are an estimated 33 million men and women with overactive bladder (OAB) in the USA. Despite the prevalence of OAB, it remains a frequently misdiagnosed condition. OAB has shared symptomatology ...
There are an estimated 33 million men and women with overactive bladder (OAB) in the USA. Despite the prevalence of OAB, it remains a frequently misdiagnosed condition. OAB has shared symptomatology with other common urologic conditions, namely recurrent urinary tract infections (UTIs). Here, we will review key distinguishing features of OAB that aid in establishing an accurate diagnosis and recent advances in OAB management.
- Nocturia and associated mortality: observational data from the REDUCE trial. [Journal Article]
- PCProstate Cancer Prostatic Dis 2018 Sep 13
- CONCLUSIONS: Although the findings are limited to men, half of whom ingested dutasteride, the interruption of sleep by nocturia may have long-term impact on health and may warrant targeted intervention.
- Self-assessed goal achievement (SAGA) after Holmium laser enucleation of the prostate (HoLEP): Association with patients' postoperative satisfaction. [Journal Article]
- PlosPLoS One 2018; 13(9):e0203825
- This study aimed to determine serial changes in self-assessed goal achievement (SAGA) and treatment satisfaction after HoLEP, to identify correlations between the two, and to compare them with result...
This study aimed to determine serial changes in self-assessed goal achievement (SAGA) and treatment satisfaction after HoLEP, to identify correlations between the two, and to compare them with results assessed by traditional outcome measures. For a total of 170 patients, outcomes were evaluated serially at postoperative 1-, 3-, 6-, and 12-months using IPSS, OABSS, SAGA questionnaires and uroflowmetry. The SAGA questionnaire consisted of five questions including one open-ended question (self-assessed goals and degree of SAGA) and another question regarding treatment satisfaction. The number of self-assessed treatment goals was two or more in 74.1% of the patients. Most common treatment goal was relief from straining/hesitancy, followed by increased daytime frequency, nocturia and feeling of incomplete emptying. Degree of achievement for the first or second goal and treatment satisfaction tended to increase with time throughout the follow-up period. Patients with the greatest treatment satisfaction scores showed greater improvement by traditional outcome parameters including quality of life (QOL) index, total OABSS, maximum flow rate (Qmax), post-void residual urine volume (PVR) and bladder voiding efficiency (BVE) compared to those without treatment satisfaction. After adjusting for other influential variables, the improvements in subjective outcome parameters including total IPSS, QOL index and total OABSS were significantly associated with treatment satisfaction, but improvements in objective outcome parameters including Qmax, PVR and BVE were not. In addition, the degree of SAGA for the first goal or second goal was more predictive in determining treatment satisfaction than the traditional outcome measures. In conclusion, treatment goals of patients with lower urinary tract symptoms (LUTS)/BPH vary from individual to individual. The degree of SAGA and treatment satisfaction for HoLEP tends to increase with time throughout the follow-up period. Compared to the traditional outcome measures, the degree of goal achievement can be more predictive when assessing patient-centered outcomes such as treatment satisfaction.
- Comparison of urologic and non-urologic presentation in interstitial cystitis/bladder pain syndrome patients with and without Hunner lesions. [Journal Article]
- NUNeurourol Urodyn 2018 Sep 06
- CONCLUSIONS: Hunner lesions can be identified in both men and women. There are significant overlaps in terms of their urologic and non-urologic presentation. Further investigation is needed on phenotypic and biological distinction between IC/BPS with and without Hunner lesions.
- [Contribution of pharmacological research to the discovery of a first-in-class drug, mirabegron, for the treatment of overactive bladder]. [Journal Article]
- NYNihon Yakurigaku Zasshi 2018; 152(3):111-118
- Overactive bladder (OAB) is defined as urgency, with or without urge incontinence, usually with frequency and nocturia. Antimuscarinic drugs are often prescribed as a standard care; however, the trea...
Overactive bladder (OAB) is defined as urgency, with or without urge incontinence, usually with frequency and nocturia. Antimuscarinic drugs are often prescribed as a standard care; however, the treatment discontinuation due to the adverse events including dry mouth and constipation has been an issue. Taking these situations into account, we considered that a novel OAB drug having a different mechanism from antimuscarinics fills the unmet medical need. It has been known that, during bladder filling, activation of sympathetic nerves results in bladder smooth muscle relaxation via the β-adrenergic receptor (AR) stimulation. In 1999, three Japanese groups independently provided evidence for the existence of β3-AR in human bladder smooth muscles and some of these groups showed that β3-AR activation is mainly involved in the relaxation induced by β adrenergic stimulation. Therefore, we conducted pharmacological research focusing on β3-AR as a novel target molecule for the treatment of OAB. A selective β3-AR agonist mirabegron showed the relaxant effect in rat bladder smooth muscle and decreased resting intravesical pressure in anesthetized rats. Mirabegron also improved storage function in a rat detrusor overactivity model. Furthermore, in vitro isometric contraction study using human bladder tissues was conducted to predict the clinical efficacy and mirabegron showed the relaxant effect in human bladder smooth muscle. In clinical studies with OAB patients, mirabegron demonstrated promising efficacy and tolerability. These pharmacological evidences contributed to the approval of mirabegron as a first-in-class drug for OAB treatment in Japan ahead of other countries.
- FUNCTIONAL CONSTIPATION AND OVERACTIVE BLADDER IN WOMEN: A POPULATION-BASED STUDY. [Journal Article]
- AGArq Gastroenterol 2018 Aug 21
- CONCLUSIONS: Functional constipation is associated with overactive bladder and its dry subtype, particularly in the younger population. In addition, this association is responsible for lower quality of life scores, especially when urinary incontinence is present. The presence of manual maneuvers and less than three defecations per week should direct us to look for overactive bladder.
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- Texture analysis of 3D dose distributions for predictive modelling of toxicity rates in radiotherapy. [Journal Article]
- RORadiother Oncol 2018 Aug 31
- CONCLUSIONS: Inclusion of 3D dosimetric texture analysis features in predictive modelling of GI and GU toxicity rates in prostate cancer radiotherapy improved prediction performance, which was statistically significant for GI.