Neurourology and urodynamics
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Multicenter Study Comparative Study
Reference values for the Nocturnal Bladder Capacity Index.
The Nocturnal Bladder Capacity Index (NBCi) has been reported to be useful in distinguishing between nocturia caused by low bladder capacity and nocturnal polyuria. This paper aims to calculate reference values for NBCi from an asymptomatic population by comparing these with NBCi values from patients with lower urinary tract symptoms (LUTS) to obtain an indication of the sensitivity with which the NBCi detects low nocturnal bladder capacity. This paper also compares the sensitivity of rounded and unrounded calculations of NBCi. ⋯ We suggest that an unrounded NBCi of 1.3 be considered a cutoff point above which reduced nocturnal bladder capacity should be investigated as a cause of nocturia. Rounding the NBCi lead to an underestimation of elevated values in a population of female patients with LUTS.
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Expanded indications for neuromodulation are continually being explored. We evaluated secondary changes in bowel function after successful neuromodulation for voiding symptoms. ⋯ Studies have indicated that neuromodulation improves FI in carefully selected patients. The impact on other bowel conditions, including IBS, is unclear. Since voiding and bowel symptoms often coexist, it is crucial to fully evaluate all potential treatment benefits.
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The need for an indwelling transurethral catheter in patients with postoperative thoracic epidural analgesia (TEA) is a matter of controversy. Subjective observations are ambivalent and the literature addressing this issue is scarce. As segmental blockade can be achieved with epidural analgesia, we hypothesized that analgesia within segments T4-T11 has no or minimal influence on lower urinary tract function. Thus, we evaluated the effect of TEA on lower urinary tract function by urodynamic studies. ⋯ TEA has a significant effect on bladder emptying with clinically relevant postvoid residual (PVR) necessitating (indwelling or intermittent) catheterization or monitoring of PVR.
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Randomized Controlled Trial Multicenter Study Comparative Study
Investigation of the clinical efficacy and safety of pregabalin alone or combined with tolterodine in female subjects with idiopathic overactive bladder.
To assess the efficacy and safety of pregabalin alone or in combination with tolterodine extended release (ER) in subjects with idiopathic OAB. ⋯ Pregabalin, alone or with tolterodine ER may offer an alternative treatment option for idiopathic OAB in women.
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Randomized Controlled Trial
A pilot study of botulinum toxin for interstitial cystitis/painful bladder syndrome.
Preliminary studies using botulinum toxin (BTX) have demonstrated some benefits in treating interstitial cystitis (IC)/painful bladder syndrome (PBS) pain. The purpose of this study was to investigate the efficacy of a periurethral injection of BTX to block urethral visceral and somatic afferent fibers, for the treatment of IC/PBS. ⋯ Periurethral injection of botulinum toxin in women did not effectively treat the pain of IC/PBS. While the results from this study are negative, there is still a valid rationale for further investigations of novel injection protocols given the dearth of current effective treatments.