Optimizing overactive bladder (OAB) management has the potential to improve quality of life. We sought to determine whether bilateral was more effective than unilateral Percutaneuous Tibial Nerve Stimulation (PTNS) at improving OAB symptoms. Participants were randomized to either bilateral or unilateral PTNS and followed for 12 weeks. OAB questionnaire short form (OABqSF) and Incontinence Impact questionnaire (IIQ) were administered at baseline and every 4 weeks through week 12. Participants also completed a 2-day voiding diary weekly. Our primary outcome was change in OABqSF from baseline to completion of study. Secondary outcomes included change in IIQ, number of daily voids, nocturia and incontinence episodes. Score changes were compared using ANOVA and pairwise t-test. We randomized 36 women, mean age 68.7 (range 32-90) years. Overall, baseline OABqSF and IIQ scores were similar between the groups. Both groups showed significant improvement in OABqSF over time. 55.6% of participants in the unilateral group and 66.7% of participants in the bilateral group had improvement per OABqSF scores. While both groups showed improvement in IIQ, only the bilateral group's improvement was statistically significant. Although, the mean and median differences in OABqSF, IIQ, and incontinence episodes were lower in the bilateral group, the difference between the groups was not significant. Both unilateral and bilateral PTNS led to significant decreases in OABqSF with a trend for more improvement in the bilateral group. IIQ score only improved in the bilateral group suggesting a potential benefit from bilateral use. The trial was registered on clinicaltrials.gov, NCT03535857.

This patient case series investigated the impact that the urinary catheter Luja™ with Micro-hole Zone Technology (MHZT) has had on the daily life of patients using intermittent catheters. With intermittent catheterisation (IC) representing the gold standard for daily bladder management for people with urinary tract dysfunctions, the novel urinary catheter Luja is designed to perform differently to conventional eyelet catheters and to address known urinary tract infection risk factors. Using semi-structured patient interviews conducted by health professionals, the real-life experiences of a diverse group of IC patients using the Luja catheter were collected. During the interviews most patients reported positive feedback from using the Luja catheter. Most mentioned perceiving a lower frequency of urinary tract infections, and many mentioned perceiving easier, faster and complete bladder emptying with the Luja catheter compared with their previous conventional eyelet catheter. These findings highlight the advantages that patients using the Luja catheter may experience during daily bladder management.

Retrospective cohort study. To identify clinical and demographic factors associated with functional recovery and length of hospital stay in individuals with spinal cord injury undergoing inpatient rehabilitation. Physical Medicine and Rehabilitation Center at Ankara Bilkent City Hospital, Turkey. Medical records of patients with spinal cord injury admitted for inpatient rehabilitation between January 2020 and September 2023 were retrospectively reviewed. Demographic characteristics, injury-related variables, neurological level, ASIA classification, SCIM III scores, complications, assistive rehabilitation interventions, bladder management, and functional status were collected. Univariate analyses (Mann-Whitney U, Kruskal-Wallis, Chi-square) were performed, followed by multivariate regression to identify independent predictors of functional outcomes. A total of 342 patients were included (mean age 38.9 ± 16.2 years). The mean length of stay was 41.6 ± 20.3 days. Univariate analyses showed that age, time since injury, neurological level, multiple hospitalizations, SCIM III scores, complications, advanced rehabilitation technologies, and bladder catheterization were significantly associated with both functional status and hospitalization duration (p < 0.05). Multivariate regression demonstrated that age (β = -0.24, 95% CI: -0.35 to -0.13, p < 0.001), presence of complications (β = -0.31, 95% CI: -0.46 to -0.17, p < 0.001), and bladder catheterization (β = -0.19, 95% CI: -0.32 to -0.07, p = 0.004) were independent predictors of discharge SCIM III scores. Age, neurological integrity, complications, and bladder management are key determinants of functional outcomes in SCI rehabilitation, while these factors also influence length of stay. Early complication prevention, optimized bladder care, and tailored rehabilitation strategies may enhance recovery and shorten hospitalization. No commercial sponsorship was received for this study.

BackgroundSpinal cord injury (SCI) is a life-altering condition, often leading to long-term disability, significantly impacting individuals worldwide. However, there is a dearth of research on the life experiences of people affected by SCI, particularly in lower-middle-income countries. Thus, this study aimed to explore the psychosocial impact of people living with SCI in Bangladesh.MethodsThis study employed a qualitative approach which included conducting 22 In-depth Interviews (IDIs) with persons with SCI in Bangladesh. Data were collected from October 2023 to December 2023 within the Spinal Cord Injuries’ Development Association Bangladesh (SCIDAB), a rehabilitation center for SCI patients. Thematic analysis was utilized for this study.ResultsUtilizing the bio-psychosocial framework, findings highlighted the biological, psychological, and social factors underlying the psychological barriers experienced by participants. Sub-themes identified included biological factors: paralysis and loss of sensation, challenges in bowel and bladder management, psychological factors: a sudden change in life, and loss of independence and autonomy; insecurity about the future, suicidal thoughts, stigmatized by society, and social isolation; and social factors: lack of support system, lack of specialized working environment, and transportation obstacles.ConclusionIndividuals living with SCI reported experiencing both significant physical and psychosocial impacts. In addition to providing effective mental health services, there is a critical need for comprehensive rehabilitation for people affected by SCI and social awareness within the community is essential to reduce stigma and foster inclusion.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-25312-5.

This paper summarizes the management and nursing experience of a rare case involving uterine impaction with acute urinary retention in mid-pregnancy (14th week). Following the failure of conservative treatment, a multidisciplinary team (comprising obstetricians, sonographers, and specialist nurses) collaborated to perform manual reduction under real-time ultrasound guidance, achieving successful resolution. Nursing priorities spanned three phases of manual reduction: pre-, intra-, and post-procedure stages. Comprehensive measures encompassed clinical observation, positioning interventions, bladder management, psychological support, and infection control, yielding favourable maternal and neonatal outcomes. This case underscores that early recognition of entrapment signs and tailored, precision nursing management according to the patient’s condition are pivotal for favourable outcomes.

RECOMMENDATIONS 1. We recommend that HCPs ask PLWO if they have concerns about managing self-care activities such as bathing, getting dressed, bowel and/or bladder management, skin and/or wound care, foot care (Level 3, Grade C). 2. We recommend that HCPs assess falls risk in PLWO, as this could interfere with their ability to participate in physical activity and their interest in doing so (Level 3, Grade C).

This study aimed to investigate the relationship between tissue bridges and bladder and bowel outcomes in chronic cervical spinal cord injury (SCI). Between July 2020 and January 2024, 44 patients with chronic cervical SCI were retrospectively included in this cross-sectional study at a specialized SCI center. Lesion severity was assessed by tissue bridges, lesion length, lesion width, and lesion area. Bladder and bowel outcomes were evaluated with Spinal Cord Independence Measure (SCIM), International Standards to Document Autonomic Function following SCI, and Geffner-Gonzalez-Santacruz-Flor Bladder Function Scale. Patients were categorized as independent bladder management or bladder dysfunction based on SCIM. Correlation analysis was applied to investigate associations between lesion severity and clinical outcomes. Binary logistic regression analysis and receiver operating characteristic (ROC) curve analysis were conducted to identify crucial factors and critical values for independent bladder management. In chronic cervical SCI, the width of tissue bridges was positively associated with bladder and bowel outcomes, while lesion length, lesion width, and lesion area showed negative associations (P < 0.05). Binary logistic regression analysis identified tissue bridges as a protective factor for independent bladder management (P < 0.05). ROC analysis indicated that tissue bridges larger than 1.80mm may allow for independent bladder management (P < 0.01). The width of tissue bridges was associated with bladder outcomes. These findings suggest that tissue bridges may potentially provide valuable insights for bladder management in patient counseling and personalized treatment plans.

Management of overactive bladder (OAB) has a stepwise approach in adults and children. This does not account for individual patient variations, which may explain suboptimal outcomes in many patients. Distinct OAB profiles, based on patient characteristics, symptoms, urodynamic findings and imaging have been discussed in Part 1. Personalized treatment and escalation pathways based on OAB profiling may lead to faster OAB symptom control and quality of life improvement, reduced cumulative side effects and costs, and improved treatment adherence. A Think Tank at the International Consultation on Incontinence-Research Society (ICI-RS) 2025 discussed the question, "Can OAB management be improved by phenotyping, and targeting therapy according to urgency type and other characteristics?" The group discussed the current literature on this topic and developed a list of research questions and strategies to help shape the future of the field. Tailored combination of antimuscarinics and/or beta3 agonists, with botulinum toxin A (BTX-A) and/or sacral nerve stimulation (SNS) was considered a high priority research topic. Profile-based individual treatment selection and delivery protocols for BTX-A and SNS are potential means to improve outcomes, as is the early escalation to BTX-A and SNS in the treatment pathway of both adults and children. Finally, phenotype-based treatment requires tight treatment outcome follow-up and possible adjustment (including re-phenotyping) for which tools need to be developed. Development and validation of a patient-based flow-chart to replace the current stepwise approach in OAB management will allow tailored treatment, aimed to improve therapeutic success, and to reduce side effects.

IntroductionSpinal cord injury (SCI) individuals undergoing home-based rehabilitation face multiple challenges, including functional impairments, bladder dysfunction, and employment barriers. Poor bladder management impacts autonomy, health, and quality of life, while limited mobility and environmental inaccessibility hinder return-to-work.ObjectiveTo assess rehabilitation priorities and unmet needs among home-based individuals with SCI, focusing on bladder management, functional limitations, and employment reintegration. The study aims to identify personal, medical, and environmental factors affecting rehabilitation outcomes.MethodsA cross-sectional survey was conducted from May to September 2023 by West China Hospital, Sichuan University. A total of 3,055 SCI individuals across mainland China completed an online questionnaire assessing demographics, functional status, rehabilitation goals, and employment challenges. Descriptive statistics, t-tests, ANOVA, Chi-square, and multivariate regression were used for data analysis.ResultsChallenges: Most participants (80.88%) had traumatic SCI. Significant daily life barriers included financial burden (46.0%), unemployment (44.1%), accessibility issues (34.3%), health concerns (29.5% frequent medical visits; 25.7% persistent issues), and stigma (26.8%). Only 2.7% could walk ≥1 km independently. Rehabilitation Goals: Bladder function improvement (49%) was the top priority, followed by restoring mobility (standing 17%; walking 16%) and preventing complications (10%). Notably, 63.3% did not define specific bladder management targets. Predictors: Multivariate analysis showed that thoracic/cervical injury, complete paralysis, and limited mobility were predictors of prioritizing bladder management (p<0.001). Employment reintegration was significantly influenced by mobility level, environmental accessibility, and social factors such as stigma and recurrent illness.ConclusionSCI individuals face intertwined challenges that impact rehabilitation and social participation. Bladder care, mobility, psychosocial stressors, and environmental access are key factors shaping rehabilitation priorities and employment outcomes. Individualized, biopsychosocial approaches are essential to promote recovery and community reintegration.

Background/Objectives: Bladder cancer is characterized by high recurrence and progression rates, posing a challenge to current diagnostic and treatment strategies. This review aims to provide a comprehensive overview of emerging technologies, including novel PET tracers, AI-assisted cystoscopy, theragnostics, and molecular biomarkers. Methods: We performed a narrative review of the recent literature focusing on innovations in imaging, AI, theragnostics, and biomarker research relevant to bladder cancer diagnosis and management. Results: Several novel PET tracers, such as 68Ga-PSMA and fibroblast activation protein inhibitor (FAPI), demonstrated potential in improving detection sensitivity. AI-enhanced cystoscopy has shown promise in real-time lesion detection, while theragnostic agents enable combined diagnostic and therapeutic applications. Advances in molecular biomarkers, including circulating Tumor DNA (ctDNA) and gene expression signatures, offer new avenues for patient stratification and monitoring. Conclusions: Integration of advanced imaging, AI, theragnostics, and biomarker analysis may transform bladder cancer management, supporting personalized and more effective care strategies.

ABSTRACTIntroductionSpinal cord injury (SCI) is associated with complex complications and long‐term disability. Mobile health applications are crucial for managing their complications and challenges, given their high adoption rate among these patients. While previous studies have developed and evaluated self‐management mobile applications for SCI in other languages and contexts, to date, no Persian‐language application tailored to the unique needs of individuals with SCI in Iran and other Persian‐speaking countries has been published. This study aims to develop and evaluate the short‐term usability of a self‐management mobile application through the participation of 20 people with spinal cord injuries.MethodsThis applied developmental study was conducted in 2024 in two phases: the design and development phase and the usability evaluation phase. The application's key requirements and required capabilities were identified in the first phase, and a conceptual model was developed using Microsoft Visio. In the second phase, the application's usability was evaluated using the MAUQ questionnaire.ResultsThe application's menu services included modules for autonomic dysreflexia, skin care, bowel management, lifestyle, bladder management and a specialist finder. In the usability evaluation phase of the SCI self‐management mobile application, its usability score was 78.7%, signifying an acceptable level of usability.ConclusionIn this study, the design and development of the application were tailored to the needs of Persian‐speaking participants with SCI to ensure alignment with both the linguistic/cultural requirements and self‐management needs of this population. Accordingly, usability evaluation was conducted to identify and address potential issues, ensuring that the final product is comprehensive and effectively covers most complications and challenges faced by individuals with SCI.

Reducing post-stroke urinary tract infection through protocolized bladder management.

Patient-reported outcome measures in Spina Bifida from adolescence to adulthood - A systematic review.

We present the TENSmini, a compact and wearable device (38 $\times$ 38 $\times$ 21 mm${}^{3}$, weighing only 31 g), designed for home-based self-management of overactive bladder syndrome (OAB). The device integrates two conductive textile electrodes into a sock, which can be washed and reused. It is wirelessly controlled with mobile devices to generate current pulses with adjustable frequency from 1 to 100 Hz, pulse width of 50 to 250 $\mu$s, and amplitude of up to 60 mA. A safety-enhanced drive circuit with galvanic isolation and automatic detection mechanism monitors electrode connections, prevents over-current, and protects users against open-circuit conditions. We report on the electrical properties of the conductive textile electrodes and present results from a real-world study involving ten human participants. The findings confirm that the wearable device effectively stimulates the tibial nerve and performs comparable to a clinical-grade stimulator. In general, the proposed system shows potential for OAB management due to its wearability, improved safety features, and long-term reusability.

Prospective, descriptive, analytical, observational study involving 12 multicenter, international centers from Spain and Italy. Determine the method for bladder voiding in spinal cord injury (SCI) patients concerning different intrinsic and environmental variables. Neurogenic bladder is common in spinal cord injury (SCI) patients, profoundly impacting their quality of life. While clean intermittent catheterization (CIC) is the preferred method due to fewer complications and infections and improved quality of life, alternative methods like indwelling catheterization or condom catheters are viable options for bladder management. Data was gathered along the acute (at hospital admission), subacute (expectations at discharge) and hospital discharge phases. Data from 266 SCI patients was gathered. Main procedure for bladder voiding at the time of admission was indwelling catheterization (n = 242, 91.0%) and CIC was the most used procedure at discharge (n = 122, 45.9%). CIC is the preferred procedure when the evaluation of expectations at discharge is done (n = 181, 68.6%). The probability of achieving reflex voiding at discharge was higher as the American Spinal Injury Association (ASIA) Impairment Scale score improved (p < 0.001). A relationship was established with the level of injury (p < 0.001) and body mass index (p = 0.017), in addition to marital status, age and history of depression. Initial information about CIC was mostly provided by the urologist (n = 137, 73.3%) while training was predominantly done by the nurse (n = 159, 87.8%). Differences in neurogenic bladder management were identified regarding level and injury severity, SCIM, BMI, marital status, age and depression history. B Braun Medical S.A.U.

Systematic review and meta-analysis on the role of transcutaneous electrical nerve stimulation in children with overactive bladder - Pooled analysis of nine randomized controlled trials.

ABSTRACTObjectivesWe aimed to assess lower urinary tract function and morphological changes in kidney transplant recipients with a history of graft pyelonephritis and investigate the association between specific types of lower urinary tract dysfunction and the risk of recurrent graft pyelonephritis.MethodsWe retrospectively reviewed the medical records of kidney transplant recipients hospitalized for febrile graft pyelonephritis more than 1 year after transplantation between April 2019 and October 2023. Patients underwent cystography and urodynamic studies after infection control and were followed up for at least 12 months. They were classified based on urodynamic findings, and recurrence‐free survival was analyzed.ResultsTwenty‐four patients were included. Vesicoureteral reflux of the grafted kidney was observed in 20 (83.3%) patients. Detrusor overactivity, detrusor underactivity, and low‐compliance bladders were diagnosed in 8 (33.3%), 12 (50.0%), and 7 (29.2%) patients, respectively. Based on urodynamic findings, treatment and bladder management were modified in 20 patients. During a median follow‐up of 33 months, seven patients developed recurrent graft pyelonephritis. Detrusor overactivity remained an independent risk factor for recurrent graft pyelonephritis (odds ratio, 21.4; p = 0.04). Patients with detrusor overactivity or underactivity but not low‐compliance bladder had significantly shorter recurrence‐free survival compared with those without these dysfunctions (p = 0.017, 0.038, and 0.38, respectively).ConclusionsPersistent lower urinary tract dysfunction, particularly detrusor overactivity, is a significant risk factor for recurrent graft pyelonephritis. Comprehensive evaluation of vesicoureteral reflux and lower urinary tract function via urodynamic studies is important to improve posttransplant outcomes in patients with a history of graft pyelonephritis.

Introduction. Detrusor overactivity has been detected in approximately 50% of women with overactive bladder symptoms. According to the NICE guidelines, urodynamic testing is mandatory confirm the diagnosis of detrusor overactivity before performing minimally invasive treatment. Material and methods. This study retrospectively analyzes 76 women, categorized into two groups based on age: reproductive age (n = 49) and climacteric period (n = 27), referred to the Timofei Moșneaga Republican Clinical Hospital between 2022 and 2024 for symptoms of overactive bladder. The research focused on physical examination, questionnaires, bladder diary, urinalysis, and urodynamic measurements before and after botulinum toxin type A injections in 30 patients with overactive bladder refractory to first-line therapy. Results. In women with overactive bladder, the reproductive group was as follows: moderate problems (51%) &gt; very severe problems (31%), severe problems (18%) (p = 0.02); in the group of women in the climacteric period: severe problems (48%) &gt; very severe problems (37%) &gt; moderate problems (15%) (p = 0.10). Based on urodynamics data, the diagnosis of overactive bladder with detrusor overactivity was confirmed by establishing the presence of phasic contractions of the detrusor (3.9 ± 1.15), increased values of detrusor pressure (45.9 ± 23.9 cmH2O) and reduced bladder compliance (10.4 ± 11.4 ml/cmH2O). In 100% of cases, these findings predicted an effective botulinum toxin type A injection. Daytime urinary frequency, nocturia, and urinary urgency scores improved significantly after botulinum toxin type A injection by 41.7%, 26.1% and 34.1%, respectively. Conclusion. The study revealed age differences in overactive bladder symptom severity between the women in both groups. The reproductive period group experienced moderate complications, while the climacteric period group had more severe complications. Administration of botulinum toxin type A through detrusor injection has been shown to be efficacious in the management of overactive bladder

Global insights into overactive bladder management: A survey of physician preferences and practices

To evaluate lower urinary tract symptoms (LUTS) in toilet-trained children with anorectal malformations (ARM), identify risk factors for neurogenic bladder dysfunction (NBD) and develop a scoring system to predict poor urological outcomes. This retrospective study reviewed records and conducted interviews for lower urinary tract symptoms (LUTS) and bladder management strategies in ARM patients treated at our center between April 2014 and March 2019. Logistic regression analysis identified risk factors, while a scoring system was developed using the Number Needed to Treat (NNT) metrics. Out of 166 patients, 32.5% (n = 54) exhibited LUTS. High ARM significantly increased the risk of NBD (RR: 2.43; p < 0.0001). Additional risk factors included vertebral anomalies (RR: 1.66; p = 0.0486), prior bladder surgeries (RR: 2.68; p < 0.0001), and abdomino-perineal reconstruction (RR: 2.88; p < 0.0001). The developed scoring system, with a threshold score of ≥ 12, demonstrated a sensitivity of 70.4% and specificity of 76.8% for predicting NBD. This study highlights the significant prevalence of NBD in ARM patients and identifies critical risk factors. The scoring system offers a practical tool for early risk stratification, aiding in timely interventions. Further prospective studies are needed to validate the scoring system and refine management strategies.