Bladder Syndrome Research Articles

Sleep Disorders and Childhood Enuresis in Women with Overactive Bladder Syndrome: Cross-Sectional Study

Sleep Disorders and Childhood Enuresis in Women with Overactive Bladder Syndrome: Cross-Sectional Study

Anxiety and depressive disorders in patients with primary painful bladder syndrome. Part 1: Symptoms and clinical progression

The article is dedicated to affective disorders developing in patients with primary painful bladder syndrome. The causes of their development and influence on the quality of patients’ life are considered. An overview of the etiopathogenic links between anxiety and depressive disorders and bladder pain is presented. it should be noted that common comorbidity with depressive and anxiety disorders is a risk factor for the unfavorable course and chronicity of pain conditions that requires to involve a psychotherapist or psychiatrist for examination and treatment of patients with primary painful bladder syndrome, and, if the somatoform nature of primary painful bladder syndrome is found, for prescribing relevant drug and non-drug treatment.

A Novel Spectrofluorimetric Method for Vibegron in the Newly FDA Approved Pharmaceutical Formulation and in Human Plasma: Analytical QbD Strategy for Method Development and Optimization.

Vibegron is a novel selective beta-3 adrenergic receptor agonist molecule, recently approved by US Food and Drug Administration (FDA) in tablet pharmaceutical formulation for treating overactive bladder syndrome. Such formulation necessitates the development of a simple, fast and cost-effective methodology capable of assaying the drug in various real samples with high sensitivity. Herein, a facile and robust spectrofluorimetric method was introduced, for the first time, for vibegron quantification based on analytical quality-by-design approach. The method involves drug reaction with dansyl chloride at pH 9.8, as a smart approach to overcome the non-fluorescent nature of vibegron, giving a highly fluorescent yellow derivative measured at 514nm after being excited at 345nm. Plausible reaction scheme between the drug and dansyl chloride was elucidated through studying the differences in their infrared (IR) spectra. Variables affecting fluorescence intensities were carefully screened and rationally optimized via preliminary scouting studies and central composite design for accurate and robust results. Full International Council for Harmonisation (ICH) validation protocol was followed where linearity was achieved in range of 20.0-400.0 ng/mL with minimum detectability of 3.6 ng/mL. The proposed method expressed good capability in assaying the marketed dosage forms with no excipient inference. Finally, the high sensitivity of such method paved the way for extending its application to quantify vibegron in spiked human plasma at concentrations around its real human plasma concentrations for further bioavailability studies.

Assessing the Work Productivity Impact of Overactive Bladder Syndrome Among Employees at a Brazilian Hospital.

Few studies have investigated the relationship between work productivity (WP) and overactive bladder syndrome (OABS). The majority of those that do use generic productivity questionnaires or only include WP as a secondary outcome. We evaluated the impact of OABS on specific domains of WP, with the hypothesis that OABS has an impact on the domains of efficiency, concentration, vigor, and irritability, lost working hours, interruptions, and impairment to the work schedule. An observational, cross-sectional study with 576 female employees (without SBH 447, dry OABS 63, wet OABS 66) was carried out. The 8-item Overactive Bladder Questionnaire (OAB-V8), International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB), and a WP questionnaire developed by the authors were used. Non-parametric tests were adopted to associate OABS with productivity. The correlation between the instruments was performed using the Spearman test, adopting a value of p = 0.05. There was a significant impact of urinary symptoms on WP (p = 0.03) in the domains of productivity/efficiency (p = 0.03), restlessness (p < 0.05), and interruptions to go to the bathroom (p = 0.03), which was higher among employees with wet OABS. Urgency and urge urinary incontinence (UUI) were the symptoms with the greatest productive impact (p = 0.01, p < 0.001). A significant correlation was found between WP scores and OAB-V8 and ICIQ-AOB scores in both groups (p < 0.05). OABS impacted WP, in the domains of efficiency, restlessness, and interruptions to go to the bathroom, with urgency and UUI being the symptoms with the greatest impact on productivity.

Predictive Factors for Clean Intermittent Catheterization after Intravesical OnabotulinumtoxinA Injections in Women with Overactive Bladder: a Danish Retrospective Cohort Study.

We aimed to evaluate the clean intermittent catheterization (CIC) rate in women undergoing their first OnabotulinumtoxinA (BTX-A) treatment and to investigate factors predictive of initiating CIC. This was a retrospective cohort of women, who had their first BTX-A treatment for symptoms of overactive bladder (OAB) syndrome, with a pretreatment urodynamic study (UDS). We reviewed demographic, medical and gynecological history, UDS, pretreatment bladder diaries, objective examinations, BTX-A treatment details, and post-void residual (PVR) reports in the electronic medical record. Botox® Allergan 100 International Units were injected into the detrusor at 10-20 sites. Statistical analyses included univariate and multivariate logistic regression analyses. We included 397 women. Median age was 68 (Q1-Q3: 54-76) years. CIC rate was 8.6% (n = 34) following the first BTX-A treatment. Urgency urinary incontinence (UUI) reduced the risk of undergoing CIC (OR 0.30, 95% CI 0.09-0.97). A bladder capacity of 500ml or greater in the bladder diary increased the risk of CIC (OR 2.46, 95% CI 1.06-5.70), whereas reported leakages were associated with a decreased risk of CIC (OR 0.24, 95% CI 0.10-0.57). Multivariate logistic regression analysis showed that anterior colporrhaphy (OR 3.71, 95% CI 1.52-9.06) and 10-ml increments in median maximum cystometric capacity (OR 1.03, 95% CI 1.00-1.06) predicted CIC, whereas UUI was a protective factor for CIC (OR 0.23, 95% CI 0.07-0.79). A history of anterior colporrhaphy, large bladder capacity, and absence of incontinence episodes in bladder diary or UDS were risk factors for CIC after the first BTX-A treatment.

Short and long-term clinical results of a minimally invasive syringe adapter for catheter free instillation of intravesical treatments

Introduction:Intravesical treatment is currently dependent on catheterization which can cause urethral discomfort and risk of urinary tract infections in selected patient groups such as interstitial cystitis/bladder pain syndrome (IC/BPS), overactive bladder syndrome (OAB) and recurrent urinary tract infections (rUTI). This study describes real-life clinical experience of a minimally invasive syringe adapter (Ialudapter®) for catheter-free instillation of intravesical treatment. Methods:A retrospective study from a single center was performed. Quantitative and qualitative data was obtained on the use of the syringe adapter (IALUADAPTER®) in 61 patients with IC/BPS (n=48), rUTI (n=6) and mixed /other diagnoses (including OAB; n= 7) who were receiving intravesical therapy. The evaluation period was 6 months during 2018–2019. Reasons for trying the syringe adapter, reasons for continuing with it and occurrence of UTIs before and during the evaluation period were recorded. In addition, 3 year follow-up data were obtained to assess long-term usage of the syringe adapter. Results:Mean follow-up was 4 months. The use of the syringe adapter was successful in 75% and a positive experience in 74% with the latter continuing to use the syringe adapter. Long-term (>3 yrs) adherence of 40% was observed. The patients reported less pain (41%) while 23% reported that it was easier to use compared to conventional catheters. Only 6 UTIs were observed in the follow-up period. Discussion and conclusions:This retrospective study shows that the Ialudapter® is a good, safe alternative to conventional catheterization for intravesical treatment.

Exploring paruresis (‘shy bladder syndrome’) and factors that may contribute to it: a cross-sectional UK survey study

ObjectivesTo assess the prevalence and severity of paruresis (‘shy bladder syndrome’) in a population of university staff and students and to determine if there was any relationship between demographics, self-esteem, presence of social anxiety disorders and negative toilet experiences and paruresis.DesignWe undertook an anonymised cross-sectional online survey using Microsoft Forms. We invited participants aged 18 and over to complete the survey which included demographic information; any pre-existing medically or self-diagnosed anxiety-related conditions; Shy Bladder Scale (SBS); Rosenberg Self-Esteem Scale (RSES) and questions about using school toilets in their younger life. We defined ‘mild’ and ‘severe’ paruresis based on total SBS cut-off scores of greater than or equal to 31 and greater than or equal to 40. We calculated prevalence of paruresis, and explored differences in self-esteem, school toilet experience and social anxiety disorders between individuals with and without paruresis. Multivariable logistic regression was used to determine which variables had any influence on having a ‘mild’ and ‘severe’ paruresis diagnosis.SettingWe distributed the survey to all staff and students via their university email address as well as promoting the survey on university social media sites.ResultsWe received responses from 356 individuals. Most participants (237, 66.6%) were within the 18–30 year age category and most (277, 77.8%) were white. There were 221 (62.1%) females, 119 (33.4%) males and 16 (4.5%) other genders. The prevalence of ‘mild’ paruresis was 25.8% and of ‘severe’ paruresis 14.9% in this sample. 73.0% indicated that they had at least one medically or self-diagnosed anxiety disorder. There was a statistically significant difference in the total SBS score between individuals with and without an existing anxiety disorder (8 vs 19, &lt;0.001). The adjusted odds of ‘mild’ paruresis were higher for men than women (OR 3.39; 95% CI 1.90 to 6.06), lower for those with a lower RSES score (OR 0.90; 95% CI 0.85 to 0.96), lower for those for a lower school toilet experience score (OR 0.88; 95% CI 0.78 to 0.99) and higher for those with at least one anxiety disorder (OR 3.164; 95% CI 1.52 to 6.59). The adjusted odds of ‘severe’ paruresis were higher for men than women (OR 2.60; 95% CI 1.32 to 5.12), lower for those with a lower RSES score (OR 0.90; CI 0.84 to 0.97) and higher for those with at least one anxiety disorder (OR 2.99 (1.18–7.56)).ConclusionLarge organisations should consider measures to help manage anxiety and improve toilet experiences. These could include resources and signposting to manage anxiety disorders and single-occupancy toilets and toilets in quiet areas to limit anxiety associated with shy bladder syndrome.

The Mickey Mouse Sign: A Novel Sign for a Compliant and Underactive Bladder Syndrome

The Mickey Mouse Sign: A Novel Sign for a Compliant and Underactive Bladder Syndrome

How Can We Show That Artificial Intelligence May Improve Our Assessment and Management of Lower Urinary Tract Dysfunctions?-ICI-RS 2024.

The integration of artificial intelligence (AI) into functional urology management must be assessed for its clinical utility, but hopefully will change, perhaps to revolutionize the way LUTD and other conditions are assessed, the aim being to offer patients more rapid and effective management which enhances patient outcomes. The aim of this proposal, discussed at the ICI-RS annual meeting, is to evaluate the available evidence on AI and the way it might change the approach to urodynamic (UDS) diagnoses, including overactive bladder syndrome (OAB), and perhaps other LUTDs such as bladder outflow obstruction. A compendium of discussion based on the current evidence related to AI and its potential applications in UDS and OAB. AI-powered diagnostic tools are being developed to analyze complex datasets from urodynamic studies, imaging, and other diagnostic tests. AI systems can leverage large volumes of clinical data to recommend personalized treatment plans based on individual patient profiles to optimize surgical procedures, enhance diagnostic precision, tailor the therapy, reduce the risk of complications, and improve outcomes. In the future, AI will be able to provide tailored counseling regarding the outcomes and potential side effects of drugs and procedures to a given patient. AI's role in functional urology has been poorly investigated, and its implementation across several areas may improve clinical care and the pathophysiological understanding of functional urologic conditions.

Unilateral and Bilateral Transcutaneous Tibial Nerve Stimulation in Women With Overactive Bladder Syndrome: A Randomized Controlled Study (UBTTNS-OAB Study).

The efficacy of unilateral versus bilateral Transcutaneous Tibial Nerve Stimulation (TTNS) for women with Overactive Bladder Syndrome (OAB) remains uncertain. To compare the efficacy of unilateral and bilateral TTNS in the tibial region in women with OAB. This randomized, controlled, triple-blind clinical trial included women with OAB or urgency-predominant urinary incontinence (UUI). Participants were randomized (1:1) into the Unilateral Tibial Group or Bilateral Tibial Group. Before treatment, they underwent a pre-assessment including peripheral sensitivity examination and completion of sociodemographic data and seven validated questionnaires on urinary symptoms, quality of life, sleep, and psycho-emotional aspects. TTNS interventions were administered twice weekly (12 sessions, 30 min each). Posttreatment, participants underwent another physical examination and completed the same questionnaires, with a 30-day follow-up. Categorical variables were analyzed using Chi-square or Fisher's Exact Test, while numerical variables were assessed with the Mann-Whitney test. Group comparisons over time utilized intention-to-treat ANOVA (p < 0.05). Thirty-five women participated: 17 in the unilateral group and 18 in the bilateral group. Mean ages were 55.1 (±14.7) years and 52.7 (±12.6) years, respectively (p = 0.680). Initial OAB severity (ICIQ-OAB) did not differ significantly between groups (p = 0.561). Both groups showed significant improvement in ICIQ-OAB scores: unilateral group from 10.1 (±3.4) to 5.8 (±3.4) (p < 0.001), bilateral group from 9.3 (±3.3) to 5.1 (±4) (p < 0.001), with no intergroup difference (p = 0.395). Improvement in UUI symptoms was observed: unilateral group from 2.2 (±1.4) to 0.7 (±1.5), bilateral group from 1.5 (±1.9) to 0.2 (±0.5), without significant intergroup difference (p = 0.645). Quality of life scores improved similarly between groups (p = 0.055). TTNS appears to be effective in improving bladder storage and UUI symptoms in women with OAB, with no difference between unilateral and bilateral applications. Brazilian Registry of Clinical Trials (REBEC) (RBR: 96f2fgkn).

Telerehabilitation Program Impact on Overactive Bladder Symptoms and Metabolic Health in Obese Women: a Randomized Controlled Trial

INTRODUCTION. Overactive bladder syndrome is caused by many factors including obesity, insulin resistance and poor dietary habits. Since it is a chronic disease and needs time to be treated, introducing telepilates in addition to Mediterranean diet would encourage better adherence and results to the treatment program. AIM. To assess the impact of a virtual group-based telerehabilitation program on overactive bladder symptoms and metabolic health in women with obesity. MATERIAL AND METHODS. Eighty obese women (BMI 30.0–34.9 kg/m2) between the ages of 35 and 45 were allocated into two equal groups, 40 for each: (A) supervised telepilates and (B) unsupervised telepilates. The supervised group participated in a 12-week Pilates workout program over videoconference platforms three times a week. Meanwhile, the unsupervised group only received four online meetings. The groups’ diet was the Mediterranean style. The Hemostatic Model of Insulin Resistance (HOMA-IR), body mass index (BMI), waist circumference (WC), Patient Perception of Urgency Scale (PPIUS), Overactive Bladder Questionnaire Short Form (OAB-q SF), and Telehealth Usability Scale (TUS) were measured. RESULTS AND DISCUSSION. The supervised telepilates group exhibited statistically significant amelioration of overactive bladder symptoms and a reduction in HOMA-IR (p 0.001), while the unsupervised telepilates group showed insignificant changes in these measures (p 0.05). Furthermore, the supervised telepilates group showed significantly greater reductions in BMI and WC (p 0.001) than the unsupervised telepilates group (p 0.05). Additionally, the supervised telegroup outperformed the unsupervised telegroup on all parameters of TUS (p 0.001) CONCLUSION. Women with obesity experienced decrease in overactive bladder symptoms and improved metabolic health after completing a 12-week telepilates training program.

127 - UPK3A+ umbrella cell damage mediated by TLR3-NR2F6 triggers programmed destruction of urothelium in Hunner-type interstitial cystitis/painful bladder syndrome

127 - UPK3A+ umbrella cell damage mediated by TLR3-NR2F6 triggers programmed destruction of urothelium in Hunner-type interstitial cystitis/painful bladder syndrome

Sexual Dysfunction in Patients with Overactive Bladder Syndrome Treated with Botulinum Toxin

Introduction: Overactive bladder (OAB) is a syndrome of the lower urinary tract characterized by urinary urgency, frequency, and nocturia, with or without urgency urinary incontinence. OAB significantly impacts all aspects of life—social, psychological, physical, professional, domestic, and sexual—for both women and men. The aim of this study was to investigate sexual dysfunction in both women and men with OAB treated with intravesical onabotulinumtoxinA (Botox) injections using the Sexual Quality of Life questionnaire in two versions: female (SQoL-F) and male (SQoL-M). Methods: Forty sexually active patients (thirty women and ten men) with idiopathic OAB were recruited. Patients completed the SQoL-F or SQoL-M questionnaire before treatment, and again at 3 and 6 months after treatment with intravesical onabotulinumtoxinA injections. Results: All 40 patients completed the study (30 women and 10 men). There were no statistically significant differences in SQoL results before the procedure or at 3- and 6-months post-treatment. Conclusions: OAB treatment with onabotulinumtoxinA did not significantly affect the quality of sexual life in either women or men. Further research is needed using questionnaires specifically designed to assess the sexual life of patients with OAB, especially in men.

169 - A closer look into overactive bladder syndrome: exploring the use of NESA microcurrents neuromodulation.

169 - A closer look into overactive bladder syndrome: exploring the use of NESA microcurrents neuromodulation.

219 - Characterization of the Urethral Virome in Female Patients with Overactive Bladder Syndrome compared to Controls: a pilot study

219 - Characterization of the Urethral Virome in Female Patients with Overactive Bladder Syndrome compared to Controls: a pilot study

168 - Dorsal Genital Nerve stimulation in patients with overactive bladder syndrome. A feasibility study with the novel UCon neurostimulator

168 - Dorsal Genital Nerve stimulation in patients with overactive bladder syndrome. A feasibility study with the novel UCon neurostimulator

Control of nerve-mediated and urothelial ATP release by a protein kinase G-dependent pathway in the mouse bladder

Aim:ATP signalling is involved in urinary bladder motor and sensory pathways, including stimulation-mediated release from parasympathetic varicosities to detrusor muscle and from urothelial cells when mechanically stressed. Both modalities are present in humans and other mammals but are especially prominent in overactive bladder syndromes. There is therefore an unmet need to understand how to regulate such release. This study tested the hypothesis that the nitric oxide (NO•)/ soluble guanylate cyclase (sGC)/ cyclic GMP/ protein kinase-G (PKG) pathway has a central role. Methods:In vitro nerve-mediated contractions and ATP/acetylcholine (ACh) release were measured from bladder wall strips, as was ATP release from urothelial cell suspensions subject to mechanical stresses. Enhanced spontaneous contractile activity was also measured in bladder wall preparations of spinal cord-injured mice. Interventions were designed to increase cellular cGMP levels (a cell-permeable cGMP analogue, a NO•donor, a phosphodiesterase inhibitor (PDEI), a sGC activator), or agents to reduce activity of pathway enzymes (sCG or PKG). Results:ATP-dependent contractions were reduced by the above interventions, as was ATP release; but ACh-dependent contractions and ACh release were unaffected. Spontaneous contractile activity was also reduced by the cGMP analogue and by a PDEI. ATP release from urothelial cell suspensions was also reduced by similar interventions. Conclusions:ATP release from efferent nerves and from urothelial cells were selectively reduced by upregulating the NO•/sGC/cGMP/PKG pathway. Translational aspects are discussed with respect to purinergic pathways and overactive bladder pathologies.

267 - Darifenacin versus Parasacral Transcutaneous Electrical Nerve Stimulation for Overactive Bladder Syndrome in Patients Infected With Human T-Cell Lymphotropic Virus 1 – Preliminary Results of a Randomized Clinical Trial

267 - Darifenacin versus Parasacral Transcutaneous Electrical Nerve Stimulation for Overactive Bladder Syndrome in Patients Infected With Human T-Cell Lymphotropic Virus 1 – Preliminary Results of a Randomized Clinical Trial

173 - Predictive factors for clean intermittent catheterization after intravesical onabotulinumtoxinA injections in women with overactive bladder syndrome: A Danish retrospective cohort study

173 - Predictive factors for clean intermittent catheterization after intravesical onabotulinumtoxinA injections in women with overactive bladder syndrome: A Danish retrospective cohort study

Urge Symptoms after Vaginal Uterosacral Plication in Urinary Incontinence Patients without Proximal Urethral Mobility: A Prospective Study

Introduction: The primary objective of this study was to evaluate the impact of vaginal uterosacral plication on urge symptoms and quality of life in a cohort of patients with uterosacral ligament insufficiency and urge symptoms. Methods: A total of 40 female patients were included in the study, and their posterior fornix was supported with gauze to simulate the surgical procedure. Uterosacral plication was applied to patients who experienced a decrease in urinary incontinence, nocturia, a sense of urgency, and a decrease in urge urinary incontinence symptoms or complete recovery. Images of the bladder, bladder neck, urethra, and symphysis pubis were obtained preoperatively and 1 year postoperatively. POP-Q staging was also performed, and patients completed the Overactive Bladder Evaluation Form (OAB-V8) and the Incontinence Impact Questionnaire Short Form (ICIQ-SF). Results: Results from the OAB-V8 questionnaire showed that postoperative nocturia scores improved by 72.1% compared to preoperative scores, and the need to urinate at night and waking up scores improved by 68.3%. The mean bladder neck thickness and the mean detrusor thickness were significantly decreased from 10 to 9.2 (p < 0.0001) and from 8.7 to 6.4 (p < 0.0001), respectively. The ICIQ-SF questionnaire scores showed a 68.4% improvement in urinary incontinence affecting daily life after the operation. Conclusion: This study adds to the clinical evidence that uterosacral ligament support improves symptoms of overactive bladder syndromes, including urgency and nocturia. The use of pelvic floor ultrasound and the apical tamponade test is important in patient selection for the correct indication.