Urinary Tract Dysfunction Research Articles

Onset of Spontaneous Filling and Voiding Cycles in the Lower Urinary Tract: A Modeling Study.

Spontaneous filling and voiding cycles represent a key dynamical feature of the healthy lower urinary tract. Some urinary tract dysfunctions, such as over-flow incontinence, may alter the natural occurrence of these cycles. As the function of the lower urinary tract arises from the interplay of a multitude of factors, it is difficult to determine which of them can be modulated to regain spontaneous cycles. In this study, we develop a mathematical model of the lower urinary tract that can capture filling and voiding cycles in the form of periodic solutions of a system of ordinary differential equations. After experimental validation, we utilize this model to study the effect that several physiological quantities have on the onset of cycles. We find that some parameters have an associated numerical threshold that determines whether the system exhibits healthy cycles or settles in a state of constant overflow.

A better understanding of basic science may help our management of LUTS/LUTD in older persons with nocturnal polyuria and nocturia: ICI-RS 2024.

To discuss the role of autocrine/paracrine signaling of urothelial arginine vasopressin (AVP) on mammalian bladder capacities and micturition thresholds, impact of distension on water/urea reabsorption from the bladder, review of the literature to better characterize the central/peripheral effects of AVP, desmopressin (dAVP) toxicity, and urine biomarkers of nocturia. This review summarizes discussions during an International Consultation on Incontinence-Research Society2024 think tank with respect to the role of urothelial AVP in aged individuals with nocturnal polyuria, impact of solute and water reabsorption by the bladder on uninterrupted sleep, central effects of AVP, pharmacological basis of dAVP toxicity, and biomarkers in nocturia/lower urinary tract dysfunction(LUTD) with neurological diseases. Consensus recognized AVP function and pathways in thecentral nervous system(CNS), pre-proAVP localized using immunohistochemistry in bladder sections from adult/aged noncancerous human punch biopsies and rodent bladder sections is likely to accelerate the systemic uptake of water and urea from the bladder of anesthetized mice instilled with 3H-water and 14C-urea. Mechanisms for charged and uncharged solutes and water transport across the bladder, mechanism of dAVP toxicity, and utility of urine biomarkers in those with neurological diseases/nocturia were determined from literature reviews. Pre-proAVP is present in human/rodent bladders and may be involved in water reabsorption from bladder that prevents the sensation of fullness for uninterrupted sleep in healthy adults. The mechanism of action of AVP in the CNS was discussed, as was electrolyte/water transport across the bladder, the basis for dAVP toxicity, and feasibility of urine biomarkers to identify nocturia/LUTDwith neurological diseases.

Cortical intermittent theta burst stimulation on gait pathomechanics and urinary tract dysfunction in incomplete spinal cord injury patients: Protocol for a randomized controlled trial

Gait impairment and neurogenic bladder are co-existing common findings in incomplete spinal cord injury (iSCI). Repetitive transcranial magnetic stimulation (rTMS), evident to be a promising strategy adjunct to physical rehabilitation to regain normal ambulation in SCI. However, there is a need to evaluate the role of Intermittent theta burst stimulation (iTBS), a type of patterned rTMS in restoring gait and neurogenic bladder in SCI patients. The aim of the present study is to quantify the effect of iTBS on spatiotemporal, kinetic, and kinematic parameters of gait and neurogenic bladder dyssynergia in iSCI. After maturing all exclusion and inclusion criteria, thirty iSCI patients will be randomly divided into three groups: Group-A (sham), Group-B (active rTMS) and Group-C (active iTBS). Each group will receive stimulation adjunct to physical rehabilitation for 2 weeks. All patients will undergo gait analysis, as well assessment of bladder, electrophysiological, neurological, functional, and psychosocial parameters. All parameters will be assessed at baseline and 6th week (1st follow-up). Parameters except urodynamics and gait analysis will also be assessed after the end of the 2 weeks of the intervention (post-intervention) and at 12th week (2nd follow-up). Appropriate statistical analysis will be done using various parametric and non-parametric tests based on results.

Long term clinical follow up of four patients with Wolfram syndrome and urodynamic abnormalities.

Wolfram syndrome is characterised by insulin-dependent diabetes (IDDM), diabetes insipidus (DI), optic atrophy, sensorineural deafness and neurocognitive disorders. The DIDMOAD acronym has been recently modified to DIDMOAUD suggesting the rising awareness of the prevalence of urinary tract dysfunction (UD). End stage renal disease is the commonest cause of mortality in Wolfram syndrome. We present a case series with main objective of long term follow up in four children having Wolfram syndrome with evaluation of their urodynamic profile. A prospective follow up of four genetically proven children with Wolfram syndrome presenting to a tertiary care pediatric diabetes clinic in Pune, India was conducted. Their clinical, and urodynamic parameters were reviewed. IDDM, in the first decade, was the initial presentation in all the four children (three male and one female). Three children had persistent polyuria and polydipsia despite having optimum glycemic control; hence were diagnosed to have DI and treated with desmopressin. All four patients entered spontaneous puberty. All patients had homozygous mutation in WFS1 gene; three with exon 8 and one with exon 6 novel mutations. These children with symptoms of lower urinary tract malfunction were further evaluated with urodynamic studies; two of them had hypocontractile detrusor and another had sphincter-detrusor dyssynergia. Patients with hypocontractile bladder were taught clean intermittent catheterization and the use of overnight drain. We report a novel homozygous deletion in exon 6 of WFS-1 gene. The importance of evaluation of lower urinary tract malfunction is highlighted by our case series. The final bladder outcome in our cases was a poorly contractile bladder in three patients.

Artificial Intelligence-Based Patient Monitoring System for Medical Support.

In this paper, we present the development of a monitoring system designed to aid in the management and prevention of conditions related to urination. The system features an artificial intelligence (AI)-based recognition technology that automatically records a user's urination activity. Additionally, we developed a technology that analyzes movements to prevent neurogenic bladder. Our approach included the creation of AI-based recognition technology that automatically logs users' urination activities, as well as the development of technology that analyzes movements to prevent neurogenic bladder. Initially, we employed a recurrent neural network model for the urination activity recognition technology. For predicting the risk of neurogenic bladder, we utilized convolutional neural network (CNN)-based AI technology. The performance of the proposed system was evaluated using a study population of 30 patients with urinary tract dysfunction, who collected data over a 60-day period. The results demonstrated an average accuracy of 94.2% in recognizing urinary tract activity, thereby confirming the effectiveness of the recognition technology. Furthermore, the motion analysis technology for preventing neurogenic bladder, which also employed CNN-based AI, showed promising results with an average accuracy of 83%. In this study, we developed a urination disease monitoring system aimed at predicting and managing risks for patients with urination issues. The system is designed to support the entire care cycle of a patient by leveraging AI technology that processes various image and signal data. We anticipate that this system will evolve into digital treatment products, ultimately providing therapeutic benefits to patients.

Prospective study of safety and objective improvement in sysmptoms of GSM (Genitourinary syndrome of menopause) withEr:YAG vaginal /urethral laser treatment

: Genitourinary Syndrome of Menopause (GSM) is the condition which combines the conditions of vulvovaginal atrophy (VVA) and urinary tract dysfunction which are associated with oestrogen deficiency. GSM is treated using vaginal laser therapy by using non-ablative Er: YAG laser therapy to evaluate the effectiveness and safety of this therapy. The present study was planned to evaluate the safety and objective improvement in symptoms of GSM with Er:yag vaginal / urethral laser treatment in sextual and urinary symptoms of post / peri menopausal women on long term basis. A prospective study was conducted at V care laser centre from 2020 on words to till date. Total sample population enrolled was 74 among them 53 completed 1 follow up and 29 had completed 2 follow up. Data were collected before and subsequent 2 follow ups over next 12 months on parameters like dryness, dyspareunia, itching/ burning and lower urinary tract symptoms, data were collected using VLQ (vaginal laxity questionnaire), VHIS (vaginal health index score), FSDS-R (The female sexual distress scale – revised)and Satisfaction questionnaire (0-3) assessed on FSFI. : The study showed symptomatic improvement among patients with GSM like no pain or mild pain among 79.31% and 20.39% respectively, no itching (72.41%) at the end of 2 follow up. There was an improvement in vaginal condition (normal – 93.10%) at the end of 2 follow up. Majority of patients reported no sexual distress (82.7%). : The non-ablative Er: YAG laser therapy is efficacious and safe modality for treatment of symptoms in cases of genitourinary syndrome of menopause. It also offers a promising, minimally invasive safe treatment for SUI.

The impact of cystocele repair on urge symptoms in women with pelvic organ prolapse.

The purpose of this study was to evaluate the impact of cystocele repair on urinary urge symptoms and to determine the likelihood that urge symptoms are caused by cystocele and therefore cured by cystocele repair. The secondary aim was to assess the impact of baseline cystocele stage POP on the improvement of urge symptoms following surgical treatment of POP. A total of 321 female patients with cystocele stages II, III or IV (POP), who underwent repair surgery for pelvic organ prolapse, were included. A retrospective analysis was performed to determine the presence of urge symptoms in patients with cystocele and to evaluate how many patients were cured from urge symptoms by the cystocele repair. Postoperative data were obtained by interview during a follow-up examination six weeks after surgery. Preoperatively, 52.02% of all patients diagnosed with cystocele stages II, III or IV POP experienced urge symptoms. Urge symptoms were cured in 88.62% of patients with cystocele stages II after POP repair (p < 0.005). 88.60% of patients with cystocele stage II POP and 88.68% of patients with cystocele stages III to IV POP reported improvement in urge symptoms (p < 0.005). Despite cystocele repair, 11.4% of patients with preoperative cystocele stage II POP and 11.32% with preoperative cystocele stages III and IV POP reported persistent urge symptoms. 5.84% of the study group who showed no urge symptoms preoperatively, experienced de novo urge symptoms after following surgery (p < 0.005). Cystocele repair cured urge symptoms in the majority of patients. Therefore, repair of bladder prolapse may help to differentiate urge symptoms from other urinary tract dysfunctions and assist in determining a proper diagnosis and treatment. However, the severity of POP had no significant influence on the improvement in urge symptoms following cystocele repair. Risk of de novo urge symptoms after anatomical repair still needs to be explored.

Risk factors for catheter–associated urinary tract infections following radical hysterectomy for cervical cancer

Radical hysterectomy is the mainstay of treatment for early-stage cervical cancer. Urinary tract dysfunction is one of the most common complications after radical hysterectomy, and prolonged catheterization has previously been defined as a significant risk factor for catheter-associated urinary tract infections. This study aimed to determine the rate of catheter-associated urinary tract infections after radical hysterectomy for cervical cancer, and to identify additional risk factors for developing catheter-associated urinary tract infections in this population. We reviewed patients who underwent radical hysterectomy for cervical cancer from 2004 to 2020 after institutional review board approval. All patients were identified from institutional Gynecologic Oncology surgical and tumor databases. The inclusion criterion was radical hysterectomy for early-stage cervical cancer. Exclusion criteria included inadequate hospital follow-up, insufficient records of catheter use in the electronic medical record, urinary tract injury, and preoperative chemoradiation. Catheter-associated urinary tract infection was defined as an infection diagnosed in a catheterized patient or within 48 hours of catheter removal, with significant bacteriuria (>103 cfu/mL) and symptoms or signs attributable to the urinary tract. Data analysis was performed using comparative analysis and univariate and multivariable logistic regression using Excel, GraphPad Prism, and IBM SPSS Statistics. Of the 160 included patients, 12.5% developed catheter-associated urinary tract infections. In univariate analysis, catheter-associated urinary tract infection was significantly associated with current smoking history (odds ratio, 3.76; 95% confidence interval, 1.39-10.08), minimally invasive surgical approach (odds ratio, 5.24; 95% confidence interval, 1.91-16.87), estimated surgical blood loss >500 mL (odds ratio, 0.18; 95% confidence interval, 0.04-0.57), operative time >300 minutes (odds ratio, 2.92; 95% confidence interval, 1.07-9.36), and increased duration of catheterization (odds ratio, 18.46; 95% confidence interval, 3.67-336). After adjusting for interactions and controlling for potential confounders with multivariable analysis, current smoking history and catheterization for >7 days were identified as independent risk factors for development of catheter-associated urinary tract infections (adjusted odds ratio, 3.94; 95% confidence interval, 1.28-12.37; adjusted odds ratio, 19.49; 95% confidence interval, 2.78-427). Preoperative smoking cessation interventions for current smokers should be implemented to decrease risk for postoperative complications, including catheter-associated urinary tract infections. In addition, catheter removal within 7 postoperative days should be encouraged in all women undergoing radical hysterectomy for early-stage cervical cancer in an effort to decrease infection risk.

Nutrigenomics: SNPs correlated to Food Preferences and Susceptibilities.

Nutrigenomics explores the intricate interplay between single nucleotide polymorphisms (SNPs), food preferences, and susceptibilities. This study delves into the influence of SNPs on food sensitivities, allergies, tyramine intolerance, and taste preferences. Genetic factors intricately shape physiological reactions to dietary elements, with polymorphisms contributing to diverse sensitivities and immune responses. Tyramine intolerance, arising from metabolic inefficiencies, unveils genetic markers exerting influence on enzyme function. SNPs transcend genetic diversity by exerting substantial impact on food sensitivities/allergies, with specific variants correlating to heightened susceptibilities. Genes accountable for digesting food components play pivotal roles. Given the rising prevalence of food sensitivities/allergies, understanding genetic foundations becomes paramount. In the realm of taste and food preferences, SNPs sculpt perception and choice, yielding variances in taste perception and preferences for sweetness, bitterness, and umami. This genetic medley extends its reach to encompass wider health implications. In this review article, we have focused on how polymorphisms wield significant sway over physiological responses, sensitivities, and dietary inclinations. Unraveling these intricate relationships illuminates the path to personalized nutrition, potentially revolutionizing tailored recommendations and interventions.

Protective Effects of a Polyphenolic Phytochemical Quercetin against Oxidative Dysfunctions in Rats.

Quercetin hastraditionally been used in various oxidative and urinary tract dysfunctions. Thecurrent project is consequently set to evaluate the defensive efficacy ofQuercetin against potassium bromate (KBrO3) induced testiculartissue oxidative dysfunctions through biochemical, hormonal, and genotoxicmarkers. To observe theprotective efficacy of Quercetin against urinogenital oxidative dysfunction inrats, thirty six albino male rats were divided into six groups. Protectiveefficacies of Quercetin were checked on reproductive hormonal levels,antioxidant enzyme activities, lipids peroxidation (LP), and DNA damages. Potassium bromate exposure in experimentalanimals caused a reduction in the activities of antioxidant enzymes and disturbedhormonal secretions while enhancing the peroxidation of lipids andfragmentations of DNA. Cotreatment of Quercetin considerably (P<0.01)reversed these abnormalities with admiration to levels of hormones, antioxidantenzymes activities, and peroxidations of lipids secure to those seen inuntreated rats. (P < 0.01). The findings of the current project revealedthat various doses of Quercetin are able to keep the testicular organ fromabnormal free radical dysfunctions. These improvements might be due to theantioxidant ability of polyphenolic bioactive constituent, i.e., Quercetin.

Upper urinary dilatation and treatment of 26 patients with diabetes insipidus: A single-center retrospective study.

ObjectiveTo describe the urinary tract characteristics of diabetes insipidus (DI) patients with upper urinary tract dilatation (UUTD) using the video-urodynamic recordings (VUDS), UUTD and all urinary tract dysfunction (AUTD) systems, and to summarize the experience in the treatment of DI with UUTD.MethodsThis retrospective study analyzed clinical data from 26 patients with DI, including micturition diary, water deprivation tests, imaging data and management. The UUTD and AUTD systems were used to evaluate the urinary tract characteristics. All patients were required to undergo VUDS, neurophysiologic tests to confirm the presence of neurogenic bladder (NB).ResultsVUDS showed that the mean values for bladder capacity and bladder compliance were 575.0 ± 135.1 ml and 51.5 ± 33.6 cmH2O in DI patients, and 42.3% (11/26) had a post-void residual >100 ml. NB was present in 6 (23.1%) of 26 DI patients with UUTD, and enterocystoplasty was recommended for two patients with poor bladder capacity, compliance and renal impairment. For the 24 remaining patients, medication combined with individualized and appropriate bladder management, including intermittent catheterization, indwelling catheter and regular voiding, achieved satisfactory results. High serum creatinine decreased from 248.0 ± 115.8 μmoI/L to 177.4 ± 92.8 μmoI/L in 12 patients from a population with a median of 108.1 μmoI/L (IQR: 79.9-206.5 μmoI/L). Forty-four dilated ureters showed significant improvement in the UUTD grade, and the median grade of 52 UUTD ureters decreased from 3 to 2.ConclusionBladder distension, trabeculation and decreased or absent sensations were common features for DI patients with UUTD. Individualized therapy by medication combined with appropriate bladder management can improve UUTD and renal function in DI patients.

Numerical investigation of urethra flow characteristics in benign prostatic hyperplasia

Background and objectiveConventional practice includes a limited depiction of urethral pressure and flows based on fragmented gross clinical observations. However, with technological advancements in simulations, computational fluid dynamics (CFD) can provide an alternative approach to predict the bladder pressure with a concordant quantitative flow field in the urethra. Thus, this study aims to comprehensively analyze the urine flow characteristics in various urethra models using simulations. MethodsThree-dimensional urethra models were constructed for seven specific subjects based on clinical radiographs. Simulations with Reynolds averaged Navier-Stokes model were performed to quantitatively investigate the urine flow under various volume flow rate of voided urine. ResultsUnder benign prostatic hyperplasia, the spindle shape of the prostatic urethra (PRU) generates wake flow. The wake flow was also observed in several regions downstream of the PRU, depending on the urethra shape. This wake flow resulted in total pressure loss and urinary tract dysfunction. When comparing pre- and post-operative urethra models, the bladder pressure decreased by 14.98% in P04 and 4.67% in P06. Thus, we identified variability between surgical results of patients. The bladder pressure according to the volume flow rate of voided urine was investigated using simulations and the theoretical consideration based on hydrodynamics. In theoretical consideration, the bladder pressure was expressed as a second-order polynomial for volume flow rate. These results concur with the simulation results. ConclusionNumerical simulation can describe the urine flow field in the urethra, providing the possibility to predict the bladder pressure without requiring painful, invasive interventions, such as cystoscopy. Furthermore, effective treatments to improve urination function can be formulated to be patient-specific, by detecting causes and problem regions based on quantitative analysis and predicting post-surgical outcomes.

Chronic pelvic pain in women

Chronic pelvic pain (CPP) is a common and complex condition. It affects up to 24% of women worldwide (1:6) and has a prevalence rate similar to asthma or back pain. The International Association for the study of Pain defines it as: ‘chronic or persistent pain perceived in structures related to the pelvis of either men or women. It is often associated with negative cognitive, behavioural, sexual, and emotional consequences as well as with symptoms suggestive of lower urinary tract, sexual, bowel, pelvic floor or gynaecological dysfunction.’ CPP lasts over 6 months and causes functional problems to the lives of sufferers.

Urinary Tract Involvement in Wolfram Syndrome: A Narrative Review.

Wolfram Syndrome (WS) is a rare neurodegenerative disease with autosomal recessive inheritance and characterized by juvenile onset, non-autoimmune diabetes mellitus and later followed by optic atrophy leading to blindness, diabetes insipidus, hearing loss, and other neurological and endocrine dysfunctions. A wide spectrum of neurodegenerative abnormalities affecting the central nervous system has been described. Among these complications, neurogenic bladder and urodynamic abnormalities also deserve attention. Urinary tract dysfunctions (UTD) up to end stage renal disease are a life-threatening complication of WS patients. Notably, end stage renal disease is reported as one of the most common causes of death among WS patients. UTD have been also reported in affected adolescents. Involvement of the urinary tract occurs in about 90% of affected patients, at a median age of 20 years and with peaks at 13, 21 and 33 years. The aim of our narrative review was to provide an overview of the most important papers regarding urological impairment in Wolfram Syndrome. A comprehensive search on PubMed including Wolfram Syndrome and one or more of the following terms: chronic renal failure, bladder dysfunction, urological aspects, and urinary tract dysfunction, was done. The exclusion criteria were studies not written in English and not including urinary tract dysfunction deep evaluation and description. Studies mentioning general urologic abnormalities without deep description and/or follow-up were not considered. Due to the rarity of the condition, we considered not only papers including pediatric patients, but also papers with pediatric and adult case reports

Review: Natural products isolated from Portulaca oleracea (purslane, Ma-Chi-Xian): Focus on oleraciamides and oleracones

Abstract. Bailly C. 2021. Review: Natural products isolated from Portulaca oleracea (purslane, Ma-Chi-Xian): Focus on oleraciamides and oleracones. Nusantara Bioscience 13: 202-210. The plant Portulaca oleracea L., known as purslane in English and Ma-Chi-Xian in Chinese, is largely used in traditional medicine to treat a variety of diseases and conditions, including dysentery, urinary tract dysfunctions, and post-partum bleeding. It is also an edible plant, with a high nutritional potential. Extracts of P. oleracea display antioxidant, anti-inflammatory and antiproliferative activities, associated with the presence of numerous bioactive secondary metabolites, including alkaloids, terpenoids, lignans and polysaccharides. The present review provides a specific focus on two sub-groups of natural products isolated in recent years from P. oleracea: the alkaloids oleraciamides A-to-G, and the oleracones A-to-L which are mostly flavonoids. Their structural diversity and pharmacological properties, described in recent publications and patents, have been analyzed. These two subgroups of natural products deserve additional studies to delineate their mechanism of action. They could serve as a starting point to the design of novel anti-inflammatory agents, at least for some of them. This review provides a global view of these compounds, necessary to promote further phytochemical studies and to better apprehend the traditional use of the plant and its extracts.

Is Urodynamic Study an Essential Step in Preoperative Evaluation of Women with Pelvic Organ Prolapse with Urinary Tract Dysfunction: Prospective Comparative Study

Is Urodynamic Study an Essential Step in Preoperative Evaluation of Women with Pelvic Organ Prolapse with Urinary Tract Dysfunction: Prospective Comparative Study

Risk factors for catheter-associated urinary tract infections following radical hysterectomy for cervical cancer

Objectives: Radical hysterectomy is the mainstay of treatment for early-stage cervical cancer. Urinary tract dysfunction is one of the most common complications after radical hysterectomy, and prolonged catheterization has previously been defined as a significant risk factor for catheter-associated urinary tract infections (CAUTI). The purpose of this study was to determine the rate of CAUTI after radical hysterectomy for cervical cancer and identify additional risk factors for developing CAUTI in this population. Methods: We reviewed patients who underwent a radical hysterectomy for cervical cancer from 2004-2020 after institutional IRB approval. All patients were identified from our institution's Gynecologic Oncology surgical database. Inclusion criterion was radical hysterectomy for early-stage cervical cancer. Exclusion criteria included inadequate hospital follow-up, insufficient records of catheter use in the electronic medical record, urinary tract injury, and preoperative chemoradiation. CAUTI was defined as an infection diagnosed in a catheterized patient or within 48 hours of catheter removal, with significant bacteriuria (>103 cfu/mL) and symptoms or signs attributable to the urinary tract. Data analysis was performed using comparative analysis and univariate and multivariate logistic regression using Excel, GraphPad, and SPSS. Results: A total of 276 patients were identified. After applying exclusion criteria, 160 patients were included in the data analysis. The distribution of patients across FIGO stage is as follows: IA1 4.5% (n=4), IA2 6.3% (n=10), IB1 75.6% (n=121), IB2 13.8% (n=22), IIA2 1.9% (n=3). The mean length of indwelling catheter use was 9.3 days (range 0-33 days). 28.8% of patients (n=40) had a urinary catheter placement more than 1 time prior to passing a voiding trial. 12.6% of patients (n=20) were diagnosed with CAUTI. Minimally invasive surgery (MIS) was associated with longer catheterizations compared to an open approach (mean 12.8 days vs 6.9 days, p Conclusions: Catheterization over five days significantly increased the risk for CAUTI development after radical hysterectomy for cervical cancer. Smoking history, increased age, and minimally invasive surgical route are independent predictors for CAUTI. Earlier catheter removal should be encouraged in patients with these risk factors.

A mechanism linking perinatal 2,3,7,8 tetrachlorodibenzo-p-dioxin exposure to lower urinary tract dysfunction in adulthood.

ABSTRACTBenign prostatic hyperplasia/lower urinary tract dysfunction (LUTD) affects nearly all men. Symptoms typically present in the fifth or sixth decade and progressively worsen over the remainder of life. Here, we identify a surprising origin of this disease that traces back to the intrauterine environment of the developing male, challenging paradigms about when this disease process begins. We delivered a single dose of a widespread environmental contaminant present in the serum of most Americans [2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD), 1 µg/kg], and representative of a broader class of environmental contaminants, to pregnant mice and observed an increase in the abundance of a neurotrophic factor, artemin, in the developing mouse prostate. Artemin is required for noradrenergic axon recruitment across multiple tissues, and TCDD rapidly increases prostatic noradrenergic axon density in the male fetus. The hyperinnervation persists into adulthood, when it is coupled to autonomic hyperactivity of prostatic smooth muscle and abnormal urinary function, including increased urinary frequency. We offer new evidence that prostate neuroanatomical development is malleable and that intrauterine chemical exposures can permanently reprogram prostate neuromuscular function to cause male LUTD in adulthood.

A rare cause of transitory hematuria and urinary tract dysfunction in children: Answers.

A rare cause of transitory hematuria and urinary tract dysfunction in children: Answers.

A rare cause of transitory hematuria and urinary tract dysfunction in children: Questions

A rare cause of transitory hematuria and urinary tract dysfunction in children: Questions