Is it Possible to Regenerate the Underactive Detrusor? Part 2 Electrical Stimulation Therapies, Treatment of Bladder Outlet Obstruction, Constipation, and Pelvic Floor Disorders ICI-RS 2024.

Autor: Sinha S; Department of Urology, Apollo Hospital, Hyderabad, India., Gajewski JB; Department of Urology, Dalhousie University, Halifax, Canada., Tarcan T; Departments of Urology, Marmara University School of Medicine and Koç University School of Medicine, Istanbul, Turkey., Van Huele A; Department of Urology, Ghent University Hospital, Ghent, Belgium., Cruz F; Departamento de Urologia, Hospital de S. João, Faculdade de Medicina do Porto, Porto, Portugal., Martinez EM; Department of Urology, La Fe University and Polytechnic Hospital, Valencia, Spain., Przydacz M; Department of Urology, Jagiellonian University, Krakow, Poland., Bou Kheir G; Department of Urology, Ghent University, Ghent, Belgium., Lombardo R; Sant'Andrea Hospital, Sapienza University, Rome, Italy., Wein A; Desai-Seth Institute of Urology, University of Miami, Miami, USA., Abrams P; Department of Urology, University of Bristol, Bristol, UK.
Jazyk: angličtina
Zdroj: Neurourology and urodynamics [Neurourol Urodyn] 2024 Oct 07. Date of Electronic Publication: 2024 Oct 07.
DOI: 10.1002/nau.25594
Abstrakt: Introduction: Detrusor muscle weakness is commonly noted on urodynamics in patients with refractory voiding difficulty. No clinical therapy has been proven to augment the strength of a detrusor contraction.
Methods: This subject was discussed at a think-tank at the International Consultation on Incontinence-Research Society (ICI-RS) held in Bristol, June 2024. The discussions of the think-tank are being published in two parts. This second part discusses the role of electrical stimulation therapies, treatment of bladder outlet obstruction, constipation, and pelvic floor disorders, in the enhancement of strength of a detrusor contraction.
Results: Electrical stimulation therapies, specifically sacral neuromodulation, have long been used in the salvage of patients with refractory nonobstructive voiding dysfunction. Clinical improvements can be noted in men following bladder outlet resistance reduction surgery especially, though not limited to those with demonstrable obstruction. Some patients may also show improvement with pelvic floor relaxation therapies and constipation care. However, there is a lack of high-quality urodynamic data to demonstrate an improvement in the strength of a detrusor contraction with these therapies. The think-tank recommends standards for future clinical studies examining treatments aimed at improving an underactive detrusor.
Conclusions: Studies need to examine whether clinical improvement following treatment of patients with an underactive detrusor is associated with improvement in strength of the detrusor contraction. New therapeutic options should apply specified standards for assessing and reporting the impact on detrusor contraction.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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