Bulking agents are more cost-effective than MUS over a 1-year time horizon in the treatment of SUI in patients without urethral hypermobility. In women who lack urethral hypermobility, BA remain a cost-effective option in this patient population.
MCI and early dementia were prevalent in our population seeking care for PFDs. Women with cognitive impairment experienced worse condition-specific QoL.
Objectives: Urinary urgency, in the absence of infection and incontinence, is a common and distressing symptom; however, the pathogenesis of urgency remains unknown. The aim of this study was to determine if urinary urgency is associated with clinical and biochemical markers of neurogenic inflammation. We hypothesized that worse urinary urgency is associated with greater severity of neuropathic pain and higher levels of urinary inflammatory neuropeptides NGF and BDNF. Materials and Methods: We conducted a prospective cross sectional study of women presenting with urinary urgency. Exclusion criteria were urinary incontinence and urinary tract infection. All women completed validated questionnaires to measure urinary urgency and other urinary symptoms. The severity of neuropathic pain and neuropathic pain characteristics (eg. burning pain, hypersensitivity to touch) were measured using a validated questionnaire (PainDETECT). Urinary NGF, BDNF, and creatinine were measured in first morning clean catch urine specimen, collected within one week of completing the questionnaires, using commercially available ELISA kits. Women were dichotomized into two groups based on the severity of urinary urgency, mild versus moderate/severe urgency. Neuropathic pain was defined as the presence of pain score R19 on the PainDETECT. We compared the proportion of women with neuropathic pain as well as neuropathic pain characteristics between women with mild and moderate/severe urgency using chi-squared test. Univariable and multivariable linear regression were used to examine the relationship between urgency, pain scores, and urinary neuropeptides. Results: We recruited a total of 103 women. Of these, 41 had mild urinary urgency and 62 had moderate/severe urgency. Mean age, BMI, and parity was not significantly different between the two groups. Women with moderate/severe urgency were more likely to report neuropathic pain than women with mild urgency (27 vs 9%, p = 0.04). Women with moderate/
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