We found that the proportion of patients who considered electronic questionnaires to be equivalent to or better than paper versions was higher than those who preferred paper questionnaires regardless of age, gender or education level.

INTRODUCTION AND OBJECTIVES: Endoscopic injection of urethral bulking agents is an office procedure that is used to treat stress urinary incontinence secondary to internal sphincteric deficiency. Validation studies are important in simulator evaluation. The ENI simulator has not been formally validated, although it has been used widely at University of California, Irvine. We aimed to demonstrate the descriptive analysis as a first step for the face, content, and construct validities of this simulator in the future.METHODS: Dissected female porcine bladders were mounted in a modified Hysteroscopy Diagnostic Trainer (Figure 1). Using routine endoscopic equipment for this procedure with video monitoring, 6 urologists (experts group) and 6 urology trainee (novice group) completed urethral bulking agent injections on a total of 12 bladders using ENI simulator. Face and content validities were assessed by using structured quantitative survey which rating the realism. Construct validity was assessed, by comparing the performance of experts and novices, using Objective Structured Assessment of Technical Skills. Trainees also completed a post-procedure feedback survey. Effective injections were evaluated by measuring the retrograde urethral opening pressure, visual cystoscopic coaptation, and post-procedure gross anatomic examination.RESULTS: All 12 participants felt the simulator was a good training tool and should be used as essential part of urology training (face validity). ENI simulator showed good face and content validity with average score varies between the experts and the novices was 3.9/5 and 3.8/5 respectively. Content validity evaluation showed that most aspects of the simulator were adequately realist (mean Likert scores 3.9-3.8/5). However, the bladder does not bleed, and sometimes thin. Experts significantly outperformed novices (P<001) across all measure of performance therefore establishing construct validity.CONCLUSIONS: The ENI simulator shows face, content and construct validities, although few aspects of simulator were not very realist (e.g., bleeding). This study provides a base for the future formal validation for this simulator and for continuing use of this simulator in endourology training.

Purpose: This study investigated the effect of gabapentin on lower urinary tract dysfunction focusing on urethral activities and cystitis-induced visceral hyperalgesia in a mouse model of painful bladder syndrome/ interstitial cystitis (PBS/IC). The electromyography of urethral sphincter was difficult to obtain, but contained useful information to examine the drug effect in mice. Methods: Female C57BL/6J mice were intraperitoneally (ip) dosed with either saline or 200 mg/kg of cyclophosphamide (CYP) 48 hours before experimental evaluation. Cystitis mice were treated with administration of Gabapentin (25 or 50 mg/kg, ip). Bladder and external urethral sphincter (EUS) functions were obtained and analyzed during continuous bladder infusion. The visceral pain-related visceromotor reflex (VMR) was recorded in response to isotonic bladder distension. Results: Cystitis mice showed shorter inter-contraction intervals and increased occurrence of non-voiding contractions during bladder infusion, with increased VMR during IBD, indicating cystitis-induced bladder hyperalgesia. Gabapentin (50 mg/kg) suppressed effects of CYP on cystometry, but not on EUS activity, during bladder infusion. The effect on urodynamic recordings lasted 4 hours. VMR was significantly reduced by gabapentin. Conclusions: The present study showed that CYP-induced cystitis in mice is a model of visceral hyperalgesia affecting detrusor contractions, not urethral activations. The technique of using EUS electromyography to evaluate the drug effects on urethral activities is novel and useful for future investigations. Gabapentin can be as a potential treatment for detrusor overactivity and PBS/IC.

The ENI simulator shows face, content and construct validities, although few aspects of simulator were not very realistic (e.g., bleeding).This study provides a base for the future formal validation for this simulator and for continuing use of this simulator in endourology training.