Association of Age With Lower Urinary Tract Function in Adult Men Presenting for Urodynamics: A Database Analysis

Sinha, Sanjay; Matina, Lavina

doi:10.48083/lqxf2741

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…Paradoxically, young men under 30 years undergoing urodynamics are less likely to be obstructed and more likely to show an underactive detrusor. 14 …”

Section: Discussionmentioning

confidence: 99%

Management Modalities of Primary Bladder Neck Obstruction in Young Adult Men: A Systematic Review and Meta-analysis

Mittal,

Singh,

Panwar

et al. 2024

Urology Research & Practice

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Objective: This systematic review was done to critically appraise the various evidence available in the literature for the presenting symptoms, diagnosis, and management modalities for primary bladder neck obstruction diagnosed on invasive urodynamics in young adult men 18-50 years of age. Methods: A search was conducted on PubMed, Embase, and Cochrane Central Register of Controlled Trials databases until July 2022 to find English-language studies relevant to the topic. Results: A total of 10 studies were included. The estimated difference in International Prostate Symptom Score between baseline and 3 months in the subgroup of medical and surgical treatment was found to be −8.82 and −11.25, respectively ( P = .37), and after 12 months, it was found to be −7.69 and −17.70 respectively ( P < .001). The pooled estimate for the difference in Qmax between baseline and 3 months after medical and surgical treatments in the subgroup was found to be 2.92 and 7.03, respectively ( P = .18), and after 12 months, it was found to be 4.54 and 7.74, respectively ( P < .001). The pooled estimate of the difference in post-void residue before and after 3 months of medical and surgical treatments in a subgroup was found to be −31.15 and −70, respectively ( P < .001), and after 12 months, it was found to be −31.49 and −156.00, respectively ( P < .001). Quality of life scores improved in both subgroups. Conclusion: The alpha-blockers are effective in managing primary bladder neck obstruction in the short term, while bladder neck incision is preferred for better long-term outcomes.

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“…Paradoxically, young men under 30 years undergoing urodynamics are less likely to be obstructed and more likely to show an underactive detrusor. 14 …”

Section: Discussionmentioning

confidence: 99%

Management Modalities of Primary Bladder Neck Obstruction in Young Adult Men: A Systematic Review and Meta-analysis

Mittal,

Singh,

Panwar

et al. 2024

Urology Research & Practice

View full text Add to dashboard Cite

show abstract

“…In some studies, up to half of all men referred for urodynamics show underactivity. 12,13 This suggests that a cutoff of 100 might have inadequate discriminant value for defining clinically relevant underactivity.…”

Section: Discussionmentioning

confidence: 99%

“…BCI has two classes for defining normal (strong, BCI > 150; normal, BCI > 100) and only one for abnormal (underactivity, BCI < 100). In some studies, up to half of all men referred for urodynamics show underactivity 12,13 . This suggests that a cutoff of 100 might have inadequate discriminant value for defining clinically relevant underactivity.…”

Section: Discussionmentioning

confidence: 99%

The bladder contractility and bladder outlet obstruction indices in adult men: Results of a global Delphi consensus study

Sinha

Agrò

Dmochowski

et al. 2022

Neurourology and Urodynamics

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Aims This Delphi study was planned to examine global expert consensus with regard to utility, accuracy, and categorization of Bladder Contractility Index (BCI) and Bladder Outlet Obstruction Index (BOOI) and the related evidence. Methods Twenty‐eight experts were invited to answer the two‐round survey including three foundation questions and 15 survey questions. Consensus was defined as ≥75% agreement. The ordinal scale (0–10) in round 1 was classified into “strongly agree,” “agree,” “neutral,” “disagree,” and “strongly disagree” for the final round. A systematic search for evidence was conducted for therapeutic studies that have examined outcome stratified by the indices in men. Results Nineteen experts participated in the survey with 100% completion. Consensus was noted with regard to 6 of 19 questions. Experts strongly agreed with utility of quantifying bladder contractility and bladder outflow obstruction with near unanimity regarding the latter. There was consensus that BCI and BOOI were accurate, that BCI was clinically useful, and for defining severe bladder outflow obstruction as BOOI > 80. Systematic search yielded 69 publications (BCI 45; BOOI 50). Most studies examined the indices as a continuous variable or by standard cutoffs (BCI 100, 150; BOOI 20, 40). Conclusion There is general agreement among experts on need for indices to quantify bladder contractility and bladder outflow obstruction as well as with regard to accuracy and utility of BCI and BOOI indices. Few studies have examined the discriminant power of existing cutoffs or explored new ones. This is an extraordinary knowledge gap in the field of urology.

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Is It Possible to Regenerate the Underactive Detrusor? Part 1 Molecular and Stem Cell Therapies Targeting the Urinary Bladder and Neural Axis ICI‐RS 2024

Sinha,

Cruz,

Cuenca

et al. 2024

Neurourology and Urodynamics

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IntroductionDetrusor muscle weakness is commonly noted on urodynamics in patients with refractory voiding difficulty. No approved therapies have been proven to augment the strength of a detrusor voiding contraction.MethodsThis subject was discussed by a think‐tank at the International Consultation on Incontinence‐ Research Society (ICI‐RS) meeting held in Bristol, June 2024. The discussions of the think‐tank are being published in two parts. This first part discusses molecular and stem cell therapies targeting the urinary bladder and the neural axis.ResultsSenescence of the urothelium and extracellular ATP acting through P2X3 receptors might be important in detrusor underactivity. Several molecules such as parasympathomimetics, acotiamide, ASP8302, neurokinin‐2 agonists have been explored but none has shown unequivocal clinical benefit. Different stem cell therapy approaches have been used, chiefly in neurogenic dysfunction, with some studies showing benefit. Molecular targets for the neural axis have included TRPV‐4, Bombesin, and serotoninergic receptors and TAC‐302 which induces neurite growth.ConclusionsSeveral options are currently being pursued in the search for an elusive molecular or stem cell option for enhancing the power of the detrusor muscle. These encompass a wide range of approaches that target each aspect of the contraction mechanism including the urothelium of bladder and urethra, myocyte, and neural pathways. While none of these have shown unequivocal clinical utility, some appear promising. Lessons from other fields of medicine might prove instructive.Clinical Trial RegistrationNot necessary. Not a clinical trial.

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Association of Age With Lower Urinary Tract Function in Adult Men Presenting for Urodynamics: A Database Analysis

Cited by 3 publications

References 27 publications

Management Modalities of Primary Bladder Neck Obstruction in Young Adult Men: A Systematic Review and Meta-analysis

Management Modalities of Primary Bladder Neck Obstruction in Young Adult Men: A Systematic Review and Meta-analysis

The bladder contractility and bladder outlet obstruction indices in adult men: Results of a global Delphi consensus study

Is It Possible to Regenerate the Underactive Detrusor? Part 1 Molecular and Stem Cell Therapies Targeting the Urinary Bladder and Neural Axis ICI‐RS 2024

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