Evaluation of Transrectal Voiding Ultrasonography in Men with Micturition Difficulties without Apparent Organic Obstruction of the Lower Urinary Tract

Tosaka, Akira; Fujii, Yasuhisa; Oka, Kaoru

doi:10.1159/000480800

Cited by 7 publications

(5 citation statements)

References 13 publications

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“…17 Renal and bladder ultrasonography is a standard assessment in adult patients suspected of having long-lasting dysfunctional voiding. 25,26 Other imaging modalities, such as VCUG, are not recommended routinely in adult patients unless other conditions, such as VUR or urethral stricture are suspected.…”

Section: Discussionmentioning

confidence: 99%

Dysfunctional voiding: Challenges of disease transition from childhood to adulthood

Morin

Akhavizadegan

Kavanagh

et al. 2018

CUAJ

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Section: Discussionmentioning

confidence: 99%

Dysfunctional voiding: Challenges of disease transition from childhood to adulthood

Morin

Akhavizadegan

Kavanagh

et al. 2018

CUAJ

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“…12 Whatever the muscle involved that increases urethral resistance, it would lower the urine flow rate. Such variability of definition may explain the wide prevalence range reported among men (14%-43%) [13][14][15][16] and women with lower urinary tract symptoms (LUTS) (10.5%-34.6%). 12,17,18 Other researchers report a much lower prevalence of "learned VD" (2% of urodynamic investigations for LUTS in an adult population).…”

Section: And Etiology Of DV In Children and Adultsmentioning

confidence: 99%

“…Others, proposed perineal ultrasound as a method of high sensitivity and good specificity for diagnosing DV, at least in women . Small studies have proposed alternative methods such as transrectal voiding ultrasonography in men . DV can also be diagnosed when the characteristic fluctuating flow pattern is accompanied by mirror image changes in detrusor pressure (Pdet) so that when the flow goes down Pdet goes up and vice versa.…”

Section: How Well Do We Understand and Diagnose DV In Children And Admentioning

confidence: 99%

Can we improve our management of dysfunctional voiding in children and adults: International Consultation on Incontinence Research Society; ICI‐RS2018?

Tarcan

Gontard

Apostolidis

et al. 2019

Neurourology and Urodynamics

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Aims: Dysfunctional voiding (DV) remains a poorly understood and a poorly managed problem, both in children and adults. The Think Tank (TT) discussed how to improve the management of DV in these two different age groups and in transitional care. Methods: During the 2018 International Consultation on Incontinence Research Society held in Bristol, a multidisciplinary TT on DV was created. The presentations and subsequent discussion, leading to research recommendations intended to improve the management of DV in children and adults are summarized. Results: To improve the management of DV in children and adults, the TT panel proposed: (1) to conduct reliable prevalence studies of DV; (2) to perform longitudinal studies to prospectively test the sequence hypothesis by answering the following questions: (a) Which, if any children show a progression from overactive bladder or voiding postponement to DV?; (b) Which children develop each disorder without precursors?; and (c) Is there a continuation of DV from childhood to adulthood, or are adult cases new-onset presentations?;(3) to obtain detailed information regarding psychopathology to understand which comorbid psychological disorders prevail and at which rate, in those suffering DV; (4) to develop and validate diagnostic tools specifically for DV; (5) to better establish urodynamic correlates of DV specific for different age groups; and (6) to generate prospective long-term data regarding the efficacy of different treatment options and management strategies. Conclusions: The future research recommendations of this TT may improve our management of DV in children and adults. K E Y W O R D S biofeedback, dysfunctional voiding, emptying symptoms, overactive bladder, urethral sphincter, urodynamics

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“…[ 34 ] Limited data in men suggests that transrectal voiding ultrasound may help in identifying men with DV. [ 40 ] In neurologically normal men with voiding difficulty without any obvious cause, 85% of men with bladder neck dilatation of >7 mm on a voiding transrectal ultrasound were noted to have DV on a complete urodynamics. [ 40 ] Perineal USG has been used in women with DV to assess sphincter volume.…”

Section: Investigative Evaluationmentioning

confidence: 99%

“…[ 40 ] In neurologically normal men with voiding difficulty without any obvious cause, 85% of men with bladder neck dilatation of >7 mm on a voiding transrectal ultrasound were noted to have DV on a complete urodynamics. [ 40 ] Perineal USG has been used in women with DV to assess sphincter volume. [ 41 ] Urethral sphincter volume of more than 1.96 cm 3 was predictive of DV in women with recurrent urinary infection.…”

Section: Investigative Evaluationmentioning

confidence: 99%

Dysfunctional voiding: A review of the terminology, presentation, evaluation and management in children and adults

Sinha

2011

Indian J Urol

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Dysfunctional voiding (DV) is a voiding disorder characterized by dyssynergic striated sphincteric activity in the absence of a proven neurological etiology. It can present at any age with a spectrum of storage and voiding symptoms that may resemble florid neurogenic bladder. There is a striking lack of clarity regarding what this entity represents, the diagnostic methodology and treatment. The limitations of existing guideline documents are analyzed. Specifically, use of the term “habitual”, the assumption that bladder changes are secondary to the outlet, the emphasis on “staccato” voiding and the implication of striated urethral sphincter are discussed. Literature shows that DV may also present with continuous slow flow or normal flow. Dyssynergia may be at the level of the striated urethral sphincter, the pelvic floor or both, better termed “striated urethral sphincter-pelvic floor complex” (SUS-PFC).A diagnostic algorithm is provided so that patients are evaluated on merit rather than on the basis of different philosophies of individual centers. High-risk markers such as hydronephrosis, vesicoureteral reflux, renal failure or marked voiding difficulty should prompt a formal urodynamics evaluation and imaging for neurological etiology. Patients with predominantly storage symptoms with incidental staccato voiding can be managed initially, on the basis of non-invasive evaluation. Conservative urotherapy including biofeedback is appropriate initial management for patients without high risk factors. Treatment and evaluation should be escalated based on response. Patients with severe DV will need treatment similar to neurogenic bladder including clean intermittent catheterization and measures to control storage pressures.

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Evaluation of Transrectal Voiding Ultrasonography in Men with Micturition Difficulties without Apparent Organic Obstruction of the Lower Urinary Tract

Cited by 7 publications

References 13 publications

Dysfunctional voiding: Challenges of disease transition from childhood to adulthood

Dysfunctional voiding: Challenges of disease transition from childhood to adulthood

Can we improve our management of dysfunctional voiding in children and adults: International Consultation on Incontinence Research Society; ICI‐RS2018?

Dysfunctional voiding: A review of the terminology, presentation, evaluation and management in children and adults

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