The Role of Uroflowmetry Biofeedback and Biofeedback Training of the Pelvic Floor Muscles in the Treatment of Recurrent Urinary Tract Infections in Women With Dysfunctional Voiding: A Randomized Controlled Prospective Study

Minardi, Daniele; d'Anzeo, Gianluca; Parri, Gianni; Polito, Massimo; Piergallina, Mara; Asmar, Ziad El; Marchetti, Mara; Muzzonigro, Giovanni

doi:10.1016/j.urology.2009.11.019

Cited by 62 publications

(33 citation statements)

References 22 publications

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“…Though it cannot be excluded that bacterial colonization might inflame the bladder mucosa or the prostate and, consequently, alter bladder voiding, it seems rather likely that uncomplete micturition favors bacterial proliferation and UTI. This hypothesis is reinforced by previous series having demonstrated that high PVR is a risk factor for UTI or AB (Carlson et al, 2001;Truzzi et al, 2008) and that the reduction of PVR reduces the incidence of UTI (Minardi et al, 2010). Moreover, in our study, like in others (Marschall et al, 2012), patients with higher PVR had a poorer outcome as was shown by significantly higher rates of bacteremia and by the trend to a longer delay of apyrexia.…”

Section: Discussionsupporting

confidence: 87%

High bacterial titers in urine are predictive of abnormal postvoid residual urine in patients with urinary tract infection

Caron

Alexandre

Pestel-Caron

et al. 2015

Diagnostic Microbiology and Infectious Disease

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Section: Discussionsupporting

confidence: 87%

High bacterial titers in urine are predictive of abnormal postvoid residual urine in patients with urinary tract infection

Caron

Alexandre

Pestel-Caron

et al. 2015

Diagnostic Microbiology and Infectious Disease

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“…Bladder neck dysfunction, dysfunctional voiding and poor relaxation of the external sphincter can be treated with alpha blockers, clean intermittent catheterization or botulinum A injection 3 ; however, their specific treatments may differ. Transurethral incision of the bladder neck can provide definitive treatment for bladder neck dysfunction 3, 20, 21 , while the first-line treatment for dysfunctional voiding and poor relaxation of the external sphincter is pelvic relaxation training 3, 22 . We found that a large post-void residual might be a good parameter in the differential diagnosis of bladder neck dysfunction and dysfunctional voiding/poor relaxation of the external sphincter.…”

Section: Discussionmentioning

confidence: 99%

Videourodynamic Studies of Women with Voiding Dysfunction

Hsiao

Lin

Kuo

2017

Sci Rep

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This retrospective study is aimed to present videourodynamic findings of women with symptoms of voiding dysfunction in a medical center. Of 1914 women, the diagnoses included bladder outlet obstruction (BOO, n = 810, 42.3%), bladder dysfunction (n = 1,048, 54.8%) and normal tracings (n = 56, 2.9%). Anatomic BOO (n = 49) included cystocele (n = 19) and urethral stricture (n = 30). Common functional BOOs included dysfunctional voiding (n = 325, 17.0%) and poor relaxation of the external sphincter (n = 336, 17.6%). Common bladder dysfunction subtypes included detrusor underactivity (n = 337, 17.6%), detrusor hyperactivity with impaired contractility (n = 231, 12.1%), and bladder oversensitivity (n = 325, 17.0%). Receiver operating characteristic (ROC) analysis were performed, and the following optimum cutoff values were determined: (1) voiding detrusor pressure at a maximum flow rate (Pdet.Qmax) = 30 cmH2O for differentiating BOO from bladder dysfunction and normal tracings, with an ROC area of 0.78; (2) the Abrams-Griffiths number = 30 for differentiating anatomic from functional BOO, with an ROC area of 0.66; (3) post-void residual = 200 mL for differentiating bladder neck dysfunction from the other BOOs, with an ROC area of 0.69; (4) Pdet.Qmax = 30 cmH2O for differentiating dysfunctional voiding from poor relaxation of the external sphincter with an ROC area of 0.93. The above findings can be used as initial guide for management of female BOO.

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“…Recurrent UTIs may occur in up to 42% of women with DV (146). Minardi et al have recently demonstrated that in women with both DV and recurrent UTI, pelvic-floor physiotherapy can significantly reduce the rate of UTI recurrence (147). …”

Section: Physiologic Abnormalitiesmentioning

confidence: 99%

Anatomy and Physiology of the Urinary Tract: Relation to Host Defense and Microbial Infection

Hickling

Sun

2015

Microbiol Spectr

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The urinary tract exits to a body surface area that is densely populated by a wide range of microbes. Yet, under most normal circumstances, it is typically considered sterile, i.e., devoid of microbes, a stark contrast to the gastrointestinal and upper respiratory tracts where many commensal and pathogenic microbes call home. Not surprisingly, infection of the urinary tract over a healthy person’s lifetime is relatively infrequent, occurring once or twice or not at all for most people. For those who do experience an initial infection, the great majority (70% to 80%) thankfully do not go on to suffer from multiple episodes. This is a far cry from the upper respiratory tract infections, which can afflict an otherwise healthy individual countless times. The fact that urinary tract infections are hard to elicit in experimental animals except with inoculum 3–5 orders of magnitude greater than the colony counts that define an acute urinary infection in humans (105 cfu/ml), also speaks to the robustness of the urinary tract defense. How can the urinary tract be so effective in fending off harmful microbes despite its orifice in a close vicinity to that of the microbe-laden gastrointestinal tract? While a complete picture is still evolving, the general consensus is that the anatomical and physiological integrity of the urinary tract is of paramount importance in maintaining a healthy urinary tract. When this integrity is breached, however, the urinary tract can be at a heightened risk or even recurrent episodes of microbial infections. In fact, recurrent urinary tract infections are a significant cause of morbidity and time lost from work and a major challenge to manage clinically. Additionally, infections of the upper urinary tract often require hospitalization and prolonged antibiotic therapy. In this chapter, we provide an overview of the basic anatomy and physiology of the urinary tract with an emphasis on their specific roles in host defense. We also highlight the important structural and functional abnormalities that predispose the urinary tract to microbial infections.

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The Role of Uroflowmetry Biofeedback and Biofeedback Training of the Pelvic Floor Muscles in the Treatment of Recurrent Urinary Tract Infections in Women With Dysfunctional Voiding: A Randomized Controlled Prospective Study

Cited by 62 publications

References 22 publications

High bacterial titers in urine are predictive of abnormal postvoid residual urine in patients with urinary tract infection

High bacterial titers in urine are predictive of abnormal postvoid residual urine in patients with urinary tract infection

Videourodynamic Studies of Women with Voiding Dysfunction

Anatomy and Physiology of the Urinary Tract: Relation to Host Defense and Microbial Infection

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