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Mechanobiology of Bladder Urothelial Cells
Published in Jiro Nagatomi, Eno Essien Ebong, Mechanobiology Handbook, 2018
Shawn Olsen, Kevin Champaigne, Jiro Nagatomi
The lower urinary tract, which consists of the bladder, urethra, and urethral sphincters, is responsible for the storage and timely elimination of urine. According to the definitions of the International Continence Society, lower urinary tract symptoms (LUTS) can be categorized as storage, voiding, or post-micturition symptoms [1]. LUTS include frequency, urgency, incontinence, intermittency, and the feeling of incomplete emptying, among others. The EpiLUTS study [2] estimated the prevalence of LUTS, occurring at least “often” in individuals aged 40 and older, to be 47.9% for men and 52.5% for women in the United States, the United Kingdom, and Sweden. These symptoms are considered bothersome and affect the quality of life of the patient as well as the patient's family [3]. The proper functioning of the lower urinary tract is dependent upon complex, coordinated interactions between the structural, muscular, and nervous system components [4]. Unlike most other visceral organs, the bladder and urethra are under both involuntary and voluntary control, providing for both reflexive responses and the conscious control of micturition [5]. Mechanical parameters such as bladder wall tension or intravesical pressure due to bladder filling or shear stress due to urine flow through the urethra, are sensed at the cellular level and contribute to both conscious sensation and reflex responses. Malfunctions in these sensing responsibilities are therefore likely to cause lower urinary tract dysfunction [6,7]. However, the mechanisms by which sensory transduction is accomplished at the cellular level within the lower urinary tract are not well understood.
Transperineal Mapping of the Prostate for Biopsy Strategies
Published in Ayman El-Baz, Gyan Pareek, Jasjit S. Suri, Prostate Cancer Imaging, 2018
Daniel Kaplon, Winston Barzell
Our initial practice was to leave an indwelling Foley catheter following the procedure, but in the past 100 patients a post-op catheter has not been routinely utilized. By meticulous avoidance of the urethral and bladder mucosa in the biopsies, significant urinary bleeding should be an exceedingly rare event. Complications with 3-DPM are usually minor (9,13). In our study cited below, 12 of 140 patients (8.6%) developed minor complications (none requiring hospitalization), including urinary retention (6 of the 12), worsening lower urinary tract symptoms (LUTS) (2 of the 12), and fever, scrotal edema, significant gross hematuria, perineal ecchymosis (1 each).
Reproductive system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Lower urinary tract symptoms (LUTS) is a collective term applied to symptoms including difficulty initiating or maintaining micturition and post-voiding symptoms [116]; these include nocturia, urge incontinence, poor stream and dribbling. The commonest cause in men is benign prostatic hypertrophy (BPH) and it is estimated that up to one-third of men over 65 years will experience symptoms.
A novel metric for treatment durability in clinical trials of minimally invasive treatments for benign prostatic hyperplasia
Published in Expert Review of Medical Devices, 2020
Larry E. Miller, Alexis E. Te, Samir K. Bhattacharyya, Sean Lilienfeld, Ryan A. Dornbier, Kevin T. McVary
Data for this analysis were derived from pivotal trial manuscripts of two minimally invasive BPH treatments – water vapor thermal therapy (WVTT) and prostatic urethral lift (PUL). WVTT utilizes convective radiofrequency to create stored thermal energy in the form of steam, which is delivered transurethrally into the transition zone of the prostate to ablate tissue, thereby reducing LUTS. The PUL procedure involves transurethral placement of permanent suture-based metallic implants that provide mechanical separation of the obstructing lateral prostatic lobes, thereby enlarging the urethral lumen and relieving LUTS. In the American Urological Association BPH Clinical Guidelines for surgical management of lower urinary tract symptoms (LUTS) [2,3], each treatment was recommended for well-selected men who desired a less invasive alternative to transurethral resection of the prostate (TURP). Published results were available through 4 years of follow-up with WVTT [4] and 5 years of follow-up with PUL [5]. Due to the increasing interest and the availability of long-term data with these minimally invasive BPH treatments, 4-year follow-up data from the WVTT and PUL pivotal trials were utilized for all analyses.
Sacral neuromodulation for the treatment of overactive bladder: systematic review and future prospects
Published in Expert Review of Medical Devices, 2022
Sam Tilborghs, Stefan De Wachter
Overactive bladder (OAB) syndrome covers several lower urinary tract symptoms including urgency incontinence, urinary urgency, frequency, and nocturia [1,2]. One in three adults >40y suffer from moderate to severe OAB with the prevalence increasing with age [3]. It represents a chronic condition with a significant impact on health-care cost. The economic impact in the United States (US) alone is calculated around 82.6 billion dollars per year, causing a plethora of healthcare concerns [4–6].
Publications update
Published in Journal of Medical Engineering & Technology, 2018
The latest Medtech Innovation Briefings published are:Neon EEG electrode for EEG monitoring in newborns (MIB155). Neon EEG (Incereb) is a device which fits over the scalp of a newborn, like a cap., and contains a passive electrode array for the purpose of recording an EEG when connected to a suitable recording system. This briefing is provided to aid local decision making.NephroCheck test to help assess the risk of acute kidney injury in critically ill patients (MIB156). NephroCheck (including VITROS NephroCheck) test is an in vitro diagnostic test used to measure urinary biomarkers of kidney injury as an aid in detecting acute kidney injury. This briefing is provided to aid local decision making.AlignRT in breast cancer radiotherapy (MIB157). This is a patient position monitoring system. This briefing focuses on its use during breast cancer radiation therapy. This briefing is provided to aid local decision making.Rezum for treating benign prostatic hyperplasia (MIB158). This device uses steam to ablate prostate tissue with the aim of improving lower urinary tract symptoms secondary to benign prostatic hyperplasia. This briefing is provided to aid local decision making.The Vest for delivering high-frequency chest wall oscillation in people with complex neurological needs (MIB159). This device is intended to deliver high-frequency chest wall oscillation for clearing airways. The focus of this briefing is its use in adults and children with complex neurological needs, such as cerebral palsy and motor neurone disease (also known as amyotrophic lateral sclerosis). This briefing is provided to aid local decision making.OxyMask for delivering oxygen therapy (MIB160). This is a novel design of mask which is intended to improve the efficiency and convenience of oxygen therapymyAIRVO2 for the treatment of chronic obstructive pulmonary disease (MIB161). This device is designed to warm and humidify respiratory gases used for nasal high-flow therapy. This briefing focuses on its potential use in a community setting. This briefing is provided to aid local decision making.