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AUA 2018 Lower Urinary Tract Conditions – Nocturia

AUA 2018: A Catheter Insertion Force Assessment Tool: Design and Preclinical Results

San Francisco, CA USA (UroToday.com) Xiaoyin Ling, master mechanical engineering student from the University of Minnesota, presented data that evaluated the efficacy of a novel catheter insertion force assessment tool for quantitatively measuring the force of urinary catheter insertion in situ. As an introduction, Ms. Ling explained how despite urethral catheterization being among the most common procedures performed, there is no standardized approach to Foley catheter insertion.

AUA 2018: Risk Factors Associated with Fecal Incontinence in Patients with Overactive Bladder

San Francisco, CA USA (UroToday.com) This session featured studies that evaluated conditions associated with urinary incontinence including obesity, fecal incontinence and depression. Fecal incontinence (FI) is associated with many pelvic floor disorders and has a devastating impact on quality of life. Many patients as well as clinicians are hesitant to discuss FI due to discomfort with the topic and lack of knowledge regarding its treatment. However, it is very important for physicians to address FI, as its treatments can be very effective and have a significant positive impact on quality of life.

AUA 2018: Concomitant Procedures Performed at the Time of Midurethral Sling Affect Post Operative Urinary Retention Rate

San Francisco, CA USA (UroToday.com) Urinary retention is a well-known risk factor in the surgical treatment of stress urinary incontinence (SUI) with midurethral sling (MUS). Urinary retention is usually transient, however close to 2% of women will undergo a sling revision or removal surgery for urinary retention. Regardless of its transient nature, the time spent with an indwelling catheter or performing self-catheterization is frustrating for patients. Appropriate and thorough counseling pre-operatively can minimize this frustration. In order to do this effectively, clinicians will need to be able to identify risk factors that make urinary retention more likely. The authors here aim to identify risk factors for urinary retention as related to concomitant procedures performed at the time of MUS.

AUA 2018: Impact of Lifetime Obesity on Urinary Incontinence in the Women’s Health Initiative

San Francisco, CA USA (UroToday.com) Several studies in this session addressed the association of obesity and the metabolic syndrome with urinary incontinence. Obesity is a known risk factor for developing urinary incontinence (UI), and some studies have suggested that obese women have worse outcomes in the treatment of urinary incontinence. Recently there has been an emphasis on research into the prevention of pelvic floor disorders, and obesity prevention may be a target for urinary incontinence prevention. However, this is a difficult field to study as it requires long-term, longitudinal data on weight and urinary incontinence, as well as other patient factors. The Women’s Health Initiative (WHI) data allows for the long-term study of multiple factors affecting women and their health over time.

AUA 2018: The Utility of Urodynamic Evaluation in Clinical Practice

San Francisco, CA USA (UroToday.com) This moderated poster session included several studies regarding the quality of urodynamic studies (UDS) and whether they add to treatment planning in patient management. The publication of the VALUE trial in 2012 caused many clinicians to question the utility of urodynamics. However, many urologists have argued that the patient population in this trial was of minimal complexity and the results of this landmark trial do not apply to the general clinical population. Rena Malik, MD and colleagues sought to evaluate the value of urodynamic studies in their patient population, a tertiary referral center.

AUA 2018: Elevated Post-Void Residual Volumes, Not Associated with Self-Reported Urinary Tract Infections: A Report From The Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN)

San Francisco, CA (UroToday.com) Elevated post-void residuals (PVR) have traditionally been reported as risk factors for developing recurrent urinary tract infections (UTI). A PVR measures the volume remaining in the bladder following urination, thereby marking how well the bladder is able to empty. An elevated PVR >30 ml has been shown to be a significant factor associated with recurrent UTIs1. Similarly, elderly women with high PVRs were more likely to have recurrent UTIs, which improved with oral estrogen replacement therapy2. 

AUA 2018: Safety & Efficacy of the eCOIN™ Implantable Tibial Nerve Stimulation Device for Overactive Bladder Syndrome

San Francisco, CA (UroToday.com) Posterior tibial nerve stimulation (PTNS) has been shown to be an effective treatment option for patients with overactive bladder (OAB). Typically, patients require 12 weeks of treatment in which they undergo 30-minute sessions once weekly in the clinic. However, clinical benefit may be short-lived, and occasional treatments may be needed to sustain symptom improvement.
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