The following full text is a publisher's version. For additional information about this publ... more The following full text is a publisher's version. For additional information about this publication click this link.
Background The type of pneumonia that is caused by the new coronavirus (SARS-CoV-2) has spread ac... more Background The type of pneumonia that is caused by the new coronavirus (SARS-CoV-2) has spread across the world in a pandemic. It is not clear if COVID-19 patients have any lower urinary tract signs or symptoms. Methods The effect of COVID-19 on lower urinary tract function was studied in a prospective multi-centre, observational study including 238 patients who were admitted with symptoms caused by COVID-19 to the university hospital of Aachen in Germany and Tabriz in Iran. Results None of the patients reported to have any lower urinary tract symptoms. SARS-CoV-2 was found in the urine of 19% of the tested patients. The mortality rate in COVID-19 infected patients with microscopic haematuria together with white blood cells in their urine, was significantly increased from 48 to 61% in the Tabriz cohort (p-value = 0.03) and from 30 to 35% in the Aachen cohort (p-value =0.045). Furthermore, in the group of patients with SARS-CoV-2 urine PCR, the mortality rate rose from 30 to 58%. (p-...
Hypothesis / aims of study This novel study evaluated the safety and performance of the newly dev... more Hypothesis / aims of study This novel study evaluated the safety and performance of the newly developed wireless tibial neurostimulator, intended for home care use, for the treatment of patients with OAB. OAB affects millions of people worldwide with neuromodulation offering a minimally invasive and reversible treatment option for patients who have failed first-line therapy. Multiple neuroanatomical pathways have been described for neuromodulation including the S3 nerve root, pudendal nerve and tibial nerve (1), with limited and preliminary publications on implantable tibial nerve stimulators (2,3). A novel peripheral tibial neurostimulator (BlueWind Medical Ltd.) for the treatment of OAB was recently developed. The system composed of an implant, which is wirelessly powered by an external control unit (ECU) that controls the therapeutic parameters and is worn by the patient during treatment at home. A Physician Programmer is used to remotely set individual stimulation parameters for...
Complications occurred in two women of 45 and 54 years of age who were treated with tension-free ... more Complications occurred in two women of 45 and 54 years of age who were treated with tension-free midurethral sling procedures. The first woman was treated with transobturator tape due to stress incontinence and an overactive bladder. The procedure resulted in a worsening of the overactive bladder. The second woman was treated with tension-free vaginal tape (TVT) due to stress incontinence and subsequently suffered from pain on urinating. In the first patient, the tape was found to be too tight and following adjustment of the tape tension, the overactive bladder symptoms and the stress incontinence disappeared. The second woman experienced bladder erosion on the right side. After removal of the tape, the symptoms disappeared but the stress incontinence returned. During the last few years, the surgical treatment of stress urinary incontinence has shifted towards the positioning of tension-free tapes. Because this minimally invasive technique is fairly simple to perform, the number of ...
Hypothesis / aims of study Female stress urinary incontinence (SUI) is a common medical condition... more Hypothesis / aims of study Female stress urinary incontinence (SUI) is a common medical condition with a significant impact on quality of life [1]. According to most guidelines, after more conservative measures, a midurethral sling procedure is treatment of first choice. For patients who do not respond to slings or who are unfit for surgery, options are limited. Urethral bulking agents offer an alternative treatment option, albeit with questionable clinical success rates. If a treatment with a bulking agent can combine a good and durable clinical success rate with a low complication rate, it might be a viable alternative to more invasive treatments for certain patient groups. Since 2013 Urolastic has been used as an injectable treatment for female stress urinary incontinence. Although results seem promising, not much data is available on the efficacy and safety of this procedure[2,3]. We therefore retrospectively assessed the subjective improvement and the complications in patients ...
Lower urinary tract disorders and colorectal diseases like faecal incontinence often are caused b... more Lower urinary tract disorders and colorectal diseases like faecal incontinence often are caused by neurological disorders. One solution is functional restoration via the pathways of the nervous system by electrical stimulation of the involved nervous tracts. New basic and clinical research suggest that peripheral and more superficial techniques can successfully applied to correct functional urogenital and anorectal disorders. These new techniques allow more general applicability. This workshop provide the basic science that creates the foundation for electrical stimulation. Latest non-invasive and minimal invasive techniques and results are presented. The aim is to provide insight in basic and clinical electrophysiological mechanisms of electrical stimulation. The objectives are: to understand the basics of electrical stimulation with emphasis on neuroplasticity and therapeutic stimulation; to realise that electrical stimulation can be applied in various forms; to have knowledge abo...
PURPOSE Until recently, the urine of healthy individuals was assumed to be sterile. However, impr... more PURPOSE Until recently, the urine of healthy individuals was assumed to be sterile. However, improvement of bacterial detection methods has debunked this assumption. Recent studies have shown that the bladder contains microbiomes, which are not detectable under standard conditions. In this review, we aimed to present an overview of the published literature regarding the relationship between urinary microbiota and functional disorders of the genitourinary system. METHODS We searched Medline, PubMed, Embase, The Cochrane library and Scopus to identify RCTs published, with MeSH and free keywords including microbiota, bladder pain syndrome, prostatitis, kidney stone disease, and bladder cancer until September 2020. Randomized controlled trials investigating microbiome and lower urinary tract symptoms were included. Non-randomized trials, cross-over trials and pooled studies were excluded. The articles were critically appraised by two reviewers. CONCLUSION The urine microbiome is a newly...
Stoelzel M9, Schermer CR10, Siddiqui E11 1Royal Hallamshire Hospital, Sheffield, UK; 2Hospital S ... more Stoelzel M9, Schermer CR10, Siddiqui E11 1Royal Hallamshire Hospital, Sheffield, UK; 2Hospital S João and Faculty of Medicine/i3S Institute, Porto, Portugal; 3Radboudumc University Medical Centre, Nijmegen, The Netherlands; 4King’s College Hospital, London, UK; 5Institute of Clinical Sciences, Göteborg, Sweden; 6University of Alberta, Edmonton, Canada; 7St Elizabeth’s Medical Center, Brighton, MA, USA; 8University of Toronto, Toronto, Canada; 9Astellas Pharma Europe, Data Science, Leiden, The Netherlands; 10Astellas Pharma US, Medical Affairs, Americas, Northbrook, IL, USA; 11Astellas Pharma, Global Medical Affairs, Chertsey, Surrey, UK Safety and tolerability of overactive bladder treatments using a large integrated database of mirabegron clinical studies involving >10,000 overactive bladder patients
Introduction and objectives: Overactive bladder syndrome (OAB) is defined as urinary urgency, wit... more Introduction and objectives: Overactive bladder syndrome (OAB) is defined as urinary urgency, with or without urgent urinary incontinence; it is often associated with urinary frequency and nocturia, in the absence of any pathological or metabolic conditions that may cause or mimic OAB. The aim of this study was to evaluate the long-term real-life adherence of transcutaneous tibial nerve stimulation (TTNS) in the treatment of OAB, patient satisfaction of the treatment, and reasons for quitting therapy. Materials and methods: In this single center study, all patients who had a positive effect on percutaneous tibial nerve stimulation (PTNS) and continued to receive home-based treatment with TTNS since 2012 were included for analysis. Patients were retrospectively asked to fill out a questionnaire regarding satisfaction, reasons for quitting, and additional or next line of therapy. Results: We included 42 patients for this study, 81% of these patients were female (n = 34). The median ag...
Fig 2) Immunofluorescence stainings on wildtype (WT; A,B,C,D,I) and TRPV4 -/(E,F,G,H,J) mice blad... more Fig 2) Immunofluorescence stainings on wildtype (WT; A,B,C,D,I) and TRPV4 -/(E,F,G,H,J) mice bladder (A-H) and kidney (I,J) tissue using antibodies against TRPV4 (A,F) and AJ’s (Ecadherin; E-cad (B,D,E,G,I ,J). Images C & H show merged image. • TRPV4 co localizes with AJ’s in WT mouse (A-C). No TRPV4 signal was detected in TRPV4 -/mouse tissue (F). • WT mouse bladders show distinct formation of AJ’s between connecting urothelial cells (B,D; arrow). • In TRPV4 -/mice, AJ formation is reduced and intercellular spaces are larger (G,E). • This pattern also is seen in the distal collecting ducts of the kidney, where there are less cell junction ridges (AJ’s) visible in the TRPV4 -/mice (J) compared to WT mice (I) (arrows). Fig 4) A, B, C: TEM imaging of wild type bladder with normal urothelium. A) overview, B) normal tight junction (red arrow), C) normal AJ’s (orange arrow) & desmosomes (blue arrow), D, E, F : TEM imaging of TRPV4 -/mouse bladder urothelium. E) overview with enlarged int...
The introduction of the tensionfree vaginal tape in 1995 drastically changed the landscape of sur... more The introduction of the tensionfree vaginal tape in 1995 drastically changed the landscape of surgical procedures for stress urinary incontinence (SUI). Because of the uncomplicated technique many urologists and gynecologists embraced the procedure with tripled the number of annual procedures in the beginning of this century. At the same time polypropylene was used for the development of surgical procedures of pelvic organ prolapse (POP). Especially the use of polypropylene for POP has caused many severe clinical complications. This caused a huge reduction of these kind of surgical procedures and it is performed nowadays only under strict conditions. At the same time the use of polypropylene for SUI was scrutinized and questioned. Nowadays, in the Ango-Saxon countries the use of polypropylene tapes for SUI is not recommended. This manuscript explores the role of polypropylene tapes for SUI. Questions that are dealt with are: How dangerous are polypropylene tapes anyway? What are the...
Surgical nonautologous meshes have been used for several decades to repair abdominal wall herniae... more Surgical nonautologous meshes have been used for several decades to repair abdominal wall herniae. Implantable materials have been adopted for the treatment of female and male stress urinary incontinence (SUI) and female pelvic organ prolapse (POP). A consensus review of existing data based on published meta-analyses and reviews. This document summarises the deliberations of a consensus group meeting convened by the European Association of Urology (EAU) and the European Urogynecological Association, to explore the current evidence relating to the use of polypropylene (PP) materials used for the treatment of SUI and POP, with reference to the 2016 EAU guidelines (European Association of Urology 2016), the European Commission's SCENIHR report on the use of surgical meshes (SCENIHR 2015), other available high-quality evidence, guidelines, and national recommendations. Current data suggest that the use of nonautologous durable materials in surgery has well-established benefits but s...
The following full text is a publisher's version. For additional information about this publ... more The following full text is a publisher's version. For additional information about this publication click this link.
Background The type of pneumonia that is caused by the new coronavirus (SARS-CoV-2) has spread ac... more Background The type of pneumonia that is caused by the new coronavirus (SARS-CoV-2) has spread across the world in a pandemic. It is not clear if COVID-19 patients have any lower urinary tract signs or symptoms. Methods The effect of COVID-19 on lower urinary tract function was studied in a prospective multi-centre, observational study including 238 patients who were admitted with symptoms caused by COVID-19 to the university hospital of Aachen in Germany and Tabriz in Iran. Results None of the patients reported to have any lower urinary tract symptoms. SARS-CoV-2 was found in the urine of 19% of the tested patients. The mortality rate in COVID-19 infected patients with microscopic haematuria together with white blood cells in their urine, was significantly increased from 48 to 61% in the Tabriz cohort (p-value = 0.03) and from 30 to 35% in the Aachen cohort (p-value =0.045). Furthermore, in the group of patients with SARS-CoV-2 urine PCR, the mortality rate rose from 30 to 58%. (p-...
Hypothesis / aims of study This novel study evaluated the safety and performance of the newly dev... more Hypothesis / aims of study This novel study evaluated the safety and performance of the newly developed wireless tibial neurostimulator, intended for home care use, for the treatment of patients with OAB. OAB affects millions of people worldwide with neuromodulation offering a minimally invasive and reversible treatment option for patients who have failed first-line therapy. Multiple neuroanatomical pathways have been described for neuromodulation including the S3 nerve root, pudendal nerve and tibial nerve (1), with limited and preliminary publications on implantable tibial nerve stimulators (2,3). A novel peripheral tibial neurostimulator (BlueWind Medical Ltd.) for the treatment of OAB was recently developed. The system composed of an implant, which is wirelessly powered by an external control unit (ECU) that controls the therapeutic parameters and is worn by the patient during treatment at home. A Physician Programmer is used to remotely set individual stimulation parameters for...
Complications occurred in two women of 45 and 54 years of age who were treated with tension-free ... more Complications occurred in two women of 45 and 54 years of age who were treated with tension-free midurethral sling procedures. The first woman was treated with transobturator tape due to stress incontinence and an overactive bladder. The procedure resulted in a worsening of the overactive bladder. The second woman was treated with tension-free vaginal tape (TVT) due to stress incontinence and subsequently suffered from pain on urinating. In the first patient, the tape was found to be too tight and following adjustment of the tape tension, the overactive bladder symptoms and the stress incontinence disappeared. The second woman experienced bladder erosion on the right side. After removal of the tape, the symptoms disappeared but the stress incontinence returned. During the last few years, the surgical treatment of stress urinary incontinence has shifted towards the positioning of tension-free tapes. Because this minimally invasive technique is fairly simple to perform, the number of ...
Hypothesis / aims of study Female stress urinary incontinence (SUI) is a common medical condition... more Hypothesis / aims of study Female stress urinary incontinence (SUI) is a common medical condition with a significant impact on quality of life [1]. According to most guidelines, after more conservative measures, a midurethral sling procedure is treatment of first choice. For patients who do not respond to slings or who are unfit for surgery, options are limited. Urethral bulking agents offer an alternative treatment option, albeit with questionable clinical success rates. If a treatment with a bulking agent can combine a good and durable clinical success rate with a low complication rate, it might be a viable alternative to more invasive treatments for certain patient groups. Since 2013 Urolastic has been used as an injectable treatment for female stress urinary incontinence. Although results seem promising, not much data is available on the efficacy and safety of this procedure[2,3]. We therefore retrospectively assessed the subjective improvement and the complications in patients ...
Lower urinary tract disorders and colorectal diseases like faecal incontinence often are caused b... more Lower urinary tract disorders and colorectal diseases like faecal incontinence often are caused by neurological disorders. One solution is functional restoration via the pathways of the nervous system by electrical stimulation of the involved nervous tracts. New basic and clinical research suggest that peripheral and more superficial techniques can successfully applied to correct functional urogenital and anorectal disorders. These new techniques allow more general applicability. This workshop provide the basic science that creates the foundation for electrical stimulation. Latest non-invasive and minimal invasive techniques and results are presented. The aim is to provide insight in basic and clinical electrophysiological mechanisms of electrical stimulation. The objectives are: to understand the basics of electrical stimulation with emphasis on neuroplasticity and therapeutic stimulation; to realise that electrical stimulation can be applied in various forms; to have knowledge abo...
PURPOSE Until recently, the urine of healthy individuals was assumed to be sterile. However, impr... more PURPOSE Until recently, the urine of healthy individuals was assumed to be sterile. However, improvement of bacterial detection methods has debunked this assumption. Recent studies have shown that the bladder contains microbiomes, which are not detectable under standard conditions. In this review, we aimed to present an overview of the published literature regarding the relationship between urinary microbiota and functional disorders of the genitourinary system. METHODS We searched Medline, PubMed, Embase, The Cochrane library and Scopus to identify RCTs published, with MeSH and free keywords including microbiota, bladder pain syndrome, prostatitis, kidney stone disease, and bladder cancer until September 2020. Randomized controlled trials investigating microbiome and lower urinary tract symptoms were included. Non-randomized trials, cross-over trials and pooled studies were excluded. The articles were critically appraised by two reviewers. CONCLUSION The urine microbiome is a newly...
Stoelzel M9, Schermer CR10, Siddiqui E11 1Royal Hallamshire Hospital, Sheffield, UK; 2Hospital S ... more Stoelzel M9, Schermer CR10, Siddiqui E11 1Royal Hallamshire Hospital, Sheffield, UK; 2Hospital S João and Faculty of Medicine/i3S Institute, Porto, Portugal; 3Radboudumc University Medical Centre, Nijmegen, The Netherlands; 4King’s College Hospital, London, UK; 5Institute of Clinical Sciences, Göteborg, Sweden; 6University of Alberta, Edmonton, Canada; 7St Elizabeth’s Medical Center, Brighton, MA, USA; 8University of Toronto, Toronto, Canada; 9Astellas Pharma Europe, Data Science, Leiden, The Netherlands; 10Astellas Pharma US, Medical Affairs, Americas, Northbrook, IL, USA; 11Astellas Pharma, Global Medical Affairs, Chertsey, Surrey, UK Safety and tolerability of overactive bladder treatments using a large integrated database of mirabegron clinical studies involving >10,000 overactive bladder patients
Introduction and objectives: Overactive bladder syndrome (OAB) is defined as urinary urgency, wit... more Introduction and objectives: Overactive bladder syndrome (OAB) is defined as urinary urgency, with or without urgent urinary incontinence; it is often associated with urinary frequency and nocturia, in the absence of any pathological or metabolic conditions that may cause or mimic OAB. The aim of this study was to evaluate the long-term real-life adherence of transcutaneous tibial nerve stimulation (TTNS) in the treatment of OAB, patient satisfaction of the treatment, and reasons for quitting therapy. Materials and methods: In this single center study, all patients who had a positive effect on percutaneous tibial nerve stimulation (PTNS) and continued to receive home-based treatment with TTNS since 2012 were included for analysis. Patients were retrospectively asked to fill out a questionnaire regarding satisfaction, reasons for quitting, and additional or next line of therapy. Results: We included 42 patients for this study, 81% of these patients were female (n = 34). The median ag...
Fig 2) Immunofluorescence stainings on wildtype (WT; A,B,C,D,I) and TRPV4 -/(E,F,G,H,J) mice blad... more Fig 2) Immunofluorescence stainings on wildtype (WT; A,B,C,D,I) and TRPV4 -/(E,F,G,H,J) mice bladder (A-H) and kidney (I,J) tissue using antibodies against TRPV4 (A,F) and AJ’s (Ecadherin; E-cad (B,D,E,G,I ,J). Images C & H show merged image. • TRPV4 co localizes with AJ’s in WT mouse (A-C). No TRPV4 signal was detected in TRPV4 -/mouse tissue (F). • WT mouse bladders show distinct formation of AJ’s between connecting urothelial cells (B,D; arrow). • In TRPV4 -/mice, AJ formation is reduced and intercellular spaces are larger (G,E). • This pattern also is seen in the distal collecting ducts of the kidney, where there are less cell junction ridges (AJ’s) visible in the TRPV4 -/mice (J) compared to WT mice (I) (arrows). Fig 4) A, B, C: TEM imaging of wild type bladder with normal urothelium. A) overview, B) normal tight junction (red arrow), C) normal AJ’s (orange arrow) & desmosomes (blue arrow), D, E, F : TEM imaging of TRPV4 -/mouse bladder urothelium. E) overview with enlarged int...
The introduction of the tensionfree vaginal tape in 1995 drastically changed the landscape of sur... more The introduction of the tensionfree vaginal tape in 1995 drastically changed the landscape of surgical procedures for stress urinary incontinence (SUI). Because of the uncomplicated technique many urologists and gynecologists embraced the procedure with tripled the number of annual procedures in the beginning of this century. At the same time polypropylene was used for the development of surgical procedures of pelvic organ prolapse (POP). Especially the use of polypropylene for POP has caused many severe clinical complications. This caused a huge reduction of these kind of surgical procedures and it is performed nowadays only under strict conditions. At the same time the use of polypropylene for SUI was scrutinized and questioned. Nowadays, in the Ango-Saxon countries the use of polypropylene tapes for SUI is not recommended. This manuscript explores the role of polypropylene tapes for SUI. Questions that are dealt with are: How dangerous are polypropylene tapes anyway? What are the...
Surgical nonautologous meshes have been used for several decades to repair abdominal wall herniae... more Surgical nonautologous meshes have been used for several decades to repair abdominal wall herniae. Implantable materials have been adopted for the treatment of female and male stress urinary incontinence (SUI) and female pelvic organ prolapse (POP). A consensus review of existing data based on published meta-analyses and reviews. This document summarises the deliberations of a consensus group meeting convened by the European Association of Urology (EAU) and the European Urogynecological Association, to explore the current evidence relating to the use of polypropylene (PP) materials used for the treatment of SUI and POP, with reference to the 2016 EAU guidelines (European Association of Urology 2016), the European Commission's SCENIHR report on the use of surgical meshes (SCENIHR 2015), other available high-quality evidence, guidelines, and national recommendations. Current data suggest that the use of nonautologous durable materials in surgery has well-established benefits but s...
Uploads
Papers