Duane Hickling

CUA guideline on adult overactive bladder

Required.research,.future.trends,.and.conclusion...................................................................................................... E163 J .Corcos, et al Jacques Corcos, MD, FRCSC1; Mikolaj Przydacz, MD1; Lysanne Campeau, MD, PhD, FRCSC1; Gary Gray, MD, FRCSC2; Duane Hickling, MD, MSCI, FRCSC3; Christiane Honeine, RN, BN1; Sidney B. Radomski, MD, FRCSC4; Lynn Stothers, MD, MHSc, FRCSC5; Adrian Wagg, MD, FRCP (Lond), FRCP (Edin), FHEA6

Canadian Urological Association position statement on the use of transvaginal mesh

Stress incontinence (SUI) and pelvic organ prolapse (POP) are common conditions. There is high-level evidence that midurethral mesh slings for stress incontinence are effective and safe; however, the rare but serious potential risks of this surgery must be discussed with the patient. The use of transvaginal mesh for prolapse repair does not appear to be supported by the current evidence, and its use should be restricted to specialized pelvic floor surgeons and specific clinical situations.

Complications of male incontinence surgery

Urinary incontinence can result following surgical treatment of benign prostatic hyperplasia or prostate cancer and can be associated with significant morbidity and decreased quality of life. The artificial urinary sphincter and male sling are the current surgical treatment options for male stress urinary incontinence. Physicians and patients must be fully aware of the potential risks, shared and unique, of each procedure. This article will discuss recognized complications of the artificial urinary sphincter and the male sling with respect to temporal occurrence (intraoperative, early post-operative and delayed/long-term).

Do Urodynamic Findings Other Than Outlet Obstruction Influence the Decision to Perform a Transurethral Resection of Prostate

OBJECTIVE To determine if urodynamic findings other than high-pressure voiding influence the decision to perform a transurethral resection of prostate (TURP). METHODS Four clinical scenarios were created featuring a healthy 65-year-old man. An electronic survey was distributed to members of the International Continence Society and the Society for Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction. RESULTS Eighty-six urologists responded (median age was 45-54 years, 62% described their practice as academic). Scenario 1: an incidental residual urine >1 L with detrusor underactivity. The majority (76%) would offer a TURP; however, the estimated chance that the residual volume would improve was only 57%. Scenario 2: retention with detrusor overactivity but no voluntary voiding contraction. The majority (72%) would offer a TURP; however, the average chance quoted that he would void was only 48%. Scenario 3: catheter-dependent retention and an underactive detrusor. The majority (89%) would offer a TURP; however, the average chance quoted that he would void was only 53%. Scenario 4: a man with only frequency and urgency, but urodynamic bladder outlet obstruction. The majority (90%) would offer him a TURP; however, the average chance that his frequency and urgency would improve was only 64%, and the average estimated postoperative risk of urgency incontinence was 33%. Willingness to offer TURP did not correlate with physician characteristics. CONCLUSION Urodynamic findings other than bladder outlet obstruction were associated with modest perceived outcomes after TURP; however, despite this, urologists are still willing to offer this intervention.

A pilot randomized-controlled trial of the urodynamic efficacy of mirabegron for patients with neurogenic lower urinary tract dysfunction

To determine the effectiveness of mirabegron in patients with neurogenic lower urinary tract dysfunction.

Predictors of sling revision after mid-urethral sling procedures: a case-control study

To identify patient characteristics and surgical factors predictive of complications requiring mid‐urethral sling (MUS) revision/removal.

The role of preoperative urodynamics in stress urinary incontinence surgery

The routine use of urodynamics prior to incontinence surgery continues to be debated. The evidence available from randomized, control trials suggests that preoperative urodynamics do not improve surgical outcomes and are not cost-effective.

Frequent urinary tract infections in a premenopausal woman

A 35-year-old healthy premenopausal woman presented with a 24-hour history of worsening dysuria and urinary frequency. She had no associated flank pain or costovertebral angle tenderness to suggest pyelonephritis. Urine dipstick testing was positive for leukocyte esterase and nitrite. The patient