Suzanne Biers

The past, present and future of augmentation cystoplasty

Whats known on the subject? and What does the study add?

The effects of a new selective β3-adrenoceptor agonist (GW427353) on spontaneous activity and detrusor relaxation in human bladder

To examine the effects of a new selective β3‐adrenoceptor agonist, GW427353 on human detrusor function, as β2‐ and β3‐adrenoceptors have been identified in the bladder, and can mediate detrusor relaxation, but β3‐adrenoceptors are less widely distributed and β3‐adrenoceptor agonists should have the therapeutic advantage of producing fewer treatment side‐effects.

Effects of imatinib mesylate (Glivec®) as a c‐kit tyrosine kinase inhibitor in the guinea‐pig urinary bladder

AIMSnIn the gastrointestinal tract, slow wave activity in smooth muscle is generated by the interstitial cells of Cajal (ICC). Detrusor smooth muscle strips of most species show spontaneous contractions which are triggered by action potential bursts, however, the pacemaker mechanisms for the detrusor are still unknown. Recently, ICC-like cells have been found in guinea-pig bladder, using antibodies to the c-kit receptor. We have investigated the effects of Glivec, a c-kit tyrosine kinase inhibitor, on spontaneous action potentials in guinea-pig detrusor and intravesical pressure of isolated guinea-pig bladders.nnnMETHODSnChanges in the membrane potential were measured in guinea-pig detrusor smooth muscle using conventional microelectrode techniques. Pressure changes in the bladder were recorded using whole organ bath techniques.nnnRESULTSnSmooth muscle cells in detrusor muscle bundles exhibited spontaneous action potentials, and spontaneous pressure rises occurred in isolated bladders. Glivec (10 microM) converted action potential bursts into continuous firing with no effects on the shape of individual action potentials. Glivec (>50 microM) reduced the amplitude of spontaneous pressure rises in the whole bladder in a dose dependent manner and abolished spontaneous action potentials in detrusor smooth muscle cells.nnnCONCLUSIONSnThe results suggest that ICC-like cells may be responsible for generating bursts of action potentials and contractions in detrusor smooth muscle. Drugs inhibiting the c-kit receptor may prove useful for treating the overactive bladder.

Electrical nerve stimulation to promote micturition in spinal cord injury patients: A review of current attempts.

In this review, we focus on the current attempts of electrical nerve stimulation for micturition in spinal cord injury (SCI) patients.

Does laser ablation prostatectomy lead to oncological compromise

To assess the incidence and outcome of incidental prostate cancer detected at transurethral resection of the prostate (TURP), and to evaluate whether laser ablation prostatectomy would miss significant cancer by failing to provide tissue for histopathological analysis.

Overactive bladder syndrome and lower urinary tract symptoms after prostate cancer treatment.

Purpose of review To assess the contemporary literature on the prevalence, cause and management of lower urinary tract symptoms (LUTS) and bladder overactivity following treatment of prostate cancer with radical surgery, radiotherapy and minimally invasive therapies for localized prostate cancer, including cryotherapy and high-intensity focused ultrasound (HIFU). Recent findings Generally, the highest risk of urinary incontinence is after open radical prostatectomy (7–40%), although not all contemporary studies demonstrate a difference between open and laparoscopic techniques. An increased incidence of bladder overactivity is seen with radiotherapy (as compared to radical prostatectomy). Bladder outlet obstruction is most commonly encountered after radical prostatectomy and radiotherapy combination therapy (up to 26%). It manifests as voiding LUTS or urinary retention, and the risk can accumulate over time. Cryotherapy and HIFU provide effective cancer treatment with lower risks of urinary incontinence, but have fewer published studies and shorter follow-up. Medical treatment options for LUTS include alpha blockers, anticholinergics, and potentially intravesical glycosaminoglycan analogue instillations. Stress urinary incontinence requires surgical correction with artificial urinary sphincter or suburethral slings. Summary Patients who have undertaken successful prostate cancer treatment have a good prognosis, and commonly present for further interventions to optimise quality of life if bothersome urinary symptoms are experienced. It is important to be vigilant for and treat any adverse urinary consequences.

Bladder pain syndrome: contemporary management and future strategies

Formally called interstitial cystitis (IC), nomenclature for this chronic inflammatory disease of the bladder has changed several times. It is of unknown aetiology, and is diagnosed after excluding other bladder pathologies. Patients typically suffer from urinary frequency, nocturia, urgency and bladder or suprapubic pain. It is associated with autoimmune and inflammatory conditions, cognitive, behavioural, emotional and sexual symptoms, and pain elsewhere in the body. Cystoscopy after bladder hydrodistension may show glomerulations (red petechiae on the urothelium) and/or bladder ulceration (Hunner’s ulcer) in around 10–15%.1 Bladder ulcers are considered pathognomonic for bladder pain syndrome (BPS).

Chronic pelvic pain in benign and functional urological conditions: A review and comparison of the UK and European guidelines:

We aim to provide a general overview of the available UK and European guidelines on non-oncological causes of chronic pelvic pain, and highlight any differences in practice. We have reviewed the current guidelines on chronic pelvic pain syndrome (defined as chronic pelvic pain with no identified underlying cause and/or the pain is non-specific or involves more than one organ) and other specific organ pain syndromes particularly relevant to urological clinical practice, including prostate pain syndrome, bladder pain syndrome and gynaecological causes of chronic pelvic pain. We have identified a relative paucity of UK guidelines, and accept that the European Association of Urology provides a comprehensive and current evidence based reference and guide which is utilised and regarded by most urologists as the ‘gold standard’ in UK practice.

Results of the British Association of Urological Surgeons female stress urinary incontinence procedures outcomes audit 2014-2017

To analyse the results of the stress urinary incontinence (SUI) audit conducted by the British Association of Urological Surgeons (BAUS), and to present UK urologists’ contemporary management of SUI.

Urinary Catheters, Drains and Stomas

This chapter gives an overview of the different types of catheter available for bladder drainage, with details of their composition, size and style. We include technical tips on the insertion and the recognition and management of catheter complications, with an emphasis on catheter associated urinary tract infections and antibiotic stewardship. A description of the different types and indications for surgical drains is also provided, and a comprehensive overview of the types of stoma used in urological practice, including continent catheterisable channels (Mitrofanoff and Yang-Monti), ileal conduit, double-barrelled wet colostomy, vesicostomy and ureterostomy.