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Turmel N, Hentzen C, Tan E, Haddad R, Chesnel C, Le Breton F, Amarenco G. Aqua: A new questionnaire assessing anticholinergic side effects in neurogenic population (Aqua: Anticholinergic side effects questionnaire). Prog Urol 2022; 32:751-755. [PMID: 35729028 DOI: 10.1016/j.purol.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/25/2022] [Accepted: 05/06/2022] [Indexed: 10/18/2022]
Abstract
AIMS Validate a new questionnaire to assess the side effects secondary to anticholinergics in neurogenic population suffering from Adult neurogenic lower urinary tract dysfunction (ANLUTD). METHODS We conducted a prospective, monocentric study in a Neuro-urology Department of a University Hospital between February 2015 and April 2020. To allow a full psychometric validation of a questionnaire, the study protocol included 3 steps: qualitative interviews, feasibility study and validation study. The primary outcome was good psychometric properties defined with good internal consistency reliability (Cronbach's α>0.7) and good test-retest reliability (intraclass correlation coefficient (ICC)>0.7). RESULTS we included 64 patients with ANLUTD secondary to neurogenic disorders. Feasibility study demonstrate very good acceptation and comprehension for 97% of patients. Validation study showed good internal consistency with Cronbach's α=0,69 and very good ICC=0,73. AQUA is composed with 8 items scoring 0 (no side effect) to 2 (major side effect) for a total score between 0 to 16. Time to fulfill is very quick. Mean score in our population was 4,1 (sd 2,9). CONCLUSION AQUA is the first validated tool to assess side effects secondary to antimuscarinic treatment for neurogenic population suffering from ANLUTD. LEVEL OF PROOF 2.
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Affiliation(s)
- N Turmel
- Sorbonne université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Service de Neuro urologie et explorations urodynamiques, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Service de médecine physique et réadaptation, hôpital Danielle Casanova, 11, rue Danielle Casanova, 93200 St Denis, France.
| | - C Hentzen
- Sorbonne université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Service de Neuro urologie et explorations urodynamiques, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - E Tan
- Sorbonne université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Service de Neuro urologie et explorations urodynamiques, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - R Haddad
- Sorbonne université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Service de Neuro urologie et explorations urodynamiques, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - C Chesnel
- Sorbonne université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Service de Neuro urologie et explorations urodynamiques, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - F Le Breton
- Sorbonne université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Service de Neuro urologie et explorations urodynamiques, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - G Amarenco
- Sorbonne université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Service de Neuro urologie et explorations urodynamiques, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
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Hentzen C, Haddad R, Turmel N, Biardeau X, Bey E, Amarenco G, Denys P, Gamé X, Phé V, Peyronnet B, Perrouin-Verbe MA, Joussain C. [Prioritization of risk situations in neuro-urology: Guidelines based on the Delphi method from Association française d'urologie (AFU), Association francophone internationale des groupes d'animation de la paraplégie (AFIGAP), Groupe de neuro-urologie de langue française (GENULF), Société française de médecine physique et de réadaptation (SOFMER) and Société interdisciplinaire francophone d'urodynamique et de pelvi-périnéologie (SIFUD-PP)]. Prog Urol 2022; 32:635-655. [PMID: 35659166 DOI: 10.1016/j.purol.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/06/2022] [Accepted: 04/28/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE During the COVID-19 pandemic, a care reorganization was mandatory, and affected patients in different areas, including management of neurogenic lower urinary tract dysfunction. This work aims to provide validated schedule concerning the assessment and management of patients in neuro-urology. METHODS Based on a literature review and their own expertise, a steering committee composed of urologists and physical medicine and rehabilitation practitioners generated a comprehensive risk-situation list and built a risk scale. A panel of French-speaking experts in neuro-urology was asked to define the timing for each clinical situation and validated these new recommendations through a Delphi process approach. RESULTS The 49 experts included in the rating group validated 163 propositions among the 206 initial items. The propositions were divided into four domains - diagnosis and assessment, treatment, follow-up, and complications - and two sub-domains - general (applicable for all neurological conditions) and condition-specific (varying according to the neurological condition (spinal cord injury, multiple sclerosis, brain injury, Parkinsonism, spinal dysraphism, lower motor neuron lesions)). CONCLUSIONS This multidisciplinary collaborative work generates recommendations based on expert opinion, providing a validated timing for assessment and management of patients in neuro-urology which may help clinicians to reorganize their patients' list with a personalized medicine approach, in a context of health crisis or not.
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Affiliation(s)
- C Hentzen
- GRC 01, GREEN (groupe de recherche clinique en neuro-urologie), Sorbonne université, hôpital Tenon, AP-HP, 75020 Paris, France.
| | - R Haddad
- GRC 01, GREEN (groupe de recherche clinique en neuro-urologie), Sorbonne université, hôpital Tenon, AP-HP, 75020 Paris, France
| | - N Turmel
- GRC 01, GREEN (groupe de recherche clinique en neuro-urologie), Sorbonne université, hôpital Tenon, AP-HP, 75020 Paris, France; Département de médecine physique et de réadaptation, hôpital Danièle-Casanova, 93205 Saint-Denis, France
| | - X Biardeau
- Département d'urologie, université de Lille, CHU de Lille, hôpital Claude-Huriez, 59000 Lille, France
| | - E Bey
- Département d'urologie et d'andrologie, CHU de Nîmes, université de Montpellier, Nîmes, France
| | - G Amarenco
- GRC 01, GREEN (groupe de recherche clinique en neuro-urologie), Sorbonne université, hôpital Tenon, AP-HP, 75020 Paris, France
| | - P Denys
- Inserm, département de neuro-urologie et d'andrologie, service de médecine physique et de réadaptation, université Paris-Saclay, UMR 1179, hôpital Raymond-Poincaré, AP-HP, Paris, France
| | - X Gamé
- Département d'urologie, transplanttion rénale et andrologie, CHU de Rangueil, TSA 50032, 31059 Toulouse, France
| | - V Phé
- Département d'urologie, Sorbonne Université, hôpital Tenon, AP-HP, Paris, France
| | - B Peyronnet
- Département d'urologie, université de Rennes, Rennes, France
| | - M A Perrouin-Verbe
- Département d'urologie, University of Nantes, hôtel Dieu Hospital, Nantes, France
| | - C Joussain
- Inserm, département de neuro-urologie et d'andrologie, service de médecine physique et de réadaptation, université Paris-Saclay, UMR 1179, hôpital Raymond-Poincaré, AP-HP, Paris, France
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Desprez C, Turmel N, Chesnel C, Sheikh Ismael S, Tamiatto M, Tan E, Haddad R, Le Breton F, Leroi AM, Hentzen C, Amarenco G. Fecal incontinence subtype assessment (FI-SA): A new tool to distinguish among subtypes of fecal incontinence in a neurogenic population. Clin Res Hepatol Gastroenterol 2022; 46:101900. [PMID: 35259498 DOI: 10.1016/j.clinre.2022.101900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Two subtypes of fecal incontinence (FI) are defined in the literature (urge and passive FI). The pertinence of this classification is unknown due to conflicting findings and heterogeneity of definitions. However, no questionnaire is available to clearly classify patients among subtypes. The objective of the present study was to develop and validate a new tool (Fecal incontinence subtype assessment, FI-SA) in order to better classify patients among the different subtypes of FI. METHODS A prospective monocentric study was conducted in consecutive patients with FI according to Rome IV criteria. To validate psychometric properties of the FI-SA questionnaire, a literature review and qualitative interviews were performed and discussed with an expert panel. A feasibility study was realized to assess acceptability and comprehension of items. The reproducibility was investigated in a validation study. RESULTS Comprehension and acceptability were excellent in 90% of patients in the feasibility study (n = 30). Validation study (n = 100) showed a good reproducibility with an intra-class correlation coefficient of 0.91 and 0.89 for questions 1 and 2. Time to fill the questionnaire was 40.0 s. 98.0% patients were classified among subtypes of FI: 34.0% passive FI, 32.0% urge FI and 32.0% mixed FI. CONCLUSION FI-SA is the first questionnaire to classify patients among subtypes of FI with good psychometric characteristics and the first questionnaire introducing the concept of mixed FI. FI-SA could help to determine the pertinence of this classification of FI in the management of these patients.
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Affiliation(s)
- C Desprez
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France; Rouen University Hospital, Digestive physiology Department, 76000 Rouen, France.
| | - N Turmel
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France; Casanova Hospital, 93200 Saint-Denis, France
| | - C Chesnel
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France
| | - S Sheikh Ismael
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France; ELSAN, Clinique Le Floride, 66420 Le Barcarès, France
| | - M Tamiatto
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France
| | - E Tan
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France
| | - R Haddad
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France
| | - F Le Breton
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France
| | - A-M Leroi
- Rouen University Hospital, Digestive physiology Department, 76000 Rouen, France
| | - C Hentzen
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France
| | - G Amarenco
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, 75020 Paris, France
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Chesnel C, Hentzen C, Haddad R, Charlanes A, Le Breton F, Turmel N, Amarenco G. Adherence to transanal irrigation in older adults: first-year assessment. Tech Coloproctol 2021; 25:1055-1063. [PMID: 34185193 DOI: 10.1007/s10151-021-02479-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 06/09/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND While the prevalence of chronic constipation and fecal incontinence increases with age, few data on transanal irrigation in older adults are available. The aim of this study was to assess the adherence and predictive factors for adherence to transanal irrigation during the first year of use in older adults. METHODS This retrospective study included all patients over 65 years old, who had therapeutic education for transanal irrigation with the Peristeen® device between January 2010 and July 2019 in a neuro-urology department of a university hospital in France. The adherence rate was assessed at 1, 3, 6, and 12 months. Predictive factors for adherence were looked for by comparing persistent population and non-persistent population at 1, 3, 6, and 12 months. RESULTS Sixty-nine patients over 65 years old were included. The adherence rate was 73.9% at 1 month, 55.1% at 3 months, 46.4% at 6 months, and 40.1% at 1 year. No predictive factor for adherence to transanal irrigation was identified. CONCLUSIONS Adherence to transanal irrigation during the first year in older adults remains close to that in the adult general population. Predictive factors of adherence remain unclear.
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Affiliation(s)
- C Chesnel
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020, Paris, France. .,Department of Neuro-Urology, Tenon Hospital, 4, rue de la Chine, 75020, Paris, France. .,GRAPPPA (Clinical Research Group of Perineal Dysfunctions in Older Adults), Department of Neuro-Urology, Tenon Hospital, Paris, France.
| | - C Hentzen
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020, Paris, France.,Department of Neuro-Urology, Tenon Hospital, 4, rue de la Chine, 75020, Paris, France.,GRAPPPA (Clinical Research Group of Perineal Dysfunctions in Older Adults), Department of Neuro-Urology, Tenon Hospital, Paris, France
| | - R Haddad
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020, Paris, France.,Department of Neuro-Urology, Tenon Hospital, 4, rue de la Chine, 75020, Paris, France.,GRAPPPA (Clinical Research Group of Perineal Dysfunctions in Older Adults), Department of Neuro-Urology, Tenon Hospital, Paris, France
| | - A Charlanes
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020, Paris, France.,Department of Neuro-Urology, Tenon Hospital, 4, rue de la Chine, 75020, Paris, France.,GRAPPPA (Clinical Research Group of Perineal Dysfunctions in Older Adults), Department of Neuro-Urology, Tenon Hospital, Paris, France
| | - F Le Breton
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020, Paris, France.,Department of Neuro-Urology, Tenon Hospital, 4, rue de la Chine, 75020, Paris, France
| | - N Turmel
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020, Paris, France.,Department of Neuro-Urology, Tenon Hospital, 4, rue de la Chine, 75020, Paris, France.,GRAPPPA (Clinical Research Group of Perineal Dysfunctions in Older Adults), Department of Neuro-Urology, Tenon Hospital, Paris, France
| | - G Amarenco
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020, Paris, France.,Department of Neuro-Urology, Tenon Hospital, 4, rue de la Chine, 75020, Paris, France.,GRAPPPA (Clinical Research Group of Perineal Dysfunctions in Older Adults), Department of Neuro-Urology, Tenon Hospital, Paris, France
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Desprez C, Turmel N, Chesnel C, Mistry P, Tamiatto M, Haddad R, Le Breton F, Leroi AM, Hentzen C, Amarenco G. Comparison of clinical and paraclinical characteristics of patients with urge, mixed, and passive fecal incontinence: a systematic literature review. Int J Colorectal Dis 2021; 36:633-644. [PMID: 33210162 DOI: 10.1007/s00384-020-03803-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE Two subgroups of fecal incontinence (FI) are described in literature and used in clinical practice. However, the pertinence of this classification of FI is still unknown as there are no clear established guidelines. To a better understanding, we performed a systematic review to characterize the different types of FI (active, passive, or mixed) on the basis of clinical presentation and complementary explorations. METHODS This systematic literature review was performed in reference to recommendations for systematic review using PRISMA guidelines without date restriction, until May 2020. This systematic review was performed without temporal limitation using MEDLINE-PubMed, Cochrane Library, and Google Scholar databases. RESULTS Six hundred nine unique citations were identified from all the databases combined. Of those, 21 studies met the inclusion criteria, with 8 retrospective observational studies and 13 prospective observational studies. There was a lack of homogeneity in definitions of passive and urge (active) FI among studies. Prevalence of passive and urge FI was respectively of 4.0-5.0 and 15.0-35.0%. Clinical characteristics, physical examination, and endoanal imaging were not evaluated in most studies. In anorectal manometry, maximal squeeze pressure was higher in passive FI subgroup in most studies and results regarding maximal resting pressure remain discordant. There seemed to be no difference regarding first sensation volume and maximal tolerable volume among subgroups. A few studies evaluated pudendal terminal nerve motor latency with no difference among subgroups. CONCLUSION There is a lack of well-conducted prospective studies comparing the different subtypes of FI with validated definitions in both clinical and paraclinical examinations.
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Affiliation(s)
- Charlotte Desprez
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France. .,Digestive physiology Unit, Rouen University Hospital, 1 rue de Germont, 76031, Rouen, France.
| | - N Turmel
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - C Chesnel
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - P Mistry
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - M Tamiatto
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - R Haddad
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - F Le Breton
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - A-M Leroi
- Digestive physiology Unit, Rouen University Hospital, 1 rue de Germont, 76031, Rouen, France
| | - C Hentzen
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
| | - G Amarenco
- GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France
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Grasland M, Turmel N, Chesnel C, Haddad R, Le Breton F, Amarenco G, Hentzen C. [Neurological complications of coitus: Review of literature]. Prog Urol 2021; 31:392-405. [PMID: 33581982 DOI: 10.1016/j.purol.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Sexual activity is composed of different phases (excitation, plateau, resolution). Each phase is associated with cardiovascular, respiratory, muscular and hormonal modification which can have an influence on the nervous system. This impact has been studied many times in literature, but no study has synthetized the complications related to coitus or orgasm. METHOD Systematic review of literature on neurological complications, except headache, of coitus based on Medline and Embase. RESULTS We screened 1424 articles and selected 46 for this review. 7 (15 %) were clinical or epidemiologic studies, 6 (13 %) were reviews of literature and 33 (72 %) were cases or series of cases reports. 12 articles (26 %) talked about strokes, 10 (22 %) about subarachnoid hemorrhage, 9 (20 %) about reversible cerebral vasoconstriction syndrome. We found 3 (7 %) articles for each of the following complication: intraparenchymal, hematoma and epilepsy. Autonomic hypereflexia was treated in 3 articles (7 %). Only 1 article was included concerning ictus, spinal cord injury, neuralgia and cataplexia. These events can be considered as rare as emergencies related to sexual activity represent only 0.1 % of all emergencies and among these, 12 % are neurological. 31 of the reported cases concerned vascular events (stroke or hemorrhage) and 18 (58 %) of these patients had a patent malformation (aneurism, intracardiac shunt, foramen ovale). CONCLUSION This is one of the first review of literature trying to synthetise the neurological complications of coitus. Many articles exist in literature. It is necessary to prevent the occurrence of these complications in a population already at risk of neurological events.
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Affiliation(s)
- M Grasland
- GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne université, 75020 Paris, France.
| | - N Turmel
- GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne université, 75020 Paris, France
| | - C Chesnel
- GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne université, 75020 Paris, France
| | - R Haddad
- GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne université, 75020 Paris, France
| | - F Le Breton
- GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne université, 75020 Paris, France
| | - G Amarenco
- GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne université, 75020 Paris, France
| | - C Hentzen
- GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, AP-HP, hôpital Tenon, Sorbonne université, 75020 Paris, France
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Amarenco G, Kerdraon J, Chesnel C, Le Breton F, Sheikh Ismaël S, Turmel N, Hentzen C. [Effects of attention and desire to void on sensory evoked cortical potentials following perineal stimulation]. Prog Urol 2020; 30:604-609. [PMID: 32434663 DOI: 10.1016/j.purol.2020.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Cortical somatosensory evoked potentials (SEP) are usually used to test the integrity of lemniscal pathways and thus provide arguments for the neurogenic etiology of sensory symptoms. For example, PES by perineal stimulation (SEP-P) has been shown to be altered in incontinence or neurogenic sexual dysfunction. We wanted to verify the integrity, structure and amplitude of far-field responses of PES-P in two conditions, the first without feeling the need to urinate (S0), the second with urgency (US). METHODS SEP-P were recorded in ten patients without neurological pathology in both conditions S0 and US after stimulation of the dorsal nerve of the penis/clitoris. Three consecutive responses each averaged over 1000 passages at a frequency of 3Hz were recorded. RESULTS Seven men and 3 women were included. All patients had normal SEP-P in terms of amplitude and latency of the P40 complex and fully reproducible especially for late responses. These early P40 responses were identical in both S0 and US states. Conversely, the far-field potentials, i.e. the late responses, were different in the two states, with a significant decrease (P<0.008 paired T-test) in the amplitude of cortical responses in the US state. CONCLUSION We observe that the late components of SEP-P were altered by the need to urinate urgently with sustained and selective attention to this need. These late components of SEP-P could be useful to better specify the attentional mechanisms involved in the continence-voiding cycle and to specify pathological sensory dysfunctions (urgency, painful bladder, frequency…). LEVEL OF EVIDENCE 4.
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Affiliation(s)
- G Amarenco
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France.
| | - J Kerdraon
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - C Chesnel
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - F Le Breton
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - S Sheikh Ismaël
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - N Turmel
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - C Hentzen
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
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Leroux C, Grasland M, Turmel N, Le Breton F, Chesnel C, Hentzen C, Amarenco G. [Urinary disorders of Wolfram syndrome. Clinical and urodynamic analysis from 6 observations]. Prog Urol 2019; 30:205-208. [PMID: 31761518 DOI: 10.1016/j.purol.2019.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 10/24/2019] [Accepted: 10/28/2019] [Indexed: 12/01/2022]
Abstract
Wolfram syndrome is a neurodegenerative disorder characterized by childhood onset diabetes mellitus, optic nerve atrophy, diabetes insipidus, hearing impairment, brainstem alteration and commonly bladder and bowel dysfunction. OBJECTIVE We present here, 6 new cases of urinary dysfunction in this rare disease. RESULTS All patients had urinary retention with overactive bladder. The urodynamic assessment found overactive detrusor in 3 cases. Five out of six patients performed self-catheterization and were treated with anticholinergics or intradetrusor injection of botulinum toxin. The follow-up at 5 years found an alteration of the upper urinary tracts and a renal failure 3/6. CONCLUSION Urinary dysfunction is common in Wolfram syndrome, mainly characterized by overactive bladder and urinary retention. The urological risk is major requiring a systelmatic follow-up of these patients. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- C Leroux
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France.
| | - M Grasland
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France
| | - N Turmel
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Le Breton
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Chesnel
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Hentzen
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - G Amarenco
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
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Amarenco G, Turmel N, Chesnel C, Mezzadri M, Le Breton F, Charlanes A, Hentzen C. [Vaginal gas: Review]. Prog Urol 2019; 29:1035-1040. [PMID: 31759885 DOI: 10.1016/j.purol.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this article was to review the literature about vaginal winds (VW). METHODS A literature review (Medline database, Cochrane Library and Google scholar) with no time limit was performed using keywords "vaginal winds", "vaginal noise", "vaginal gaz", "flatus vaginalis", "vaginal flatus", "colpophony", "Garrulitas vulvae", "vaginal laxity". RESULTS From 412 articles about VW, 15 have been selected and 99 from 110 about vaginal laxity. VW occurs during physical exercises but also during and just after coïtus. The prevalence is about 20%. The pathophyiology of VW is probably a vaginal hyperlaxity itself secondary to pelvic floor muscles weakness and thus increased diameter of vaginal hiatus. VW alter sexual function in female patients but this sexual function seems not influenced in male partners. Tampons or pessaries are currently the most commonly proposed treatment (but naturally impossible to use during sexual intercourse), but some results from vaginal laser therapy are encouraging. CONCLUSION Data from the literature suggest that vaginal winds are frequent and seriously impact quality of life of female patients. Childbirth and more generally vaginal laxity are the main causes. Pelvic-floor exercises, tampons, pessaries, surgery and laser can be proposed in order to improve sexual function in patients seeking treatment.
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Affiliation(s)
- G Amarenco
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - N Turmel
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Chesnel
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - M Mezzadri
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Le Breton
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - A Charlanes
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Hentzen
- GREEN GRC-01 UPMC (Group of Clinical Research in Neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France
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Miget G, Hentzen C, Turmel N, Chesnel C, Charlanes A, Le Breton F, Amarenco G. [Impact of body mass index on lower urinary tract disorders in multiple sclerosis]. Prog Urol 2019; 29:366-370. [PMID: 31133495 DOI: 10.1016/j.purol.2019.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 04/20/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Lower urinary tract symptoms (LUTS), and principally overactive bladder, are common in multiple sclerosis (MS). However, their origin is not necessarily unique. Obesity is widely recognized as a risk factor for stress urinary incontinence (SUI) and overactive bladder (OAB) in the general population. We wanted to evaluate the influence of body mass index (BMI) on LUTS in the MS population. MATERIALS AND METHODS We conducted an uncontrolled monocentric retrospective study in 260 subjects classified into 4 BMI groups: underweight, normal weight, overweight, obese people. Comparisons by Mann-Whitney test were made between different BMI groups, in the overall population and then by gender. LUTS (SUI, OAB, BOO (bladder outlet obstruction) were assessed using USP questionnaire. RESULTS In women, the mean OAB score was higher for obese women, 10.27 (SD=4.5) than for normal weight women, 7.96 (SD=4.58), P=0.024. The SUI score was lower for normal weight, 1.69 (SD=2.38) than for overweight, 3.19 (SD=2.91), P=0.002 and obese subjects, 3.80 (SD=3.23), P=0.0005. As in the overall population, the BOO score was higher in subjects with normal weight, 4.09 (SD=3.33) than in subjects with overweight, 1.91 (SD=2.03), P=0.0003 and in obese subjects, 2.33 (SD=2.37), P=0.013. The same comparisons in men were not significant. CONCLUSION In this series, increased BMI was associated with higher OAB and SUI USP questionnaire scores, in women presenting with MS. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- G Miget
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France.
| | - C Hentzen
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - N Turmel
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - C Chesnel
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - A Charlanes
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - F Le Breton
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - G Amarenco
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
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Turmel N, Hentzen C, Miget G, Chesnel C, Charlanes A, Le Breton F, Tan E, Amarenco G. [Urethral pain during clean intermittent self catheterization: Retrospective analysis of 77 patients]. Prog Urol 2019; 29:360-365. [PMID: 31109758 DOI: 10.1016/j.purol.2019.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 04/19/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Clean self-intermittent catheterization (CIC) is the gold standard of the therapeutic approach of chronic urinary retention. Usually, CIC are safe, effective but in some cases catheterization can determine urethral pain during catheter insertion or withdrawal leading to poor adherence and compliance. To determine prevalence of pain during CIC and verify its impact on adherence to treatment. METHOD Retrospective study with evaluation of pain during CIC one month following CIC teaching session by means specific and validated questionnaires: ICDQ (Intermittent Catheterization Difficulties Questionnaire), InCasaq (Intermittent Catheterization Satisfaction Questionnaire), I-CAS (Intermittent Catheterization Adherence Scale). RESULTS Seventy-seven patients were recruited and 28 (36%) described pain during CIC. There is a strong relationship between pain and poor adherence (P<0.01). Female patients had a higher risk of urethral pain during CIC and in contrary BMI>25kg/m2 seems to be a protective factor of pain. CONCLUSION In this series, urethral pain was associated with low compliance and adherence to CIC. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- N Turmel
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France.
| | - C Hentzen
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - G Miget
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - C Chesnel
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - A Charlanes
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - F Le Breton
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - E Tan
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - G Amarenco
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
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Biardeau X, Haddad R, Chesnel C, Charlanes A, Hentzen C, Turmel N, Campagne S, Capon G, Fatton B, Gamé X, Jeandel C, Kerdraon J, Mares P, Mezzadri M, Petit AC, Peyronnet B, Soler JM, Thuillier C, Deffieux X, Robain G, Amarenco G, Manceau P. [Use of botulinum toxin A in pelvic floor dysfunctions in the elderly: A review]. Prog Urol 2019; 29:216-225. [PMID: 30621961 DOI: 10.1016/j.purol.2018.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The present article is the final report of a multi-disciplinary meeting supported by the GRAPPPA (group for research applied to pelvic floor dysfunctions in the elderly). The objective was to conduct a comprehensive review on the role of botulinum toxin A (BonTA) in the treatment of pelvic floor dysfunctions in the elderly. METHODS The present article, written as a comprehensive review of the literature, combines data issued from the scientific literature with expert's opinions. Review of the literature was performed using the online bibliographic database MedLine (National Library of Medicine). Regarding intra-detrusor BonTA injections, only articles focusing on elderly patients (>65 yo) were included. Regarding other localizations, given the limited number of data, all articles reporting outcomes of BonTA were included, regardless of studies population age. In case of missing or insufficient data, expert's opinions were formulated. RESULTS Although, available data are lacking in this specific population, it appears that BonTA could be used in the non-fraily elderly patients to treat overactive bladder or even neurogenic detrusor overactivity, with a success rate comparable to younger population at 3 months (88.9% vs. 91.2%), 6 months (49.4% vs. 52.1%) and 12 months (23.1% vs. 22.3%), as well as a significant decrease in number of voids per day (11.4 vs. 5.29 P<0.001) and in the number of pads per day (4.0 vs. 1.3, P<0.01). Furthermore, BonTA is likely to be offered in the future as a treatment of fecal incontinence and obstructed defecation syndrome symptoms. Concerning bladder outlet obstruction/voiding dysfunction symptoms, intra-urethral sphincter BonTA should not be recommended. CONCLUSION BonTA injections are of interest in the management of various pelvic floor dysfunctions in the elderly, and its various applications should be better evaluated in this specific population in order to further determine its safety and efficacy.
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Affiliation(s)
- X Biardeau
- Service d'urologie et d'andrologie, hôpital Claude-Huriez, université Lille, CHU Lille, 59000 Lille, France.
| | - R Haddad
- Service de médecine physique et réadaptation, hôpital Rotschild, 75012 Paris, France
| | - C Chesnel
- GRC 01, Green-groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne universités, AP-HP, 75020 Paris, France; Service de neuro-urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - A Charlanes
- GRC 01, Green-groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne universités, AP-HP, 75020 Paris, France; Service de neuro-urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - C Hentzen
- GRC 01, Green-groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne universités, AP-HP, 75020 Paris, France; Service de neuro-urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - N Turmel
- GRC 01, Green-groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne universités, AP-HP, 75020 Paris, France; Service de neuro-urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - S Campagne
- Service de gynécologie, CHU Estaing, 63003 Clermont-Ferrand, France
| | - G Capon
- Service d'urologie, centre hospitalier Pellegrin, 33076 Bordeaux, France
| | - B Fatton
- Service de gynécologie, CHU de Nîmes, 30000 Nîmes, France
| | - X Gamé
- Service d'urologie, transplantation rénale et andrologie, CHU Rangueil, 31000 Toulouse, France
| | - C Jeandel
- Service de gériatrie, CHU de Montpellier, 34000 Montpellier, France
| | - J Kerdraon
- GRC 01, Green-groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne universités, AP-HP, 75020 Paris, France; Centre mutualiste de rééducation et réadaptation Kerpape, BP 78, 56275 Ploemeur cedex, France
| | - P Mares
- Service d'urologie, CHRU Carémeau, 30029 Nîmes cedex 9, France
| | - M Mezzadri
- Service de gynécologie, hôpital Lariboisière, AP-HP, 75010 Paris, France
| | - A-C Petit
- Centre de santé, 8, rue Neibecker, 93440 Dugny, France
| | - B Peyronnet
- Service d'urologie, CHU de Rennes, 35000 Rennes, France
| | - J-M Soler
- GRC 01, Green-groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne universités, AP-HP, 75020 Paris, France; Service de médecine physique et réadaptation, centre Bouffard-Vercelli, 66290 Cerbère, France
| | - C Thuillier
- Service d'urologie, CHU de Grenoble, 38700 La Tronche, France
| | - X Deffieux
- GRC 01, Green-groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne universités, AP-HP, 75020 Paris, France; Service de gynécologie, hôpital Antoine-Béclère, AP-HP, 92140 Clamart, France
| | - G Robain
- Service de médecine physique et réadaptation, hôpital Rotschild, 75012 Paris, France; GRC 01, Green-groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne universités, AP-HP, 75020 Paris, France
| | - G Amarenco
- GRC 01, Green-groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne universités, AP-HP, 75020 Paris, France; Service de neuro-urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - P Manceau
- GRC 01, Green-groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne universités, AP-HP, 75020 Paris, France; Service de neuro-urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; Service de neurologie, hôpital Avicennes, 93000 Bobigny, France
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- Groupe de recherche appliquée à la pathologie pelvi-périnéale des personnes âgées (GRAPPPA), 75020 Paris, France
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Honore T, Le Breton F, Turmel N, Bignani B, Chesnel C, Charlanes A, Amarenco G. [Efficacy of botulinum toxin A injections in the urethral sphincter in patients with difficulties to perform self-intermittent catherization]. Prog Urol 2018; 28:370-376. [PMID: 29776876 DOI: 10.1016/j.purol.2018.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 03/23/2018] [Accepted: 04/04/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate safety and efficacy of botulinum toxin A injections in the urethral striated sphincter in patients with difficulties to perform self-intermittent catherization. METHODS In this prospective study, 12 patients suffering from upper motor neuron diseases (8 multiple sclerosis, 2 myelitis, 1 brain injury, 1 multi system atrophy) and with difficulties to perform self-intermittent catherization, defined by a ICDQ score>1 (Intermittent Catheterization Difficulty Questionnaire) have had injections of 100U BOTOX® under EMG guidance in the urethral striated sphincter, for a total of 15 injections. Evaluations consisted of two questionnaires (ICDQ and PGI-A, Patient Global Improvement) 30 days after the injection. RESULTS 30 days after the injection, ICDQ was improved with a mean decrease of the total score of 7.8 (SD=5.9, P<0,001). In the same manner, all the patients were improved with a mean PGI-A score of 2.3. In 73.3 % of cases, the PGI-A score was equal to 2 (improvement=much better), and in 20 % it was equal to 3 (improvement=a little better). CONCLUSIONS Botulinum toxin A injections in the urethral striated sphincter in patients with difficulties to perform self-intermittent catherization seem to safe and effective. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- T Honore
- Service MPR, hôpital Pontchaillou, 2, rue Henri-le-Guilloux, 35000 Rennes, France.
| | - F Le Breton
- GRC 01, Groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC Université-Paris-06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - N Turmel
- GRC 01, Groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC Université-Paris-06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - B Bignani
- Service de MPR, hôpital Pitié-Salpêtrière, 47, boulevard de l'Hôpital, 75013 Paris, France
| | - C Chesnel
- GRC 01, Groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC Université-Paris-06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - A Charlanes
- GRC 01, Groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC Université-Paris-06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - G Amarenco
- GRC 01, Groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC Université-Paris-06, AP-HP, 4, rue de la Chine, 75020 Paris, France.
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Turmel N, Charlanes A, Hentzen C, Chesnel C, Le Breton F, Amarenco G. [Post micturition incontinence and Cowper's syringocele: 3 new case reports]. Prog Urol 2018; 28:236-238. [PMID: 29358074 DOI: 10.1016/j.purol.2017.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 12/10/2017] [Accepted: 12/21/2017] [Indexed: 11/17/2022]
Affiliation(s)
- N Turmel
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris-06, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - A Charlanes
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris-06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Hentzen
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris-06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Chesnel
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris-06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Le Breton
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris-06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - G Amarenco
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris-06, AP-HP, 4, rue de la Chine, 75020 Paris, France
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15
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Turmel N, Hentzen C, Chesnel C, Charlannes A, Le Breton F, Amarenco G. [Food, diet and dietetic in treatment of urinary tract dysfunctions. A review]. Prog Urol 2017; 27:395-401. [PMID: 28576427 DOI: 10.1016/j.purol.2017.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 04/20/2017] [Accepted: 05/02/2017] [Indexed: 11/29/2022]
Abstract
Overactive bladder symptoms (OAB) are frequent and can impact quality of life for these patients. Numerous and various treatments could be proposed in order to improve well-being and quality of life, but all these treatments have side effects and determine for many patients, important care constraints. We present here a review of food and diet in OAB. MATERIAL AND METHODS Literature review from PubMed Medline database and Google scholar to August 2016, without time restriction. Two hundred and ninety-six articles were screened, in English and in French, and finally, 10 were retained. HAS recommandation have been used for level of evidence. RESULTS On the 10 studies included, only two randomised controled trial were included. The first one showed decreases on urgency (by a half) (P=0.02) and on frequency (by a third) (P=0.035), secondary to reduction of caffeine consumption by a half after education [LE2]. The second randomized trial showed significant decreases on the first need to void in urodynamic study after caffeine consumption (170mL vs. 210mL) [LE2]. Feed like bread, chicken or nutrient like vitamin C or D were assessed in cohort or observational studies and appear as protective factors of OAB onset. Instead carbonated drinks may have a negative impact on symptoms, increasing urinary incontinence (OR 1.41 [95 % CI: 1.02-1.95]) [LE2], and there are contradictory results for alcohol consumption. CONCLUSION Diet seems to have an impact on overactive bladder syndrome and particularly caffeine consumption, which increases storage symptoms.
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Affiliation(s)
- N Turmel
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - C Hentzen
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Chesnel
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - A Charlannes
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Le Breton
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - G Amarenco
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
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Bignami B, Honore T, Turmel N, Haddad R, Weglinski L, Le Breton F, Amarenco G. [Post-orgasmic illness syndrome]. Prog Urol 2017; 27:446-448. [PMID: 28431830 DOI: 10.1016/j.purol.2017.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/23/2017] [Accepted: 03/17/2017] [Indexed: 11/18/2022]
Affiliation(s)
- B Bignami
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - T Honore
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - N Turmel
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - R Haddad
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - L Weglinski
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Le Breton
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - G Amarenco
- GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), service de neuro-urologie, hôpital Tenon, Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
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Nattel S, Turmel N, Macleod R, Solymoss BC. Actions of intravenous magnesium on ventricular arrhythmias caused by acute myocardial infarction. J Pharmacol Exp Ther 1991; 259:939-46. [PMID: 1941638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Although the antiarrhythmic properties of magnesium are well recognized, its mechanisms of antiarrhythmic action are poorly understood. This study was designed to characterize the effects of magnesium on ventricular tachyarrhythmias related to acute myocardial infarction (MI) in dogs. When the circumflex coronary artery was occluded repeatedly for 10 min at 30-min intervals, ventricular fibrillation (VF) occurred in 30, 35 and 33% of dogs during occlusions 1, 2 and 3, respectively. Magnesium pretreatment reduced the incidence of VF to 14% during occlusion 3 (P less than .05 compared to occlusions without magnesium pretreatment). Neither the prevalence of ventricular ectopic complexes 24 h after MI nor arrhythmia inducibility 4 days after infarction were significantly altered by i.v. magnesium. Magnesium significantly attenuated the ST segment elevation (an index of ischemic injury) and ventricular conduction slowing caused by MI. Because magnesium has been reported to reverse the effects of hyperkalemia, we evaluated the role of this action by infusing potassium directly into a coronary artery (to mimic ischemia-induced hyperkalemia) and administered i.v. magnesium. Potassium infusion markedly slowed intraventricular conduction, an effect fully reversed by discontinuing potassium administration but unaffected by i.v. magnesium. We conclude that magnesium has antiarrhythmic actions only during the early phases of an experimental MI, and that these actions are associated with attenuation of indices of ischemic injury and conduction slowing. These properties of magnesium are similar to those of calcium antagonists, and suggest that magnesium's calcium antagonist properties may be important in its antiarrhythmic actions.
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Affiliation(s)
- S Nattel
- Department of Medicine, Montreal Heart Institute, Canada
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