[Overactive bladder: urodynamic characteristics of detrusor overactivity due to the etiology of low urinary tract dysfun- ction].

The aim of the study was to detect features of detrusor overactivity as an urodynamic phenomenon in patients with different etiology of low urinary tract dysfunction. MATERIALS AND METHODS: The study included 283 patients (61% females and 39% males) aged 18-82 years (49.2+/-13.5) with neurogenic overactive bladder (n=197), idiopathic overactive bladder (n=41), radiation cystitis (n=8) and chronic pelvic pain (n=37). All patients underwent an urodynamic study (UDS) in Sverdlovsk Regional Clinical Hospital in the period from 2017 to 2020. RESULTS: Detrusor overactivity was detected by UDS in 63.4% patients with idiopathic, 94.2% with neurogenic overactive bladder (OAB) and 2.7% in patients with pelvic pain. Maximal amplitude of detrusor pressure during involuntary bladder contraction was significantly higher in neurogenic dysfunction than in idiopathic (25.76+/-26.21 cm 2 and 10.1+/-3.4 cm 2 respectively, =0.003). According to the ROC-analysis, detrusor pressure amplitude has a high predictor value in the diagnosis of a neurogenic origin of overactive bladder (AUC=0.863, p=0.045). The sensitivity of pressure more than 9.5 cm 20 was 88%. Bladder volume at the time of first involuntary contraction was 137+/-120 ml and 218+/-120 ml (=0.07) for neurogenic and idiopathic OAB respectively. Neurogenic detrusor overactivity followed by urgency incontinence more often than idiopathic (59.5% vs 19.2%). CONCLUSION: Neurogenic detrusor overactivity is characterized by larger amplitude and higher rate of urgency incontinence.

[Sensitivity and specificity of urinary and serum neurotrophins in the diagnosis of neurogenic detrusor overactivity in multiple sclerosis].

Lower urinary tract dysfunction is common among neurological patients. Traditionally, the basic method of diagnosis is a complex urodynamic study. In recent years, many studies have focused on the search for new non-invasive diagnostic modalities. In particular, neurotrophins are considered as potential biological markers of a neurogenic bladder. AIM: To estimate the sensitivity and specificity of the serum and urinary nerve growth factor (NGF) and brain neurotrophic factor (BDNF) in MS patients as markers of detrusor overactivity. MATERIALS AND METHODS: The study comprised 20 patients with multiple sclerosis, who complained of voiding problems. The control group consisted of 20 people without neurological diseases, lower urinary tract symptoms and detrusor overactivity estimated by filling cystometry. Apart from standard laboratory tests, diagnostic evaluation included a complex urodynamic study, ultrasound of the urinary tract, cystoscopy, testing serum and urinary NGF and BDNF using the enzyme immunoassay. The diagnostic significance of neurotrophins was evaluated using ROC analysis. RESULTS: According to the ROC analysis, the diagnostic sensitivity and specificity of serum NGF as a marker of detrusor hyperactivity was 57% and 93%, respectively (for serum NGF more or equal 26 pg/ml). The quality of the test according to the expert scale of AUC values was "very good" (AUC=0.806). Detecting NGF in patients urine was less effective. The sensitivity and specificity were 52% and 40%, respectively (for NGF more or equal 6 pg/ml). The quality of the test according to the expert scale of AUC values was "average" (AUC=0.64). The serum BDNF demonstrated high sensitivity (90%) and low specificity (23%), AUC=0.56. The urinary BDNF was more informative, (AUC=0.65). The combination of all four markers provides a sensitivity of 85.7% and a specificity of 66.7% (AUC=0.824). CONCLUSIONS: Testing serum and urinary neurotrophins in patients with multiple sclerosis can be used to diagnose detrusor overactivity. The NGF is a highly specific biomarker, while the BDNF is highly sensitive. Combined testing for serum NGF and BDNF is most informative.

[Russian version of the neurogenic bladder symptom score (NBSS)].

AIM: The Neurogenic Bladder Symptom Score (NBSS) is widely used now for the bladder symptoms assessment in neurogenic low urinary tract dysfunction. It is suitable for all patients, regardless of a bladder management method. NBSS contains 24 questions, which focus on incontinence, storage and voiding symptoms, urinary complicationsand life quality.With the permission of the authors (Dr.Welk et al.), NBSS had been translated into Russian according to the cultural and lingual adaptation algorithm. OBJECTIVES: Validate the Russian version of NBSS for multiple sclerosis patients. DESIGN, SETTING, AND PARTICIPANTS: The study included 80respondents: group A - 40 multiple sclerosis (MS) patients with neurogenic bladder, group B - 40 multiple sclerosis (MS) patients without bladder dysfunction, group C - healthy controls. All participants filled out the NBSS two times with an interval of two weeks. They also completed other measurement tools (IPSS,OAB Awareness Tool, WHOQOL BREF).Data were used to determine the internal consistency (Cronbachs alfa), external validity (Pearson correlation), and test-re-test reliability with interclass correlation coefficient. RESULTS: The mean of the NBSS total in the group A was 22.56+/-12.6, which significantly (p<0.001) exceeded score in comparable groups B (6.42+/-2.3) and C (5.31+/-1.9). The Cronbachs alfa of the total and the in continence, storage/voiding, and consequences domains was 0.939, 0,965, 0,801 and 0.712 respectively, which confirms the high internal consistency of the Russian version of the NBSS. External validity was verified by the relevant correlations with other questionnaires. Test-retest reliability was excellent. The interclass correlation coefficients were >0.85 (p<0.001) for all subdomains and the overall score. CONCLUSION: The Russian version of the NBSS demonstrated good validity and reliability and may be recommended for use in clinical practice.

[Results of a multicenter trial of serenoa repens extract (permixon) in patients with chronic abacterial prostatitis].

Chronic prostatitis (CP) morbidity now makes up 8 to 35% in males aged 20-40 years (N.A. Lopatkin et al., 1998; O.L. Tiktinsky, 1999). In general population CP incidence rate is 5 to 8% (J.C. Nickel, 1999). Phytotherapy is now widely practiced in CP. A multicenter trial conducted by the authors demonstrates high efficacy ofpermixon in the treatment of chronic prostatitis/chronic pelvic pain syndrome. The results of 6-month follow-up are presented.