Karel Everaert - Academia.edu (original) (raw)
Papers by Karel Everaert
Archives of Dermatology, 2003
To evaluate the safety and efficacy of botulinum toxin type A (BTX-A) (BOTOX) over 16 months in t... more To evaluate the safety and efficacy of botulinum toxin type A (BTX-A) (BOTOX) over 16 months in the treatment of bilateral primary axillary hyperhidrosis. A 16-month study with initial double-blind randomization to 50 U of BTX-A or placebo per axilla. After 4 months, participants could receive up to 3 further treatments with open-label BTX-A over 12 months. Fourteen dermatology or neurology clinics in Germany, Belgium, and the United Kingdom. Of 207 individuals aged between 17 and 74 years who had persistent bilateral primary axillary hyperhidrosis that interfered with daily activities, 174 (84%) completed the study. The baseline gravimetric assessment was a spontaneous sweat production of 50 mg or greater in each axilla prior to initial treatment. At week 4 after each treatment, the response rate of subjects who had at least a 50% reduction from baseline in axillary sweating, as measured by gravimetric assessment, was evaluated. Adverse events were spontaneously reported throughout the study, together with quality-of-life parameters and assessment of neutralizing antibodies to BTX-A. Over the 16-month period, 356 BTX-A treatments were given to 207 subjects. After placebo treatment, the response rate at week 4 was 34.7%. After the first, second, and third treatment with BTX-A, response rates at week 4 were 96.1%, 91.1%, and 83.3%, respectively. For subjects receiving more than 1 treatment, the mean duration between BTX-A treatments was approximately 7 months; however, 28% of subjects completed the study after only 1 BTX-A treatment. Subjects' satisfaction after treatments was consistently high, their quality of life improved, and there was a reduction in the impact of the disease on their lives. The safety profile of BTX-A after repeated treatments was excellent and no confirmed positive results for neutralizing antibodies to BTX-A occurred. Repeated intradermal injections of BTX-A over 16 months for treatment of primary axillary hyperhidrosis is safe and efficacious.
International journal of urology : official journal of the Japanese Urological Association, Jan 22, 2015
To evaluate the impact of onabotulinumtoxinA on individual domains of the quality of life questio... more To evaluate the impact of onabotulinumtoxinA on individual domains of the quality of life questionnaires in a pooled analysis of two phase 3 trials in overactive bladder patients with urinary incontinence who were inadequately managed by ≥1 anticholinergic. Patients received intradetrusor injections of onabotulinumtoxinA 100U (n = 557) or placebo (n = 548). The proportions of patients with a positive response (condition "greatly improved" or "improved") on the Treatment Benefit Scale, and changes in Incontinence Quality of Life scores and King's Health Questionnaire domain scores were analyzed in the overall population and subgroups with clean intermittent catheterization use and urinary tract infection status during the first 12 weeks of treatment. Responses to individual King's Health Questionnaire items were also assessed. Significantly greater proportions of onabotulinumtoxinA-treated patients achieved positive Treatment Benefit Scale response versus ...
Advances in therapy, Jan 28, 2015
The higher sensitivity to desmopressin (dDAVP) found in women and older patients with nocturnal p... more The higher sensitivity to desmopressin (dDAVP) found in women and older patients with nocturnal polyuria (NP) has partially been unraveled, leading to adaptation of the dosage based on gender. However, besides age and gender, other factors might play a role in differences in sensitivity and side effects. The aim of this study is to design a pharmacokinetic/pharmacodynamic (PD) assay to identify appropriate treatment for different groups of patients, primarily dependent on differences in age and gender. This interventional pilot study was carried out in Ghent University Hospital, Belgium, between 2011 and 2013. Patients with NP were subjected to a water load test (15 mL/kg), as well as an administration of 120 µg dDAVP oral disintegrating tablet (ODT) followed by blood analysis to determine plasma dDAVP levels and urine analysis for diuresis rate, osmolality, free water clearance and sodium clearance. Six female and six male patients were included (range 30-89 years old; mean age 69 ...
European Urology Supplements, 2014
![Research paper thumbnail of [Update on the second line management of idiopathic overactive bladder]](https://attachments.academia-assets.com/42479062/thumbnails/1.jpg)
](Progrès en Urologie
The overactive bladder syndrome (OAB) negatively affects the daily life of many people worldwide ... more The overactive bladder syndrome (OAB) negatively affects the daily life of many people worldwide and conservative treatments, such as antimuscarinics, not always bring relief and/or are associated with considerable side effects resulting in treatment failure. Second line treatment options used to be invasive surgical procedures. However, less radical, minimally invasive and reversible alternatives, such as sacral neuromodulation and botulinum toxin A have emerged. Of these, only sacral neuromodulation with InterStim Therapy has been approved for OAB and been recommended by the International Consultation on Incontinence (ICI) in 2004. Nevertheless, depending of country rules and habits, both seem to be used by urologists in clinical practice for treating idiopathic OAB (I OAB). Therefore, this review attempts to provide an update on the available clinical evidence concerning the efficacy and safety, and the current position of sacral neuromodulation and botulinum toxin A in the secon...
Application of sacral and pudendal nerve stimulation in children with a voiding disorder: a retro... more Application of sacral and pudendal nerve stimulation in children with a voiding disorder: a retrospective analysis Purpose: Sacral/Pudendal nerve stimulation with InterStim has been applied in adults for more than a decade. Little is known about the effectiveness of sacral nerve stimulation in children and even less is known about the results of pudendal nerve stimulation in the pediatric population.The results of our series of Interstim therapy in children with severe voiding dysfunction, in whom neither intensive medical treatment nor behavioral therapies have succeeded, are described. Methods: A retrospective analysis of 18 patients (9 to 17 years old) with neurogenic bladder dysfunction, Fowler syndrome, dysfunctional elimination syndrome and/ or bladder overactivity (50% had proven overactivity) was performed. The mean follow-up time was 28,8 months after implantation. Seven patients received pudendendal nerve stimulation (5 of them had sacral stimulation first) and a total of ...
European Urology, 2015
Diagnosis of nocturnal polyuria (NP) is based on a bladder diary. Addition of a renal function pr... more Diagnosis of nocturnal polyuria (NP) is based on a bladder diary. Addition of a renal function profile (RFP) for analysis of concentrating and solute-conserving capacity allows differentiation of NP pathophysiology and could facilitate individualized treatment. To map circadian rhythms of water and solute diuresis by comparing participants with and without NP. This prospective observational study was carried out in Ghent University Hospital between 2011 and 2013. Participants with and without NP completed a 72-h bladder dairy. RFP, free water clearance (FWC), and creatinine, solute, sodium, and urea clearance were measured for all participants. The study participants were divided into those with (n=77) and those without (n=35) NP. The mean age was 57 yr (SD 16 yr) and 41% of the participants were female. Compared to participants without NP, the NP group exhibited a higher diuresis rate throughout the night (p=0.015); higher FWC (p=0.013) and lower osmolality (p=0.030) at the start of the night; and persistently higher sodium clearance during the night (p<0.001). The pathophysiologic mechanism of NP was identified as water diuresis alone in 22%, sodium diuresis alone in 19%, and a combination of water and sodium diuresis in 47% of the NP group. RFP measurement in first-line NP screening to discriminate between water and solute diuresis as pathophysiologic mechanisms complements the bladder diary and could facilitate optimal individualized treatment of patients with NP. We evaluated eight urine samples collected over 24h to detect the underlying problem in NP. We found that NP can be attributed to water or sodium diuresis or a combination of both. This urinalysis can be used to adapt treatment according to the underlying mechanism in patients with bothersome consequences of NP, such as nocturia and urinary incontinence.
The Journal of Urology, 2015
Neurourology and urodynamics, Jan 10, 2015
The following is a report of the proceedings of the Nocturia Think Tank sessions of the annual In... more The following is a report of the proceedings of the Nocturia Think Tank sessions of the annual International Consultation on Incontinence-Research Society, which took place September 22-24, 2014 in Bristol, UK. The report is organized into sections pertaining to the main topic of discussion focussing on the question as to whether a new definition and classification of nocturia and nocturnal polyuria would improve the outcome of management in our patients. First, discussions identified theoretical and practical shortcomings of current definitions. Secondly, the utility of several nocturnal polyuria definitions was tested in a real life population in relation to the symptom nocturia, in order to display weaknesses of these definitions. Thirdly, we explored in a clinical population the utility of bladder diary based parameters by asking the question: when nocturia improves, which of these parameters improve most? Based on the above explorations the Think Tank summarized elements of the...
Minerva urologica e nefrologica = The Italian journal of urology and nephrology, 2014
In this article we reviewed the pathophysiology, diagnosis and treatment of varicoceles. The etio... more In this article we reviewed the pathophysiology, diagnosis and treatment of varicoceles. The etiology and pathogenesis of varicoceles cannot be explained by one theory. Valve dysfunction, ontogenetic collateral formation and the nutcracker phenomenon seem to act synergistically. Hyperthermia, elevated hydrostatic pressure and antisperm agents are suggested as possible causes for the pathophysiology how varicoceles induce infertility. However the combination of patient's lifestyle, genetic factors and the consequences of reflux into the pampiniform plexus are believed to contribute to the infertility. Although venography stays the gold standard, the combination of physical examination, color Doppler ultrasound and thermography has the highest sensitivity and specificity to diagnose a varicocele. Regarding infertility, we are still searching for strict criteria or grading, to decide which patients with a varicocele may or may not have benefit from treatment. Treatment of varicocel...
Acta clinica Belgica, Jan 6, 2014
This review highlights the current views on and differences and similarities between nocturnal en... more This review highlights the current views on and differences and similarities between nocturnal enuresis (NE) in children and nocturia in adults, which might be a guidance to elucidate the missing links in our knowledge. In both conditions, a genetic factor is suspected. Reduced bladder capacity and nocturnal polyuria are the main underlying lower urinary tract-related conditions. There is a link with sleep disorders, although it is not clear whether this is a cause or consequence. Physical and mental health are comprised in both conditions, however, in different ways. In NE, constipation and attention deficit disorder are the most important comorbidities and the effect on mental health and quality of life is mainly through the negative impact on self-esteem. In nocturia, cardiovascular disease and fall injuries are important comorbidities, mainly affecting the older nocturia population; personal distress and depression are consequences of the related poor sleep quality. For both con...
Neurourology and urodynamics, Jan 18, 2014
This study aims to clarify differences in parameters based on frequency volume chart (FVC) and on... more This study aims to clarify differences in parameters based on frequency volume chart (FVC) and on daytime and nighttime urine according to the nocturia frequency, age, and gender. This observational study was executed between 2011 and 2013. Participants (>18 years, ≤65 years) with or without nocturia (controls) were included and completed a 72 hr FVC; osmolality and sodium excretion were analyzed on daytime and nighttime urine. (1) Nocturia severity: Compared to controls (N = 38), those with ≥2 nocturia episodes (N = 29) have higher nocturnal voided volume (NVV) (P < 0.001) based on increased sodium excretion (P = 0.003) and lower functional bladder capacity (P < 0.001). Those with one nocturia episode (N = 21) present with lower bladder capacity (P = 0.005). (2) Gender: women with 1 and ≥2 episodes have lower bladder capacity than controls (P = 0.047 and P < 0.001, respectively). Men with ≥2 episodes present with increased NVV (P = 0.001) and decreased bladder capacity ...
Journal of the American Geriatrics Society, 2013
Progrès en Urologie, 2014
ABSTRACT Étude des données poolées de 2 études comparatives de phase 3 de BOTOX® versus placebo :... more ABSTRACT Étude des données poolées de 2 études comparatives de phase 3 de BOTOX® versus placebo : analyse de l’efficacité sur l’incontinence urinaire et la qualité de vie selon l’état d’infection urinaire ou la nécessité d’autosondage (AS).
European Urology Supplements, 2014
![Research paper thumbnail of [Second-line therapy of idiopathic detrusor overactivity. Sacral neuromodulation and botulinum toxin A]](https://attachments.academia-assets.com/42478479/thumbnails/1.jpg)
](Der Urologe. Ausg. A, 2010
The syndrome of idiopathic overactive bladder (I-OAB) impairs quality of life for the affected in... more The syndrome of idiopathic overactive bladder (I-OAB) impairs quality of life for the affected individuals. Conservative treatment options such as antimuscarinics are not always effective, and resulting side effects can lead the patient to stop treatment. In recently years, minimally invasive and reversible sacral neuromodulation and botulinum toxin A have become available. Currently, the approved treatment option for I-OAB that is recommended by the International Consultation on Incontinence is sacral neuromodulation by InterStim therapy. This article gives an overview of the present clinical evidence on the effectiveness and reliability of these two treatment modalities as well as the current significance of sacral neuromodulation and botulinum toxin A for the second-line treatment of adult I-OAB.
Eur Urol Suppl 2011;10(2):268 complications. Perineal drainage was removed at 12 hours and all pa... more Eur Urol Suppl 2011;10(2):268 complications. Perineal drainage was removed at 12 hours and all patients were discharged the morning after surgery. Minor scrotal hematoma presented in 6 cases (24%). Urethal catheter was removed in three weeks. Two cases (8%) in the SU subgroup needed a suprapubic catheter due to urinary fistula formation and followed spontaneous resolution. All patients were continent after surgery and those with sexual life conserved potency. Urethrography + uroflow were performed at 6-months and patients were discharged after a follow-up of 24 months. Urethral dilatation was needed only in a case (4%) in the AU arm. Conclusions: Open reconstruction for complex urethral stricture with membranous involvement has been successful in 96% of the cases in this series. Despite our experience is limited, very proximal SU with dorsal oral mucosa seems equally effective and safe than an AU procedure. We perform this modified Barbagli´s technique for bulbo-membranous strictures longer than 4 cm with very satisfactory results.
Current Infectious Disease Reports, 2011
Spinal cord injuries (SCI) result in different lower urinary tract dysfunctions. Because of both ... more Spinal cord injuries (SCI) result in different lower urinary tract dysfunctions. Because of both the disease and the bladder drainage method, urinary tract infections (UTIs) are one of the most frequent conditions seen in SCI patients. Diagnosis is not always easy due to lack of symptoms. Asymptomatic bacteriuria needs no treatment. If symptoms occur, antibiotherapy is indicated. Duration depends mainly on severity of illness and upper urinary tract or prostatic involvement. Choice of antibiotherapy should be based on local resistance profiles, but fluoroquinolones seems to be an adequate empirical treatment. Prevention of UTI is important, as lots of complications can be foreseen. Catheter care, permanent low bladder pressure and clean intermittent catheterization (CIC) with hydrophilic catheters are interventions that can prevent UTI. Probiotics might be useful, but data are limited.
Progrès en Urologie, 2009
Le point sur les traitements de seconde ligne de l'hyperactivité vésicale idiopathique 531 KEYWOR... more Le point sur les traitements de seconde ligne de l'hyperactivité vésicale idiopathique 531 KEYWORDS Overactive bladder; Urge urinary incontinence; Sacral neuromodulation; Botulinum toxin A Summary The overactive bladder syndrome (OAB) negatively affects the daily life of many people worldwide and conservative treatments, such as antimuscarinics, not always bring relief and/or are associated with considerable side effects resulting in treatment failure. Second line treatment options used to be invasive surgical procedures. However, less radical, minimally invasive and reversible alternatives, such as sacral neuromodulation and botulinum toxin A have emerged. Of these, only sacral neuromodulation with InterStim TM Therapy has been approved for OAB and been recommended by the International Consultation on Incontinence (ICI) in 2004. Nevertheless, depending of country rules and habits, both seem to be used by urologists in clinical practice for treating idiopathic OAB (I OAB). Therefore, this review attempts to provide an update on the available clinical evidence concerning the efficacy and safety, and the current position of sacral neuromodulation and botulinum toxin A in the second line management of adults with I OAB.
European Urology Supplements, 2007
Archives of Dermatology, 2003
To evaluate the safety and efficacy of botulinum toxin type A (BTX-A) (BOTOX) over 16 months in t... more To evaluate the safety and efficacy of botulinum toxin type A (BTX-A) (BOTOX) over 16 months in the treatment of bilateral primary axillary hyperhidrosis. A 16-month study with initial double-blind randomization to 50 U of BTX-A or placebo per axilla. After 4 months, participants could receive up to 3 further treatments with open-label BTX-A over 12 months. Fourteen dermatology or neurology clinics in Germany, Belgium, and the United Kingdom. Of 207 individuals aged between 17 and 74 years who had persistent bilateral primary axillary hyperhidrosis that interfered with daily activities, 174 (84%) completed the study. The baseline gravimetric assessment was a spontaneous sweat production of 50 mg or greater in each axilla prior to initial treatment. At week 4 after each treatment, the response rate of subjects who had at least a 50% reduction from baseline in axillary sweating, as measured by gravimetric assessment, was evaluated. Adverse events were spontaneously reported throughout the study, together with quality-of-life parameters and assessment of neutralizing antibodies to BTX-A. Over the 16-month period, 356 BTX-A treatments were given to 207 subjects. After placebo treatment, the response rate at week 4 was 34.7%. After the first, second, and third treatment with BTX-A, response rates at week 4 were 96.1%, 91.1%, and 83.3%, respectively. For subjects receiving more than 1 treatment, the mean duration between BTX-A treatments was approximately 7 months; however, 28% of subjects completed the study after only 1 BTX-A treatment. Subjects' satisfaction after treatments was consistently high, their quality of life improved, and there was a reduction in the impact of the disease on their lives. The safety profile of BTX-A after repeated treatments was excellent and no confirmed positive results for neutralizing antibodies to BTX-A occurred. Repeated intradermal injections of BTX-A over 16 months for treatment of primary axillary hyperhidrosis is safe and efficacious.
International journal of urology : official journal of the Japanese Urological Association, Jan 22, 2015
To evaluate the impact of onabotulinumtoxinA on individual domains of the quality of life questio... more To evaluate the impact of onabotulinumtoxinA on individual domains of the quality of life questionnaires in a pooled analysis of two phase 3 trials in overactive bladder patients with urinary incontinence who were inadequately managed by ≥1 anticholinergic. Patients received intradetrusor injections of onabotulinumtoxinA 100U (n = 557) or placebo (n = 548). The proportions of patients with a positive response (condition "greatly improved" or "improved") on the Treatment Benefit Scale, and changes in Incontinence Quality of Life scores and King's Health Questionnaire domain scores were analyzed in the overall population and subgroups with clean intermittent catheterization use and urinary tract infection status during the first 12 weeks of treatment. Responses to individual King's Health Questionnaire items were also assessed. Significantly greater proportions of onabotulinumtoxinA-treated patients achieved positive Treatment Benefit Scale response versus ...
Advances in therapy, Jan 28, 2015
The higher sensitivity to desmopressin (dDAVP) found in women and older patients with nocturnal p... more The higher sensitivity to desmopressin (dDAVP) found in women and older patients with nocturnal polyuria (NP) has partially been unraveled, leading to adaptation of the dosage based on gender. However, besides age and gender, other factors might play a role in differences in sensitivity and side effects. The aim of this study is to design a pharmacokinetic/pharmacodynamic (PD) assay to identify appropriate treatment for different groups of patients, primarily dependent on differences in age and gender. This interventional pilot study was carried out in Ghent University Hospital, Belgium, between 2011 and 2013. Patients with NP were subjected to a water load test (15 mL/kg), as well as an administration of 120 µg dDAVP oral disintegrating tablet (ODT) followed by blood analysis to determine plasma dDAVP levels and urine analysis for diuresis rate, osmolality, free water clearance and sodium clearance. Six female and six male patients were included (range 30-89 years old; mean age 69 ...
European Urology Supplements, 2014
Progrès en Urologie
The overactive bladder syndrome (OAB) negatively affects the daily life of many people worldwide ... more The overactive bladder syndrome (OAB) negatively affects the daily life of many people worldwide and conservative treatments, such as antimuscarinics, not always bring relief and/or are associated with considerable side effects resulting in treatment failure. Second line treatment options used to be invasive surgical procedures. However, less radical, minimally invasive and reversible alternatives, such as sacral neuromodulation and botulinum toxin A have emerged. Of these, only sacral neuromodulation with InterStim Therapy has been approved for OAB and been recommended by the International Consultation on Incontinence (ICI) in 2004. Nevertheless, depending of country rules and habits, both seem to be used by urologists in clinical practice for treating idiopathic OAB (I OAB). Therefore, this review attempts to provide an update on the available clinical evidence concerning the efficacy and safety, and the current position of sacral neuromodulation and botulinum toxin A in the secon...
Application of sacral and pudendal nerve stimulation in children with a voiding disorder: a retro... more Application of sacral and pudendal nerve stimulation in children with a voiding disorder: a retrospective analysis Purpose: Sacral/Pudendal nerve stimulation with InterStim has been applied in adults for more than a decade. Little is known about the effectiveness of sacral nerve stimulation in children and even less is known about the results of pudendal nerve stimulation in the pediatric population.The results of our series of Interstim therapy in children with severe voiding dysfunction, in whom neither intensive medical treatment nor behavioral therapies have succeeded, are described. Methods: A retrospective analysis of 18 patients (9 to 17 years old) with neurogenic bladder dysfunction, Fowler syndrome, dysfunctional elimination syndrome and/ or bladder overactivity (50% had proven overactivity) was performed. The mean follow-up time was 28,8 months after implantation. Seven patients received pudendendal nerve stimulation (5 of them had sacral stimulation first) and a total of ...
European Urology, 2015
Diagnosis of nocturnal polyuria (NP) is based on a bladder diary. Addition of a renal function pr... more Diagnosis of nocturnal polyuria (NP) is based on a bladder diary. Addition of a renal function profile (RFP) for analysis of concentrating and solute-conserving capacity allows differentiation of NP pathophysiology and could facilitate individualized treatment. To map circadian rhythms of water and solute diuresis by comparing participants with and without NP. This prospective observational study was carried out in Ghent University Hospital between 2011 and 2013. Participants with and without NP completed a 72-h bladder dairy. RFP, free water clearance (FWC), and creatinine, solute, sodium, and urea clearance were measured for all participants. The study participants were divided into those with (n=77) and those without (n=35) NP. The mean age was 57 yr (SD 16 yr) and 41% of the participants were female. Compared to participants without NP, the NP group exhibited a higher diuresis rate throughout the night (p=0.015); higher FWC (p=0.013) and lower osmolality (p=0.030) at the start of the night; and persistently higher sodium clearance during the night (p&amp;amp;amp;amp;amp;amp;amp;lt;0.001). The pathophysiologic mechanism of NP was identified as water diuresis alone in 22%, sodium diuresis alone in 19%, and a combination of water and sodium diuresis in 47% of the NP group. RFP measurement in first-line NP screening to discriminate between water and solute diuresis as pathophysiologic mechanisms complements the bladder diary and could facilitate optimal individualized treatment of patients with NP. We evaluated eight urine samples collected over 24h to detect the underlying problem in NP. We found that NP can be attributed to water or sodium diuresis or a combination of both. This urinalysis can be used to adapt treatment according to the underlying mechanism in patients with bothersome consequences of NP, such as nocturia and urinary incontinence.
The Journal of Urology, 2015
Neurourology and urodynamics, Jan 10, 2015
The following is a report of the proceedings of the Nocturia Think Tank sessions of the annual In... more The following is a report of the proceedings of the Nocturia Think Tank sessions of the annual International Consultation on Incontinence-Research Society, which took place September 22-24, 2014 in Bristol, UK. The report is organized into sections pertaining to the main topic of discussion focussing on the question as to whether a new definition and classification of nocturia and nocturnal polyuria would improve the outcome of management in our patients. First, discussions identified theoretical and practical shortcomings of current definitions. Secondly, the utility of several nocturnal polyuria definitions was tested in a real life population in relation to the symptom nocturia, in order to display weaknesses of these definitions. Thirdly, we explored in a clinical population the utility of bladder diary based parameters by asking the question: when nocturia improves, which of these parameters improve most? Based on the above explorations the Think Tank summarized elements of the...
Minerva urologica e nefrologica = The Italian journal of urology and nephrology, 2014
In this article we reviewed the pathophysiology, diagnosis and treatment of varicoceles. The etio... more In this article we reviewed the pathophysiology, diagnosis and treatment of varicoceles. The etiology and pathogenesis of varicoceles cannot be explained by one theory. Valve dysfunction, ontogenetic collateral formation and the nutcracker phenomenon seem to act synergistically. Hyperthermia, elevated hydrostatic pressure and antisperm agents are suggested as possible causes for the pathophysiology how varicoceles induce infertility. However the combination of patient's lifestyle, genetic factors and the consequences of reflux into the pampiniform plexus are believed to contribute to the infertility. Although venography stays the gold standard, the combination of physical examination, color Doppler ultrasound and thermography has the highest sensitivity and specificity to diagnose a varicocele. Regarding infertility, we are still searching for strict criteria or grading, to decide which patients with a varicocele may or may not have benefit from treatment. Treatment of varicocel...
Acta clinica Belgica, Jan 6, 2014
This review highlights the current views on and differences and similarities between nocturnal en... more This review highlights the current views on and differences and similarities between nocturnal enuresis (NE) in children and nocturia in adults, which might be a guidance to elucidate the missing links in our knowledge. In both conditions, a genetic factor is suspected. Reduced bladder capacity and nocturnal polyuria are the main underlying lower urinary tract-related conditions. There is a link with sleep disorders, although it is not clear whether this is a cause or consequence. Physical and mental health are comprised in both conditions, however, in different ways. In NE, constipation and attention deficit disorder are the most important comorbidities and the effect on mental health and quality of life is mainly through the negative impact on self-esteem. In nocturia, cardiovascular disease and fall injuries are important comorbidities, mainly affecting the older nocturia population; personal distress and depression are consequences of the related poor sleep quality. For both con...
Neurourology and urodynamics, Jan 18, 2014
This study aims to clarify differences in parameters based on frequency volume chart (FVC) and on... more This study aims to clarify differences in parameters based on frequency volume chart (FVC) and on daytime and nighttime urine according to the nocturia frequency, age, and gender. This observational study was executed between 2011 and 2013. Participants (>18 years, ≤65 years) with or without nocturia (controls) were included and completed a 72 hr FVC; osmolality and sodium excretion were analyzed on daytime and nighttime urine. (1) Nocturia severity: Compared to controls (N = 38), those with ≥2 nocturia episodes (N = 29) have higher nocturnal voided volume (NVV) (P < 0.001) based on increased sodium excretion (P = 0.003) and lower functional bladder capacity (P < 0.001). Those with one nocturia episode (N = 21) present with lower bladder capacity (P = 0.005). (2) Gender: women with 1 and ≥2 episodes have lower bladder capacity than controls (P = 0.047 and P < 0.001, respectively). Men with ≥2 episodes present with increased NVV (P = 0.001) and decreased bladder capacity ...
Journal of the American Geriatrics Society, 2013
Progrès en Urologie, 2014
ABSTRACT Étude des données poolées de 2 études comparatives de phase 3 de BOTOX® versus placebo :... more ABSTRACT Étude des données poolées de 2 études comparatives de phase 3 de BOTOX® versus placebo : analyse de l’efficacité sur l’incontinence urinaire et la qualité de vie selon l’état d’infection urinaire ou la nécessité d’autosondage (AS).
European Urology Supplements, 2014
Der Urologe. Ausg. A, 2010
The syndrome of idiopathic overactive bladder (I-OAB) impairs quality of life for the affected in... more The syndrome of idiopathic overactive bladder (I-OAB) impairs quality of life for the affected individuals. Conservative treatment options such as antimuscarinics are not always effective, and resulting side effects can lead the patient to stop treatment. In recently years, minimally invasive and reversible sacral neuromodulation and botulinum toxin A have become available. Currently, the approved treatment option for I-OAB that is recommended by the International Consultation on Incontinence is sacral neuromodulation by InterStim therapy. This article gives an overview of the present clinical evidence on the effectiveness and reliability of these two treatment modalities as well as the current significance of sacral neuromodulation and botulinum toxin A for the second-line treatment of adult I-OAB.
Eur Urol Suppl 2011;10(2):268 complications. Perineal drainage was removed at 12 hours and all pa... more Eur Urol Suppl 2011;10(2):268 complications. Perineal drainage was removed at 12 hours and all patients were discharged the morning after surgery. Minor scrotal hematoma presented in 6 cases (24%). Urethal catheter was removed in three weeks. Two cases (8%) in the SU subgroup needed a suprapubic catheter due to urinary fistula formation and followed spontaneous resolution. All patients were continent after surgery and those with sexual life conserved potency. Urethrography + uroflow were performed at 6-months and patients were discharged after a follow-up of 24 months. Urethral dilatation was needed only in a case (4%) in the AU arm. Conclusions: Open reconstruction for complex urethral stricture with membranous involvement has been successful in 96% of the cases in this series. Despite our experience is limited, very proximal SU with dorsal oral mucosa seems equally effective and safe than an AU procedure. We perform this modified Barbagli´s technique for bulbo-membranous strictures longer than 4 cm with very satisfactory results.
Current Infectious Disease Reports, 2011
Spinal cord injuries (SCI) result in different lower urinary tract dysfunctions. Because of both ... more Spinal cord injuries (SCI) result in different lower urinary tract dysfunctions. Because of both the disease and the bladder drainage method, urinary tract infections (UTIs) are one of the most frequent conditions seen in SCI patients. Diagnosis is not always easy due to lack of symptoms. Asymptomatic bacteriuria needs no treatment. If symptoms occur, antibiotherapy is indicated. Duration depends mainly on severity of illness and upper urinary tract or prostatic involvement. Choice of antibiotherapy should be based on local resistance profiles, but fluoroquinolones seems to be an adequate empirical treatment. Prevention of UTI is important, as lots of complications can be foreseen. Catheter care, permanent low bladder pressure and clean intermittent catheterization (CIC) with hydrophilic catheters are interventions that can prevent UTI. Probiotics might be useful, but data are limited.
Progrès en Urologie, 2009
Le point sur les traitements de seconde ligne de l'hyperactivité vésicale idiopathique 531 KEYWOR... more Le point sur les traitements de seconde ligne de l'hyperactivité vésicale idiopathique 531 KEYWORDS Overactive bladder; Urge urinary incontinence; Sacral neuromodulation; Botulinum toxin A Summary The overactive bladder syndrome (OAB) negatively affects the daily life of many people worldwide and conservative treatments, such as antimuscarinics, not always bring relief and/or are associated with considerable side effects resulting in treatment failure. Second line treatment options used to be invasive surgical procedures. However, less radical, minimally invasive and reversible alternatives, such as sacral neuromodulation and botulinum toxin A have emerged. Of these, only sacral neuromodulation with InterStim TM Therapy has been approved for OAB and been recommended by the International Consultation on Incontinence (ICI) in 2004. Nevertheless, depending of country rules and habits, both seem to be used by urologists in clinical practice for treating idiopathic OAB (I OAB). Therefore, this review attempts to provide an update on the available clinical evidence concerning the efficacy and safety, and the current position of sacral neuromodulation and botulinum toxin A in the second line management of adults with I OAB.
European Urology Supplements, 2007