The COVID-19 pandemic led to limit patients' visits to the neuro-urology department. Telemedicine was seen as a pragmatic solution to provide follow-up care. This study aimed to assess the efficiency and satisfaction of a telephone consultation in neuro-urology. Methods: During the pandemic, the scheduled medical visits were converted into telephone consultation. For each teleconsultation, the physician assessed the efficiency and the patient-rated global satisfaction of the teleconsultation. The physician and the patient assessed whether this teleconsultation replaced a physical visit. Results: About 358 neurologic patients were included in the study. The mean efficiency of the telephone consultation was 9.3/10 (±1.5). The mean global satisfaction was 9.0/10 (±1.3). The majority of the patients (52.4%) would prefer a physical consultation. 90.2% might convert some clinic visits to teleconsultations in the future. No agreement was found between the patient and the physician when they were asked if the teleconsultation replaced the physical consultation initially scheduled (weight kappa = 0.02; 95% confidence interval = [−0.06 to 0.11]). Cognitive impairment, difficulty to obtain relevant information, and lack of physical examination were unfavorable to the efficiency of the teleconsultation. Cognitive impairment, embarrassing nature of the teleconsultation, and preference for a physical consultation were unfavorable to satisfaction of the patient. Conclusion: Telemedicine in neuro-urology was associated with a high satisfaction of the patients and was described as efficient by the physicians. Despite this, the majority of the patients reported a preference for physical consultation. The COVID-19 pandemic might be an opportunity to refine our practices in neuro-urology and to develop telemedicine.

Le "postorgasmic illness syndrome" (POIS) ou « syndrome de la maladie post-orgasmique » (SMPO) est un syndrome rare décrit récemment qui regroupe un ensemble de symptômes cliniquesphysiques ou cognitifs-apparaissant électivement après une éjaculation ou un orgasme et pouvant perdurer plusieurs jours. Les étiologies et les mécanismes physiopathologiques du POIS restent discutés. Une allergie à une des protéines composant le liquide séminal ou à une protéine excrétée pendant l'éjaculation, une origine psychosomatique, un équivalent migraineux ou épiletique, et une dysrégulation végétative restent les mécanismes les plus évoqués. Mots-clés : Postorgasmic Illness Syndrome Postorgasmic illness syndrome (POIS) is a rare and recently described syndrome. It gathers a set of clinical symptoms-physical or cognitive-that occur electively after an ejaculation or an orgasm and may last several days. The etiologies and physiopathological mechanisms of POIS remain discussed. An allergy to one of the proteins composing the seminal fluid or to a protein excreted during ejaculation, a psychosomatic origin, a migrainous or epileptic equivalent, and a vegetative dysregulation remain the most evoked mechanisms.

No abstract

Introduction: This study aimed to empirically validate a French version of the Neurogenic Bladder Symptoms Score-Short From (NBSS-SF), a psychometric multidimensional tool to assess lower urinary tract symptoms (LUTS) for patients with a neurological condition. Methods: One hundred and five participants with multiple sclerosis or spinal cord injury prospectively completed the questionnaire at baseline and 7–14 days later. The α coefficient of Cronbach (internal consistency) and the intraclass correlation coefficient (ICC) (test-retest reliability) were calculated. Results: The internal consistency for the overall questionnaire was high (Cronbach’s α coefficients from 0.79), while coefficients for each subscale were variable (urinary incontinence 0.91; storage and voiding 0.69; consequences 0.25). For test-retest reliability, 88/105 (84%) patients filled and sent back their questionnaire 10 days (±3.6 days) after baseline version. ICC was 0.90 for the total score and was 0.73 for the urinary incontinence subdomain, 0.79 for storage and voiding, and 0.75 for consequences. Conclusions: The psychometric qualities of the French version of the NBSS-SF are well-supported, thus providing a valid tool to measure bladder symptoms across three different domains in patients with a neurogenic bladder.

Aim:The aim was to determine which criteria are most influential in guiding the patient's choice of catheter during clean intermittent self-catheterization (CISC) education.Methods: A questionnaire exploring five traits (catheter design, catheter length, the comfort of use, nurse's explanations, and how easy it was to carry and dispose of the catheter) was administered to all patients who succeeded in performing CISC. The patients had to report the criterion that most influenced their choice, and rate the importance of each criterion from 1 to 4 on a Likert scale (strongly disagree, somewhat disagree, somewhat agree, strongly agree). The study assessed the impact that age, sex, etiology, dependency, motor or sensory upper limb deficiency, and position required to perform CISC may have had on the importance of the different criteria. Results: Seventy-three patients were included (mean age, 50.9 ± 14.3 years).The most important criterion was the nurse's explanations (44%), followed by comfort of handling (32%), the discreet aspect of carrying the catheter (15%), and catheter length (7%). The esthetic aspect was not important for 34% of patients, whereas all the other criteria were important for at least 82% of patients. The comfort of handling was more often a priority for those with motor or sensory upper limb disorders (P < .01). The other characteristics of the patients did not impact the way they prioritized the criteria. Conclusion: These results highlight the importance of extensive training for nurses involved in CISC education, as their explanations have the greatest impact on the patient's choice of the catheter. K E Y W O R D S intermittent urethral catheterization, patient education as topic, patient preference, neurogenic, nurses, teaching, urinary bladder, urinary retention

Background. Lower urinary tract symptoms, especially overactive bladder, are frequent and disabling in individuals with multiple sclerosis (IwMS). An association with gait disorders is common, which could aggravate continence difficulties and affect quality of life. The association between the need to void and walking has never been studied in this population. Objective. The primary aim of this study was to assess the effect of a strong desire to void (SDV) on walking speed in IwMS and lower urinary tract symptoms. The secondary aim was to identify clinical or urodynamic factors associated with walking speed impairment at SDV in this population. Methods. We included IwMS with urinary disorders and Expanded Disability Status Scale score < 7 in this observational study. Individuals underwent 3 10-m walk tests (10MWT) and one Timed Up and Go (TUG) test at SDV and at post-void (PV). Results. Among the 72 IwMS included (mean [SD] age 50.6 [11.6] years; 46 [64%] females), the mean (SD) speed for 10MWT was 1.00 (0.31) m.s-1 at SDV and 1.07 (0.30) m.s-1 at PV (p<0.0001). Time for TUG was also increased when individuals felt SDV: mean 11.53 (4.6) sec at SDV versus 10.77 (3.8) sec at PV (p=0.004). No predictors of greater impairment of walking speed at SDV were identified. Conclusion. This study suggests a clinical impact of bladder sensation on walking speed in IwMS and urinary disorders. None of the individual characteristics could predict greater decrease in gait velocity at SDV.

PurposeThe aim of this study is to compare the clinical and urodynamic characteristics of urinary disorders in multiple sclerosis (MS) patients in a geriatric population with a nongeriatric population.MethodsThis study was conducted retrospectively between 2010 and 2016. Each patient with MS aged 65 and older was matched with 2 patients with MS aged less than 65 in sex, form of MS, and Expended Disability Status Scale (EDSS). Demographic data, urinary symptoms, treatment, quality of life, repercussion of lower urinary tract symptoms on daily life activities and psychological state and urodynamic parameters were collected. Differences between the 2 populations were evaluated using Student test, chi-square, or Fischer tests.ResultsTwenty-four patients with MS aged 65 and older (mean age, 69.8 years) were matched with 48 patients aged less than 65 years (mean age, 49.4 years). Maximum urethral closure pressure was lower in the elderly population than in the nongeriatric population (mean±standard deviation [SD]: 35.6±18.5 cm H₂O vs. 78.2±52.3 cm H₂O, P<0.001). In the male population, there was no statistical difference in any other clinical or urodynamic endpoints. In the female population, voiding symptoms was more described in the nongeriatric population (Urinary Symptom Profile low stream: 3.4±3.5 vs. 1.7±2.4, P=0.04), geriatric population had less urinary treatment (P=0.05). LUTS had less impact on quality of life (Qualiveen: 1.4±1.0 vs. 2.1±0.9, P=0.02) on the geriatric population than in the nongeriatric of female MS patients.ConclusionsGeriatric population of MS has few differences of urinary disorders compared to a nongeriatric population with EDSS, sex, and MS form equal. However, the psychological impact of these urinary disorders is less important in female geriatric population.

No abstract