A review of prospective Clinical Trials for neurogenic bladder: The place of surgery, experimental techniques and devices

Abstract

IntroductionThe neurogenic urinary bladder has been known for at least 30 years now and the concepts behind it are continuously evolving, but there is actually not much work that has been done to accumulate solid clinical evidence in this field. We review the surgical and experimental techniques used in the management of this condition.Material and methodsTo achieve our goal, we performed Internet searches using the same search string: Urinary bladder, neurogenic. In each case, the search was limited to clinical trial, subjects were human and the language was English. After duplicate removal, we obtained a final number of 580 papers. Data was extracted from each paper into a database file and was analyzed separately for adult and pediatric populations.ResultsA total of 70 full text papers were reviewed and analyzed according to the previously mentioned algorithm. The first prospective, randomized surgical trials were published less than 20 years ago, starting with 1994, and the number of papers published each year since then has remained in the range of 1–3. The oldest prospective clinical trial for this indication dates back to 1975. The total number of patients included in surgical trials is 3453, out of which 59% are males. The papers include a total of 369 children (21.2%), essentially looking at all the techniques that are also used in adults.ConclusionsThere is still a lot of work to be done in order to obtain a significant level of evidence in the field of surgical procedures used in neurogenic bladder patients.

Tissue Fixation System ligament repair cures major pelvic organ prolapse in ageing women with minimal complications – a 10-year Japanese experience in 960 women

“…Other than SUI, these conditions are not considered surgically curable. Indeed, few prospective trials even address these issues [ 23 , 24 ]. The conclusion from these trials is always the same: pathogenesis is unknown; no cure is possible [ 23 , 24 ].…”

“…How does application of the Integral Theory System [ 44 ] bring high bladder/bowel/ chronic pelvic pain (CPP) cure rates, when ‘consensus group’ recommendations from more traditional expert associations [ 21 ] such as the European Urology Association [ 22 ] invariably conclude that pathogenesis is unknown and no cure is possible? [ 23 , 24 ].…”

Effects of overactive bladder on treatment-related behaviour and quality of life in an Eastern European country: findings from the LUTS POLAND Study

“…Treatment-related behaviours also depend on the availability of therapeutic options [35,36]. The treatment availability has a particular effect on treatment receiving and treatment continuation.…”

Combined Application of Aminoglycosides and Ascorbic Acid in the Elimination of Proteus mirabilis Rods Responsible for Causing Catheter-Associated Urinary Tract Infections (CAUTIs)—A Molecular Approach

“…Proteus mirabilis , an opportunistic pathogen belonging to the Morganellaceae family, is a common cause of urinary tract infections (UTIs), especially those detected in patients with urinary tract structural or neurological abnormalities [ 1 ]. One of them is the neurogenic bladder defined as bladder dysfunction resulting from a central or peripheral neurologic insult [ 2 ]. The incidence of Proteus rods in the neurogenic population amounts to a small percentage [ 3 ].…”