Methylglyoxal and Advanced Glycation End Products (AGEs): Targets for the Prevention and Treatment of Diabetes-Associated Bladder Dysfunction?

Biomedicines, Journal Year: 2024, Volume and Issue: 12(5), P. 939 - 939

Published: April 23, 2024

Methylglyoxal (MGO) is a highly reactive α-dicarbonyl compound formed endogenously from 3-carbon glycolytic intermediates. accumulated in plasma and urine of hyperglycemic diabetic individuals acts as potent peptide glycation molecule, giving rise to advanced end products (AGEs) like arginine-derived hydroimidazolone (MG-H1) carboxyethyl-lysine (CEL). Methylglyoxal-derived AGEs exert their effects mostly via activation RAGE, cell surface receptor that initiates multiple intracellular signaling pathways, favoring pro-oxidant environment through NADPH oxidase generation high levels oxygen species (ROS). Diabetic bladder dysfunction bothersome urological complication patients with poorly controlled diabetes mellitus may comprise overactive bladder, urge incontinence, poor emptying, dribbling, incomplete emptying the urinary retention. Preclinical models type 1 2 have further confirmed relationship between voiding dysfunction. Interestingly, healthy mice supplemented MGO for prolonged periods exhibit vivo vitro dysfunction, which accompanied by increased AGE formation RAGE expression, well ROS overproduction tissues. Drugs reported scavenge inactivate metformin, polyphenols, alagebrium (ALT-711) shown favorable outcomes on obese leptin-deficient MGO-exposed mice. Therefore, MGO, AGEs, be critically involved pathogenesis individuals. However, there are no clinical trials designed test drugs selectively inhibit MGO–AGEs–RAGE signaling, aiming reduce manifestations diabetes-associated This review summarizes current literature role MGO–AGEs–RAGE–ROS axis directly ameliorate also reviewed here.

Language: Английский

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Potential for Misdiagnosis of Detrusor Underactivity Due to Urodynamic Voiding Position and Seating Characteristics

Neurourology and Urodynamics, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 27, 2025

ABSTRACT Background Detrusor underactivity (DUA) is a lower urinary tract (LUT) diagnosis that diagnosed with multichannel urodynamic studies (UDS). The effect of voiding position and DUA detection unclear. Objectives We investigated whether moving individuals from the UDS chair to their typical would more accurately assess detrusor function in cases absent or nonrepresentative voiding. hypothesized patients unable achieve representative void while on may be misdiagnosed DUA, changing reveal intact function. Methods retrospectively studied who underwent single provider over 2 years. Studies were included if patient was moved new after unsuccessful unrepresentative attempts chair. Two neurourologists reanalyzed recorded: time spent attempting position, bladder contraction occurred chair, pdet Q max when occurred, presence Valsalva effort. Results 503 UDS; 94/503 81/94 interpretable. 71% without demonstrated position. Conclusion surface can impact produce during testing. Positional change natural positions surfaces improves

Language: Английский

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Effect of Acotiamide on Detrusor Underactivity Induced Through Bilateral Pelvic Nerve Crush Injury in Rats

International Neurourology Journal, Journal Year: 2025, Volume and Issue: 29(1), P. 3 - 9

Published: March 28, 2025

Purpose: To investigate the effectiveness of acotiamide on lower urinary tract dysfunction by using a rat model neurogenic underactive bladder induced through pelvic nerve crush (PNC) injury.Methods: Bilateral PNC injuries were performed 8-week-old female Sprague-Dawley rats (PNC group); sham surgery group was used as control (control group). Two weeks after surgery, awake cystometrography (CMG) performed, and (10 or 100 mg/kg) subcutaneously administered to groups. Subsequently, CMG parameter values obtained before treatment compared.Results: In baseline CMG, compared group, revealed statistically significant elevations in intercontraction intervals (ICIs), number nonvoiding contractions, pressure, threshold capacity, voided volumes, postvoid residual. However, contraction amplitudes voiding efficiency significantly decreased. with values, 10-mg/kg resulted amplitudes. Treatment 100-mg/kg led decreases ICI volume. there no changes noted parameters (n=6). Compared administration decreased (1,025±186 seconds vs. 578±161 seconds; P=0.012), capacity (1,841±323 µL 871±174 µL, respectively; P=0.0059) residual (223±46 44±22 P=0.023), increased (22.09±1.76 cm H₂O 43.84±6.87 H₂O, P=0.012) (0.87±0.02 0.94±0.03, P=0.029).Conclusions: Acotiamide showed bladder, possibly activation afferent detrusor activities.

Language: Английский

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Beyond urodynamics: non-invasive approaches to diagnosing detrusor underactivity in men with lower urinary tract symptoms – a systematic review

BMC Urology, Journal Year: 2025, Volume and Issue: 25(1)

Published: March 6, 2025

To evaluate and synthesize existing evidence on non-invasive methods for diagnosing detrusor underactivity (DU) in men presenting with lower urinary tract symptoms (LUTS), focusing their feasibility diagnostic accuracy. A systematic search of PubMed, Scopus, Web Science databases was conducted original articles reporting tests DU LUTS. Data extraction focuses study characteristics, methods, The risk bias assessed using the QUADAS-2 tool. Eighteen studies involving 7390 patients, whom 3194 were diagnosed DU, included our analysis. evaluated ultrasound parameters, biomarkers, uroflowmetry results, symptom questionnaires, clinical characteristics. Developed models, including those based artificial intelligence (AI), nomograms also assessed. questionnaire DUA-SQ showed highest sensitivity 95.8%, while measurements, such as wall thickness 100% specificity but limited (42%). Models incorporating variables achieved rates over 75%. Uroflowmetry particularly presence "sawtooth" "interrupted" waveforms, demonstrated 80% 87%. Biomarkers, serum adiponectin urine NO/ATP ratio, 79% 88.5%, respectively. AI models potential, sensitivities ranging from 65.9% to 79.7%. Due poor quality data heterogeneity, meta-analysis not performed. Non-invasive DUA-SQ, demonstrate though accuracies vary. Further research is needed standardize these enhance reliability. protocol registered PROSPERO (CRD42024556425). applicable.

Language: Английский

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Prospective Comparative Study of EMSella Therapy and Surgical Anterior Colporrhaphy for Urinary Incontinence: Outcomes and Efficacy

Healthcare, Journal Year: 2025, Volume and Issue: 13(8), P. 864 - 864

Published: April 10, 2025

Background: This prospective comparative study investigates urinary incontinence (UI), often associated with grade 2 cystocele, a condition that poses significant physical, emotional, and social challenges for affected women. While anterior colporrhaphy remains the gold standard anatomical correction, non-invasive alternatives such as EMSella therapy have gained increasing attention. The compares outcomes of these two distinct approaches in managing UI pelvic organ prolapse. Materials Methods: involved 133 menopausal women cystocele UI, including 78 treated 55 therapy, across Romanian healthcare centers. Outcomes were assessed through prolapse reduction (POP-Q), bladder function normalization, recurrence rates, quality life (PFDI-20, PFIQ-7), patient satisfaction, complication recovery times, or professional disruptions. Results: Anterior was more effective correction (88% vs. 64% achieving stage 0 prolapse) normalization (72% 55%, p = 0.04), lower one-year rates (14% 31%, 0.03). allowed faster recovery, 91% resuming daily activities within week. Both groups showed improvement life, but reductions PFDI-20 PFIQ-7 scores after surgery. had fewer infections no dyspareunia, reflecting better safety profile. Conclusions: significantly benefit cystocele. provides definitive superior long-term outcomes, represents safer, less invasive alternative rapid making it ideal patients mild conditions surgical contraindications. Treatment should be tailored to individual needs preferences.

Language: Английский

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Detrusor Underactivity Diagnosis Method Based on a Multi-View Multi-Head Graph Attention Network

Published: Jan. 1, 2025

Language: Английский

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A guide to diabetic bladder dysfunction

Independent Nurse, Journal Year: 2025, Volume and Issue: 2025(5), P. 14 - 22

Published: May 2, 2025

Diabetes affects multiple body systems and can have a major effect on health well being. Here Linda Nazarko explains how type two diabetes bladder function in women

Language: Английский

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A new nomogram for the evaluation of detrusor underactivity and bladder outlet obstruction in nonneurogenic female patients with lower urinary tract symptoms who undergo urodynamic studies

Neurourology and Urodynamics, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 13, 2024

Abstract Introduction Micturition physiology differs in men and women. However, the results standard urodynamic studies women with lower urinary tract symptoms (LUTS) were extrapolated from men. Nowadays, only validated nomogram for females is Solomon–Greenwell's. it evaluated bladder outlet obstruction (BOO) without considering detrusor underactivity (DU). This study aims to create a that includes an evaluation of DU BOO nonneurogenic validate against videourodynamic along other nomograms. Materials Methods For first analysis (creation cohort), we included 183 LUTS who underwent between 2022 2023. Exclusion criteria neurologic diseases, renal transplantation, trouble performing flow‐pressure study. Baseline characteristics patients, parameters, classifications on different nomograms indexes evaluated. A logistic regression found Qmax PdetQmax as predictors BOO. The Barco–Castillo was created by clustering adjusted regression. second (test) cohort 2023 2024, including 142 patients validation nomogram. p < 0.05 considered significant. Results All parameters compared both cohorts, no significant differences. median age creation 50 years old (interquartile range [IQR] 39–63). had previous clear diagnosis. cluster two groups (yes/no) (yes/no). We graph based according data. test 44 (IQR 33.75–59) same indication receiver operating characteristic (ROC) curve showed accuracy 85.4% nomogram, 68.5% Blaivas–Groutz, 58.1% Solomon–Greenwell, 57.1% BOOI, 50% LinPURR. DU, 80.5% PIP‐1, 80.2% Barco–Castillo, 76.6% BCI, 70.1% Conclusions When evaluating women's studies, important focus female discourage use previously standardized encourage using new determine currently easiest more accurate tool.

Language: Английский

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Diabetic bladder dysfunction

British Journal of Community Nursing, Journal Year: 2024, Volume and Issue: 29(5), P. 232 - 237

Published: May 2, 2024

More than 4.3 million people in the UK have been diagnosed with diabetes and there are thought to be a further 850 000 living who not yet ( Diabetes UK, 2024 ). Around half of all adults experience bladder dysfunction. It is one most common complications diabetes, little medical literature it often unrecognised poorly treated Wittig et al, 2019 This article uses case history approach examine how can affect bladder.

Language: Английский

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Artificial Intelligence Tools in Pediatric Urology: A Comprehensive Review of Recent Advances

Diagnostics, Journal Year: 2024, Volume and Issue: 14(18), P. 2059 - 2059

Published: Sept. 17, 2024

Artificial intelligence (AI) is providing novel answers to long-standing clinical problems, and it quickly changing pediatric urology. This thorough analysis focuses on current developments in AI technologies that improve urology diagnosis, treatment planning, surgery results. Deep learning algorithms help detect problems with previously unheard-of precision disorders including hydronephrosis, pyeloplasty, vesicoureteral reflux, where AI-powered prediction models have demonstrated promising outcomes boosting diagnostic accuracy. AI-enhanced image processing methods significantly improved the quality interpretation of medical images. Examples these are deep-learning-based segmentation contrast limited adaptive histogram equalization (CLAHE). These guarantee higher identification classification urological disorders, AI-driven ground truth construction approaches aid standardization improvement training data, resulting more resilient consistent models. being used for surgical support as well. AI-assisted navigation devices difficult operations like pyeloplasty by decreasing complications increasing also helps long-term patient monitoring, predictive analytics, customized strategies, all which results younger patients. However, there practical, ethical, legal issues integration need be carefully navigated. To close knowledge gaps, investigation required, especially areas standardized datasets radiologic segmentation. In end, has potential completely transform enhancing care, effectiveness treatments, spurring advancements this exciting area.

Language: Английский

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