Rationale for the use of anticholinergic agents in overactive bladder with regard to central nervous system and cardiovascular system side effects

Purpose: Central nervous system (CNS) and cardiovascular system (CVS) side effects of anticholinergic agents used to treat overactive bladder (OAB) are underreported. Hence, this review aimed to focus on the mechanisms of CNS and CVS side effects of anticholinergic drugs used in OAB treatment, which may help urologists in planning the rationale for OAB treatment. Materials and Methods: PubMed/MEDLINE was searched for the key words "OAB," "anticholinergics," "muscarinic receptor selectivity," "blood-brain barrier," "CNS," and "CVS side effects." Additional relevant literature was determined by examining the reference lists of articles identified through the search. Results: CNS and CVS side effects, pharmacodynamic and pharmacokinetic properties, the metabolism of these drugs, and the clinical implications for their use in OAB are presented and discussed in this review. Conclusions: Trospium, 5-hydroxymethyl tolterodine, darifenacin, and solifenacin seem to have favorable pharmacodynamic and pharmacokinetic properties with regard to CNS side effects, whereas the pharmacodynamic features of darifenacin, solifenacin, and oxybutynin appear to have an advantage over the other anticholinergic agents (tolterodine, fesoterodine, propiverine, and trospium) with regard to CVS side effects. To determine the real-life situation, head-to-head studies focusing especially on CNS and CVS side effects of OAB anticholinergic agents are urgently needed

Natural history of patients with multicystic dysplastic kidney - what followup is needed?

Purpose: Most clinicians recommend followup with annual ultrasound for patients with multicystic dysplastic kidney. The aim of this study was to determine whether followup ultrasound provides any clinical benefit

Additional benefit of laparoscopy for nonpalpable testes: Finding a contralateral patent processus

OBJECTIVES To determine the incidence of contralateral patent processus vaginalis discovered at laparoscopy in patients presenting with a unilateral nonpalpable testis

Management of Bladder Cancer After Renal Transplantation

Objectives. In renal transplant recipients, the risk of developing bladder cancer and rate of diagnosis of advanced staged bladder cancer are generally higher than the general population. Also, it is more challenging to treat renal transplant recipients than the regular patient population. We aimed to evaluate the efficacy and safety of radical cystectomy (RC) and urinary diversion with ileal conduit in renal transplant recipients

Does Vaginal Anti-Incontinence Surgery Affect Sexual Satisfaction? A Comparison of TVT and Burch-Colposuspension

Objective: To evaluate the sexual satisfaction rates of women who underwent tension-free vaginal tape (TVT) procedure for stress urinary incontinence and compare it with the results of Burch-colposuspension

Intermediate-Risk Group in Patients with Transitional Cell Carcinoma of the Bladder: Prediction of High-Risk Patients in This Heterogeneous Group

Objective: To determine whether recurrence at first follow-up cystoscopy predicts future recurrence in patients with an intermediate risk of superficial bladder cancer. Methods: In total, 304 patients were classified as low (n = 60), intermediate (n = 177) or high risk (n = 67) based on the primary pathological/clinical findings, as previously described in literature. The intermediate-risk group was further divided into 2 subgroups based on recurrence at the first follow-up cystoscopy: A (recurrence negative) and B (recurrence positive). Results: The mean recurrence rates of low-, intermediate- and high-risk patients were 1.76, 6.41 and 9.49, respectively (p < 0.05). Similarly, the difference in the recurrence rates between subgroups A (4.37) and B (9.12) was found to be statistically significant (p = 0.00). Additionally, while the difference between the low-risk group and subgroup A was statistically significant (p = 0.008), there was no significance between subgroup B and the high-risk group (p = 0.892). In the multivariate analysis, the most significant prognostic parameter for recurrence was the outcome of the first follow-up cystoscopy, followed by tumor multiplicity and grade. Conclusions: Patients showing recurrence at first follow-up cystoscopy in the intermediate-risk group should be classified as high-risk patients and treated accordingly. Copyright (C) 2009 S. Karger AG, Base

Voiding Dysfunction due to Multiple Sclerosis: a Large Scale Retrospective Analysis

Purpose: To assess the outcome of urologic evaluation in patients with voiding dysfunction due to multiple sclerosis (MS) and to determine the relationship between urological and neurological parameters of these patients

STENT GRAFT APPLICATIONS AND RESULTS IN PATIENTS WITH THORACIC AORTIC PATHOLOGIES

Objective: The aim of this study was to evaluate the long-term results of patients who underwent thoracic stent grafting