Levy, Stephan; Dequirez, Pierre-Luc; Mercier, Jeremy; Taha, Fayek; Goujon, Anna; Seguier, Denis; Mesnard, Benoît; de Mazancourt, Emilien Seizilles; Joussen, Guillaume; Margue, Gaelle; Berchiche, William; Anastay, Vassili; Deleuze, Claire; Kaulanjan, Kevin; Cotte, Juliette; Peyrottes, Arthur; Gamé, Xavier; Peyronnet, Benoit
In: Fr J Urol, vol. 34, no. 3, pp. 102580, 2024, ISSN: 2950-3930.
@article{pmid38417189,
title = {[Current state of knowledge of urology residents and fellows on the neuro-urological management of spina bifida patients in France]},
author = {Stephan Levy and Pierre-Luc Dequirez and Jeremy Mercier and Fayek Taha and Anna Goujon and Denis Seguier and Benoît Mesnard and Emilien Seizilles de Mazancourt and Guillaume Joussen and Gaelle Margue and William Berchiche and Vassili Anastay and Claire Deleuze and Kevin Kaulanjan and Juliette Cotte and Arthur Peyrottes and Xavier Gamé and Benoit Peyronnet},
doi = {10.1016/j.fjurol.2024.102580},
issn = {2950-3930},
year = {2024},
date = {2024-02-01},
journal = {Fr J Urol},
volume = {34},
number = {3},
pages = {102580},
abstract = {OBJECTIVE: To assess the current knowledge of French urology residents and fellows about neurogenic lower urinary tract dysfunction and their management in patients with spina bifida.nnMATERIAL AND METHOD: A 7-question questionnaire, covering the responder's experience and the various stages in the neuro-urological management of spina bifida, was drafted by an expert urologist. Responses were collected within 5days of being e-mailed to members of the Association française des urologues en formation (AFUF), and a descriptive analysis was carried out.nnRESULTS: Of the 448 members, 155 completed the questionnaire. Of the participants, 83.8% said they knew the definition of spina bifida, and 76.8% had already had to care for a spina bifida patient. Of the participants, 48.4% correctly estimated the number of spina bifida patients in France. Neurogenic lower urinary tract dysfunction to look for and the specificities of management seemed to have been acquired by a majority of respondents (correct response rates of 70.7% and 75.4%, respectively), unlike the extra-urological aspects (53.9%), and the choice of examinations useful for the initial work-up and follow-up (55.8%).nnCONCLUSION: While the expected neurogenic lower urinary tract dysfunction and the specificities of therapeutic management of spina bifida patients appear to be well known to urologists in training, knowledge of extra-urological symptoms and the choice of examinations could be improved. These results could be used to adjust the teaching given to French urologists in training on the urological management of spina bifida patients.nnLEVEL OF EVIDENCE: Grade 4.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To assess the current knowledge of French urology residents and fellows about neurogenic lower urinary tract dysfunction and their management in patients with spina bifida.nnMATERIAL AND METHOD: A 7-question questionnaire, covering the responder’s experience and the various stages in the neuro-urological management of spina bifida, was drafted by an expert urologist. Responses were collected within 5days of being e-mailed to members of the Association française des urologues en formation (AFUF), and a descriptive analysis was carried out.nnRESULTS: Of the 448 members, 155 completed the questionnaire. Of the participants, 83.8% said they knew the definition of spina bifida, and 76.8% had already had to care for a spina bifida patient. Of the participants, 48.4% correctly estimated the number of spina bifida patients in France. Neurogenic lower urinary tract dysfunction to look for and the specificities of management seemed to have been acquired by a majority of respondents (correct response rates of 70.7% and 75.4%, respectively), unlike the extra-urological aspects (53.9%), and the choice of examinations useful for the initial work-up and follow-up (55.8%).nnCONCLUSION: While the expected neurogenic lower urinary tract dysfunction and the specificities of therapeutic management of spina bifida patients appear to be well known to urologists in training, knowledge of extra-urological symptoms and the choice of examinations could be improved. These results could be used to adjust the teaching given to French urologists in training on the urological management of spina bifida patients.nnLEVEL OF EVIDENCE: Grade 4.
[Prevention of dysraphism in France through mandatory food fortification with folic acid]
Dhombres, Ferdinand; Guilbaud, Lucie; de Saint-Denis, Timothée; Jouannic, Jean-Marie
In: Gynecol Obstet Fertil Senol, vol. 52, no. 1, pp. 60–62, 2024, ISSN: 2468-7189.
@article{pmid37918686,
title = {[Prevention of dysraphism in France through mandatory food fortification with folic acid]},
author = {Ferdinand Dhombres and Lucie Guilbaud and Timothée de Saint-Denis and Jean-Marie Jouannic},
doi = {10.1016/j.gofs.2023.10.007},
issn = {2468-7189},
year = {2024},
date = {2024-01-01},
journal = {Gynecol Obstet Fertil Senol},
volume = {52},
number = {1},
pages = {60--62},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Langlais, Tristan; Bouy, Alois; Eloy, Gauthier; Mainard, Nicolas; Skalli, Wafa; Vergari, Claudio; Vialle, Raphaël
In: Orthop Traumatol Surg Res, vol. 109, no. 6, pp. 103654, 2023, ISSN: 1877-0568.
@article{pmid37399990,
title = {Sagittal plane assessment of manual concave rod bending for posterior correction in adolescents with idiopathic thoracic scoliosis (Lenke 1 and 3)},
author = {Tristan Langlais and Alois Bouy and Gauthier Eloy and Nicolas Mainard and Wafa Skalli and Claudio Vergari and Raphaël Vialle},
doi = {10.1016/j.otsr.2023.103654},
issn = {1877-0568},
year = {2023},
date = {2023-10-01},
journal = {Orthop Traumatol Surg Res},
volume = {109},
number = {6},
pages = {103654},
abstract = {OBJECTIVES: The objectives of this study were to evaluate the repeatability and reproducibility of a method for measuring freehand rod bending and to analyze the relationship between the rod's bend and the resulting sagittal correction.nnMATERIALS AND METHODS: All the children who underwent correction by posterior translation using pedicle screws at all levels were included prospectively in 2018 and 2019. The rod's sagittal parameters were measured retrospectively by three independent surgeons on two separate occasions using the same protocol. After the rods were bent but before they were inserted, the surgeon traced the contours of the rods on a sheet of paper that was later scanned and analyzed semiautomatically. The spinal parameters were calculated based on biplanar radiographs taken preoperatively, postoperatively and at the final follow-up visit. Patients who had less than 10° thoracic kyphosis (T5-T12) made up the "Lenke N-" subgroup.nnRESULTS: Thirty patients were included (14 of whom were Lenke N-) who had a Cobb angle of 59.2±11.3° preoperatively and 13.3±8.4° postoperatively (p<0.00001). The inter- and intrarater ICC for the rod measurements were>0.9 (excellent). The mean kyphosis of the concave rod was 48.4±5.7° (38.3-60.9°). The mean change in T5-T12 kyphosis was 9.7±10.8° (-14.3-30.8°) (p<0.0001) in the entire population, while it was 17.7±7.1° (5.5-30.8°) (p<0.0001) in the Lenke N- subgroup. The change in thoracic kyphosis was positively correlated with the kyphosis of the concave rod (rho=0.52; p=0.003).nnCONCLUSION: This study found excellent reproducibility and repeatability of measuring freehand rod bending. The kyphosis applied to the concave rod is positively correlated to the change in the resulting kyphosis and made it possible to restore satisfactory thoracic kyphosis.nnLEVEL OF EVIDENCE: III.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: The objectives of this study were to evaluate the repeatability and reproducibility of a method for measuring freehand rod bending and to analyze the relationship between the rod’s bend and the resulting sagittal correction.nnMATERIALS AND METHODS: All the children who underwent correction by posterior translation using pedicle screws at all levels were included prospectively in 2018 and 2019. The rod’s sagittal parameters were measured retrospectively by three independent surgeons on two separate occasions using the same protocol. After the rods were bent but before they were inserted, the surgeon traced the contours of the rods on a sheet of paper that was later scanned and analyzed semiautomatically. The spinal parameters were calculated based on biplanar radiographs taken preoperatively, postoperatively and at the final follow-up visit. Patients who had less than 10° thoracic kyphosis (T5-T12) made up the “Lenke N-” subgroup.nnRESULTS: Thirty patients were included (14 of whom were Lenke N-) who had a Cobb angle of 59.2±11.3° preoperatively and 13.3±8.4° postoperatively (p<0.00001). The inter- and intrarater ICC for the rod measurements were>0.9 (excellent). The mean kyphosis of the concave rod was 48.4±5.7° (38.3-60.9°). The mean change in T5-T12 kyphosis was 9.7±10.8° (-14.3-30.8°) (p<0.0001) in the entire population, while it was 17.7±7.1° (5.5-30.8°) (p<0.0001) in the Lenke N- subgroup. The change in thoracic kyphosis was positively correlated with the kyphosis of the concave rod (rho=0.52; p=0.003).nnCONCLUSION: This study found excellent reproducibility and repeatability of measuring freehand rod bending. The kyphosis applied to the concave rod is positively correlated to the change in the resulting kyphosis and made it possible to restore satisfactory thoracic kyphosis.nnLEVEL OF EVIDENCE: III.
Mainard, Nicolas; Saghbini, Elie; Langlais, Tristan; Vialle, Raphael; Nectoux, Eric; de Gauzy, Jerome Sales; Fron, Damien; Canavese, Federico
In: Eur Spine J, vol. 32, no. 9, pp. 3118–3132, 2023, ISSN: 1432-0932.
@article{pmid37382696,
title = {Clinical and radiological results of final fusion in patients who underwent lengthening with magnetically controlled growing rods. About 66 patients with a mean follow-up of 5 years},
author = {Nicolas Mainard and Elie Saghbini and Tristan Langlais and Raphael Vialle and Eric Nectoux and Jerome Sales de Gauzy and Damien Fron and Federico Canavese},
doi = {10.1007/s00586-023-07834-x},
issn = {1432-0932},
year = {2023},
date = {2023-09-01},
journal = {Eur Spine J},
volume = {32},
number = {9},
pages = {3118--3132},
abstract = {PURPOSE: The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up.nnMETHODS: This was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included.nnRESULTS: A total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1-9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3-68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5-17). The main and secondary curves were significantly (p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference (p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up. After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery.nnCONCLUSION: Final fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications.nnLEVEL OF EVIDENCE: Level 4.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: The aim of this study was to evaluate the effects of definitive arthrodesis on frontal and sagittal spine balance in EOS patients treated with MCGR, as well as the complications associated with this procedure and the outcome at last follow-up.nnMETHODS: This was a multicentre study in 10 French centres. All patients who underwent posterior spinal arthrodesis after completion of MCGR treatment, regardless of age, etiology of scoliosis between 2011 and 2022, were included.nnRESULTS: A total of 66 patients who had a final fusion after the lengthening programme were included in the study. The mean follow-up time was 5.5 ± 1.7 years (range: 2.1-9). The mean follow-up time after arthrodesis was 24 ± 18 months (range: 3-68) and the mean age at arthrodesis was 13.5 ± 1.5 years (range: 9.5-17). The main and secondary curves were significantly (p < 0.005 and p = 0.03) improved by arthrodesis (16.4° and 9° respectively) and stabilised at the last follow-up. The T1-T12 and T1-S1 distances increased by 8.4 mm and 14 mm with spinal fusion, with no significant difference (p = 0.096 and p = 0.068). There was no significant improvement in the rest of the parameters with arthrodesis, nor was there any significant deterioration at last follow-up. After final fusion, there were a total of 24 complications in 18 patients (27.3%) that routinely led to repeat surgery.nnCONCLUSION: Final fusion after MCGR provides satisfactory additional correction of the main and secondary curves and a moderate increase in the T1-T12 distance but has no impact on sagittal balance and other radiological parameters. The post-operative complication rate is particularly high in patients at risk of complications.nnLEVEL OF EVIDENCE: Level 4.
Viallard, Lisa; Voiry, Caroline; Maze, Stéphanie; Fontaine, Sylvie; Kerdraon, Jacques; Bonan, Isabelle; Peyronnet, Benoît
In: Prog Urol, vol. 33, no. 8-9, pp. 421–426, 2023, ISSN: 1166-7087.
@article{pmid36922295,
title = {[Uroflowmetry: A follow-up tool for neurogenic bladder patients treated by transcutaneous tibial posterior stimulation?]},
author = {Lisa Viallard and Caroline Voiry and Stéphanie Maze and Sylvie Fontaine and Jacques Kerdraon and Isabelle Bonan and Benoît Peyronnet},
doi = {10.1016/j.purol.2023.02.001},
issn = {1166-7087},
year = {2023},
date = {2023-08-01},
journal = {Prog Urol},
volume = {33},
number = {8-9},
pages = {421--426},
abstract = {OBJECTIVE: Neurogenic bladders can suffer from overactivity, underactivity or dyssynergia depending on the level of the initial lesion. These symptoms can lead to severe alterations of the upper urinary tract. One of the first-line treatments is the transcutaneous tibial posterior stimulation (TTNS), which was demonstrated to be efficient on urodynamics. But it is an invasive, expensive and sometimes not patient-accepted examination, contrary to the uroflowmetry. The aim of this study is to assess the feasibility of a follow-up with a uroflowmetry when treated by TTNS and show that the maximum flow rate increased after treatment, displaying a better detrusor contraction.nnMETHODS: In total, 38 patients with neurogenic bladder undergoing a 12-weeks TTNS treatment and with 2 uroflowmetries interpretable before and after treatment were included. The maximum flow rate (Qmax), the urinated volume and the post-void residual (PVR) were retrieved from the uroflowmetry, and the USP-score and the urinary discomfort were asked at each appointment.nnRESULTS: Qmax is increased from 17,53ml/s to 18,26ml/s, as well as the PVR (from 76,97ml to 79,16ml). Urinated volume is decreased from 241,4ml to 193,66ml. Patients feel enhanced after TTNS according to the decrease in the USP-score and the urinary discomfort scale.nnCONCLUSION: The increase of the cystomanometric capacity and the delay of the detrusor overactivity due to TTNS explains the reduction of the urinated volume and the increase of PVR. Increased Qmax might show a better voluntary bladder contraction, with a restraint due to the lack of abdominal pressure measurement during voiding.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: Neurogenic bladders can suffer from overactivity, underactivity or dyssynergia depending on the level of the initial lesion. These symptoms can lead to severe alterations of the upper urinary tract. One of the first-line treatments is the transcutaneous tibial posterior stimulation (TTNS), which was demonstrated to be efficient on urodynamics. But it is an invasive, expensive and sometimes not patient-accepted examination, contrary to the uroflowmetry. The aim of this study is to assess the feasibility of a follow-up with a uroflowmetry when treated by TTNS and show that the maximum flow rate increased after treatment, displaying a better detrusor contraction.nnMETHODS: In total, 38 patients with neurogenic bladder undergoing a 12-weeks TTNS treatment and with 2 uroflowmetries interpretable before and after treatment were included. The maximum flow rate (Qmax), the urinated volume and the post-void residual (PVR) were retrieved from the uroflowmetry, and the USP-score and the urinary discomfort were asked at each appointment.nnRESULTS: Qmax is increased from 17,53ml/s to 18,26ml/s, as well as the PVR (from 76,97ml to 79,16ml). Urinated volume is decreased from 241,4ml to 193,66ml. Patients feel enhanced after TTNS according to the decrease in the USP-score and the urinary discomfort scale.nnCONCLUSION: The increase of the cystomanometric capacity and the delay of the detrusor overactivity due to TTNS explains the reduction of the urinated volume and the increase of PVR. Increased Qmax might show a better voluntary bladder contraction, with a restraint due to the lack of abdominal pressure measurement during voiding.
Andre, Emilie; Courtivron, Benoit De; Bergerault, François; Abelin-Genevois, Kariman; Odent, Thierry
In: Eur Spine J, vol. 32, no. 7, pp. 2574–2579, 2023, ISSN: 1432-0932.
@article{pmid37173531,
title = {Influence of the thoracolumbar junction flexibility on the risk of adding-on after posterior vertebral arthrodesis for thoracic idiopathic adolescent scoliosis},
author = {Emilie Andre and Benoit De Courtivron and François Bergerault and Kariman Abelin-Genevois and Thierry Odent},
doi = {10.1007/s00586-023-07763-9},
issn = {1432-0932},
year = {2023},
date = {2023-07-01},
journal = {Eur Spine J},
volume = {32},
number = {7},
pages = {2574--2579},
abstract = {PURPOSE: The objective was to analyze the role of the thoracolumbar sagittal flexibility on the outcome after posterior spinal fusion of Lenke 1 and 2 adolescent idiopathic scoliosis with last touched vertebra as the lowest instrumented vertebra.nnMETHODS: We included 105 thoracic AIS patients who had a posterior spinal fusion with a 2 years minimum follow-up. Thoracolumbar junction flexibility was assessed on dynamic sagittal X-rays and compared to the standing position. Adding-on was defined according to radiographic Wang criteria. The junction was considered flexible if the variability from the static position to flexion and/or extension was greater than 10°.nnRESULTS: Mean age of the patients was 14 ± 2 years. The preoperative mean Cobb angle was 61 ± 12.7° and 27.5 ± 7.7° after surgery. Mean follow-up was 3.1 years. Twenty-nine patients (28%) developed an adding-on. Thoracolumbar junction range of motion was higher (p = 0.017) with higher flexibility in flexion (p < 0.001) in the no adding-on group. In no adding-on group, 53 patients (70%) had a flexible thoracolumbar junction, and 23 patients (30%) had a stiff thoracolumbar junction in flexion and flexible in extension. In adding-on group, 27 patients (93%) had a stiff thoracolumbar junction, and 2 patients (7%) had a flexible junction in flexion and stiff in extension.nnCONCLUSION: The flexibility of the thoracolumbar junction is a determining factor in the surgical outcome after posterior spinal fusion for AIS and should be considered in correlation with the frontal and sagittal alignment of the spine.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: The objective was to analyze the role of the thoracolumbar sagittal flexibility on the outcome after posterior spinal fusion of Lenke 1 and 2 adolescent idiopathic scoliosis with last touched vertebra as the lowest instrumented vertebra.nnMETHODS: We included 105 thoracic AIS patients who had a posterior spinal fusion with a 2 years minimum follow-up. Thoracolumbar junction flexibility was assessed on dynamic sagittal X-rays and compared to the standing position. Adding-on was defined according to radiographic Wang criteria. The junction was considered flexible if the variability from the static position to flexion and/or extension was greater than 10°.nnRESULTS: Mean age of the patients was 14 ± 2 years. The preoperative mean Cobb angle was 61 ± 12.7° and 27.5 ± 7.7° after surgery. Mean follow-up was 3.1 years. Twenty-nine patients (28%) developed an adding-on. Thoracolumbar junction range of motion was higher (p = 0.017) with higher flexibility in flexion (p < 0.001) in the no adding-on group. In no adding-on group, 53 patients (70%) had a flexible thoracolumbar junction, and 23 patients (30%) had a stiff thoracolumbar junction in flexion and flexible in extension. In adding-on group, 27 patients (93%) had a stiff thoracolumbar junction, and 2 patients (7%) had a flexible junction in flexion and stiff in extension.nnCONCLUSION: The flexibility of the thoracolumbar junction is a determining factor in the surgical outcome after posterior spinal fusion for AIS and should be considered in correlation with the frontal and sagittal alignment of the spine.
Brochard, Charlène; Jezequel, Magali; Blanchard-Dauphin, Anne; Kerdraon, Jacques; Perrouin-Verbe, Brigitte; Leroi, Anne-Marie; Reymann, Jean Michel; Peyronnet, Benoît; Morçet, Jeff; Siproudhis, Laurent
In: Colorectal Dis, vol. 25, no. 6, pp. 1267–1276, 2023, ISSN: 1463-1318.
@article{pmid36799340,
title = {Transanal irrigation is a better choice for bowel dysfunction in adults with Spina bifida: A randomised controlled trial},
author = {Charlène Brochard and Magali Jezequel and Anne Blanchard-Dauphin and Jacques Kerdraon and Brigitte Perrouin-Verbe and Anne-Marie Leroi and Jean Michel Reymann and Benoît Peyronnet and Jeff Morçet and Laurent Siproudhis},
doi = {10.1111/codi.16518},
issn = {1463-1318},
year = {2023},
date = {2023-06-01},
journal = {Colorectal Dis},
volume = {25},
number = {6},
pages = {1267--1276},
abstract = {AIM: To compare transanal irrigation with conservative bowel management for the treatment of bowel dysfunction in Spina bifida (SB) patients.nnMETHODS: Patients with SB and bowel dysfunction were randomly assigned to receive either transanal irrigation or conservative bowel management. The effectiveness of the treatment was defined as a decrease of 4 points in the neurogenic bowel dysfunction (NBD) score at week 10. Data on incontinence (Cleveland scores; Jorge-Wexner [JW]) and constipation (Knowles-Eccersley-Scott Symptom Constipation Score [KESS]) were recorded at 10 and 24 weeks after inclusion. Data were analysed on an intention-to-treat basis.nnRESULTS: A total of 34 patients were randomised: 16 patients to conservative bowel management and 18 patients to transanal irrigation. A total of 19/31 (61%) patients improved at week 10, 13 (76%) in the transanal irrigation group versus six (43%) in the conservative group (p = 0.056). In the irrigation group, the decrease in NBD score was -6.9 (-9.9 to -4.02) versus -1.9 (-6.5 to -2.8) in the conservative group (p = 0.049 in univariate and p = 0.004 in multivariate analysis). The NBD, Cleveland (JW and KESS) and Rosenberg scores were significantly lower in the transanal irrigation group than in the conservative bowel management group at week 10.nnCONCLUSIONS: This prospective, randomised, controlled, multicentre study in adult patients with SB suggests that transanal irrigation may be more effective than conservative bowel management.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
AIM: To compare transanal irrigation with conservative bowel management for the treatment of bowel dysfunction in Spina bifida (SB) patients.nnMETHODS: Patients with SB and bowel dysfunction were randomly assigned to receive either transanal irrigation or conservative bowel management. The effectiveness of the treatment was defined as a decrease of 4 points in the neurogenic bowel dysfunction (NBD) score at week 10. Data on incontinence (Cleveland scores; Jorge-Wexner [JW]) and constipation (Knowles-Eccersley-Scott Symptom Constipation Score [KESS]) were recorded at 10 and 24 weeks after inclusion. Data were analysed on an intention-to-treat basis.nnRESULTS: A total of 34 patients were randomised: 16 patients to conservative bowel management and 18 patients to transanal irrigation. A total of 19/31 (61%) patients improved at week 10, 13 (76%) in the transanal irrigation group versus six (43%) in the conservative group (p = 0.056). In the irrigation group, the decrease in NBD score was -6.9 (-9.9 to -4.02) versus -1.9 (-6.5 to -2.8) in the conservative group (p = 0.049 in univariate and p = 0.004 in multivariate analysis). The NBD, Cleveland (JW and KESS) and Rosenberg scores were significantly lower in the transanal irrigation group than in the conservative bowel management group at week 10.nnCONCLUSIONS: This prospective, randomised, controlled, multicentre study in adult patients with SB suggests that transanal irrigation may be more effective than conservative bowel management.
Risk factors for upper urinary tract deterioration in adult patients with spina bifida
Haudebert, Camille; Hascoet, Juliette; Samson, Emmanuelle; Jezequel, Magali; Voiry, Caroline; Brochard, Charlène; Richard, Claire; Kerdraon, Jacques; Siproudhis, Laurent; Manunta, Andréa; Peyronnet, Benoit
In: World J Urol, vol. 41, no. 4, pp. 1187–1192, 2023, ISSN: 1433-8726.
@article{pmid36808530,
title = {Risk factors for upper urinary tract deterioration in adult patients with spina bifida},
author = {Camille Haudebert and Juliette Hascoet and Emmanuelle Samson and Magali Jezequel and Caroline Voiry and Charlène Brochard and Claire Richard and Jacques Kerdraon and Laurent Siproudhis and Andréa Manunta and Benoit Peyronnet},
doi = {10.1007/s00345-023-04314-1},
issn = {1433-8726},
year = {2023},
date = {2023-04-01},
journal = {World J Urol},
volume = {41},
number = {4},
pages = {1187--1192},
abstract = {PURPOSE: Neurogenic bladder associated with spina bifida disease remains a major cause for mortality or morbidity due to kidney damages. However, we currently do not know which urodynamic findings are associated with an higher risk of upper tract damages in spina bifida patients. The objective of the present study was to evaluate urodynamic findings associated with functional kidney failure and/or with morphological kidney damages.nnMETHODS: A large single-center restrospective study was conducted in our national referral center for spina bifida patients using our patients' files. All urodynamics curves were assessed by the same examinator. Functional and/or morphological evaluation of the upper urinary tract were done at the same moment as the urodynamic exam (between 1 week before and 1 month after). Kidney function was assessed using creatinine serum levels or 24 h urinary creatinine levels (creatinine clearance) for walking patients, or with the 24 h urinary creatinine level for wheelchair-users.nnRESULTS: We included 262 spina bifida patients in this study. Fifty-five patients had a poor bladder compliance (21.4%) and 88 of them had detrusor overactivity (33.6%). Twenty patients had a stage 2 kidney failure (eGFR < 60 ml/min) and 81 patients out of 254 (30.9%) had an abnormal morphological examination. There were three urodynamic findings significantly associated with UUTD: bladder compliance (OR = 0.18; p = 0.007), Pdetmax (OR = 14.7; p = 0.003) and detrusor overactivity (OR = 1.84; p = 0.03).nnCONCLUSION: In this large series of spina bifida patients, maximum detrusor pressure and bladder compliance are the main urodynamic findings determinants of UUTD risk.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: Neurogenic bladder associated with spina bifida disease remains a major cause for mortality or morbidity due to kidney damages. However, we currently do not know which urodynamic findings are associated with an higher risk of upper tract damages in spina bifida patients. The objective of the present study was to evaluate urodynamic findings associated with functional kidney failure and/or with morphological kidney damages.nnMETHODS: A large single-center restrospective study was conducted in our national referral center for spina bifida patients using our patients’ files. All urodynamics curves were assessed by the same examinator. Functional and/or morphological evaluation of the upper urinary tract were done at the same moment as the urodynamic exam (between 1 week before and 1 month after). Kidney function was assessed using creatinine serum levels or 24 h urinary creatinine levels (creatinine clearance) for walking patients, or with the 24 h urinary creatinine level for wheelchair-users.nnRESULTS: We included 262 spina bifida patients in this study. Fifty-five patients had a poor bladder compliance (21.4%) and 88 of them had detrusor overactivity (33.6%). Twenty patients had a stage 2 kidney failure (eGFR < 60 ml/min) and 81 patients out of 254 (30.9%) had an abnormal morphological examination. There were three urodynamic findings significantly associated with UUTD: bladder compliance (OR = 0.18; p = 0.007), Pdetmax (OR = 14.7; p = 0.003) and detrusor overactivity (OR = 1.84; p = 0.03).nnCONCLUSION: In this large series of spina bifida patients, maximum detrusor pressure and bladder compliance are the main urodynamic findings determinants of UUTD risk.
Goudelocke, Colin; Xavier, Keith; Pecha, Barry; Burgess, Kimberly; Perrouin-Verbe, Marie-A; Krlin, Ryan; Michaels, Jodi; Shah, Sagar; Peyronnet, Benoît; Zaslau, Stanley; Champs, Mylène; Papi, Bianca; Bittner, Katie; Elterman, Dean; Nitti, Victor
In: Neurourol Urodyn, vol. 42, no. 4, pp. 761–769, 2023, ISSN: 1520-6777.
@article{pmid36917003,
title = {Evaluation of clinical performance and safety for the rechargeable InterStim Micro device in overactive bladder subjects: 6-month results from the global postmarket ELITE study},
author = {Colin Goudelocke and Keith Xavier and Barry Pecha and Kimberly Burgess and Marie-A Perrouin-Verbe and Ryan Krlin and Jodi Michaels and Sagar Shah and Benoît Peyronnet and Stanley Zaslau and Mylène Champs and Bianca Papi and Katie Bittner and Dean Elterman and Victor Nitti},
doi = {10.1002/nau.25171},
issn = {1520-6777},
year = {2023},
date = {2023-04-01},
journal = {Neurourol Urodyn},
volume = {42},
number = {4},
pages = {761--769},
abstract = {AIMS: Sacral neuromodulation (SNM) is an advanced therapy option for the treatment of overactive bladder (OAB), nonobstructive urinary retention, and fecal incontinence. The aim of this ongoing prospective, multicenter, global, postmarket study is to confirm safety and clinical performance of the InterStim Micro system for SNM in all indications. Reported here are the results for the OAB cohort through 6-month follow-up.nnMETHODS: Eligible OAB subjects that had a successful therapy evaluation were enrolled after implant of an InterStim Micro implantable pulse generator (IPG). Subjects completed voiding diaries and the Overactive Bladder Quality of Life questionnaire (OAB-q) at baseline and follow-up visits occurring at 3 months and 6 months postimplant. Safety was evaluated as device-, procedure-, or therapy-related adverse events. The primary objective for the OAB cohort was to demonstrate an improvement in OAB-q Health Related Quality of Life (HRQL) total score at 3 months postimplant compared to baseline.nnRESULTS: Sixty-eight OAB subjects were enrolled and implanted with an InterStim Micro IPG. Of those, 67 and 66 subjects completed the 3- and 6-month follow-up visits, respectively. The OAB-q HRQL demonstrated a statistically significant improvement from baseline to 3-month follow-up with an average increase of 33 ± 24 points (n = 67, p < 0.001). The change was also observed at 6-months with an average increase of 31 ± 23 points (n = 65) compared to baseline. Eighty-two percent of subjects achieved the minimally important difference in HRQL score at 3- and 6-month, respectively, with a change of 10 points or greater. The majority of subjects reported that their bladder condition was better at 3-month (92.5%, 62/67) and 6-month (89%, 59/66) compared to before they were treated with SNM therapy delivered by the InterStim Micro system. For subjects with urgency urinary incontinence (UUI), the average change from baseline to follow-up in UUI episodes/day was -3.6 (95% CI: -4.7, -2.6; n = 62) at 3-month and -3.7 (95% CI: -4.7, -2.7; n = 61) at 6-month. Among subjects with urgency-frequency (UF), the average change from baseline to follow up in voids/day was -4.5 (95% CI: -6.3, -2.7; n = 52) at 3-months and -4.4 (95% CI: -6.0, -2.7; n = 52) at 6-month. The cumulative incidence of device-, procedure-, or therapy- related adverse events was 7.4% (5/68). Out of these five related adverse events, there was one serious adverse event (1.5%, implant site pain) at the time of database snapshot.nnCONCLUSIONS: These data confirm the safety and clinical performance of the InterStim Micro device for subjects with OAB by demonstrating a significant improvement in OAB-q HRQL score at 3-month. Similar improvements were observed at 6 months in addition to an incidence of adverse events that is comparable to previously reported rates for SNM.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
AIMS: Sacral neuromodulation (SNM) is an advanced therapy option for the treatment of overactive bladder (OAB), nonobstructive urinary retention, and fecal incontinence. The aim of this ongoing prospective, multicenter, global, postmarket study is to confirm safety and clinical performance of the InterStim Micro system for SNM in all indications. Reported here are the results for the OAB cohort through 6-month follow-up.nnMETHODS: Eligible OAB subjects that had a successful therapy evaluation were enrolled after implant of an InterStim Micro implantable pulse generator (IPG). Subjects completed voiding diaries and the Overactive Bladder Quality of Life questionnaire (OAB-q) at baseline and follow-up visits occurring at 3 months and 6 months postimplant. Safety was evaluated as device-, procedure-, or therapy-related adverse events. The primary objective for the OAB cohort was to demonstrate an improvement in OAB-q Health Related Quality of Life (HRQL) total score at 3 months postimplant compared to baseline.nnRESULTS: Sixty-eight OAB subjects were enrolled and implanted with an InterStim Micro IPG. Of those, 67 and 66 subjects completed the 3- and 6-month follow-up visits, respectively. The OAB-q HRQL demonstrated a statistically significant improvement from baseline to 3-month follow-up with an average increase of 33 ± 24 points (n = 67, p < 0.001). The change was also observed at 6-months with an average increase of 31 ± 23 points (n = 65) compared to baseline. Eighty-two percent of subjects achieved the minimally important difference in HRQL score at 3- and 6-month, respectively, with a change of 10 points or greater. The majority of subjects reported that their bladder condition was better at 3-month (92.5%, 62/67) and 6-month (89%, 59/66) compared to before they were treated with SNM therapy delivered by the InterStim Micro system. For subjects with urgency urinary incontinence (UUI), the average change from baseline to follow-up in UUI episodes/day was -3.6 (95% CI: -4.7, -2.6; n = 62) at 3-month and -3.7 (95% CI: -4.7, -2.7; n = 61) at 6-month. Among subjects with urgency-frequency (UF), the average change from baseline to follow up in voids/day was -4.5 (95% CI: -6.3, -2.7; n = 52) at 3-months and -4.4 (95% CI: -6.0, -2.7; n = 52) at 6-month. The cumulative incidence of device-, procedure-, or therapy- related adverse events was 7.4% (5/68). Out of these five related adverse events, there was one serious adverse event (1.5%, implant site pain) at the time of database snapshot.nnCONCLUSIONS: These data confirm the safety and clinical performance of the InterStim Micro device for subjects with OAB by demonstrating a significant improvement in OAB-q HRQL score at 3-month. Similar improvements were observed at 6 months in addition to an incidence of adverse events that is comparable to previously reported rates for SNM.
[The French National Committee on Obstetrical and Fetal Ultrasound guidelines 2022 (CNEOF)]
2023, ISSN: 2468-7189.
@misc{pmid36649816,
title = {[The French National Committee on Obstetrical and Fetal Ultrasound guidelines 2022 (CNEOF)]},
author = { },
doi = {10.1016/j.gofs.2023.01.006},
issn = {2468-7189},
year = {2023},
date = {2023-04-01},
journal = {Gynecol Obstet Fertil Senol},
volume = {51},
number = {4},
pages = {221--226},
abstract = {The 2022 CNEOF guidelines (Conférence nationale d'échographie obstétricale et fœtale) report has been recently issued. It presents the necessary evolutions for the years to come, in a philosophy of optimal security for patients and caregivers, through a homogenization of ultrasound screening practices. As a source of changes in practices, this new version raises concerns, and even reticence, which must be heard and addressed, by reminding that this report is not fixed and can be adapted to the realities of practice over time and their feedback. This short text presents the CNEOF, the novelties of the 2022 report and details some important parts of the report that have been a source of questioning in the month following its publication. The aim of this text is to present a summary (in addition to the full report) to reassure, through education, all the parties involved in this medical practice which is so exciting and of major importance for perinatal health. Thus, the types of ultrasound examinations (screening, diagnostic, expertise…), the conditions of their realization, dating, biometries and the items part of the ultrasound reports are presented with elements of precision useful for their implementation.},
keywords = {},
pubstate = {published},
tppubtype = {misc}
}
The 2022 CNEOF guidelines (Conférence nationale d’échographie obstétricale et fœtale) report has been recently issued. It presents the necessary evolutions for the years to come, in a philosophy of optimal security for patients and caregivers, through a homogenization of ultrasound screening practices. As a source of changes in practices, this new version raises concerns, and even reticence, which must be heard and addressed, by reminding that this report is not fixed and can be adapted to the realities of practice over time and their feedback. This short text presents the CNEOF, the novelties of the 2022 report and details some important parts of the report that have been a source of questioning in the month following its publication. The aim of this text is to present a summary (in addition to the full report) to reassure, through education, all the parties involved in this medical practice which is so exciting and of major importance for perinatal health. Thus, the types of ultrasound examinations (screening, diagnostic, expertise…), the conditions of their realization, dating, biometries and the items part of the ultrasound reports are presented with elements of precision useful for their implementation.