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Prof. Hann-Chorng Kuo
Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien Taiwan

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0 Urodynamics
0 neurourology
0 LUTS
0 female urology
0 Stress urinary incontinence

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Journal article
Published: 02 June 2021 in Toxins
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External urethral sphincter (EUS) dysfunction is a common, bothersome female voiding dysfunction. This study aims to analyze the characteristics of different types of female EUS dysfunction, as well as to determine the outcome predictors of sphincteric botulinum toxin A (BoNT-A) injection. Women receiving sphincteric BoNT-A injections for refractory EUS dysfunction were retrospectively reviewed. A comparison of the baseline clinical, urodynamic parameters and the treatment responses were made for patients with different EUS dysfunctions. A total of 106 females were included. Significantly increased detrusor overactivity, detrusor contracting pressure and the bladder outlet obstruction index with decreased urge sensation were noted in patients diagnosed with dysfunctional voiding or detrusor sphincter dyssynergia comparing to those diagnosed with poor relaxation of the external urethral sphincter. The average subjective improvement rate was 67% for the injection. The therapeutic effect was not affected by the type of EUS dysfunction. The multivariate analysis revealed that bladder neck narrowing and catheterization history were predictive of negative outcomes. There is a distinct urodynamic presentation for each type of female EUS dysfunction. Sphincteric BoNT-A injection provides a good therapeutic outcome for refractory EUS dysfunction. A narrowing bladder neck and a history of catheterization suggest poor therapeutic outcomes.

ACS Style

Yin-Chien Ou; Kuan-Hsun Huang; Hau-Chern Jan; Hann-Chorng Kuo; Yao-Lin Kao; Kuen-Jer Tsai. Therapeutic Efficacy of Urethral Sphincteric Botulinum Toxin Injections for Female Sphincter Dysfunctions and a Search for Predictive Factors. Toxins 2021, 13, 398 .

AMA Style

Yin-Chien Ou, Kuan-Hsun Huang, Hau-Chern Jan, Hann-Chorng Kuo, Yao-Lin Kao, Kuen-Jer Tsai. Therapeutic Efficacy of Urethral Sphincteric Botulinum Toxin Injections for Female Sphincter Dysfunctions and a Search for Predictive Factors. Toxins. 2021; 13 (6):398.

Chicago/Turabian Style

Yin-Chien Ou; Kuan-Hsun Huang; Hau-Chern Jan; Hann-Chorng Kuo; Yao-Lin Kao; Kuen-Jer Tsai. 2021. "Therapeutic Efficacy of Urethral Sphincteric Botulinum Toxin Injections for Female Sphincter Dysfunctions and a Search for Predictive Factors." Toxins 13, no. 6: 398.

Journal article
Published: 19 May 2021 in Toxins
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Although female dysfunctional voiding (DV) is common in urological practice, it is difficult to treat. This study evaluated the therapeutic efficacy of urethral botulinum toxin A (BoNT-A) on non-neurogenic female DV. Based on the videourodynamic study (VUDS), the DV was classified into three subgroups according to the obstructive site. A successful treatment outcome was defined as an improvement of voiding efficiency by 10% and reported global response assessment by ≥1. The study compared therapeutic efficacy, baseline urodynamic parameters, and changes in urodynamic parameters between the treatment success and failure groups and among three DV subgroups. Predictive factors for successful treatment were also investigated. A total of 81 women with DV were categorized into three groups: 55 (67.9%) had mid-urethral DV, 19 (23.5%) had distal urethral DV, and 7 (8.6%) had combined BN dysfunction and mid-urethral DV after BN transurethral incision. The treatment outcome was successful for 55 (67.9%) patients and failed for 26 (32.1%). Successfully treated patients had a significant decrease of detrusor pressure, post-void residual volume, and bladder outlet obstruction index, as well as an increase in voiding efficiency at follow-up versus the treatment failure group. The logistic regression of urodynamic parameters and clinical variables revealed that a greater volume of first sensation of filling predicts a successful BoNT-A treatment outcome (p = 0.047). The urethral BoNT-A injection is effective in treating non-neurogenic women with DV, with a success rate of 67.9%. The videourodynamic characteristics of DV may differ among patients but does not affect the treatment outcome.

ACS Style

Yuan-Hong Jiang; Cheng-Ling Lee; Sheng-Fu Chen; Hann-Chorng Kuo. Therapeutic Effects of Urethral Sphincter Botulinum Toxin A Injection on Dysfunctional Voiding with Different Videourodynamic Characteristics in Non-Neurogenic Women. Toxins 2021, 13, 362 .

AMA Style

Yuan-Hong Jiang, Cheng-Ling Lee, Sheng-Fu Chen, Hann-Chorng Kuo. Therapeutic Effects of Urethral Sphincter Botulinum Toxin A Injection on Dysfunctional Voiding with Different Videourodynamic Characteristics in Non-Neurogenic Women. Toxins. 2021; 13 (5):362.

Chicago/Turabian Style

Yuan-Hong Jiang; Cheng-Ling Lee; Sheng-Fu Chen; Hann-Chorng Kuo. 2021. "Therapeutic Effects of Urethral Sphincter Botulinum Toxin A Injection on Dysfunctional Voiding with Different Videourodynamic Characteristics in Non-Neurogenic Women." Toxins 13, no. 5: 362.

Review
Published: 18 May 2021 in Toxins
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Although intravesical botulinum toxin type A (BoNT-A) injection for functional bladder disorders is effective, the injection-related problems—such as bladder pain and urinary tract infection—make the procedure invasive and inconvenient. Several vehicles have recently been developed to deliver BoNT-A without injection, thereby making the treatment less or non-invasive. Laboratory evidence revealed that liposome can carry BoNT-A across the uroepithelium and act on sub-urothelial nerve endings. A randomized placebo controlled study revealed that intravesical administration of liposome-encapsulated BoNT-A and TC-3 hydrogel embedded BoNT-A can improve urinary frequency, urgency, and reduce incontinence in patients with overactive bladders. A single-arm prospective study also revealed that intravesical administration of TC-3 hydrogel embedded BoNT-A can relieve bladder pain in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). We recently administered suprapubic energy shock wave (ESW) after BoNT-A intravesical administration in six patients with IC/BPS. Although pain reduction and symptom improvement were not significant, immunochemical staining showed cleaved synaptosome-associated protein 25 in the bladder after the procedure. This suggests that ESW can promote passage of BoNT-A across the uroepithelium. In conclusion, using vehicles to intra-vesically deliver BoNT-A for functional bladder disorders is promising. Further studies are necessary to confirm the efficacy and explore novel applications.

ACS Style

Jia-Fong Jhang; Hann-Chorng Kuo. Novel Applications of Non-Invasive Intravesical Botulinum Toxin a Delivery in the Treatment of Functional Bladder Disorders. Toxins 2021, 13, 359 .

AMA Style

Jia-Fong Jhang, Hann-Chorng Kuo. Novel Applications of Non-Invasive Intravesical Botulinum Toxin a Delivery in the Treatment of Functional Bladder Disorders. Toxins. 2021; 13 (5):359.

Chicago/Turabian Style

Jia-Fong Jhang; Hann-Chorng Kuo. 2021. "Novel Applications of Non-Invasive Intravesical Botulinum Toxin a Delivery in the Treatment of Functional Bladder Disorders." Toxins 13, no. 5: 359.

Original paper
Published: 17 May 2021 in International Journal of Clinical Practice
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Purpose The role of urodynamic study in the diagnosis and prognostication of interstitial cystitis/bladder pain syndrome (IC/BPS) is still controversial. This study evaluated the correlation of the baseline voiding dysfunctions and long-term treatment outcome in patients with non-Hunner's ulcer IC (NHIC). Materials and methods A total of 211 NHIC patients were enrolled. All patients underwent videourodynamic (VUDS) examination at baseline to identify their voiding conditions and received subsequent treatments. The primary endpoint was Global Response Assessment (GRA) at the interview. Secondary endpoints included O'Leary-Sant symptom score (OSS), Visual Analogue Scale (VAS) for pain and the rate of IC symptom flare-up. Results The mean age was 56.8 ± 12.8 years, and mean duration of IC was 16.0 ± 9.9 years. At baseline, 83 (39.3%) patients had a voiding dysfunction and 132 (62.7%) had 1 to 3 co-morbidities. The duration, co-morbidities, treatments, changes in OSS and VAS, maximum bladder capacity (MBC), glomerulations, GRA and flare-up rate showed no significant difference among different subgroups. When we divided patients by their storage and voiding conditions, patients with non-hypersensitivity bladder (HSB) (n = 32) had significantly greater MBC (P = .002) whereas those with HSB with (n = 76) or without (n = 103) voiding dysfunction had higher glomerulation (P = .021). When we analysed voiding dysfunction subgroups by GRA, patients with a GRA of ≥2 had a significantly shorter duration of disease (13.9 ± 8.6 years, P = .021). There were also significant associations between GRA and the changes of OSS (P < .001) and VAS (P < .001). Conclusions VUDS can disclose voiding dysfunction in 39.3% of NHIC patients. With adequate therapy, the voiding dysfunctions in NHIC patients do not affect long-term treatment outcome.

ACS Style

Wan‐Ru Yu; Wei‐Chuan Chang; Hann‐Chorng Kuo. Voiding dysfunctions in patients with non‐Hunner's ulcer interstitial cystitis/bladder pain syndrome do not affect long‐term treatment outcome. International Journal of Clinical Practice 2021, e14372 .

AMA Style

Wan‐Ru Yu, Wei‐Chuan Chang, Hann‐Chorng Kuo. Voiding dysfunctions in patients with non‐Hunner's ulcer interstitial cystitis/bladder pain syndrome do not affect long‐term treatment outcome. International Journal of Clinical Practice. 2021; ():e14372.

Chicago/Turabian Style

Wan‐Ru Yu; Wei‐Chuan Chang; Hann‐Chorng Kuo. 2021. "Voiding dysfunctions in patients with non‐Hunner's ulcer interstitial cystitis/bladder pain syndrome do not affect long‐term treatment outcome." International Journal of Clinical Practice , no. : e14372.

Original article
Published: 06 May 2021 in LUTS: Lower Urinary Tract Symptoms
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Objectives To investigate whether adding an anticholinergic or beta‐3 agonist can improve the therapeutic effect of intravesical onabotuliumtoxinA injection in patients with refractory overactive bladder (OAB). Methods Ninety OAB patients who received an intravesical 100‐U onabotulinumtoxinA injection 1 month previously were consecutively invited into a prospective, randomized, open‐label study. They were randomly adding on solifenacin 5 mg daily (QD) (30 patients), mirabegron 50 mg QD (31 patients), or no medication (29 patients, control). All enrolled patients completed a 3‐day voiding diary, Overactive Bladder Symptom Score (OABSS) and Urgency Severity Scale (USS) questionnaires, Global Response Assessment (GRA) scale, and uroflowmetry at baseline (1 month after intravesical onabotulinumtoxinA injection) and 3‐, 6‐, 9‐, and 12‐month follow‐up. The primary end point was the effective therapeutic outcome defined as no OAB wet during the 12‐month period. The secondary end point included changes of GRA, OABSS, and the parameters of the voiding diary at 3 months. Results The baseline data were comparable among the three groups. The percentage of OAB wet in the mirabegron‐added‐on group was significantly less than that in the solifenacin‐added‐on and onabotulinumtoxinA‐only groups at four different time points (P = .02). At 3 months, the changes of GRA, OABSS, USS, urge urinary incontinence, frequency, nocturia episodes, and functional bladder capacity in the mirabegron‐added‐on group were significantly greater than those in the other groups. No serious adverse events were reported. Conclusions Adding mirabegron could increase the therapeutic effects, mainly on OAB symptoms and GRA scale, after intravesical onabotulinumtoxinA injection in refractory OAB patients.

ACS Style

Chung‐Cheng Wang; Cheng‐Ling Lee; Yi‐Ting Hwang; Hann‐Chorng Kuo. Adding mirabegron after intravesical onabotulinumtoxinA injection improves therapeutic effects in patients with refractory overactive bladder. LUTS: Lower Urinary Tract Symptoms 2021, 1 .

AMA Style

Chung‐Cheng Wang, Cheng‐Ling Lee, Yi‐Ting Hwang, Hann‐Chorng Kuo. Adding mirabegron after intravesical onabotulinumtoxinA injection improves therapeutic effects in patients with refractory overactive bladder. LUTS: Lower Urinary Tract Symptoms. 2021; ():1.

Chicago/Turabian Style

Chung‐Cheng Wang; Cheng‐Ling Lee; Yi‐Ting Hwang; Hann‐Chorng Kuo. 2021. "Adding mirabegron after intravesical onabotulinumtoxinA injection improves therapeutic effects in patients with refractory overactive bladder." LUTS: Lower Urinary Tract Symptoms , no. : 1.

Journal article
Published: 31 March 2021 in International Neurourology Journal
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Purpose: The aim of this study was to investigate the efficacy of autologous platelet-rich plasma (PRP) in the treatment of stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD) refractory to medical treatment.Methods: Thirty-five patients with SUI due to urodynamically proven ISD were prospectively enrolled. Five milliliters of PRP (2.5–5 times the platelet concentration in peripheral blood) was injected into the external sphincter at 5 sites; all patients received 4 injections at monthly intervals. The primary end-point was the change in SUI severity as assessed by a visual analogue scale (VAS of SUI). The secondary-endpoints were the Global Response Assessment score and changes in urodynamic parameters from baseline to 3 months after treatment.Results: The mean age of patients was 68.7±12 years; the median duration of SUI was 4 years. Five patients had neurogenic SUI, while 30 had nonneurogenic SUI (21 with postprostatectomy incontinence, 6 with previous radical cystectomy, and 3 with other etiologies). Complete dryness was achieved in 7 patients (20.0%) while moderate improvement was observed in 14 (40.0%). The mean VAS of SUI score decreased significantly from 6.57±1.89 to 3.77±2.41 after treatment. The abdominal leak point pressure (ALPP) increased significantly from 98.3±55.8 to 157.3±79.3 cm H2O. There was no increase of ALPP in neurogenic SUI and less increase of ALPP in patients with failed treatment outcomes. No perioperative adverse events or severe complications occurred.Conclusions: Urethral PRP injection is safe and effective in increasing urethral resistance and improving SUI. PRP could be an alternative treatment modality for male and female patients with moderate SUI due to nonneurogenic causes.

ACS Style

Yuang-Hong Jiang; Ping-Jui Lee; Hann-Chorng Kuo. Therapeutic Efficacy of Urethral Sphincter Injections of Platelet-Rich Plasma for the Treatment of Stress Urinary Incontinence due to Intrinsic Sphincter Deficiency: A Proof-of-Concept Clinical Trial. International Neurourology Journal 2021, 25, 51 -58.

AMA Style

Yuang-Hong Jiang, Ping-Jui Lee, Hann-Chorng Kuo. Therapeutic Efficacy of Urethral Sphincter Injections of Platelet-Rich Plasma for the Treatment of Stress Urinary Incontinence due to Intrinsic Sphincter Deficiency: A Proof-of-Concept Clinical Trial. International Neurourology Journal. 2021; 25 (1):51-58.

Chicago/Turabian Style

Yuang-Hong Jiang; Ping-Jui Lee; Hann-Chorng Kuo. 2021. "Therapeutic Efficacy of Urethral Sphincter Injections of Platelet-Rich Plasma for the Treatment of Stress Urinary Incontinence due to Intrinsic Sphincter Deficiency: A Proof-of-Concept Clinical Trial." International Neurourology Journal 25, no. 1: 51-58.

Original clinical article
Published: 01 March 2021 in Neurourology and Urodynamics
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Objectives Both detrusor underactivity (DU) and bladder outlet obstruction are the common causes of chronic urinary retention. Some novel treatment approaches focus on modulating micturition reflex and external urethral sphincter (EUS) function. This study used electrophysiologic (EP) studies to investigate the micturition reflex and EUS conditions of chronic urinary retention patients. Methods Sixty patients with urodynamic DU and chronic urinary retention were studied using (1) bulbocavernous reflex (BCR) by electric stimulation, (2) electromyography (EMG) of the EUS, and (3) nerve conduction velocity (NCV) studies of the pudendal nerve. The EP findings were analyzed in DU patients with different etiologies. Results The BCR was positive in 41.7% of patients. In EMG studies, denervation, reinnervation, and reduced recruitment of the EUS were observed in 21.7%, 71.7%, and 88.3% patients, respectively. Decreased amplitude of pudendal nerve conduction in NCV studies was noted in 73.3% of patients. Patients with sacral neuropathy had a lower BCR positive rate (p = 0.001), a nonsignificant but higher denervation rate (p = 0.059) in EMG studies, and a higher rate of decreased amplitude in NCV (p = 0.011) than those without sacral neuropathy. Excluding patients with sacral neuropathy or diabetes mellitus, a high percentage of neurologic deficits was still detected in EP studies. Conclusions Chronic urinary retention patients with urodynamic DU not only have bladder dysfunction, but also potential neuropathy in the sacral reflexes, pudendal nerve, or urethral sphincter innervation. The neurologic deficits explored in EP studies may affect the decision‐making around the therapy to restore the voiding function in DU.

ACS Style

Yuan‐Hong Jiang; Hann‐Chorng Kuo. High percentage of neurologic deficits in the electrophysiology study of the lower urinary tract in patients with detrusor underactivity and chronic urinary retention. Neurourology and Urodynamics 2021, 40, 883 -890.

AMA Style

Yuan‐Hong Jiang, Hann‐Chorng Kuo. High percentage of neurologic deficits in the electrophysiology study of the lower urinary tract in patients with detrusor underactivity and chronic urinary retention. Neurourology and Urodynamics. 2021; 40 (3):883-890.

Chicago/Turabian Style

Yuan‐Hong Jiang; Hann‐Chorng Kuo. 2021. "High percentage of neurologic deficits in the electrophysiology study of the lower urinary tract in patients with detrusor underactivity and chronic urinary retention." Neurourology and Urodynamics 40, no. 3: 883-890.

Journal article
Published: 16 January 2021 in Journal of the Formosan Medical Association
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The impact of neurologic disorders on the clinical outcome of suburethral sling procedures has seldom been studied. Our aim is to elucidate factors predicting further anti-incontinence interventions or transvaginal urethrolysis after a re-adjustable pubovaginal sling procedure (PVS), especially in patients with neurologic disorders. Medical records of all consecutive women who underwent re-adjustable PVS for stress urinary incontinence (SUI) were reviewed. A total of 589 women were enrolled, 152 (25.8%) women were found to have persistent or recurrent SUI after surgery, and 39 (6.6%) women underwent further anti-incontinence interventions. Postoperative voiding dysfunction was found in 46 (7.8%) women, and 23 women (3.9%) underwent transvaginal urethrolysis. Low body mass index (hazard ratio = 0.92) and low functional bladder capacity (dL, hazard ratio = 0.83) were factors predicting the presence of persistent/recurrent SUI. However, the presence of spinal cord disorder (hazard ratio = 8.91) and a history of prior surgery for pelvic organ prolapse (hazard ratio = 2.51) were factors predicting further anti-incontinence interventions. A high post-void residual volume (PVR, dL, hazard ratio = 1.52) and preoperative bladder outlet obstruction (BOO, hazard ratio = 5.39) were factors predicting postoperative voiding dysfunction. Similarly, a high PVR (dL, hazard ratio = 1.50) and preoperative BOO (hazard ratio = 5.38) were factors predicting transvaginal urethrolysis. A PVR >1.51 dL was an optimal cut-off value for predicting transvaginal urethrolysis. The presence of spinal cord disorder and prior surgery for pelvic organ prolapse were predictors of further anti-incontinence interventions after re-adjustable PVS. In addition, a large PVR and preoperative BOO were predictors of transvaginal urethrolysis after re-adjustable PVS.

ACS Style

Sheng-Mou Hsiao; Hann-Chorng Kuo. Predictors of further anti-incontinence interventions or transvaginal urethrolysis after a pubovaginal sling procedure in women with and without neurologic disorders. Journal of the Formosan Medical Association 2021, 120, 1464 -1477.

AMA Style

Sheng-Mou Hsiao, Hann-Chorng Kuo. Predictors of further anti-incontinence interventions or transvaginal urethrolysis after a pubovaginal sling procedure in women with and without neurologic disorders. Journal of the Formosan Medical Association. 2021; 120 (7):1464-1477.

Chicago/Turabian Style

Sheng-Mou Hsiao; Hann-Chorng Kuo. 2021. "Predictors of further anti-incontinence interventions or transvaginal urethrolysis after a pubovaginal sling procedure in women with and without neurologic disorders." Journal of the Formosan Medical Association 120, no. 7: 1464-1477.

Journal article
Published: 13 January 2021 in Scientific Reports
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This study aimed to investigate the diagnostic values of urine cytokines in interstitial cystitis/bladder pain syndrome (IC/BPS) and overactive bladder (OAB) patients, and to develop a novel diagnostic algorithm. Urine samples were collected from 40 IC/BPS, 40 OAB patients, and 30 controls. Commercially available multiplex immunoassays were used to analyze 31 targeted cytokines. Urine cytokine profiles were significantly different among study groups and controls. MIP-1β showed the highest sensitivity (92.2%) for identifying diseased study patients from controls. The cytokines with high diagnostic values for distinguishing between IC and OAB included IL-10, RANTES, eotaxin, CXCL10, IL-12p70, NGF, IL-6, IL-17A, MCP-1, and IL-1RA. The diagnostic algorithm was subsequently developed according to the diagnostic values obtained. MIP-1β was selected for the initial screening test to diagnose diseased patients and controls with diagnostic rates of 81.6% and 68.4%, respectively. As confirmation tests for IC/BPS, the diagnostic rates of eotaxin, CXCL10, and RANTES were 73.3%, 72.7%, and 69.7%, respectively. As the confirmation test for OAB, the diagnostic rate of IL-10 was 60%. Urine cytokine profiles of IC/BPS and OAB patients differed from those of controls and might be useful as biomarkers for diagnosis. A novel pilot diagnostic algorithm was developed based on these profiles.

ACS Style

Yuan-Hong Jiang; Jia-Fong Jhang; Yung-Hsiang Hsu; Han-Chen Ho; Ya-Hui Wu; Hann-Chorng Kuo. Urine biomarkers in ESSIC type 2 interstitial cystitis/bladder pain syndrome and overactive bladder with developing a novel diagnostic algorithm. Scientific Reports 2021, 11, 1 -9.

AMA Style

Yuan-Hong Jiang, Jia-Fong Jhang, Yung-Hsiang Hsu, Han-Chen Ho, Ya-Hui Wu, Hann-Chorng Kuo. Urine biomarkers in ESSIC type 2 interstitial cystitis/bladder pain syndrome and overactive bladder with developing a novel diagnostic algorithm. Scientific Reports. 2021; 11 (1):1-9.

Chicago/Turabian Style

Yuan-Hong Jiang; Jia-Fong Jhang; Yung-Hsiang Hsu; Han-Chen Ho; Ya-Hui Wu; Hann-Chorng Kuo. 2021. "Urine biomarkers in ESSIC type 2 interstitial cystitis/bladder pain syndrome and overactive bladder with developing a novel diagnostic algorithm." Scientific Reports 11, no. 1: 1-9.

Journal article
Published: 11 January 2021 in Scientific Reports
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To evaluate the correlations of clinical symptoms, urodynamic parameters, and long-term treatment outcomes with different findings of cystoscopic hydrodistention (HD) in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). This retrospective analysis of 486 patients with IC/BPS investigated baseline clinical symptoms, disease duration, medical comorbidities, urodynamic findings, cystoscopic characteristics [including maximal bladder capacity (MBC) and the presence of glomerulations and Hunner’s lesions], and outcomes according to the five IC/BPS HD subtypes based on the glomerulation grade, MBC, and the presence of Hunner’s lesions. Receiver operation characteristic analysis identified an optimal cutoff value of MBC ≥ 760 ml as a predictor of satisfactory outcomes. Glomerulation grade and MBC were significantly correlated (r = − 0.403, P < 0.001), and both were significantly associated with IC Symptom Index scores. The rate of satisfactory outcomes was better for the patients with low glomerulation grade and MBC ≥ 760 ml (64.2%), and significantly worse for those with Hunner’s lesions (36.8%); no significant differences were noted among the other groups. The results suggested that IC/BPS patients can be classified into the following three distinct subgroups: (1) those with low glomerulation grade and MBC ≥ 760 ml; (2) those with low glomerulation grade and MBC < 760 ml, or with high glomerulation grade regardless of MBC; and (3) those with Hunner’s lesions. The results showed that three IC/BPS subgroups had distinct bladder characteristics and treatment outcomes. The patients with high MBC and low glomerulation grade after HD had more medical comorbidities but a significantly higher rate of satisfactory treatment outcome.IRB: 105-25-B.

ACS Style

Wan-Ru Yu; Jia-Fong Jhang; Han-Chen Ho; Yuan-Hong Jiang; Cheng-Ling Lee; Yung-Hsiang Hsu; Hann-Chorng Kuo. Cystoscopic hydrodistention characteristics provide clinical and long-term prognostic features of interstitial cystitis after treatment. Scientific Reports 2021, 11, 1 -9.

AMA Style

Wan-Ru Yu, Jia-Fong Jhang, Han-Chen Ho, Yuan-Hong Jiang, Cheng-Ling Lee, Yung-Hsiang Hsu, Hann-Chorng Kuo. Cystoscopic hydrodistention characteristics provide clinical and long-term prognostic features of interstitial cystitis after treatment. Scientific Reports. 2021; 11 (1):1-9.

Chicago/Turabian Style

Wan-Ru Yu; Jia-Fong Jhang; Han-Chen Ho; Yuan-Hong Jiang; Cheng-Ling Lee; Yung-Hsiang Hsu; Hann-Chorng Kuo. 2021. "Cystoscopic hydrodistention characteristics provide clinical and long-term prognostic features of interstitial cystitis after treatment." Scientific Reports 11, no. 1: 1-9.

Journal article
Published: 31 December 2020 in International Neurourology Journal
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Patients with neurogenic lower urinary tract dysfunction (NLUTD) experience urinary incontinence with or without difficult urination, which might promote recurrent urinary tract infection (UTI) and exacerbate upper urinary tract function. Nonetheless, appropriate bladder management has been shown to reduce urological complications and improve quality of life. In addition to pharmacological therapy and surgical intervention, botulinum toxin A (BoNT-A) has been widely utilized in NLUTD. The therapeutic efficacy of detrusor BoNT-A injections for neurogenic detrusor overactivity due to spinal cord injury (SCI), multiple sclerosis, or other central nervous system lesions, such as cerebrovascular accident, Parkinson disease, early dementia, and pediatric NLUTD due to myelomeningocele, has been well established, with repeated BoNT-A injections every 6 to 9 months being necessary to maintain its therapeutic effects. Urethral BoNT-A injection can decrease urethral sphincter resistance and facilitate efficient voiding in patients with NLUTD who wish to preserve self-voiding. Detrusor BoNT-A injection can also decrease the occurrence of autonomic dysreflexia in patients with SCI, even after failed augmentation enterocystoplasty, with additional benefits including reduced UTI episodes and preserved renal function with repeated injections. However, this treatment does have some side effects. Complete informed consent for BoNT-A injection therapy with full disclosure of its potential complications should therefore be obtained before this procedure is undertaken.

ACS Style

Yuan-Hong Jiang; Sheng-Fu Chen; Hann-Chorng Kuo. Frontiers in the Clinical Applications of Botulinum Toxin A as Treatment for Neurogenic Lower Urinary Tract Dysfunction. International Neurourology Journal 2020, 24, 301 -312.

AMA Style

Yuan-Hong Jiang, Sheng-Fu Chen, Hann-Chorng Kuo. Frontiers in the Clinical Applications of Botulinum Toxin A as Treatment for Neurogenic Lower Urinary Tract Dysfunction. International Neurourology Journal. 2020; 24 (4):301-312.

Chicago/Turabian Style

Yuan-Hong Jiang; Sheng-Fu Chen; Hann-Chorng Kuo. 2020. "Frontiers in the Clinical Applications of Botulinum Toxin A as Treatment for Neurogenic Lower Urinary Tract Dysfunction." International Neurourology Journal 24, no. 4: 301-312.

Original article
Published: 16 November 2020 in LUTS: Lower Urinary Tract Symptoms
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This clinical study used autologous intravesical platelet-rich plasma (PRP) injections to treat patients with recurrent urinary tract infection (rUTI). Changes in urothelial proliferation, cytoskeleton, and barrier function protein expression after treatment were investigated. All patients underwent 4-monthly intravesical PRP injections with 1-year follow-up. Successful treatment was defined as ≤2 UTI episodes within the preceding 1 year. Bladder biopsies were performed at the first and fourth PRP injection, and specimens were investigated by Western blot for the proteins sonic hedgehog (Shh), CD34, cytokeratin 5 (CK5), CK14, CK20, zonula occludens-1 (ZO-1), E-cadherin, inflammatory proteins tryptase and p38, apoptotic protein BAX (BCL2-associated X protein) and caspase-3, functional proteins M2 (muscarinic receptor 2) and M3, and beta-adrenoceptor-3, with glyceraldehyde phosphate dehydrogenase used as normalizing protein for quantification. The study enrolled 22 patients with rUTI and 17 controls, with successful outcome in 14 of 22 (63.6%) patients. Compared with controls, Western blot quantification results showed that rUTI patients had lower CD34, CK20, M3, and ZO-1, but higher CK5, BAX, and caspase-3 at baseline. The reduced CD34, CK20, M2, and M3 expressions at baseline were significantly increased after repeat PRP injections. Patients with a successful outcome had significant increase of CD34, Shh, CK20, M2, and M3 expressions after PRP injections. Intravesical PRP repeat injections improve the urothelial cell proliferation and increase the CK 20 expression in umbrella cells. PRP repeat injections have a beneficial effect on bladder urothelium-associated changes in rUTI. Thus, PRP injection may restore urothelial health and prevent UTI recurrence in intractable rUTI.

ACS Style

Yuan‐Hong Jiang; Jia‐Fong Jhang; Yung‐Hsiang Hsu; Han‐Chen Ho; Teng‐Yi Lin; Lori A. Birder; Hann‐Chorng Kuo. Urothelial health after platelet‐rich plasma injection in intractable recurrent urinary tract infection: Improved cell proliferation, cytoskeleton, and barrier function protein expression. LUTS: Lower Urinary Tract Symptoms 2020, 1 .

AMA Style

Yuan‐Hong Jiang, Jia‐Fong Jhang, Yung‐Hsiang Hsu, Han‐Chen Ho, Teng‐Yi Lin, Lori A. Birder, Hann‐Chorng Kuo. Urothelial health after platelet‐rich plasma injection in intractable recurrent urinary tract infection: Improved cell proliferation, cytoskeleton, and barrier function protein expression. LUTS: Lower Urinary Tract Symptoms. 2020; ():1.

Chicago/Turabian Style

Yuan‐Hong Jiang; Jia‐Fong Jhang; Yung‐Hsiang Hsu; Han‐Chen Ho; Teng‐Yi Lin; Lori A. Birder; Hann‐Chorng Kuo. 2020. "Urothelial health after platelet‐rich plasma injection in intractable recurrent urinary tract infection: Improved cell proliferation, cytoskeleton, and barrier function protein expression." LUTS: Lower Urinary Tract Symptoms , no. : 1.

Original article
Published: 01 November 2020 in LUTS: Lower Urinary Tract Symptoms
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Objectives Recurrent urinary tract infection (rUTI) is a common infectious disease in women. This study investigated the urothelial cell proliferation, the cytoskeleton, barrier proteins, and inflammatory protein expression in women with rUTIs. Methods Female patients with recurrent or persistent UTIs were recruited. Bladder mucosal specimens were investigated by Western blot and immunohistochemical staining for the urothelial cytoskeleton proteins cytokeratin 5 (CK5), CK14, and CK20; proteins involved in cellular proliferation, including CD34, sonic hedgehog (SHH), and tumor protein 63 (TP63); barrier proteins zonula occludens 1 (ZO‐1) and E‐cadherin; inflammatory proteins p38 and tryptase; and proapoptotic proteins Bcl2‐associated agonist of cell death protein (BAD), Bcl2‐associated X protein (BAX), and caspase‐3. Women with stress urinary incontinence without bladder symptoms served as controls. Bladder specimens from 18 recurrent UTI patients with rUTIs and 12 persistent UTIs, and 17 controls were analyzed, and protein expressions were compared between the three groups. Results Cell proliferation protein expression for CD34, SHH, and TP63 was significantly lower in the urothelium of patients with rUTIs than in controls. Expression of CK5 increased, whereas CK20 decreased significantly in rUTIs compared with those of controls. Apoptotic proteins BAD, BAX, and caspase‐3 were significantly higher in patients with rUTIs. However, barrier proteins ZO‐1 and E‐cadherin, and tryptase were not significantly lower in patients with rUTIs. Conclusion Deficits in expression of proteins involved in urothelial cell proliferation, cytoskeleton, and barrier function were noted in patients with rUTIs. These urothelial deficits may be due to deficient proliferation and differentiation resulting in inadequate urothelial barrier function and further in rUTIs.

ACS Style

Jia‐Fong Jhang; Teng‐Yi Lin; Han‐Chen Ho; Yuan‐Hong Jiang; Yung‐Hsiang Hsu; Lori A. Birder; Hann‐Chorng Kuo. Deficits of urothelial cell proliferation, cytoskeleton, and barrier function protein expressions in patients with recurrent and persistent urinary tract infections. LUTS: Lower Urinary Tract Symptoms 2020, 1 .

AMA Style

Jia‐Fong Jhang, Teng‐Yi Lin, Han‐Chen Ho, Yuan‐Hong Jiang, Yung‐Hsiang Hsu, Lori A. Birder, Hann‐Chorng Kuo. Deficits of urothelial cell proliferation, cytoskeleton, and barrier function protein expressions in patients with recurrent and persistent urinary tract infections. LUTS: Lower Urinary Tract Symptoms. 2020; ():1.

Chicago/Turabian Style

Jia‐Fong Jhang; Teng‐Yi Lin; Han‐Chen Ho; Yuan‐Hong Jiang; Yung‐Hsiang Hsu; Lori A. Birder; Hann‐Chorng Kuo. 2020. "Deficits of urothelial cell proliferation, cytoskeleton, and barrier function protein expressions in patients with recurrent and persistent urinary tract infections." LUTS: Lower Urinary Tract Symptoms , no. : 1.

Original clinical article
Published: 14 October 2020 in Neurourology and Urodynamics
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Aims Patients with urinary retention due to detrusor acontractility (DA) might regain voiding efficiency (VE) after treatment. This study investigated the long‐term outcomes and predictors of recovery following treatment. Methods A total of 32 patients with DA were retrospectively identified and enrolled. DA was defined by Pdet.Qmax = 0 cmH2O and postvoid residual (PVR) > 300 ml determined through videourodynamic study (VUDS). All patients received medical or surgical treatment and were followed up for at least 3 months, during which repeat VUDS was conducted. Detrusor contractility recovery was confirmed when patients were able to void with a Pdet.Qmax ≥ 10 cmH2O after treatment. Results Our patients comprised 22 women and 10 men (mean age, 73.2 ± 9.7 years; mean follow‐up duration, 1.6 ± 1.8 [0.3–7.4] years). Follow‐up VUDS revealed that 14 (43.9%) patients recovered from detrusor contractility, with five patients recovering within 1 year and nine after 1 year. Pdet.Qmax, voided volume, PVR, maximum flow rate, and VE significantly improved in both the recovery and nonrecovery groups. The recovery group had significantly better VE (p = .039) and significantly lower bladder compliance (74.2 ± 83.2 vs. 119 ± 82.6; p = .007) than the nonrecovery group. Receiver operating characteristic (ROC) analysis revealed an optimum bladder compliance cutoff value of <80 ml/cmH2O for predicting detrusor contractility recovery with an area under the ROC curve of 0.780. Conclusions Among the included patients with DA, 43.9% had detrusor contractility recovery after treatment, with bladder compliance of <80 ml/cmH2O predicting bladder function recovery.

ACS Style

Sheng‐Fu Chen; Chung‐Hsin Peng; Hann‐Chorng Kuo. Will detrusor acontractility recover after medical or surgical treatment? A longitudinal long‐term urodynamic follow‐up. Neurourology and Urodynamics 2020, 40, 228 -236.

AMA Style

Sheng‐Fu Chen, Chung‐Hsin Peng, Hann‐Chorng Kuo. Will detrusor acontractility recover after medical or surgical treatment? A longitudinal long‐term urodynamic follow‐up. Neurourology and Urodynamics. 2020; 40 (1):228-236.

Chicago/Turabian Style

Sheng‐Fu Chen; Chung‐Hsin Peng; Hann‐Chorng Kuo. 2020. "Will detrusor acontractility recover after medical or surgical treatment? A longitudinal long‐term urodynamic follow‐up." Neurourology and Urodynamics 40, no. 1: 228-236.

Journal article
Published: 16 September 2020 in Scientific Reports
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Repeated intravesical injections of autologous platelet-rich plasma (PRP) have been shown to improve symptoms in patients with interstitial cystitis/bladder pain syndrome (IC/BPS); however, there is a paucity of objective evidence of the effectiveness of this therapy. In this study, we investigated the changes in urinary markers after PRP treatment. Forty patients with IC/BPS who were refractory to conventional therapy received four injections of PRP at monthly intervals; 10 mL PRP solution with 2.5 times the peripheral blood platelet concentration was used. Urine levels of thirteen functional proteins, growth factors, and cytokines were assessed at baseline and at the 4th PRP injection. The clinical parameters included visual analog scale (VAS) pain score, daily urinary frequency, nocturia episodes, functional bladder capacity, and global response assessment (GRA). The GRA and symptom score significantly decreased post-treatment. In patients with GRA ≥ 2, the success rates at 1 month and at 3 months after the 4th PRP injection were 70.6% and 76.7%, respectively. The VAS pain score, frequency, and nocturia showed a significant decrease (all p < 0.05). Urinary levels of nerve growth factor, matrix metalloproteinase-13, and vascular endothelial growth factor significantly decreased post-treatment (p = 0.043, p = 0.02, and p = 0.000, respectively); platelet-derived growth factor-AB showed a significant increase (p = 0.004) at the 4th PRP treatment compared with baseline. In this study, repeated intravesical PRP injections provided significant symptom improvement in IC/BPS patients with concomitant changes in the related biomarker levels. Trial registration: ClinicalTrial.gov: NCT03104361; IRB: TCGH 105-48-A.

ACS Style

Yuan-Hong Jiang; Yuh-Chen Kuo; Jia-Fong Jhang; Cheng-Ling Lee; Yung-Hsiang Hsu; Han-Chen Ho; Hann-Chorng Kuo. Repeated intravesical injections of platelet-rich plasma improve symptoms and alter urinary functional proteins in patients with refractory interstitial cystitis. Scientific Reports 2020, 10, 1 -8.

AMA Style

Yuan-Hong Jiang, Yuh-Chen Kuo, Jia-Fong Jhang, Cheng-Ling Lee, Yung-Hsiang Hsu, Han-Chen Ho, Hann-Chorng Kuo. Repeated intravesical injections of platelet-rich plasma improve symptoms and alter urinary functional proteins in patients with refractory interstitial cystitis. Scientific Reports. 2020; 10 (1):1-8.

Chicago/Turabian Style

Yuan-Hong Jiang; Yuh-Chen Kuo; Jia-Fong Jhang; Cheng-Ling Lee; Yung-Hsiang Hsu; Han-Chen Ho; Hann-Chorng Kuo. 2020. "Repeated intravesical injections of platelet-rich plasma improve symptoms and alter urinary functional proteins in patients with refractory interstitial cystitis." Scientific Reports 10, no. 1: 1-8.

Original article
Published: 25 August 2020 in LUTS: Lower Urinary Tract Symptoms
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Objective This study evaluated the efficacy and safety of imidafenacin 0.1 mg twice daily vs placebo for Taiwanese patients with overactive bladder (OAB) after a 12‐week oral administration. Methods This randomized, double‐blind, placebo‐controlled, two‐arm, parallel‐group, prospective study enrolled 118 patients across 11 study sites in Taiwan. Subjects were randomized to imidafenacin or placebo in a 2:1 ratio and entered the 12‐week treatment period. At the subsequent visits, efficacy outcome measures and safety assessments were collected for analysis. The primary efficacy outcome was the change in the mean number of micturitions per day. Secondary endpoints included mean changes from baseline in urgency episodes and urge incontinence episodes per day and mean volume voided per micturition. Safety outcomes were also collected and compared between groups. Results A total of 78 and 40 patients were allocated to the imidafenacin and placebo groups, respectively. Among them, 100 patients (imidafenacin, 65 and placebo, 35) completed the trial. Compared with placebo, imidafenacin was significantly better at reducing the number of micturitions per day (−1.29 ± 2.23 vs ‐0.46 ± 3.49, P = .0171) and reducing the mean number of urge incontinence episodes (−0.15 ± 0.52 vs 0.04 ± 0.50, P = .0386) at week 12. Adverse events were reported in 35 subjects (44.9%) and 16 (40%) in the imidafenacin and placebo groups, including constipation (n = 3, 4), dry mouth (n = 11, 2), and urinary tract infection (n = 7, 4), respectively. One patient in the imidafenacin group had mild dysuria. Conclusion Imidafenacin demonstrated efficacy and safety in the treatment of OAB in Taiwanese patients.

ACS Style

Yao‐Chi Chuang; Chih‐Chieh Lin; Po‐Ming Chow; Chi‐Shun Lien; Ke‐Hung Tsui; Chieh‐Lung Chou; Hsiang‐Ying Lee; En Meng; Hann‐Chorng Kuo. A double‐blind, randomized, placebo‐controlled, parallel study to evaluate the efficacy and safety of imidafenacin in patients with overactive bladder in Taiwan. LUTS: Lower Urinary Tract Symptoms 2020, 13, 108 -117.

AMA Style

Yao‐Chi Chuang, Chih‐Chieh Lin, Po‐Ming Chow, Chi‐Shun Lien, Ke‐Hung Tsui, Chieh‐Lung Chou, Hsiang‐Ying Lee, En Meng, Hann‐Chorng Kuo. A double‐blind, randomized, placebo‐controlled, parallel study to evaluate the efficacy and safety of imidafenacin in patients with overactive bladder in Taiwan. LUTS: Lower Urinary Tract Symptoms. 2020; 13 (1):108-117.

Chicago/Turabian Style

Yao‐Chi Chuang; Chih‐Chieh Lin; Po‐Ming Chow; Chi‐Shun Lien; Ke‐Hung Tsui; Chieh‐Lung Chou; Hsiang‐Ying Lee; En Meng; Hann‐Chorng Kuo. 2020. "A double‐blind, randomized, placebo‐controlled, parallel study to evaluate the efficacy and safety of imidafenacin in patients with overactive bladder in Taiwan." LUTS: Lower Urinary Tract Symptoms 13, no. 1: 108-117.

Journal article
Published: 16 August 2020 in International Journal of Environmental Research and Public Health
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Background: to elucidate the predictors of progression-free survival (PFS) and overall survival (OS) in high-risk endometrial cancer patients. Methods: the medical records of all consecutivewomen with high-risk endometrial cancer were reviewed. Results: among 92 high-risk endometrial cancer patients, 30 women experienced recurrence, and 21 women died. The 5-year PFS and OS probabilities were 65.3% and 75.9%, respectively. Multivariable Cox regression revealed that body mass index (hazard ratio (HR) = 1.11), paraaortic lymph node metastasis (HR = 11.11), lymphovascular space invasion (HR = 5.61), and sandwich chemoradiotherapy (HR = 0.15) were independently predictors of PFS. Body mass index (HR = 1.31), paraaortic lymph node metastasis (HR = 32.74), non-endometrioid cell type (HR = 11.31), and sandwich chemoradiotherapy (HR = 0.07) were independently predictors of OS. Among 51 women who underwent sandwich (n = 35) or concurrent (n = 16) chemoradiotherapy, the use of sandwich chemoradiotherapy were associated with better PFS (adjusted HR = 0.26, 95% CI = 0.08–0.87, p = 0.03) and OS (adjusted HR = 0.11, 95% CI = 0.02–0.71, p = 0.02) compared with concurrent chemoradiotherapy. Conclusion: compared with concurrent chemoradiotherapy, sandwich chemoradiotherapy was associated with better PFS and OS in high-risk endometrial cancer patients. In addition, high body mass index, paraaortic lymph node metastasis, and non-endometrioid cell type were also predictors of poor OS in high-risk endometrial cancer patients.

ACS Style

Hui-Hua Chen; Wan-Hua Ting; Hsu-Dong Sun; Ming-Chow Wei; Ho-Hsiung Lin; Sheng-Mou Hsiao. Predictors of Survival in Women with High-Risk Endometrial Cancer and Comparisons of Sandwich versus Concurrent Adjuvant Chemotherapy and Radiotherapy. International Journal of Environmental Research and Public Health 2020, 17, 5941 .

AMA Style

Hui-Hua Chen, Wan-Hua Ting, Hsu-Dong Sun, Ming-Chow Wei, Ho-Hsiung Lin, Sheng-Mou Hsiao. Predictors of Survival in Women with High-Risk Endometrial Cancer and Comparisons of Sandwich versus Concurrent Adjuvant Chemotherapy and Radiotherapy. International Journal of Environmental Research and Public Health. 2020; 17 (16):5941.

Chicago/Turabian Style

Hui-Hua Chen; Wan-Hua Ting; Hsu-Dong Sun; Ming-Chow Wei; Ho-Hsiung Lin; Sheng-Mou Hsiao. 2020. "Predictors of Survival in Women with High-Risk Endometrial Cancer and Comparisons of Sandwich versus Concurrent Adjuvant Chemotherapy and Radiotherapy." International Journal of Environmental Research and Public Health 17, no. 16: 5941.

Review article
Published: 12 July 2020 in LUTS: Lower Urinary Tract Symptoms
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Chronic pelvic pain (CPP) is an extremely bothersome condition which leads to major effects in women's everyday life. In addition to visceral sources of pain, pelvic floor dysfunction including myofascial pain and spasm on the pelvic floor muscles causing hypertonicity are causes often overlooked. Injecting botulinum toxin type A (BoNT‐A) into hypertonic pelvic floor muscles may aid the relaxation of pelvic floor musculature. The muscles that are injected in CPP treatment include the obturator internus, levator ani (pubococcygeus, iliococcygeus, and puborectalis), and coccygeus. Generally, injections can be performed tolerably with safety under conscious sedation combined with local anesthesia. Most practitioners perform BoNT‐A injection of pelvic floor muscles using anatomical landmarks identified by manual palpation only. For the precise location of injection sites, some needle guidance techniques were proposed, including electromyography, electrical stimulation, ultrasound, fluoroscopy, and/or computed tomography. Side effects of BoNT‐A injection in CPP are rare and self‐limiting. Because of the reversible nature of BoNT‐A, reinjection appears to be necessary. Increasing proof points out that BoNT‐A is a promising treatment option for CPP in women. We conducted a review of published literature in Pubmed, using chronic pelvic pain in women, hypertonic pelvic floor, and botulinum toxin as the keywords. This article aims to summarize the treatment techniques and results of BoNT‐A injection for hypertonic pelvic floor in women with chronic pelvic pain.

ACS Style

Fei‐Chi Chuang; Tsai‐Hwa Yang; Hann‐Chorng Kuo. Botulinum toxin A injection in the treatment of chronic pelvic pain with hypertonic pelvic floor in women: Treatment techniques and results. LUTS: Lower Urinary Tract Symptoms 2020, 13, 5 -12.

AMA Style

Fei‐Chi Chuang, Tsai‐Hwa Yang, Hann‐Chorng Kuo. Botulinum toxin A injection in the treatment of chronic pelvic pain with hypertonic pelvic floor in women: Treatment techniques and results. LUTS: Lower Urinary Tract Symptoms. 2020; 13 (1):5-12.

Chicago/Turabian Style

Fei‐Chi Chuang; Tsai‐Hwa Yang; Hann‐Chorng Kuo. 2020. "Botulinum toxin A injection in the treatment of chronic pelvic pain with hypertonic pelvic floor in women: Treatment techniques and results." LUTS: Lower Urinary Tract Symptoms 13, no. 1: 5-12.

Journal article
Published: 23 June 2020 in International Journal of Environmental Research and Public Health
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The aim was to compare the clinical outcomes and prognostic factors of cervical cancer between elderly and younger women, and to explore which treatment strategy is more appropriate for elderly patients. We retrospectively reviewed patients with cervical cancer receiving definitive radiotherapy (RT) between 2007 and 2016, and divided them into two age groups: age < 70 vs. age ≥ 70. The clinical outcomes were compared between the two age groups. The median follow-up was 32.2 months. A total of 123 patients were eligible, 83 patients in group 1 (age < 70), and 40 patients in group 2 (age ≥ 70). Patients in group 2 received less intracavitary brachytherapy (ICRT) application, less total RT dose, and less concurrent chemoradiotherapy (CCRT), and tended to have more limited external beam radiotherapy (EBRT) volume. The treatment outcomes between the age groups revealed significant differences in 5-year overall survival (OS), but no differences in 5-year cancer-specific survival (CSS), 66.2% vs. 64.5%, and other loco-regional control. In multivariate analyses for all patients, the performance status, pathology with squamous cell carcinoma (SCC), International Federation of Gynecology and Obstetrics (FIGO) stage, and ICRT application were prognostic factors of CSS. The elderly patients with cervical cancer had comparable CSS and loco-regional control rates, despite receiving less comprehensive treatment. Conservative treatment strategies with RT alone could be appropriate for patients aged ≥ 70 y/o, especially for those with favorable stages or histopathology.

ACS Style

Peiyu Hou; ChenHsi Hsieh; MingChow Wei; Shengmou Hsiao; Peiwei Shueng. Differences in Treatment Outcomes and Prognosis between Elderly and Younger Patients Receiving Definitive Radiotherapy for Cervical Cancer. International Journal of Environmental Research and Public Health 2020, 17, 4510 .

AMA Style

Peiyu Hou, ChenHsi Hsieh, MingChow Wei, Shengmou Hsiao, Peiwei Shueng. Differences in Treatment Outcomes and Prognosis between Elderly and Younger Patients Receiving Definitive Radiotherapy for Cervical Cancer. International Journal of Environmental Research and Public Health. 2020; 17 (12):4510.

Chicago/Turabian Style

Peiyu Hou; ChenHsi Hsieh; MingChow Wei; Shengmou Hsiao; Peiwei Shueng. 2020. "Differences in Treatment Outcomes and Prognosis between Elderly and Younger Patients Receiving Definitive Radiotherapy for Cervical Cancer." International Journal of Environmental Research and Public Health 17, no. 12: 4510.

Original article
Published: 18 June 2020 in International Urogynecology Journal
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We report long-term changes in VUDS profiles of women with dysfunctional voiding and investigate potential predictors for treatment response. Women with dysfunctional voiding and available VUDS data between November 1997 and June 2018 were enrolled for retrospective analysis. The patients were all treated with medication first. In refractory patients, urethral botulinum toxin was provided as an additional option. The primary outcome was the change of VUDS parameters between baseline and follow-up studies. The secondary outcomes were baseline parameters and clinical factors that were associated with the BOOI response (> 10 points of BOOI reduction). A total of 195 women with DV were included in this study. The mean age was 54.5 years old. Sixty patients received urethral botulinum toxin injection. For all patients, Pdet decreased from 47.2 to 36.8 cm H2O (p < 0.0001), and BOOI decreased from 26.4 to 17.7 (p = 0.0001). Patients with urethral injection had significantly smaller Qmax, voided volume, and voiding efficiency (VE) and significantly larger PVR and BOOI at baseline, indicating a severer obstruction in this group. The overall BOOI response rate was 44% (85/195). A higher baseline BOOI was associated with the BOOI response in multivariate analysis. In this long-term study of women with dysfunctional voiding, medical treatment with or without urethral botulinum toxin injection both resulted in reduction of Pdet and BOOI. A more prominent obstructive profile at baseline VUDS study was associated with a higher rate of BOOI response at follow-up study.

ACS Style

Po-Ming Chow; Sheng-Mou Hsiao; Hann-Chorng Kuo. Obstructive patterns in videourodynamic studies predict responses of female dysfunctional voiding treated with or without urethral botulinum toxin injection: a long-term follow-up study. International Urogynecology Journal 2020, 31, 2557 -2564.

AMA Style

Po-Ming Chow, Sheng-Mou Hsiao, Hann-Chorng Kuo. Obstructive patterns in videourodynamic studies predict responses of female dysfunctional voiding treated with or without urethral botulinum toxin injection: a long-term follow-up study. International Urogynecology Journal. 2020; 31 (12):2557-2564.

Chicago/Turabian Style

Po-Ming Chow; Sheng-Mou Hsiao; Hann-Chorng Kuo. 2020. "Obstructive patterns in videourodynamic studies predict responses of female dysfunctional voiding treated with or without urethral botulinum toxin injection: a long-term follow-up study." International Urogynecology Journal 31, no. 12: 2557-2564.