Purpose: To investigate the long-term therapeutic satisfaction after augmentation enterocystoplasty (AE) or non-AE bladder therapy in patients with Hunner interstitial cystitis (HIC).Methods: From 2013 to 2024, patients with cystoscopically confirmed HIC who received AE or non-AE bladder-preserving therapy were retrospectively analyzed. Treatment outcomes were analyzed using the subjective global assessment response, symptoms, and urodynamic parameters. The patients’ symptoms and urodynamic parameters were compared between AE and non-AE groups from baseline to follow-up endpoint.Results: A total of 54 patients (48 women and 6 men) were included with a mean age of 58.6±11.4 years at diagnosis and a mean follow-up period of 9.4±5.8 years. AE and non-AE therapy was performed in 17 (31.5%) and 37 patients (68.5%), respectively. A final satisfactory outcome was reported in 13 (76.5%) of the 17 HIC patients after AE and in 26 of the 37 patients (70.3%) after non-AE therapy. Compared with patients who had no improvement, patients who had improved outcomes after AE exhibited decreased interstitial cystitis symptom index (P=0.007) and visual analogue scale (P=0.013) scores and increased bladder fullness sensation (P=0.002) and cystometric bladder capacity (P=0.019). Patients who had no improved outcomes after AE did not experience pain relief or increased bladder fullness sensation or bladder capacity. Only 23.4% of the patients treated with AE required repeat surgery or intravesical therapy in the first 1–3 years. By contrast, patients treated with non-AE therapy required repeat intravesical therapy for the recurrence of Hunner lesions or bladder symptoms.Conclusions: Both AE or non-AE therapy can result in satisfactory outcomes in more than 70% of HIC patients. AE provides early relief of bladder pain and increases bladder capacity, and non-AE therapy can also relieve pain and improve functional bladder capacity, resulting in improved outcomes.

Bladder neck dysfunction (BND) is a pathophysiology associated with voiding dysfunction in patients with neurogenic or non-neurogenic voiding dysfunction. Botulinum toxin A (BoNT-A) injection is a minimally invasive alternative for treating bladder outlet dysfunction; however, its efficacy for BND has not been well established. In this retrospective study, 41 patients with videourodynamic study-confirmed BND who failed medical therapy received a transurethral bladder neck injection of 100-U BoNT-A. Treatment outcomes were assessed using the Global Response Assessment. After BoNT-A injection, the patients were followed up and subsequent urological management was recorded. At 6 months, 65.9% of the patients reported satisfactory outcomes (26.8% successful and 39.0% improved). Patients with non-neurogenic BND had the highest satisfaction rate, higher than those with neurogenic BND (NBND) with and without detrusor sphincter dyssynergia (DSD). Among patients without detrusor acontractility (DA), a higher bladder outlet obstruction index predicted treatment failure. Patients with pure BND confirmed by urodynamics may benefit more from BoNT-A injections, whereas those with high baseline voiding detrusor pressure or spinal cord injury with detrusor sphincter dyssynergia may have less favorable results. Bladder neck BoNT-A injections for treating BND-associated voiding dysfunction did not achieve very successful outcomes. Only 26.8% of the patients had successful treatment outcomes, while 39.0% had improved outcomes and 34.1% failed the treatment.

Objectives: Lack of familiarity and limited digital literacy frequently limit the ability and willingness of older adults to use digital health tools. This study aimed to investigate the factors influencing the intention to use digital health information and services (DHIAS) and their actual use among indigenous Taiwanese older adults, based on the theory of planned behaviour (TPB) and digital health literacy. Design: Cross-sectional quantitative study using a structured questionnaire. Setting: Community-based settings at the primary care level; 11 cultural health stations located in Eastern Taiwan. Participants: A total of 170 Indigenous elders aged ≥55 years were recruited. Inclusion criteria included: Indigenous descent, aged ≥55 years, cognitively intact and able to communicate in Mandarin. All participants completed the interview-based survey. Primary and secondary outcome measures: The primary outcomes were the intention to use DHIAS and its actual use. Predictors included digital health literacy and TPB constructs. All variables were measured using validated or adapted items within the questionnaire. Results: The mean score for intention to use DHIAS was 1.50 (SD=0.90) and the mean score for actual behaviour was 1.68 (SD=1.14). Hierarchical regression analyses indicated that subjective norms (β=0.270, p<0.001)—a core construct of TPB—and digital health literacy (β=0.603, p<0.001) significantly predicted intention, accounting for 55.7% of the variance. Intention (β=0.732, p<0.001) and digital health literacy (β=0.146, p<0.025) were significant predictors of actual behaviour, accounting for 72.4% of the variance. Conclusions: Digital health literacy and TPB constructs critically influence digital health engagement among older populations. Interventions aimed at improving digital health engagement among older populations should focus on enhancing digital skills and creating socially supportive environments. Future studies should explore culturally tailored strategies to reduce digital disparities in communities with limited healthcare access.