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The Underactive Bladder

For many, a diagnosis of an underactive or atonic bladder represents the end of the line in terms of management options. It remains a poorly understood and even more poorly appreciated condition, both in terms of underlying pathophysiology and alternatives...

Underactive Bladder

This book is an excellent update on the concept of the underactive bladder. The authors and editors led by Chris Chapple address some of the controversies surrounding definitions, diagnosis and treatment. The International Continence Society (ICS) currently defines detrusor overactivity...

Bladder cancer

Case 1 A 78-year-old female presents with a week history of painless haematuria. She’s a smoker and used to work in the textiles industry. She underwent a flexible cystoscopy. What does this image show? What are the two-week wait National...

Selective denervation of the bladder

The treatment of refractory overactive bladder is currently limited to neuromodulation (sacral nerve stimulation or percutaneous tibial nerve stimulation) or botulinum toxin injections. Although all these options are valuable, they have their own limitations and may not be suitable for...

Molecular biology – bladder cancer

Background Bladder cancer is the most common cancer of the urinary tract and approximately 90% of bladder cancers diagnosed in North America and Europe are transitional cell carcinomas (TCC). For the purposes of diagnosis and treatment, bladder cancer is often...

Bladder carcinoma MRI

Bladder malignancy is one of the commonest malignancies of the renal tract, accounting for approximately 6% of male malignancy and 2% of female malignancy. The incidence increases with patient age with 70% of patients being over the age of 65...

Non-urothelial bladder malignancies

Case 1 An 80-year-old gentleman presented with a history of visible haematuria and recurrent urinary tract infections (UTIs). He has been performing intermittent self catheterisation (ISC) for detrusor underactivity for over 20 years. A flexible cystoscopy showed these appearances of...

Bladder urothelial neoplasms in children

Urothelial bladder neoplasms are rare in children, occurring in 0.1-0.4% of the population before the age of 20. There are no current paediatric guidelines to their management. This study retrospectively reviews the files of patients from three tertiary centres between...

Botox® instillation into the bladder

Patients with refractory overactive bladder (OAB) may be offered OnabotulinumtoxinA (Botox®) as one of the third-line options. Given the invasive nature of requiring cystoscopy, injections via a needle and local anaesthesia, it would be simpler, more convenient and more accessible...

New therapy for overactive bladder

Overactive bladder (OAB) is a complex symptom that can adversely affect quality of life. So far pharmacotherapy has focused on anti-cholinergic drugs. Recently, beta-adrenoreceptors have been identified as having an effect on the detrusor muscle and urothelium. Beta-3 is the...

PTNS in overactive bladder

This article will be of interest to those who undertake percutaneous tibial nerve stimulation (PTNS) or are planning to start doing so. This is a computer aided search between 2000-2011 to identify randomised controlled trials (RCT), controlled clinical trials (CCT)...

Recent developments in bladder cancer

There have been some exciting developments in bladder cancer over the last few years. Immunotherapy has prolonged survival in a proportion of patients with metastatic disease, with sustained efficacy in some. Advances in genetic analysis and molecular subtyping make personalised...