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Pathophysiology of Detrusor Underactivity/Acontractile Detrusor
Michael B. Chancellor
According to the standardization of terminology from the International Continence Society, 1 detrusor under-activity (DU) is urodynamically defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emptying within a normal time span. Acontractile detrusor (AD) is one that cannot be demonstrated to contract during urodynamic studies. DU or AD (DU/AD) can be developed from various kinds of conditions, when afferent and/or efferent pathways innervating the bladder are mainly damaged. Various myogenic factors in detrusor muscles also cause AD as well as DU.
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The Underactive Bladder
Michael B. Chancellor and Ananias C. Diokno
This book provides up-to-date guidance on optimal care of the patient with an underactive bladder. It covers all aspects of management, including clinical evaluation, urodynamic diagnosis, standard care, drug therapy, and emerging treatment options. Nursing issues are extensively discussed, and advice offered on the use of catheters and avoidance of catheter-related complications. Further chapters address epidemiology, pathophysiology, animal modeling, and health care costs.
While most practitioners are familiar with overactive bladder, the converse condition of underactive bladder has generally remained far below the radar. As a consequence, there is still a lack of empirically validated treatments and effective treatment strategies. This is a matter of concern, especially as the burden of the condition is expected to rise in line with the aging of global populations. The Underactive Bladder is a major step forward in raising awareness, exploring best practices in patient care, and searching for future therapies. It will be invaluable for urologists, geriatricians, other specialists, researchers, and nurses.
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Underactive Bladder in Older Adults
Laura E. Lamb and Michael B. Chancellor
Overactive bladder is one of the most common bladder problems, but an estimated 20 million Americans have underactive bladder (UAB), which makes going to the bathroom difficult, increases the risk of urinary tract infections, and even leads to institutionalization. This article provides an overview of UAB in older adults, and discusses the prevalence, predisposing factors, cause, clinical investigations, and treatments. At present, there is no effective therapy for UAB. A great deal of work still needs to be done on understanding the pathogenesis and the development of effective therapies.
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Botulinum Toxin in Urology
Michael B. Chancellor
The minimally invasive use of botulinum toxin (BoNT) in the lower urinary tract has revolutionized the treatment of debilitating bladder, urethra, and prostate conditions refractory to conventional therapy. This is the first book focusing on the practical application of BoNT to the genitourinary tract. An introductory section discusses the biology, pharmacology, and safety of BoNT in the lower urinary tract. Applications of BoNT in the bladder and the prostate and pelvic floor are then covered in detail, with reviews of the latest clinical series and techniques of BoNT injection in both adults and children. The book closes by considering non-genitourinary uses of BoNT and addressing issues of health economics as well as providing insights from experts from across the world. This is a practical, hands-on book that also includes appendices containing easy to read instructions for patients undergoing bladder and prostate BoNT injections and specific nursing procedural issues.
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Atlas of Urodynamics
Michael B. Chancellor
By pairing the highest quality images with succinct text, this fully revised atlas explains methods of diagnosis, evaluation and treatment. Detailing how to set up a urodynamic laboratory and discusses equipment and individual urodynamic techniques Illustrating neurologic conditions, looking at the special problems of pediatric and geriatric patients With unique, carefully reproduced urodynamic tracings and scans show you what to expect in the lab The highly regarded author team is led by Dr. Jerry Blaivas, a recognized expert in the field who received the Lifetime Achievement Award from the Society for Urodynamics and Female Urology.
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