Comments on: What causes problems with the lower urinary tract?

By: Eugene Goh

Eugene Goh — Thu, 23 Nov 2023 06:58:57 +0000

In reply to Cindy Amundsen. Thank you very much Dr Cindy ! I hope there will be a breakthrough in the next few years with clinically proven results which will change and bring back the basic quality of life for my of the patients like me having to live with this condition with unknown causes. I am also wondering if these are some post covid or vaccine effects which created the issues.

By: Cindy Amundsen

Cindy Amundsen — Mon, 20 Nov 2023 23:09:57 +0000

In reply to EUGENE GOH. Hello Eugene, I am sorry to hear about your UAB condition. Although no obvious myogenic or neurogenic cause can be attributed to the etiology of your UAB, loss of the ability of the bladder to contract well is the focus of ongoing research. As you can see in my article, research with biomedical engineers who can develop various forms of stimulators may result in the ability to stimulate directly the nerves in the urethra and/or bladder resulting in improved function of the underactive bladder. I agree current medications such as the one you are on only try and relax the urethral muscles so that an underactive bladder muscle might be able to empty better. As you mention, the medications are suboptimal and likely neurostimulation will be the answer in the future.

By: EUGENE GOH

EUGENE GOH — Sun, 19 Nov 2023 03:31:27 +0000

Hi Cindy and team, I am a patient suffering from underactive bladder. Did a whole lot of MRI and CT Scans for the past 8 months since diagnosed through urodynamics procedure in May 2023. The causes are not neurogenic or myogenic. It is classified as idiopathic. No medical procedure nor medication which can reverse the issue except that I was given Tamsulosin by the urologist to help manage the symptoms daily. It does affect the basic quality of life both mentally and emotionally. Very unfortunately, UAB is not very well researched or spoken about in the medical world after I read up so much about the chronic condition. I was wondering if there are any new advances or proven medication in treating or improving this condition. If only there was a breakthrough innovation in this area, it will probaby relieve and save hundreds of millions of patients suffering in silence when diagnosed early. Thanks !

By: Cindy Amundsen

Cindy Amundsen — Tue, 31 Oct 2023 13:51:30 +0000

Hi Nancy,
Here are a few articles. One is a review articles discussing vaginal estrogen use, another a cochrane review comparing vaginal estrogen and systemic estrogen as they relate to treating LUT symptoms, and the other a randomized trial comparing a medication for OAB vs. vaginal estradiol. I hope this helps. There are papers on the benefits for preventing recurrent urinary tract infections with the use of vaginal estrogen and how the urogenital microbiome changes/improves with vaginal estrogen use. Relationships are being made between a “healthy” microbiome and bladder function and it is thought that estrogen plays a role.

Shifren.Jan. Genitourinary Syndrome of menopause. Clinical Obstetrics and Gynecology. September 2018. 61 (3): p 508-516.

Cody June, Jacobs Madeleine Louisa, Richardson Karen, et al. Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev. 2012 Oct 17;10(10).CD001405.
doi: 10.1002/14651858.CD001405.pub3.

Ellington DR, Szychowski JM, Malek JM, Gerten KA, Burgio KL, Richter HE. Combined Tolterodine and Vaginal Estradiol Cream for Overactive Bladder Symptoms After Randomized Single-Therapy Treatment. Female Pelvic Med Reconstr Surg. 2016 Jul-Aug;22(4):254-60.

By: Nancy Frazier Anderson

Nancy Frazier Anderson — Fri, 27 Oct 2023 19:49:37 +0000

Cindy: Can you supply any research papers that deal with minumum LUTD and treatment with Estradiol for elderly women?

Thanks for any references.