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Article ; Online: The Use of Uroflowmetry as a Diagnostic Test.

Sinha, Sanjay

2024 Volume 25, Issue 5, Page(s) 99–107

Abstract: Purpose of review: Uroflowmetry is widely used for initial non-invasive evaluation of lower urinary tract disorders. Current clinical use is mostly restricted to a scrutiny of the maximum flow rate and uroflow pattern recorded by a conventional ... ...

Abstract	Purpose of review: Uroflowmetry is widely used for initial non-invasive evaluation of lower urinary tract disorders. Current clinical use is mostly restricted to a scrutiny of the maximum flow rate and uroflow pattern recorded by a conventional flowmeter in a health care facility. There are several advancements in our understanding and in available technologies that promise to transform clinical utilization of this simple test. Recent findings: Several aspects of the uroflow test in addition to maximum flow rate and uroflow pattern show potential diagnostic utility. This includes flow acceleration, uroflow indices, uroflow-electromyography including lag time, stop uroflow test, and uroflow-based nomograms. There are initial attempts to use artificial intelligence in analysis. There is also new data with regard to factors influencing variability of uroflow testing that might influence the diagnostic value in as yet uncertain ways including diurnal variability, postural variability, locational variability, and operator variability. There are new technologies for uroflow testing in a home environment allowing for easy repetition. However, there are several challenges owing to a paucity of clinical data and standardization. There are also critical lacunae in terminology that need to be addressed. There are exciting new advancements in the field of uroflowmetry. However, there is need to standardize and validate the newer uroflow tracing analyses and technologies.
MeSH term(s)	Humans ; Artificial Intelligence ; Urodynamics ; Urinary Bladder ; Urologic Diseases ; Diagnostic Tests, Routine
Language	English
Publishing date	2024-02-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057354-6
ISSN	1534-6285 ; 1527-2737
ISSN (online)	1534-6285
ISSN	1527-2737
DOI	10.1007/s11934-024-01200-0
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Article ; Online: Follow-up for the upper urinary tract in patients with high-risk neurogenic lower urinary tract dysfunction.

Sinha, Sanjay

World journal of urology

2023 Volume 41, Issue 11, Page(s) 3309–3316

Abstract: Purpose: Patients with neurogenic lower urinary tract dysfunction (nLUTD) can be at risk of preventable damage to the upper urinary tract (UUT), a risk that varies with the underlying diagnosis. Existing literature fails to document precisely which ... ...

Abstract	Purpose: Patients with neurogenic lower urinary tract dysfunction (nLUTD) can be at risk of preventable damage to the upper urinary tract (UUT), a risk that varies with the underlying diagnosis. Existing literature fails to document precisely which domains of UUT must be followed. This review focusses on surveillance of UUT with special emphasis on high-risk nLUTD. Methods: Narrative review of available evidence and current global guidelines to identify patients of nLUTD at higher risk of UUT damage and to define each domain that needs to be followed. Results: Patients with open spina bifida, spinal cord injury, and anorectal malformation, as well as those with unsafe features on clinical evaluation or urodynamics should be considered at high risk. Structured program should include evaluation of (1) glomerular filtration rate (GFR) which can be estimated ± measured, (2) renal growth (in pre-pubertal children) by ultrasonography, (3) renal scarring by baseline nuclear renogram, (4) hydronephrosis and stones by ultrasonography, (5) vesicoureteral reflux by baseline video-urodynamics, (6) non-GFR measures of renal function (somatic growth, hypertension, proteinuria, anemia and metabolic acidemia). Serum creatinine-based estimations of GFR are more likely to be confounded in select patients with high-risk nLUTD than cystatin-based estimations and measured-GFR. Urological guidelines do not always describe details of UUT surveillance and appear to lack cognizance of nephrology guidelines for evaluation of kidneys. Conclusion: A structured surveillance protocol that includes clear documentation of each domain of the UUT is important in ensuring optimum care for patients with high-risk nLUTD.
MeSH term(s)	Child ; Humans ; Urinary Bladder, Neurogenic/complications ; Urinary Bladder, Neurogenic/diagnosis ; Follow-Up Studies ; Urinary Bladder ; Urinary Tract/diagnostic imaging ; Kidney ; Urodynamics
Language	English
Publishing date	2023-09-13
Publishing country	Germany
Document type	Review ; Journal Article
ZDB-ID	380333-8
ISSN	1433-8726 ; 0724-4983
ISSN (online)	1433-8726
ISSN	0724-4983
DOI	10.1007/s00345-023-04602-w
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Zs.A 1832: Show issues

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Article ; Online: Can apparently transient life events trigger long-term lower urinary tract symptoms?

Sinha, Sanjay / Vasudeva, Pawan

Neurourology and urodynamics

2024

Abstract: Introduction: One-time life events such as neurological injury can result in lifelong lower urinary tract symptoms (LUTS). However, it is unclear whether an apparently transient life event can also trigger long-term LUTS. This review examines the ... ...

Abstract	Introduction: One-time life events such as neurological injury can result in lifelong lower urinary tract symptoms (LUTS). However, it is unclear whether an apparently transient life event can also trigger long-term LUTS. This review examines the possibility of an association and hypothesizes the pathogenesis. Methods: A pubmed search was conducted using the MeSH words "life change events," "child abuse," or "stress disorders, Posttraumatic", and LUTS. Additional manuscripts were identified by a hand and citation search. Results: Long-term LUTS was noted following temporally remote childhood sexual abuse, adverse childhood experiences, and stressful experiences in adults. There was evidence for an association of childhood sexual abuse and adverse childhood events with both storage as well as voiding LUTS. There was limited evidence that the number of adverse childhood events might increase the risk and severity of LUTS. There was evidence of an association between post-traumatic stress disorder in adults and LUTS. The finding of mental health disorders in such patients could explain some but not all of the observed association suggesting that other factors might also be important. Conclusions: There is an association noted between apparently transient lifetime events and the subsequent reporting of LUTS. The timing of these adverse experiences might be important in determining the propensity for clinical manifestation. There is a need to explore this association, establish causality, and determine the underlying etiopathogenesis.
Language	English
Publishing date	2024-01-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604904-7
ISSN	1520-6777 ; 0733-2467
ISSN (online)	1520-6777
ISSN	0733-2467
DOI	10.1002/nau.25303
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Article ; Online: Commentary on "Cross-over data supporting long-term antibiotic treatment in patients with painful lower urinary tract symptoms, pyuria, and negative urinalysis".

Sinha, Sanjay

International urogynecology journal

2019 Volume 30, Issue 3, Page(s) 415

MeSH term(s)	Anti-Bacterial Agents ; Humans ; Lower Urinary Tract Symptoms ; Pyuria ; Urinalysis ; Urinary Tract Infections
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2019-02-01
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	1050631-7
ISSN	1433-3023 ; 0937-3462
ISSN (online)	1433-3023
ISSN	0937-3462
DOI	10.1007/s00192-019-03875-3
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Zs.A 3070: Show issues

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Article ; Online: RE: Panicker et al. Do we understand voiding dysfunction in women? Current understanding and future perspectives: ICI-RS 2017.

Sinha, Sanjay

Neurourology and urodynamics

2018 Volume 38, Issue 2, Page(s) 875

MeSH term(s)	Female ; Humans ; Lower Urinary Tract Symptoms ; Urodynamics
Language	English
Publishing date	2018-12-28
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	604904-7
ISSN	1520-6777 ; 0733-2467
ISSN (online)	1520-6777
ISSN	0733-2467
DOI	10.1002/nau.23906
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Article: Gender Equality in Indian Urology.

Sinha, Sanjay / Ganpule, Arvind P

Indian journal of urology : IJU : journal of the Urological Society of India

2022 Volume 38, Issue 2, Page(s) 83–84

Language	English
Publishing date	2022-04-01
Publishing country	India
Document type	Editorial
ZDB-ID	639268-4
ISSN	1998-3824 ; 0970-1591
ISSN (online)	1998-3824
ISSN	0970-1591
DOI	10.4103/iju.iju_80_22
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Article: Follow-up urodynamics in patients with neurogenic bladder.

Sinha, Sanjay

Indian journal of urology : IJU : journal of the Urological Society of India

2017 Volume 33, Issue 4, Page(s) 267–275

Abstract: Introduction: Neurogenic bladder patients are at long-term risk of secondary upper urinary tract damage. Symptoms are unreliable and follow-up urodynamics is the only method of ascertaining safety of bladder pressures. This review examines the ... ...

Abstract	Introduction: Neurogenic bladder patients are at long-term risk of secondary upper urinary tract damage. Symptoms are unreliable and follow-up urodynamics is the only method of ascertaining safety of bladder pressures. This review examines the recommendations, shortcomings and utilization of existing guidelines. The evidence with regard to follow-up urodynamics in different settings relevant to neurogenic bladder is evaluated and an algorithm is proposed. Methods: A pubmed search was conducted for studies on follow-up urodynamics in patients with neurogenic bladder. Additional search was made of secondary sources including reviews and guidelines. Results: The need for follow-up urodynamics should be considered in all patients undergoing an initial assessment and weighed against the risks. Existing guidelines, while unanimous in their recommendation of its utilization, give scant details regarding its incorporation in clinical management. Follow-up urodynamics can document efficacy and identify the need for escalation of therapy in patients on intermittent catheterization and antimuscarinics. Patients with spinal injury, spinal dysraphism and anorectal malformations are at higher risk for upper tract damage. Follow-up urodynamics can help identify patients suitable for intravesical botulinum and mark those destined for failure. Patients undergoing augmentation cystoplasty may be candidates for less aggressive urodynamic follow-up. Conclusions: Neurogenic bladder is managed by a broad cross-section of physicians. Clear recommendations and a management algorithm are important for improving patient care. Follow-up urodynamics can identify patients at risk, prevent renal dysfunction and improve the quality of life. There is an urgent need for more evidence on this important subject.
Language	English
Publishing date	2017-10-02
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	639268-4
ISSN	1998-3824 ; 0970-1591
ISSN (online)	1998-3824
ISSN	0970-1591
DOI	10.4103/iju.IJU_358_16
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Article: Augmentation cystoplasty in children with stages III and IV chronic kidney disease secondary to neurogenic bladder.

Sinha, Sanjay / Shah, Mehul

Asian journal of urology

2021 Volume 9, Issue 3, Page(s) 313–317

Abstract: Objective: This study examines the outcome of augmentation cystoplasty (AC) in children with stages III and IV chronic kidney disease (CKD) secondary to neurogenic bladder in which transplantation was not imminent.: Methods: Hospital records of all ... ...

Abstract	Objective: This study examines the outcome of augmentation cystoplasty (AC) in children with stages III and IV chronic kidney disease (CKD) secondary to neurogenic bladder in which transplantation was not imminent. Methods: Hospital records of all children with CKD stages III and IV who underwent AC between 2008 and 2017 were retrieved to study outcome and complications including estimated glomerular filtration rate (eGFR, National Kidney Foundation Calculator), somatic growth (percentiles, compared with population data), and febrile urinary tract infections (fUTIs) requiring admission. Statistical analysis was performed using R. Results: AC was performed in 13 children with CKD stages III and IV (10 girls; median 8.0 years) with median follow-up of 51 months. Patients had incontinence (10/13), reflux (7/13), and hydronephrosis (13/13) despite antimuscarinics and intermittent catheterization. Bladder capacity was 74% of expected and median compliance was 5 mL/cm H Conclusion: AC carries acceptable morbidity in children with CKD stages III and IV secondary to neurogenic bladder. Surgery is effective with improvements in continence, eGFR, somatic growth, and propensity for fUTIs. Ureteric re-implantation might not be necessary.
Language	English
Publishing date	2021-06-01
Publishing country	Singapore
Document type	Journal Article
ZDB-ID	2831144-9
ISSN	2214-3882
ISSN	2214-3882
DOI	10.1016/j.ajur.2021.05.010
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Article ; Online: Management Modalities of Primary Bladder Neck Obstruction in Young Adult Men: A Systematic Review and Meta-analysis.

Mitta, Ankur / Singh, Gurpremjit / Kumar Panwar, Vikas / Sinha, Sanjay / Kumar Mandal, Arup

Urology research & practice

2024 Volume 50, Issue 1, Page(s) 25–35

Abstract: Objective: This systematic review was done to critically appraise the various evidence available in the literature for the presenting symptoms, diagnosis, and management modalities for primary bladder neck obstruction diagnosed on invasive urodynamics ... ...

Abstract	Objective: This systematic review was done to critically appraise the various evidence available in the literature for the presenting symptoms, diagnosis, and management modalities for primary bladder neck obstruction diagnosed on invasive urodynamics in young adult men 18-50 years of age. Methods: A search was conducted on PubMed, Embase, and Cochrane Central Register of Controlled Trials databases until July 2022 to find English-language studies relevant to the topic. Results: A total of 10 studies were included. The estimated difference in International Prostate Symptom Score between baseline and 3 months in the subgroup of medical and surgical treatment was found to be -8.82 and -11.25, respectively (P = .37), and after 12 months, it was found to be -7.69 and -17.70 respectively (P .001). The pooled estimate for the difference in Qmax between baseline and 3 months after medical and surgical treatments in the subgroup was found to be 2.92 and 7.03, respectively (P = .18), and after 12 months, it was found to be 4.54 and 7.74, respectively (P .001). The pooled estimate of the difference in post-void residue before and after 3 months of medical and surgical treatments in a subgroup was found to be -31.15 and -70, respectively (P .001), and after 12 months, it was found to be -31.49 and -156.00, respectively (P .001). Quality of life scores improved in both subgroups. Conclusion: The alpha-blockers are effective in managing primary bladder neck obstruction in the short term, while bladder neck incision is preferred for better longterm outcomes.
Language	English
Publishing date	2024-03-07
Publishing country	Turkey
Document type	Journal Article
ISSN	2980-1478
ISSN (online)	2980-1478
DOI	10.5152/tud.2024.23155
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Article: Understanding genomic medicine for thoracic aortic disease through the lens of induced pluripotent stem cells.

Singh, Aminder A / Shetty, Deeti K / Jacob, Aishwarya G / Bayraktar, Semih / Sinha, Sanjay

Frontiers in cardiovascular medicine

2024 Volume 11, Page(s) 1349548

Abstract: Thoracic aortic disease (TAD) is often silent until a life-threatening complication occurs. However, genetic information can inform both identification and treatment at an early stage. Indeed, a diagnosis is important for personalised surveillance and ... ...

Abstract	Thoracic aortic disease (TAD) is often silent until a life-threatening complication occurs. However, genetic information can inform both identification and treatment at an early stage. Indeed, a diagnosis is important for personalised surveillance and intervention plans, as well as cascade screening of family members. Currently, only 20% of heritable TAD patients have a causative mutation identified and, consequently, further advances in genetic coverage are required to define the remaining molecular landscape. The rapid expansion of next generation sequencing technologies is providing a huge resource of genetic data, but a critical issue remains in functionally validating these findings. Induced pluripotent stem cells (iPSCs) are patient-derived, reprogrammed cell lines which allow mechanistic insights, complex modelling of genetic disease and a platform to study aortic genetic variants. This review will address the need for iPSCs as a frontline diagnostic tool to evaluate variants identified by genomic discovery studies and explore their evolving role in biological insight through to drug discovery.
Language	English
Publishing date	2024-02-19
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2024.1349548
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