In the authors’ opinion, the response may be related to hypothalamicpituitary axis activation secondary to stress, resulting in a functional impact on the end organ. Similar effects on the gastrointestinal system, in accordance with those previously reported, suggested that this response may be initiated centrally. Although this study did not review pain or urgency, it made an advancing step in understanding the pathophysiology of these complex disorders. Risk Factors of De Novo OAB and Stress Incontinence After Urethral Diverticulectomy The most recognized complications after surgical

removal of urethral Inhibitors,research,lifescience,medical diverticulum are diverticula recurrence, urethrovaginal fistula, and de novo urinary incontinence. The incidence of de novo urinary incontinence is reported in the literature to occur in 1.7% to 20.3% of patients, but only a few research papers debate whether it is required to perform a preventive surgery in those patients at risk. In this study, Dr. Young-Ho Kim7 and colleagues from the Department of Urology, SCH Inhibitors,research,lifescience,medical University Bucheon Hospital (Bucheon, South Korea) assessed risk factors related to de novo stress urinary incontinence (SUI) and OAB by retrospective review of past history, and findings of pelvic magnetic resonance (MR) imaging of patients with urethral Inhibitors,research,lifescience,medical diverticulum. The method consisted of reviewing the 28 patients who underwent surgical removal

of urethral diverticulum between 2002 and 2007 regarding medical history, physical examination, pelvic MR imaging, Inhibitors,research,lifescience,medical changes of voiding 5-HT Receptor inhibitor symptoms (by Bristol female lower urinary tract symptoms), and occurrence of SUI. The authors also analyzed risk factors of OAB and SUI including age, body mass index (BMI), number of deliveries, size and location of diverticulum, and history of pelvic surgery. Mean

age of patients was 38 (range, 20 to 59 years). OAB was present before surgery in 4 patients and occurred afterward in another 5 patients (20.8%). De novo SUI occurred in 4 of 28 patients (14.3%) after surgical procedure- one of them having both SUI and OAB. Age, BMI, number of deliveries, and history of pelvic surgery did not statistically relate to occurrence Inhibitors,research,lifescience,medical of SUI or OAB. The authors found a relationship between diverticulum size and position and de novo SUI or OAB. SUI occurred in 3 and OAB in 5 out of the 7 patients with diverticulum > 3 cm. Among 11 patients with diverticulum located in proximal urethra, SUI occurred in 4 patients and OAB in 5 patients. In patients with urethral diverticulum > 3 cm Thalidomide in diameter and located in proximal urethra on pelvic MR imaging, incidence of SUI and OAB was significantly higher. The authors reported that 3 out of 28 patients had a large defect of urethra after removal of urethral diverticulum or weakened periurethral fascia by repeated inflammation and simultaneously underwent Martius labial fat pad interposition. None of them complained about any symptom of SUI or OAB after surgery.