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Michel KF, Rangnekar AN, Slinger M, Gan ZS, Smith AL. Association of Smoking Status and Pack Year History With Urinary Urgency Symptoms. Neurourol Urodyn 2024. [PMID: 39268788 DOI: 10.1002/nau.25587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/30/2024] [Accepted: 08/28/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND AND OBJECTIVES Overactive bladder and its hallmark symptom, urgency, are thought to be multifactorial in pathogenesis. Smoking is a particularly important risk factor to understand because it is modifiable; studies evaluating an association between smoking and urgency have been inconclusive. We therefore sought to rigorously assess the relationship between smoking and urgency in terms of both a temporal and quantitative pack year history of smoking while controlling for other possible confounding factors. METHODS Community-based adult women were recruited using the ResearchMatch website to participate in an online survey of bladder health which included questions to assess urgency symptoms, medical comorbidities, and detailed smoking history. Smoking history was studied as the independent variable in three different formulations: smoking status (never vs. former vs. current), continuous pack year history, and categorical pack year history. The outcomes studied included urgency (any urgency in the past 7 days), moderate urgency (urgency at least half the time), and urgency urinary incontinence (UUI). Chi-square tests were performed to detect associations between smoking and these outcomes, and multivariate regression was then performed to control for possible confounders and to help determine the comparative influence of temporality versus quantity of smoking history. RESULTS In 1720 women who completed the questionnaire, current smoking status was associated with a 23% increase in the risk of experiencing urgency (RR 1.23) and a 78% increase in the risk of experiencing moderate urgency (RR 1.78) relative to never smokers. The risk of experiencing UUI was 40% higher (RR 1.40). Lifetime pack year history was also significantly associated with urgency outcomes, although only in smokers/former smokers who had a 20+ pack year history (RR 1.15, 1.60, and 1.25 for urgency, moderate urgency, and UUI, respectively). The presence of former smoking history was not significantly associated with urgency outcomes, even when controlling for cumulative pack years. CONCLUSIONS This analysis of a large cross-sectional database of women suggests a strong, consistent link between current smoking status and urinary urgency and UUI. By contrast, no increased risk of urgency was attributed to former smoking status. Analysis of pack year history suggests a dose-response relationship wherein ≥ 20 pack years was significantly associated with a higher risk of all urgency outcomes. In models controlling for pack year history, the association of current smoking with urgency remained significant and former smoking remained nonsignificant. Taken together, this supports greater attention being given to the contribution of current smoking to urgency symptoms, and to the need for further longitudinal work to determine if smoking cessation can be a strategy to treat urgency.
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Affiliation(s)
- Katharine F Michel
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Avanti N Rangnekar
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michelle Slinger
- Drexel University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Zoe S Gan
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ariana L Smith
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Qudah S, Abufaraj M, Farah R, Almazeedi A, Ababneh A, Alnabulsi M, Qatawneh A, Hyassat D, Ajlouni K. The prevalence of overactive bladder and its impact on the quality of life: A cross-sectional study. Arab J Urol 2023; 22:39-47. [PMID: 38205386 PMCID: PMC10776079 DOI: 10.1080/2090598x.2023.2221403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/30/2023] [Indexed: 01/12/2024] Open
Abstract
Objective Overactive bladder (OAB) is a common condition affecting both men and women and has been shown to affect the quality of life. We conducted this study to estimate the prevalence of OAB, and to incorporate symptom severity, symptom bother and health-related quality of life (HRQL) in the assessment of OAB and evaluate associated factors. Methodology A total of 940 participants were categorized into non-OAB and OAB using the Overactive Bladder Symptom Score (OABSS). HRQL and symptom bother were measured using the Overactive Bladder Questionnaire - Short Form (OAB-q SF). Descriptive analyses and multivariable regression analyses were performed. Results The prevalence of OAB among our population was 27.4%. Patients with older age (Odd ratio [OR] = 2.26, 95% confidence interval [CI]: 1.6-3), higher body mass index (BMI) (OR = 2.6, 95% CI: 1.8-3.8), comorbidities (OR = 2.6, 95% CI: 1.9-3.5) and history of recurrent urinary tract infection (UTI) s (OR = 1.9, 95% CI: 1.4-2.6) were significantly associated with increased risk of OAB (p < 0.001). The mean OAB symptom bothers score was 35.7 + 22.9 and increased significantly across OAB severity groups (p < 0.001). The mean HRQL score was 73.3 + 22 and a significant decreased across OAB severity groups (p < 0.001). All OAB symptoms showed significant positive correlation with increased symptom bother (p < 0.001) in addition to significant inverse correlation with HRQL (p < 0.001). Conclusion OAB is a prevalent condition in our population and the associated symptoms negatively affect HRQL. In this study, the detrimental effect is not exclusive to UUI and can be attributed to the other elements in the symptom spectrum of OAB. Screening for OAB should be considered during routine clinical visits using validated and reliable measures for early detection of symptoms and possible modification of risk factors to improve the outcome.
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Affiliation(s)
- Shrouq Qudah
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Mohammad Abufaraj
- Division of Urology, Department of Special Surgery, Jordan University Hospital, Amman, Jordan
| | - Randa Farah
- Department of Internal Medicine, School of Medicine, Jordan University Hospital, Amman, Jordan
| | | | - Ali Ababneh
- Division of Urology, Department of Special Surgery, Jordan University Hospital, Amman, Jordan
| | - Mazen Alnabulsi
- Division of Urology, Department of Special Surgery, Jordan University Hospital, Amman, Jordan
| | - Ayman Qatawneh
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Dana Hyassat
- The National Center for Diabetes, Endocrinology and Genetic (NCDEG)/The University of Jordan, Amman, Jordan
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology and Genetic (NCDEG)/The University of Jordan, Amman, Jordan
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Microhematuria in Women Presenting for Overactive Bladder. Curr Urol Rep 2023; 24:25-32. [PMID: 36445613 DOI: 10.1007/s11934-022-01128-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW Microscopic hematuria and overactive bladder are two common urologic conditions. The objective of this review is to provide an overview of current literature as well as highlight important guidelines that will aid physicians in the diagnostic workup of microscopic hematuria in patients experiencing symptoms of overactive bladder. RECENT FINDINGS Updated microscopic hematuria guidelines provide a structured and appropriate workup for women based on risk factors, which stratifies patients to prevent unnecessary procedures and imaging. Women presenting with microscopic hematuria in the setting of overactive bladder should undergo microscopic hematuria workup according to their risk stratification while receiving appropriate treatment for their overactive bladder. The physician should consider the presence of irritative voiding symptoms during the investigation and management of microscopic hematuria in patients with overactive bladder and should not delay overactive bladder treatment due to the presence of microscopic hematuria.
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Efficacy and safety of skin-adhesive low-level light therapy for overactive bladder: a Phase III study. Int Urogynecol J 2022; 33:3573-3580. [PMID: 35389054 PMCID: PMC9666307 DOI: 10.1007/s00192-022-05153-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/18/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Overactive bladder (OAB) is a common condition that remains challenging to treat. We hypothesized that skin-adhesive low-level light therapy (LLLT) would be an effective treatment for OAB caused by bladder muscle contraction. Accordingly, we aimed to evaluate the efficacy and safety of an LLLT device for the treatment of OAB. METHODS This prospective, randomized, double-blind, placebo-controlled, multicenter trial included patients with a clinical diagnosis of OAB who were treated at either of two university hospitals. Patients were instructed to apply an LLLT device (Color DNA-WSF) or a sham device at home three times daily for 12 weeks. The primary outcome was the change in the mean daily number of urge urinary incontinence (UUI) episodes between baseline and 12 weeks. The secondary outcomes were the mean changes in incontinence, voiding, and nocturia episodes from baseline and the likelihood of achieving a > 50% reduction in UUI and incontinence episodes after 12 weeks. All patients completed the Overactive Bladder Symptom Score (OABSS), Urogenital Distress Inventory-6 (UDI-6), and Impact Urinary Incontinence-7 (IIQ-7) questionnaires. Safety parameters included treatment-emergent adverse events. RESULTS Compared with those in the sham group, the numbers of UUI and urinary incontinence episodes in the LLLT group were significantly decreased at week 12 (UUI, (-1.0 ± 1.7 vs. -0.4 ± 2.5, P = 0.003; urinary incontinence, -1.1 ± 1.9 vs. -0.5 ± 2.9, P=0.002). Furthermore, the OABSS, UDI-6, and IIQ-7 scores at week 12 tended to be better in the LLLT group than in the sham group. The incidence of device-related treatment-emergent adverse events was similar between groups. CONCLUSIONS LLLT may be clinically useful and safe for the treatment of OAB.
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Onur R, Bayrak Ö, Coşkun B, Tahra A, Ocakoglu G, Buyuran G, Mega E, Gungor Ugurlucan F, Ozturk GB. Clinical preferences and treatment attitudes among urologists, gynecologists, and geriatricians: An independent online questionnaire survey for comparison of treatment choices in the management of overactive bladder. Neurourol Urodyn 2022; 41:1914-1923. [DOI: 10.1002/nau.25050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/30/2022] [Accepted: 09/08/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Rahmi Onur
- Department of Urology, School of Medicine Marmara University Istanbul Turkey
| | - Ömer Bayrak
- Department of Urology, School of Medicine Gaziantep University Gaziantep Turkey
| | - Burhan Coşkun
- Department of Urology, School of Medicine Uludag University Bursa Turkey
| | - Ahmet Tahra
- Department of Urology, School of Medicine Istanbul Medeniyet University Istanbul Turkey
| | - Gokhan Ocakoglu
- Department of Bioistatistic, School of Medicine Uludag University Bursa Turkey
| | - Gorkem Buyuran
- Department of Urology, School of Medicine Gaziantep University Gaziantep Turkey
| | - Ertunc Mega
- Department of Gynecology and Obstetrics Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital Istanbul Turkey
| | - Funda Gungor Ugurlucan
- Department of Obstetrics and Gynecology, Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
| | - Gulistan Bahat Ozturk
- Department of Geriatrics, Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
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Goldberg N, Tamam S, Weintraub AY. The association between overactive bladder and fibromyalgia: A systematic review and meta-analysis. Int J Gynaecol Obstet 2022; 159:630-641. [PMID: 35641437 DOI: 10.1002/ijgo.14290] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/09/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Overactive bladder is a common syndrome that significantly affects the quality of life. Fibromyalgia is characterized by widespread pain, impacting patients' lives. The exact mechanisms of the two syndromes remain unknown, but there is an overlap between the suspected pathophysiologies. OBJECTIVE To present an overview of the current research on the association between overactive bladder (OAB) and fibromyalgia. SEARCH STRATEGY A systematic search of four electronic databases was conducted. SEARCH STRATEGY Studies examining the correlation between OAB and fibromyalgia with female patients aged over 18 years were included. DATA COLLECTION AND ANALYSIS Two reviewers screened the studies for eligibility. Eligible studies were screened for quality. A meta-analysis was performed for eligible studies. MAIN RESULTS Seven studies were included in the final review, of which six presented a positive association between the syndromes. The studies demonstrated a positive association between fibromyalgia and the severity of OAB and an adverse effect on the quality of life related to OAB. A mean effect size of 1.96 (95% confidence interval 0.85-3.06) was calculated. CONCLUSION OAB and fibromyalgia are both complex and multifactorial syndromes. The study presents an association between them, but additional studies on the topic should be conducted for a more precise conclusion.
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Affiliation(s)
- Nitzan Goldberg
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Shai Tamam
- Library of Life Sciences and Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Y Weintraub
- Faculty of Health Sciences, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Chen YC, Liang YC, Ho SJ, Chen HW, Juan YS, Tsai WC, Huang SP, Lee JT, Liu YP, Kao CY, Lin YK, Long CY, Wu MN, Chen CJ, Wu WJ. Does COVID-19 Vaccination Cause Storage Lower Urinary Tract Symptoms? J Clin Med 2022; 11:jcm11102736. [PMID: 35628863 PMCID: PMC9148126 DOI: 10.3390/jcm11102736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 01/27/2023] Open
Abstract
We investigated the storage lower urinary tract symptoms (LUTS) before and after the first dose of coronavirus disease 2019 (COVID-19) vaccine and the association between pre-vaccinated overactive bladder (OAB) and the worsening of storage LUTS following COVID-19 vaccination. This cross-sectional study in a third-level hospital in Taiwan used the validated pre- and post-vaccinated Overactive Bladder Symptom Score (OABSS). Diagnosis of OAB was made using pre-vaccinated OABSS. The deterioration of storage LUTS was assessed as the increased score of OABSS following vaccination. Of 889 subjects, up to 13.4% experienced worsened storage LUTS after vaccination. OAB was significantly associated with an increased risk of worsening urinary urgency (p = 0.030), frequency (p = 0.027), and seeking medical assistance due to urinary adverse events (p < 0.001) after vaccination. The OAB group faced significantly greater changes in OABSS-urgency (p = 0.003), OABSS-frequency (p = 0.025), and total OABSS (p = 0.014) after vaccination compared to those observed in the non-OAB group. Multivariate regression revealed that pre-vaccinated OAB (p = 0.003) was a risk for the deterioration of storage LUTS. In conclusion, storage LUTS may deteriorate after vaccination. OAB was significantly associated with higher risk and greater changes in worsening storage LUTS. Storage LUTS should be closely monitored after COVID-19 vaccination, especially in those OAB patients.
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Affiliation(s)
- Yu-Chen Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yin-Chi Liang
- School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Shuo-Jung Ho
- School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Hao-Wei Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
| | - Yung-Shun Juan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Wei-Chung Tsai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan
- Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Shu-Pin Huang
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Jung-Ting Lee
- Si Wan College, National Sun-Yat Sen University, Kaohsiung 80424, Taiwan
| | - Yu-Peng Liu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chung-Yao Kao
- Department of Electrical Engineering, National Sun-Yat Sen University, Kaohsiung 80424, Taiwan
| | - Yen-Ko Lin
- Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Medical Humanities and Education, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Cheng-Yu Long
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Meng-Ni Wu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chao-Ju Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Wen-Jeng Wu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Senel C, Kizilay YO, Turan K, Ongun S, Tuzel E. Does total knee arthroplasty affect overactive bladder symptoms in female patients? Int Urogynecol J 2022; 33:939-945. [PMID: 35212786 DOI: 10.1007/s00192-022-05121-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/03/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND HYPOTHESIS In the current study we hypothesized that total knee arthroplasty might improve the overactive bladder symptoms by providing pain relief and improving physical function. METHODS One hundred patients who underwent total knee arthroplasty were preoperatively evaluated for overactive bladder and 47 patients that met inclusion criteria were included in this study. All the patients included in the study were assessed both preoperatively and at the 3rd month postoperatively using the Overactive Bladder-Validated 8 (OAB-V8) questionnaire for overactive bladder symptoms, the Oxford Knee Score (OKS) for pain and physical function, and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity. RESULTS The mean age of the patients was 65.4 ± 7 (56-83) years. The OAB-V8, OKS and IPAQ-SF scores significantly improved at the 3rd month postoperatively compared with the initial assessment. All the OAB-V8 domains, namely, frequency, urgency, nocturia, and urgency urinary incontinence, significantly improved following total knee arthroplasty. CONCLUSIONS Our results showed that following total knee arthroplasty, overactive bladder questionnaire scores significantly improved at the 3rd month postoperatively.
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Affiliation(s)
- Cagdas Senel
- Department of Urology, Balikesir University School of Medicine, Balikesir, Turkey.
| | - Yusuf Onur Kizilay
- Department of Orthopedics and Traumatology, Atlas University School of Medicine, Istanbul, Turkey
| | - Kayhan Turan
- Department of Orthopedics and Traumatology, Atlas University School of Medicine, Istanbul, Turkey
| | - Sakir Ongun
- Department of Urology, Balikesir University School of Medicine, Balikesir, Turkey
| | - Emre Tuzel
- Department of Urology, Balikesir University School of Medicine, Balikesir, Turkey
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Staack A, Distelberg B, Moldovan C, Belay RE, Sabaté J. The Impact of Caffeine Intake on Mental Health Symptoms in Postmenopausal Females with Overactive Bladder Symptoms: A Randomized, Double-Blind, Placebo-Controlled Trial. J Womens Health (Larchmt) 2022; 31:819-825. [PMID: 35363563 DOI: 10.1089/jwh.2021.0467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Caffeine has been associated with a dose-dependent variety of mental health changes, which have been found to precede or be a complication of overactive bladder (OAB) symptoms after menopause. The current study examines the effects of low and moderate caffeine intake on anxiety, depression, sleep, and stress in postmenopausal females with OAB. Materials and Methods: Eighty-one females were randomized in a prospective, double-blind, placebo-controlled study. Participants were allocated to 200 mg/day caffeine, 400 mg/day caffeine, and placebo capsules for 1 week each in a crossover design and evaluated using validated mental health questionnaires. Symptoms during each treatment phase were measured using Beck Anxiety and Depression Inventory, Insomnia Severity Index, and Perceived Stress Scale. Linear regression models were used to examine the impact of low (200 mg/day) and moderate (400 mg/day) dose of caffeine and placebo on mental health. Results: Fifty-six female participants finished the study. The mean age was 69.2 years (58.0-84.0 years). Two females dropped out during the treatment phase with 400 mg/day caffeine intake due to side effects associated with headaches and nausea. Moderate dose of caffeine showed a small positive effect on mental health, specifically a decrease in anxiety during 7 days of exposure (p < 0.05). Conclusions: Moderate caffeine use may decrease anxiety in postmenopausal patients with underlying OAB, whereas depression, insomnia, and perceived stress were not affected by low-to-moderate caffeine intake. Our results support that counseling efforts on moderate caffeine consumption in postmenopausal patients underline that low-to moderate caffeine intake may be appropriate and possibly beneficial unless contraindicated due to other underlying conditions. Clinical Trials Registration: clinicaltrials.gov (NCT02180048).
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Affiliation(s)
- Andrea Staack
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - Brian Distelberg
- Department of Counseling and Family Sciences, School of Behavioral Health, Loma Linda University, Loma Linda, California, USA
| | | | - Ruth E Belay
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - Joan Sabaté
- Department of Nutrition, School of Public Health, Loma Linda University, Loma Linda, California, USA
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Prevalence of and Associated Factors for Overactive Bladder Subtypes in Middle-Aged Women: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030383. [PMID: 35334559 PMCID: PMC8950349 DOI: 10.3390/medicina58030383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/17/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
Abstract
Background and Objectives: The living environment can manifest physiological responses in humans, with cohabiting couples often having similar health statuses. The aim of this study was to (1) examine the prevalence of the overactive bladder (OAB) with or without incontinence and (2) identify associated factors for OAB with and without incontinence (including environmental factors, such as living with a partner who has OAB) in middle-aged women. Materials and Methods: In this cross-sectional study, the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OBA) was administered to 970 couples. Data were analyzed using descriptive statistics, chi-square analyses, and multivariate logistic regression. Results: Responses to the ICIQ-OBA among middle-aged women generated a higher prevalence of OAB with incontinence (OABwet; 41%) than OAB without incontinence (OABdry; 26%; p < 0.001). The factors associated with OABwet were as follows: being age ≥ 55 years (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.02−1.95), having a body mass index (BMI) ≥ 27 kg/m2 (OR, 1.50; 95% CI, 1.03−2.17), having vaginitis (OR, 1.89; 95% CI, 1.28−2.80), and having partners with OABwet (OR, 2.35; 95% CI, 1.74−3.19). Having partners with OABdry (OR, 1.81; 95% CI, 1.34−2.44) was an associated factor for OABdry. Conclusions: This study identified the associated factors for OAB subtypes (OABwet and OABdry) in middle-aged women. These findings can support treatment and preventive strategies for health providers who care for patients with OAB. As part of the treatment and preventative strategies, the risk that partners may introduce to the development of OAB in women should also be considered.
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Guzelsoy M, Gunes A, Coban S, Turkoglu AR, Onen E, Ocakoglu G, Karadag M. Frequency of overactive bladder (OAB) and the factors affecting it in patients with obstructive sleep apnea syndrome (OSAS). Urologia 2022; 90:58-67. [PMID: 35188003 DOI: 10.1177/03915603221078263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate the prevalence of overactive bladder (OAB) in patients with obstructive sleep apnea syndrome (OSAS) and the factors affecting it. MATERIALS AND METHODS A total of 255 patients were included in this prospectively designed study. Among all patients, 166 were male, 89 were female; 213 patients were married and 42 were single. All patients underwent polysomnography. All patients completed the OAB-V8 form. OSAS was diagnosed via polysomnography. OAB was diagnosed via OABV8. The participants were evaluated as patients with and without OAB and those with and without OSAS. SPSS for Windows version 18.0 software was used for the statistical analysis and the level of significance was set at α = 0.05. RESULTS The prevalence of OAB was high among the OSAS patients (66.3%, n = 136). Age, body mass index, waist circumference, marital status, oxygen desaturation index (ODI4) ⩾4%, apneahypopnea index (AHI), the number and duration of decreases in O2 saturation below 90%, wake after sleep onset (WASO) duration, and groups, and OSAS severity were different in the OAB group (p < 0.05). Duration and number of O2 saturation <90%, and ODI4 are higher in the OSAS group and OAB group (p < 0.05). In multivariate logistic regression analysis, AHI, WASO, age, and marital status were the factors influencing OAB. CONCLUSION OAB is seen at a high rate in OSAS patients. Hypoxia is the main basis for both diseases and probably it is the common pathway. AHI, WASO, age, and marital status can provide valuable information to physicians for predicting OAB.
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Affiliation(s)
- Muhammet Guzelsoy
- Department of Urology, Bursa Yuksek Ihtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Aygul Gunes
- Department of Neurology, Bursa Yuksek Ihtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Soner Coban
- Department of Urology, Bursa Yuksek Ihtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Ali Riza Turkoglu
- Department of Urology, Bursa Yuksek Ihtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Efe Onen
- Department of Urology, Bursa Yuksek Ihtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Gokhan Ocakoglu
- Department of Biostatistics, Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Mehmet Karadag
- Department of Pulmonary Diseases, Uludag University, Faculty of Medicine, Bursa, Turkey
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Hajjar R, Tsolakian I, Chaaya M, Daher A, Bazi T. Overactive bladder syndrome in nulliparous female university students: prevalence and risk factors including waterpipe smoking. Int Urogynecol J 2021; 33:1207-1223. [PMID: 34825923 DOI: 10.1007/s00192-021-05004-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/17/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objective was to assess the prevalence of symptoms of overactive bladder syndrome (OAB) among healthy nulliparous female university students, and to evaluate the correlation of these symptoms with a variety of factors, including waterpipe (WP) smoking. METHODS This is a cross-sectional study. A questionnaire was administered to evaluate symptoms of OAB in healthy nulliparous female university students. Variables assessed included body mass index (BMI), cigarette smoking, WP smoking, consumption of alcohol, coffee, and tea with and without artificial sweeteners, soft drinks, and energy drinks. Adjusted odds ratio were calculated to determine the correlation of these variables with OAB symptoms. RESULTS A total of 767 out of 2,900 females responded to the questionnaire. Bothersome frequency was reported in 32.3%, and nocturia in 47.5% of the women. Urgency and urgency urinary incontinence (UUI) were present in 25.5 and 24.7% of the study participants respectively. Urgency was associated with WP smoking (p value 0.048). Bothersome frequency was associated with artificial sweeteners used with coffee and tea (p value 0.013). UUI was associated with cigarette smoking (p value 0.034) and elevated BMI (p value < 0.001). OAB symptoms were not found to be significantly associated with soft drink and energy drink consumption. A lower prevalence of nocturia (p value 0.009) and urgency was associated with alcohol consumption (p value 0.017). More than two-thirds (69.2%) of WP smokers expressed readiness to decrease WP smoking if this would improve their lower urinary tract symptoms (LUTS). CONCLUSION Overactive bladder is common in healthy young nulliparous women and is associated with multiple risk factors, including WP smoking.
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Affiliation(s)
- Rima Hajjar
- Department of Obstetrics and Gynecology, American University in Beirut-Medical Center, PO Box 11-0236, Beirut, Riad El Solh, 1107 2020, Lebanon
| | - Ibrahim Tsolakian
- Department of Obstetrics and Gynecology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Monique Chaaya
- Department of Epidemiology and Population Health, Stanford, CA, USA
| | - Alaa Daher
- Department of Obstetrics and Gynecology, American University in Beirut-Medical Center, PO Box 11-0236, Beirut, Riad El Solh, 1107 2020, Lebanon
| | - Tony Bazi
- Department of Obstetrics and Gynecology, American University in Beirut-Medical Center, PO Box 11-0236, Beirut, Riad El Solh, 1107 2020, Lebanon.
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Validation of the Croatian Version of the 8-Item Overactive Bladder Questionnaire (OAB-V8). Female Pelvic Med Reconstr Surg 2021; 27:e687-e690. [PMID: 34534199 DOI: 10.1097/spv.0000000000001098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The present study was conducted with the aim to translate, adapt, and validate the 8-item Overactive Bladder Questionnaire (OAB-V8) in Croatia. METHODS This study included a total of 58 female patients with OAB and 66 healthy women. The translation to Croatian followed standardized procedure. All eligible participants completed OAB-V8 at inclusion and 2 weeks after to assess test-retest reliability. Cronbach α coefficient was calculated to assess internal consistency. RESULTS Our study demonstrated high internal consistency for all items at both visits (Cronbach α between 0.799 and 0.847), with stable internal consistency reliability across items during the 2-week period. However, the exception is the item "waking up at night to urinate," which significantly changed during the 2-week period. Intraclass correlation for OAB-V8 items ranged from 0.810 to 1.0, with Spearman correlations greater than 0.9 for all items (P < 0.01). There were strong significant correlations between frequency of urination during daytime and uncomfortable and sudden urge to urinate, and between nocturia and waking up at night. Discriminative validity showed statistically significant score differences between patients and the control group. CONCLUSIONS The Croatian version of the OAB-V8 was successfully translated, adapted, and validated so the questionnaire is now ready for use as a reliable tool for initial screening and assessing patients with OAB in everyday Croatian clinical practice.
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Gonzalez DC, Khorsandi S, Mathew M, Enemchukwu E, Syan R. A Systematic Review of Racial/Ethnic Disparities in Female Pelvic Floor Disorders. Urology 2021; 163:8-15. [PMID: 34627869 DOI: 10.1016/j.urology.2021.09.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/16/2021] [Accepted: 09/19/2021] [Indexed: 11/24/2022]
Abstract
Numerous studies have investigated the influence of health disparities among women with pelvic floor disorders with varied results. Racial/ethnic disparities, in particular, inconsistently indicate differences in prevalence of disease, disease severity, and treatment outcomes. We aim to review the body of literature examining racial/ethnic disparities in pelvic floor disorders, including overactive bladder, stress urinary incontinence, pelvic organ prolapse, and interstitial cystitis. A better understanding of these disparities may help guide clinicians, researchers, and advocates in providing improved education, outreach opportunities, and access to care in minority women with pelvic floor disorders.
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Affiliation(s)
- Daniel C Gonzalez
- Department of Urology, Division of Female Urology, University of Miami, Miami, FL
| | - Shayan Khorsandi
- Department of Obstetrics and Gynecology, Division of Urogynecology, Stanford University, School of Medicine, Stanford, CA
| | - Megan Mathew
- Department of Urology, Division of Female Urology, University of Miami, Miami, FL
| | - Ekene Enemchukwu
- Department of Urology, Stanford University, School of Medicine, Stanford, CA
| | - Raveen Syan
- Department of Urology, Division of Female Urology, University of Miami, Miami, FL.
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16
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Zhou H, Chen W, Yan Y, Wu B, Wang J, Fu C. Efficacy of non-pharmacological interventions in patients with overactive bladder: A protocol for systematic review and network meta-analysis. Nurs Open 2021; 9:402-407. [PMID: 34562343 PMCID: PMC8685856 DOI: 10.1002/nop2.1078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/06/2021] [Accepted: 09/02/2021] [Indexed: 12/29/2022] Open
Abstract
Background Some meta‐analyses have proved the superiority of non‐pharmacological interventions in overactive bladder (OAB), but the best choice is still controversial. Aim To assess the most effective interventions in female with OAB. Methods Studies for relevant randomized controlled trials which compare different kinds of non‐pharmacological interventions in females with OAB will be retrieved from 8 databases including PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Database, VIP Database and China Biology Medicine disc, from inception to 1 January 2021. After screening titles and abstracts, detailed data including participates, interventions and outcomes will be extracted according to the eligible criteria. Then, Cochrane risk‐of‐bias tool will be used to assess the quality of the literature. The pairwise meta‐analysis will be conducted by STATA. Network meta‐analysis will be performed to compare and rank the effects of different non‐pharmacological interventions, in terms of alleviation of symptoms, by OpenBUGS, R and STATA. Results This network meta‐analysis will present the best available evidence about non‐pharmacological interventions for OAB to both relieve symptoms and improve life quality.
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Affiliation(s)
| | - Wenzhen Chen
- The School of Nursing, Anhui University of Chinese Medicine, Hefei, China
| | - Yunzhu Yan
- Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Boyu Wu
- Hunan University of Chinese Medicine, Changsha, China
| | - Jing Wang
- The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Chengwei Fu
- The Second Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
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17
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Fang JJ, Wu MP, Yen YC, Wu JC, Chin HY. Overactive bladder syndrome is associated with detrusor overactivity and abnormal voiding pattern in nulliparous women. J Chin Med Assoc 2021; 84:865-869. [PMID: 34433190 DOI: 10.1097/jcma.0000000000000611] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Pregnancy and childbirth are frequently associated with overactive bladder syndrome (OAB). However, the role of parous effects in OAB among nulliparous (NP) women remains controversial. METHODS This study investigated abnormal voiding patterns and detrusor overactivity (DO) among NP women with OAB in comparison with parous women. From August 2011 to December 2018, 906 patients met the inclusion criteria for participation and were divided into three groups: 221 patients in the NP group, 571 patients in the normal spontaneous delivery (NSD) group, and 114 patients in the cesarean section (CS) group. Urodynamic study examinations were performed, and the presence of DO, abnormal voiding patterns, and maximum urethral closure pressure (MUCP) was recorded. Data were analyzed using analysis of variance, χ2 tests, and independent t tests. RESULTS Compared with parous women in the NSD and CS groups, patients in the NP group had a significantly higher prevalence of abnormal voiding patterns, DO, and MUCP. Furthermore, abnormal voiding patterns were significantly associated with DO and MUCP, respectively, especially in the NP group. CONCLUSION We hypothesized that hypertonicity or poor relaxation of the pelvic muscle in NP women may cause functional BOO, which is related to their OAB.
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Affiliation(s)
- Jessica Jay Fang
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Ming-Ping Wu
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chi Mei Medical Center, Tainan and College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan, ROC
| | - Yu-Chun Yen
- Biostatistics Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan, ROC
| | - Jeng-Cheng Wu
- Department of Urology, Taipei Medical University Hospital and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Hung-Yen Chin
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Country Hospital, Taipei, Taiwan, ROC
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Celenay ST, Karaaslan Y, Coban O, Oskay K. A comparison of Kinesio taping and external electrical stimulation in addition to pelvic floor muscle exercise and sole pelvic floor muscle exercise in women with overactive bladder: a randomized controlled study. Disabil Rehabil 2021; 44:5124-5132. [PMID: 34098818 DOI: 10.1080/09638288.2021.1925751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare the effects of Kinesio taping® (KT) and external electrical stimulation (ES) in addition to pelvic floor muscle exercise (PFME) and sole PFME in women with overactive bladder (OAB). MATERIAL AND METHODS Patients with OAB were randomly allocated into PFME, PFME + KT, PFME + ES groups. All treatments were carried out for 6 weeks. OAB symptoms with voiding diary and Overactive Bladder-Version8 (OAB-V8), pelvic floor muscle strength (PFMS) with perineometer, quality of life with King's Health Questionnaire (KHQ) were assessed before (BT) and after treatment (AT). AT, the perception of improvement was inquired. RESULTS AT, OAB symptoms and KHQ scores decreased and PFMS improved in all groups (p < 0.05). The intergroup comparisons revealed a further decrease in voids/day, voids/night, OAB-V8, and some KHQ scores, and a further increase in the perception of improvement in the PFME + KT and PFME + ES groups compared to the PFME group (p < 0.05). In the PFME + ES group, there was a further decrease in numbers of incontinence compared to the PFME group, and in severity measures scores compared to the other groups (p < 0.05). CONCLUSION KT and external ES in addition to PFME were more effective than PFME alone in the treatment of OAB.IMPLICATIONS FOR REHABILITATIONPelvic floor muscle exercise was found to be effective in reducing overactive bladder symptoms and increasing quality of life.Kinesio taping or external electrical stimulation in addition to pelvic floor muscle exercise is more effective in improving overactive bladder symptoms, quality of life, and perception of improvement than pelvic floor muscle exercise alone.Kinesio taping and external electrical stimulation can be used as a complementary application in the treatment of overactive bladder.Pelvic floor muscle exercise, pelvic floor muscle exercise + Kinesio taping, and pelvic floor muscle exercise + electrical stimulation applications should be included in conservative treatment options in patients with overactive bladder to reduce symptoms and cost, and improve quality of life.
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Affiliation(s)
- Seyda Toprak Celenay
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Ankara Yildirim Beyazit University Ankara, Ankara, Turkey
| | - Yasemin Karaaslan
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, Beykent University, Istanbul, Turkey
| | - Ozge Coban
- Faculty of Gulhane Physiotherapy and Rehabilitation, Health Science University, Ankara, Turkey
| | - Kemal Oskay
- Department of Urology, Ankara Gazi Mustafa Kemal Hospital, Ankara, Turkey
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Rashid S, Babur MN, Khan RR, Khalid MU, Mansha H, Riaz S. Prevalence and associated risk factors among patients with overactive bladder syndrome in Pakistan. Pak J Med Sci 2021; 37:1185-1189. [PMID: 34290805 PMCID: PMC8281156 DOI: 10.12669/pjms.37.4.4262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/27/2021] [Accepted: 03/18/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives: To determine the Prevalence and associated risk factors among patients with overactive bladder syndrome in Pakistan. Methods: This was a community-based, face to face, cross sectional survey to calculate the prevalence and its associated risk factors. A sample of 1058 patients, women and men aged between 35 to 60 years having symptoms of overactive bladder was selected through convenience sampling from different cities of Pakistan during September to December 2020. Data was collected by using an Overactive Bladder Scoring System (OABSS) tool for prevalence and a developed questionnaire to rule out the risk factors. Results: The prevalence was 27.4% (n=289) and it increased with age. The average ages for women and men were 44.60±7.88 and 46.14±7.69 years respectively. The OAB prevalence was the lowest among the participants aged 35-43 years 15.2% (n=55) while it was highest among those who were aged 53-60 years 49.6%, (n=127). The age, body mass index, diabetes mellitus, income, family history, parity and urinary tract infection were found to be significant associated risk factors for overactive bladder with p value <0.05. Conclusion: The overall prevalence of overactive bladder was 27.4% and it does not differ by gender, hypertension, pelvic surgery, smoking, constipation and sleep while it has significant association with age, body mass index, diabetes mellitus, income, parity and urinary tract infections.
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Affiliation(s)
- Sajid Rashid
- Prof. Dr. Sajid Rashid, PP-DPT. Principal / HOD Multan College of Physiotherapy, MMDC, Multan, Pakistan
| | - Muhammad Naveed Babur
- Prof. Dr. Muhammad Naveed Babur, PhD. Principal, Isra Institute of Rehabilitation Sciences, Isra University, Islamabad, Pakistan
| | - Rehan Ramzan Khan
- Dr. Rehan Ramzan Khan, MSPT-OMPT. Assistant Professor Multan College of Physiotherapy, MMDC, Multan, Pakistan
| | - Muhammad Usman Khalid
- Dr. Muhammad Usman Khalid, MSPT-OMPT. Assistant Professor Multan College of Physiotherapy, MMDC, Multan, Pakistan
| | - Haroon Mansha
- Dr. Haroon Mansha, tDPT. Assistant Professor Multan College of Physiotherapy, MMDC, Multan, Pakistan
| | - Saima Riaz
- Dr. Saima Riaz, PhD. Assistant Professor Riphah College of Rehabilitation & Allied Health Sciences, RIU, Lahore, Pakistan
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Abstract
Modifiable lifestyle-related risk factors are the object of increasing attention, with a view to primary and tertiary prevention, to limit the onset and development of diseases.Also in the urological field there is accumulating evidence of the relationship between urological diseases and lifestyle-related risk factors that can influence their incidence and prognosis. Risk factors such as nutrition, physical activity, sexual habits, tobacco smoking, or alcohol consumption can be modified to limit morbidity and reduce the social impact and the burdensome costs associated with diagnosis and treatment.This review synthesizes the current clinical evidence available on this topic, trying to satisfy the need for a summary on the relationships between the most important lifestyle factors and the main benign urological diseases, focusing on benign prostatic hyperplasia (BPH), infections urinary tract (UTI), urinary incontinence (UI), stones, erectile dysfunction, and male infertility.
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Affiliation(s)
- Riccardo Bientinesi
- Department of Urology, Agostino Gemelli Hospital Foundation - IRCCS, Catholic University Medical School, Rome, Italy
| | - Carlo Gandi
- Department of Urology, Agostino Gemelli Hospital Foundation - IRCCS, Catholic University Medical School, Rome, Italy
| | - Luigi Vaccarella
- Department of Urology, Agostino Gemelli Hospital Foundation - IRCCS, Catholic University Medical School, Rome, Italy
| | - Emilio Sacco
- Department of Urology, Agostino Gemelli Hospital Foundation - IRCCS, Catholic University Medical School, Rome, Italy
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21
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The Prevalence of Overactive Bladder Symptoms in Women in Algeria, Egypt, Jordan and Lebanon: A Cross-Sectional Population-Based Survey. Adv Ther 2021; 38:1155-1167. [PMID: 33354738 PMCID: PMC7889545 DOI: 10.1007/s12325-020-01588-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/28/2020] [Indexed: 01/10/2023]
Abstract
Aims Estimate the prevalence of symptoms suggestive of overactive bladder (OAB) in women living in the Middle East to describe their demographic characteristics and explore treatment-seeking behavior. Methods Cross-sectional, population-based survey of women aged ≥ 40 years resident in Algeria, Jordan, Lebanon or Egypt. Respondents were recruited using computer-assisted telephone interview over approximately 4 months. Eligible respondents were asked to complete the OAB-V8, a validated questionnaire that explores the extent of bother from the key symptoms of OAB without clinical investigations. In addition, information regarding demographics, comorbidities and treatment behavior was collected, and respondents were stratified by age. Results A total of 2297 eligible women agreed to participate. Mean age was 54 ± 10 years; over half (59.3%) were aged 40–55 years. Overall, 53.8% of eligible women had symptoms suggestive of OAB (Jordan 58.5%; Egypt 57.5%; Algeria 49.9%; Lebanon 49.0%), with over 90% also reporting symptoms of urinary incontinence. Only 13.0% of women with symptoms suggestive of OAB were currently receiving treatment, while most (74.3%) had never been treated; these data were consistent across country and age categories. Among the untreated subgroup, almost half (48.7%) reported they were ‘not bothered by symptoms,’ while 8.4% considered OAB to be ‘part of normal aging’ and 4.7% did not know it was treatable. Conclusion A high prevalence of symptoms suggestive of OAB was observed, and the majority had symptoms of urinary incontinence. Despite the high prevalence, most women had never received treatment. Considering the potential significant impact of OAB symptoms on health, quality of life and productivity, these findings highlight an unmet medical need in the population studied. Strategies to improve treatment-seeking behavior (e.g., through education and tackling the stigma associated with OAB symptoms) may improve the diagnosis, management and health outcomes of women with OAB in the Middle East. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-020-01588-4.
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22
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Omran A, Leca BM, Oštarijaš E, Graham N, Da Silva AS, Zaïr ZM, Miras AD, le Roux CW, Vincent RP, Cardozo L, Dimitriadis GK. Metabolic syndrome is associated with prostate enlargement: a systematic review, meta-analysis, and meta-regression on patients with lower urinary tract symptom factors. Ther Adv Endocrinol Metab 2021; 12:20420188211066210. [PMID: 34900218 PMCID: PMC8664322 DOI: 10.1177/20420188211066210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is defined by at least three of the following five criteria: blood pressure ⩾130/85 mmHg, fasting blood glucose ⩾5.6 mmol/l, triglycerides concentration ⩾1.7 mmol/l, waist circumference ⩾102 cm (for men), and high-density lipoprotein cholesterol concentration <1.03 mmol/l (for men). MetS has been associated with worse lower urinary tract symptoms (LUTS) and higher International Prostate Symptom questionnaire scores. MATERIALS AND METHODS MEDLINE, Cochrane, ClinicalTrials.gov, and SCOPUS were critically appraised for all peer-reviewed manuscripts that suitably fulfilled our protocol's inclusion criteria established a priori. Meta-analytical and meta-regression calculations were performed in R using the Sidik-Jonkman and Hartung-Knapp random effects model and predefined covariates. RESULTS A total of 70 studies (n = 90,206) were included in qualitative synthesis. From these, 60 studies focused on MetS and LUTS: 44 reported positive correlations, 5 reported negative correlations, 11 reported no association, and 10 studies focused on MetS and total prostate volume (TPV). MetS positively correlated with moderate LUTS [odds ratio (OR) = 1.56, 95% confidence interval (CI) = 1.35-1.80], severe LUTS (OR = 2.35, 95% CI = 1.82-3.03), overactive bladder (OAB; OR = 3.2, 95% CI = 1.6-5.8), and nocturia severity (OR = 2.509, 95% CI = 1.571-4.007) at multivariate analysis. A total of 30 studies (n = 22,206) were included in meta-analysis; MetS was significantly associated with higher TPV (mean differences = 4.4450 ml, 95% CI = 2.0177-6.8723), but no significant predictive factors for effect sizes were discovered. CONCLUSION Our meta-analysis demonstrates a significant association between the aggravating effects of MetS, which commonly coexists with obesity and benign prostate enlargement.
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Affiliation(s)
| | | | - Eduard Oštarijaš
- Institute for Translational Medicine, University of Pecs Medical School, Pecs, Hungary
| | - Natasha Graham
- Department of Obstetrics & Gynaecology, Queen Elizabeth Hospital, London, UK
| | - Ana Sofia Da Silva
- Department of Urogynaecology, King’s College Hospital NHS Foundation Trust, London, UK
| | | | - Alexander D. Miras
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Carel W. le Roux
- Diabetes Complication Research Centre, School of Medicine and Medical Science, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Royce P. Vincent
- Faculty of Life Sciences and Medicine, School of Life Course Sciences, King’s College London, London, UKDepartment of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, London, UK
| | - Linda Cardozo
- Department of Urogynaecology, King’s College Hospital NHS Foundation Trust, London, UK
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Mostafaei H, Shariat SF, Salehi-Pourmehr H, Janisch F, Mori K, Quhal F, Hajebrahimi S. The clinical pharmacology of the medical treatment for overactive bladder in adults. Expert Rev Clin Pharmacol 2020; 13:707-720. [PMID: 32500759 DOI: 10.1080/17512433.2020.1779056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Overactive bladder is a prevalent symptom complex that affects the patient's quality of life. Any disruption between the neuronal micturition pathway can lead to bladder overactivity. Neurogenic causes, myogenic causes, aging, bladder outlet obstruction, sex, and psychological factors are some of the factors contributing to bladder overactivity. The complaint of any symptoms of OAB, which is highly prevalent and affects overall QOL, often needs therapeutic interventions. When conservative therapy methods fail, the addition of medications is recommended. The most commonly used agents for the treatment of OAB are antimuscarinic drugs. New classes of drugs, such as beta-3 agonists, have enriched our pharmacologic armamentarium. AREAS COVERED In this review, with a special focus on oral pharmacological treatments, we discussed the definition, etiology, symptoms, diagnosis, and management of OAB. EXPERT OPINION OAB is a multifactorial condition with every patient presenting with a different collection of symptoms and signs. Medical therapies should be given in conjunction with behavioral therapies. Using high or low doses, flexible doses, and stopping or changing the medications are interchangeable strategies based on the level of treatment efficacy and patient satisfaction.
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Affiliation(s)
- Hadi Mostafaei
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna , Vienna, Austria.,Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences , Tabriz, Iran
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna , Vienna, Austria.,Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University , Moscow, Russia.,Department of Urology, University of Texas Southwestern Medical Center , Dallas, TX, USA.,Department of Urology, Second Faculty of Medicine, Charles University , Prague, Czech Republic.,Department of Urology, Weill Cornell Medical College , New York, NY, USA.,Karl Landsteiner Institute of Urology and Andrology , Vienna, Austria.,Department of Urology, University of Jordan , Amman, Jordan
| | - Hanieh Salehi-Pourmehr
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences , Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences , Tabriz, Iran
| | - Florian Janisch
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna , Vienna, Austria.,Department of Urology, Medical University of Hamburg , Hamburg, Germany
| | - Keiichiro Mori
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna , Vienna, Austria.,Department of Urology, The Jikei University School of Medicine , Tokyo, Japan
| | - Fahad Quhal
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna , Vienna, Austria.,King Fahad Specialist Hospital-Dammam , Saudi Arabia
| | - Sakineh Hajebrahimi
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences , Tabriz, Iran
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Wagg A, Staskin D, Engel E, Herschorn S, Kristy RM, Schermer CR. Efficacy, safety, and tolerability of mirabegron in patients aged ≥65yr with overactive bladder wet: a phase IV, double-blind, randomised, placebo-controlled study (PILLAR). Eur Urol 2019; 77:211-220. [PMID: 31733990 DOI: 10.1016/j.eururo.2019.10.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 10/04/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND The majority of patients with overactive bladder (OAB) are aged >65yr. There has been no prospectively designed study assessing treatment efficacy with the β3-adrenoreceptor agonist, mirabegron, specifically in this age group. OBJECTIVE A phase IV study comparing flexibly dosed mirabegron versus placebo in elderly patients with OAB and urgency incontinence. DESIGN, SETTING, AND PARTICIPANTS Community-dwelling patients aged ≥65yr with OAB for ≥3mo. INTERVENTION Following a 2-wk placebo run in, patients with one or more incontinence episodes, three or more urgency episodes, and an average of eight or more micturitions/24h were randomised 1:1 to double-blind 25mg/d mirabegron or matched placebo, for 12wk. After week 4 or 8, the dose could be increased to 50mg/d mirabegron/matched placebo based on patient and investigator discretion. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Coprimary endpoints: change from baseline to end of treatment (EOT) in the mean numbers of micturitions/24h and incontinence episodes/24h. Secondary endpoints: change from baseline to EOT in the mean volume voided/micturition, mean number of urgency episodes/24h, and mean number of urgency incontinence episodes/24h. Analysis of covariance (ANCOVA) was used for the mean number of micturitions/24h, mean volume voided/micturition, and mean number of urgency episodes/24h. Stratified rank ANCOVA was used for the mean numbers of incontinence episodes/24h and urgency incontinence episodes/24h. RESULTS AND LIMITATIONS Statistically significant improvements were observed for mirabegron versus placebo in change from baseline to EOT in the mean number of micturitions/24h, mean number of incontinence episodes/24h, mean volume voided/micturition, mean number of urgency episodes/24h, and mean number of urgency incontinence episodes/24h. Safety and tolerability were consistent with the known mirabegron safety profile. CONCLUSIONS Mirabegron efficacy, safety, and tolerability over 12 wk were confirmed in patients aged ≥65yr with OAB and incontinence. PATIENT SUMMARY We examined the effect of mirabegron compared with placebo in people aged 65yr or older with overactive bladder and incontinence. Mirabegron improved the symptoms of overactive bladder compared with placebo. Side effects were similar to those already known for mirabegron.
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Affiliation(s)
- Adrian Wagg
- Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | - David Staskin
- Division of Urology, St Elizabeth's Medical Center, Boston, MA, USA
| | - Eli Engel
- Bayview Research Group, LLC, Valley Village, CA, USA
| | | | - Rita M Kristy
- Astellas Pharma Global Development, Inc., Northbrook, IL, USA
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Vitamin D and thiol-disulfide homeostasis levels in postmenopausal women with overactive bladder syndrome. J Med Biochem 2019; 39:1-6. [PMID: 32549770 DOI: 10.2478/jomb-2019-0003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 01/29/2019] [Indexed: 01/13/2023] Open
Abstract
Background This study aimed to find a relationship between vitamin D concentration and thiol-disulfide homeostasis in the pathophysiology of overactive bladder (OAB) syndrome in postmenopausal women. Methods A total of 76 postmenopausal women, referred for routine controls, were recruited between January and March 2018 to participate in this study. Participants with an overactive bladder questionnaire (OAB-q) score of >11 (n = 34) were included in the OAB syndrome group, while those with a score of <5 (n = 42) were included in the control group. Serum total antioxidant capacity, ischemia-modified albumin, C-reactive protein, 25-hydroxy vitamin D levels, and thiol-disulfide homeostasis were measured. Results Patients with OAB syndrome had waist circumferences of 106 ± 11 cm, and their body mass indexes (BMIs) were 30.8 ± 4.8 kg/m2. The control groups' waist circumferences were 102 ± 11 cm and their BMIs were 28.9 ± 4.3 kg/m2 (p = 0.069 and p = 0.098, respectively). The level of vitamin D in the control group was 33.7 (IQR: 30.7) nmol/L and 27.0 (IQR: 27.5) nmol/L (p = 0.081) in the OAB syndrome group. Conclusions We were not able to demonstrate with certainty any significant relationships between serum 25-hydroxy vitamin D levels and thiol-disulfide homeostasis parameters and OAB syndrome.
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