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The effects of simulated childbirth trauma on the gene expression of neurotransmitter receptors in the bladder of female rats. J Formos Med Assoc 2021; 120:1305-1313. [PMID: 33472764 DOI: 10.1016/j.jfma.2020.12.030] [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: 04/20/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND/PURPOSE To investigate the effects of simulated childbirth on the gene expression of parasympathetic muscarinic, purinergic (P2X), and neurokinin receptors of lower urinary tract in rats. METHODS In all, twenty-four primiparous pregnant Sprague-Dawley female rats were equally divided into three groups: (1). Control group; 8 rats, (2) intra-vaginal balloon dilation for 2 h group; 8 rats, (3) and for 4 h group; 8 rats. After balloon dilatation for 4 months, all rats were sacrificed. We analyzed the gene expression of parasympathetic muscarinic, purinergic (P2X), and neurokinin receptors by real-time quantitative PCR (q-PCR). We quantified pro-inflammatory cytokines of TNF-α and IL-6 by Enzyme-linked immunosorbent assays (ELISA). The urodynamic parameters and micturition frequency by cystometry (CMG) were recorded. RESULTS Our results showed that the balloon dilation significantly increased micturition frequency and modified peak micturition pressure compare to those in the control groups. Balloon dilation significantly decreased voiding interval and bladder volume compared to those in the control groups. Gene expressions of M3 muscarinic, P2X3 purinergic receptors, and significantly increased following balloon dilation for 2 hours and 4 hours than those in the control group. In addition, we found that NK1R and NK3R receptors were significantly decreased after balloon dilation compare to control group. The marked increase of TNF-α and IL-6 were also seen in the 2 balloon groups. CONCLUSION The results of our study suggested that birth trauma may impair the function of urinary tract, this being partly related to the changes in the gene expression of the neurotransmitter receptors of the lower urinary tract.
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Kosilov K, Loparev S, Kuzina I, Kosilova L, Prokofyeva A. Socioeconomic status and health-related quality of life among adults and older with overactive bladder. Int J Qual Health Care 2019; 31:289-297. [PMID: 30107414 DOI: 10.1093/intqhc/mzy163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 05/20/2018] [Accepted: 07/11/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To study the effect of socioeconomic status (SES) on health-related quality of life (HRQoL) among persons with overactive bladder (OAB). DESIGN A randomized HRQoL study was conducted from the year 2014 until the year 2016 based on the OAB pathology department of the regional clinical diagnostics center. SETTING The medical institutions where the study was conducted had outpatient care. PARTICIPANTS The simple response frequency was 81%. A total of 1893 men and women with OAB aged 35-85 (average 58.3 years) were selected by blind random sampling. Included into the group of examined individuals were persons who diagnosis provided after the examination was OAB. INTERVENTION Evaluation of HRQoL was conducted using the SF-6D questionnaire. The OAB diagnosis was confirmed using the OAB-questionnaire and uroflowmetry. MAIN OUTCOME MEASURE(S) We hypothesized that the impact of SES on the HRQoL of patients with OAB has significant features. RESULTS Described for the first time were HRQoL measures in various SES levels within different ages of people suffering from OAB. The strongest relationship was identified between education level, professional activity and HRQoL measures; meanwhile the weakest relationship was between income and HRQoL measures. We also confirmed the efficiency of evaluating HRQoL while using SF-6D and SRH as an external standard. CONCLUSION The improvement of HRQoL in persons with OAB is contingent upon increment in their level of awareness about the methods of OAB treatment and the effectiveness of treatment for severe symptoms of LUT pathology, increased social support and, possibly, physical activity.
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Affiliation(s)
- Kirill Kosilov
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation.,Department of Fundamental of Medicine, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
| | - Sergay Loparev
- Department of Urology, City Polyclinic No. 3, Vladivostok, Russian Federation
| | - Irina Kuzina
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
| | - Liliya Kosilova
- Department of the Functional Methods of Examination, Med. Association No. 2 of Vladivostok-City, Vladivostok, Russian Federation
| | - Alexandra Prokofyeva
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
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Rahkola-Soisalo P, Balcerzak M, Ruotsalainen J, Mikkola TS. Patient utilization survey of mirabegron prescribed for overactive bladder. Investig Clin Urol 2019; 60:114-119. [PMID: 30838344 PMCID: PMC6397924 DOI: 10.4111/icu.2019.60.2.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 01/21/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose Mirabegron, a β3-adrenoreceptor agonist, is used to treat overactive bladder. The factors affecting persistence of mirabegron use or symptom improvement are not thoroughly known, but could be related to patient characteristics. Therefore, we evaluated persistence of medication use, symptom improvement, and quality of life among Finnish mirabegron users. In addition, we assessed possible predictors of change in these variables. Materials and Methods Participants (52 men, 118 women) with an initial mirabegron prescription were recruited nationwide from 79 pharmacies. Volunteers were interviewed at baseline and after 6 months. Subject and clinical characteristics, symptom severity, and quality of life (EQ-5D-5L) were assessed using a visual analogue scale. Results Of 170 participants, 144 (84.7%) were reached after 6 months. The rate of persistent mirabegron use was 50.7%. Experiencing adverse effects (29.6%) was the most common reason for discontinuation of medication. A primary health care unit as a prescription site (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.03–4.9) was associated with increased risk for discontinuation. Mirabegron relieved symptoms in 45.2% and enhanced quality of life in 41.7% of the participants. Age <64 years was associated with better probability of symptom improvement (OR, 2.7; 95% CI, 1.1–6.8), whereas none of the other parameters assessed predicted change in quality of life. Conclusions In this Finnish population, 50.7% of the participants continued using mirabegron after 6 months. The prescription site seemed to be important for persistent use, which may be related to patient counseling. Younger patients were more likely to benefit from treatment with mirabegron.
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Affiliation(s)
- Päivi Rahkola-Soisalo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | | | - Tomi S Mikkola
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
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Concepcion K, Cheng Y, McGeechan K, Robertson S, Stewart M, Bateson D, Estoesta J, Chiarelli P. Prevalence and associated factors of urinary leakage among women participating in the 45 and Up Study. Neurourol Urodyn 2018; 37:2782-2791. [DOI: 10.1002/nau.23770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 06/23/2018] [Indexed: 11/09/2022]
Affiliation(s)
| | - Yan Cheng
- Family Planning NSW; Ashfield New South Wales Australia
| | - Kevin McGeechan
- Family Planning NSW; Ashfield New South Wales Australia
- The University of Sydney; Sydney New South Wales Australia
| | | | - Mary Stewart
- Family Planning NSW; Ashfield New South Wales Australia
| | - Deborah Bateson
- Family Planning NSW; Ashfield New South Wales Australia
- The University of Sydney; Sydney New South Wales Australia
| | - Jane Estoesta
- Family Planning NSW; Ashfield New South Wales Australia
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Xu D, Zhao M, Huang L, Wang K. Overactive bladder symptom severity, bother, help-seeking behavior, and quality of life in patients with type 2 diabetes: a path analysis. Health Qual Life Outcomes 2018; 16:1. [PMID: 29291738 PMCID: PMC5749008 DOI: 10.1186/s12955-017-0829-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 12/14/2017] [Indexed: 02/05/2023] Open
Abstract
Background This study aimed to investigate the relationships among overactive bladder (OAB) symptom severity, bother, help-seeking behavior, and quality of life (QOL) in patients with type 2 diabetes. Methods A total of 127 diabetic patients, aged at least 18 years, with overactive bladder from a hospital in Shandong Province, China, were recruited for this study. Symptom severity, bother, and quality of life were assessed using the Overactive Bladder Symptom Score (OABSS), Patient Perception of Bladder Condition (PPBC), and Overactive Bladder Questionnaire Short Form (OAB-q SF), respectively. Help-seeking behavior was assessed by asking patients whether they consulted health care professionals or received treatment for their bladder problems. A two-step path analysis was performed to analyze the data. Results OAB symptom severity was directly associated with lower levels of QOL, and the strength of this association was no longer significant when taking bother and help-seeking behavior into account. Bother increased with OAB symptom severity, and patients with bothersome OAB tended to have lower levels of QOL. Moreover, bother increased help-seeking behavior; however, patients who sought help tended to have lower levels of QOL. Conclusions Our findings highlight the role of bother and help-seeking behavior in the relationship between OAB symptom severity and QOL. To improve a patient’s QOL, health care providers should focus not only on symptom bother but also on dysfunctional help-seeking patterns.
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Affiliation(s)
- Dongjuan Xu
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China.,School of Nursing, Purdue University, West Lafayette, Indiana, 47907, USA
| | - Meng Zhao
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Liqun Huang
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Kefang Wang
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China.
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Abstract
Lower urinary tract symptoms-in particular, storage disorders (for example, urinary incontinence) as well as bladder underactivity-are major health-related problems that increase with age. Yet lower urinary tract symptoms remain under-diagnosed and poorly managed, and incontinence has been cited as the major reason for institutionalization in elderly populations and is one of the most common conditions in primary care practice. Although lifestyle and behavior therapy has been used as a useful treatment regimen for urge incontinence, medications (often used as adjunct) can provide additional benefit. This review will include current therapies used for treatment of urinary incontinence.
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Affiliation(s)
- Bronagh McDonnell
- Department of Medicine, University of Pittsburgh School of Medicine, A 1217 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA
| | - Lori Ann Birder
- Department of Medicine, University of Pittsburgh School of Medicine, A 1217 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA.,Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, A 1217 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA
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Heesakkers J, Espuña Pons M, Toozs Hobson P, Chartier-Kastler E. Dealing with complex overactive bladder syndrome patient profiles with focus on fesoterodine: in or out of the EAU guidelines? Res Rep Urol 2017; 9:209-218. [PMID: 29184855 PMCID: PMC5673033 DOI: 10.2147/rru.s146746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Overactive bladder (OAB) syndrome is a common, complex, and challenging condition. To assist the management of these patients, the European Association of Urology (EAU) updates its guidelines annually. This review reports the presentations from the symposium titled “Dealing with complex OAB patient profiles: in or out of the EAU guidelines?” held at the 32nd EAU Annual Congress in March 2017 in London. The symposium focused on three groups of OAB patients: women who may also suffer pelvic organ prolapse, stress urinary incontinence, the genitourinary syndrome of menopause (GSM); patients at risk of cognitive impairment; and elderly patients. The aim of the symposium was to determine how the 2017 EAU guidelines can best assist physicians, as well as to assess the benefits of fesoterodine in these patients. The EAU guidelines recommend antimuscarinic agents (grade A) for the medical treatment of OAB. In women, OAB is correlated with GSM, both of which are underdiagnosed and undertreated. Fesoterodine decreases OAB symptoms and the associated limitation of physical activity. A combination of fesoterodine and vaginal estrogens is appropriate for OAB associated with GSM. In patients at risk of cognitive impairment, prescribers should pay particular attention to the choice of medication. Fesoterodine is a Pgp substrate with limited ability to cross the blood–brain barrier, which may explain the lack of negative effects on the central nervous system observed in clinical trials of this agent. OAB should not be regarded as a normal consequence of aging. Fesoterodine has been extensively investigated in the elderly, and is the only anticholinergic drug licensed for OAB in this population, rated B (beneficial) according to the Fit for the Aged classification for lower-urinary-tract symptoms. The EAU guidelines are a valuable resource for physicians managing patients with OAB, and the pharmacological properties of fesoterodine offer credible clinical advantages in these three patient groups.
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Affiliation(s)
- John Heesakkers
- Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Montserrat Espuña Pons
- Pelvic Floor Unit, ICGON, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | | | - Emmanuel Chartier-Kastler
- Department of Urology, Academic Hospital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Paris 6 University, Sorbonne Universités, Paris, France
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Factors of adherence to treatment with trospium in employees. UROLOGICAL SCIENCE 2017. [DOI: 10.1016/j.urols.2017.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Cheng CL, Li JR, Lin CH, de Groat WC. Positive association of female overactive bladder symptoms and estrogen deprivation: A nationwide population-based cohort study in Taiwan. Medicine (Baltimore) 2016; 95:e4107. [PMID: 27428195 PMCID: PMC4956789 DOI: 10.1097/md.0000000000004107] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Estrogen is considered to be a unique hormone in females that has an impact on voiding function. Animal models and clinical epidemiologic studies showed high correlation between estrogen deficiency and female overactive bladder (OAB) symptoms. We designed a population-based cohort study from a national health database to assess the association of estrogen deprivation therapy and female OAB. MATERIALS AND METHODS This study examined the records of 16,128 patients ranging in age from 18 to 40 that were included in the Taiwan National Health Insurance Research Database (NHIRD) in the years between 2001 and 2010. Of these, 1008 had breast cancer with hormone therapy only and the other 15,120 controls did not have breast cancer or hormone therapy. All patients with neurologic diseases and those with pre-existing OAB identified by information in the NHIRD database were excluded. OAB was defined by medications prescribed for at least 1 month. Risk of new onset OAB in the breast cancer and nonbreast cancer groups was estimated. Fourteen patients (1.4%) experienced OAB in the breast cancer group. Overall, breast cancer with estrogen deprivation therapy increased the risk of OAB by 14.37-fold (adjusted hazard ratio, 95% confidence interval 7.06-29.27). Subgroup analysis showed that in the older age breast cancer group (36-40), a lower Charlson comorbidity index (CCI) score and antidepressant medication use for at least 30 days had an impact on the increase of OAB risk. After adjustment of variables, the higher CCI and the use of antipsychotic drugs increased risk of OAB 3.45-fold and 7.45-fold, respectively. The Kaplan-Meier analysis of OAB-free survival in the breast cancer group showed a significant time-dependent increase in incidence of OAB. CONCLUSION Estrogen deprivation in young patients with breast cancer increased the risk of OAB. The OAB development rate was steady and fast in the beginning 3 years after estrogen deprivation. This result indicates a role of estrogen in the modulation of female voiding function.
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Affiliation(s)
- Chen-Li Cheng
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital
- Institute of Medicine, Chun Sang Medical University
- Correspondence: Chen-Li Cheng, Taichung Veterans General Hospital, Taichung, Taiwan ()
| | - Jian-Ri Li
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital
- Institute of Medicine, Chun Sang Medical University
- Department of Medicine and Nursing, Hungkuang University
| | - Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - William C. de Groat
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. The efficacy of different doses of solifenacin in elderly patients after treating a urinary tract infection. Arab J Urol 2015; 13:203-8. [PMID: 26413348 PMCID: PMC4563008 DOI: 10.1016/j.aju.2015.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/29/2015] [Accepted: 07/02/2015] [Indexed: 11/05/2022] Open
Abstract
Objective To determine the efficacy and safety of solifenacin for correcting the residual symptoms of an overactive bladder (OAB) in patients who were treated for a urinary tract infection (UTI). Patients and methods Using random sampling, 524 patients aged >60 years were selected (347 women, 66.2%, and 177 men, 33.8%). They denied the presence of any symptoms of detrusor overactivity in their medical history, but had a diagnosis of a UTI. At least 1 month after the end of treatment and a laboratory confirmation of the absence of infection, each patient completed an OAB-Awareness Tool questionnaire (OAB signs, total score 8 points), and a noninvasive examination of urinary function (uroflowmetry). Each day patients in group A took solifenacin 10 mg and those in group B took 5 mg, with patients in group C being given a placebo. Results During the study 58.8% of patients had symptoms of an OAB at 1 month after the end of the treatment for a UTI, and normal laboratory markers. During treatment with the standard and higher dose of solifenacin, within 8 weeks most variables of the condition of the lower urinary tract reached a normal state or improved. Conclusion Patients aged >60 years who had been treated for a UTI have a high risk of developing symptoms of an OAB. Solifenacin in standard doses is an efficient and safe means of managing overactive detrusor symptoms after a UTI.
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Affiliation(s)
- Kirill V Kosilov
- School of Humanities, Far Eastern Federal University, Russian Federation
| | - Sergay A Loparev
- Department of Urology, City Polyclinic No. 3, Russian Federation
| | | | - Liliya V Kosilova
- Department of the Functional Methods of Examination, Medical Association No. 2 of Vladivostok City, Vladivostok, Primorsky Region, Russian Federation
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Influence of different doses of trospium and solifenacin on manageability of OAB symptoms with different severity in elderly men and women. JOURNAL OF CLINICAL UROLOGY 2015. [DOI: 10.1177/2051415815600970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective: We studied the rationale for using standard and increased dosages of solifenacin and trospium against overactive bladder (OAB) symptoms of different severity among elderly patients. Methods: A total of 327 patients took part in the study: 199 women and 128 men older than 65 years (median age 69.1). The state of the lower urinary tracts was estimated by cystometry, ICIQ-SF and bladder diaries. Frequency of urgency urinary incontinence (UUI) was taken as a criterion of OAB symptom severity. Result: Administration of double-dosed trospium and solifenacin leads to decrease of frequency of UUI both in the group with severe symptoms (B1: 6.1 (0.5) →2.4 (0.9), p ⩽ 0.05), and in the group with moderate symptoms of OAB (A1: 2.8 (0.8) →0.5 (0.4), p ⩽ 0.001). Under a combination of trospium and solifenacin in doses recommended by manufacturers, UUI decreased authentically in the group with moderate symptoms (A2: 2.9 (0.5) →0.9 (0.5), p ⩽ 0.05) and unauthentically in the group with severe symptoms of detrusor dysfunction (B2: 7.0 (1.2) → 4.3 (1.5), p ⩾ 0.05). During the experiment six patients (1.8%) elected not to participate because of intolerable adverse events. Forty-seven more individuals (14.4%) felt adverse effects, among which the most frequent were: xerostomia (15 patients or 4.6%), faintness (nine patients or 3.8%), dryness of integuments (six patients or 1.8%). Conclusion: A standard-dose combination of solifenacin and trospium in older patients with moderate symptoms of OAB enables a good therapeutic effect in a short time without increasing risk of side effects. High therapeutic doses of antimuscarinic drugs are reasonable for older men and women with severe symptoms of OAB. Increasing the dose of simultaneous use of solifenacin and trospium yields a good therapeutic effect to correct UUI; however, it raises the hazard of appearance of adverse effects. The number of side effects in the group of elderly individuals who were taking the combination of increased and standard dosages of solifenacin and trospium does not significantly differ.
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Affiliation(s)
- Kirill V Kosilov
- Far Eastern Federal University, Department of Social Sciences, Russian Federation
| | - Sergey A Loparev
- Department of Urology, City Polyclinic no. 3, Russian Federation
| | | | - Liliya V Kosilova
- Department of the Functional Methods of Examination, Med. Association no. 2 of Vladivostok-City, Russian Federation
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Kosilov K, Loparev S, Kosilova L, Ivanovskaya M. Comparative effectiveness of combined high-dosed Trospium and Solifenacin for severe OAB symptoms in age-related aspect. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2015. [DOI: 10.1111/ijun.12076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Kirill Kosilov
- Far Eastern Federal University, Institute of Physical Health; Ayax 10 F733 Vladivostok Primorsky region Russian Federation
| | - Sergey Loparev
- City Polyclinic No 3; Department of Urology; Lugovaya-st. 55 Vladivostok Russian Federation
| | - Liliya Kosilova
- Far Eastern State University of Fishing; Lugovaya-st. 52b Vladivostok Russian Federation
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De Ridder D, Roumeguère T, Kaufman L. Urgency and other lower urinary tract symptoms in men aged ≥ 40 years: a Belgian epidemiological survey using the ICIQ-MLUTS questionnaire. Int J Clin Pract 2015; 69:358-65. [PMID: 25648652 DOI: 10.1111/ijcp.12541] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 08/10/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIMS The aim of this study was to assess prevalence and associated bother of male lower urinary tract symptoms (LUTS), especially of urgency and other storage symptoms, since these are generally assumed to be underdiagnosed/undertreated in men. METHODS Data on bladder condition of men ≥ 40 years were prospectively collected by 124 general practitioners (GPs) during a regular visit for any reason, using the validated ICIQ-MLUTS questionnaire. For 13 symptoms, prevalence (scale 0-4) and bother (scale 0-10) were scored. General bladder-related quality of life (scale 0-3) was also assessed. RESULTS Data from 5890 men (mean age: 61.2 years) were analysed. A total of 7.7% had urgency most or all of the time (score ≥ 3) and 6.2% had bothersome urgency (score ≥ 3 + bother score ≥ 5). Nocturia (69.2%) and urgency (58.3%) were the most prevalent and bothersome symptoms. Both prevalence and bother of all LUTS increased with age. Additionally, 28.9% of men reported to be a little bothered by their bladder condition in everyday life, while 11.9% were bothered a lot/very much (2.5% in age group 40-49 years increasing to 29.2% in those > 80 years). CONCLUSIONS In the general population of men ≥ 40 years who visited a GP for any reason, 41% indicated to be at least a little bothered by their bladder condition. The prevalence of LUTS, especially nocturia and urgency, is high and a significant number of men indicated to be seriously bothered. Increasing awareness of male LUTS, and storage symptoms in particular, is warranted to discuss management options that could increase quality of life.
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Affiliation(s)
- D De Ridder
- Department of Urology, University Hospitals KU Leuven, Leuven, Belgium
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Sahai A, Dowson C, Cortes E, Seth J, Watkins J, Khan MS, Dasgupta P, Cardozo L, Chapple C, De Ridder D, Wagg A, Kelleher C. Validation of the bladder control self-assessment questionnaire (B-SAQ) in men. BJU Int 2014; 113:783-8. [DOI: 10.1111/bju.12521] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Arun Sahai
- Department of Urology; Guy's Hospital; MRC Centre for Transplantation; King's College London; King's Health Partners; London UK
| | - Christopher Dowson
- Department of Urology; Guy's Hospital; MRC Centre for Transplantation; King's College London; King's Health Partners; London UK
| | - Eduardo Cortes
- Department of Gynaecology; Guy's and St Thomas’ NHS Trust; London UK
| | - Jai Seth
- Department of Urology; Guy's Hospital; MRC Centre for Transplantation; King's College London; King's Health Partners; London UK
| | - Jane Watkins
- Department of Urology; Guy's Hospital; MRC Centre for Transplantation; King's College London; King's Health Partners; London UK
| | - Muhammed Shamim Khan
- Department of Urology; Guy's Hospital; MRC Centre for Transplantation; King's College London; King's Health Partners; London UK
| | - Prokar Dasgupta
- Department of Urology; Guy's Hospital; MRC Centre for Transplantation; King's College London; King's Health Partners; London UK
| | - Linda Cardozo
- Department of Urogynaecology; King's College Hospital; London UK
| | | | - Dirk De Ridder
- Department of Urology; University Hospitals Leuven; Leuven Belgium
| | - Adrian Wagg
- Division of Geriatric Medicine; Department of Medicine; University of Alberta; Edmonton AB Canada
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The “bother” of urinary incontinence. Int Urogynecol J 2014; 25:947-51. [DOI: 10.1007/s00192-014-2337-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 01/20/2014] [Indexed: 11/25/2022]
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Wan X, Wang C, Xu D, Guan X, Sun T, Wang K. Disease stigma and its mediating effect on the relationship between symptom severity and quality of life among community-dwelling women with stress urinary incontinence: a study from a Chinese city. J Clin Nurs 2014; 23:2170-9. [PMID: 24393307 DOI: 10.1111/jocn.12482] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Xiaojuan Wan
- School of Nursing; Shandong University; Jinan China
| | - Cuili Wang
- School of Nursing; Shandong University; Jinan China
| | - Dongjuan Xu
- School of Nursing; Shandong University; Jinan China
- School of Public Health; University of Minnesota; MN USA
| | | | - Tao Sun
- Beijing Tongren Hospital affiliated to Capital Medical University; Jinan China
| | - Kefang Wang
- School of Nursing; Shandong University; Jinan China
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Kosilov K, Loparev S, Ivanovskaya M, Kosilova L. Maintenance of the therapeutic effect of two high-dosage antimuscarinics in the management of overactive bladder in elderly women. Int Neurourol J 2013; 17:191-6. [PMID: 24466467 PMCID: PMC3895512 DOI: 10.5213/inj.2013.17.4.191] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 12/03/2013] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To improve the long-term efficiency of the pharmacologic management of overactive bladder (OAB) in elderly women. METHODS The study comprised 229 women (mean age, 66.3 years; range, 65-77 years) with urodynamically and clinically confirmed OAB. All patients received the most effective treatment regimen based on the data obtained in the initial part of the study (trospium 60 mg/day + solifenacin 40 mg/day, for 6 weeks), and positive results similar to those in the first phase were obtained. They were then divided into four groups, based on the maintenance therapy: group A (59 women), trospium (60 mg/day) + solifenacin (40 mg/day) for 1 month; group B (51 women), electrical stimulation of the detrusor muscle for 1 month; group C (63 women), laser puncture for 1 month; group D (56 women), placebo. Maintenance therapy was administered 2.5 months after completion of primary treatment. The patients' condition was monitored through the OAB questionnaire for 1 year and by urodynamic examination at months 6 and 7 from the start of the study. RESULTS In group A, the clinical and urodynamic results achieved after the initial + main treatment phase (two high-dosage antimuscarinics of different generations, trospium and solifenacin, for a total of 2.5 months) were maintained for at least 7 months. Electrical stimulation of the urinary bladder as a method of maintenance therapy proved to be less effective. In groups C and D, deterioration in results was observed at 6-8 months, which led us to conclude that laser puncture was an inefficient method of maintenance therapy in elderly women with OAB. CONCLUSIONS Maintenance treatment of OAB in elderly women with a combination of high-dosage antimuscarinics is an effective method for reducing the risk of recurrence of the disease.
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Affiliation(s)
| | - Sergey Loparev
- Department of Urology, City Polyclinic No. 3, Vladivostok, Russia
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Milsom I, Coyne KS, Nicholson S, Kvasz M, Chen CI, Wein AJ. Global prevalence and economic burden of urgency urinary incontinence: a systematic review. Eur Urol 2013; 65:79-95. [PMID: 24007713 DOI: 10.1016/j.eururo.2013.08.031] [Citation(s) in RCA: 254] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 08/13/2013] [Indexed: 10/26/2022]
Abstract
CONTEXT The prevalence and economic burden of urgency urinary incontinence (UUI) are difficult to ascertain because of overlap with data on overactive bladder and other types of incontinence. OBJECTIVE To summarize the evidence on the global prevalence and economic burden of UUI. EVIDENCE ACQUISITION A PubMed search was performed used the following terms: (urgency urinary incontinence OR urge incontinence OR mixed incontinence OR overactive bladder) AND (burden OR cost OR economic OR prevalence). A similar search was conducted using Embase. English-language articles published from 1991 through 2013 on non-neurogenic UUI were retained. EVIDENCE SYNTHESIS We retained 54 articles (50 studies); 22 large-scale, population-based surveys indicated varying UUI prevalence estimates with ranges of 1.8-30.5% in European populations, 1.7-36.4% in US populations, and 1.5-15.2% in Asian populations, with prevalence dependent on age and gender. Nineteen smaller-scale studies supported these findings. Despite varying methods, 11 studies estimating the costs of UUI worldwide consistently concluded that the economic burden is substantial and will increase markedly as the population ages. In a 2005 multinational study, the annual cost-of-illness estimate for UUI in Canada, Germany, Italy, Spain, Sweden, and the United Kingdom was €7 billion. A US cost-of-illness study reported a total cost of $66 billion in 2007 US dollars. The costs of routine care and nursing home admissions for UUI were major contributors to the cost. CONCLUSIONS UUI affects millions of men and women worldwide. Current evidence demonstrates the substantial economic burden of UUI to patients and society. Worldwide public health and clinical management programs are needed to improve UUI awareness and highlight the need for early diagnosis and management.
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Affiliation(s)
- Ian Milsom
- Department of Obstetrics and Gynecology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
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Rosenberg MT. Urgency, incontinence and other urinary issues … why bother? Int J Clin Pract 2013; 67:192-3. [PMID: 23409685 DOI: 10.1111/ijcp.12060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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