1
|
Babu R, Ashwin M. Over Active Bladder Index (OABI): A New Objective Tool Based on Uroflow Parameters for Diagnosis of Overactive Bladder in Children. J Pediatr Surg 2024; 59:522-527. [PMID: 37953162 DOI: 10.1016/j.jpedsurg.2023.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/29/2023] [Accepted: 10/07/2023] [Indexed: 11/14/2023]
Abstract
AIMS The aim of this study is to propose an objective uroflow based index for diagnosing over active bladder (OAB). MATERIALS AND METHODS Thirty patients with OAB and 30 controls were used in the pilot study. Three uroflow parameters: Uroflow index (UI = Qave/Qmax), voided volume ratio (VVR = voided volume/expected bladder capacity) and time to Q max (TQmax) were studied. Linear regression was performed for the three parameters with controls/OAB patients. Further 28 patients & 32 controls were recruited in a second validation study. RESULTS Mean (s.d) UI was 0.7 (0.1) in control while 0.4 (0.1) in OAB (p = 0.001). Mean (s.d) VVR was 0.7 (0.1) in control while 0.5 (0.1) in OAB (p = 0.01). Mean (s.d) TQmax was 5.2 (1.2) in control while 2.1 (1.8) in OAB (p = 0.001). Good correlation was noted with all parameters UI (r = 0.89); VVR (r = 0.87) and TQmax (r = 0.76); when all three were combined as an index the correlation was better (r = 0.95). Based on the beta coefficients an OAB Index [OABI = 8(UI)+9(VVR)+0.5(TQmax)] was proposed; ROC analysis revealed a cutoff of 12 (AUC 0.96). An OABI of <12 was proposed for diagnosing OAB, 12-15 for equivocal and >15 for normal children. In the validation study OABI had 93 % sensitivity; 100 % specificity; 100 % positive predictive value & 94 % negative predictive value. The overall accuracy was 97 %. CONCLUSION While current diagnosis of OAB is mainly subjective, the proposed OABI is an objective way of diagnosing OAB using uroflow parameters. OABI may also help to assess treatment response. Further larger studies are warranted.
Collapse
Affiliation(s)
- Ramesh Babu
- Department of Pediatric Urology, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.
| | - Muthukumar Ashwin
- Department of Pediatric Urology, Sri Ramachandra Institute of Higher Education & Research, Chennai, India
| |
Collapse
|
2
|
López-Fando Lavalle L, Calleja Hermosa P, Velasco Balanza C, Jiménez Cidre M, Gutiérrez Baños JL, Viegas V, Sánchez Ramírez A, Esteban Fuertes M, Gutiérrez Ruiz C, Peri Cusí L, Castro Díaz D, Arlandis Guzmán S. Bladder Capacity in Women With Overactive Bladder Syndrome: A Cross-sectional Study. Urology 2023; 179:44-49. [PMID: 37353085 DOI: 10.1016/j.urology.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To evaluate bladder capacity in women with idiopathic overactive bladder syndrome (OAB) through bladder diary, cystomanometry, and uroflowmetry and assess the concordance of the different measures of bladder capacity. A secondary objective is to describe the relationship between bladder capacity and urinary frequency in OAB patients. METHODS An observational cross-sectional multicentric study was conducted, including female patients diagnosed with idiopathic OAB. All participants underwent a urodynamic study and completed a 3-day bladder diary (3dBD). Different parameters were used to calculate bladder capacity: maximum cystometric capacity (MCC) assessed at the end of filling cystometry, voided volume (VV) during the uroflowmetry, maximum voided volume (VVmax), and average voided volume (VVmed), both assessed through the 3dBD. Reproducibility analysis was performed to assess the agreement among the different bladder capacity measures. Intraclass correlation coefficient (ICC) and weighted Kappa index were used. Bladder capacity parameters were also assessed in relation to urinary frequency. RESULTS Bladder capacity measures were diminished in this population, except for VVmax. Poor correlation was found between the different bladder capacity variables (ICC and weighted Kappa index <0.4). Twenty-four-hour frequency and average VV present a weak negative linear relationship (Pearson coefficient -0.344). CONCLUSION MCC and average VV are reduced in OAB patients. MCC does not correlate well with functional bladder volumes determined by voiding diary in the OAB population.
Collapse
|
3
|
Nagata R, Matsuura E, Nozuma S, Dozono M, Noguchi Y, Ando M, Hiramatsu Y, Kodama D, Tanaka M, Kubota R, Yamakuchi M, Higuchi Y, Sakiyama Y, Arata H, Higashi K, Hashiguchi T, Nakane S, Takashima H. Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder. Front Neurol 2023; 14:1137958. [PMID: 36860574 PMCID: PMC9968745 DOI: 10.3389/fneur.2023.1137958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/23/2023] [Indexed: 02/17/2023] Open
Abstract
Objective Autoimmune autonomic ganglionopathy (AAG) is a rare disorder characterized by autonomic failure associated with the presence of anti-ganglionic acetylcholine receptor (gAChR) antibodies; however, several studies have reported that individuals with anti-gAChR antibodies present with central nervous system (CNS) symptoms such as impaired consciousness and seizures. In the present study, we investigated whether the presence of serum anti-gAChR antibodies correlated with autonomic symptoms in patients with functional neurological symptom disorder/conversion disorder (FNSD/CD). Methods Clinical data were collected for 59 patients presenting with neurologically unexplained motor and sensory symptoms at the Department of Neurology and Geriatrics between January 2013 and October 2017 and who were ultimately diagnosed with FNSD/CD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Correlations between serum anti-gAChR antibodies and clinical symptoms and laboratory data were analyzed. Data analysis was conducted in 2021. Results Of the 59 patients with FNSD/CD, 52 (88.1%) exhibited autonomic disturbances and 16 (27.1%) were positive for serum anti-gAChR antibodies. Cardiovascular autonomic dysfunction, including orthostatic hypotension, was significantly more prevalent (75.0 vs. 34.9%, P = 0.008), whereas involuntary movements were significantly less prevalent (31.3 vs. 69.8%, P = 0.007), among anti-gAChR antibody-positive compared with -negative patients. Anti-gAChR antibody serostatus did not correlate significantly with the frequency of other autonomic, sensory, or motor symptoms analyzed. Conclusions An autoimmune mechanism mediated by anti-gAChR antibodies may be involved in disease etiology in a subgroup of FNSD/CD patients.
Collapse
Affiliation(s)
- Ryusei Nagata
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Eiji Matsuura
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Satoshi Nozuma
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Mika Dozono
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yutaka Noguchi
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masahiro Ando
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yu Hiramatsu
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Daisuke Kodama
- Division of Neuroimmunology, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
| | - Masakazu Tanaka
- Division of Neuroimmunology, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
| | - Ryuji Kubota
- Division of Neuroimmunology, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
| | - Munekazu Yamakuchi
- Department of Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yujiro Higuchi
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yusuke Sakiyama
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hitoshi Arata
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Keiko Higashi
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Teruto Hashiguchi
- Department of Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shunya Nakane
- Department of Neurology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Hiroshi Takashima
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan,*Correspondence: Hiroshi Takashima ✉
| |
Collapse
|
4
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
5
|
Aniulis P, Podlipskyte A, Smalinskiene A, Aniuliene R, Jievaltas M. Association of gene polymorphisms with women urinary incontinence. Open Med (Wars) 2021; 16:1190-1197. [PMID: 34514165 PMCID: PMC8389500 DOI: 10.1515/med-2021-0332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/04/2021] [Accepted: 06/25/2021] [Indexed: 11/16/2022] Open
Abstract
Aim of study was set to investigate the association of women urinary incontinence (UI) with serotonin receptor HTR2A T102C and beta 3-adrenergic receptor ADRB3 Trp64Arg genes polymorphisms. The study included 110 women with Urge, Stress, and Mixed UI types and the control group – 105 continent women. Both groups have filled in the ICIQ-FLUTS questionnaire and their blood genotyping was performed. Urge UI subgroup was older and had higher body mass index (BMI) in comparison to other UI types and control group. More than half of all women had family history of UI in Stress UI and Mixed UI subgroups. The frequency of HTR2A T102C gene polymorphism’s minor allele C and genotype CC was significantly more expressed in Urge UI subgroup, as compared with control group (C-77.3 vs 58.7%, p = 0.007 and CC-57.6 vs 31.1%, p = 0.015). The ADRB3 Trp64Arg gene polymorphism did not differ between groups. The regression analysis revealed CC genotype (OR = 3.06, 95% CI: 1.11–8.43; p = 0.030) and allele C (OR = 2.53, 95% CI: 1.16–5.53; p = 0.020) were risk factors for development of Urge UI. We conclude that HTR2A T102C gene polymorphism affected the development of Urge UI.
Collapse
Affiliation(s)
- Povilas Aniulis
- Urology Clinic, Medical Academy, Lithuanian University of Health Sciences, A. Mickeviciaus Str. 9, Kaunas LT-44307, Lithuania
| | - Aurelija Podlipskyte
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga LT-00135, Lithuania
| | - Alina Smalinskiene
- Institute of Biology Systems And Genetic Research, Lithuanian University Of Health Sciences, Kaunas LT-44307, Lithuania
| | - Rosita Aniuliene
- Obstetrics And Gynecology Clinic, Medical Academy, Lithuanian University of Health Sciences, Kaunas LT-44307, Lithuania
| | - Mindaugas Jievaltas
- Urology Clinic, Medical Academy, Lithuanian University of Health Sciences, A. Mickeviciaus Str. 9, Kaunas LT-44307, Lithuania
| |
Collapse
|
6
|
Çırakoğlu A, Fejzullahu A, Benli E, Yuce A, Ayyıldız A, Aynacıoğlu AŞ. Association between the Trp64Arg polymorphism of the ADRB3 gene and overactive bladder. Neurourol Urodyn 2021; 40:1780-1785. [PMID: 34260097 DOI: 10.1002/nau.24742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/09/2021] [Accepted: 06/05/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The β3 -adrenergic receptor (ADRB3) is very important in the regulation of the human detrusor muscle function. The well-known tryptophan64arginine polymorphism of the ADRB3 gene alters the response of the receptor to various stimuli, including adrenalin and noradrenalin, and may increase the susceptibility to develop overactive bladder (OAB). Therefore, this study was performed to determine whether ADRB3 Trp64Arg polymorphism is associated with the pathophysiology of OAB syndrome. METHODS The study group (n = 150) consists of 72 patients with OAB and 78 controls without OAB. Venous blood samples were taken from all participants to analyze the ADRB3 gene Trp64Arg polymorphism using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) assay. We compared the distribution of Trp64Arg polymorphism and symptom severity in both OAB and non-OAB subjects using χ2 test and Mann-Whitney's U test, respectively. RESULTS The frequency of the 64Arg variant (heterozygous plus homozygous) in OAB and non-OAB subjects was 15.3% and 14.1%, respectively. There was no statistically significant difference between the OAB and non-OAB groups in regard to the distribution frequency of ADRB3 Trp64Arg polymorphism. The total frequency (OAB + non-OAB, 76 women and 74 men) of the Arg64 variant allele was 5.9% and 10.8% in women and in men, respectively. Although the frequency of the Arg64 variant was nearly twofold higher in men compared to women, the difference was not statistically significant. CONCLUSIONS These results demonstrated that the ADRB3 Trp64Arg polymorphism is not significantly associated with OAB syndrome in a sample of Turkish OAB patients.
Collapse
Affiliation(s)
| | - Arta Fejzullahu
- Health Sciences Research Center, Istanbul Aydin University, Istanbul, Turkey
| | - Erdal Benli
- Department of Urology, Medical Faculty, Ordu University, Ordu, Turkey
| | - Ahmet Yuce
- Department of Urology, Medical Faculty, Ordu University, Ordu, Turkey
| | - Ali Ayyıldız
- Department of Urology, Medical Faculty, Adiyaman University, Adiyaman, Turkey
| | - A Şükrü Aynacıoğlu
- Department of Medical Pharmacology, Medical Faculty, Istanbul Atlas University, Istanbul, Turkey
| |
Collapse
|
7
|
Milsom I, Wagg A, Oelke M, Chapple C. Which drugs are best for overactive bladder? From patients' expectations to physicians' decisions. Int J Clin Pract 2021; 75:e13870. [PMID: 33251651 PMCID: PMC8047881 DOI: 10.1111/ijcp.13870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/26/2020] [Accepted: 11/20/2020] [Indexed: 11/27/2022] Open
Abstract
AIM In order to help physicians determine which drugs are the best for treating overactive bladder (OAB) symptoms, this review considered three questions: what are the patient's expectations? What information is generated by the Multicriteria Decision Analysis (MCDA) model? What can physicians expect from medical treatments? METHODS A comprehensive literature search was undertaken on these three topics in order to assist physicians regarding the optimum treatment modality for OAB. RESULTS Patients' difficulties in reporting symptoms and their expectations of treatment outcomes interfere with the success of treatment. To assist physicians in meeting patients' expectations and to choose the most appropriate treatment, a new approach, recognised by the European Medicines Agency, the MCDA model was used to compare the benefits and safety of OAB treatments. CONCLUSION The MCDA model is useful for comparing the benefit-safety profiles of OAB drugs in order to equip clinicians with information on the drug that might best meet their patient's needs. Flexibly dosed fesoterodine appeared to be most efficacious in resolving urgency and urgency incontinence compared with other drugs, and resolution of urinary urgency appears to be associated with a reduced number of reported adverse events.
Collapse
Affiliation(s)
- Ian Milsom
- Department of Obstetrics and GynecologySahlgrenska AcademyGothenburg UniversityGothenburgSweden
| | - Adrian Wagg
- Department of MedicineUniversity of AlbertaEdmontonAlbertaCanada
| | - Matthias Oelke
- Department of UrologyPediatric Urology and Urologic OncologySt. Antonius HospitalGronauGermany
| | - Christopher Chapple
- Department of UrologySheffield Teaching Hospitals NHS Foundation TrustRoyal Hallamshire HospitalSheffieldUnited Kingdom
| |
Collapse
|
8
|
Wang Y, Shi C, Wang Y, Jiao W, Wang X, Zhang J, Shi G, Wu D. The Correlation between Severity of Overactive Bladder Symptoms with Female Sexual Dysfunction and Sexual Satisfaction of Partners. Urol Int 2020; 105:124-130. [PMID: 33176322 DOI: 10.1159/000508764] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/16/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE Sexual dysfunction in women with overactive bladder (OAB) syndrome has been an important topic, while the sexual satisfaction of partners has not been fully investigated. Our aim was to explore the association between the severity of OAB with female sexual dysfunction and sexual satisfaction of partners. METHODS A total of 323 patients with OAB recruited in our hospital were included in our study from September 2017 to March 2019. Data were collected by Overactive Bladder Symptom Score (OABSS) questionnaire, self-designed questionnaire for basic characteristics; Female Sexual Function Index (FSFI); and sexual satisfaction survey for sex partners of patients. χ2 test or 1-way ANOVA was used to compare the variables among groups. Logistic regression analysis was performed to analyze the severity of OAB with female sexual dysfunction and sexual satisfaction of partners. The correlations between different OABSS domains with female sexual dysfunction and sexual satisfaction of partners were assessed. RESULTS All the patients were classified into mild (n = 107), moderate (n = 98), severe (n = 118) OAB group based on OABSS. Most of the basic information were similar among groups, except for BMI, highest education, occupation, fertility, and history of pelvic floor surgery. After multiple factors correction, the severity of OAB, exercise frequency, and the history of pelvic floor surgery were statistically associated with the female sexual dysfunction and sexual satisfaction of partners. Urgency score was significantly correlated with female sexual dysfunction, and the urge incontinence was most significantly associated with the sexual satisfaction of partners. CONCLUSION Severe OAB was closely associated with female sexual dysfunction and sexual satisfaction of partners. The urgency and urge incontinence should be focused for OAB management.
Collapse
Affiliation(s)
- Yangyun Wang
- Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chaoliang Shi
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Yang Wang
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Wei Jiao
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Xilong Wang
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Jun Zhang
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Guowei Shi
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Denglong Wu
- Department of Urology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China,
| |
Collapse
|
9
|
Abstract
INTRODUCTION The purpose of monitoring a patient treated for overactive bladder (OAB) is to ensure the effectiveness of the treatment and to detect any side effects. OBJECTIVE To synthesize current knowledge on the follow-up and the evaluation of non-neurogenic OAB treatments. METHOD A systematic literature review based on Pubmed, Embase, Google Scholar was conducted in June 2020. RESULTS The definition of success of OAB treatments is not consensual. Definitions of success in clinical trials usually use bladder diary data. However, they cannot always be transposed into clinical practice because they do not measure the overall effectiveness of a treatment, reported by the patient, or the satisfaction with the treatment. It is then necessary to have symptom questionnaires with an assessment of quality of life. Indeed, the concept of therapeutic success is different depending on the view of the physician or the patient. It is therefore important to carefully assess with the patient, and before initiating any treatment, the objectives and expected results of the treatment. The definition of "refractory" OAB is heterogeneous but important to select candidates for second-line treatments. Monitoring a patient with OAB is essential to adapt the treatment to efficacy and tolerance, but also to detect any change in symptoms that may reveal another urological disease. CONCLUSION The success or failure of OAB treatments depends on the interaction of many factors, including objective criteria measured by the clinician, and subjective criteria of perception of the treatment effectiveness by the patient.
Collapse
Affiliation(s)
- V Phé
- Service d'urologie, hôpital Pitié-Salpêtrière, AP-HP Sorbonne université, Paris, France.
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, université Paul-Sabatier, Toulouse, France
| |
Collapse
|
10
|
Neves da Costa J, Oliveira Lopes MV, Baena de Moraes Lopes MH. Simultaneous Concept Analysis of Diagnoses Related to Urinary Incontinence. Int J Nurs Knowl 2020; 31:109-123. [DOI: 10.1111/2047-3095.12254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 07/06/2019] [Accepted: 07/08/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Juliana Neves da Costa
- School of Nursing (FEnf)Universidade Estadual de Campinas (Unicamp) Campinas São Paulo Brazil
| | | | | |
Collapse
|
11
|
Salvatore S, Espuña-Pons M, Tubaro A. Urinary Urgency: A Symptom In Need Of A Cure. Res Rep Urol 2019; 11:327-331. [PMID: 31850283 PMCID: PMC6910097 DOI: 10.2147/rru.s216757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/16/2019] [Indexed: 11/23/2022] Open
Abstract
Urgency, defined as "a sudden, compelling desire to pass urine which is difficult to defer", is not always reported by patients with overactive bladder, and is not usually described in these words. Urgency is known to have a strong negative impact on patients' quality of life and requires attention from healthcare professionals, as they play a key role in establishing the diagnosis and in deciding, together with the patient, the most appropriate treatment. This topic was debated during the symposium "Urinary Urgency: A Symptom in Need of a Cure?", held at the 11th Annual Meeting of the European Urogynaecology Association (EUGA) in October 2018 in Milan, Italy. The presentation of two clinical cases, those of a young, active woman and a retired teacher, illustrated the importance of this cornerstone symptom and demonstrated how fesoterodine may represent an important option in the management of this condition. The experts concluded that the physician should not leave urgency undeclared or untreated; that the patient should be involved in the choice of treatment; and that fesoterodine, which offers flexible dosing and has proven, consistent positive results on urgency episodes and urgency urinary incontinence, with very low/no risk of impairment of cognitive function, appears to be one of the good choices in the treatment of this symptom.
Collapse
Affiliation(s)
- Stefano Salvatore
- Urogynecology Unit, Obstetrics and Gynecology Unit, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy
| | - Montserrat Espuña-Pons
- Urogynecology Unit, ICGON, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| |
Collapse
|
12
|
Gibson W, Morrison R, Wagg A, Hunter KF. Is the strong desire to void a source of diverted attention in healthy adult volunteers? Neurourol Urodyn 2019; 39:324-330. [PMID: 31782977 DOI: 10.1002/nau.24201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 10/20/2019] [Indexed: 01/23/2023]
Abstract
AIMS The strong desire to void (SDV) induces changes in both cognition and gait. This may be due to the sensation of urinary urge acting as a source of diverted attention. This exploratory study examined the influence of SDV and a standardized distracting task on the performance of two measures of cognition, a simple reaction time (SRT) test and the trail making B test (TMT-B). METHODS 18 volunteers, 8 male and 10 female, without lower urinary tract symptoms (LUTS) (mean age: 20.5, range: 20-47), performed a test of SRT and the TMT-B under three conditions; undistracted with an empty bladder, while experiencing SDV, and when performing a simultaneous distracting task, the auditory n back test. RESULTS A statistically significant increase in SRT was found when experiencing SDV and when distracted compared with the undistracted, bladder empty condition. The time taken to compete the TMT-B significantly increased with distraction but was not affected by SDV. CONCLUSION SDV induced a similar but smaller change in reaction time when compared with a distracting task, suggesting that SDV may act as a source of diverted attention in continent, healthy volunteers.
Collapse
Affiliation(s)
- William Gibson
- Division of Geriatric Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Rachael Morrison
- Division of Geriatric Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Adrian Wagg
- Division of Geriatric Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
13
|
Tae BS, Park TY, Jeon BJ, Chung H, Lee YH, Park JY, Bae JH, Choi H. Seasonal Variation of Overactive Bladder Symptoms in Female Patients. Int Neurourol J 2019; 23:334-40. [PMID: 31694352 DOI: 10.5213/inj.1938078.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 01/03/2019] [Indexed: 11/20/2022] Open
Abstract
Purpose To evaluate seasonal variations of overactive bladder (OAB) symptoms in women who visited hospital clinics. Methods Medical records of female patients treated for OAB symptoms from January 2011 to December 2017 were retrospectively reviewed. Patients with pyuria at the first visit, those who did not complete the questionnaire, and those with <3 overactive bladder symptom scores (OABSS) were excluded. Uroflowmetric parameters, 3-day micturition diary, and OABSS were analyzed. Results A total of 582 patients with OAB symptoms who visited the hospital were enrolled in this study. Patients were grouped into 1 of the 3 season groups (cold, intermediate, and hot) depending on the average temperature of the month that the patient first visited the urologic department outpatient clinic. The total OABSS was significantly different between the 3 season groups (cold [7.25±3.20] vs. intermediate [6.24±3.40] vs. hot [5.51±3.20], P=0.001). The proportion of patients who had moderate OAB symptoms (6≤OABSS) was higher in the cold season group (56.2%) than in the other season groups (intermediate, 42.1%; hot, 31.8%; P=0.002). Differences in the number of micturitions (12.12±4.56 vs. 10.95±4.39, P=0.021) and number of urgent urinary incontinence episodes (2.06±0.94 vs. 2.48±0.87, P=0.001) between the cold and hot season groups were also significant. However, differences in the nocturia episode, total daytime voided volume, and mean voided volume between season groups were not significant. Conclusions Different urinary symptoms and uroflowmetric parameters were correlated with seasonal variation. OAB symptoms might be worse in cold season than in other seasons.
Collapse
|
14
|
Wróbel A, Skorupska K, Rechberger E, Woźniak A, Miotla P, Kubik-Komar A, Skorupski P, Rechberger T. Reliability of the Polish version of the Overactive Bladder Symptom Score (OABSS) questionnaire : Correlation of the OABSS with urodynamic study and the UDI-6 and IIQ-7 questionnaires. Int Urogynecol J 2019; 30:2135-2139. [PMID: 31396639 PMCID: PMC6861195 DOI: 10.1007/s00192-019-04060-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Overactive bladder (OAB) and mixed urinary incontinence (MUI) are significant problems worldwide. Their broad definition makes them difficult to diagnose; therefore, specialists need a tool to confirm diagnosis. The Overactive Bladder Symptom Score (OABSS) is used in the objective diagnosis of OAB. We aimed to develop and evaluate the effectiveness of OABSS for patients in Poland suffering from OAB and MUI and to correlate it with UDI-6 and IIQ-7. METHODS A total of 824 women suffering from urinary incontinence (UI) aged between 18 and 75 years were included. SUI (n = 290); OAB (n = 285) and MUI (n = 249) were confirmed by medical history and urodynamic study. Of the subjects, 821 women completed the Polish version of OABSS on two separate visits: weeks 0 and 2. In addition, they undertook UDI-6 and IIQ-7 during Week 2. The Cronbach's alpha (α) was used to estimate the internal consistency. Scores were compared using the intraclass correlation coefficient (ICC). RESULTS We observed statistically significant differences (p < 0.0005) between mean scores of OABSS among patients from the study groups OAB-SUI and MUI-SUI. We did not observe statistically significant differences between patients from the MUI and OAB groups (p > 0.11). Analysis also did not show statistically significant differences between visits. The internal consistency was very good: α = 0.89 (SUI); = 0.9 (OAB); = 0.82 (MUI). In all groups, test-retest reliability was excellent; ICC was >0.99. CONCLUSIONS The Polish version of the OABSS is a reliable tool for females suffering from UI. However, OABSS does not distinguish patients with MUI from patients with OAB.
Collapse
Affiliation(s)
- Andrzej Wróbel
- 2nd Department of Gynecology, Medical University in Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland
| | - Katarzyna Skorupska
- 2nd Department of Gynecology, Medical University in Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland.
| | - Ewa Rechberger
- 2nd Department of Gynecology, Medical University in Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland
| | - Andrzej Woźniak
- 2nd Department of Gynecology, Medical University in Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland
| | - Pawel Miotla
- 2nd Department of Gynecology, Medical University in Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland
| | - Agnieszka Kubik-Komar
- Department of Applied Mathematics and Computer Science, University of Life Science, Lublin, Poland
| | - Pawel Skorupski
- 2nd Department of Gynecology, Medical University in Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland
| | - Tomasz Rechberger
- 2nd Department of Gynecology, Medical University in Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland
| |
Collapse
|
15
|
Liao C, Kuo H. Mirabegron escalation to 50 mg further improves daily urgency and urgency urinary incontinence in Asian patients with overactive bladder. J Formos Med Assoc 2019; 118:700-6. [DOI: 10.1016/j.jfma.2018.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/04/2018] [Accepted: 08/13/2018] [Indexed: 12/12/2022] Open
|
16
|
Appukuttan S, Padmakumar M, Young JS, Brain KL, Manchanda R. Investigation of the Syncytial Nature of Detrusor Smooth Muscle as a Determinant of Action Potential Shape. Front Physiol 2018; 9:1300. [PMID: 30294280 PMCID: PMC6158746 DOI: 10.3389/fphys.2018.01300] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/29/2018] [Indexed: 11/13/2022] Open
Abstract
Unlike most excitable cells, certain syncytial smooth muscle cells are known to exhibit spontaneous action potentials of varying shapes and sizes. These differences in shape are observed even in electrophysiological recordings obtained from a single cell. The origin and physiological relevance of this phenomenon are currently unclear. The study presented here aims to test the hypothesis that the syncytial nature of the detrusor smooth muscle tissue contributes to the variations in the action potential profile by influencing the superposition of the passive and active signals. Data extracted from experimental recordings have been compared with those obtained through simulations. The feature correlation studies on action potentials obtained from the experimental recordings suggest the underlying presence of passive signals, called spontaneous excitatory junction potentials (sEJPs). Through simulations, we are able to demonstrate that the syncytial organization of the cells, and the variable superposition of the sEJPs with the "native action potential", contribute to the diversity in the action potential profiles exhibited. It could also be inferred that the fraction of the propagated action potentials is very low in the detrusor. It is proposed that objective measurements of spontaneous action potential profiles can lead to a better understanding of bladder physiology and pathology.
Collapse
Affiliation(s)
- Shailesh Appukuttan
- Computational Neurophysiology Lab, Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, India
| | - Mithun Padmakumar
- Computational Neurophysiology Lab, Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, India
| | - John S Young
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Keith L Brain
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Christ Church, University of Oxford, Oxford, United Kingdom
| | - Rohit Manchanda
- Computational Neurophysiology Lab, Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, India
| |
Collapse
|
17
|
Medina Lucena H, Tincello DG. Validation of a water-load protocol to define the pattern of bladder sensation. Int Urogynecol J 2018; 30:767-772. [PMID: 30121702 PMCID: PMC6491398 DOI: 10.1007/s00192-018-3735-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 07/23/2018] [Indexed: 12/21/2022]
Abstract
Introduction and hypothesis The aim of this study was to confirm reliability of a water-load diuresis protocol and to assess the utility of bladder sensation curves. Methods For confirmation of fixed diuresis rate (phase 1), 12 volunteers consumed 250–300 ml of water every 15 min and recorded bladder sensation on a visual analogue scale (VAS) every 5 min to maximum sensation over two filling cycles: voids 1 and 2 (V1 and V2). The test was performed twice. For test–retest validation (phase 2), 24 participants underwent the same protocol drinking 300 ml of water every 15 min. Diuresis rates and voided volumes were compared between cycles and across tests. Results In phase 1, there was no difference in median void volume (V1 735 ml, V2 678 ml p = 0.433) or median diuresis rates (V2 12.1 ml/min, V3 14.4 ml/min p = 0.136) between cycles. When comparing those who drank 250–300 ml/15 min, there was less variability in those drinking 300-ml aliquots, so this was standardised for later experiments; 95% upper confidence limit of variability of the diuresis rate was calculated as 4.5 ml/min. Any test with a greater difference was rejected as invalid. In phase 2, only 16 participants were analysed. There was no difference in median void volumes between tests [V1 763 ml and 820 ml (p = 0.109) and V2 788 ml and 796 ml (p = 0.266)] or in diuresis rates between test 1 (12.33 ml/min) and 2 (14.40 ml/min) (p = 0.056). Median area under the curve was similar between test 1 404.96 and test 2 418.63. Conclusions This refined protocol reliably produced stable diuresis with a water load of 300 ml/15 min, excluding those with a difference in diuresis rate > 4.5 ml/min.
Collapse
Affiliation(s)
- Hayser Medina Lucena
- Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester, Leicestershire, LE1 7RH, UK.
| | - Douglas G Tincello
- Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester, Leicestershire, LE1 7RH, UK
| |
Collapse
|
18
|
Andersson KE, Choudhury N, Cornu JN, Huang M, Korstanje C, Siddiqui E, Van Kerrebroeck P. The efficacy of mirabegron in the treatment of urgency and the potential utility of combination therapy. Ther Adv Urol 2018; 10:243-256. [PMID: 30034543 PMCID: PMC6048625 DOI: 10.1177/1756287218781255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 04/29/2018] [Indexed: 01/23/2023] Open
Abstract
Urgency is the prevalent and most bothersome symptom of overactive bladder (OAB) and the treatment of urgency is the primary objective in the management of OAB. Urgency has a major impact on other symptoms of OAB and culminates in an increased frequency of micturition and reduced volume voided, which may contribute to shorter intervals between the need to void. Antimuscarinic agents and mirabegron, a β3-adrenoceptor agonist, constitute the main oral pharmacotherapeutic options for the treatment of urgency and other OAB symptoms. The reduction of urgency and other OAB symptoms significantly improve health-related quality of life. This review will explore the distinct mechanisms of action and effects of antimuscarinic agents and mirabegron, in relation to their effect on the pathophysiology of urgency. The review will also provide an overview of the various validated measurements of urgency and the numerous clinical trials regarding antimuscarinic agent monotherapy, mirabegron monotherapy, or combination treatment with mirabegron added on to the antimuscarinic agent solifenacin. A narrative review of the literature relating to pathophysiology of urgency, the validated measurements of urgency, and clinical trials relating to the pharmacological treatment of urgency. Antimuscarinic agent monotherapy, mirabegron monotherapy, or combination treatment with mirabegron added on to the antimuscarinic agent solifenacin statistically significantly reduce the symptoms of urgency compared with placebo. Combination therapy with mirabegron added on to solifenacin also statistically significantly reduces the symptoms of severe urgency compared with antimuscarinic agent monotherapy. A critique of the clinical benefits of combination therapy is also provided. Combination therapy provides an alternative treatment in patients with OAB that includes urgency who respond poorly to first-line monotherapy and who may otherwise often move on to more invasive treatments.
Collapse
Affiliation(s)
- Karl-Erik Andersson
- Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA Aarhus Institute for Advanced Sciences (AIAS), Aarhus University, Aarhus, Denmark
| | - Nurul Choudhury
- Astellas Pharma Europe Ltd., 2000 Hillswood Drive, Chertsey, Surrey, KT16 0RS, UK
| | - Jean-Nicolas Cornu
- Department of Urology, Rouen University Hospital and University of Rouen, Rouen, France
| | - Moses Huang
- Astellas Pharma Europe Ltd., Chertsey, Surrey, UK
| | - Cees Korstanje
- Astellas Pharma Europe Research and Development, Leiden, The Netherlands
| | - Emad Siddiqui
- Astellas Pharma Medical and Development, Leiden, The Netherlands
| | | |
Collapse
|
19
|
Kwon T, Oh TH, Choi S, Cho WY, Min K, Lee JZ, Moon KH. Influence of Daytime or Nighttime Dosing with Solifenacin for Overactive Bladder with Nocturia: Impact on Nocturia and Sleep Quality. J Korean Med Sci 2017; 32:1491-1495. [PMID: 28776345 PMCID: PMC5546969 DOI: 10.3346/jkms.2017.32.9.1491] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 06/03/2017] [Indexed: 11/20/2022] Open
Abstract
We compared changes in nocturia and sleep-related parameters between daytime and nighttime solifenacin dosing in patents with overactive bladder (OAB) and nocturia. We comparatively analyzed the data of a 12-week prospective, open-label, multicenter, randomized study. All 127 patients who presented to 5 centers in Korea for the treatment of OAB with nocturia between January 2011 and December 2013 were enrolled in this study. The patients were divided into 2 groups by medication timing: group 1, daytime (n = 62); and group 2, nighttime (n = 65). The International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and Athens Insomnia Scale (AIS) were used to assess OAB symptoms and sleep quality. We evaluated the parameter changes before and 12 weeks after daytime or nighttime solifenacin administration. Baseline data, which included sex, age, body mass index (BMI), total AIS, IPSS, and OABSS, did not differ between the 2 groups. Total IPSS, OABSS, and total AIS significantly improved after solifenacin administration regardless of timing (P < 0.001). After solifenacin administration, the number of nocturia episodes decreased in the group 1 and 2 (P < 0.001). There were no significant intergroup differences in changes in AIS, IPSS, OABSS, and number of nocturia episodes 12 weeks after solifenacin administration. Treating OAB with solifenacin may improve nocturia and sleep quality, but advantages did not differ significantly by medication timing.
Collapse
Affiliation(s)
- Taekmin Kwon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Tae Hee Oh
- Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Seong Choi
- Department of Urology, Kosin University College of Medicine, Busan, Korea
| | - Won Yeol Cho
- Department of Urology, Dong-A University College of Medicine, Busan, Korea
| | - Kweonsik Min
- Department of Urology, Inje University College of Medicine, Busan, Korea
| | - Jeong Zoo Lee
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Kyung Hyun Moon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
| |
Collapse
|
20
|
Honglertsakul C. Brief communication (Original). Validity and reliability of Thai version Overactive Bladder Symptom Score (OABSS-T). ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0803.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background: Overactive bladder (OAB) is a symptom-based condition, difficult to evaluate and impairs human related quality of life. A questionnaire is essential for the diagnosis and evaluation of treatment outcomes. The Overactive Bladder Symptom Score (OABSS) questionnaire has been mentioned previously as a useful tool for quantifying symptoms, severity, and treatment outcomes.
Objectives: To examine the psychometric properties of the OABSS in Thai women with overactive bladder.
Methods: Sixty women aged over 18 years, diagnosed with overactive bladder syndrome were recruited. They visited in two sessions at a two-week intervals using an OABSS questionnaire translated into Thai by a group of translators comprised of bilingual doctors and native speakers. OABSS in Thai preserves the original format using seven questions.
Results: Sixty woman aged over 18 years with overactive bladder symptoms were recruited (mean age 56; SD17.8). Content validity revealed a high score of symptoms. Internal consistency of the questionnaire from both visits showed a Cronbach alpha at 0.80 and 0.82 respectively. There was a strong association between the seven-item OABSS score at visit 1 and visit 2 with an intraclass correlation coefficient (ICC) of 0.96 (95% CI 0.947-0.981).
Conclusion: The OABSS Thai version is valid, and easily evaluates symptoms and severity of OAB. It could be used not only by urologists, but also by other healthcare providers as a screening tool for OAB in Thailand.
Collapse
Affiliation(s)
- Chavalit Honglertsakul
- Division of Urology, Department of Surgery, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University Bangkok 10300, Thailand
| |
Collapse
|
21
|
Chapple CR, Siddiqui E. Mirabegron for the treatment of overactive bladder: a review of efficacy, safety and tolerability with a focus on male, elderly and antimuscarinic poor-responder populations, and patients with OAB in Asia. Expert Rev Clin Pharmacol 2017; 10:131-151. [DOI: 10.1080/17512433.2017.1275570] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Christopher R Chapple
- Department of Urology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, UK
| | - Emad Siddiqui
- Global Medical Affairs, Astellas Pharma Europe Ltd, Chertsey, Surrey, UK
| |
Collapse
|
22
|
Tuncer M, Yazici O, Kafkasli A, Sabuncu K, Salepci B, Narter F, Gungor GA, Yucetas U. Critical evaluation of the overactive bladder and urgency urinary incontinence association with obstructive sleep apnea syndrome in a relatively young adult male population. Neurourol Urodyn 2016; 36:1804-1808. [DOI: 10.1002/nau.23184] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 11/07/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Murat Tuncer
- Dr. Lutfi Kirdar Kartal Training and Research Hospital Urology Clinic; Istanbul Turkey
| | - Ozgur Yazici
- Dr. Lutfi Kirdar Kartal Training and Research Hospital Urology Clinic; Istanbul Turkey
| | - Alper Kafkasli
- Dr. Lutfi Kirdar Kartal Training and Research Hospital Urology Clinic; Istanbul Turkey
| | - Kubilay Sabuncu
- Dr. Lutfi Kirdar Kartal Training and Research Hospital Urology Clinic; Istanbul Turkey
| | - Banu Salepci
- Dr. Lutfi Kirdar Kartal Training and Research Hospital Chest Diseases Clinic; Istanbul Turkey
| | - Fehmi Narter
- Dr. Lutfi Kirdar Kartal Training and Research Hospital Urology Clinic; Istanbul Turkey
| | - Gulten A. Gungor
- Dr. Lutfi Kirdar Kartal Training and Research Hospital Chest Diseases Clinic; Istanbul Turkey
| | - Ugur Yucetas
- Istanbul Training and Research Hospital Urology Clinic; Istanbul Turkey
| |
Collapse
|
23
|
Bakali E, Hong J, Gillespie J, Tincello D. Saccharin increases perception of bladder filling in a forced diuresis experiment. Neurourol Urodyn 2016; 36:1363-1368. [DOI: 10.1002/nau.23112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 08/11/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Evangelia Bakali
- Department of Health Sciences; University of Leicester; Leicester UK
| | - Jennifer Hong
- Department of Health Sciences; University of Leicester; Leicester UK
| | - James Gillespie
- Newcastle University Medical and Dental Schools; Newcastle upon Tyne UK
| | - Douglas Tincello
- Department of Health Sciences; University of Leicester; Leicester UK
| |
Collapse
|
24
|
Shim JS, Kim JH, Choi H, Park JY, Bae JH. Diagnostic Tool for Assessing Overactive Bladder Symptoms: Could the International Prostate Symptom Storage Subscore Replace the Overactive Bladder Symptom Score? Int Neurourol J 2016; 20:209-13. [PMID: 27706011 DOI: 10.5213/inj.1632534.267] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/04/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The goal of this study was to compare the International Prostate Symptom Storage Subscore (IPSS-s) and the overactive bladder symptom score (OABSS) as tools for assessing the symptoms of overactive bladder (OAB). METHODS A cross-sectional study was conducted of a sample of 1,341 patients aged 50 years and older with lower urinary tract complaints who had undergone a medical examination at one of several centers. For each patient, we reviewed the International Prostate Symptom Score and the OABSS. The patients were divided into 2 groups according to their IPSS-s result (group 1, score ≥6; group 2, score<6) and into another 2 groups according to their OABSS diagnosis (group 3, OAB patients; group 4, non-OAB patients). We determined whether the OABSS varied to a statistically significant extent between groups 1 and 2. Furthermore, we evaluated the correlation of IPSS-s severity with the OABSS results in group 3, and the OAB diagnosis rate was compared between groups 1 and 2. RESULTS In groups 1 and 2, the OABSS results were not found to vary to a statistically significant extent (P=0.326). In group 3, no significant correlation was found between IPSS-s severity and the OABSS results (P=0.385). In the prevalence analysis, no statistically significant difference was found among the groups, and the receiver operating characteristic curve showed an area under the curve of 0.474. CONCLUSIONS The results of this cross-sectional analysis suggest that the IPSS-s and the OABSS are not significantly correlated. Although both scores are used to measure OAB symptoms, the simultaneous use of IPSS-s and OABSS is not warranted.
Collapse
|
25
|
Veit-Rubin N, Cartwright R, Esmail A, Digesu GA, Fernando R, Khullar V. The location of pain and urgency sensations during cystometry. Neurourol Urodyn 2016; 36:620-625. [PMID: 26879227 DOI: 10.1002/nau.22975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 01/26/2016] [Indexed: 11/10/2022]
Abstract
AIMS The relationship between bladder pain and urinary urgency sensations is poorly understood. We analyzed the relationship between locations and intensities of urgency and pain sensations felt during filling cystometry. METHODS Participants completed the King's Health Questionnaire (KHQ) to indicate presence of bladder pain or urgency. During cystometry, participants scored the intensity of urgency and pain, both in the suprapubic and the urethral region, on a VAS scale of 0-10 at a baseline, at first desire, normal desire, strong desire to void, and at maximum cystometric capacity during filling. We allocated the participants to six groups; those reporting urgency or not, pain or not, both symptoms and neither. Friedman's Test was used to ascertain if all scores increased significantly, the Wilcoxon Signed Rank Test was used to demonstrate the difference between scores, and agreement for findings during cystometry was tested with Mann-Whitney U. RESULTS A total of 68 women participated; 38 participants reported pain, 57 reported urgency, and 33 reported both symptoms. Pain and urgency scores significantly increased during cystometry (P < 0.0001). For participants reporting pain, suprapubic pain was rated significantly higher than urethral pain. Participants reporting both symptoms, felt more urgency than pain, and again pain more suprapubically than urethrally. Participants reporting only urgency scored suprapubic and urethral urgency similarly at all desires. CONCLUSIONS Pain and urgency are well differentiated sensations and are felt at different locations although pain is seemingly easier localized. Neurourol. Urodynam. 36:620-625, 2017. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Nikolaus Veit-Rubin
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Rufus Cartwright
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Alisha Esmail
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - G Alessandro Digesu
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Ruwan Fernando
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Vikram Khullar
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| |
Collapse
|
26
|
Jiménez Cidre MA, López-Fando L, Esteban M, Franco A, Arlandis S, Castro D, Prieto L, Salinas J, Gutiérrez C, Gutiérrez Baños JL, Cambronero J; Grupo de investigación en Resultados de Salud en Urología Funcional y Urodinámica. How should we address the diagnosis of overactive bladder in women? Actas Urol Esp 2016; 40:29-36. [PMID: 26493277 DOI: 10.1016/j.acuro.2015.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 08/05/2015] [Accepted: 08/06/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Determine the degree of completion, agreement and diagnostic performance of various instruments for assessing the presence and intensity of urgency and other symptoms of idiopathic overactive bladder (OAB) and determine which is the best diagnostic combination. MATERIAL AND METHODS Observational, noninterventional, cross-sectional multicentre study on 247 women aged 18 years or older, with a clinical diagnosis of OAB, evaluated in 55 functional urology and urodynamic units. The women completed the Patient Perception of Intensity of Urgency Scale questionnaire, an independent bladder control self-assessment questionnaire (B-SAQ), the Overactive Bladder Questionnaire Short-Form and a 3-day voiding diary (VD3d), and they underwent a urodynamic study (UDS). The degree of completion and agreement among the instruments was assessed using the Kappa index (95% CI) and Cramér's V. The diagnostic performance of each tool and their combination was studied using absolute frequencies of positive cases for each OAB symptom. RESULTS The patients mean age was 57.66 years (SD, 13.43). There was a high degree of completion (>85%). The agreement among the instruments was poor or moderate, and there was no agreement with the UDS. The best combination of tools for the diagnosis of OAB in women was the B-SAQ and VD3d. CONCLUSIONS The degree of completion of all instruments was high, the agreement between them was poor-moderate and not significant for the UDS. The instruments that had the best diagnostic performance for assessing urgency and other OAB symptoms, providing data on their severity and discomfort, were the B-SAQ and the VD3d.
Collapse
|
27
|
Ciftci S, Ozkurkcugil C, Yilmaz H, Ustuner M, Yavuz U, Yuksekkaya M, Cekmen MB. Urinary nerve growth factor and a variable solifenacin dosage in patients with an overactive bladder. Int Urogynecol J 2016; 27:275-80. [DOI: 10.1007/s00192-015-2825-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/04/2015] [Indexed: 11/27/2022]
|
28
|
Abstract
We reviewed the literature on transcutaneous electrical nerve stimulation (TENS) used as a therapy for overactive bladder (OAB) symptoms, with a particular focus on: stimulation site, stimuli parameters, neural structures thought to be targeted, and the clinical and urodynamic outcomes achieved. The majority of studies used sacral or tibial nerve stimulation. The literature suggests that, whilst TENS therapy may have neuromodulation effects, patient are unlikely to benefit to a significant extent from a single application of TENS and indeed clear benefits from acute studies have not been reported. In long-term studies there were differences in the descriptions of stimulation intensity, strategy of the therapy, and positioning of the electrodes, as well as in the various symptoms and pathology of the patients. Additionally, most studies were uncontrolled and hence did not evaluate the placebo effect. Little is known about the underlying mechanism by which these therapies work and therefore exactly which structures need to be stimulated, and with what parameters. There is promising evidence for the efficacy of a transcutaneous stimulation approach, but adequate standardisation of stimulation criteria and outcome measures will be necessary to define the best way to administer this therapy and document its efficacy.
Collapse
|
29
|
Toglia MR, Serels SR, Laramee C, Karram MM, Nandy IM, Andoh M, Seifeldin R, Sergio FS. Solifenacin for Overactive Bladder: Patient-Reported Outcomes from a Large Placebo-Controlled Trial. Postgrad Med 2015; 121:151-8. [DOI: 10.3810/pgm.2009.09.2062] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
30
|
Mitchell SA, Brucker BM, Kaefer D, Aponte M, Rosenblum N, Kelly C, Hickling D, Nitti VW. Evaluating patients' symptoms of overactive bladder by questionnaire: the role of urgency in urinary frequency. Urology 2014; 84:1039-43. [PMID: 25443897 DOI: 10.1016/j.urology.2014.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 07/01/2014] [Accepted: 07/03/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To explain what role urinary urgency has on urinary frequency in patients with overactive bladder (OAB). MATERIALS AND METHODS We prospectively enrolled 102 patients with OAB over a 6-week period. Patients were assessed with the OAB-q and a pilot questionnaire to identify which urinary symptoms were most bothersome and what underlying cause subjects attributed urinary frequency to. Associations between epidemiologic characteristics, OAB-q scores, and subject responses to the pilot questionnaire, were examined for statistical significance with the Pearson chi square test. RESULTS The study population comprised 85% women and 15% men, with mean age 67.4 years and mean OAB-q score 54. Subjects reported their most bothersome symptom was: frequency 24.5%, urgency or urgency incontinence 48.0%, nocturia 27.5%. Of the patients most bothered by frequency, 64% identified the International Continence Society definition of urgency or "fear of leakage" as the underlying reason for their frequency. Overall, 82.4% and 48.0% of patients reported urgency or urgency incontinence as a symptom and most bothersome symptom respectively. However, when patients were specifically asked what drives their urinary frequency, these percentages increased to 89.2% and 63.7%. CONCLUSION This pilot study confirms that urgency is a large factor underlying the drive to void frequently in OAB, even when patients do not admit to urgency as the most bothersome symptom.
Collapse
|
31
|
Slovak M, Chapple CR, Barker AT. WITHDRAWN: Non-invasive transcutaneous electrical stimulation in the treatment of overactive bladder. Asian J Urol 2014. [DOI: 10.1016/j.ajur.2014.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
32
|
Andersson KE, Nomiya M, Yamaguchi O. Chronic Pelvic Ischemia: Contribution to the Pathogenesis of Lower Urinary Tract Symptoms (LUTS): A New Target for Pharmacological Treatment? Low Urin Tract Symptoms 2014; 7:1-8. [PMID: 26663644 DOI: 10.1111/luts.12084] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 09/30/2014] [Accepted: 10/05/2014] [Indexed: 11/28/2022]
Abstract
The incidence of lower urinary tract symptoms, including overactive bladder (OAB), is continuing to rise, and is associated with a negative impact on quality of life and a heavy economic burden. A major risk factor for OAB is advancing age. The etiology of OAB is multifactorial and appears to involve myogenic, neurogenic, and urotheliogenic factors. In this article, we review the strengthening preclinical evidence supporting the contribution of chronic pelvic ischemia to the pathogenesis of OAB. In animal models, chronic ischemia induced by arterial injury and a high-fat diet upregulates markers of oxidative stress and proinflammatory cytokines in the urothelium and lamina propria, and leads to increased expression of nerve growth factor. These processes result in increased afferent activity and an increased frequency of micturition, reflecting a state of bladder hyperactivity. In severe, prolonged cases, bladder overactivity may develop into underactivity. Antimuscarinic therapies are the mainstay of OAB treatment, but their usefulness is limited by modest efficacy and troublesome side-effects. Our increasing understanding of the contribution of chronic ischemia to OAB is leading toward novel therapeutic options targeting chronic pelvic ischemia and its morphological, functional, and oxidative consequences. Preclinical trials have demonstrated encouraging results with α1 -adrenoreceptor blockade, phosphodiesterase type 5 inhibition, β3 -adrenoreceptor agonism, free radical scavenging, and stem cell therapy, in preventing morphological, biochemical and functional changes induced by chronic bladder ischemia.
Collapse
Affiliation(s)
- Karl-Erik Andersson
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Masanori Nomiya
- Division of Bioengineering and Lower Urinary Tract Diseases Research, Nihon University School of Engineering, Koriyama, Japan
| | - Osamu Yamaguchi
- Division of Bioengineering and Lower Urinary Tract Diseases Research, Nihon University School of Engineering, Koriyama, Japan
| |
Collapse
|
33
|
Han JY, Lee KS, Park WH, Park CH, Lee JG, Lee JZ, Kim DY, Na YG, Kwon DD, Choo MS. A comparative study on the efficacy of solifenacin succinate in patients with urinary frequency with or without urgency. PLoS One 2014; 9:e112063. [PMID: 25401784 PMCID: PMC4234319 DOI: 10.1371/journal.pone.0112063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 10/08/2014] [Indexed: 11/19/2022] Open
Abstract
Objectives Patients with overactive bladder (OAB) often have trouble perceiving urgency because of difficulties in distinguishing between urgency and desire to void. Empirical antimuscarinic treatment of patients with frequency only may be reasonable if conservative management has failed. We compared the efficacy of solifenacin in patients with frequency with or without urgency. Materials and Methods This multicenter, 12-week, open-label, comparative, non-inferiority clinical trial assessed whether the solifenacin efficacy for frequency without urgency is non-inferior to its efficacy for frequency with urgency. All patients had micturition frequency ≥8 voids/day with or without urgency. Primary efficacy variable: daily frequency change at 12 weeks relative to baseline. Secondary efficacy variables: change at 12 weeks relative to baseline in Patients' Perception of Bladder Condition (PPBC), OAB Symptom Score (OABSS), and Benefit, Satisfaction, Willingness to continue (BSW) questionnaire. Results Of the 286 enrolled patients, 240 (83.9%) completed the study (without urgency n = 115; with urgency n = 125). Full dataset analysis revealed that the groups without and with urgency exhibited significant reductions in daily micturition frequency of −2.49±0.35 (mean ± standard error) and −2.63±0.37, respectively. The lower limit of the 95% two-sided CI of the comparison of the two group means was −1.14, which is smaller than the −0.8 margin of clinical equivalence. The two groups did not differ in improvement in PPBC, OABSS, or BSW scores. Both tolerated the treatment well. Conclusions It was not possible to verify that the solifenacin efficacy for frequency alone was non-inferior to its efficacy for OAB. Nevertheless, solifenacin tended to be effective for frequency regardless of urgency. Trial Registration ClinicalTrials.gov NCT00979472
Collapse
Affiliation(s)
- Ji-Yeon Han
- Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kyu-Sung Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Hee Park
- Department of Urology, Inha University College of Medicine, Incheon, Korea
| | - Choal Hee Park
- Department of Urology, Keimyung University School of Medicine, Daegu, Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jeong Zoo Lee
- Department of Urology, Pusan National University Hospital, Busan, Korea
| | - Duk Yoon Kim
- Department of Urology, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Yong Gil Na
- Department of Urology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Dong Deuk Kwon
- Department of Urology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Myung-Soo Choo
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- * E-mail:
| |
Collapse
|
34
|
Rana Z, Cyr RA, Chen LN, Kim BS, Moures RA, Yung TM, Lei S, Collins BT, Suy S, Dritschilo A, Lynch JH, Collins SP. Improved irritative voiding symptoms 3 years after stereotactic body radiation therapy for prostate cancer. Front Oncol 2014; 4:290. [PMID: 25374844 PMCID: PMC4204455 DOI: 10.3389/fonc.2014.00290] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 10/07/2014] [Indexed: 11/18/2022] Open
Abstract
Background: Irritative voiding symptoms are common in elderly men and following prostate radiotherapy. There is limited clinical data on the impact of hypofractionated treatment on irritative voiding symptoms. This study sought to evaluate urgency, frequency, and nocturia following stereotactic body radiation therapy (SBRT) for prostate cancer. Methods: Patients treated with SBRT monotherapy for localized prostate cancer from August 2007 to July 2011 at Georgetown University Hospital were included in this study. Treatment was delivered using the CyberKnife® with doses of 35–36.25 Gy in five fractions. Patient-reported urinary symptoms were assessed using the International Prostate Symptom Score (IPSS) before treatment and at 1, 3, 6, 9, and 12 months post-treatment and every 6 months thereafter. Results: Two hundred four patients at a median age of 69 years received SBRT with a median follow-up of 4.8 years. Prior to treatment, 50.0% of patients reported moderate to severe lower urinary tract symptoms (LUTS) and 17.7% felt that urinary frequency was a moderate to big problem. The mean prostate volume was 39 cc and 8% had prior procedures for benign prostatic hyperplasia. A mean baseline IPSS-irritative (IPSS-I) score of 4.8 significantly increased to 6.5 at 1 month (p < 0.0001), however returned to baseline at 3 months (p = 0.73). The IPSS-I score returned to baseline in 91% of patients by 6 months and 96% of patients by 2 years. Transient increases in irritative voiding symptoms were common at 1 year. The mean baseline IPSS-I score decreased to 4.4 at 24 months (p = 0.03) and 3.7 at 36 months (p < 0.0001). In men with moderate to severe LUTS (IPSS ≥ 8) at baseline, the mean IPSS-I decreased from a baseline score of 6.8–4.9 at 3 years post-SBRT. This decrease was both statistically (p < 0.0001) and clinically significant (minimally important difference = 1.45). Only 14.6% of patients felt that urinary frequency was a moderate to big problem at 3 years post-SBRT (p = 0.23). Conclusion: Treatment of prostate cancer with SBRT resulted in an acute increase in irritative urinary symptoms that peaked within the first month post-treatment. Irritative voiding symptoms returned to baseline in the majority of patients by 3 months post-SBRT and were actually improved from baseline at 3 years post-SBRT.
Collapse
Affiliation(s)
- Zaker Rana
- Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA
| | - Robyn A Cyr
- Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA
| | - Leonard N Chen
- Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA
| | - Brian S Kim
- Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA
| | - Rudy A Moures
- Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA
| | - Thomas M Yung
- Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA
| | - Siyuan Lei
- Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA
| | - Brian T Collins
- Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA
| | - Simeng Suy
- Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA
| | - Anatoly Dritschilo
- Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA
| | - John H Lynch
- Department of Urology, Georgetown University Hospital , Washington, DC , USA
| | - Sean P Collins
- Department of Radiation Medicine, Georgetown University Hospital , Washington, DC , USA
| |
Collapse
|
35
|
Gotoh M, Kobayashi T, Sogabe K. Characterization of symptom bother and health-related quality of life in Japanese female patients with overactive bladder. Neurourol Urodyn 2014; 34:730-5. [PMID: 25212503 DOI: 10.1002/nau.22663] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 06/30/2014] [Indexed: 11/06/2022]
Abstract
AIMS To analyze the impact of overactive bladder (OAB) symptoms and patient characteristics on symptom bother and quality of life (QOL). METHODS An analysis of the data of 967 patients from SET-Q, a prospective, multicenter, open, observational study in the post-marketing setting, was performed. The eligible subjects were treatment-naive female patients with OAB who complained of an urgency episode at least once a week. Symptom bother and QOL were assessed by the OAB-questionnaire (OAB-q), and severity of OAB symptoms was estimated by the OAB symptom score (OABSS). Multiple regression analysis was utilized for clarifying how OAB symptom severity affects QOL. RESULTS The symptoms with the highest bother score were daytime frequency and urgency in the under-50s age group, urgency in the 50s, 60s, and 70s age groups, night-time frequency and urgency incontinence in the over-80s age group, respectively. With an increase in severity of OAB as well as severity of urgency assessed by the OABSS, an increase in symptom bother and impairment in health-related quality of life (HRQL) in the OAB-q were observed. Multiple regression analysis demonstrated the significant relationship with urgency and nighttime frequency to symptom bother, and also significant interaction between age and urgency incontinence, associated with further negative effect on HRQLs in elderly patients. CONCLUSIONS This large sample study, by utilizing the scored questionnaire for symptom severity, bother and HRQL, showed that the symptoms with the highest bother were age-dependent. It was also confirmed that symptom bother will be inferred by the OABSS.
Collapse
Affiliation(s)
- Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Keizo Sogabe
- Medical Affairs, Astellas Pharma Inc., Tokyo, Japan
| |
Collapse
|
36
|
Chapple C, Khullar V, Nitti VW, Frankel J, Herschorn S, Kaper M, Blauwet MB, Siddiqui E. Efficacy of the β3-adrenoceptor agonist mirabegron for the treatment of overactive bladder by severity of incontinence at baseline: a post hoc analysis of pooled data from three randomised phase 3 trials. Eur Urol 2015; 67:11-4. [PMID: 25092537 DOI: 10.1016/j.eururo.2014.06.052] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 06/30/2014] [Indexed: 11/24/2022]
Abstract
UNLABELLED The β3-adrenoceptor agonist mirabegron is approved for treatment of the symptoms of overactive bladder (OAB). Incontinence can be the most bothersome of OAB symptoms. Hence, we conducted a post hoc analysis of pooled data from three randomised, double-blind, placebo-controlled, 12-wk, phase 3 studies of mirabegron to evaluate the efficacy of mirabegron 50mg in incontinent OAB patients and in subgroups of patients stratified by severity of incontinence at baseline (an average of two or more [FAS-I ≥ 2 subgroup] or four or more [FAS-I ≥ 4 subgroup] incontinence episodes per 24h at baseline, where FAS-I is the full analysis set-incontinence population) and to determine correlations between measures of efficacy and disease severity. Mirabegron 50mg resulted in statistically significant improvements from baseline to final visit versus placebo in mean number of incontinence episodes, micturitions, and urgency episodes per 24h and mean volume voided per micturition in the pooled incontinent population and in the FAS-I ≥ 2 and FAS-I ≥ 4 subgroups. Treatment effect versus placebo for incontinence and urgency episodes increased with increasing severity of incontinence at baseline. Moderate correlations were seen between improvement in both frequency of incontinence episodes and micturitions and baseline incontinence and micturition frequency, respectively, with mirabegron 50mg and placebo. PATIENT SUMMARY Incontinence can be the most bothersome of OAB symptoms; mirabegron 50mg once daily is effective for treatment of OAB symptoms in incontinent patients, and its effect increases with increasing severity of incontinence.
Collapse
|
37
|
Bright E, Cotterill N, Drake M, Abrams P. Developing and Validating the International Consultation on Incontinence Questionnaire Bladder Diary. Eur Urol 2014; 66:294-300. [DOI: 10.1016/j.eururo.2014.02.057] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 02/26/2014] [Indexed: 01/15/2023]
|
38
|
Chuang FC, Liu HT, Wang LY, Kuo HC. Overactive Bladder Changes with Time: A 5-Year Longitudinal Followup of Changes in Overactive Bladder Symptoms, Urodynamic Studies and Urinary Nerve Growth Factor Levels. J Urol 2014; 192:458-63. [PMID: 24594404 DOI: 10.1016/j.juro.2014.02.091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2014] [Indexed: 01/12/2023]
Affiliation(s)
- Fei-Chi Chuang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China
| | - Hsin-Tzu Liu
- Department of Urology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, Republic of China
- Institute of Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan, Republic of China
| | - Li-Yu Wang
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan, Republic of China
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, Republic of China
- Department of Urology, Tzu Chi University, Hualien, Taiwan, Republic of China
| |
Collapse
|
39
|
Rossanese M, Novara G, Challacombe B, Iannetti A, Dasgupta P, Ficarra V. Critical analysis of phase II and III randomised control trials (RCTs) evaluating efficacy and tolerability of a β3-adrenoceptor agonist (Mirabegron) for overactive bladder (OAB). BJU Int 2014; 115:32-40. [DOI: 10.1111/bju.12730] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Marta Rossanese
- Department of Experimental and Clinical Medical Sciences; Urology Unit; University of Udine; Udine
| | - Giacomo Novara
- Department of Surgical; Oncologic and Gastrointestinal Sciences; Urologic Unit; University of Padua; Padua Italy
| | | | - Alessandro Iannetti
- Department of Surgical; Oncologic and Gastrointestinal Sciences; Urologic Unit; University of Padua; Padua Italy
| | | | - Vincenzo Ficarra
- Department of Experimental and Clinical Medical Sciences; Urology Unit; University of Udine; Udine
| |
Collapse
|
40
|
Coyne KS, Sexton CC, Thompson C, Bavendam T, Brubaker L. Development and psychometric evaluation of the urgency questionnaire for evaluating severity and health-related quality of life impact of urinary urgency in overactive bladder. Int Urogynecol J 2014; 26:373-82. [DOI: 10.1007/s00192-014-2435-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 05/03/2014] [Indexed: 11/24/2022]
|
41
|
Zeren MF, Yüksel MB, Temeltas G. The comparison of urodynamic findings ?n women with various types of urinary ?ncontinence. Int Braz J Urol 2014; 40:232-9. [DOI: 10.1590/s1677-5538.ibju.2014.02.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 11/25/2013] [Indexed: 11/22/2022] Open
|
42
|
Abstract
OBJECTIVE There is currently a lack of formal guidance for assessing treatment response and non-response in patients with overactive bladder (OAB). Such guidance would be useful for both clinical practice and the design of clinical trials. Our purpose was to review and assess definitions of treatment response and non-response used in patients with OAB. METHODS We conducted a systematic review of articles published between January 1, 2005 and August 8, 2013 using PubMed. Search terms included (overactive bladder) AND ('treatment response' OR responder OR success OR satisfied OR goal OR refractory OR nonresponder OR fail OR persistent OR dissatisfied). Limits were 'humans' and 'English'. Studies conducted in subjects with neurogenic detrusor overactivity, conditions other than OAB, or OAB symptoms following lower urinary tract/pelvic surgery were excluded; case reports and letters were also excluded. RESULTS The literature search returned 423 articles, of which 75 met the inclusion criteria and defined a specific threshold by which treatment response or non-response was determined for patients receiving behavioral therapy and/or treatment with an antimuscarinic, β3-agonist, botulinum toxin, or neural stimulation. One published abstract from congress proceedings and three additional articles that were not identified by the search were included; thus, a total of 79 records were included. A wide variety of symptom-based definitions and patient-reported outcomes (PROs) were used. Symptom-based definitions frequently used a threshold of 50-100% improvement in general or specific symptoms; urgency urinary incontinence (UUI) was often used in studies with incontinent patients. Definitions based on PROs frequently used measures of satisfaction, general improvement, or goal achievement. Studies of patients with refractory OAB often referred to a failure to respond to ≥1 other therapy, or to poor efficacy or unacceptable tolerability, without further specification. Limitations of this review are that only English language articles were included and that only the PubMed database was used for the literature search. CONCLUSIONS There is considerable heterogeneity in the definitions of treatment response and non-response in trials of patients with OAB; some standardization would be beneficial. However, there is also heterogeneity among patients of what constitutes treatment success or failure, and conceptualizations of treatment response and non-response in both clinical trials and clinical practice must take patient characteristics into account. For patients with UUI, it is recommended that the criteria for treatment response include this symptom, as measured by change in the absolute number of UUI episodes or achievement of continence, given its impact on patients' lives and associated bother. PROs provide important information that confirm symptom-based measures by demonstrating that observed changes in symptoms are meaningful to the patient. In clinical practice, measures of treatment satisfaction and goal achievement can be highly useful.
Collapse
Affiliation(s)
- Howard B Goldman
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University , Cleveland, OH , USA
| | | | | | | | | |
Collapse
|
43
|
Chapple CR, Drake MJ, Van Kerrebroeck P, Cardozo L, Drogendijk T, Klaver M, Van Charldorp K, Hakimi Z, Compion G. Total urgency and frequency score as a measure of urgency and frequency in overactive bladder and storage lower urinary tract symptoms. BJU Int 2014; 113:696-703. [DOI: 10.1111/bju.12555] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Christopher R. Chapple
- Royal Hallamshire Hospital; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Gotoh M, Kobayashi T, Sogabe K. Impact of symptom improvement on patients' bother and quality of life in female patients with overactive bladder treated by solifenacin (SET-Q). Int J Urol 2013; 21:505-11. [PMID: 24304092 DOI: 10.1111/iju.12355] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 10/27/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To analyze the relationship between symptom improvement and health-related quality of life in female overactive bladder patients treated with solifenacin. METHODS We carried out a prospective, multicenter, open-label study. Eligible patients were treatment-naive female patients with overactive bladder, with an urgency episode at least once a week. Symptoms were quantitatively assessed by the Overactive Bladder Symptom Score, and quality of life by the Overactive Bladder questionnaire. Changes of symptom severity, bother, and quality of life were assessed at baseline and 12 weeks after treatment with solifenacin 5, 7.5 or 10 mg once daily. RESULTS Data from 523 patients (mean age 66 years) were analyzed. Solifenacin significantly improved the total Overactive Bladder Symptom Score and also all subscores for the four symptoms (daytime frequency, urgency, night-time frequency and urgency incontinence). Solifenacin also significantly improved the four quality of life subscales, total quality of life and symptom bother scores of the Overactive Bladder questionnaire. The severity of night-time frequency at baseline positively affected the improvement in the quality of life subscale of Sleep, and the severity of daytime frequency at baseline positively affected the improvement of coping and social interaction. Improvement of severity in various symptoms positively affected the improvement of bother and the quality of life subscales. CONCLUSIONS Solifenacin provides an overall improvement of bother and quality of life in female overactive bladder patients. Symptom severity before treatment and improvement of symptom severity seem to variably affect this improvement.
Collapse
Affiliation(s)
- Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | | |
Collapse
|
45
|
Das R, Buckley JD, Williams MT. Descriptors of sensation confirm the multidimensional nature of desire to void. Neurourol Urodyn 2013; 34:161-6. [PMID: 24249522 DOI: 10.1002/nau.22520] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 10/10/2013] [Indexed: 11/10/2022]
Abstract
AIMS To collect and categorize descriptors of "desire to void" sensation, determine the reliability of descriptor categories and assess whether descriptor categories discriminate between people with and without symptoms of overactive bladder. METHODS This observational, repeated measures study involved 64 Australian volunteers (47 female), aged 50 years or more, with and without symptoms of overactive bladder. Descriptors of desire to void sensation were derived from a structured interview (conducted on two occasions, 1 week apart). Descriptors were recorded verbatim and categorized in a three-stage process. Overactive bladder status was determined by the Overactive Bladder Awareness Tool and the Overactive Bladder Symptom Score. McNemar's test assessed the reliability of descriptors volunteered between two occasions and Partial Least Squares Regression determined whether language categories discriminated according to overactive bladder status. Post hoc Chi squared analysis and relative risk calculation determined the size and direction of overactive bladder prediction. RESULTS Thirteen language categories (Urgency, Fullness, Pressure, Tickle/tingle, Pain/ache, Heavy, Normal, Intense, Sudden, Annoying, Uncomfortable, Anxiety, and Unique somatic) encapsulated 344 descriptors of sensation. Descriptor categories were stable between two interviews. The categories "Urgency" and "Fullness" predicted overactive bladder status. Participants who volunteered "Urgency" descriptors were twice as likely to have overactive bladder and participants who volunteered "Fullness" descriptors were almost three times as likely not to have overactive bladder. CONCLUSIONS The sensation of desire to void is reliably described over sessions separated by a week, the language used reflects multiple dimensions of sensation, and can predict overactive bladder status.
Collapse
Affiliation(s)
- Rebekah Das
- Nutritional Physiology Research Centre, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | | | | |
Collapse
|
46
|
Affiliation(s)
- N I Osman
- Department of Urology, Royal Hallmashire Hospital, Sheffield, UK
| | | |
Collapse
|
47
|
Phé V, de Wachter S, Rouprêt M, Chartier-Kastler E. How to define a refractory idiopathic overactive bladder? Neurourol Urodyn 2013; 34:2-11. [DOI: 10.1002/nau.22512] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 09/23/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Véronique Phé
- Department of Urology, Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Paris 6 University; Paris France
| | - Stefan de Wachter
- Department of Urology; University Hospital Antwerpen; Antwerpen Belgium
| | - Morgan Rouprêt
- Department of Urology, Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Paris 6 University; Paris France
| | - Emmanuel Chartier-Kastler
- Department of Urology, Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Paris 6 University; Paris France
| |
Collapse
|
48
|
Jang H, Han DS, Yuk SM. Changes of neuregulin-1 (NRG-1) expression in a rat model of overactive bladder induced by partial urethral obstruction: is NRG-1 a new biomarker of overactive bladder? BMC Urol 2013; 13:54. [PMID: 24152577 PMCID: PMC4015862 DOI: 10.1186/1471-2490-13-54] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 10/22/2013] [Indexed: 11/10/2022] Open
Abstract
Background To determine whether neuregulin-1(NRG-1) is a potential new biomarker of overactive bladder (OAB) induced by partial urethral obstruction in a rat model of OAB and to evaluate the urothelium as a therapeutic target of OAB. Methods Female Sprague–Dawley rats were separated into three 20-animal groups: normal, OAB, and 5-hydroxymethyl tolterodine (5-HMT)-treated OAB. In the OAB and OAB + 5-HMT groups, the urethra of each animal was partially obstructed; the OAB + 5-HMT group received intravenous 5-HMT for 3 weeks. At the conclusion of the 5-HMT dosing, the rats in each group underwent cystometrography, and the bladders were histologically evaluated. The expression of brain derived-neurotrophic factor (BDNF) and NRG-1 were evaluated in the urothelium. Results Compared with the control group, the OAB group showed a markedly increased bladder weight and a significant decrease in the micturition interval and volume; rats in the OAB + 5-HMT group showed decreased bladder weights and an improved micturition interval and volume. BDNF and NRG-1 were expressed at significantly higher levels in the OAB group, and were significantly reduced in the OAB + 5-HMT group compared with the control group. Conclusions The study suggests that NRG-1 is a potential new biomarker of OAB; the urothelium might be a therapeutic target for OAB treatment.
Collapse
Affiliation(s)
| | | | - Seung Mo Yuk
- The Department of Urology, The Catholic University of Korea, DaeJeon St, Mary's Hospital, Daeheung-dong, jug-gu, Daejeon, South Korea.
| |
Collapse
|
49
|
SONG M, CHUN JY, YOO DS, HAN JY, CHOO MS. Correlation of the Overactive Bladder Symptom Score, and the Voiding Diary and Urodynamic Parameters in Patients with Overactive Bladder Syndrome. Low Urin Tract Symptoms 2013; 6:180-4. [DOI: 10.1111/luts.12035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 07/26/2013] [Accepted: 08/19/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Miho SONG
- Department of Urology; Asan Medical Center, University of Ulsan College of Medicine; Seoul Korea
| | - Ji-Youn CHUN
- Department of Urology; Asan Medical Center, University of Ulsan College of Medicine; Seoul Korea
| | - Dae Sun YOO
- Department of Urology; Eulji University Hospital, Eulji University College of Medicine; Daejeon Korea
| | - Ji-Yeon HAN
- Departments of Urology; Pusan National University Yangsan Hospital, Pusan National University School of Medicine; Yangsann Korea
| | - Myung-Soo CHOO
- Department of Urology; Asan Medical Center, University of Ulsan College of Medicine; Seoul Korea
| |
Collapse
|
50
|
Osman NI, Chapple CR. The management of overactive bladder syndrome: a review of the European Association of Urology Guidelines. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/cpr.13.48] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|