Mechanism of traditional Chinese medicine in treating overactive bladder

Overactive bladder syndrome (OAB) has made increasing progress in mechanism and treatment research. Traditional Chinese medicine (TCM) is a common complementary therapy for OAB, and it has been found to be effective. However, the intervention mechanism of TCM in the treatment of OAB is still unclear. The aim of this review is to consolidate the current knowledge about the mechanism of TCM: acupuncture, moxibustion, herbs in treating OAB, and the animal models of OAB commonly used in TCM. Finally, we put forward the dilemma of TCM treatment of OAB and discussed the insufficiency and future direction of TCM treatment of OAB.

Retrospective interview-based long-term follow-up study of cats diagnosed with idiopathic cystitis in 2003-2009

OBJECTIVES

The aim of this study was to register long-term recurrence rates and mortality rates in cats diagnosed with feline idiopathic cystitis (FIC), with an observation period until death or a minimum of 10 years.

METHODS

Data regarding recurrence of signs of feline lower urinary tract disease (FLUTD) and FLUTD-related mortality in cats diagnosed with FIC between 2003 and 2009 were obtained through structured telephone interviews with the cat owners from December 2018 until February 2019. The interviews were based on a standardised questionnaire covering whether the cat was still alive or not, whether death/euthanasia were due to FLUTD and whether the cat had experienced recurrent episodes of clinical signs of FLUTD. If recurrences had occurred, exact numbers or estimates of 1-3, 4-6 or >6 recurrences were recorded.

RESULTS

The owners of 50/105 FIC cats included in a previous study (48%) were available for inclusion in the present study. At the time of the interview, only 6/50 cats (12%) were still alive. The FLUTD-related mortality rate was 20% (n = 10/50). Twenty-three cats (46%) had no recurrences, three cats (6%) were euthanased shortly after diagnosis, nine cats (18%) had 1-3 recurrences, three cats (6%) had 4-6 recurrences and six cats (12%) had >6 recurrences. For the remaining six cats, the number of recurrences was uncertain.

CONCLUSIONS AND RELEVANCE

The long-term prognosis for cats diagnosed with FIC may, based on the results from the present study, be regarded as fairly good, as approximately 70% of the cats either recovered without additional episodes, experienced only a few recurrences, are still alive after a minimum of 10 years since inclusion in the study, or were euthanased for reasons unrelated to FLUTD.

Influence of patient sex on the effectiveness of sacral neuromodulation: A cohort study from China

BACKGROUND

Sacral neuromodulation (SNM) has been widely used to treat lower urinary tract dysfunction. Studies have shown a higher conversion rate among female patients than among male patients. However, the influence of gender on the clinical effectiveness of SNM remains unclear. We aimed to confirm whether patients of both genders show similar benefits after SNM treatment.

MATERIALS AND METHODS

Clinical data of patients with lower urinary tract symptoms associated with pelvic floor dysfunction (overactive bladder, neurogenic bladder, interstitial cystitis/painful bladder syndrome, idiopathic urinary retention) treated with SNM in 10 medical centres in China between January 2012 and December 2016 were retrospectively collected. The patients were classified by gender. Variations in objective (voiding diary) and subjective scores in the baseline, testing, and last follow-up periods were compared. Data were analysed using statistical measures.

RESULTS

The study included 203 patients (93 males, 110 females). There were no statistical differences in baseline information between the two groups, both groups showed improvement over time. Unsatisfactory improvement was observed in the quality of life and sexual life scores of both groups over the entire treatment period (all p＞0.05). Although there was a difference in the maximum voiding volume between the groups at baseline, no difference was observed at the last follow-up (p = 0.004, p = 0.044, p = 0.124), unlike in the average volume where a difference was noted at the last follow-up (p = 0.085, p = 0.964, p = 0.031). While there were no differences in quality of life, sexual life, or pelvic pain and urinary urgency frequency scores at baseline, a significant difference was observed at the last follow-up, and the degree of improvement was less among female patients (p = 0.836, p = 0.131, p = 0.015; p = 0.294, p = 0.265, p = 0.013; p = 0.299, p = 0.087, p = 0.015).

CONCLUSION

SNM treatment elicited a similar effect on patients of both gender; however, a significant difference was observed regarding patient satisfaction with the treatment. Further preoperative patient education, especially, for female patients with interstitial cystitis/painful bladder syndrome may improve patient satisfaction.