Female Overactive Bladder Patients Research Articles

THE RELATIONSHIP OF THE INCIDENT OF METABOLIC SYNDROME AND OVERACTIVE BLADDER IN FEMALE PATIENTS AT DR. M. DJAMIL PADANG IN 2023

Overactive Bladder (OAB) is a chronic medical condition that has a negative impact on an individual's health and quality of life. Cardiovascular problems are considered to be one of the risks associated with OAB where one of the higher cardiovascular parameters is metabolik syndrome. Aim to determine the relationship between  metabolik syndrome and Overactive Bladder in female patients at Dr. M. Djamil Hospital Padang. Quantitative research with a case control design using a questionnaire according to the Overactive Bladder Symptom Score (OABSS) and examination based on metabolik syndrome symptoms. The research was conducted at Dr. M. Djamil Hospital Padang in November 2022 to September 2023. There were 60 respondents who were divided into the OAB (28/60) and no-OAB group (32/60). Most respondents were aged 50-59 years (45,0%), graduated from high school (53.3%), worked as housewives (76.7%) and had diabetes mellitus (78,3%). In this study it was also found that 48,3% of respondents suffered from hypertension and 45.0% suffered from obesity. A total of 46.7% of respondents experienced OAB symptoms with a higher percentage of OAB found in the metabolik syndrome group (76,7%) than no-metabolik syndrome group (16.7%). Bivariate analysis found a relationship between metabolik syndrome and overactive bladder symptoms (p = 0.000) with metabolik syndrome affected the incidence of overactive bladder by 16.4 times (OR 16.42, (CI 95% 4.56-59.07). There is a relationship between metabolik syndrome and the incidence of OAB.

Association between COVID-19 and increased incidence of overactive bladder symptoms in female patients: A retrospective analysis

Introduction and objectivesTo investigate female patients' post-COVID-19 voiding symptoms and to research how they relate to overactive bladder (OAB). PatientsOne hundred and forty patients aged 20–50 years who were hospitalised and discharged due to COVID-19 at Kartal Dr. Lütfi Kırdar City Hospital between 2021 and 2022 and 50 patients with a history of COVID-19 among two hundred female patients who presented to the urology outpatient clinic with symptoms related to OAB were retrospectively analysed. Bladder diary, overactive bladder symptom score (OABSS), uroflowmetry values and time of onset of symptoms of symptomatic patients were recorded for all patients. Disease-free individuals for control purposes were not included in the study. ResultsIt was observed that 38% of 140 hospitalized patients had a symptomatic change related to OAB, and there was a significant difference in voiding diary, OABSS, and uroflowmetry Qmax values between symptomatic and non-symptomatic patients after COVID-19. (p:0.001) There was a significant difference between the pre-COVID-19 (estimated) and post-COVID-19 (current) voiding diary and OABSS values of all symptomatic patients (with and without a history of hospitalization). (p:0.001) When these two groups were compared with each other, there was a significant difference between the post-COVID-19 voiding diary, OABSS values, and the meantime to the onset of symptoms in inpatients and outpatients (p:0.001) ConclusionCOVID-19 may be associated with urgency/urge incontinence and overactive bladder in female patients.

Asociación entre COVID-19 y el aumento en la incidencia de síntomas de vejiga hiperactiva en pacientes femeninas: un análisis retrospectivo

Introduction and objectivesTo investigate female patients’ post-COVID-19 voiding symptoms and to research how they relate to overactive bladder (OAB). PatientsOne hundred and forty patients aged 20-50 years who were hospitalised and discharged due to COVID-19 at Kartal Dr. Lütfi Kırdar City Hospital between 2021 and 2022 and 50 patients with a history of COVID-19 among two hundred female patients who presented to the urology outpatient clinic with symptoms related to OAB were retrospectively analysed. Bladder diary, overactive bladder symptom score (OABSS), uroflowmetry values and time of onset of symptoms of symptomatic patients were recorded for all patients. Disease-free individuals for control purposes were not included in the study. ResultsIt was observed that 38% of 140 hospitalized patients had a symptomatic change related to OAB, and there was a significant difference in voiding diary, OABSS, and uroflowmetry Qmax values between symptomatic and non-symptomatic patients after COVID-19 (p: 0.001). There was a significant difference between the pre-COVID-19 (estimated) and post-COVID-19 (current) voiding diary and OABSS values of all symptomatic patients (with and without a history of hospitalization) (p: 0.001). When these two groups were compared with each other, there was a significant difference between the post-COVID-19 voiding diary, OABSS values, and the meantime to the onset of symptoms in inpatients and outpatients (p: 0.001). ConclusionCOVID-19 may be associated with urgency/urge incontinence and overactive bladder in female patients.

LBA01-18 COMPARISON OF MIRABEGRON AND VIBEGRON FOR CLINICAL EFFICACY AND SAFETY IN FEMALE PATIENTS WITH OVERACTIVE BLADDER: A MULTICENTER, PROSPECTIVE RANDOMIZED CROSSOVER TRIAL

LBA01-18 COMPARISON OF MIRABEGRON AND VIBEGRON FOR CLINICAL EFFICACY AND SAFETY IN FEMALE PATIENTS WITH OVERACTIVE BLADDER: A MULTICENTER, PROSPECTIVE RANDOMIZED CROSSOVER TRIAL

The choice of therapeutic agent in female overactive bladder patients in real-world practice.

The reasons why anticholinergic drugs or β3 adrenergic agonists are selected as treatments for overactive bladder (OAB) are unclear. The aim of this study was to investigate the background data of female OAB patients that were prescribed anticholinergic drugs or β3 adrenergic agonists in a real-world setting. Between January 2013 and December 2014, 75 patients who had been diagnosed with OAB were included in this study. Administered medications, age, the persistence on treatment rate at one-year, medical history, pretreatment total Overactive Bladder Symptom Score (OABSS), pretreatment score for each OABSS factor, body mass index (BMI), and various comorbidities were evaluated retrospectively. Since there were many types of anticholinergic drugs and few patients, we grouped the patients into those that were prescribed anticholinergic drugs (group A) and those that were prescribed β3 adrenergic agonists (group B). 75 patients (29 in group A and 46 in group B) were included in this study. There were no significant differences in age, BMI, obesity, medical history, pretreatment total OABSS, or pretreatment score for each OABSS factor. There was a significant difference in the post-voiding residual urine volume (PVR) between the groups (group A: 22 ml, group B: 9 ml; p = 0.0252). The 1-year persistence on treatment rate was 28% in both groups. There were no significant differences in clinical characteristics of patients who were prescribed anticholinergics and β3 adrenergic agonists for OAB treatment, but a marginal difference of PVR value before treatment. The 1-year persistence rates of anticholinergic drugs and β3 adrenergic agonists were considered to be almost equivalent.

Unraveling the impact of Lactobacillus spp. and other urinary microorganisms on the efficacy of mirabegron in female patients with overactive bladder.

Overactive bladder (OAB) is a disease that seriously affects patients' quality of life and mental health. To address this issue, more and more researchers are examining the relationship between OAB treatment and urinary microecology. In this study, we sought to determine whether differences in treatment efficacy were related to microbiome diversity and composition as well as the abundance of specific genera. Machine learning algorithms were used to construct predictive models for urine microbiota-based treatment of OAB. Urine samples were obtained from 64 adult female OAB patients for 16S rRNA gene sequencing. Patients' overactive bladder symptom scores (OABSS) were collected before and after mirabegron treatment and patients were divided into effective and ineffective groups. The relationship between the relative abundance of certain genera and OABSS were analyzed. Three machine learning algorithms, including random forest (RF), supporting vector machine (SVM) and eXtreme gradient boosting (XGBoost) were utilized to predict the therapeutic effect of mirabegron based on the relative abundance of certain genera in OAB patients' urine microbiome. The species composition of the two groups differed. For one, the relative abundance of Lactobacillus was significantly higher in the effective group than in the ineffective group. In addition, the relative abundance of Gardnerella and Prevotella in the effective group was significantly lower than in the ineffective group. Alpha-diversity and beta-diversity differed significantly between the two groups. LEfSe analysis revealed that Lactobacillus abundance increased while Prevotella and Gardnerella abundance decreased in the effective group. The Lactobacillus abundance ROC curve had high predictive accuracy. The OABSS after treatment was negatively correlated with the abundance of Lactobacillus, whereas the relationship between OABSS and Prevotella and Gardnerella showed the opposite trend. In addition, RF, SVM and XGBoost models demonstrated high predictive ability to assess the effect of mirabegron in OAB patients in the test cohort. The results of this study indicate that urinary microbiota might influence the efficacy of mirabegron, and that Lactobacillus might be a potential marker for evaluating the therapeutic efficacy of mirabegron in OAB patients.

The detection of urinary viruses is associated with aggravated symptoms and altered bacteriome in female with overactive bladder.

Although it is known that changes in bacterial components of the urinary microbiome are associated with overactive bladder (OAB), the specific role of viruses is still insufficiently investigated. The aim of the present study is to evaluate the role of urinary viruses in woman with OAB, and analyze the potential relationship between viruses, bacteria and disease. Catheterized urine samples were collected from 55 women with OAB and 18 control individuals. OAB patients fulfilling the following criteria were considered eligible for this study: female, 18 years of age or older; presented with classic OAB symptoms defined by the International Continence Society; and OAB Symptom Score (OABSS) total score ≥ 3 points and question 3 (urgency) score ≥ 2 points. Based on results of metagenomic next-generation sequencing (mNGS), all participants were divided into virus-infected and virus-uninfected groups for analysis. The results of mNGS showed that the diversity of the OAB group was lower than that of the control group when focused on bacterial sequences, which was consistent with our previous study. According to the questionnaire filled out by the patients, OABSS and 8-item OAB questionnaire, female OAB patients who had viruses detected in their urine had more severe symptoms. In parallel, John Cunningham virus (mainly subtype 7 and subtype 2) was the most frequently detected virus in urine. Correlation analysis indicated that risk factors for virus infection in OAB patients include age, habit of holding urine and pelvic surgery history. Given our preliminary data, viral infection can aggravate OAB severity and affect the composition of bacterial. Further research is required to explain how viral infections can aggravate OAB patient symptoms and cause bacterial changes.

The Effects of Suburethral Tension Adjustable Sling (Remeex system) for Female Urinary Incontinence between Pure Intrinsic Sphincter Deficiency and Intrinsic Sphincter Deficiency with Overactive Bladder: Initial Experience with Propensity Score Matching

Objective: To compare the therapeutic efficacy after suburethral adjustable sling (Remeex system) for female stress urinary incontinence (SUI) between pure intrinsic s phincter deficiency (ISD) and ISD with overactive bladder (OAB) group. Methods: The study subjects were 86 female patients with ISD who underwent Remeex system to treat female SUI and who were available for 12 months follow-up. We retrospectively studied both patients who underwent Remeex system due to pure ISD (group I) and those who underwent Remeex system due to ISD with OAB (group II). Improvement in objective and subjective symptoms were retrospectively evaluated using a 1hr pad weight test, global response assessment (GRA) and overactive bladder symptom score (OABSS). Results: Group I included 43 patients and group II included 43 patients of mean ages 56.8 ± 7.5 and 57.4 ± 6.6 years, respectively. Use of 1 hr pad weight test showed that incontinence decreased after the procedures in both groups, and that of group I patients was significantly lower than that of group II patients. The mean GRA score was significant a higher score in group I. The OABSS of patients in group II were 8.2 ± 1.1 and 7.2 ± 1.1, respectively, before and at 12 months after operation, did differ significantly. The mean change of OABSS of group II patients was significantly more decreased than that of group I patients. Conclusions: The Remeex system showed a greater patient satisfaction and a higher cure rate in pure ISD than ISD with OAB in female patients with urinary incontinence.

Evaluation of pelvic floor muscle elasticity in patients with overactive bladder syndrome using real-time tissue elastography

Introduction and hypothesisThe purpose of this study was to compare the muscle elasticity of the striated urethral sphincter (SUS) using real-time tissue elastography (RTE) as an evaluation of pelvic floor muscle (PFM) function between overactive bladder (OAB) patients and healthy women. MethodsThe subjects were 8 healthy middle-aged women (healthy group; age range 57–65 years) and 9 female OAB patients (OAB group; age range 42–80 years). The target sites of elastography were the striated urethral sphincter (SUS) and adipose tissue as the reference site; muscle elasticity was calculated as the strain ratio (SR) of the SUS to the reference site. Evaluations were performed at rest and during PFM contraction. The OAB group completed OAB symptom and quality of life questionnaires. The SUS SR was compared between the groups. The SUS SR at rest and during PFM contraction was compared within groups using the t-test and Wilcoxon’s test. The relationship between the questionnaire results and the SUS SR was evaluated by correlation analysis. ResultsIntergroup comparisons between the healthy and OAB groups showed no significant differences in SUS SR at rest and during PFM contraction. On intragroup comparisons, the SUS SR was significantly higher during PFM contraction than at rest in the healthy group (p = 0.011); in the OAB group, there was no significant difference in the SUS SR between rest and PFM contraction. The SUS SR was not significantly correlated with questionnaire results for OAB symptoms. ConclusionThis study shows the potential to non-invasively confirm the inability of OAB patients to correctly perform PFM contraction using RTE.

Correlation between overactive bladder and detrusor overactivity: a retrospective study.

The primary objective of this study is to determine the prevalence of overactive bladder (OAB) and detrusor overactivity (DO) in female patients who were referred for urodynamic study (UDS) because of lower urinary tract symptoms (LUTS). The secondary objective is to determine the subjective and objective differences between female OAB patients with and without DO. All female patients who underwent UDS for LUTS between June 2016 and September 2019 were retrospectively reviewed. Personal history, medical history, physical examination, and validated questionnaires were collected. One-hour pad test and multichannel urodynamic study was performed. All statistical analyses were conducted by SAS 9.4. P-value < 0.05 was considered statistically significant. A total of 4184 female patients underwent UDS because of LUTS between June 2016 and September 2019; 1524 patients were analyzed for OAB or DO. The occurrence of OAB was 36.4%. The overall incidence of DO in OAB patients was 15.5%; 9.5% of all patients had DO findings on UDS, and 4.6% were incidental findings. There were significant differences among mean age, parity, ICIQ-UI SF, OABSS, POPDI-6, and all UDS parameters (except for maximal urethral pressure and pressure transmission ratio) between patients with and without DO. In patients with DO, there were no significant differences among age, parity, and BMI with or without OAB symptoms. However, there were significant differences among mean OABSS, ICIQ-UI SF, UDI-6, POPDI-6, IIQ-7, and pad test. Patients with DO are associated with older age, increased parity, greater urine leakage, and worse storage and micturition functions on UDS. Combinations of subjective and objective measurements are better predictive models for OAB patients.

The use of urinary biomarkers in the diagnosis of overactive bladder in female patients. A systematic review and meta-analysis.

Nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and other proteins are related to overactive bladder (OAB) syndrome, as their urinary concentrations are significantly different from those of the general non-OAB population. This review aims to systematically assess whether NGF, BDNF, and other urinary by-products can be used as potential biomarkers to manage women with OAB. This was a systematic review and metanalysis that was conducted according to PRISMA guidelines. Studies were identified by electronic search of Medline, Scopus, ScienceDirect, Embase, and Cochrane Register until October 2020. The included studies investigated the correlation of OAB with NGF, BDNF, and other potential biomarkers in symptomatic women and their controls. Twelve studies (581 female OAB patients and 394 female controls) were included. Urinary NGF, NGF/Cr, BDNF/Cr, ATP/Cr, and PGE2/Cr ratios were identified as potential biomarkers in female OAB patients. Results of the meta-analysis indicated that uNGF [standard mean difference (SMD) 1.45, 95% CI 0.53-2.36], NGF/Cr ratio (SMD 1.23, 95% CI 0.67-1.78), BDNF/Cr ratio (SMD 0.78, 95% CI 0.006-1.50), and BDNF/Cr ratio (RR 0.78, 95% CI 0.006-1.50) were increased in female OAB patients compared to healthy controls, whereas no difference was found for the PGE2/Cr and ATP/Cr ratios. Current data are inadequate to assess any other potential biomarkers, such as urinary MDA, ATP, and cytokines, in the management of OAB in female patients. uNGF, NGF/Cr, and BDNF/Cr ratio could be used in the assessment of female OAB patients. Further studies are needed to specify OAB urinary titer levels in OAB subgroups and healthy women and their potential as diagnostic and management tools in OAB women.

Comparison between efficacy of solifenacin and oxybutynin for the treatment of overactive bladder in women.

Objective: To compare the efficacy of solifenacin and oxybutynin in the treatment of overactive bladder in female patients. Study Design: Quasi Experimental study. Setting: Department of Urology, Institute of Kidney Diseases, Peshawar. Period: July 2018 to May 2019. Material &amp; Methods: After selection of 312 female patients with overactive bladder by simple random sampling, written informed consent was taken and pre-treatment overactive bladder symptoms (OABS) score was calculated. Patients were randomly distributed in two equal groups of 156 subjects, where Group A received Oxybutynin (3 mg, BD) and Group B received Solifenacin (5mg, OD) for a period 12 weeks. Patients were called for follow up visit to determine and compare the efficacy of study drugs. Those who showed improvement in at least 03 points in OABS score taken pre-treatment were considered as positive responders. Results: The mean age of patients was 38.8 ± 7.62 years with age range from 20 to 50 years. 110 (70.5%) subjects in oxybutynin treated group while 126 (80.8%) subjects in solifenacin treated group reported significant improvement in OAB symptoms. Conclusion: Solifenacin is relatively more effective than oxybutynin for treating female patients with overactive bladder.

Effect of oxybutynin patch versus mirabegron on nocturia-related quality of life in female overactive bladder patients: A multicenter randomized trial.

To investigate the effect of oxybutynin patch versus β3-adrenoceptor agonist mirabegron on nocturia-related quality of life in female overactive bladder patients. In the present study, female overactive bladder patients were enrolled. The patients were randomly allocated into two groups: the oxybutynin patch group and the mirabegron group. Each of the drugs was given for 8weeks. The changes in the total Nocturia Quality of Life Questionnaire score were evaluated. Parameters on a frequency volume chart were also evaluated. In total, 100 patients (51 oxybutynin patch, 49 mirabegron) were treated with oxybutynin patch or mirabegron. The changes in the Nocturia Quality of Life Questionnaire score 4weeks after administration were 3.8±18.6 and 8.7±13.1 with the oxybutynin patch group and the mirabegron group, respectively, which were significantly higher than those at the baseline. Furthermore, the changes in the Nocturia Quality of Life Questionnaire score 8weeks after administration were 4.3±16.5 and 7.7±12.3, respectively. A statistical difference was seen only in the mirabegron group. Regarding the Nocturia Quality of Life Questionnaire subscores, oxybutynin patch and mirabegron significantly improved the Nocturia Quality of Life Questionnaire bother/concern subscore 4 and 8weeks after administration, whereas the Nocturia Quality of Life Questionnaire sleep/energy subscore was not significantly improved in each period. Eight weeks after administration, 24-h frequency, 24-h urinary urgency and mean voided urine volume were improved in both groups statistically. The oxybutynin patch improves quality of life, focusing mainly on nocturia by improving the bother/concern subscores of the Nocturia Quality of Life Questionnaire in the short term.

Comparison of Oral Sodium Bicarbonate and Solifenacin Treatment in Female Overactive Bladder Patients With Acidic Urine pH

(Abstracted from Female Pelvic Med Reconstr Surg 2020;26:649–653) Overactive bladder (OAB) syndrome affects 1 of 7 US women. The syndrome is characterized by the presence of urinary urgency, with or without urgency urinary incontinence, usually accompanied by frequency and nocturia.

Excessive accumulation of visceral fat is associated with lower urinary symptoms including overactive bladder in female patients.

ObjectiveTo assess the relationship between visceral fat accumulation and lower urinary tract symptoms in female patients.MethodsIn this single‐center study, we enrolled all women who underwent screening abdominal computed tomography 3 months before the study, irrespective of whether they experienced lower urinary tract symptoms. The Overactive Bladder Symptom Score was used to assess subjective symptoms. Uroflowmetry and ultrasound assessment of post‐void residual urine were carried out to assess objective signs. We analyzed the relationship between lower urinary tract symptoms and various body fat accumulation parameters, including visceral fat area, visceral fat volume and total abdominal fat volume, assessed using computed tomography scans.ResultsA total of 182 patients were divided into the overactive bladder (n = 71, 39.0%) and the non‐overactive bladder (n = 111, 61.0%) groups. The visceral fat area, visceral fat volume and visceral fat volume/total abdominal fat volume values were all significantly higher in the overactive bladder group than in the non‐overactive bladder group (P < 0.001). Of these parameters, the visceral fat volume/total abdominal fat volume ratio showed the strongest correlation with the total Overactive Bladder Symptom Score (r = 0.394, P < 0.001). The maximum urine flow rate correlated negatively with the visceral fat volume/total abdominal fat volume value (visceral fat volume/total abdominal fat volume r = –0.289, P < 0.001). Subsequent multivariate analysis showed that a high visceral fat volume/total abdominal fat volume value, age and metabolic syndrome‐related diseases were independent risk factors for the presence of overactive bladder.ConclusionsExcessive accumulation of visceral fat is independently associated with overactive bladder in females.

Mirabegrone versus Solifenacine in Treatment of Overactive Bladder in Female Patients in Zagazig University Hospitals

Background: Overactive bladder (OAB) syndrome, consisting of urgency, with or without urgency incontinence, often with frequency (voiding more than eight times in a 24- h period) and nocturia (need to wake up one or more times per night for urination), is a highly prevalent disorder with a significant impact on quality of life (QoL). Objective: To evaluate the safety and efficacy of mirabegron 50 mg in comparison to solifenacin 5 mg in the treatment of female patients suffering from overactive bladder symptoms. Patients and Methods: This prospective randomized study was conducted in Zagazig University Hospitals during the period From November 2018 to April 2019. Thirty consecutive female patients aged from 18 to 65 years old were included in this study. Results: Mirabegrone significantly was associated with hypertension only in one case, and Solifenacine significantly was associated with blurred vision, constipation and dry mouth. Comparison between mirabegron and solifenacin group according to day and night frequency, urge and urge incontinence pretreatment showed that there was no significant difference between both groups. Comparison between mirabegron and solifenacin groups according to day and night frequency, urge and urge incontinence after taking mirabegrone or solifenacin showed that mirabegron group was significantly lower as regards day and night frequency also in urgency and urgency incontinence post treatment. Conclusions: Solifenacin and mirabegron were effective in improving over active bladder symptoms. Mirabegron showed greater tolerability with fewer patients discontinuing therapy because of side effects. mirabegron can be considered as the drug with the better balance between efficacy and tolerability in the treatment of OAB.

Bladder sensations in male and female overactive bladder patients compared to healthy volunteers: a sensation-related bladder diary evaluation

Objectives: To investigate the differences in bladder sensations of overactive bladder (OAB) patients compared to healthy volunteers. In addition, to see if bladder sensations are different in men and women.Methods: In a prospective, longitudinal study (METC 09-2-095), 66 volunteers and 68 OAB patients were included. Anticholinergic medication was stopped. Subjects filled out a sensation-related bladder diary (SR-BD), for two periods of 3 days, including a 4-points urgency scale and visual analogue scale for perception of bladder fullness.Results: In total, 6160 voids were assessed. Patients voided more often with higher degrees of urge at a lower mean voided volume (193 vs 270 ml/void; p < 0.001) than healthy volunteers. The mean urinary frequency per litre diuresis was also higher (5.8 vs 4.1/l; p < 0.001) in patients. At the same voided volume: patients perceived a higher mean bladder fullness, independent of the degree of urge, and higher urgency (1.4 vs 0.5/100 ml; p < 0.001) than healthy volunteers. There were no gender differences in the above-mentioned voiding parameters, except for the mean voided volume at urge 3 in volunteers (340 ml in men vs 362 ml in women; p = 0.03) and urge 1 in patients (171 ml in men vs 135 ml in women; p = 0.027).Conclusions: Bladder sensations were significantly increased in everyday life for both male and female OAB patients compared to healthy volunteers. OAB patients experienced a higher mean bladder fullness sensation, independent of the degree of urge, and higher mean urge/urgency at the same voided volume than volunteers. Bladder sensations are crucial in the assessment of treatment response.

Long-term persistence with mirabegron in a real-world clinical setting.

To examine the long-term persistence rate with mirabegron in a real-world clinical setting. We retrospectively collected the data of patients who were prescribed mirabegron. We investigated the persistence rate and the reason for the discontinuation. The analysis included patient's age, diagnosis, Overactive Bladder Symptom Score, prostatic volume, the prescription by specialists for lower urinary tract dysfunction, drug-naïve patients, replacement of antimuscarinics or add-on therapy to antimuscarinics. A total of 556 patients were included. Among them, 401 patients (72%) had overactive bladder and the other 155 (28%) were categorized as having other storage symptoms. During the observation period, 170 patients (42%) with overactive bladder discontinued mirabegron. The reasons for discontinuation in patients with overactive bladder included unmet expectation of treatment (45 patients, 26%), any adverse events (38 patients, 22%) or symptom improvement (37 patients, 22%). The persistence or discontinuation was not related with age, Overactive Bladder Symptom Score, prostatic volume or the prescription by specialists, while older male patients tended to continue mirabegron. The 3-year persistence rates in female and male overactive bladder patients were 46% and 51%, respectively, and these were better than those in patients with storage symptoms without urgency. In female overactive bladder patients, the persistence rate with mirabegron used as add-on therapy to antimuscarinics was higher than that in the drug-naïve patients on the Kaplan-Meier curve. The present study shows a relatively good long-term persistence rate with mirabegron in overactive bladder patients, notwithstanding the retrospective study in an academic hospital. The combined treatment with antimuscarinics could result in a good persistence rate with mirabegron.

MicroRNAs as potential biomarkers to predict the risk of urinary retention following intradetrusor onabotulinumtoxin-A injection.

MicroRNAs (miRs) control post-transcriptional gene expression, and this is relevant in understanding better chronic diseases and treatment outcomes. The role of miRs in the pathology and treatment outcomes of overactive bladder (OAB) is unknown. In this study, we assessed the differential expression of miRs in OAB patients responding with either normal or elevated post-void residual volumes (PVRs) ≥200 mL following intradetrusor injection of onabotulinumtoxin-A (onaBoNT-A). Female OAB patients refractory to OAB drugs were consented for this study. Cystoscopic-guided punch bladder biopsy was obtained at the time of injection of onaBoNT-A 100 units. The expression of 13 miR species, selected for their known effect on neurotrophin expression and smooth muscle function, was measured. PVRs and urine nerve growth factor (NGF) levels were measured at baseline and at the follow-up visit. Fourteen patients with mean age of 66 years were consented. Of these patients, nine maintained PVRs <200 mL after onaBoNT-A injection to comprise the low PVR group. The other five patients with PVRs ≥200 mL comprised the high PVR group. The expression of miR221 and miR125b was upregulated by 11- and 2-fold, respectively, in patients who responded with low PVRs after onaBoNT-A (P < 0.05). Urine NGF levels at baseline were not different between the two groups. This study suggests that deficiency in the pretreatment expression of miR221 and miR125b may predispose OAB patients to high PVRs following intradetrusor onaBoNT-A. Additional studies are needed to better understand the role of miRs in OAB.

Effect of trospium chloride therapy on intraocular pressure and tear secretion in overactive bladder patients

Purpose: To investigate the effect of trospium chloride, which has an anticholinergic effect, used in overactive bladder (OAB) treatment on the intraocular pressure (IOP) and tear secretion after 12 weeks of treatment.Materials and methods: This prospective study was performed at a single center between October 2014 and January 2016. A detailed history was obtained from the female OAB patients at the eye outpatient department. After checking the exclusion criteria, oral trospium chloride 30 mg bd was started. The patients were followed-up in terms of drug effectiveness and ophthalmic and other side effects at the 4th and 12th weeks. All procedures were repeated at both of these time-points.Results: The mean age of the patients was 48.98 ± 11.98 years (range 19–75). The data of 80 OAB patients were evaluated in the study. Trospium chloride did not cause any significant change in the OAB patients regarding their 4th week and 12th week IOP measurements (p = 0.251, p = 0.340, respectively). It was found to decrease tear secretion significantly at both time-points (p = 0.020, p = 0.001, respectively). Trospium chloride treatment of one patient (1.25%) was discontinued due to dry eye.Conclusions: Trospium chloride decreases the symptoms in female OAB patients. Trospium chloride can be safely used in female OAB patients with normal IOP and no comorbidity as regards IOP changes as it did not cause a significant change in IOP in these patients. Pre-treatment and post-treatment dry eye symptoms of OAB patients about to start using trospium chloride should be queried beforehand as it can cause a statistically significant decrease in tear secretion. We concluded that it would be appropriate to refer the patients to an ophthalmologist before starting the drug if relevant symptoms are present.