Mean Overactive Bladder Symptom Score Research Articles

The impact of catheter removal time on urinary continence and overactive bladder symptoms after robot-assisted radical prostatectomy: a retrospective analysis of consecutive 432 cases from a single institution.

After radical prostatectomy, the optimal length of postoperative catheterization time remains to be determined. This study investigates the impact of catheter removal time on urinary continence and overactive bladder (OAB) symptoms after robot-assisted radical prostatectomy (RARP). Four hundred and thirty-two consecutive patients underwent RARP by a single surgeon between Nov 2020 and Oct 2021. Time to catheter removal was categorized into 7, 10, and ≥14 days. Continence was defined as no more than 1 pad used or no more than 20 g of urine leakage per 24 hours. The patients' continence rates and overactive bladder symptom score (OABSS) were assessed at 48 hours, 1 week, 4, 12, and 24 weeks after catheter removal. Overall, continence rates were 37.3% 48 hours after catheter removal, 54.4% 1 week, 77.5% 4 weeks, 92.1% 12 weeks, and 97.9% 24 weeks after catheter removal. The median time to regain continence was 1 week. At 4 weeks after catheter removal, the continence rate in the ≥14 days group (70.5%) was significantly lower than the 7 days group (86.3%) and 10 days group (83.0%) (P=0.001). In a univariate Cox regression analysis, the presence of diabetes, higher pre-operative OABSS, and a catheterization time of 10 days were associated with worse continence recovery. The mean OABSS of patients in the continent group were significantly lower than the incontinent group at 48 hours, 4, 12 and 24 weeks after catheter removal. At 24 weeks after catheter removal, the mean OABSS in the 7 days group was significantly lower than in other groups. Early catheter removal (7 days) was associated with better continence results and lower OABSS at 4 and 24 weeks after catheter removal respectively.

Exploring pelvic floor muscle activity in men with lower urinary tract symptoms.

AimWe aimed to explore the utility of the Multiple Array Probe Leiden (MAPLe) device to assess pelvic floor muscle activity in men with lower urinary tract symptoms (LUTS).MethodsThis was an observational cohort study performed at the urology outpatient department of a large teaching hospital in the Netherlands between April and October 2018. We recruited male patients referred for the assessment of LUTS, without a history of prostate surgery, if they had an International Prostate Symptom Score greater than or equal to 8. The MAPLe device was then used to assess the puborectalis, pubococcygeus, iliococcygeus, urogenital diaphragm, and the internal and external anal sphincters during three tasks: a rest period (1 minute), five maximum voluntary contractions (held for 3 seconds each), and three maximal endurance contractions (held for 15 seconds each).ResultsIn total, 57 patients were included, 5 of which had diabetes mellitus. Muscle activity at rest was significantly lower than during either contraction task and did not differ between the muscle groups. By contrast, the external anal sphincter had significantly less activity than any other muscle group during the endurance task, and the internal anal sphincter and puborectalis had significantly less activity during the maximum voluntary contraction task. No association was found between pelvic floor muscle activity and LUTS severity during any task.ConclusionPelvic floor muscle activity and LUTS severity appear to be unrelated, but this does not completely exclude the possibility of muscle involvement in the development or experience of symptoms. Further research is needed.

Turkish validation of the overactive bladder symptom score (OABSS) and evaluation of mirabegron treatment response.

Overactive bladder (OAB) is a syndrome with symptoms such as urinary frequency, urinary urgency and urge incontinence. The aim of this study is to assess the validity and reliability of the Turkish overactive bladder symptom score (OABSS) and to evaluate the results of mirabegron treatment with OABSS. The study was carried out with 117 patients who applied to the urology outpatient clinic between June 2018-January 2019. OABSS Turkish validation was developed from the English version. Demographic data of the patients were recorded. The OABSS, overactive bladder questionnaire (OAB-v8) and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were filled out by the patients. The patients were asked to fill in these questionnaires after 2weeks. Patients receiving mirabegon treatment were evaluated with the same questionnaires and bladder diaries after 8weeks. A total of 117 OAB patients, including 82 OAB-wet and 35-OAB dry, were included in the study. The mean age of the patients was 46.79 ± 14.26 (18-78) years, and the mean duration of OAB complaint was 32.28 ± 32.21months. The mean score of the OABSS is 9.9 ± 3.14. The results of the reliability assessment showed that the intraclass correlation coefficient of the total OABSS score was 0.71 (weighted coefficients of individual item points, 0.635-0.831), and the Cronbach α was 0.736. In the validity analysis, the OABSS total score was highly correlated with that belonging to other questionnaire forms (OAB-v8, ICIQ-SF and bladder diary). After the treatment with mirabegron, mean OABSS scores of the patients improved significantly from baseline to the 8th week (p < 0.001). The Turkish version of the OABSS has been approved as a valid and reliable tool for evaluating OAB. Mirabegron used daily improved the symptoms of OAB in patients.

Role of Serum and Urinary Biomarkers in Evaluation and Management of Patients With Overactive Bladder

Background: This study compared urinary and serum nerve growth factor levels and serum C-reactive protein levels in patients with overactive bladder, before and after treatment with antimuscarinic agents, to evaluate their diagnostic and therapeutic importance. Methods: This was a prospective case-control study conducted between February 2014 and December 2014 which included patients with a confirmed diagnosis of overactive bladder (overactive bladder group) and healthy controls (control group). All patients visiting urology out-patient department with urgency, frequency, and urge incontinence were assessed for overactive bladder and, if eligible, were enrolled in the study. Biomarkers were evaluated before in both groups and after antimuscarinic treatment in the overactive bladder group. Results: Overall, 80 participates were enrolled (overactive bladder, n = 40; control, n = 40). The mean age was not different between the two groups (overactive bladder, 48.6 years; control, 46.9 years [ P = 1.01]) and females were more in both the groups (60% and 55%, respectively). The majority (70%) of patients presented with frequency and urgency. After 3 months of treatment with antimuscarinics, the mean overactive bladder symptom score decreased significantly from 8.4 to 4.85 ( P &lt; .001). The mean urinary and serum nerve growth factor levels and serum C-reactive protein levels also decreased significantly from baseline after 3 months of treatment with antimuscarinics (24.78 pg/mL, 22.46 pg/mL, 0.89 mg/L, respectively; P &lt; .0001). Conclusions: Measurement of urinary and serum nerve growth factor levels has diagnostic and therapeutic potential in patients with overactive bladder.

Urinary symptoms are correlated with quality of life after deep brain stimulation in Parkinson's disease.

AimsDeep brain stimulation (DBS) is known to dramatically improve motor complications in patients with Parkinson's disease (PD), but its effect on urinary symptoms and health‐related quality of life (HRQOL) remains unknown. We aimed to examine the relationship between urinary symptoms and HRQOL in patients with PD who underwent DBS.MethodsThe International Prostate Symptom Score (IPSS) and overactive bladder symptom score (OABSS) were determined to evaluate urinary symptoms in patients with PD who underwent DBS. Postoperative evaluations were performed at 3 months, 1 year, and 3 years postoperatively. We also performed a urodynamic study (UDS) in 13 patients with PD preoperatively and postoperatively. A follow‐up UDS was performed 2.0 ± 0.5 years postoperatively.ResultsThe preoperative urinary symptoms questionnaire was completed by 28 patients, of whom 14 completed the postoperative urinary symptoms questionnaire after 3 months, 18 after 1 year, and 10 after 3 years. The mean OABSS and IPSS did not change significantly at any follow‐up periods postoperatively. When assessing the relationship between urinary symptoms and HRQOL and motor functions, the OABSS and IPSS showed significant positive correlations with HRQOL at 3 months postoperatively. The OABSS and IPSS showed significant positive correlations with activities of daily living (ADL) during the off‐phase at 3 years postoperatively. All urodynamic parameters remained unchanged postoperatively.ConclusionsDeep brain stimulation did not significantly affect urinary dysfunctions in patients with PD. Urinary symptoms might partially contribute to HRQOL at 3 months postoperatively and ADL during the off‐phase at 3 years postoperatively.

Overactive bladder syndrome and bladder wall thickness in patients with obstructive sleep apnea syndrome.

ABSTRACTObjectiveThe main objective of the present study was to evaluate the presence of overactive bladder (OAB) syndrome, nocturia, urgency, and urge incontinence in patients with obstructive sleep apnea syndrome (OSAS), and measure bladder wall thickness (BWT) in these patients.Materials and MethodsThe patient group was composed of 38 patients with OSAS. The control group was composed of 15 healthy individuals. All patients were evaluated using the Epworth Sleepiness Scale (ESS) and Overactive Bladder Symptom Score (OABSS). The bladder wall thickness was measured by transabdominal ultrasound (US). The presence of nocturia, urinary urgency, and urge incontinence were also evaluated.ResultsThe mean OABSS was significantly higher in the patient group compared with the control group (p=0.048). The minimum oxygen saturation (Min.SO2) of patients with urgency was found to be significantly lower (p=0.014). The time spent below 90% of oxygen saturation (SO2) was significantly longer in patients with urinary urgency (p=0.009). There was no difference in BWT measurements between the patient group and the control group. There was a significant relationship between BWT values and OABSS in patients with OSAS (p=0.002).ConclusionThe results of the present study suggest that OSAS is associated with OAB syndrome. As a key symptom of OAB, urgency correlates with hypoxia in cases with OSAS. Although the present study did not observe any difference in BWT measurements between the patients and the control group, there was a correlation between BWT measurements and OABSS in patients with OSAS.

Comparison of the Effect of Naftopidil 75 mg and Tamsulosin 0.2 mg on the Bladder Storage Symptom With Benign Prostatic Hyperplasia: Prospective, Multi-institutional Study

To compare the efficacies of naftopidil and tamsulosin in terms of reducing storage symptoms in patients with benign prostatic hyperplasia. This prospective randomized study was performed at 10 centers. Ninety-four patients that had been taking tamsulosin for more than 8 weeks, but had an Overactive Bladder Symptom Score (OABSS) of greater than 3 points, were initially enrolled. After a 1-week washout period, patients were divided into 2 groups. Forty-five patients were treated with tamsulosin 0.2 mg daily, and 49 patients were treated with naftopidil 75 mg daily for 8 weeks. Total International Prostate Symptoms Score (IPSS), storage symptom scores, nocturia times, OABSS, maximal flow rates (Qmax), and postvoid residual volumes were checked before and after the 8-week treatment period. Mean patient ages in the tamsulosin and naftopidil groups were 64.8 and 66.0 years, respectively. Baseline characteristics were not significantly different. In the tamsulosin group, mean total IPSS decreased from 19.1 to 15.1 after the 8-week treated period (P = .001), and in the naftopidil group, mean total IPSS decreased from 16.9 to 13.1 (P = .001). Mean storage symptom scores were reduced in the tamsulosin and naftopidil groups from 8.0 to 6.6 (P = .002) and from 7.6 to 6.1 (P = .001), respectively. Mean nocturia times in the naftopidil groups decreased significantly from 2.5 to 1.9 (P = .001), and mean OABSSs were reduced from 7.7 to 6.0 (P = .001) and from 7.4 to 6.0 (P = .001), respectively. Total IPSS, storage symptom scores, nocturia times, and OABSS were significantly reduced by naftopidil and tamsulosin. Moreover, the naftopidil group showed better improvements in nocturia than the tamsulosin group.

MP09-14 COMPARISON OF THE EFFICACY OF COMBINATION THERAPY WITH AN ANTICHOLINERGIC AGENT AND AN α1-BLOCKER VERSUS A β3-ADRENOCEPTOR AGONIST AND AN α1-BLOCKER FOR PATIENTS WITH BENIGN PROSTATIC ENLARGEMENT COMPLICATED BY OVERACTIVE BLADDER: A RANDOMIZED, PROSPECTIVE TRIAL BASED ON A URODYNAMIC STUDY

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Medical & Non-surgical Therapy1 Apr 2017MP09-14 COMPARISON OF THE EFFICACY OF COMBINATION THERAPY WITH AN ANTICHOLINERGIC AGENT AND AN α1-BLOCKER VERSUS A β3-ADRENOCEPTOR AGONIST AND AN α1-BLOCKER FOR PATIENTS WITH BENIGN PROSTATIC ENLARGEMENT COMPLICATED BY OVERACTIVE BLADDER: A RANDOMIZED, PROSPECTIVE TRIAL BASED ON A URODYNAMIC STUDY Yoshihisa Matsukawa, Takashi Fujita, Masashi Kato, Yasuhito Funahashi, Tokunori Yamamoto, and Momokazu Gotoh Yoshihisa MatsukawaYoshihisa Matsukawa More articles by this author , Takashi FujitaTakashi Fujita More articles by this author , Masashi KatoMasashi Kato More articles by this author , Yasuhito FunahashiYasuhito Funahashi More articles by this author , Tokunori YamamotoTokunori Yamamoto More articles by this author , and Momokazu GotohMomokazu Gotoh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.322AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although several randomized studies have reported the efficacy of a combination therapy (CT) with an anticholinergic agent and an α1-blocker or β3-adrenoceptor agonist and an α1-blocker for patients with benign prostatic enlargement (BPE) complicated by overactive bladder (OAB), no study has compared the improvement of subjective and objective symptoms in patients with BPE/OAB, between the two drugs. We compared the efficacy of CT with an anticholinergic agent and an α1-blocker, and CT with β3-adrenoceptor agonist and an α1-blocker for patients with BPE/OAB, by conducting a urodynamic study (UDS). METHODS This was a randomized prospective study involving 80 outpatients with untreated BPE (IPSS ≥8, IPSS- QOL ≥3, prostate volume ≥25 mL) associated with urinary urgency at least once per week, who had an OAB symptom score (OABSS) of ≥3. The patients were randomly assigned to receive CT with silodosin at 8 mg/day and fesoterodine 4 mg/day (Feso-CT group) or CT with silodosin and mirabegron 50 mg/day (Mira-CT group). Changes in parameters from baseline to 12 weeks after administration were assessed based on IPSS, IPSS-QOL, OABSS, and voiding and storage functions, as measured using a UDS. RESULTS In the efficacy analysis, 33 patients from the Feso-CT group (mean age, 71.3 years; mean prostate volume, 47.2 mL) and 31 patients from the Mira-CT group (70.8 years, 45.9 mL) were included. Although the mean IPSS and OABSS significantly improved in both groups, the improvement in OABSS in the Feso-CT group was significantly greater than that in the Mira-CT group. With regard to the storage function assessed by UDS, the Feso-CT group demonstrated a significantly greater improvement in terms of the incidence of detrusor overactivity. Urodynamic voiding function significantly improved in both groups, without significant inter-group difference (Table). CONCLUSIONS CT with silodosin and fesoterodine or mirabegron significantly improved subjective and objective symptoms in patients with BPE and OAB. Thus, CT with fesoterodine was thought to be more effective than CT with mirabegron, with regard to storage symptoms and functions. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e105 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Yoshihisa Matsukawa More articles by this author Takashi Fujita More articles by this author Masashi Kato More articles by this author Yasuhito Funahashi More articles by this author Tokunori Yamamoto More articles by this author Momokazu Gotoh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Nocturia Improvement With Surgical Correction of Sleep Apnea.

PurposeTo evaluate changes in nocturia after surgical correction of obstructive sleep apnea (OSA).MethodsA total of 66 patients were included in the present study. All had been diagnosed with OSA syndrome by polysomnography and underwent uvulopalatopharyngoplasty (UPPP). Preoperative and postoperative lower urinary tract symptoms (LUTS), quality of life (QoL), and nocturia episodes were evaluated using the International Prostate Symptom Score (IPSS) and overactive bladder symptom score (OABSS) questionnaires. Three months postoperatively, telephone interviews were performed to determine the success of surgery, current LUTS, and nocturia episodes. Patients were divided into surgical success and failure groups. Surgical success was defined as snoring decrease more than 50% based on the patient’s subjective judgment.ResultsThe response rate was 56% and success rate was 73%. In all patients, nocturia episodes significantly decreased from 1.7±1.1 to 0.8±1.2 (P=0.002). Mean IPSS score, OABSS score, and QoL scores were also significantly improved. The success group showed a significant decrease in nocturia episodes, and total IPSS, OABSS, and QoL scores. However, the failure group did not show significant changes in all parameters.ConclusionsOSA correction improved nocturia as well as other LUTS. These improvements were not observed in the failure group. This study shows that OSA is a cause of nocturia and that other LUTS and nocturia can be improved by surgical correction of OSA.

Safety and Effectiveness of Mirabegron in Patients with Overactive Bladder in a Real-World Clinical Setting: A Japanese Post-Marketing Study.

To provide real-world data on Japanese patients with overactive bladder (OAB) initiating treatment with the β3 -adrenoceptor agonist, mirabegron. This study examined prescribing patterns, adverse drug reaction (ADR) incidence, and treatment effectiveness. Full medical histories, including prior/concomitant drug use, were collected before initiating mirabegron treatment. After 12 weeks mirabegron, physicians assessed ADR incidence and treatment effectiveness. Residual urine volume was assessed and patients completed the Overactive Bladder Symptom Score (OABSS) and International Prostate Symptom Score-Quality of Life (I-PSS QoL) surveys at Baseline and 12 weeks. Data were collected between April 2012 and July 2014. Of 9795 OAB patients (46.8% male; 80.8% ≥65 years), 71.7% had coexisting disease [notably benign prostatic hyperplasia (BPH, 32.4%), hypertension (31.9%), and diabetes mellitus (9.4%)] and 53.4% reported concomitant drug use (27.8% α1 -antagonists, 6.3% anticholinergics). The incidence of total ADRs was 6.07% [including constipation (0.97%), thirst (0.47%), and dysuria (0.44%)], of serious ADRs, 0.21%, of cardiovascular ADRs, 0.48% and of urinary retention, 0.31%. Incidence of total ADRs in patients with concomitant cardiovascular disease was 10.09% and of those related to urinary retention in men with untreated BPH, 0.88%. After 12 weeks treatment, physicians judged mirabegron as "effective" in 80.7% of patients, 63.6% of patients achieved the three-point minimal clinically important change from Baseline in the mean OABSS, and the I-PSS QoL decreased significantly from Baseline (-2.1 ± 1.77; P < 0.001). In the clinical setting, mirabegron is well tolerated, with no unanticipated ADRs, and is an effective treatment for Japanese patients with OAB.

Association between ambient temperature and lower urinary tract symptoms: a community-based survey.

ABSTRACTPurpose The aim of this study was to evaluate the individual change of International prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS) in each patient by temperature conditions.Materials and Methods The severity of lower urinary tract symptoms (LUTS) was explored using the IPSS and OABSS questionnaires that were completed by 2.486 subjects (923 males and 1.563 females) aged 60 years and older. Korea Meteorological Administration data was used to determine daily average temperature and daily temperature difference on the interview dates at each site.Results The mean IPSS and mean age for males was 13.45±8.24 and 75.03±6.20 years, respectively. The mean OABSS and mean age for females was 4.41±3.10 and 73.74±6.03years, respectively. Daily average temperature and daily temperature difference ranged from-3.4-28.3oC and 2.2-16.9oC, respectively. Age was a significantly risk factor for IPSS, OABSS, and QoL (P<0.001, <0.001, and 0.005, respectively). After multiple regression analysis, daily average temperatures did not show a statistically significant change in IPSS and OABSS. Only daily temperature differences were associated with male LUTS.Conclusions While LUTS could be worsened in low temperatures generally, IPSS and OABSS were not affected by daily average temperature conditions. Daily temperature differences may be more influential than daily average temperatures.

Five-Year Follow-Up Study of Transurethral Plasmakinetic Resection of the Prostate for Benign Prostatic Hyperplasia.

To explore the long-term clinical efficacy and safety of transurethral plasmakinetic resection of the prostate (PKRP) for benign prostatic hyperplasia (BPH). A total of 550 patients with BPH who had undergone PKRP from October 2006 to September 2009 were enrolled in this study. All patients were evaluated at baseline and follow-up (3, 12, 24, 36, 48, 60 months postoperatively) by peak flow rate (Qmax), postvoid residual (PVR), quality of life (QoL), International Prostate Symptom Score (IPSS), and Overactive Bladder Symptom Score (OABSS). Operative details and postoperative complications regarded as safety outcomes were documented. A total of 467 patients completed the 5-year follow-up. The mean duration of surgery was 36.43 minutes, mean catheterization time was 48.81 hours, mean hospital stay was 4.21 days. At 60 months postoperatively, the mean Qmax increased from 6.94 mL/s at baseline to 19.28 mL/s, the mean PVR decreased from 126.33 mL to 10.45 mL, the mean IPSS score decreased from 15.79 to 7.51, the mean QoL score decreased from 4.36 to 1.91, and the mean OABSS score decreased from 6.39 to 3.65 (P < 0.001), respectively. In perioperative complications, the blood transfusion rate was 2.7%, urinary tract infection rate was 3.6%; no transurethral resection syndrome (TUR syndrome) occurred. In late complications, urethral stricture rate was 5.4%, recurrent bladder outlet obstruction rate was 2.1%, and the reoperation rate was 4.5%. PKRP is based on conventional monopolar transurethral resection of the prostate (TURP) and uses a bipolar plasmakinetic system. Our results indicate that the long-term clinical efficacy and safety of PKRP for BPH are remarkable. In particular, the incidence of urethral stricture, recurrent bladder outlet obstruction, and reoperation is low. We suggest that PKRP is a reliable minimally invasive technique that may be the preferred procedure for the treatment of patients with BPH.

MP27-02 THE ASSOCIATION BETWEEN VASCULAR RISK FACTORS AND OVER ACTIVE BLADDER

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality of Life1 Apr 2015MP27-02 THE ASSOCIATION BETWEEN VASCULAR RISK FACTORS AND OVER ACTIVE BLADDER Teruhiko Tsuru, Isao Araki, Sayaka Kadowaki, Takashi Hisamatsu, Akira Fujiyoshi, Akihiro Kawauchi, Katsuyuki Miura, and Hirotsugu Ueshima Teruhiko TsuruTeruhiko Tsuru More articles by this author , Isao ArakiIsao Araki More articles by this author , Sayaka KadowakiSayaka Kadowaki More articles by this author , Takashi HisamatsuTakashi Hisamatsu More articles by this author , Akira FujiyoshiAkira Fujiyoshi More articles by this author , Akihiro KawauchiAkihiro Kawauchi More articles by this author , Katsuyuki MiuraKatsuyuki Miura More articles by this author , and Hirotsugu UeshimaHirotsugu Ueshima More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1164AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Bladder wall ischemia caused by the arteriosclerosis with age is paid attention to the factor of over active bladder (OAB). To investigate the association between vascular risk factors and OAB, we performed a random cross-sectional epidemiological study. METHODS This study was conducted using a population-based sample of 518 male, aged 61-83 years, who participated in the Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA) between 2010 and 2013. We investigate the association between Over Active Bladder Symptom Score (OABSS) and Vascular Risk Factors: age, body mass index (BMI), percent body fat, waist circumference, lifetime cigarette consumption, drinking history, sleep time, systolic blood pressure, diastolic blood pressure, hypertension, diabetes mellitus (DM), hyperlipidemia, ankle/brachial pressure index (ABI), pulse wave velocity (PWV), abdominal aortic calcification score, total cholesterol (TC), high-density lipoprotein (HDL), triglycerides (TG). RESULTS The mean age was 71.8+/-6.0 years old and the mean OABSS was 2.9+/-2.2. The proportions of OAB were 19.9% and OAB wet were 9.1%. OAB patient, compared with non OAB patient, was significantly higher in lifetime cigarette consumption (p=0.0006), abdominal aortic calcification score (p=0.007), age (p=0.01), percent body fat (p=0.01), BMI (p=0.02). In univariate regression Aanalysis, age (p<0.0001), triglycerides (p=0.012), abdominal aortic calcification score (p=0.023), diastolic blood pressure (p=0.028),and hyperlipidemia (p=0.036) were significantly correlated with OABSS. In multivariate logistic regression analysis, age (p<0.0001), HL (p=0.03), lifetime cigarette consumption (p=0.03), TG (p=0.03) were significantly correlated with OABSS. CONCLUSIONS According to our data, age and classical vascular risk factors: hyperlipidemia, lifetime cigarette consumption, and triglycerides, are independent predictors of OABSS, but abdominal aortic calcification score, considered to be directly correlated with Bladder wall ischemia, is not proved because of collinearity with age. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e302-e303 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Teruhiko Tsuru More articles by this author Isao Araki More articles by this author Sayaka Kadowaki More articles by this author Takashi Hisamatsu More articles by this author Akira Fujiyoshi More articles by this author Akihiro Kawauchi More articles by this author Katsuyuki Miura More articles by this author Hirotsugu Ueshima More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Solifenacin or Mirabegron Could Improve Persistent Overactive Bladder Symptoms After Dutasteride Treatment in Patients With Benign Prostatic Hyperplasia

To evaluate the clinical response and adverse events (AEs) of solifenacin (SOL) or mirabegron (MIR) in benign prostatic hyperplasia patients with persistent overactive bladder (OAB) symptoms after dutasteride (DUT) treatment. Fifty cases with residual OAB symptom score (OABSS) ≥ 5 and OABSS Q3 ≥ 2 after at least 6 months treatment of DUT were included in this study. Patients were administered 5 mg/d of SOL (N = 25) or 50 mg/d of MIR (N = 25), and International Prostate Symptom Score (IPSS) and OABSS were prospectively collected at 4 and 12 weeks. The safety was evaluated by changes in postvoided residual urine volume and the incidence of AEs. After DUT administration, the mean prostate volume, IPSS, and OABSS were 39.0 mL, 17.6, and 8.1, respectively. SOL 5 mg significantly reduced the IPSS, OABSS, and OABSS Q3 at 4 and at 12 weeks (-3.1, -2.7, -1.3; P <.05); however, 4 patients could not continue the SOL treatment owing to AEs. All patients could continue the 12 weeks of MIR treatment, and MIR 50 mg reduced IPSS and OABSS at 4 weeks and reduced IPSS, OABSS, and the OABSS Q3 (-3.0, -2.5, -0.9; P <.05) at 12 weeks. Postvoided residual urine volume increased by ≥ 100 mL after treatment in 2 cases in the SOL group but not in any patient in the MIR group. Additional SOL or MIR might result in amelioration of the persistent OAB symptom after DUT treatment in patients with an enlarged prostate.

Urodynamic Evaluation of the Efficacy of Mirabegron on Storage and Voiding Functions in Women With Overactive Bladder

To investigate the effects of mirabegron (50mg once daily for 12weeks) in treatment-naïve women with overactive bladder (OAB) based on urodynamic studies. This was an open-labeled, single-center, prospective study involving 65 recruited outpatients. The OAB symptom score was used for assessing the severity of subjective symptoms. Urodynamic studies, including uroflowmetry, cystometry, and pressure flow study, were conducted to evaluate objective symptoms. The first desire to void, maximum cystometric capacity, and occurrence of detrusor overactivity were measured as storage function parameters, whereas maximum flow rate, detrusor pressure at Qmax, and postvoid residual urine volume were assessed as voiding function parameters. A total of 60 patients with a mean age of 72.3years (50-86years) were included in the analysis. The subjective symptom parameter (ie, the mean OAB symptom score) decreased significantly from 9.4 to 6.2 points (P<.001). In objective symptom parameters, both the first desire to void and maximum cystometric capacity significantly improved after treatment, and detrusor overactivity disappeared in 14 of 35 patients (40.0%) compared with that at baseline (P<.01). The voiding function parameters (ie, mean maximum flow rate, detrusor pressure at Qmax, and postvoid residual urine volume) did not significantly change, demonstrating that mirabegron does not inhibit voiding function. Mirabegron improves storage function and subjective symptoms, without influencing voiding function, in women with OAB.

Overactive bladder symptom score to evaluate efficacy of solifenacin for the treatment of overactive bladder symptoms

Background Overactive bladder (OAB) is a series of symptoms with high prevalence in elderly people. This study was conducted using the overactive bladder symptom score (OABSS) to evaluate the efficacy of solifenacin succinate for the treatment of OAB. Methods This was a prospective, multicenter, single-arm, 12-week study that enrolled 241 OAB patients. The patients received 5-10 mg/day solifenacin. Changes in OABSS, symptoms from voiding diary, perception of bladder condition (PPBC) score, international prostate symptom score (IPSS) and quality of life (QOL) were evaluated at weeks 0, 4, and 12. The relationship between OABSS and PPBC score or parameters of voiding diary was also evaluated. Results At baseline, the mean OABSS for all patients was 9.41±2.40, and was reduced significantly at week 12 (-3.76 points; 61.21%, P &lt;0.0001). The OABSS subscore, PPBC score, IPSS, and QOL were also significantly reduced during the study (P &lt;0.0001). The overall incidence of adverse events was 19.91% (44 cases). The gastrointestinal system was the most commonly affected (11.31%). Around 5.88% of the cases had adverse events related to the genitourinary system. There was a strong correlation between OABSS and urinary symptoms that was recorded in the 3-day voiding dairy. Conclusions We showed that solifenacin was clinically effective for relieving OAB symptoms, considering the balance between efficacy, patients' well-being, and tolerability. OABSS integrates four OAB symptoms into a single score and can be a useful tool for research and clinical practice.

Factors influencing patient satisfaction with antimuscarinic treatment of overactive bladder syndrome: Results of a real‐life clinical study

To investigate patient satisfaction with antimuscarinic treatment of overactive bladder syndrome, and to identify factors having a significant influence on satisfaction. A cross-sectional questionnaire survey was carried out to assess treatment satisfaction among male and female patients with overactive bladder (age ≥20 years) in the Hokuriku district of Japan. The overactive bladder symptom scores, treatment efficacies, adverse events (dry mouth and constipation), and patient satisfaction scores were investigated and compared among patients using different antimuscarinic therapeutics. In total, 977 survey respondents (52.6% men; mean age 73.6 years) received antimuscarinic treatment. The mean overactive bladder symptom score of these patients was 6.17; in addition, 32.3% patients were satisfied with their treatment, but 33.1% were dissatisfied. Factors having a significant influence on treatment satisfaction were sex (men were less satisfied), efficacy, adverse events and the overactive bladder symptom score. Constipation negatively influenced patient satisfaction to a greater extent than did dry mouth. Patient satisfaction varied according to the drug used. Constipation was less severe with the immediate-release-type agents (imidafenacin and oxybutynin) than with the extended-release-type (propiverine, solifenacin or tolterodine). Just one-third of Japanese Hokuriku patients with overactive bladder seem to be satisfied with their antimuscarinic treatment. Patient satisfaction is impaired by poor efficacy and the presence of adverse events; furthermore, constipation should be recognized as an adverse event that negatively influences patient satisfaction to a greater extent than dry mouth. Patient satisfaction differs according to the antimuscarinic agent used, with higher patient satisfaction being associated with less severe constipation.

Clinical Impact of Solifenacin on Generic and Symptom‐Specific Quality of Life for Females with Overactive Bladder: Using the Overactive Bladder Symptom Score and Rand Medical Outcomes Study 36‐Item Health Survey

We evaluated the effectiveness of antimuscarinic treatment on disease-specific and generic quality of life (QoL) in females with clinically diagnosed overactive bladder (OAB) by prospectively analyzing improvements in the overactive bladder symptom score (OABSS) and the Rand Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). We prospectively recruited newly diagnosed female patients with OAB. Pretreatment disease-specific symptoms were documented, and generic QoL questionnaires were administered. All subjects received solifenacin 5 mg/day for >8 weeks. Symptoms and general health-related QoL (HRQoL) were assessed using the OABSS and SF-36, respectively. Other objective variables, such as maximum urinary flow rate and postvoid residual urine volume, were also evaluated. Seventy-eight subjects met all inclusion criteria and no exclusion criteria. After 8 weeks, the mean OABSS decreased by approximately 50% compared with baseline (from 9.1 ± 2.8 to 4.5 ± 3.6). All individual scores in OABSS improved after administration of solifenacin. Before treatment, the scores of the study subjects in all SF-36 domains were significantly worse than the age- and gender-adjusted Japanese national norms (P < 0.01), except the vitality (VT) scale. Intra-group comparisons between age groups showed worse mental health (MH) scores in all age groups. In the OAB group, three mean SF-36 scales (physical function [PF], VT, and MH) significantly improved after treatment. Treatment of OAB with solifenacin is associated with significant improvement in generic HRQoL and disease-specific symptoms at 8 weeks after drug administration. Particularly for generic HRQoL as measured by the SF-36, solifenacin treatment effectively improves three SF-36 scores: PF, VT, and MH.

High Classification of Chronic Heart Failure Increases Risk of Overactive Bladder Syndrome and Lower Urinary Tract Symptoms

To assess the urologic symptoms among patients with chronic heart failure (CHF) and to explore whether a higher classification of CHF increases the risk associated with overactive bladder syndrome (OAB) and lower urinary tract symptoms. A total of 214 ambulatory patients with CHF (129 men and 85 women) and 378 age-matched subjects (222 men and 156 women) were enrolled in the present study. The urologic symptoms were evaluated using the Overactive Bladder Symptom Score (OABSS) and International Prostate Symptom Score (IPSS) from January to June 2010. Compared with the controls, the patients with CHF had a significantly greater mean OABSS (4.6±3.6 vs 3.4±3.1, P<.001), total IPSS (8.3±6.9 vs 6.9±7.6, P=.021), and storage IPSS (4.8±3.5 vs 3.7±3.3, P<.001). Of the patients with CHF, 34.1% had moderate/severe OAB symptoms (OABSS≥6), and 43.5% had moderate/severe lower urinary tract symptoms (IPSS≥8). Compared with patients who had New York Heart Association (NYHA) class I CHF, the patients with NYHA class III CHF had a significantly greater OABSS and total, storage, and voiding IPSSs. Patients with NYHA class II CHF did not. A greater body mass index and stroke were significantly associated with the OABSS and storage IPSS, and pulmonary disease was significantly associated with the voiding IPSS. The patients with CHF had more storage urinary symptoms suggestive of OAB than did the age-matched controls. Among the patients with CHF, greater NYHA class heart function was significantly associated with OAB and lower urinary tract symptoms.