Overactive Bladder Symptom Score Score Research Articles

Safety and Effectiveness of Vibegron in Japanese Patients With Overactive Bladder: A Japanese Postmarketing Survey.

To evaluate the safety and effectiveness of vibegron, a highly selective β3-adrenoceptor agonist, in Japanese patients with overactive bladder (OAB) in a real-world clinical setting. This prospective survey was conducted from August 2019 to July 2023 using a central registration method. Patients newly treated with vibegron for OAB were followed for 12 weeks, and those who continued treatment were observed for up to 52 weeks. Adverse drug reactions (ADRs) and the overall improvement level were assessed, and overactive bladder symptom score (OABSS) and International Prostate Symptom Score-Quality of Life (IPSS QOL) score were collected. Of the 1848 patients in the safety analysis set, 154 ADRs were reported in 141 patients (7.63%). Common ADRs were increased residual urine volume (1.30%), constipation (1.14%), dysuria and urinary retention (0.97% each), cystitis (0.65%), and dry mouth (0.32%). The incidence of urinary retention-related adverse events (AEs) was higher in male patients, patients ≥ 65 years old, and patients with benign prostatic hyperplasia. The effectiveness rate was 88.8% among the 1561 patients in the effectiveness analysis set. Significant improvement in both OABSS and IPSS QOL scores was observed at all observation periods. The rate of achieving the minimal clinically important change in OABSS total score at the final evaluation was 75.35%. OABSS scores were also significantly reduced in all subgroup analyses. This survey found no major concerns regarding the safety and effectiveness of vibegron in Japanese OAB patients, except for urinary retention-related AEs. Vibegron is considered to represent a useful drug for treating OAB symptoms in a real-world clinical setting.

Association Between Frailty and Pelvic Organ Prolapse in Elderly Women: A Retrospective Study

Introduction and HypothesisThis study evaluated the association between pelvic organ prolapse (POP), frailty, and sarcopenia to explore how POP treatment can extend healthy life expectancy in elderly women.MethodsWe conducted a retrospective study of prospectively collected data, comparing women with mild POP (stages 0–II) with those with advanced POP (stages III and IV). The inclusion criteria for this study were women who visited the clinic with at least one symptom of pelvic floor dysfunction and underwent imaging studies between April 2020 and November 2022. Initially, 119 patients met these inclusion criteria. Patients were excluded if they had a history of previous POP treatment, did not respond to the study survey, or were lost to follow-up. After applying these exclusion criteria, 82 patients were included in the final analysis, of whom 65 underwent surgery (laparoscopic sacrocolpopexy, colpocleisis, tension-free vaginal tape, and native tissue repair). Assessments included POP Quantification, Kihon Checklist, Pelvic Organ Prolapse Quality of Life (P-QOL) questionnaire, International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and Incontinence Symptom Questionnaire (ICIQ-SF). Pelvic muscles were measured using MRI or CT. Immunohistochemical analysis of estrogen receptor alpha (ERα), estrogen receptor beta , and androgen receptor was performed on surgical specimens from 43 patients.ResultsThe median age of participants was 75 years. Of the 82 patients, 48 (58.5%) were classified as frail or pre-frail, and 22 (26.8%) exhibited motor impairment. Advanced POP (stages 3 and 4) was seen in 41 patients. These patients had more motor function impairments (advanced, 16; mild, 6; p = 0.01). Patients with advanced POP had poorer P-QOL, ICIQ-SF (median: 9.5 vs 4, p = 0.006) and OABSS (7 vs 4, p = 0.008) scores, and smaller pubococcygeus muscle diameter (2.5 vs 3 cm, p = 0.017). Postoperatively, significant improvements were seen in P-QOL (all domains except personal relationships: p < 0.001), total IPSS (11 vs 4, p < 0.001), OABSS (6 vs 5, p = 0.033), and ICIQ-SF scores (6 vs 2, p < 0.001). ERα expression was associated with preoperative frailty (r = −0.37, p = 0.014).ConclusionsAdvanced POP correlates with poorer QOL, worse urinary symptoms, and reduced pubococcygeus muscle diameter, consistent with sarcopenia, compared with mild POP.

Enhancing the autologous fascial sling procedure: A novel fixation method for treating stress urinary incontinence in female patients.

Synthetic mid-urethral sling surgery has long been the standard surgical treatment for stress urinary incontinence (SUI) worldwide. Using an autologous fascial sling is an alternative to reduce adverse events. We evaluated the treatment outcomes of a novel fixation method applied to the autologous transobturator fascial (TOF) sling procedure for female patients with SUI. A retrospective study was conducted between 2017 and 2020, including 33 patients with SUI who underwent mid-urethral TOF sling surgery with the novel fixation method. We used a self-locking feature (V-LOC™) that was fixed to each side of skin layer above the obturator foramen, and the tension of the fascia sling was adjusted by manipulating the V-LOC™ suture. We analyzed all data collected through questionnaires, including Urinary Distress Inventory-Short Form (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), Overactive Bladder Symptom Score (OABSS), and Clinical Global Impressions of Improvement (CGI-I). Adverse events were also recorded. This study included 33 female patients aged 39-79 (mean 59.76 years). Following the procedure, there was a significant reduction in the total scores of UDI-6, IIQ-7, and OABSS (preoperative 9.73±4.35, 10.21±5.79, 6.06±4.03 and postoperative 3.52±3.41, 0.85±3.67, 3.06±2.90, respectively) (p < 0.001). Further analysis of each sub-score of the questionnaires revealed significant improvement in certain symptoms. The mean total score of CGI-I was 2.00 ± 0.80. The maximum flow rate was documented for 18 patients, and no significant reduction was observed after the procedure (p = 0.804). Complications reported included voiding dysfunction in two patients (6.1 %), inguinal pain in one patient (3.0 %), and mild delayed wound healing in one patient (3.0 %). This modified TOF sling surgery with a novel fixation method by V-LOC™ suture offers feasibility and adjustability as its main advantages. Our study demonstrated significant improvements in patient outcomes.

Effectiveness of Japanese traditional medicine yokukansan for nocturia due to sleep disorders

AbstractAimTo evaluate the effectiveness of yokukansan, a traditional Japanese medicine, as treatment for nocturia due to sleep disorders.MethodsIn this study, we included patients diagnosed with nocturia due to sleep disorders, evaluated using the Pittsburgh Sleep Quality Index (PSQI). Participants received 2.5 g of yokukansan, three times daily, for 12 weeks. We evaluated the changes in the overactive bladder (OAB) symptom score (OABSS), hours of undisturbed sleep (HUS), and PSQI score. In addition, patients were categorized based on the severity of their sleep disorders, and we divided patients into two groups according to whether the severity of the disorder was downgraded after treatment: the improved and unchanged groups.ResultsAmong 35 patients with a mean ± standard deviation age of 73.2 ± 10.5 years, yokukansan administration was associated with significant improvements in nighttime urinary frequency (from 3.8 ± 2.1 to 2.1 ± 1.9), total OABSS score (from 4.9 ± 1.8 to 2.9 ± 1.9), OABSS urgency score (from 1.3 ± 1.0 to 0.7 ± 0.9), HUS (from 2.2 ± 0.6 to 3.5 ± 1.1 h), and global PSQI score (from 11.9 ± 3.1 to 10.0 ± 1.4; all p &lt; 0.001). In addition, significant improvements were noted in both the improved and unchanged groups in terms of the total OABSS, nocturia, and urgency scores. Furthermore, yokukansan treatment was related to improved global PSQI scores in both groups (improved group: from 10.8 ± 0.7 to 8.6 ± 0.5, p = 0.001; unchanged group: from 12.3 ± 3.4 to 10.4 ± 1.3, p = 0.004).ConclusionYokukansan may effectively ameliorate nocturia due to sleep disorders.

Efficacy and Safety of Combination Therapy With Vaginal and Urethral Erbium-Doped Yttrium-Aluminum-Garnet (Er:YAG) Laser for Overactive Bladder With Urinary Incontinence.

This retrospective cohort study with propensity score (PS) matching aimed to evaluate the efficacy and safety of a combination therapy with vaginal and urethral erbium:yttrium aluminum garnet laser (VEL+UEL) (SP Dynamis; Fotona d.o.o., Ljubljana, Slovenia) in the treatment of overactive bladder with urinary incontinence (OAB-wet). The study included female OAB-wet patients aged 65 and above who were already taking OAB medication. Data obtained from electronic medical records were subjected to propensity score matching. All patients received instructions on pelvic floor exercises and were prescribed an appropriate dose of OAB medication. The VEL+UEL group (n=30) underwent three monthly laser sessions, while the control group (n=30) did not receive the treatment. Clinical outcomes were evaluated using the Overactive Bladder Symptom Score (OABSS), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), three-day urination diary, and Vaginal Health Index Score (VHIS). Medication usage and adverse events were also assessed. Statistical analysis and R code were performed using the AI chatbot GPT-4.0. The VEL+UEL group showed significant improvements in OABSS score, ICIQ-SF score, voided volume, daytime frequency, nocturia, and VHIS after 12 months of treatment (p<0.001). Notably, 13.3% of patients transitioned from OAB-wet to OAB-dry. In contrast, the control group did not exhibit significant changes. Medication use was significantly reduced in the VEL+UEL group compared to the control group (p<0.001). No long-term side effects were reported. Combination therapy with VEL+UEL demonstrated efficacy and safety in the treatment of OAB-wet. Improvements in OAB symptoms, voided volume, frequency, nocturia, and vaginal health were observed, with a subset of patients transitioning to OAB-dry. VEL+UEL therapy offers a potential treatment option for OAB-wet, reducing medication use and improving patient outcomes. Further research is warranted to investigate the mechanism, long-term effects, safety, and cost-effectiveness of VEL+UEL therapy.

Prevalence of Pelvic Floor Disorders in Parous Women from the Tibet Autonomous Region: A Cross-Sectional Study.

Pelvic floor disorder (PFD) seriously affects the everyday life of women. This cross-sectional study aimed to evaluate the prevalence and risk factors for postpartum PFD in women living in the Tibet Autonomous Region (TAR). Parous women who attended the outpatient gynaecology clinic at our hospital between June 2022 and August 2022 were screened in this study. The demographic and clinical data of these women were collected. Their pelvic floor functions were evaluated via a pelvic organ prolapse (POP) quantification examination, the Pelvic Floor Distress Inventory Questionnaire-20 (PFDI-20) and the Overactive Bladder Symptom Score (OABSS). A total of 201 women were included in this study, of whom 81.09% (163/201) were Tibetan. Twenty-seven women (13.43%) were diagnosed with POP stage ≥2 and 27 women (13.43%) with an OABSS score ≥3. The median PFDI-20 total score was 4.17 (range 0-43.75). Han women (n = 38) in the TAR had much lower PFDI-20 total scores, compared with Tibetan women (n = 163) (p < 0.05). The results of the multiple linear regression models showed that the PFDI-20 scores obtained from women living in the TAR were closely related to parity, history of heavy weight lifting, age, history of instrumental deliveries, ethnicity and number of caesarean sections. Pelvic floor disorder is common among parous women living in the TAR. Ethnicity, parity, history of heavy weight lifting, age, history of instrumental deliveries and number of caesarean sections are the factors closely related to the PFDI-20 scores.

The effectiveness of gabapentin in treating overactive bladder: a quasi-experimental study

Introduction: Overactive bladder (OAB) is a common condition in urology that affects individuals of various ages and genders, significantly impacting their quality of life. Objectives: The study aimed to examine the effectiveness of gabapentin in treating OAB in Jordan. Patients and Methods: This study was conducted at a private clinic in Jordan between 2020 and 2022. It utilized a one-group pre- and post-test design involving 50 patients. The intervention involved administering gabapentin at a daily dose of 400 mg. The effectiveness of gabapentin was evaluated using the overactive bladder symptom score (OABSS) questionnaire, administered before and after six weeks of gabapentin administration. Results: The study sample consisted of 50 patients aged between 45 and 85 years, with a mean age of 65.2 years. After the treatment, all individual variables, such as urgency, frequency, nocturia, and urgency incontinence, showed significant reductions compared to the pre-intervention values. The mean total OABSS significantly decreased from 14.6 before to 6.8 after the intervention. The paired t test yielded a result of 9.84 with a P value of less than 0.001, indicating a statistically significant improvement. Conclusion: The noteworthy improvement in OABSS scores, urgency, nocturia, frequency of micturition, and urge incontinence observed in this study suggests that gabapentin could have a role as a treatment option for OAB patients.

Chronological Changes of Lower Urinary Tract Symptoms in Elderly Patients with Prostate Cancer after Low-Dose-Rate Prostate Brachytherapy.

To compare chronological changes in lower urinary tract symptoms (LUTS) after low-dose-rate prostate extended-release therapy (LDR-BT) using the overactive bladder symptom score (OABSS) in patients aged ≥ 75 years (elderly group) versus those aged < 75 years (control group). Patients with prostate cancer who underwent LDR-BT at Gifu University Hospital were included in this study. The International Prostate Symptom Score (IPSS), OABSS, and quality of life-based on urinary symptoms (IPSS-QOL) were evaluated before and after LDR-BT. We compared chronological changes in IPSS, OABSS, and IPSS-QOL in the elderly group with those in the control group and assessed the association between the resolution of OABSS and clinicopathological covariates. A total of 484 patients were enrolled in this study. In the elderly group, the total IPSS, OABSS, and frequency scores increased at 1 month postoperatively, whereas the control group showed an increase at 3 months postoperatively. Multivariate analysis identified changes from baseline to the maximum OABSS and pre-treatment OABSS as significant predictors of delayed resolution of OABSS after LDR-BT. Changes in pre-treatment OABSS and pre- and post-LDR-BT OABSS values were independent predictors of delayed resolution of OABSS; however, no correlation was found with age.

The Impact of Overactive Bladder on Quality of Life Affecting Physical Life, Social Life and Psychological Health among Women

Introduction: Overactive bladder (OAB) has profound impacts on the quality of life (QoL) in women, affecting their physical, social, and psychological well-being. However, comprehensive studies on the impacts of OAB among women in Bangladesh, a low-middle income country with unique cultural, social, and economic contexts, remain scarce. Methods: This prospective observational study, conducted at the Department of Obstetrics and Gynecology, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh, from January 2021 to December 2022, included 120 women visiting the study hospital with complaints of urinary leakage. Participants were surveyed on the prevalence and severity of OAB symptoms and their impact on physical life, social life, and psychological health. The Overactive Bladder Symptom Score (OABSS) and the King's Health Questionnaire (KHQ) were used to assess symptom severity and impact on quality of life, respectively. Result: The study found that OAB symptoms were prevalent among the participants, with 50.00% reporting urinary urgency, 40.00% reporting frequency of urination, 30.00% reporting nocturia, and 20.00% reporting incontinence. The severity of OAB symptoms varied, with 40.00% having a mild OABSS score, 50.00% having a moderate OABSS score, and 10.00% having a severe OABSS score. Conclusion: OAB significantly impacts the QoL of women in Bangladesh. This study underscores the need for comprehensive, multi- dimensional approaches to manage OAB, emphasizing the necessity for mental health support. It contributes to the limited literature on OAB's impact in low and middle-income countries, highlighting the need for further research and public health initiatives to improve the management and treatment of OAB in these contexts.

Comparison of micro-radiofrequency therapy and tolterodine for the treatment of newly diagnosed overactive bladder: A retrospective cohort study.

This study aimed to retrospectively compare the efficacy and safety of micro-radiofrequency (RF) therapy through the urethra vs. oral tolterodine tartrate in the treatment of newly diagnosed overactive bladder (OAB). In this study, 46 patients who were newly diagnosed with moderate-to-severe OAB were included; 23 of them underwent the micro-RF treatment procedure, and the other 23 patients took tolterodine. Bladder diaries were recorded 3 days before treatment and during the follow-up period on 1, 3, and 7 weeks after micro-RF therapy or oral tolterodine. Micturition parameters including daily voiding times, daily urge urinary incontinence (UI) episodes, daily urgency episodes, mean volume per micturition, post-void residual volume (PVR), maximum urine flow rate (Qmax), overactive bladder symptom score (OABSS), and quality of life (QoL) score were analyzed. All 46 patients underwent either micro-RF or oral tolterodine treatment, as well as a complete follow-up. The incidence of adverse events in the micro-RF group was 8.7% (2/23), and that in the tolterodine group was 43.5% (10/23). The following two adverse events happened in the micro-RF group: an injury to the urethra during catheterization in a man and a urinary tract infection in a woman, both of which were relieved or disappeared after day 3. The adverse effects in the tolterodine group were mainly dry mouth (4/23), dysuria (5/23), and constipation (8/23), but none of the patients withdrew from the drug therapy. Compared to pre-therapy, all parameters of both groups, including daily voiding times, daily urgency episodes, mean volume per micturition, OABSS, and QoL score, demonstrated significant improvements during follow-up in 7 weeks after therapy, except for daily UI episodes in the tolterodine group, while the above parameters showed bigger improvements in the micro-RF group than in the tolterodine group. Besides, the general treatment efficacy of micro-RF was 73.9% (17/23), which was significantly better than tolterodine (10/23, 43.5%), and the difference was 30.4% [95% CI: 3.4-57.5%, p = 0.036]. In this retrospective study, we found that micro-RF therapy is safe and more effective than oral tolterodine for newly diagnosed moderate-to-severe OAB in a short-term follow-up. Stronger evidence would be provided through a well-designed, prospective, randomized controlled trial.

Effects of Labor Analgesia on Pelvic Floor Function at 6 to 8 Weeks after Delivery: A Prospective Cohort Study.

The aim of the study is to determine whether the use of labor analgesia had a higher risk of pelvic floor functional problems after delivery. All primiparas who delivered at our hospital between June 2019 and May 2020 were enrolled in the study. They were divided into two groups according to their choices: delivery with labor analgesia (analgesia group, n = 76), and delivery without labor analgesia (nonanalgesia group, n = 78). The primary outcome of the study was to test the pelvic floor function by electromyography (EMG) at postpartum 6 to 8 weeks. Participants also completed questionnaires including Pelvic Floor Distress Inventory (PFDI-20), International Consultation on Incontinent Questionnaire-Short Form (ICIQ-SF), and Overactive Bladder Symptom Score (OABSS) at postpartum 6 to 8 weeks. Primiparas in the analgesia group experienced longer first and second stages of labor (p< 0.05), and had significantly higher PFDI-20 scores at postpartum 6 to 8 weeks (p< 0.05). But the differences in ICIQ-SF, OABSS scores, and Pelvic Organ Prolapse Quantification (POP-Q) system between the two groups were not significant (p > 0.05). No statistically significant difference was found in class II and class I muscles, scores of pretest resting baseline, and posttest resting baseline between primiparas with or without labor analgesia (p > 0.05). Our results strongly confirmed that labor analgesia did not increase the risk of pelvic floor dysfunction up to 6 to 8 weeks after delivery, although symptom burden might be increased after labor analgesia. · Labor analgesia did not increase risk of pelvic floor muscle dysfunction after delivery.. · There are longer first and second stages of labor in primiparas with labor analgesia.. · Primiparas with labor analgesia had more obvious subjective symptoms of PFD..

Clinical Report of Baliao Electroacupuncture Treatment on a Stroke Patient Suffering from a Neurogenic Overactive Bladder

Objective: The purpose of this case study is to report the effectiveness of Baliao acupoints electro-acupuncture treatment on a neurogenic overactive bladder induced by stroke.Method: A patient suffering from middle cerebral artery infarction was diagnosed with a neurogenic overactive bladder and treated by Korean medicine, including electro-acupuncture on Baliao acupoints six times per week. The evaluation was performed by monitoring urinary frequency and using the Korean versions of the Overactive Bladder Symptom Score (OABSS) and Urinary Incontinence Quality of Life (I-QoL).Results: After 27 days of electro-acupuncture treatment, the OABSS score improved from 6 to 3. The I-QoL total score improved from 60 to 87. The patient also showed a decrease in nocturia frequency.Conclusion: This case suggests that electro-acupuncture on Baliao acupoints can be effective for overactive bladders due to supra-pontine lesions.

Prospective randomized controlled trial comparing a ureteral stent crossing versus not crossing the bladder midline.

PurposeTo evaluate the correlation between the position of a ureteral stent and stent-related symptoms in a single-center randomized study.MethodsA total of 113 patients who required ureteral stent placement after lithotripsy were randomized at a 1:1 ratio into groups with stents crossing and not crossing the bladder midline. The ureteral stent remained in place until postoperative day 14, when we obtained each patient’s International Prostate Symptom Score (IPSS), overactive bladder symptom score (OABSS), and visual analog scale (VAS) pain score.ResultsComparing changes from baseline IPSS and OABSS scores between the two groups, the midline crossing group had a worse OABSS total score than the not crossing group (3.0 ± 2.8 vs. 2.0 ± 3.3; p = 0.032). There was no significant difference between the crossing and not crossing groups in IPSS total score (6.8 ± 7.6 vs. 5.1 ± 8.5; p = 0.14). The OABSS urgency mean score was significantly lower in the not crossing than in the crossing group (1.1 ± 1.8 vs. 1.6 ± 1.8; p = 0.042). However, there was no significant difference between groups for remaining items of the IPSS and OABSS and the mean VAS total pain score (1.9 ± 2.7 vs. 1.2 ± 1.9; p = 0.14).ConclusionA ureteral stent that crossed the bladder midline led to worse urinary symptoms. Choosing the appropriate stent length for each patient is important to minimize stent-related symptoms.Trial Registration date1 October 2018; number: UMIN000034067.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00345-022-03978-5.

Overactive bladder symptom score - translation and linguistic validation in Bengali.

Aims:Overactive bladder symptom score (OABSS) in English consists of four questionnaires. We proposed to make Bengali version and linguistic validation.Settings:Online survey.Materials and Methods:The translation and linguistic validation was done in the following manner: forward Bengali translation, backward English translation, preparation of online version, online survey, cognitive debriefing and preparation of final version. Backward translation was done by a person proficient in Bengali and English who had never seen the English version.Results:Forward Bengali translation from the English version of OABSS was made. Next backward translation was done. Question number 1 and 2 backward translation was in congruent at the first attempt. But question number 3 and 4 backward translation needed multiple time correction to come to congruence. After agreement of corrected version an online version was created. In the online version along with particulars of the participants, exclusion criteria, OAB diagnostic criteria, category of OAB depending on OABSS score were added. Then this online version was sent for online survey to Bengali-speaking persons (https://forms.gle/qEo8GuXSgxyULoaX9). Fifty-nine persons (43 male, 16 female) participated. Participants were from all-over India, covering many types of occupation. Overall prevalence of OAB was 15.5% and among male 6.9% and female 8.6%. No participants had any difficulty in understanding the questionnaires in congruence; only two persons were unable to understand the category of OAB as per OABSS.Conclusion:OABSS Bengali version is well understood in congruence and linguistically validated. Further studies would assess the reproducibility and accuracy of the questionnaire in Bengali populations.

MP52-10 CLINICAL STUDY OF A NEUROMODULATIVE SLING SYSTEM WITH TVT-XO PROCEDURE IN THE TREATMENT OF MIXED URINARY INCONTINENCE

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy II (MP52)1 Sep 2021MP52-10 CLINICAL STUDY OF A NEUROMODULATIVE SLING SYSTEM WITH TVT-XO PROCEDURE IN THE TREATMENT OF MIXED URINARY INCONTINENCE Hai-Hong Jiang, Xiao-Liang Zhu, Yasmeen Bano, Qi-Xiang Song, Kang-Li Deng, Jiahui Liu, Hongbing Liao, and Meihao Wang Hai-Hong JiangHai-Hong Jiang More articles by this author , Xiao-Liang ZhuXiao-Liang Zhu More articles by this author , Yasmeen BanoYasmeen Bano More articles by this author , Qi-Xiang SongQi-Xiang Song More articles by this author , Kang-Li DengKang-Li Deng More articles by this author , Jiahui LiuJiahui Liu More articles by this author , Hongbing LiaoHongbing Liao More articles by this author , and Meihao WangMeihao Wang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002082.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Mixed urinary incontinence (MUI) is a relatively complex medical condition. To evaluate the safety and effectiveness of the neuromodulative sling system with TVT-XO procedure in MUI, we performed surgical treatment and short-term observation on 11 women with severe MUI by using a new neuromodulative sling system combined with a new anti-incontinence TVT-XO suspension procedure. METHODS: A total of 11 adult female patients with severe MUI were included under the following screening criteria: leakage point pressure < 60 cm H2O, severe bladder urgent symptoms (overactive bladder symptom score(OABSS) >12), and no significant improvement after pelvic floor exercise and related medications. The principle of TVT-XO suspension is that two sling tapes crossover stereoscopic suspension of the urethra. The microelectric stimulating lead along the shell of the left suprapubic sling was inserted below the middle and proximal suburethral urethra. The stimulator was then attached to the lead. During neuromodulation after implantation, the urgency can be regulated through feedback. RESULTS: All 11 patients underwent TVT-XO procedure along with the neuomodulative sling system implantation successfully. With neuromodulation treatment one month after surgery, it indicated significant improvements in MUI symptoms, including the short version of questionnaire IIQ7 and the OABSS score (p < 0.05). CONCLUSIONS: Our preliminary study demonstrated the TVT-XO sling procedure along with a new neuromodulative sling can simultaneously improve patients' urinary incontinence and urgency with no serious complications. The limitations of the study include the small number of patients and the short time of the observation. We expected a large-scale trial and long-term observation of the safety and effectiveness. Source of Funding: Zhejiang Provincial Natural Science Foundation of China (No. WY20H050001), Zhejiang Provincial Medical and Health Technology Program projects of China (Nos. 2018PY031, 2018KY512, and 2019KY101), and National Natural Science Foundation of China (No. 81670695) © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e933-e933 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hai-Hong Jiang More articles by this author Xiao-Liang Zhu More articles by this author Yasmeen Bano More articles by this author Qi-Xiang Song More articles by this author Kang-Li Deng More articles by this author Jiahui Liu More articles by this author Hongbing Liao More articles by this author Meihao Wang More articles by this author Expand All Advertisement Loading ...

Mirabegron for treatment of overactive bladder symptoms in patients with Parkinson's disease: A double-blind, randomized placebo-controlled trial (Parkinson's Disease Overactive bladder Mirabegron, PaDoMi Study).

This study aimed to investigate the efficacy and safety of mirabegron for Parkinsonism patients with overactive bladder (OAB) symptoms in a randomized, placebo-controlled, multicenter study. Inclusion criteria are Parkinsonism with OAB symptoms for 4 weeks or more, OAB symptom score (OABSS) questionnaire scores greater than 2, and OABSS urgency question scores greater than 1. After a 2-week wash-out period, the patients were randomized into placebo and mirabegron groups at visit 2. Visit 3 was performed after 4 weeks of medication. Mirabegron was prescribed to the two groups for the rest of the study period at visit 4. The mean age was 68.1 ± 8.1 years and 72 males and 64 females were included. A total of 136 patients were screened, 117 patients were randomized, and 25 patients dropped out. The OABSS scores were significantly different between the two groups at Weeks 4 and 8. The OABSS scores became the same in the two groups at Week 12 (visit 5). The postvoid residual urine volume showed a mild increase to 64 ml in the mirabegron group compared to the placebo group at visit 4. Adverse events occurred in 27 patients (23.1%). The degree was mild in 26 cases (78.8%), moderate in five (15.2%), and severe in two (6.1%). Only 13 cases (39.4%) showed medication-related adverse events. Acute urinary retention occurred in a single case. The treatment satisfaction questionnaires showed no significant differences between the two groups. Mirabegron was effective in treating OAB symptoms in patients with Parkinsonism with acceptable adverse events.

Efficacy of cinnamon patch treatment for alleviating symptoms of overactive bladder: A double-blind, randomized, placebo-controlled trial

BackgroundCurrent treatments for overactive bladder (OAB) have limited efficacy, low persistence and a high rate of adverse events commonly leading to treatment cessation in clinical practice. Clinicians in Asia commonly use traditional Chinese medicine as an alternative for OAB treatment despite it having uncertain efficacy and safety. To evaluate the efficacy and safety of cinnamon patch (CP) treatment for alleviating symptoms of OAB, a double-blind randomized, placebo-controlled trial was conducted in the present study. Materials and MethodsIn this 6-week randomized clinical trial conducted in an outpatient setting, 66 subjects diagnosed as having OAB were enrolled and treated with a placebo (n=33) or CP (n=33). The OAB symptom score (OABSS) was selected as the primary end point, and a patient perception of bladder condition (PPBC), an urgency severity scale (USS), and post-voiding residual urine (PVR) volume were selected as secondary end points. Statistical analyses were performed with IBM SPSS Statistics 20. Groups were compared using an independent sample t-test, Fisher exact test, and Chi-squared test. ResultsIn total, 66 participants (40 women and 26 men), 60.35 ± 12.77 years of age, were included in the intention-to-treat analyses. Baseline characteristics were comparable between the CP (n ==33) and placebo (n ==33) groups. Treatment with a CP showed statistically significant differences in reductions in OABSS scores (9.70 ± 2.20 to 6.33 ± 2.42), PPBC scores (3.36 ± 0.60 to 2.15 ± 0.83), and USS scores (2.67 ± 0.54 to 1.64 ± 0.60). ConclusionsCompared to a placebo, treatment with CP might be considered an effective and safe complementary therapy for OAB. Further studies employing a positive control, different dosage forms, larger sample sizes, and longer treatment periods are warranted.

A randomized controlled trial to assess the effectiveness and safety of acupuncture for overactive bladder: a study in Hong Kong population

BackgroundAround 15% of the Hong Kong population was found to suffer from overactive bladder (OAB), but the current available treatments, such as medication, behavioral therapy and physical therapy are unsatisfactory. Previous studies have suggested that acupuncture may have promising effect for OAB, but some limitations on the study design render the evidence questionable. This study aimed to evaluate the effectiveness and safety of acupuncture treatment for patients with OAB in Hong Kong.MethodsOne hundred patients with OAB were enrolled. The patients were randomized to receive either active acupuncture or sham needle intervention twice a week for 8 consecutive weeks, and had a follow-up consultation 12 weeks after the completion of acupuncture intervention. The primary outcome assessment was the 3-Day Voiding Diary, which records daytime and night-time urinary frequency and symptoms, at the baseline, the end of the 8-week intervention and 12 weeks after acupuncture intervention. Secondary outcomes included Urine NGF level, Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6), as well as Overactive Bladder Symptom Score (OABSS).ResultsAfter 16 sessions of treatment, when compared with the baseline, both active and sham acupuncture significantly reduced the frequency of urgency urinary incontinence (UUI), daytime and night-time urinary frequency as well as the scores of IIQ-7, UDI-6 and OABSS. Moreover, the treatment effects could last for at least 3 months. However, no significant difference in frequency of UUI and daytime urinary frequency was found between the active and sham acupuncture groups. On the other hand, the night-time urinary frequency decreased more significantly during the treatment and follow-up in the active acupuncture group than in the sham control group after controlling baseline night-time urinary frequency. Urine NGF level could not be detected by ELISA method in our experiments.ConclusionThis study suggests a beneficial effect of acupuncture on improving OAB symptoms. Both active and sham acupuncture treatment were able to improve the symptoms of frequency of urgency urinary incontinence, and the daytime and night-time urinary frequency, while only mild adverse effects were found. This project was unable to establish the specific effect of acupuncture for OAB.Trial registration Chinese Clinical Trial Registry, ChiCTR-INR-16010048. Registered on 29 Nov 2016.

Factors Associated With Postoperative Voiding Dysfunction Post Renal Transplantation

IntroductionRenal transplantation offers a better quality of life and survival rate for patients with end-stage renal disease. However, voiding dysfunction may have results such as decreased bladder capacity that have been observed in patients with prolonged oliguria or anuria, impacting a patient’s quality of life. This study aimed to investigate preoperative factors associated with the occurrence of voiding dysfunction after renal transplantation. MethodsSeventy-one patients’ data who had undergone successful renal transplantation at Cipto Mangunkusumo General Hospital in Jakarta were collected. Preoperative characteristics including age, sex, history of hypertension, diabetes mellitus, preoperative anuria, and duration of renal substitution therapy were obtained. Multivariate analysis were performed examining the correlation of preoperative characteristics with postoperative voiding dysfunction measured by International Prostate Symptom Score storage (IPSS-s) sub-score > 5, overactive bladder symptom score (OABSS) > 5, maximum flow rate (Qmax) > 15 mL/cc, and postvoid residual volume (PVR) > 50 mL. ResultsA significant correlation of IPSS-s score suggesting storage problem with duration of preoperative dialysis was observed (odds ratio [OR] 1.052; 95% confidence interval [CI] 1.006-1.1001, P = .027). Older age and preoperative anuria were positively correlated with OABSS score > 5 (OR 1.104 and 33.567, P value .004 and .002, respectively). Negative correlation was observed between male sex and Qmax > 15mL/s (OR 1.73; 95% CI 0.033-1.907, P = .038). Male sex was negatively correlated with PVR > 50 mL (OR 0.231; P = .043) but positively correlated with the presence history of diabetes mellitus (OR 8.146; 95% CI 1.548-42.864, P = .013). ConclusionThis study demonstrated that assessment of patient age, sex, and past medical history could help determine patients’ risk for developing voiding dysfunction after renal transplantation.

Intravesical prostatic protrusion does not compromise the therapeutic effects of Mirabegron in male patients with overactive bladder

Intravesical prostatic protrusion (IPP) is associated with the degree of benign prostatic obstruction. We evaluated the effects of Mirabegron, a selective β3 adrenoceptor agonist, on overactive bladder (OAB) in male patients with different degrees of IPP. About 185 male patients ≥40years with lower urinary tract symptoms were recruited from a tertiary referral center. OAB was defined by the overactive bladder symptom score (OABSS) urgency score of ≥2 and sum score of ≥3. IPP was measured in the midsagittal section using transrectal ultrasound and patients were divided into IPP ≤5mm and IPP >5mm groups. Outcomes were assessed at the baseline, 4, and 12weeks. About 104 patients (56.2%) were diagnosed with OAB and received Mirabegron (50mg) daily use. Both IPP groups (≤5 and >5mm) had similar baseline OABSS and International Prostate Symptom Scores (IPSS). Four-week Mirabegron usage was associated with significant decreases in both symptom score measurements, OABSS: IPP ≤5mm -27.4% and IPP >5mm -19.7% (P=.419) and IPSS: -32% and -22.5% (P=.202), respectively. Urgency, urge incontinence, and nocturia sub-scores were decreased in both groups, -26.3% and -27.4% (P=.690), 53.3% and 46.2% (P=.916), and 20.8% and 15.4% (P=.958). Effects were maintained at 12weeks. We found no significant improvement in the frequency sub-score in either group. One patient stopped medication because of intolerable hypertension. Most frequent adverse event was increased residual urine (≥50mL higher than baseline), IPP ≤5mm 9.2% and IPP >5mm 5.1% (P=.707), but no case had acute urinary retention. Mirabegron is an effective drug to treat male OAB regardless of IPP grade.