Overactive Bladder Symptom Score Score Research Articles

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.

P-02-51 Add-On Treatment With Mirabegron in Men With Benign Prostatic Hyperplasia Complaining Persistent Storage Symtoms after Tamsulosin Monotherapy Improves Quality of Life

Persistent storage symptoms after medication with alpha blocker decrease quality of life (QoL) and may disturb sexual activity. Therefore, we evaluated the effect of add on therapy with mirabegron in patient with benign prostatic hyperplasia (BPH) and persistent storage symptoms after treatment with tamsulosin. We evaluated International prostatic symptom score (IPSS), overactive bladder symptom score (OABSS), PSA, prostate volume (PV), maximum flow rate (Qmax), post voided volume (PVR) before and after treatment. Patients showing baseline OABSS question 3 ≥ 4 was included in this study and treat with tamsulosin 0.2 mg as an initial drug for 1 month. After 1 month, add-on treatment with solifenacin 5 mg or mirabegron 50 mg was done to the patients who did not show improvement of OABSS scores with tamsulosin 0.2 mg. Two months later we evaluated the changes of OABSS, IPSS, Qmax and PVR. After combination treatment for 2 months, there were no significant differences of IPSS scores between the patients received add-on treatment with solifenacin and mirabegron. However, improvement of IPSS QoL score of the patients treated with mirabegron and tamsulosin (3.64±1.55) compared with solifenacin and tamsulosin (4.25±0.71).

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.

Urodynamic classification of male patients with symptoms of overactive bladder and the outcome classification

OBJECTIVE To introduce a urodynamic classification of male patients with symptoms of overactive bladder (OAB) and discuss its clinical significance in practice. METHODS From January 2015 to January 2017, there were 181 male patients from Peking University People's Hospital who were diagnosed clinically with OAB and underwent preoperative urodynamic test. Finally 126 male patients were enrolled in the research. Male OAB patients could be stratified into four groups based on the chief complaints (whether or not presenting urgency) and the results of urodynamic test (whether or not presenting detrusor overactivity and the ability to stop the involuntary contraction). The contents of this follow-up study included the basic information, the preoperative and postoperative scores of the OAB symptom score (OABSS), the preoperative and postoperative scores of the international prostate symptom score (IPSS), and the amount of the concomitant diseases. RESULTS According to the classification, the amounts of the four types of OAB patients were 32 (25.40%) for type I, 27 (21.43%) for type II, 59 (46.83%) for type III, and 8 (6.35%) for type IV, respectively. The data of their heights showed no statistical significance (P>0.05). The ages, weights and the amount of the concomitant diseases of type IV were obviously higher than those of the other three types (P 0.05). The improvement of the OABSS and IPSS scores of the type IV were obviously inferior to the other three types (P 0.05). CONCLUSION Type IV has the worst outcome and type III has the best among the four types of OAB. And this classification system will certainly have a profound significance in guiding and directing our clinical diagnosis and treatments, and evaluating the prognosis of the patients with OAB.

Effects of tamsulosin hydrochloride sustained release capsule in improving symptoms and quality of life of patients with indwelling double-J ureteral stents

Objective To investigate the influence of tamsulosin hydrochloride sustained release capsule in improving symptoms and quality of life of patients with indwelling double-J ureteral stents. Methods From March 2016 to June 2017, 96 patients with indwelling double-J ureteral catheter were randomly divided into control group and observation group, with 48 patients in each group. The control group did not take drugs after operation, and the patients in the observation group were treated with tamsulosin hydrochloride sustained release capsule once a day, totally for 1 month. All the enrolled patients completed the Ureteral Stent Symptom Questionnaire (USSQ), the International Prostate Symptom Score (IPSS) , quality of life (QOL), visual analogue scale (VAS) as well as the Overactive Bladder Symptom Score (OABSS) on the day after the removal of the stent 4 weeks after treatment. Results The mean urinary symptom index score, the pain index score, the sex index score and the ability index of work score of the observation group were (25.23±4.35), (14.58±2.84), (3.82±1.03) and (12.83±3.85) , lower than the score (31.29±4.48), (30.39±3.91), (5.83±1.94) and (18.81±5.03) of the control group. The storage stage score and IPSS total score were respectively (3.31±1.38) and (6.87±2.94), lower than the score (6.14±2.03) and (10.31±2.26) of the control group. The QOL, VAS, OABSS score were (1.54±0.93 ), (1.95±1.07) and (4.31±1.28), lower than the score(3.24±0.93), (4.04±1.23) and (9.29±2.87) of the control group. As opposed to the control group, it was observed that observation group prominently improved and the scores were statistically significant(P<0.05). Conclusions Tamsulosin hydrochloride sustained release capsule can significantly improve the related symptoms of indwelling double-J ureteral stents and prostatic symptoms, reduce pain, improve patient's quality of life. Key words: Urinary Catheterization; Adrenergic alpha-Antagonists; Signs and Symptoms; Quality of Life

Epidemic investigation of benign prostatic obstruction with coexisting overactive bladder in Shanghai Pudong New Area and its impact on the health-related quality of life

BackgroundWe aimed to investigate the prevalence, relative risk factors, and the impact on the health-related quality of life (HRQoL) of benign prostatic obstruction (BPO) with coexisting overactive bladder (OAB) in men aged over 50 and living in Shanghai Pudong New Area.MethodsUsing a multi-stage sampling and descriptive epidemiological method, 1632 men were selected from among the general population. Participants completed an evaluation of lower urinary tracts symptoms (LUTS), including international prostate symptom score (IPSS) and quality of life (QoL) questionnaires. Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) questionnaire. In addition, the Overactive Bladder Symptom Score (OABSS) and King’s health questionnaire (KHQ) were used to assess the impact of BPO with coexisting OAB on the HRQoL. Maximum flow rate (Qmax), postvoid residual urine volume (PVR) and prostate-specific antigen (PSA) were also recorded.ResultsA total of 1476 men with complete data were analyzed. The overall prevalence of BPO with coexisting OAB was 39.6%. Age and prostate volume were associated risk factors for BPO with coexisting OAB. In addition, BPO with coexisting OAB negatively impacted the HRQoL, with increased IPSS, QoL, OABSS, and KHQ scores and decreased IIEF-5 scores compared to that in patients with BPO without OAB.ConclusionsQmax, PVR and serum PSA did not predict whether the patients had a combined BPO + OAB or not. The prostate volume and age were associated risk factors for BPO with coexisting OAB. BPO is a progressive disease and may be one of the risk factors for OAB.