Overactive Bladder Symptom Score Research Articles

Comparison of the Efficacy of Low Dose Tadalafil with Tamsulosin against Lower Urinary Tract Symptoms and Sexual Dysfunction after Low Dose Rate Prostate Brachytherapy.

Patients with clinically localized prostate cancer (PCa) can be curatively treated with different modalities, including low dose rate (LDR) prostate brachytherapy (PB). LDR-PB allows the patient a relatively short recovery time compared with other treatment modalities such as prostatectomy. However, PB might exert distinct impact on quality of life, lower urinary tract symptoms (LUTS) and sexual dysfunction (SD) are two major concerns. The aim of present study was to assess prospectively the efficacy of low dose tadalafil treatment on both SD and LUTS compared with tamsulosin treatment in patients treated PB for localized PCa. Patients scheduled for PB with I-125 seeds for low or intermediate-risk localized PCa at our institution were eligible for this study. The prescribed dose was set at 160 gray. Participants were randomized into two groups; those started treating with a daily use of 0.2 mg of tamsulosin hydrochloride or 5 mg of tadalafil just after PB. The duration of the study was 12 months and the patients were assessed for urinary and sexual function status at baseline, and 1, 3, 6, and 12 months after PB. The primary study endpoints were both changes from baseline in urinary and sexual function status. Between July 2015 and August 2020, 120 participants were enrolled in this study. The median age was 68 years with the median PSA of 6.5 ng/ml. A total 15 patients were excluded within 6 months after randomization. All subjective LUTS findings, including International Prostate Symptom Score (IPSS), and Over Active Bladder Symptom Score (OABSS), were significantly deteriorated at 1, 3, and 6 months after PB compared with baseline in both groups, respectively (p<0.05). Among objective LUTS findings, a significant decrease in maximum urinary flow rate (Qmax) was found at 1, 3, 6, and 12 months after PB compared with baseline in both groups, respectively (p<0.05). A significant increase in post void residual urine (PVR) was found at 1, 3, and 6 months after PB compared to baseline in tadalafil group, whereas no significant increase was seen in tamsulosin group. There were no statistically significant differences between the 2 groups in scores of the total International Index of Erectile Function (IIEF)-15 and Erection Hardness Score (EHS) before and at 1 month post PB. The EHS was significantly higher in tadalafil group compared with tamsulosin group at 3, 6 and 12 months (p = 0.001, p = 0.004, and p = 0.019, respectively). The EHS after PB in tadalafil group was not significantly decreased from baseline. After LDR-PB, tamsulosin treatment significantly decreased PVR compared with tadalafil. On the other hand, tadalafil contributed to maintain erection hardness compared with tamsulosin.

Comparative Study Between Behavior Therapy and Behavior Therapy Plus Mirabegron 50 mg in Sexually Active Men With Bothersome Overactive Bladder Symptoms - A Multicenter, Randomized Study.

We evaluated the therapeutic effects on overactive bladder (OAB) symptoms and sexual function of behavioral therapy with or without mirabegron in sexually active male patients with OAB. Mirabegron, a selective β3 adrenoceptor agonist for the treatment of OAB, has been shown to induce corpus cavernosum relaxation. In this 4-site, randomized controlled trial, 150 sexually active men with OAB were enrolled between June 2020 and May 2022. Participants were randomly allocated (1:2) into 2 treatment groups: (1) behavioral therapy alone (n = 50) and (2) a combination of mirabegron 50 mg daily and behavioral therapy (n = 100). The evaluation was based on the overactive bladder symptoms score (OABSS), the International Index of Erectile Function, the ejaculatory domain short form, the International Prostate Symptom Score, patient perception of bladder condition, quality of life, and urodynamic parameters. The therapeutic outcomes were assessed at baseline, 4 weeks, and 12 weeks. There were 65 patients (65%) in the combination subgroup and 36 patients in the behavioral therapy who completed all 12 weeks of treatment. Both groups had a statistically significant improvement in OABSS after 12 weeks of treatment. The combination therapy group achieved a statistically significant improvement in all 4 subscores of OABSS, however, the urinary frequency (P = 0.120) and urinary incontinence (P = 0.234) subscores in the behavioral therapy only group did not show a significant change. Additionally, the combination group had a significant improvement in functional bladder capacity, which was not seen in the behavioral therapy group. However, both groups did not have a significant change in erectile or ejaculatory function. Behavioral therapy combined with mirabegron had more significant impact on the improvement of OAB than behavior therapy alone. However, both groups did not have significant changes in erectile or ejaculatory function.

Effects of transcutaneous tibial nerve stimulation for overactive bladder symptoms in adults: A randomized controlled trial

Background: Overactive bladder (OAB) is characterized by urinary urgency, frequency, and nocturia, often accompanied by urinary incontinence. OAB significantly impacts the quality of life of affected individuals. Transcutaneous Tibial Nerve Stimulation (TTNS) is a non-invasive treatment option used to manage overactive bladder (OAB) symptoms. Objective: to determine the effects of Transcutaneous Tibial Nerve Stimulation on overactive bladder symptoms in adults. Methods: A randomized controlled trial was held at the Sindh Institute of Physical Medicine and Rehabilitation with a non-probability purposive sampling technique. After screening for inclusion criteria 60 patients were randomly allocated into two Group A received Transcutaneous tibial nerve stimulation (TTNS) combined with traditional physiotherapy, while Group B just received traditional physiotherapy. Both interventions were given for six weeks. The overactive Bladder Symptom Score was used as an outcome measure tool. Results: Group A improved in all OAB parameters, including daytime frequency (p=0.008), nocturia (p=0.006), urinary urgency (p=0.002), and urge urinary incontinence (p=0.008) with a significant improvement p&lt;0.05. All OABSS parameters in group B also showed a considerable improvement (p&lt;0.05), except for urge urinary incontinence (p=0.08). Conclusion: the daytime frequency, nocturia, and urgency parameters of the overactive bladder symptoms score significantly decreased in both the TTNS+PFM group and the Traditional physiotherapy group. However, urge urinary incontinence showed significant improvement only in the TTNS+PFM group.

Языковая, культурная адаптация и валидация опросника OABSS (Overactive Bladder Symptom Score) среди пациентов с гиперактивным мочевым пузырем

Языковая, культурная адаптация и валидация опросника OABSS (Overactive Bladder Symptom Score) среди пациентов с гиперактивным мочевым пузырем

Prognostic Factors for Resolution Delay of Lower Urinary Tract Symptoms in Patients with Prostate Cancer after Low-Dose-Rate Brachytherapy.

Urinary storage symptoms after low-dose-rate brachytherapy (LDR-BT) with iodine-125 have been noted to be less likely to improve to baseline compared to voiding symptoms. This study aimed to evaluate the chronological changes in the overactive bladder symptom score (OABSS) and the time-to-resolution of OABSS in patients undergoing LDR-BT. Patients with prostate cancer who underwent LDR-BT at Gifu University Hospital were enrolled. The OABSS was evaluated before and after LDR-BT. Patients were divided into the OABSS resolution and resolution delay groups, and the association between OABSS resolution delay and clinicopathological covariates was evaluated. In total, 237 patients were enrolled in this study, with a median follow-up of 88.3 months. The OABSS in both groups worsened at 3 months following operation and gradually recovered at 9 months; however, the OABSS in the resolution delay group tended to worsen again after that. In the multivariate analysis, preoperative OABSS and the change from baseline to maximal OABSS were associated with OABSS resolution. To our knowledge, this is the first study to evaluate the delayed resolution of OABSS after LDR-BT in patients with prostate cancer. A low baseline OABSS and significant changes in the OABSS from baseline were independent predictors of delayed OABSS resolution.

Factors Related to Overactive Bladder-like Symptoms in Bladder Cancer.

The aim of the present study was to investigate the factors related to overactive bladder (OAB)-like symptoms in patients with bladder cancer. This study included 59 patients who underwent transurethral resection of bladder tumor (TURBT). OAB-like symptoms were identified based on the Overactive Bladder Symptom Score (OABSS) and International Prostate Symptom Score (IPSS) questionnaires. The main outcome measures were elucidation of bladder cancer-related factors that might induce OAB-like symptoms. Non-muscle invasive bladder cancer (NMIBC) was observed in 50 patients, and carcinoma in situ (CIS) was observed in 14 patients. OABSS total score, IPSS total score, and quality of life index were 5±3, 12±7 and 3±1, respectively. The OABSS question 1 score, indicating pollakisuria, was significantly higher in NMIBC patients with CIS than in those without CIS (presence of CIS vs. absence of CIS=1.0±0.6 : 0.5±0.6, p=0.02). IPSS question 4 score, indicating urgency (r=0.31, p=0.01), and OABSS question 4 score, indicating urgency incontinence (r=0.29, p=0.03), correlated significantly with the maximum bladder tumor diameter. Multivariate regression analysis demonstrated that presence of CIS in NMIBC cases correlated significantly with pollakisuria (p=0.02), and that maximum diameter of the bladder tumor correlated significantly with both urgency (p=0.04) and urgency incontinence (p=0.01). CIS induced pollakisuria in NMIBC. Larger diameter bladder tumors induced both urgency and urgency incontinence. Patients with bladder cancer who present with pollakisuria might have CIS.

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.

Ninjin'yoeito Improves Genitourinary Symptoms in Patients With Frailty.

Introduction In geriatric medicine, there is currently significant attention on frailty, a condition commonly associated with aging and characterized by muscle weakness and other age-related changes. Within the fields of urology and gynecology, conditions such as overactive bladder (OAB) and genitourinary syndrome of menopause (GSM) have been identified as crucial concerns due to their negative impact on the quality of life of elderly individuals. In this study, we investigated the potential of Ninjin'yoeito (NYT), a traditional Chinese herbal medicine, as a viable treatment option for frailty. Additionally, we hypothesized that NYT may also contribute to the improvement of symptoms associated with OAB and GSM, and potentially help in reducing the dosage of OAB medications. Methods In this retrospective cohort study conducted from November 2016 to November 2022, we created a website describing the relationship between frailty and genitourinary symptoms in frail patients aged ≥ 65 years with GSM who underwent pelvic floor muscle training. The patients were divided into two propensity score-matched groups: NYT group (received NYT for one year) and no-NYT group (did not receive NYT), based on their wishes. The fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) scale was used to assess frailty status. Urinary symptoms were evaluated using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and Overactive Bladder Symptom Score (OABSS). Genital symptoms were investigated using the vaginal health index score and vulvodynia swab test. The value of each score was obtained before (T0) and 12 months after (T12) treatment, and the difference (ΔT0/T12) was calculated. Results During the study period, 985 outpatients visited our clinic, of whom 725 were considered frail/pre-frail; 402 women with frailty/pre-frailty (mean age 77.5 ± 6.49 years) were included, with a median follow-up of 14.5 months. The NYT and no-NYT groups had 220 and 182 patients, respectively. After propensity score matching, each group had 159 patients. ΔT0/T12FRAIL scale score was significantly higher in the NYT group (0.13 ± 0.37) than in the no-NYT (0.01 ± 0.10) group (p=0.001.) However, urinary symptoms improved in the NYT group more than in the no-NYT in terms of the following parameters: ΔT0/T12OABSS (NYT: 0.89 ± 1.65; no-NYTl: 0.36 ± 1.14, p=0.001) and ΔT0/T12ICIQ-SF score (NYT: 1.51 ± 1.75; no-NYT: 0.42 ± 1.18, p<0.001). Genital symptoms were better in the NYT group in terms of ΔT0/T12VHIS (NYT: 0.58 ±1.08; no-NYT: 0.21 ±0.65, p<0.001). The vulvodynia swab test showed improvements in left para-hymen evoked pain in both groups. In the NYT group, 5% of the patients underwent antimuscarinic drug dose reduction for overactive bladder treatment. NYT use was not associated with significant side effects, and only 0.6% of patients reported drug allergies. Conclusion NYT improved activity levels in frail/pre-frail patients. Moreover, NYT use improved various genitourinary symptoms experienced by patients with frailty/pre-frailty. Treatment with NYT may reduce the dose of overactive bladder medications. The anticholinergic load-reducing effect of NYT may help solve the problem of polypharmacy.

Transcutaneous tibial neurostimulation and Solifenacin in urgent incontinence of postmenopausal women.

Symptoms of overactive bladder syndrome (OAB), including urinary incontinence, affect a person's quality of life and cause many personal, social and economic problems. Patients were randomly divided into three groups and received transcutaneous tibial nerve stimulation (cTTNS) with fixed parameters or with variable parameters (vTTNS) and Solifenacin drug. The main outcomes including quality of life questionnaire and OAB score and other secondary outcomes were evaluated before and after treatment for 6 weeks. ANOVA test did not show any significant difference between the three groups in quality of life score (p=0.672), OAB symptom score (p=0.159) and incontinence severity (p=0.422). The t-test demonstrated that the post treatment average quality of life score, OAB score, and incontinence severity were significantly different when compared with before treatment in all three groups (p < 0.05). All three methods were effective in treating symptoms of OAB. However, based on the clinical symptoms, cTTNS is recommended as a preferred and acceptable and safe strategy for the treatment of OAB in women over 50 years old.

Associations of Clinical and Dosimetric Parameters with Urinary Toxicities after Prostate Brachytherapy: A Long-Term Single-Institution Experience.

To examine the association of clinical, treatment, and dose parameters with late urinary toxicity after low-dose-rate brachytherapy (LDR-BT) for prostate cancer, we retrospectively studied patients with prostate cancer who underwent LDR-BT from January 2007 through December 2016. Urinary toxicity was assessed using the International Prostate Symptom Score (IPSS) and Overactive Bladder (OAB) Symptom Score (OABSS). Severe and moderate lower urinary tract symptoms (LUTS) were defined as IPSS ≥ 20 and ≥ 8, respectively; OAB was defined as a nocturnal frequency of ≥ 2 and a total OABSS of ≥ 3. In total, 203 patients (median age: 66 years) were included, with a mean follow-up of 8.4 years after treatment. The IPSS and OABSS worsened after 3 months of treatment; these scores improved to pretreatment levels after 18-36 months in most patients. Patients with a higher baseline IPSS and OABSS had a higher frequency of moderate and severe LUTS and OAB at 24 and 60 months, respectively. LUTS and OAB at 24 and 60 months were not correlated with the dosimetric factors of LDR-BT. Although the rate of long-term urinary toxicities assessed using IPSS and OABSS was low, the baseline scores were related to long-term function. Refining patient selection may further reduce long-term urinary toxicity.

The prevalence of overactive bladder and its impact on the quality of life: A cross-sectional study

ABSTRACT Objective Overactive bladder (OAB) is a common condition affecting both men and women and has been shown to affect the quality of life. We conducted this study to estimate the prevalence of OAB, and to incorporate symptom severity, symptom bother and health-related quality of life (HRQL) in the assessment of OAB and evaluate associated factors. Methodology A total of 940 participants were categorized into non-OAB and OAB using the Overactive Bladder Symptom Score (OABSS). HRQL and symptom bother were measured using the Overactive Bladder Questionnaire – Short Form (OAB-q SF). Descriptive analyses and multivariable regression analyses were performed. Results The prevalence of OAB among our population was 27.4%. Patients with older age (Odd ratio [OR] = 2.26, 95% confidence interval [CI]: 1.6–3), higher body mass index (BMI) (OR = 2.6, 95% CI: 1.8–3.8), comorbidities (OR = 2.6, 95% CI: 1.9–3.5) and history of recurrent urinary tract infection (UTI) s (OR = 1.9, 95% CI: 1.4–2.6) were significantly associated with increased risk of OAB (p < 0.001). The mean OAB symptom bothers score was 35.7 + 22.9 and increased significantly across OAB severity groups (p < 0.001). The mean HRQL score was 73.3 + 22 and a significant decreased across OAB severity groups (p < 0.001). All OAB symptoms showed significant positive correlation with increased symptom bother (p < 0.001) in addition to significant inverse correlation with HRQL (p < 0.001). Conclusion OAB is a prevalent condition in our population and the associated symptoms negatively affect HRQL. In this study, the detrimental effect is not exclusive to UUI and can be attributed to the other elements in the symptom spectrum of OAB. Screening for OAB should be considered during routine clinical visits using validated and reliable measures for early detection of symptoms and possible modification of risk factors to improve the outcome.

A Comparative Study on the effectiveness and Tolerability of Mirabegron and Antimuscarinics in the treatment of Overactive bladder

Background: Despite antimuscarinic treatment options being available as the first line agents for overactive bladder (OAB), there is still a need for distinct treatment approaches to manage its suboptimal response and noncompliance. Mirabegron, a β3-adrenoceptor agonist, could be a better alternative to antimuscarinics in OAB treatment with a good effectiveness/tolerability balance. Aim: To compare the clinical profile of mirabegron and antimuscarinics in the treatment of overactive bladder. Method: A prospective, observational study was conducted in two groups of patients who received either mirabegron (n=120) or antimuscarinics (n=120) for the treatment of OAB. Effectiveness of the drugs were assessed at baseline, 4 and 8 weeks after the treatment using the Overactive Bladder Symptom Score (OABSS) and International Prostatic Symptom Score (IPSS) questionnaires. The safety assessment was done by measuring the post-void residual (PVR) urine volume and assessing the adverse drug reactions (ADR). The probability and severity of the ADRs were measured using Naranjo scale and Hartwig’s scale respectively. Also a subgroup analysis was carried out to compare the effectiveness of the two drugs in patients with OAB related to benign prostatic hyperplasia (BPH). Results: The overall effectiveness of antimuscarinics and mirabegron was found to be similar, but mirabegron showed better reduction in the daytime frequency (p=0.049). They also differ in safety profile with the overall incidence of adverse events being significantly higher in antimuscarinics group (15.83%) (19/120) than in the mirabegron group group (1.7%) (2/120) (p&lt;0.001). In the patients with OAB related to BPH also, there was a better reduction in the daytime frequency with mirabegron than with antimuscarinics, with overall effectiveness between groups being similar. In addition, mirabegron did not worsen the voiding symptoms and was found to be a better combination with alpha1 blockers than the antimuscarinics in patients with OAB related to BPH. No significant change was there in the PVR values within and between the groups. Conclusion: Mirabegron is a better alternative to antimuscarinics in the treatment of OAB with a distinct effectiveness/tolerability balance especially in patients with OAB related to BPH.

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.

A treatment prediction strategy for overactive bladder using a machine learning algorithm that utilized data from the FAITH study.

To use machine learning algorithms to develop a model to accurately predict treatment responses to mirabegron or antimuscarinic agents in patients with overactive bladder (OAB), using real-world data from the FAITH registry (NCT03572231). The FAITH registry data included patients who had been diagnosed with OAB symptoms for at least 3 months and were due to initiate monotherapy with mirabegron or any antimuscarinic. For the development of the machine learning model, data from patients were included if they had completed the 183-day study period, had data for all timepoints and had completed the overactive bladder symptom scores (OABSS) at baseline and end of study. The primary outcome of the study was a composite outcome combining efficacy, persistence, and safety outcomes. Treatment was deemed "more effective" if the composite outcome criteria for "successful," "no treatment change," and "safe" were met, otherwise treatment was deemed "less effective." To explore the composite algorithm, a total of 14 clinical risk factors were included in the initial data set and a 10-fold cross-validation procedure was performed. A range of machine learning models were evaluated to determine the most effective algorithm. In total, data from 396 patients were included (266 [67.2%] treated with mirabegron and 130 [32.8%] treated with an antimuscarinic). Of these, 138 (34.8%) were in the "more effective" group and 258 (65.2%) were in the "less effective" group. The groups were comparable in terms of their characteristic distributions across patient age, sex, body mass index, and Charlson Comorbidity Index. Of the six models initially selected and tested, the decision tree (C5.0) model was chosen for further optimization, and the receiver operating characteristic of the final optimized model had an area under the curve result of 0.70 (95% confidence interval: 0.54-0.85) when 15 was used for the min n parameter. This study successfully created a simple, rapid, and easy-to-use interface that could be further refined to produce a valuable educational or clinical decision-making aid.

Vibegron 50 mg Once Daily Improves OABSS, OAB-q SF Score in OAB Patients ≥80 Years Old in Real-World Clinical Settings and Switching from Other OAB Drugs May Reduce Residual Urine Volume.

The treatment effects of vibegron have not previously been evaluated in a prospective, non-interventional observational study of elderly Japanese patients, particularly those ≥80 years old. In addition, no reports have referred to residual urine volume in switching cases. We therefore grouped patients by condition and investigated the treatment effects of vibegron on Overactive Bladder Symptom Score (OABSS), Overactive Bladder Questionnaire Short Form (OAB-q SF), and residual urine volume in each group. This multicenter, prospective, non-interventional, observational study consecutively enrolled OAB patients with total OABSS score ≥3 and OABSS question 3 score ≥2. Sixty-three patients from six centers were recruited. Vibegron 50 mg once daily was administered for 12 weeks as first-line monotherapy (first-line group), monotherapy switching from antimuscarinics or mirabegron due to failure of prior therapy (no washout period), or combination therapy with antimuscarinics (second-line group). OABSS, OAB-q SF, and residual urine volume were collected after 4 and 12 weeks. Adverse events were also recorded at each visit. Of the 63 patients registered, 61 were eligible for analysis (first line, n=36; second line, n=25). The OABSS, excluding daytime frequency scores, and OAB-q SF scale showed significant improvement in all conditions. Switching from mirabegron to vibegron significantly reduced residual urine volume. No serious treatment-related adverse events were encountered. Vibegron 50 mg once daily significantly improved OABSS and OAB-q SF even in patients ≥80 years old. Notably, switching from mirabegron to vibegron resulted in significant improvements to residual urine volume.

Relationship between lower urinary tract symptoms and frailty.

To elucidate the relationship between frailty and lower urinary tract symptoms (LUTS). We longitudinally evaluated the temporal changes and the relationships between frailty and LUTS in 247 community-dwelling adults (45 years or older) at baseline and at a 5-year follow-up. We used the Fried phenotype (phenotype-based frailty), 5-item modified frailty index (5i-mFI; comorbidity-based frailty), and frailty discriminant score (comprehensive frailty assessment) to evaluate frailty. LUTS were evaluated using the international prostate symptom score (IPSS) and overactive bladder symptom score (OABSS). We analyzed 247 participants with a median age of 60 years. The median IPSS and OABSS were significantly increased over the 5 years. The proportion of frail individuals did not increase significantly over the 5 years. Of the three frailty assessment tools, the 5i-mFI score significantly increased between 2014 and 2019. Multiple linear regression analyses showed that the 5i-mFI score was significantly associated with the severity of LUTS in 2014 to 5i-mFI in 2019 but not with 5i-mFI in 2014 to the severity of LUTS in 2019. The effect of LUTS on frailty might be greater than the effect of frailty on LUTS. Further large-scale studies are needed to elucidate the relationship between LUTS and frailty.

THE SAFETY AND EFFICACY OF SOLIFENACIN AS COMPARED TO MIRABEGRON IN OVERACTIVE BLADDER SYNDROME PATIENTS IN THE ADULT POPULATION OF DERA ISMAIL KHAN

An overactive bladder syndrome is a group of symptoms, i.e., frequency, urgency, nocturia, and sometimes accompanied by urge incontinence. The recent pharmacological options are some drugs, mainly used anti-muscarinic. However, anti-muscarinic drugs have different adverse effects, i.e., constipation and dry mouth. In 2011, a β3 receptor agonist, mirabegron, was studied to treat overactive bladder syndrome. This non-randomized trial was conducted in the Department of Urology, Gomal medical college, D.I. Khan, KPK Pakistan. The study was done from June 2018 to January 2022. We divided 4220 patients into two equal groups. Group a used solifenacin 5 mg for 6 weeks, while group B used mirabegron 50 mg for the same duration. We assessed safety and efficacy after 6 weeks. Most of the adverse effects were mild to moderate severity. Dry mouth occurred in 125 patients out of 2110 (5.92%) in group A and 66 out of 2110 (3.12%) in group B. p-value = 0.0001. Constipation occurred in 53 (2.51%) patients in group A and 46 (2.18%) patients in group B. p-value=0.5417. The improvement in overactive bladder symptoms score (OBSS) occurred in 1443 out of 2110 (68.38%) patients in group A and 1409 out of 2110 (66.77%) patients in group B. p-value=0.2778. Based on the results, it can be concluded that Mirabegron has fewer adverse effects than solifenacin, while both drugs are approximately similar in efficacy.

The Medical Rehabilitation of Overactive Bladder after Transurethral Resection of the Prostate: A Case Report

Introduction: Overactive bladder is a syndrome of increased urinary frequency and nocturia with or without incontinence in absence of obvious pathology. Transcutaneous Tibial Nerve Stimulation (TTNS) is one of the neuromodulation used to treat overactive bladder. We report the medical rehabilitation program in overactive bladder post-Transurethral Resection of The Prostate (TURP). The medical rehabilitation program consisted of pelvic floor muscle exercise and TTNS that may reduce the overactive bladder symptoms. This study aims to determine whether TTNS and pelvic floor muscle exercise will reduce overactive bladder symptoms after TURP. Case Presentation: a 40-year-old Asian man who developed overactive bladder symptoms after TURP had the medical rehabilitation program consisting of pelvic floor muscle exercise and TTNS. The pelvic floor exercise was given twice a day and TTNS was given twice a week for 12 cycles and repeated for 12 cycles. He was followed up by Over Active Bladder Symptoms Score (OABSS) to assess the severity of symptoms. Conclusion: The medical program rehabilitation that consisted of pelvic floor muscle exercise and TTNS reduced 50% in the severity of overactive bladder symptoms after TURP. No complications have been reported. Need further research to know the definitive result.

The efficacy and safety of medication for treating overactive bladder in patients with Parkinson's disease: a meta-analysis and systematic review of randomized double-blind placebo-controlled trials.

The goal of this meta-analysis was to determine the efficacy and safety of medication for treating overactive bladder (OAB) in patients with Parkinson's disease (PD). Papers containing predefined key terms were searched in the PubMed, Embase, Web of Science, and Cochrane Library databases up to December 2021 to collect randomized double-blind placebo-controlled trials (RCTs). The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. Two reviewers independently assessed the risk of bias using the modified Jadad scale and Cochrane risk-of-bias tool. The GRADEpro GDT was employed to evaluate the strength of evidence based on the findings of this meta-analysis. We eventually included four RCTs involving 313 patients (163 patients in the medication group and 150 patients in the placebo group). Of these, the therapeutic agent in two RCTs was mirabegron (121 and 106 patients and controls, respectively, representing 3/4 -2/3 of the patients). The results showed that the number of micturition episodes per 24h (MD -1.33; 95% CI -2.30 to -0.36; p = 0.007), the number of nocturia episodes per 24h (MD -0.33; 95% CI -0.58 to -0.08; p = 0.009) and the number of urinary incontinence episodes per 24h (MD -0.72; 95% CI -1.32 to -0.12; p = 0.02) were significantly lower in the medication group than in the placebo group. The OAB symptom score (MD -2.84; 95% CI -4.67 to -1.00; p = 0.002) and quality of life score (MD 15.15; 95% CI 12.33 to 17.96; p < 0.0001) of the medication group were significantly improved compared with those of the placebo group. However, no significant difference in the daily frequency of urinary urgency episodes was identified between the medication group and the placebo group (MD -0.79; 95% CI -1.71 to 0.14; p = 0.09). There were no significant differences between the two groups in terms of drug-related adverse events (OR 1.69; 95% CI 0.41 to 6.99; p = 0.47), especially in PD patients receiving mirabegron therapy. Medication was effective for OAB symptoms in patients with PD, and patients tolerated adverse events well.

PD33-09 SIGNIFICANCE OF SUBJECTIVE SYMPTOM SEVERITY AND ASSESSMENT OF FRACTURE RISK USING PREDICTIVE TOOLS IN PATIENTS WITH OVERACTIVE BLADDER

You have accessJournal of UrologyCME1 Apr 2023PD33-09 SIGNIFICANCE OF SUBJECTIVE SYMPTOM SEVERITY AND ASSESSMENT OF FRACTURE RISK USING PREDICTIVE TOOLS IN PATIENTS WITH OVERACTIVE BLADDER Tomohiro Matsuo, Ken Kawada, Yasufumi Ueda, Kensuke Mitsunari, Kojiro Ohba, and Ryoichi Imamura Tomohiro MatsuoTomohiro Matsuo More articles by this author , Ken KawadaKen Kawada More articles by this author , Yasufumi UedaYasufumi Ueda More articles by this author , Kensuke MitsunariKensuke Mitsunari More articles by this author , Kojiro OhbaKojiro Ohba More articles by this author , and Ryoichi ImamuraRyoichi Imamura More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003326.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Lower urinary tract symptoms (LUTS) are an independent risk factor for falls and fractures.In clinical practice, frail older LUTS patients sustain falls and fractures caused by their activities of daily living. This often leads to life-threatening events from the progression of weakness. Although LUTS per se may sometimes be a vital prognostic factor, there have been no clinical studies to predict fractures in LUTS patients.The World Health Organization developed the Fracture Risk Assessment Tool (FRAX) as “a tool for calculating the risk of fractures over the next 10 years.” FRAX is a 12-item fracture prediction screening tool that includes age, sex, smoking cessation, history of steroid therapy, comorbidities, and history of fractures that can be calculated. It is also useful for screening for hip and major fractures, not only for those with osteoporosis but also for healthy patients.Our study aimed to estimate the risk of fracture in patients with overactive bladder (OAB) using FRAX, particularly those with LUTS, and to investigate the association between individual OAB symptoms and fracture risk. METHODS: Subjects with de novo OAB and age-matched controls were enrolled, and between-group differences in bone fracture risk using the FRAX were analyzed. Severity assessment was performed using the OAB symptom score (OABSS), with OAB patients scoring ≥2 on item Q3 (urgency) and a total of ≥3. Bone fracture risk was analyzed in cases grouped based on OAB severity (non-OAB, mild-OAB [OABSS≤5) and moderate/severe-OAB [OABSS≥6]). RESULTS: This study included 324 patients: 122 in the OAB (O) group and 202 in the non-OAB (N) group. The O group had significantly higher major fracture risk in the next 10 years (O: 19.5±13.2%; N: 11.7±10.3%; p<0.001), and risk of hip fracture (O: 8.8±8.9%; N: 4.8±8.0%; p<0.001) than the N group. All four question items on OABSS and the total scores were significantly positively correlated with the risk of major fractures. Q2 (nocturia) was the most strongly correlated (r=0.401, p<0.001). The relationship between risk of hip fracture and OABSS was similar (Q2: r=0.372, p<0.001).The moderate/severe-OAB group had the highest risk of major fractures (non-OAB: 11.7±10.3%; mild-OAB: 15.5±10.9%; moderate/severe-OAB 21.5±13.9, p<0.001), and the risk of hip fracture (non-OAB: 4.8±8.0%; mild-OAB: 6.5±7.2%; moderate/severe-OAB: 10.0±9.5, p<0.001) was the highest. CONCLUSIONS: OAB patients had a higher fracture risk than non-OAB patients, and the risk of fracture was also associated with the severity of OAB. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e917 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tomohiro Matsuo More articles by this author Ken Kawada More articles by this author Yasufumi Ueda More articles by this author Kensuke Mitsunari More articles by this author Kojiro Ohba More articles by this author Ryoichi Imamura More articles by this author Expand All Advertisement PDF downloadLoading ...