Overactive Bladder Symptoms Research Articles

Favorable Postoperative Outcomes After Transvaginal Mesh Surgery Using a Wide-Arm ORIHIME® Mesh.

Introduction Transvaginal mesh surgery (TVM) is an effective treatment option for pelvic organ prolapse (POP). Although ORIHIME®, the only available mesh product, is thin, soft, and easy to handle, it has the disadvantages of sliding off or mildly adhering to the surrounding tissues. The current study compared the efficacy of using wide-arm ORIHIME (Kono Seisakusho, Japan, Tokyo), non-wide arm ORIHIME, GynemeshPS (Johnson and Johnson, Japan, Tokyo), and Polyform(Boston Scientific Japan, Japan, Tokyo) meshes for TVM. Methods The study included 116 patients who underwent TVM (Proliftwith GynemeshPS (n = 14); Elevatewith Polyform(n = 43); Upholdwith non-wide-arm ORIHIME(n = 24); Upholdwith wide-arm ORIHIME(n = 35)) at our hospital. Pre- and post-surgical changes in symptoms were measured using questionnaires and 60-minute pad weight testing and compared by mesh type and surgical methods used. Results The residual urine volume, 60-minute pad weight testing, international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), and international consultation on incontinence questionnaire-short form score (ICIQ-SF) significantly improved one year postoperatively in the TVM with the wide-arm ORIHIMEgroup. Comparison of preand one-year postoperative findings by mesh type and surgical methods used showed no significant differences in the 60-minute pad test, IPSS, Quality of Life (QOL), OABSS, and urinary incontinence in daily life scores, and improvement in residual urine volume, ICIQ-SF, and mesh exposure and POP recurrence rates in the TVM with the wide-arm ORIHIMEgroup. Conclusion TVM with wide-arm ORIHIMEhad better postoperative outcomes compared to TVM with other mesh products.

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

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

Should hormone replacement therapy (any route of administration) be considered in all postmenopausal women with lower urinary tract symptoms? Report from the ICI-RS 2023.

This International Consultation on Incontinence-Research Society report aims to summarize the evidence and uncertainties regarding the use of hormone replacement therapy by any route in the management of lower urinary tract symptoms (LUTS) including recurrent urinary tract infections (rUTI), with a review of special considerations for the elderly. Research question proposals to further this field have been highlighted. An overview of the existing evidence, guidelines, and consensus regarding the use of topical or systemic estrogens in the management of LUTS. There are currently evidence and recommendations to offer topical estrogens to postmenopausal women with overactive bladder symptoms as well as postmenopausal women with rUTIs. Systemic estrogens however have been shown in a meta-analysis to have a negative effect on LUTS and, therefore are not currently recommended. Although available evidence and recommendations exist for the use of topical estrogens, few women are commenced on these in primary care. There remain large gaps still within our knowledge of the use of estrogens within the management of LUTS, particularly on when it should be commenced, the length of time treatment should be continued for, and barriers to prescribing.

A Discrete Mathematics Approach for Understanding Risk Factors in Overactive Bladder Treatment.

Introduction Discrete mathematics, a branch of mathematics that includes graph theory, combinatorics, and logic, focuses on discrete mathematical structures. Its application in the medical field, particularly in analyzing patterns in patient data and optimizing treatment methods, is invaluable. This study, focusing on post-void residual (PVR) urine following overactive bladder (OAB) treatment, utilized discrete mathematics techniques to analyze PVR and its associated risk factors. Methods A retrospective study was conducted on 128 OAB patients who received intradetrusor onabotulinum toxin A injections between 2020 and 2022. Network graphs based on graph theory were used to analyze correlations between clinical variables, and clustering analysis was performed with PVR as the primary variable. Results The network graph analysis revealed that frailty, daytime frequency, and nocturia episodes were closely related to PVR. Clustering analysis with PVR as the primary variable divided the patients into three groups, suggesting that the group with particularly high frailty (Cluster 1) is at high risk for PVR. Moreover, significant differences in clinical indicators such as age, voiding efficiency, Overactive Bladder Symptom Score, and International Consultation on Incontinence Questionnaire-Short Form were observed in the remaining two clusters (Cluster 0 and 2). Conclusion This study demonstrates the effectiveness of discrete mathematics methods in identifying risk factors for PVR after OAB treatment and in distinguishing clinical subgroups based on patient characteristics. This approach could contribute to the formulation of individualized treatment strategies and the improvement of patient care quality. Further development and clinical application of this methodology are expected in future research.

Safety and efficacy of an α1 -blocker plus mirabegron compared with an α1 -blocker plus antimuscarinic in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia and overactive bladder: A systematic review and network meta-analysis.

Antimuscarinics and the β3-adrenoreceptor agonist, mirabegron, are commonly used for treating patients with overactive bladder (OAB) and α1 -adrenoreceptor antagonists (α1 -blockers) are the main pharmacological agents used for treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). As these conditions commonly occur together, the aim of this systematic review was to identify publications that compared the use of an α1 -blocker plus mirabegron with an α1 -blocker plus antimuscarinic in men with LUTS secondary to BPH and OAB. A meta-analysis was subsequently conducted to explore the safety and efficacy of these combinations. Included records had to be from a parallel-group, randomized clinical trial that was ≥8 weeks in duration. Participants were male with LUTS secondary to BPH and OAB. The indirect analyses that were identified compared an α1 -blocker plus OAB agent with an α1 -blocker plus placebo. The PubMed/Medical Literature Analysis and Retrieval System Online, the Excerpta Medica Database, the Cochrane Central Register of Controlled Trials, and the ClinicalTrials.gov registry were searched for relevant records up until March 5, 2020. Safety outcomes included incidences of overall treatment-emergent adverse events (TEAEs) and urinary retention, postvoid residual volume, and maximum urinary flow (Qmax ). Primary efficacy outcomes were micturitions/day, incontinence episodes/day, and urgency episodes/day, and secondary outcomes were Overactive Bladder Symptom Scoreand International Prostate Symptom Score. A Bayesian network meta-analysis approach was used for the meta-analysis. Out of a total of 1039 records identified, 24 were eligible for inclusion in the meta-analysis. There were no statistically significant differences between the α1 -blocker plus mirabegron and α1 -blocker plus antimuscarinic groups in terms of the comparisons identified for all the safety and efficacy analyses conducted. Numerically superior results were frequently observed for the α1 -blocker plus mirabegron group compared with the α1 -blocker plus antimuscarinic group for the safety parameters, including TEAEs, urinary retention, and Qmax . For some of the efficacy parameters, most notably micturitions/day, numerically superior results were noted for the α1 -blocker plus antimuscarinic group. Inconsistency in reporting and study variability were noted in the included records, which hindered data interpretation. This systematic review and meta-analysis showed that an α1 -blocker plus mirabegron and an α1 -blocker plus antimuscarinic have similar safety and efficacy profiles in male patients with LUTS secondary to BPH and OAB. Patients may, therefore, benefit from the use of either combination within the clinical setting.

The effect of long-term COVID-19 on aetiological factors related to nocturia.

This study was conducted to examine the possible aetiology of nocturia in patients with long-term COVID-19. Physical and neuropsychiatric symptoms, an increase in overactive bladder symptoms, especially from urinary system complaints, has been reported in patients with COVID-19, 10-14 weeks after the illness. A descriptive design. The study consisted of 70 patients who had experienced COVID-19, had nocturia, and were followed in the State Hospital between April and July 2022. Data were collected using a patient information form, the 'TANGO' nocturia screening tool, and the Visual Analog Scale. This study was created in accordance with the STROBE Statement Checklist. When the nocturia effects of long-term COVID-19 were examined it was determined that the urinary tract was the 'priority' aetiological condition. It was observed that there was a significant difference between the aetiological factor groups in terms of the mean age of the patients and the number of nocturia (p < .05). According to post-hoc analysis, the mean age of patients with a dominant cardio-metabolic factor was found to be significantly younger (p < .05). In addition, when comparing the number of nocturia according to the aetiological factors of the patients, it was observed that the number of nocturia was significantly frequent in the patients with a dominant sleep factor (p < .05). It was found that the urinary tract aetiological factor was dominant in patients with long-term COVID-19 and nocturia, patients with a dominant cardiovascular aetiological factor were younger, and that the number of nocturia was higher in patients with a dominant sleep factor. Identification of the early signs and symptoms and underlying causes of nocturia in individuals with post-COVID-19 syndrome will enable nurses and health professionals to guide the early identification of different underlying problems, as well as the implementation of approaches to treat and eliminate nocturia. The patients contributed to the study by agreeing to participate in the evaluation of nocturia complaints after COVID-19 infection.

Music therapy as a potential treatment for overactive bladder – a contemporary review

Overactive bladder (OAB) is a highly prevalent syndrome of urinary urgency, frequency, and nocturia disproportionately impacting individuals with anxiety and depression. Treatment for OAB involves behavioral therapy, lifestyle modifications, pharmacotherapy, and invasive procedures. Music Therapy (MT) is an evidence-based intervention with data supporting its efficacy in improving anxiety, depression, and pain scores. MT is not part of OAB treatment protocol but may serve as a non-invasive method of improving symptoms and patient satisfaction. This narrative review aimed to analyze the current data supporting MT in urology and the psychiatric conditions comorbid with OAB to determine if MT may be explored for OAB symptom relief. A nonsystematic review of literature published in 2010 and after was performed via PubMed. We found OAB is associated with depression and anxiety, with symptoms of OAB positively correlating with severity of anxiety and depression. MT is efficacious as an adjunct therapy for anxiety and depression and patient comfort during urologic procedures. We conclude MT is a potential avenue for research in adjunctive therapies for OAB considering its efficacy in alleviating symptoms of anxiety, depression, and pain, as well as improving patient satisfaction. Further research is needed to investigate the utility of MT specifically on OAB.

Regular and Irregular Use and Reasons for Discontinuation of Solifenacin Therapy in Patients with Overactive Bladder Managed by Urologists.

Solifenacin, a selective muscarinic receptor antagonist, is one of the best-tolerated and most effective medicines that relieve storage symptoms in patients with an overactive bladder (OAB). However, the persistence of solifenacin in daily clinical practice remains far below that reported in clinical trials. This study aimed to analyze the adherence of patients to the therapy and the reasons for solifenacin discontinuation and non-regular use in OAB patients managed by urologists. Data concerning non-compliance and the discontinuation of solifenacin, along with the reasons, were collected during two consecutive visits for 64,049 OAB outpatients. Over the two visits, 81.6% of the patients continued therapy, and 88.6% were taking solifenacin regularly. An age ≥ 75 yrs., the male sex, a rural or small-city dwelling, and a prescription of ≥10 mg predicted therapy continuation. The female sex, a higher education, a short or long duration of an OAB, and a non-idiopathic OAB predicted regular use. The persistence of nycturia and urinary incontinence during therapy predicted both discontinuation and non-regular use. Dissatisfaction with therapy was the most frequent reason for discontinuation. In conclusion, an initial prescription of solifenacin at a low dose reduces the chance of OAB symptom improvement and results in more frequent discontinuation. A high rate of discontinuation related to dissatisfaction suggests unrealistic expectations for OAB patients and insufficient education by urologists.

Association between oral frailty and lower urinary tract symptoms among middle-aged and older adults in community-dwelling individuals: a cross-sectional study.

We assessed the association between oral frailty risk and LUTS among middle-aged and older adults in a community-dwelling population. This cross-sectional study was conducted among 586 subjects aged ≥ 40years who participated in the Iwaki Health Promotion Project in Hirosaki, Japan. We used the International Prostate Symptom Score (IPSS) and the Overactive Bladder Symptom Score (OABSS) to assess LUTS. LUTS was defined as an IPSS score of 8 or higher or meeting diagnostic criteria for OAB. Oral frailty risk was defined as experiencing two or more of the following: decreased chewing ability, decreased biting force, and dry mouth sensation. Physical performance (10-m gait speed and grip strength) was used for analysis. The association between oral frailty risk and LUTS was examined using multivariate logistic regression analyses. The study included 218 men and 370 women, of whom 140 had LUTS. The mean age of this cohort was 59years. Significant differences were observed between the LUTS and non-LUTS groups, including age, hypertension, history of CVD, depressive status, sleep disturbance, and 10m gait speed. The prevalence of oral frailty risk was significantly higher in the LUTS group than in the non-LUTS group (26% vs. 11%, P < 0.001). Multivariate analysis revealed that age, male gender, and oral frailty risk (odds ratio: 2.67, 95% confidence interval: 1.57-4.51, P < 0.001) were independent factors for LUTS. Moreover, oral frailty risk was an independent factor in both participants aged < 65years and participants aged ≥ 65years. Oral frailty was independently associated with LUTS.

Associations between Urinary Concentrations of Polycyclic Aromatic Hydrocarbons and Overactive Bladder in US Adults: Data from the National Health and Nutrition Examination Survey 2005–2016

Introduction: Polycyclic aromatic hydrocarbons (PAHs) are a group of chemicals that can induce oxidative stress and related cytotoxicity. Whether urinary concentrations of PAHs have effects on overactive bladder (OAB) in the general population is still unclear. This study investigated the associations between urinary PAHs and OAB. Methods: 7,146 adults aged over 20 who participated in the US National Health and Nutrition Examination Survey 2005–2016 were studied. The impact of the six PAHs on OAB was evaluated by multivariate logistic regression, and percent changes related to different quartiles of those six PAH levels were calculated. Confounders including age, logarithmic urinary creatinine, gender, race, body mass index, educational level, marriage, poverty income ratio, diabetes, hypertension, and metabolic syndrome were controlled. Results: There is a significant positive correlation between urinary concentrations of the six PAHs we include in the study and the occurrence of OAB. Furthermore, individuals with higher PAH levels also reported a more severe OAB symptom score (OABSS). Conclusions: Our findings revealed that adult men in the USA with higher urinary PAHs had a higher risk of OAB incidence. These findings suggest the importance of strong environmental regulation of PAHs to protect population health. However, the underlying mechanisms still need further exploration.

Clinical tools for evaluating the severity of overactive bladder: A systematic review of psychometric properties

Objectives To systematically evaluate the evidence describing the psychometric properties of clinical measures for assessing overactive bladder symptoms (urinary urgency with or without urge urinary incontinence, urinary frequency and nocturia). To evaluate the quality of this evidence-base using the COnsensus-based Standards for selecting health status Measurement INstruments (COSMIN) checklist and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tools. Data sources Five electronic databases (CINAHL, EMBASE, MEDLINE, Scopus and Web of Science) were searched from dataset inception to August 2023. Review methods Study screening, data extraction and quality appraisal were performed by two independent authors. Inclusion criteria were studies testing one or more psychometric properties of clinical tools for the assessment of overactive bladder symptoms among adults aged 18 years and older for both sexes. The methodological quality and quality of the evidence were evaluated using the COSMIN checklist and GRADE tools, respectively. Results The search identified 40 studies totalling 10,634 participants evaluating the psychometric properties of 15 clinical tools. The COSMIN methodological quality was rated good for most measures, and the GRADE quality of evidence ranged from low (13%) to high (33%). The Overactive Bladder Symptom Score, Overactive Bladder Questionnaire and Neurogenic Bladder Symptom Score were of good methodological and high-GRADE evidence qualities. Conclusion Overactive Bladder Symptom Score, the Overactive Bladder Questionnaire and the Neurogenic Bladder Symptoms Score are promising psychometrically sound measures. The Overactive Bladder Symptom Score has been applied to the most culturally diverse populations supported by studies of good methodological and high-GRADE evidence quality.

Overactive bladder ‘symptoms’ or ‘complaints’ in young and elderly patients or healthy volunteers?

Objective:The overactive bladder symptom complex is multifactorial and heterogeneously influenced by genetic and environmental factors. The role of ageing is not exactly known. Our objective is to evaluate age-related differences in bladder sensations in healthy volunteers and overactive bladder patients. Methods:68 patients with an overactive bladder, diagnosed by their urologist using the International Continence Society criteria, and 66 healthy volunteers were included: 41 patients and 20 volunteers were ≥60 years old. Subjects filled out sensation-related bladder diaries, for 2 periods of 3 days. Results:To obtain the following results, 6160 voids were assessed. Both young and older healthy volunteers experienced storage symptoms. However, older volunteers experienced more symptoms than younger ones. The healthy aged experienced more nocturia and voided 34% more often over 6 days, compared to the young people. They experienced more urge at a lower mean voided volume too. Younger OAB patients perceived their bladder to be ∼25% fuller at 100 ml compared to younger volunteers, older patients experienced a similar mean bladder fullness sensation to their healthy peers. Fourteen healthy older volunteers experienced voids with urge 3 (need to void now), however at a higher mean voided volume compared to the older OAB patients. They both experienced the same amount of nocturia. Conclusions:Storage symptoms are widespread throughout the population in a continuum of frequency and severity of symptoms. Ageing healthy volunteers shift on this continuum, from never having any urinary complaints towards experiencing (a severity of) symptoms that fit within the ICS definition of OAB. Hence, there is an important distinction between storage symptoms and storage complaints.

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

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

Comparative effectiveness of pelvic floor muscle training, mirabegron, and trospium among older women with urgency urinary incontinence and high fall risk: a feasibility randomized clinical study

BackgroundUntreated, urgency urinary incontinence (UUI) and overactive bladder (OAB) can precipitate a vicious cycle of decreasing physical activity, social isolation, fear of falling, and falls. Structured behavioral interventions and medications are common initial treatment options, but they elicit their effects through very different mechanisms of action that may influence fall-related outcomes differently. This study will determine the feasibility of conducting a comparative effectiveness, three-arm, mixed methods, randomized clinical trial of a behaviorally based pelvic floor muscle training (PFMT) intervention versus two recent drug options in older women with UUI or OAB who are also at increased risk of falling.MethodsForty-eight women 60 years and older with UUI or OAB who screen positive for increased fall risk will be recruited through the urogynacology and pelvic health clinics of our university health system. Participants will be randomly assigned to one of three 12-week treatment arms: (1) a course of behavioral and pelvic floor muscle training (PFMT) provided by physical therapists; (2) the beta-3 agonist, mirabegron; and (3) the antimuscarinic, trospium chloride. Study feasibility will be established through objective metrics of evaluability, adherence to the interventions, and attrition. We will also assess relevant measures of OAB symptom severity, quality of life, physical activity, incident falls, and concern about falling.DiscussionThe proposed research seeks to ultimately determine if linkages between reduction in UI symptoms through treatment also reduce the risk of falling in this patient population.Trial registrationNCT05880862. Registered on 30 May 2023.

The prevalence of probable overactive bladder and associated risk factors among medical students in Jordan: a cross-sectional study

BackgroundTo discuss the impact of overactive bladder (OAB) on medical students. overactive bladder. is a chronic condition that causes sudden and intense urges to urinate, which can have significant physical and psychological effects on patients’ lives. The prevalence of OAB among medical students is relatively high, with some studies reporting rates as high as 35.4%. This research aims to shed light on the prevalence rates and risk factors associated with OAB among medical students in Jordan.MethodsA cross-sectional study was conducted using an online self-reported questionnaire as the study tool. The questionnaire collected the sociodemographic, health, and academic characteristics of medical students, as well as the new 7-item OABSS score.ResultsOut of the total sample of medical students surveyed (n = 525), 44.5% reported experiencing symptoms of OAB. Furthermore, the analysis also revealed that there was a significant difference in the prevalence of OAB between the ages of medical students. In addition, the study also found that there was a significant association between OAB symptoms and basic years, positive history of diagnostic UTI, positive history of recent trauma, high stress, and taking certain medications.ConclusionsThe study highlights the need for further research in this area and emphasizes the possible implications of OAB for medical students, including the need for additional support and resources to manage the condition.

Causal effects of gut microbiota on risk of overactive bladder symptoms: a two-sample Mendelian randomization study.

Clinical observations indicate a correlation between the gut microbiota and overactive bladder (OAB) symptoms. Nevertheless, the causal relationship and mechanisms between gut microbiota and OAB symptoms remain elusive. Two-sample Mendelian randomization (MR) analyses were performed to assess the association between gut microbiota and OAB symptoms, including urinary incontinence (UI). Data were obtained from the MiBioGen International Consortium genome-wide association studies (GWAS) dataset and the IEU GWAS database. The inverse variance weighted method was used as the primary approach in the MR analysis, with the weighted median, MR-Egger, and weighted mode methods as supplementary approaches. Sensitivity analyses were employed to assess potential violations of the MR assumptions. Our analysis identified seven gut bacterial taxa with a causal relationship to OAB and nine gut bacterial taxa associated with UI. Genera Eubacteriumfissicatenumgroup, LachnospiraceaeNK4A136group, and Romboutsia were identified as protective factors against OAB, while genera Barnesiella, FamilyXIIIAD3011group, Odoribacter, and RuminococcaceaeUCG005 were associated with an increased risk of OAB. A higher abundance of the genus Coprococcus3, order Burkholderiales, and phylum Verrucomicrobia predicted a lower risk of UI. Conversely, the class Mollicutes, genus Ruminococcus gauvreauii group, order Mollicutes RF9, and phylum Firmicutes and Tenericutes were positively correlated with UI risk. The sensitivity analysis excluded the influence of potential heterogeneity and horizontal pleiotropy. This study revealed a causal relationship between gut microbiota and OAB symptoms, providing new insights and a theoretical foundation to identify biomarkers and therapeutic targets for patients with OAB symptoms.

A pilot study on the potential of photobiomodulation to safely modify symptoms of an overactive bladder.

Photobiomodulation (PBM) may stabilize autonomic neural drive from the pontine micturition Center to the urinary bladder in individuals with overactive bladder (OAB) symptoms. A safety profile study preceded a single-case experimental design with repeated measures across subjects to establish the safety and effect direction of PBM to modify symptoms in patients with OAB. No adverse events occurred with PBM, specifically blood pressure remained unchanged. Urinary frequency improved significantly during the intervention and at follow-up. PBM therapy was associated with a meaningful impact on OAB-related quality of life and a small to medium-to-high effect size on OAB symptom severity. Nasal application of PBM is safe and may impact OAB symptoms. A controlled trial of PBM in patients with lower urinary tract symptoms is warranted.

Relationship Between Overactive Bladder and Bone Fracture Risk in Female Patients.

Overactive bladder (OAB) has recently been recognized as an independent risk factor for falls and fractures. This study aimed to predict fracture risk in female patients with OAB symptoms. We assessed and compared the fracture risk in newly diagnosed female patients with OAB to those without OAB using the Fracture Risk Assessment Tool (FRAX), and investigated the relationship between fracture risk and OAB severity. The present single-center, cross-sectional study included 177 female participants (79 with OAB, 98 without OAB). The OAB group was older (p=0.033) and shorter (p=0.010) compared to the non-OAB group. Compared to the non-OAB group, the OAB group had more patients with hypertension (p<0.001) and diabetes mellitus (p=0.011), as well as higher risks for major fractures (non-OAB group: 15.2±13.2%; OAB group: 23.6±14.1%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%; OAB group: 10.6±10.0%; p=0.007). In addition, those with moderate/severe OAB had the most significantly elevated risks for both major fractures (non-OAB group: 15.2±13.2%, mild-OAB: 17.6±12.5%, moderate/sever-OAB: 26.4±14.0%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%, mild-OAB: 6.5±7.6%, moderate/sever-OAB: 12.5±10.4%; p<0.001). Among the OAB symptoms, nocturia had the strongest correlation with fracture risk (major fracture, ρ=0.534; hip fracture, ρ=0.449; all p<0.001). Patients with severe OAB, and particularly severe nocturia, should be closely monitored with timely and aggressive symptom management; however, an interventional study incorporating the management of OAB symptoms is required to confirm whether the proactive management of OAB symptoms reduces the risk of fractures in older females.

Effect of Transcutaneous Tibial Nerve Stimulation on the Overactive Bladder in Women with Type 2 Diabetes

Background and Aims Diabetes mellitus is one of the most prevalent metabolic conditions in the world. One of its consequences is overactive bladder (OAB), which is a syndrome whose symptoms appear during the urine storage phase in the form of increased urinary frequency or urinary urgency. The prevalence of this disorder is estimated to be 22.5-24.2 % in people with type 2 diabetes (T2D). Recently, a useful technique for the treatment of OAB, named transcutaneous tibial nerve stimulation (TTNS), has been introduced. This study aims to investigate the effect of TTNS in women with T2D and OAB. Methods This randomized, double-blind clinical trial was conducted on 40 women with T2D and OAB symptoms, who were divided into two control and intervention groups. The control group performed pelvic floor muscle (PFM) training daily for one month, while the intervention group received 12 sessions of TTNS combined with PFM training. Before and after the intervention, the lower urinary tract symptoms were recorded using the Persian version of the International Consultation on Incontinence Modular Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). Independent t-test, paired t-test, Wilcoxon test, Mann-Whitney U test, and chi-square test were performed for data analysis using SPSS software, version 24. Results There was no significant difference between the two groups in the ICIQ-FLUTS score, incontinence quality of life, or PFM strength, and endurance (P&gt;0.05). However, their scores were significantly different after treatment in each group compared to the pre-treatment phase (P≤0.05). Conclusion The combination of TTNS and PFM training has no advantage over PFM training alone in managing OAB symptoms and improving PFM strength and quality of life in women with T2D.

Steps toward identification of a novel cue-positive overactive bladder phenotype in women with high-bother urinary urgency.

The objective of this study was to investigate the relationship between situational cues (running water, stress, cold, etc.) and overactive bladder (OAB) symptoms. Women scheduled for urodynamic studies for clinical indications completed surveys to characterize OAB (ICIQ-OAB and OAB-V3) and responses to situational cues (validated long-form cues survey and a novel short-form cues survey). Participants were divided into two groups (Low-Bother urgency vs. High-Bother urgency), and OAB and cue survey responses were compared. A total of 47 participants were enrolled in the study with 36 meeting inclusion criteria (15 Low-Bother and 21 High-Bother) with an overall mean age of 60.0 ± 10.0 years. The High-Bother urgency group scored significantly higher on multiple cue items in the long-form (P<0.05) and only "running water" in the short-form cues survey (P<0.05). In addition, "running water" was the only cue that was scored higher in both surveys (P<0.05). This study showed that patients with High-Bother urgency may have increased symptom responses to environmental, mood, and cognitive cues. These findings suggest increased sensitivity to cues, especially "running water" in participants with bothersome OAB and the potential presence of a cue-specific OAB phenotype.