Solifenacin Group Research Articles

Safety and Efficacy of Trospium Chloride and Solifenacin in Stroke-Induced Neurogenic Lower Urinary Tract Dysfunction: A Randomized Controlled Trial.

Neurogenic dysfunction of the lower urinary tract is one of the challenging diseases with high burdens in urology. Our study aims to evaluate the efficacy of a 4-week treatment with Solifenacin and Trospium chloride and assess their safety and impact on quality of life. Following the selection of 206 stroke patients from two centers who met specific eligibility criteria, including a clinical diagnosis of stroke, normal cognitive function, and the presence of lower urinary tract symptoms (LUTS), participants were randomly assigned to receive oral Solifenacin, Trospium chloride, or a placebo. Under the supervision of the Ethics Committee, the baseline characteristics, compliance with medication, and outcomes were monitored, gathered, and analyzed. The majority of participants were male, with a mean age of 67.3, and most had ischemic stroke. The groups had no significant difference in urinary symptoms after stroke. All of the symptoms in the study groups, according to the NBSS questionnaire, were decreased following treatment compared to the baseline (p < 0.05). After treatment, ICIQ-OAB, and ICIQ-LUTS-QOL total scores and bothersome scores decreased significantly compared to baseline (p < 0.001). When compared to the placebo, both Trospium chloride and Solifenacin alleviated symptoms according to the NBSS questionnaire and ICIQ-LUTS-QOL, total ICIQ-OAB, and the total score of ICIQ-OAB-Bothersome. However, the total LUTS-QOL-Bothersome score did not change in the active treatment groups compared to the placebo. While comparing the two drugs, these values were similar except for the total score of LUTS-QOL-Bothersome, ICIQ-OAB, and ICIQ-OAB-Bothersome in favor of the Solifenacin group. Moreover, Solifenacin had fewer side effects compared to Trospium chloride or placebo. The study analyzed 206 stroke patients in two international centers and found both drug arms effective in treating overactive bladder. However, inconsistencies were found in efficacy and safety, necessitating further studies with larger populations. This triple-blind, multicenter, randomized controlled trial was done on 206 stroke patients after getting Ethical Committee approval and registering the project on IRCT (IRCT20160606028304N2).

Relief of double-J stent-related symptoms: a comparison between mirabegron, tamsulosin and solifenacin

BackgroundInserting ureteral stents is a routine intervention that often results in problems. The cornerstone for treating stent-related symptoms is pharmacological therapy. This study was conducted to evaluate and to compare the effectiveness of mirabegron, tamsulosin, solifenacin and control in reducing double-J stent-related symptoms.ResultsPatients were evaluated preoperatively, one week after stent insertion and two weeks after the start of medications by the Ureteral Stent Symptom Questionnaire (USSQ), International Prostate Symptom Score (IPSS), overactive bladder questionnaire (OAB-q) and visual analogue pain scale (VAPS). Solifenacin and mirabegron groups had significantly lower sexual scores after the 1st and 2nd weeks post-operatively (PO) when compared with the control group. Mirabegron group had significantly lower sexual scores after 1st and 2nd weeks PO when compared with patients in tamsulosin and solifenacin groups. Patients in mirabegron group had significantly fewer additional problems after the 1st and 2nd weeks PO when compared with patients in the control and tamsulosin groups.ConclusionsTo sum up, mirabegron was found to be superior to solifenacin in lowering urinary symptoms scores, sexual performance scores and work performance scores at both first and second weeks post-operatively. Mirabegron is a good alternative choice for SRSs when tamsulosin or solifenacin is ineffective or not tolerated.

Therapeutic effectiveness and adverse drug reactions of mirabegron versus solifenacin in the treatment of overactive bladder syndrome.

Overactive bladder (OAB) syndrome is a chronic disease characterized by urinary urgency with or without urge incontinence, frequency, and nocturia and antimuscarinic drugs such as solifenacin have been the mainstay of treatment. Mirabegron a beta 3 adrenoreceptor agonist has recently gained importance in the management of OAB. The rationale of the study is that mirabegron improves the storage function without affecting voiding which increases the therapeutic effectiveness. The objective was to determine the therapeutic effectiveness of mirabegron versus solifenacin. A prospective observational study was conducted on 298 patients with OAB syndrome attending the urology outpatient department of government medical college after obtaining institutional review board clearance. Patients of both genders, belonging to the 18-65 years of age group, attending the urology outpatient department were selected for the study. Patients were evaluated using the OAB-validated 8-question awareness tool (OAB-V8 score) before and after receiving drugs by direct questionnaire method after receiving informed consent. Patients were prescribed either solifenacin 5 mg or mirabegron 25 mg once daily by the urologist. Follow-up was done after 4 and 12 weeks. Adverse drug reactions of the drugs were assessed using the Central Drug Standard Control Organization suspected adverse reaction (ADR) form, and ADRs were notified to the nearest ADR monitoring center. The mirabegron group showed maximum improvement in the mean OAB-V8 score values from baseline at 4 weeks (12.82 ± 5.86, P < 0.001) and 12 weeks (5.74 ± 3.31, P < 0.001) when compared to solifenacin. OAB-V8 scores of the solifenacin group also showed significant improvement from the baseline at 4 weeks (15.30 ± 5.54, P < 0.001) and 12 weeks (8.05 ± 4.59, P < 0.001). Heart rate, systolic, and diastolic blood pressures did not show significant changes during the follow-up in both the study groups. Thirteen patients developed ADRs such as dry mouth (four patients) and constipation (nine patients) in the solifenacin group. No ADRs were noted in the mirabegron group. Mirabegron showed maximum improvement in the OAB-V8 scores in patients with OAB syndrome, although the solifenacin group also showed improvement. Adverse effects were less in the mirabegron group when compared to the solifenacin group.

Treating overactive bladder symptoms after transurethral prostatic surgery for benign prostatic hyperplasia - Which medication to choose?

Overactive bladder (OAB) symptoms are often encountered in patients after transurethral resection of the prostate (TUR-P) or transurethral incision of the prostate (TUI-P) for benign prostatic obstruction (BPO). Either antimuscarinics or β-3 agonist has been found effective in relieving OAB symptoms. However, urologists usually do not prescribe such medication immediately after TUR-P or TUI-P to avoid an increase in postvoid residual and risk of urinary tract infection. If OAB medication can be used and adverse events (AEs) can be reduced to minimum, patients' quality of life after bladder outlet obstruction surgery could be improved. This study compared the safety and efficacy between solifenacin and mirabegron in men undergoing TUR-P or TUI-P. This prospective, randomized trial compared the safety and efficacy of OAB medication on the reduction in Urgency Severity Score (USS), OAB Symptoms Score (OABSS), International Prostate Symptom Score, and urgency urinary incontinence episodes in men with BPO undergoing surgical intervention. All patients could void smoothly after catheter removal and were randomly received daily solifenacin 5 mg, mirabegron 50 mg, or no interventions for 4 weeks. At 2 and 4 weeks postoperatively, participants' OAB symptoms and AEs were evaluated. A total of 57 men were enrolled in this study with a mean age of 70.8 ± 6.1 years. At 2 weeks postoperatively, USS (1.56 ± 1.72 vs. 2.39 ± 1.72 vs. 2.26 ± 1.73, P < 0.011) and OABSS (5.33 ± 3.65 vs. 7.67 ± 4.19 vs. 8.58 ± 4.31, P < 0.000) were significantly reduced in patients taking solifenacin, mirabegron, or control, respectively. Two patients in the solifenacin group developed urinary retention. However, the changes of variables at 4 weeks postoperatively were insignificant among the three groups. Solifenacin and mirabegron are two different drug classes both equally effective in treating immediate OAB symptoms after TUR-P or TUI-P. However, OAB symptoms could be relieved at 4 weeks without any medication. Considering AEs, β-3 agonist has a more favorable safety profile than antimuscarinics.

Efficacy and safety of combination of mirabegron and solifenacin in patients with double-J stent related overactive bladder: a prospective study

To observe the efficacy and safety of solifenacin and/or mirabegron as a medical expulsive therapy (MET) in patients with double-J stent-related overactive bladder (OAB) symptoms. A total of 219 patients with double-J stent-related OAB symptoms were prospectively randomized into two groups. One-hundred and nine cases in the combination group accepted mirabegron and solifenacin therapy and 110 cases as control only accepted solifenacin therapy. The lower urinary tract symptoms and overactive bladder questionnaire (OAB-q) health-related quality of life (HRQol) and symptom bother score between two groups were compared at the 1st, 2nd and 4th week ends. All of 219 patients were randomly assigned to two groups, of which 109 patients were included in the combination group and 110 in the solifenacin group. The incidences of LUTS, including urgency, frequent urination, and incontinence episodes, in the 2nd week (44.9% vs. 64.5%, P = 0.028; 48.6% vs. 62.7%, P = 0.036; and 40.4% vs. 56.4%, P = 0.018) and the 4th week (14.7% vs. 30.9%, P = 0.004; 16.5% vs. 33.6%, P = 0.003; and 11.9% vs. 26.4%, P = 0.007) after combination treatment were significantly lower than those in the solifenacin group. The incidence of drug-related adverse events in the solifenacin group was higher than that in the combination group, but there was no statistically significant difference (P > 0.05). In terms of secondary variables, the OAB-q HRQol score in the combination group was statistically superior in comparison with that in the solifenacin group between the second and fourth week (77.9 vs. 76.4, P = 0.020; and 87.9 vs. 85.6, P = 0.001). The OAB-q symptom bother score was higher in the solifenacin group than in the combination group (37.6 vs. 36.4, P = 0.016; and 26.2 vs. 24.8, P = 0.003). Combination therapy of solifenacin and mirabegron demonstrated significant improvements over solifenacin monotherapy in reducing OAB symptoms associated with double-J stents, and providing a higher quality of life without increasing bothersome adverse effects.

Comparison of tolterodine, trospium chloride, solifenacin treatments and its side effects on patients with pure urinary and mixed incontinence

Objective: Urinary incontinence is defined as urinary incontinence that is a social or hygienic problem and can be objectively demonstrated. It is aimed to compare tolterodine, trospium chloride and solifenacin treatments, and its side effects on patients who have complaints of pure urinary and mixed incontinence.&#x0D; Material and Method: Totally 98 patients, who applied to Ankara Etlik Zubeyde Hanım Gynecology Training and Research Hospital, Urogynecology Outpatient Clinic between November 2009 and October 2010 with compliants of urinary incontinence and met the criteria to participate in the research, have been included in this study.&#x0D; Results: A significant improvement in each three of the drug group at third and six months was determined. Solifenacin is generally more effective than the other two treatments. When total values of UDI-6 (Urinary Distress Inventory) survey is analysed, it is seen that each of three antimuscarinic drug group ensured improvement on symptoms at the end of the third month as not to be different from the improvement at the six month. Each three antimuscarinic drug group has a significant therapeutic effect on the IIQ-7 (Incontinence Impact Questionnaire) survey which questions the life quality. Whereas complaints of constipation was seen more at patients that use tolterodine and trospium chloride, there was not a significant difference despite a slight increase in the solifenacin group (p&gt;0.05). It is determined that solifenacin caused desert mouth less than the other two drug groups &#x0D; Conclusion: Tolterodine, trospium chloride and solifenacin as anticholinergic drugs meaningfully reduced the activity of bladder and increased the quality of life. Drug therapy provided an effective and efficient improvement on incontinence.

Combination therapy of solifenacin and mirabegron vs monotherapy in overactive bladder

Introduction and Objectives: Overactive bladder (OAB) with symptoms of frequency, urgency with or without urgency incontinence and nocturia is one of the most bothersome symptom affecting the quality of life of both men and women. Antimuscarinics and Beta 3 agonists both play an important role in reducing the bothersome symptoms. In this study we find the efficacy of low dose combination therapy of solifenacin 5 mg with mirabegron 25 mg vs the monotherapy solifenacin 10 mg or Mirabegron 50 mg.Materials and Methods: It is a prospective study conducted on 150 patients at Madras medical college and were divided into 3 groups. Group A received solifenacin 10 mg/day, Group B received solifenacin 5 mg/day + Mirabegron 25 mg/day and Group C received Mirabegron 50 mg/day. Patients were evaluated for improvement in frequency, urgency, leak episodes, voided volume and improvement in quality of life after a period of 4 weeks and 12 weeks. The three groups were compared using anova test and chi square test and p value was calculated.Results and Observations: Majority of patients of OAB belong to age group > 50 years and majority were females showing female predilection towards OAB. The mean duration of symptoms was 36.01± 7.91 months. Compared with monotherapy, the combination therapy resulted in a significant improvement in reducing the mean number of micturition/24hr from baseline to End of Treatment (EoT). The frequency of urgency episodes and mean number of nocturia episodes/24hr was significantly reduced in patients taking combination therapy as compared to monotherapy. In all the groups a decrease in mean number of incontinence episodes/24hr was observed from baseline to EoT but was not statistically significant. The frequency of antimuscarinic side effects (dry mouth, constipation, urinary retention) had lower incidence in combination therapy compared with solifenacin group. Conclusions: Combination therapy of solifenacin and mirabegron demonstrated significant improvement over monotherapy (solifenacin 10 mg & mirabegron 50 mg) in frequency of micturition, urgency and nocturia episodes without increasing bothersome adverse effects associated with antimuscarinic therapy.

Mirabegron vs. solifenacin in control of endoscopically inserted ureteral stent-related symptoms.

We aimed to assess the efficacy and safety of Mirabegron vs. solifenacin to treat LUTS resulting from DJ-stent insertion. A total of 97 patients who had DJ-stent inserted for urinary stone disease were randomly divided into three groups according to received treatment. Group A took Mirabegron 50mg daily, group B took solifenacin 5mg daily from the 4th day after stent placement until the stent was removed, and group C only was hydrated well. All patients were evaluated by USSQ and IPSS at 4th day post-insertion of ureteral stent, follow-up day before removing of stent and post-removal of stent. The USSQ urinary symptom scores at day 4 comparing to day of removal of stent showed significant difference in between study groups (32 ± 6-13 ± 6 vs. 31 ± 6-14 ± 4 in Mirabegron and solifenacin, respectively) and without significant difference in control group. The USSQ body pain score significantly decreased in both Mirabegron and solifenacin groups at day of stent removal comparing to day 4 post-insertion of DJ with insignificant decreasing in the control group. Quality of life scores showed significant improving in Mirabegron and solifenacin group, and there was no difference in control group at 4 and 14days after treatment. No severe complications were observed in either group. In our series, we indicate that Mirabegron and solifenacin can be used to improve symptoms caused by the insertion of DJ-stent without significant difference.

PD38-08 EFFICACY OF LOW-INTENSITY SHOCK WAVE THERAPY ON PERSISTENT STORAGE SYMPTOMS AFTER TRANSURETHRAL SURGERY FOR BENIGN PROSTATIC OBSTRUCTION: PRELIMINARY RESULTS OF A RANDOMIZED CONTROLLED TRIAL

You have accessJournal of UrologyCME1 May 2022PD38-08 EFFICACY OF LOW-INTENSITY SHOCK WAVE THERAPY ON PERSISTENT STORAGE SYMPTOMS AFTER TRANSURETHRAL SURGERY FOR BENIGN PROSTATIC OBSTRUCTION: PRELIMINARY RESULTS OF A RANDOMIZED CONTROLLED TRIAL Mohammed Hegazy, Khaled Zaky Sheir, Mohamed Ahmed Gaballah, and Ahmed Mohamed Elshal Mohammed HegazyMohammed Hegazy More articles by this author , Khaled Zaky SheirKhaled Zaky Sheir More articles by this author , Mohamed Ahmed GaballahMohamed Ahmed Gaballah More articles by this author , and Ahmed Mohamed ElshalAhmed Mohamed Elshal More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002596.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We aimed to evaluate the efficacy of low-intensity shock wave therapy (Li-SWT) on persistent storage symptoms after transurethral surgery (TUS) for benign prostatic obstruction (BPO) in a randomized controlled study. METHODS: Patients with persistent storage symptoms for at least 3 months after TUS for BPO were eligible once they have urgency episodes/24 hrs ≥1 and daytime frequency ≥8. Patients were allocated to Li-SWT versus sham versus standard of care (solifenacin 10 mg once daily) in 3:1:1 ratio. Li-SWT was applied to suprapubic and perineal regions once-weekly for 8 weeks. The treatment efficacy was assessed by overactive bladder symptoms score (OABSS) at baseline, 4, 8 and 12 weeks as well as international index of prostate symptom score (IPSS), quality of life (QoL), uroflowmetry and post-void residual urine volume (PVR) at baseline and 8 weeks. Moreover, patient compliance and treatment-related adverse effects were evaluated. Visual analogue scale (VAS) ranging from 0-10 was used for pain evaluation during Li-SWT sessions. RESULTS: A total of 115 patients were enrolled (72, 18 and 25 patients in Li-SWT, sham and solifenacin group respectively). Baseline data were comparable between groups. OABSS at 4, 8 and 12 weeks as well as IPSS and QoL at 8 weeks showed significant improvement from the baseline level in Li-SWT and solifenacin groups compared to sham group (P=0.001). Solifenacin was associated with bothersome antimuscarinic adverse effects in 84% of the patients and it was intolerable in 9.5% of them. However, no adverse effects related to Li-SWT were noted apart from local pain during the procedure (mean VAS = 4.18±1.31). CONCLUSIONS: Li-SWT ameliorates persistent storage symptoms and promotes the QoL after TUS for BPO. It can be used as an alternative treatment to muscarinic receptor blockers with similar efficacy and without bothersome adverse effects. Source of Funding: No source of funding © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e648 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohammed Hegazy More articles by this author Khaled Zaky Sheir More articles by this author Mohamed Ahmed Gaballah More articles by this author Ahmed Mohamed Elshal More articles by this author Expand All Advertisement PDF DownloadLoading ...

A Quasi Experiment on Outcome of Mirabegron and Solifenacin in the Treatment of Primary Over Active Bladder in A Tertiary Hospital in Dhaka, Bangladesh

Background: Overactive bladder (OAB) syndrome is a common symptom complex that affects millions of people worldwide, with an increasing prevalence with increased age in primary overactive bladder.&#x0D; Objective: The study was done to find out the efficacy and outcome of Mirabegron and solifenacin on primary overactive bladder.&#x0D; Methodology : This study was a quasi-experimental study conducted on 100 study population (Group A-50 Group B-50) in Urology Outpatient Department, Sir Salimullah Medical College Mitford Hospital, Dhaka from July 2017 to December 2018. Study population were total 100 men and women aged at least 18 &amp; up to 60 years (Group A -50 and Group B-50) with persistent primary overactive bladder (OAB) symptoms for 3 months or more were enrolled in this study. Patients were eligible for the study who were able to give a written informed consent before starting the intervention &amp; was also able to complete a voiding diary. Patients were recruited at the urology outpatient department, SSMCMH, Dhaka and were selected by the following inclusion and exclusion criteria. A data sheet was completed for each patient which included particulars of the patient, history, examination findings and baseline investigations. Half of the patients were enrolled in each group. Mirabegron group was experimental group and Solifenacin group was control group. Cases of Mirabegron group was given once daily dose of Mirabegron 25 mg and Solifenacin group was also given single dose of Solifenacin succinate 5 mg, at for 12 weeks.&#x0D; Result: The result of age distribution of the study patients belonged to age 31-40 years in group A (Mirabegron 25 mg) 21(42.0%) and 16(32.0%) in group B (Solifenacin 5 mg). The mean voided volume of each micturation at 12 week of treatment was more increased in group A (Mirabegron 25 mg) than group B (Solifenacin 5 mg). The mean change in micturition frequency per 24 hours, episodes of urgency per 24 hours, urge incontinence episodes per 24 hours and nocturia episodes per 24 hours were statistically significant (p&lt;0.05) between group A (Mirabegron 25 mg) and group B (Solifenacin 5 mg).&#x0D; Conclusion The study shows that Mirabegron is more effective than Solifenacin in the treatment of primary over active bladder and can be used in without organic and pathological diseases of urinary bladder&#x0D; Sir Salimullah Med Coll J 2022; 30: 55-60

Clinical Study on the Treatment of Pediatric Primary Nocturnal Enuresis by Integrated Traditional Chinese and Western Medicine

To investigate the curative effect of integrated traditional Chinese and Western medicine in the treatment of children with primary nocturnal enuresis is the objective of the study. 160 children with primary nocturnal enuresis were randomly divided into four groups and received suoquan capsules, solifenacin combined with suoquan capsules, solifenacin or behavioral intervention for 2 mo. The response rates of each group were evaluated and logistic regression analysis was used to analyze the influencing factors of curative effect. In addition, the patients were followed up after 3 mo to investigate the recurrence rate. The complete remission (complete response) rate in solifenacin combined with suoquan capsules group was higher than that in behavioral intervention group (37.5 % vs. 7.5 %, p=0.007). The complete response rate and non-response rate in the solifenacin group were lower than those in the solifenacin combined with suoquan capsules group (all p<0.05). The recurrence rate in the solifenacin group was significantly higher than that in the solifenacin combined with suoquan capsules group (72.5 % vs. 30.0 %, p=0.027). Multivariate analysis showed that treatment group, enuresis frequency and age were independent predictors of complete response at 2 mo. Integrative traditional Chinese and Western medicine has good effect in the treatment of children with primary nocturnal enuresis and the recurrence rate is low. Enuresis frequency, treatment method and age were important predictors of complete remission after treatment

Effects of β3 Agonists and Anticholinergic Drugs on Defecation in Patients With Overactive Bladder.

In clinical practice, constipation is one of the most frequent adverse events caused by drugs for overactive bladder (OAB). The occurrence of constipation greatly deteriorates the patient's quality of life. The aim of the study was to evaluate and compare the effects of three commonly used β3 agonists and anticholinergic drugs on the defecation status in patients with OAB. We retrospectively reviewed the defecation status in patients who received mirabegron, solifenacin, or fesoterodine for OAB. We evaluated changes in the (a) urological parameters using the OAB symptom score (OABSS) and (b) defecation status using the Bristol Stool Form Scale (BSFS) and constipation scoring system (CSS) following 12 weeks of drug administration. We analyzed data from 165 patients (mirabegron=56, fesoterodine=52, and solifenacin=57). The solifenacin group showed a significant decrease in BSFS (from 3.2±1.0 at baseline to 2.3±12 post-treatment) and an increase in hardened stools (p<0.001). Elimination worsened as assessed by almost all items, and the total modified CSS scores worsened significantly from 4.8±2.6 points at baseline to 8.O±4.8 points after 12 weeks of solifenacin treatment (p<0.001). The mirabegron group showed no changes in any of the CSS items. In the fesoterodine group, the CSS scores for "completeness" and "assistance" increased significantly after treatment (p<0.001 and p=0.013, respectively). All three drugs were effective for OAB. Mirabegron had almost no effect on constipation; fesoterodine, an anticholinergic drug, also had hardly any effect on defecation.

English

BACKGROUND Overactive bladder (OAB) is a chronic, age-related disorder seen in 11 % of patients. Symptoms consist of urinary urgency, with or without urinary incontinence, usually with frequency or nocturia. The objective of the present study was to compare the efficacy and side effects of mirabegron and solifenacin as primary therapies in patients with overactive bladder. METHODS This was a prospective interventional study. 100 patients aged between 18 years and 50 years with overactive bladder were included and were assigned into two treatment groups of solifenacin 5 mg or mirabegron 50 mg. They were asked to record the number of micturitions in a day, urgency episodes, incontinence episodes and volume of each micturition. All patients went through a basic workup with blood sugar to rule out diabetes, USG KUB to rule out bladder stones, and urine culture and sensitivity to rule out urinary tract infection (UTI). RESULTS 100 patients with OAB were selected for the study and divided into equal groups, 50 receiving 5 mg solifenacin and 50 receiving 50 mg mirabegron. Both groups increased the mean micturition volume but mirabegron was more effective in increasing the mean micturition in patients with OAB. Both drugs were well tolerated. There was a significant increase in mean micturition volume in mirabegron 50 mg group (by 20.7 + / - 2.2 mL), P &lt; 0.001 whereas in solifenacin group micturition volume was increased to 22.2 + / -0.97 ml). The most common side-effect in the mirabegron group was hypertension and the most common side effect in the solifenacin group was dry mouth. CONCLUSIONS Both mirabegron and solifenacin were effective in controlling the frequency of micturition, decreasing urgency and incontinence episodes and increasing the mean volume of micturition. Mirabegron was more effective than solifenacin in controlling urgency and incontinence episodes and increasing the mean volume of micturition. KEY WORDS Overactive Bladder (OAB), Micturition, Mirabegron, Solifenacin.

Evaluation of the Clinical Efficacy and Complications of Duloxetine in Comparison to Solifenacin in the Treatment of Overactive Bladder Disease in Women: A Randomized Clinical Trial.

SNRIs (serotonin and norepinephrine reuptake inhibitors) like duloxetine are known to have role in the treatment of anxiety disorder and stress urinary incontinence. According to the correlation of anxiety disorder and overactive bladder, this study aimed to evaluate the clinical efficacy and complications of duloxetine (SNRI) as a medication in the treatment of overactive bladder in the female patients. We were interested to know the probable therapeutic effect and side effects of duloxetine in overactive bladder. In this single-blinded interventional randomized clinical trial, 60 female patients with idiopathic overactive bladder (hyperreflexia) referred to the urology clinic, were divided into two groups as pilots. The first group were treated by 10mg/daily solifenacin and the second group received 20mg/daily duloxetine. The patients were evaluated by the ICIQ-OAB Questionnaire before and after one-month follow-up period. The intervention primary outcomes were evaluated by the patient's presentation of the frequency, nocturia, urgency, urge urinary incontinence and the drugs side effects as secondary outcomes were checked. Results: Sixty women with confirmed overactive bladder disease were evaluated. Solifenacin and duloxetine had the same effect on the treatment of overactive bladder (p value=0.148). The clinical symptoms were obviously relieved in both groups after treatment. Side effects were insignificantly more common in the solifenacin group (p value>0.05). However, the different frequency of blurred vision in the two groups was statistically significant (p value=0.04). The most common complication in solifenacin and duloxetine group was anxiety. The results showed that solifenacin and duloxetine improved overactive bladder symptoms. According to this evaluation, duloxetine can be a suitable alternative option for overactive bladder treatment, due to the acceptable therapeutic effect and side effects.

To Compare the Efficacy of Tamsulosin, Solifenacin and Combination of Both in the Treatment of Double-J Stent Related Irritative Lower Urinary Tract Symptoms and Low Back Pain

Background: Stent-associated symptoms can have a significant impact on patient quality of life. Hematuria, urgency, frequency, dysuria, and both bladder and flank pain are the most prevalent symptoms related to indwelling ureteral stents. Among them irritative lower urinary tract symptoms and low back pain are more frequent. Despite the stent related symptoms, because of its importance stent is being kept in situ with varieties of medication. Several alpha-adrenergic blocker and antimuscarinic drugs are used to relief these symptoms like Tamsulosin, Solifenacin, Alphazosin etc. Both Tamsulosin and Solifenacin are not costly as use daily single dose. So combination of Tamsulosin and Solifenacin may act as a reliever of stent related symptoms and also cost effective. Methods and materials: For this purpose, a total of 126 patients having unilateral double-J ureteral stent for 7 days with stent related irritative LUTS and low back pain were included in this study. This hospital based prospective randomized clinical trial was carried out in Urology department of Bangabandhu Sheikh Mujib Medical University, Dhaka, during January 2014 to June 2015, to compare the irritative IPSS, improvement of quality of life score component of IPSS ,the low back pain score for double-J ureteral stent using Tamsulosin, Solifenacin and combination of both (Tamsulosin and Solifenacin) Results: Regarding the irritative sub group of International Prostate Symptom Score (IPSS) was observed during 2nd and 4th weeks follow up IPSS was significantly (p&lt;0.05) higher in solifenacin and Tamsulosin group with compared to Tamsulosin+Solifenacin group. During 4th weeks follow up the mean quality of life (QOL) score was significantly (p&lt;0.05) higher in solifenacin group and Tamsulosin group with compared to Tamsulosin+Solifenacin group.During 2nd weeks and 4th weeks follow up visual Analogue Pain Scale (VAPS) was significantly (p&lt;0.05) higher in solifenacin group followed by Tamsulosin group and Tamsulosin+Solifenacin group. Conclusion: Combined use of Tamsulosin and Solifenacin is more effective than use of single drug (either Tamsulosin or Solifenacin) in the treatment of ureteral double-J stent related irritative LUTS and low back pain. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.48-51

Mirabegrone versus Solifenacine in Treatment of Overactive Bladder in Female Patients in Zagazig University Hospitals

Background: Overactive bladder (OAB) syndrome, consisting of urgency, with or without urgency incontinence, often with frequency (voiding more than eight times in a 24- h period) and nocturia (need to wake up one or more times per night for urination), is a highly prevalent disorder with a significant impact on quality of life (QoL). Objective: To evaluate the safety and efficacy of mirabegron 50 mg in comparison to solifenacin 5 mg in the treatment of female patients suffering from overactive bladder symptoms. Patients and Methods: This prospective randomized study was conducted in Zagazig University Hospitals during the period From November 2018 to April 2019. Thirty consecutive female patients aged from 18 to 65 years old were included in this study. Results: Mirabegrone significantly was associated with hypertension only in one case, and Solifenacine significantly was associated with blurred vision, constipation and dry mouth. Comparison between mirabegron and solifenacin group according to day and night frequency, urge and urge incontinence pretreatment showed that there was no significant difference between both groups. Comparison between mirabegron and solifenacin groups according to day and night frequency, urge and urge incontinence after taking mirabegrone or solifenacin showed that mirabegron group was significantly lower as regards day and night frequency also in urgency and urgency incontinence post treatment. Conclusions: Solifenacin and mirabegron were effective in improving over active bladder symptoms. Mirabegron showed greater tolerability with fewer patients discontinuing therapy because of side effects. mirabegron can be considered as the drug with the better balance between efficacy and tolerability in the treatment of OAB.

Mirabegron Versus Solifenacin in Multiple Sclerosis Patients With Overactive Bladder Symptoms: A Prospective Comparative Nonrandomized Study

To determine the patient-perceived effectiveness and tolerability of mirabegron compared to solifenacin in a multiple sclerosis (MS) population with overactive bladder (OAB) symptoms. MS patients with OAB symptoms who were not on medication for their urinary symptoms at enrollment were prospectively recruited. Patients enrolled in years 1-2 were prescribed mirabegron, whereas patients enrolled in years 3-4 were prescribed solifenacin. At enrollment and 6-week follow-up, patients completed several patient reported outcome measures. The primary outcome was change in OAB Questionnaire Short Form (OAB-q SF) symptom severity and minimal clinically important difference (MCID) achievement. The Patient Assessment of Constipation Symptoms (PAC-SYM) was used to assess bowel function over the treatment period. Sixty-one patients were enrolled. The majority of the mirabegron (70%) and the solifenacin (69%) group achieved the OAB-q SF symptom severity MCID. The solifenacin group had a statistically significant greater decrease in its end of study OAB-q SF score (Δ=-37.87 vs -20.43, P=.02). Constipation improved in the mirabegron group and worsened in the solifenacin group (ΔPAC-SYM=-0.38 vs +0.22; P=.02), with 30% of patients prescribed solifenacin experiencing worsening above the MCID threshold. Among MS patients, we demonstrated similar response rates to mirabegron and solifenacin, with approximately 50%-70% achieving each patient reported outcome measure's MCID. Though this small study showed some short-term evidence that improvement in urinary symptom severity was greater with solifenacin, this potential benefit must be weighed against the observed risk of worsening constipation. Further studies are needed to confirm these findings.

Comparison of the effects of trospium and solifenacin on intraocular pressure and tear secretion in patients with overactive bladder.

Comparison of the effects of trospium and solifenacin used for the treatment of overactive bladder (OAB) on intraocular pressure (IOP) and tear secretion. This study was planned as a prospective study and was conducted at a single center between October 2014 and April 2016. OAB patients were included in the study following an ophthalmic examination, IOP measurement with an applanation tonometer, and tear secretion measurement with the Schirmer I test in the ophthalmology outpatient department. The patients were started with trospium 30mg oral bid or solifenacin 5mg oral qd. They were then followed up at the 4th and 12th weeks. A total of 225 OAB patients with a mean age of 47.80 (18-75) years were evaluated. The mean age was 47.41 ± 12.65years in the trospium group (n = 104) and 48.14 ± 11.82years in the solifenacin group (n = 121) with no statistically significant difference. When the two medications were compared, no statistically significant difference was observed at the 4th and 12th weeks in terms of IOP (p = 0.988, p = 0.822) and dry eye (p = 0.764, p = 0.581). No statistically significant difference was observed between trospium and solifenacin in terms of their effects on IOP and tear secretion in OAB patients. We therefore concluded that the effects of trospium and solifenacin on IOP and tear secretion changes were similar in OAB patients without comorbidities.

Effect of electroacupuncture versus solifenacin for moderate and severe overactive bladder: a multi-centre, randomized controlled trial study protocol

BackgroundOveractive bladder is defined as “urgency, with or without urge incontinence, usually with frequency and nocturia”. Electroacupuncture may be a safe and an effective alternative therapy for overactive bladder, but the evidence is limited.MethodsWe will conduct a three-arm, non-inferiority, multi-centre randomized controlled clinical trial. A total of 420 patients with moderate and severe overactive bladder will be randomly assigned to one of three groups: the electroacupuncture group (N = 140), sham electroacupuncture group (N = 140), and solifenacin group (N = 140). The primary outcome will be the change in the overactive bladder symptom score from baseline to the end of the 12-week treatment. The secondary outcomes will include the proportion of participants with a decrease in the overactive bladder symptom score ≥ 3 at weeks 4, 8, 12, 20, and 32; the change in average 24 h values of urination, nocturnal urination, urgency incontinence and urgency episodes from baseline to weeks 4, 8, 12, 20 and 32, and so forth. The adverse events will be recorded. Statistical analysis will include covariance analysis, nonparametric tests and descriptive statistics.DiscussionThis study will answer the question of whether electroacupuncture is effective and non-inferior to solifenacin for improving the symptoms of overactive bladder patients.Trial registrationChinese clinical trial registry (ChiCTR1800019928).

Electroacupuncture for balanced mixed urinary incontinence: secondary analysis of a randomized non-inferiority controlled trial.

The aim was to investigate the effectiveness and safety of electroacupuncture (EA) in women with balanced mixed urinary incontinence (MUI) compared with PFMT plus solifenacin. This is a secondary analysis of a randomized non-inferiority clinical trial. Seventy-nine patients with balanced MUI were randomly assigned to receive either 12-week EA with 24-week follow-up or 36-week PFMT and solifenacin. Primary outcome was the proportion of participants with ≥50% reduction of mean 24-h incontinence episode frequency (IFE) through weeks 1-12 from baseline. Analysis was performed in an intention-to-treat population using a generalized linear model with a binomial distribution, adjusted for imbalances in baseline variables, and a two-sided p value of less than 0.05 was considered significant. A total of 34 participants in the EA group and 45 participants in the PFMT plus solifenacin group were included in the intention-to-treat analysis of primary outcome. Through weeks 1-12, the proportion of participants with ≥50% reduction of mean 24-h IEF was 32.4% in the EA group, and 37.2% in the PFMT plus solifenacin group, with a mean difference of -2.82% (95%CI: -23.88 to 18.23, p=0.79), revealing non-inferiority. No significant difference held true for all the secondary outcomes. Six adverse events occurred in the EA group and 22 in the PEMT plus solifenacin group. The effect of EA is similar to PFMT plus solifenacin in relieving the symptoms of both SUI and UUI and increasing participants' quality of life but with better safety. The effects of EA may sustain 24 weeks after treatment.