Total Overactive Bladder Symptom Score Research Articles

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

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

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

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

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

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

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.

MP74-19 THE PREOPERATIVE DYSLIPIDEMIA AND HIGH OVERACTIVE BLADDER SYMPTOM SCORE PREDICT DE NOVO OVERACTIVE BLADDER AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY

You have accessJournal of UrologyCME1 Apr 2023MP74-19 THE PREOPERATIVE DYSLIPIDEMIA AND HIGH OVERACTIVE BLADDER SYMPTOM SCORE PREDICT DE NOVO OVERACTIVE BLADDER AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY Hitomi Imai, Hidenori Akaihata, Yuki Harigane, Kei Yaginuma, Yu Endo, Yuki Yoshida, Yuta Matsuoka, Akifumi Onagi, Kanako Matsuoka, Seiji Hoshi, Tomoyuki Koguchi, Junya Hata, Yuichi Sato, Masao Kataoka, and Yoshiyuki Kojima Hitomi ImaiHitomi Imai More articles by this author , Hidenori AkaihataHidenori Akaihata More articles by this author , Yuki HariganeYuki Harigane More articles by this author , Kei YaginumaKei Yaginuma More articles by this author , Yu EndoYu Endo More articles by this author , Yuki YoshidaYuki Yoshida More articles by this author , Yuta MatsuokaYuta Matsuoka More articles by this author , Akifumi OnagiAkifumi Onagi More articles by this author , Kanako MatsuokaKanako Matsuoka More articles by this author , Seiji HoshiSeiji Hoshi More articles by this author , Tomoyuki KoguchiTomoyuki Koguchi More articles by this author , Junya HataJunya Hata More articles by this author , Yuichi SatoYuichi Sato More articles by this author , Masao KataokaMasao Kataoka More articles by this author , and Yoshiyuki KojimaYoshiyuki Kojima More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003348.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Some patients have de novo overactive bladder (de novo OAB) after robot-assisted radical prostatectomy (RARP). It is possible that the preoperative characteristics of the patient contribute to onset of de novo OAB after RARP. The aim of this study is to determine whether the preoperative characteristics of the patients affect the de novo OAB after RARP. METHODS: Patients without OAB who underwent RARP for localized prostate cancer at our hospital between February 2013 and October 2020 were included in this study. At 12 months after RARP, these patients were divided into the OAB-free group and de novo OAB group according to absence or presence of OAB. The preoperative age, blood pressure, obesity (BMI≥25 kg/m2), dyslipidemia (LDL-C/HDL-C ratio ≥2.5), HbA1c, uroflowmetry parameter, prostate volume (PV) and overactive bladder symptom score (OABSS) were compared between the OAB-free group and de novo OAB group. RESULTS: A total of 404 patients (67.0±5.3 years) entered the study (OAB-free group: 338 patients, de novo OAB group: 66 patients). The percentage of patients with dyslipidemia was significantly higher in the de novo OAB group than in the OAB-free group (OAB-free group vs de novo OAB group: 32.0% vs 45.5%, p=0.04). The total OABSS was significantly higher in the de novo OAB group than in the OAB-free group (OAB-free group vs de novo OAB group: 2.1±1.4 points vs 3.2±1.6 points, p<0.01). The other preoperative characteristics of the patients were not significant differences between two groups. CONCLUSIONS: We demonstrated that preoperative dyslipidemia, which was defined as LDL-C/HDL-C ratio ≥2.5 in this study, and high OABSS contributed to de novo OAB after RARP. Recent studies have demonstrated that dyslipidemia contributes to the lower urinary tract dysfunction. Several studies have also reported that elevated LDL-C/HDL-C ratio is associated with progression of atherosclerosis1). The atherosclerosis is well known to cause OAB by chronic bladder ischemia. The preoperative elevated LDL-C/HDL-C ratio may cause de novo OAB after RARP through chronic bladder ischemia. The patients with preoperative high OABSS might have bladder instability although they were not diagnosed as OAB. The bladder instability might become worse after RARP, resulting in de novo OAB. The preoperative dyslipidemia and high OABSS may be useful marker of de novo OAB after RARP. Source of Funding: 1) Noike H, et al: Relationships between intravascular ultrasonographic findings and coronary risk factors in patients with normal coronary angiography. J Cardiol. 2005;45:1-10 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1078 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hitomi Imai More articles by this author Hidenori Akaihata More articles by this author Yuki Harigane More articles by this author Kei Yaginuma More articles by this author Yu Endo More articles by this author Yuki Yoshida More articles by this author Yuta Matsuoka More articles by this author Akifumi Onagi More articles by this author Kanako Matsuoka More articles by this author Seiji Hoshi More articles by this author Tomoyuki Koguchi More articles by this author Junya Hata More articles by this author Yuichi Sato More articles by this author Masao Kataoka More articles by this author Yoshiyuki Kojima More articles by this author Expand All Advertisement PDF downloadLoading ...

The Relationship between the Presence of an Earlobe Crease and Overactive Bladder: A Cross-Sectional Case-Controlled Study.

Background and Objectives: To examine the relationship between the presence of earlobe crease (EC) and overactive bladder (OAB). Materials and Methods: The earlobes of the participants were examined macroscopically. ECs were further divided into four groups (grades 0-3) according to severity. Subjective symptoms were assessed using the OAB symptom score (OABSS), and objective findings were assessed using uroflowmetry. The relationship between these findings and the presence or absence and severity of EC was also examined. A score of ≥2 points on OABSS question 3 (urinary urgency), with a total score of ≥3 points, indicated OAB. Results: We analyzed 246 participants, including 120 (48.8%) in the EC group and 126 (51.2%) in the non-EC (N-EC) group. On the OABSS, the EC group scored higher than the N-EC group for all questions and for the total score. The total OABSS of EC grade 3 was the highest of all groups. A total of 115 (95.8%) patients in the EC group (100% in grade 3) and 69 (54.8%) in the N-EC group met the OAB criteria (p < 0.001). The voided volume and maximum flow rate of the EC group were significantly lower than those of the N-EC group (both p < 0.001). The post-void residual urine volume in the EC group was significantly higher than that in the N-EC group (p = 0.029). Multivariate analysis revealed that EC was an independent risk factor for OAB (odds ratio, 8.15; 95% confidence interval, 2.84-24.75; p < 0.001). Conclusions: The presence of an earlobe crease may be a predictive marker for OAB.

Efficacy of Transcutaneous Tibial Nerve Stimulation With Silver Spike Point® Electrodes for Refractory Overactive Bladder: A Single-Arm Study.

Background Tibial nerve stimulation therapy is a treatment option for an overactive bladder. A surface electrode called a Silver Spike Point® electrode, which does not directly puncture the skin as in transcutaneous tibial nerve stimulation, but is expected to exert the same therapeutic effect as percutaneous tibial nerve stimulation, was developed. This study investigated the efficacy and safety of tibial nerve stimulation with Silver Spike Point® electrodes for refractory overactive bladder. Methodology This was a six-week, single-arm, prospective study on the efficacy and safety of transcutaneous tibial nerve stimulation for patients with refractory overactive bladder. Each treatment lasted 30 minutes and was performed twice a week. The stimulation sites of the tibial nerve were the Sanyinjiao point (SP6) and Zhaohai point (KI6) in both legs. The primary endpoint was the change in the total overactive bladder symptom score. Results In total, 29 patients (20 males and nine females: 64.86 ± 17.98 years old) were included in this study. Two women dropped out; one because of an adverse event and the other as requested. Therefore, 27 patients completed the study. The total overactive bladder symptom and International Consultation on Incontinence Questionnaire-Short Form scores significantly decreased by 2.22 and 2.39 points, respectively (p < 0.01 each). In the frequency volume chart, the numbers of urgency episodes and leaks in 24 hours significantly decreased by 1.53 and 0.44, respectively (p = 0.02 each). Conclusions Transcutaneous tibial nerve stimulation therapy using Silver Spike Point® electrodes was useful for patients with refractory overactive bladder and, thus, has potential as a new treatment option for refractory overactive bladder.

The choice of therapeutic agent in female overactive bladder patients in real-world practice.

The reasons why anticholinergic drugs or β3 adrenergic agonists are selected as treatments for overactive bladder (OAB) are unclear. The aim of this study was to investigate the background data of female OAB patients that were prescribed anticholinergic drugs or β3 adrenergic agonists in a real-world setting. Between January 2013 and December 2014, 75 patients who had been diagnosed with OAB were included in this study. Administered medications, age, the persistence on treatment rate at one-year, medical history, pretreatment total Overactive Bladder Symptom Score (OABSS), pretreatment score for each OABSS factor, body mass index (BMI), and various comorbidities were evaluated retrospectively. Since there were many types of anticholinergic drugs and few patients, we grouped the patients into those that were prescribed anticholinergic drugs (group A) and those that were prescribed β3 adrenergic agonists (group B). 75 patients (29 in group A and 46 in group B) were included in this study. There were no significant differences in age, BMI, obesity, medical history, pretreatment total OABSS, or pretreatment score for each OABSS factor. There was a significant difference in the post-voiding residual urine volume (PVR) between the groups (group A: 22 ml, group B: 9 ml; p = 0.0252). The 1-year persistence on treatment rate was 28% in both groups. There were no significant differences in clinical characteristics of patients who were prescribed anticholinergics and β3 adrenergic agonists for OAB treatment, but a marginal difference of PVR value before treatment. The 1-year persistence rates of anticholinergic drugs and β3 adrenergic agonists were considered to be almost equivalent.

The Efficacy of Compression Stockings on Patients With Nocturia: A Single-Arm Pilot Study

Objectives: Behavioral treatment for nocturia includes wearing compression stockings. However, a reading of the cited literature for evidence shows that there is not enough research data to support this recommendation, and it is controversial. The present study aimed to investigate and supplement evidence on the effects of wearing compression stockings during the daytime in patients with nocturia.Methods: This was a single-arm prospective study to investigate the effects of compression stockings on nocturia for four weeks. Patients were asked to record a frequency-volume chart and complete various questionnaires at baseline and after four weeks, and also provide feedback on treatment satisfaction. The primary endpoint was a change in night-time frequency in the frequency-volume chart from the baseline to the end of treatment.Results: Thirty-four patients (19 men and 15 women; age: 72.3 ± 12.6 years) were included. Two patients dropped out because of pain associated with wearing compression stockings and one due to a refusal to wear compression stockings every day. Therefore 31 patients were analyzed. In the frequency-volume chart, night-time and 24-hour frequencies significantly decreased by 0.5 and 1.1 episodes, respectively (P = 0.004 and P = 0.035, respectively). The hours of undisturbed sleep significantly increased by 0.8 h (P = 0.013). No significant differences were observed in nocturnal or 24-h urine volumes, the number of urgency or urinary incontinence episodes, the mean or maximum voided volume, the nocturnal polyuria index, or the first night-time voided volume. The total overactive bladder symptom score significantly decreased (P = 0.006). Significant reductions were also observed in all overactive bladder symptom score subscores, except for the daytime frequency score.Conclusion: The present results suggest the effectiveness of wearing compression stockings during the day was satisfactory in most patients with nocturia, and the treatment was safely continued in patients who experienced no pain when wearing the stockings. Based on the results of this study, we believe that it is worth considering as a treatment for nocturia.

Does COVID-19 Vaccination Cause Storage Lower Urinary Tract Symptoms?

We investigated the storage lower urinary tract symptoms (LUTS) before and after the first dose of coronavirus disease 2019 (COVID-19) vaccine and the association between pre-vaccinated overactive bladder (OAB) and the worsening of storage LUTS following COVID-19 vaccination. This cross-sectional study in a third-level hospital in Taiwan used the validated pre- and post-vaccinated Overactive Bladder Symptom Score (OABSS). Diagnosis of OAB was made using pre-vaccinated OABSS. The deterioration of storage LUTS was assessed as the increased score of OABSS following vaccination. Of 889 subjects, up to 13.4% experienced worsened storage LUTS after vaccination. OAB was significantly associated with an increased risk of worsening urinary urgency (p = 0.030), frequency (p = 0.027), and seeking medical assistance due to urinary adverse events (p < 0.001) after vaccination. The OAB group faced significantly greater changes in OABSS-urgency (p = 0.003), OABSS-frequency (p = 0.025), and total OABSS (p = 0.014) after vaccination compared to those observed in the non-OAB group. Multivariate regression revealed that pre-vaccinated OAB (p = 0.003) was a risk for the deterioration of storage LUTS. In conclusion, storage LUTS may deteriorate after vaccination. OAB was significantly associated with higher risk and greater changes in worsening storage LUTS. Storage LUTS should be closely monitored after COVID-19 vaccination, especially in those OAB patients.

The three-year evolution of overactive bladder syndrome in community-dwelling female residents aged 40 years and above

ObjectiveIn this 3-year longitudinal cohort study, we aimed to evaluate the evolution of overactive bladder in female community residents aged 40 years and above in central Taiwan and identify its risk factors. Materials and methodsFemale community residents aged 40 years and above were invited to participate in this study and fill out a yearly Overactive Bladder Symptom Score (OABSS) questionnaire over a 3-year period. A woman was defined to have OAB if the total OABSS was ≧4 and urgency score was ≧2. At the end of the third year, the incidence, remission, persistence, and relapse of OAB in these community residents were calculated. A novel statistical analysis technique, machine learning with data mining, was applied to examine its use in this field.Five machine learning models were used to predict the risk factors associated with persistent OAB and the results were compared with the conventional logistic regression model. ResultsIn total, 1469 female residents were included in the first year and 1290 (87.8%) women completed the questionnaires for all 3 years. The prevalence of OAB was 20.2% (n = 260). The second- and third-year incidence rates of OAB were 13.5% and 7.1%. The remission rates were 39.6% and 44.3%. Twenty-two percent of the women reported relapse of OAB in the third year. The two-year OAB persistence rate was 43.8%. For the prediction of risk factors for persistent OAB, the multivariable logistic regression model had better predictive accuracy (AUC = 0.664) than the five machine learning models. Age ≧ 60 was associated with persistent OAB (OR 2.8; 95% CI: 1.34–5.89, P = 0.002). ConclusionThe yearly incidence, remission, and persistence rates of OAB were high in female community residents aged 40 years and above in central Taiwan. Older women had a higher risk of persistent OAB symptoms in this 3-year longitudinal cohort study.

Efficacy of Combination Treatment with Tadalafil and Mirabegron in Patients with Benign Prostatic Hyperplasia Who Presented with Persistent Storage Symptoms After Tadalafil Monotreatment: A Prospective, Multicenter, Open-Labeled Study.

The aim of this study is to evaluate the efficacy and safety of tadalafil, a phosphodiesterase type 5 inhibitor, plus mirabegron, a β3-adrenoreceptor agonist, in patients with benign prostatic hyperplasia who presented with persistent storage symptoms after tadalafil monotreatment. The registration of this study started in August 2016 and ended in July 2019. The inclusion criteria included patients aged ≥ 50 years who were diagnosed with benign prostatic hyperplasia and who presented with overactive bladder symptoms. Patients were treated with oral tadalafil 5 mg once daily for 4 weeks. Then, its efficacy was evaluated. Patients who responded to the treatment received oral tadalafil 5 mg once daily for 4 more weeks (monotreatment group). Meanwhile, those who did not respond received oral tadalafil 5 mg and mirabegron 50 mg, which is an add-on treatment, once daily for 4 more weeks (combination therapy group). After 8 weeks, the monotreatment group (n = 19) and the combination group (n = 56) had significantly better total Overactive Bladder Symptom Score and International Prostate Symptom Score and International Prostate Symptom Score voiding and storage subscale scores. Moreover, the two groups experienced significant improvements in the total Overactive Bladder Questionnaire and Nocturia Quality of Life Questionnaire scores, and Nocturia Quality of Life Questionnaire Bother/Concern subscale score after 8 weeks. However, there were no cases of urinary retention or serious adverse events. Combination treatment with tadalafil and mirabegron is effective and safe for patients with benign prostatic hyperplasia who presented with persistent storage symptoms after tadalafil monotreatment. Hence, tadalafil plus mirabegron is a promising therapeutic option, and it can improve overactive bladder related-quality of life.

Effects of Changes in Erectile Function After Holmium Laser Enucleation of the Prostate on Postoperative Outcomes in Patients With Benign Prostatic Hyperplasia.

Sexual function in patients with benign prostatic hyperplasia (BPH) could be affected by surgical intervention, such as holmium laser enucleation of the prostate (HoLEP). The objective of the present study was to investigate whether changes in erectile function (EF) after HoLEP affect postoperative outcomes in patients with BPH. We retrospectively reviewed 54 consecutive Japanese patients with BPH undergoing HoLEP at our institution between August 2017 and December 2020, and analyzed data obtained before and 6 months after HoLEP, including the Erection Hardness Score (EHS), International Prostate Symptom Score (IPSS), IPSS-Quality of Life (IPSS-QOL), Overactive Bladder Symptom Score (OABSS), and the Medical Outcomes Study 8-Item Short-Form Health Survey consisting of a mental health component summary (MCS) and physical health component summary (PCS). Although no significant differences were observed between preoperative and postoperative EHS, postoperative EHS deteriorated in 19 out of 54 patients. Total IPSS, IPSS-QOL, and OABSS significantly improved after HoLEP, irrespective of the deterioration of EHS; however, despite the lack of significant changes in MCS and PCS in 19 patients with deteriorated EHS, significant improvements in MCS, but not PCS, were postoperatively observed in the remaining 35. A multivariable analysis of several factors identified a preoperative estimated prostate volume >100 cm3 as an independent risk factor associated with the postoperative deterioration of EHS. HoLEP had limited impact on postoperative EF in BPH patients; however, favorable QOL may be expected in patients without the postoperative deterioration of EF. Accordingly, it may be important to consider the prostate volume and its effect on postoperative EF when selecting indications for HoLEP.

Long COVID and COVID-19-associated cystitis (CAC).

PurposeThere is scarce literature regarding genitourinary symptoms in COVID-19, especially post-acute disease otherwise known as Long COVID. We identified recovered COVID-19 patients presenting with new or worsening overactive bladder symptoms, known as COVID-19-associated cystitis (CAC).MethodsWe used the American Urological Association Urology Care Foundation Overactive Bladder (OAB) Assessment Tool to screen COVID-19 recovered patients presenting with urological complaints at our urban-located institution from 5/22/2020 to 12/31/2020. Patients 10–14 weeks post-discharge responded to 5 symptom and 4 quality-of-life (QoL) questions. We reported median symptom scores, as well as QoL scores, based on new or worsening urinary symptoms, and by sex.ResultsWe identified 350 patients with de novo or worsening OAB symptoms 10–14 weeks after hospitalization with COVID-19. The median total OAB symptom score in both men and women was 18. The median total QoL score for both men and women was 19. Patients with worsening OAB symptoms had a median pre-COVID-19 symptom score of 8 (4–10) compared to post-COVID-19 median symptom score of 19 (17–21). Median age was 64.5 (range 47–82). Median hospital length-of-stay was 10 days (range 5–30).ConclusionWe report survey-based results of patients suffering from new or worsening OAB symptoms months after their hospitalization from COVID-19. Future studies with larger sample sizes and more extensive testing will hopefully elucidate the specific pathophysiology of OAB symptoms in the context of long COVID so urologists can timely and appropriately treat their patients.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11255-021-03030-2.

Impact of urethroplasty on overactive bladder symptoms in patients with anterior urethral strictures.

To investigate the incidence of overactive bladder in men with anterior urethral stricture and to evaluate the impact of urethroplasty on its improvement. A total of 104 men with anterior urethral stricture who underwent urethroplasty between 2016 and 2020 completed a validated urethral stricture surgery patient-reported outcome measure comprising six lower urinary tract symptoms questions on voiding symptoms and overactive bladder symptom score before and 3, 6, and 12 months after urethroplasty. Patients with an urgency score of ≥2 for overactive bladder symptom score question 3, and a total overactive bladder symptom score of ≥3 were considered to have overactive bladder. An improvement in overactive bladder was defined as a decrease in the total overactive bladder symptom score by at least three points. Thirty-nine patients (37.5%) were considered to have overactive bladder, and improvement in overactive bladder after urethroplasty was found in 30 (76.9%). Maximum flow rate on uroflowmetry, postvoid residual urine volume, lower urinary tract symptoms total score, and total overactive bladder symptom score were all significantly improved after urethroplasty (P < 0.0001 for all variables). There was a positive correlation between changes in lower urinary tract symptoms total score and total overactive bladder symptom score (Spearman's correlation 0.48, P < 0.0001). Multivariate logistic regression analysis showed that greater change in lower urinary tract symptoms score was an independent predictor of improvement in overactive bladder (odds ratio 1.30, 95% confidence interval 1.06-1.59; P = 0.002). Overactive bladder is prevalent in patients with anterior urethral stricture, and can be effectively improved after urethroplasty. Improvement of voiding symptoms are key for improving overactive bladder symptoms.

Relationships between overactive bladder and cerebral white matter hyperintensity in outpatients at a memory clinic.

Cerebral small vessel disease and lower urinary tract symptoms are common in older people. However, the association between white matter hyperintensity (WMH) and overactive bladder (OAB) is not fully understood. We aimed to identify the relationship between WMH and OAB. We carried out neuropsychological testing and head magnetic resonance imaging (T2-weighted and fluid-attenuated inversion recovery) of 72 outpatients at a memory clinic and evaluated their Overactive Bladder Symptom Score. WMH was assessed using the Fazekas scale, and WMH volumes were determined using Software for Neuro-Image Processing in Experimental Research. OAB was diagnosed based on a urinary urgency score (the third question of the Overactive Bladder Symptom Score) of two or higher and a total Overactive Bladder Symptom Score of three or higher. Multivariate logistic analysis was carried out, with the presence/absence of overactive bladder as the outcome variable, and age, sex, body mass index and diabetes mellitus as covariates. Of the 72 participants, 17 (24%) were diagnosed with OAB. WMH assessed by the visual rating scale was not associated with OAB. However, participants with OAB showed significantly higher WMH volume than those without OAB. Regionally, participants with OAB showed high WMH volume in the frontal, occipital and parietal lobes. Multiple logistic regression analysis showed that WMH was significantly associated with OAB (OR 1.82, 95% CI 1.11-2.98), after adjustment for clinically important confounders. Cerebral WMH volume is associated with OAB, independent of age, sex, body mass index and diabetes mellitus. Geriatr Gerontol Int 2021; 21: 996-1002.

MP29-15 COVID-19 ASSOCIATED CYSTITIS (CAC): INCREASED URINARY SYMPTOMS AND BIOMARKERS OF INFLAMMATION IN URINE IN PATIENTS WITH ACUTE COVID-19

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II (MP29)1 Sep 2021MP29-15 COVID-19 ASSOCIATED CYSTITIS (CAC): INCREASED URINARY SYMPTOMS AND BIOMARKERS OF INFLAMMATION IN URINE IN PATIENTS WITH ACUTE COVID-19 Michael B. Chancellor, Melissa Wills, Ryan Timar, Sarah N. Bartolone, Nevedita Dhar, Sorabh Dhar, Dragana Komnenov, and Laura E. Lamb Michael B. ChancellorMichael B. Chancellor More articles by this author , Melissa WillsMelissa Wills More articles by this author , Ryan TimarRyan Timar More articles by this author , Sarah N. BartoloneSarah N. Bartolone More articles by this author , Nevedita DharNevedita Dhar More articles by this author , Sorabh DharSorabh Dhar More articles by this author , Dragana KomnenovDragana Komnenov More articles by this author , and Laura E. LambLaura E. Lamb More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002026.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Emerging evidence suggests that the bladder is one of many organs are targeted by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which contributes significantly to Coronavirus Disease 2019 (COVID-19) morbidity and leads to organ-specific complications. We were the first U.S. group to identify severe and bothersome de novo genitourinary symptoms in patients with confirmed SARS-CoV-2 infection, termed COVID-19 Associate Cystitis (CAC). We then sought to determine if this was associated with pro-inflammatory cytokines in the urine of patients. METHODS: With IRB approval, hospital discharged COVID-19 patients with normal renal function (N=53) and asymptomatic controls (N=12) completed an AUA Urology Care Foundation Overactive Bladder (OAB) Assessment Tool to determine their current urinary symptoms (score of 0 to 25, increasing severity) and provided a urine sample. Urine samples were tested for SARS-CoV-2 using PCR, CRP by ELISA, and pro-inflammatory cytokines using Luminex assays following manufacturer’s instructions. RESULTS: The median total OAB symptom score in both men and women with COVID-19 was 18 (range 4-21). The median total QOL score for both men and women with COVID-19 was 19 (range 8-24). Median age was 64.5 (range 47-82). Symptoms of CAC include increased urinary frequency, urgency, nocturia, and pain or pressure upon voiding. These symptoms were not due to urinary tract infection, acute renal injury, prostatitis, or urinary retention. These symptoms have caused worsening QOL in CAC patients, and nocturia the most bothersome symptom. The majority of COVID-19 patients did not have virus in their urine. The levels of GRO/CXCL-1, IL-6, IP-10, and CRP were significantly increased in urine samples from COVID-19 patients compared to controls. CONCLUSIONS: COVID-19 patients reported severe de novo genitourinary symptoms, most notably an increase in urgency, frequency, and nocturia. SARS-CoV-2 infection results in increased expression of proinflammatory biomarkers in the urine. The variance between individuals may reflect the severity and duration of their disease, and/or the presence of comorbidities. This data supports that COVID-19 patients, especially those with CAC, have increased inflammatory cytokines in the urine. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e496-e496 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael B. Chancellor More articles by this author Melissa Wills More articles by this author Ryan Timar More articles by this author Sarah N. Bartolone More articles by this author Nevedita Dhar More articles by this author Sorabh Dhar More articles by this author Dragana Komnenov More articles by this author Laura E. Lamb More articles by this author Expand All Advertisement PDF downloadLoading ...

Triple Therapy with Tamsulosin, Dutasteride, and Imidafenacin for Benign Prostatic Hyperplasia in Patients with Overactive Bladder Symptoms Refractory to Tamsulosin: Subgroup Analyses of the DIrecT Study

Aim: To verify if the efficacy of the triple therapy with tamsulosin, dutasteride, and imidafenacin (TDI) is influenced by any background characteristics in patients with overactive bladder (OAB). Methods: A subanalysis of data from the DIrecT study was conducted. Superiority of TDI over tamsulosin and dutasteride in terms of efficacy based on the Overactive Bladder Symptom Score (OABSS), total International Prostate Symptom Score (IPSS), IPSS quality of life index, and postvoid residual (PVR) was evaluated in binary subgroups. Results: In the treatment groups, there was a significant interaction of total OABSS with testosterone level (≥4.8 vs. <4.8 ng/mL, p = 0.043) and PVR (≥20 vs. <20 mL, p = 0.018). For the total IPSS, no significant interaction was found except for the IPSS QOL index. For the IPSS QOL index, a significant interaction was found with testosterone level (≥4.8 vs. <4.8 ng/mL, p < 0.0001) as well as with total IPSS and total OABSS. For the PVR, no significant interaction was found except with total OABSS. Conclusions: Triple therapy with TDI is suggested to be a therapeutic option for benign prostatic hyperplasia in patients with residual OAB symptoms refractory to tamsulosin and in patients with various background characteristics regardless of severity of OAB symptoms. Trial Registry No. UMIN 000011980.

A 3‐year longitudinal survey of overactive bladder in community‐dwelling male residents aged 40 years and above

To evaluate the short-term evolution and risk factors of overactive bladder (OAB) in community-dwelling male residents aged 40 years and above in central Taiwan. This was a 3-year longitudinal cohort study. From January 2012 to December 2012, community residents aged 40 years and above, living in central Taiwan, were invited to participate in this study. A yearly Overactive Bladder Symptom Score (OABSS) questionnaire was used to assess the prevalence, incidence, remission, persistence, and relapse of OAB for three consecutive years. OAB was defined as total OABSS ≧4 and urgency score ≧2. Nine hundred forty-one male residents aged ≧40 years were recruited. The prevalence of OAB was 15%. The male residents with OAB were older, had a history of urological surgery, were unemployed, had lower educational levels, and lower yearly incomes compared with male residents without OAB. The prevalence increased with age when stratified into different age cohorts (40-49, 7%; 50-59, 12.7%; 60-69, 18.2%; ≧70, 32%; P < .001). Age ≧60 (odds ratio [OR] 2.58; 95% CI, 1.62-4.11) and history of urological surgery (OR 2.85; 95% CI, 1.29-6.30) were the major risk factors after multivariable logistic regression analysis. Eight hundred participants completed all the 3 years' questionnaires. The second- and third-year incidence rates of OAB were 10% (69/691) and 6.2% (42/674), respectively. The remission rates were 47.7% (52/109) and 46% (58/126), respectively. The two-year OAB persistence rate was 30.3% (33/109). The prevalence and yearly incidence of OAB are high in community-dwelling male residents aged ≧40 years in central Taiwan. Age is an important risk factor.

Excessive accumulation of visceral fat is associated with lower urinary symptoms including overactive bladder in female patients.

ObjectiveTo assess the relationship between visceral fat accumulation and lower urinary tract symptoms in female patients.MethodsIn this single‐center study, we enrolled all women who underwent screening abdominal computed tomography 3 months before the study, irrespective of whether they experienced lower urinary tract symptoms. The Overactive Bladder Symptom Score was used to assess subjective symptoms. Uroflowmetry and ultrasound assessment of post‐void residual urine were carried out to assess objective signs. We analyzed the relationship between lower urinary tract symptoms and various body fat accumulation parameters, including visceral fat area, visceral fat volume and total abdominal fat volume, assessed using computed tomography scans.ResultsA total of 182 patients were divided into the overactive bladder (n = 71, 39.0%) and the non‐overactive bladder (n = 111, 61.0%) groups. The visceral fat area, visceral fat volume and visceral fat volume/total abdominal fat volume values were all significantly higher in the overactive bladder group than in the non‐overactive bladder group (P < 0.001). Of these parameters, the visceral fat volume/total abdominal fat volume ratio showed the strongest correlation with the total Overactive Bladder Symptom Score (r = 0.394, P < 0.001). The maximum urine flow rate correlated negatively with the visceral fat volume/total abdominal fat volume value (visceral fat volume/total abdominal fat volume r = –0.289, P < 0.001). Subsequent multivariate analysis showed that a high visceral fat volume/total abdominal fat volume value, age and metabolic syndrome‐related diseases were independent risk factors for the presence of overactive bladder.ConclusionsExcessive accumulation of visceral fat is independently associated with overactive bladder in females.