Total Overactive Bladder Symptom Score Research Articles

Nocturia Improvement With Surgical Correction of Sleep Apnea.

PurposeTo evaluate changes in nocturia after surgical correction of obstructive sleep apnea (OSA).MethodsA total of 66 patients were included in the present study. All had been diagnosed with OSA syndrome by polysomnography and underwent uvulopalatopharyngoplasty (UPPP). Preoperative and postoperative lower urinary tract symptoms (LUTS), quality of life (QoL), and nocturia episodes were evaluated using the International Prostate Symptom Score (IPSS) and overactive bladder symptom score (OABSS) questionnaires. Three months postoperatively, telephone interviews were performed to determine the success of surgery, current LUTS, and nocturia episodes. Patients were divided into surgical success and failure groups. Surgical success was defined as snoring decrease more than 50% based on the patient’s subjective judgment.ResultsThe response rate was 56% and success rate was 73%. In all patients, nocturia episodes significantly decreased from 1.7±1.1 to 0.8±1.2 (P=0.002). Mean IPSS score, OABSS score, and QoL scores were also significantly improved. The success group showed a significant decrease in nocturia episodes, and total IPSS, OABSS, and QoL scores. However, the failure group did not show significant changes in all parameters.ConclusionsOSA correction improved nocturia as well as other LUTS. These improvements were not observed in the failure group. This study shows that OSA is a cause of nocturia and that other LUTS and nocturia can be improved by surgical correction of OSA.

Comparison of mirabegron and imidafenacin for efficacy and safety in Japanese female patients with overactive bladder: A randomized controlled trial (COMFORT study).

To evaluate the efficacy and safety of mirabegron compared with imidafenacin for the treatment of female patients with overactive bladder. Patients (n = 89) were randomized to receive 0.1 mg imidafenacin twice daily (n = 47) or 50 mg mirabegron once daily (n = 42) for 12 weeks. The primary efficacy end-point was change in total Overactive Bladder Symptom Score. Secondary efficacy end-points included change in Overactive Bladder Symptom Score, 3-day micturition diary, International Prostate Symptom Score and Overactive Bladder Questionnaire. Safety assessments included adverse events, vital signs, post-void residual volume and patient-reported incidence, and severity of distinctive symptoms related to adverse events. The mirabegron group showed a significantly reduced mean total Overactive Bladder Symptom Score from baseline, but no significant differences were noted in change of total Overactive Bladder Symptom Score compared with the imidafenacin group. Significant improvements in secondary efficacy end-points were observed regarding the mean number of micturitions/24 h, mean number of urgency episodes/24 h, mean number of incontinence episodes/24 h, mean volume voided/micturition, total International Prostate Symptom Score and quality of life in both groups, with no significant differences between the groups. The overall incidence of adverse events and the incidence of dry mouth were significantly higher in the imidafenacin group than in the mirabegron group. Patient-reported incidence and the severity of dry mouth were significantly exacerbated in the imidafenacin group. Treatment with 50 mg mirabegron once daily effectively relieves overactive bladder symptoms in women with fewer adverse events than treatment with antimuscarinics.

Comparison of Silodosin and Naftopidil for Efficacy in the Treatment of Benign Prostatic Enlargement Complicated by Overactive Bladder: A Randomized, Prospective Study (SNIPER Study)

We investigated the efficacy of 2 α1-blockers with different affinities for the α1-adrenoceptor subtypes silodosin and naftopidil in the treatment of benign prostatic enlargement complicated by overactive bladder. This was a prospective, open label, randomized, multicenter study of 350 outpatients with untreated benign prostatic enlargement associated with urinary urgency at least once per week and an OABSS (Overactive Bladder Symptom Score) of 3 or greater. Patients were randomly assigned to receive silodosin 8 mg per day or naftopidil 75 mg per day. Changes in parameters from baseline to 4 and 12 weeks were assessed based on I-PSS (International Prostate Symptom Score), I-PSS quality of life, OABSS and voiding functions measured by uroflowmetry. On efficacy analysis a total of 314 patients were included in the 2 groups. No significant difference in adverse effects was observed between the groups. Mean I-PSS and I-PSS quality of life scores, and OABSS significantly improved in both groups. Statistically significantly greater improvement in the silodosin group than in the naftopidil group was observed in total OABSS (p = 0.03), I-PSS quality of life score (p = 0.005) and OABSS urgency score (p <0.001) at 12 weeks. In regard to voiding function the maximum urinary flow rate showed significant improvements in both groups but the change in the maximum flow rate in the silodosin group at 12 weeks was significantly greater than in the naftopidil group (3.6 vs 2.1 ml per second). Silodosin, a pure α1A-adrenoceptor blocker, showed greater improvement in overactive bladder symptoms along with the urinary flow rate in patients with benign prostatic enlargement complicated by overactive bladder compared to naftopidil, an α1D>A-adrenoceptor blocker.

The efficacy of mirabegron additional therapy for lower urinary tract symptoms after treatment with α1-adrenergic receptor blocker monotherapy: prospective analysis of elderly men.

BackgroundMirabegron is a β3-adrenoreceptor agonist developed for treatment of overactive bladder (OAB). α1-Adrenergic receptor blockers are effective for lower urinary tract symptoms (LUTS) in male patients. However, the efficacy of mirabegron additional treatment in elderly male patients with persistent male LUTS, especially in OAB after monotherapy with α1-adrenergic blockers, is not fully understood.MethodsThis study was conducted in male LUTS patients who were ≥ 65 years of age and had persistent OAB symptoms, regardless of whether they took an α1-adrenergic receptor blocker orally. Before and 12 weeks after mirabegron additional therapy (50 mg once daily), we evaluated the efficacy of this treatment using the Overactive Bladder Symptom Score (OABSS) and International Prostate Symptom Score (IPSS), and changes in the maximum flow rate (Qmax) and post-void residual urine volume (PVR). We evaluated patients overall and divided into two groups by age: young-old (from 65 to 74 years old) and old-old (from 75 to 84 years old).ResultsFifty men were enrolled in this study. Mirabegron additional therapy improved the total OABSS, total IPSS, and IPSS-quality of life (QOL) score. The voided volume (VV) and Qmax improved after treatment in patients overall. However, there was no significant change in PVR. The total OABSS, total IPSS, and IPSS-QOL score significantly improved in both of the young-old and old-old groups. However, a significant increasing of VV was detected in the young-old group. There were no significant differences in the Qmax or PVR in either group.ConclusionsMirabegron additional therapy was effective for male patients whose persistent LUTS and particularly OAB was not controlled with α1-adrenergic receptor blocker monotherapy, and mirabegron did not have negative effects on voiding function. Additionally, mirabegron additional therapy was considered effective regardless of patient age.Trial registrationTrial registration number (TRN) trial registration number (TRN) and date of registration: ISRCTN16759097 in July 8, 2016.

Association between obesity and lower urinary tract symptoms: propensity score matching study between healthy controls and obese patients seeking bariatric surgery

BackgroundTo date, the association between obesity and lower urinary tract symptoms (LUTS) is controversial. ObjectiveTo overcome the current inconsistent results regarding the association between obesity and LUTS and to investigate the association between obesity and LUTS using propensity score matching analysis. SettingBariatric center of excellence and health promotion center at university hospital. MethodsFrom August 2012 to December 2014, a total of 260 obese patients (77 men and 180 women) visited to our bariatric center to undergo bariatric surgery. Patients’ International Prostate Symptom Score (IPSS) and overactive bladder symptom score were compared with those of 844 healthy controls who had visited our health center during the same period. To control for the effects of age, 1:1 propensity score matching was used. ResultsAfter matching propensity score forage, 73 male patients and 176 female patients were included in our study. In men, all IPSS items except “frequency” were significantly different between obese patients and controls; median scores were higher in the obese group. In women, all IPSS items except “feeling of incomplete emptying” were significantly different between the 2 groups. Both voiding and storage subscores also had marked differences in both genders (P<.001). Total IPSS, quality of life, and total overactive bladder symptom score were significantly different in both genders (P< .001). ConclusionThere were marked differences in LUTS between obese and nonobese patients, including in voiding and storage symptoms. Considering the relatively young age of both groups, this case-control study supports the hypothesis of a relationship between obesity and bladder pathophysiology.

Persistence of solifenacin therapy in patients with overactive bladder in the clinical setting: a prospective, multicenter, observational study.

The aim of this study was to evaluate the persistence with solifenacin therapy over a 12-month period in patients with overactive bladder (OAB). This is a 52-week long, multicenter, prospective, observational study. The subjects were individuals ≥18years old with OAB symptoms for ≥3months, characterised by a total OAB Symptom Score (OABSS) of ≥3 and OABSS urgency item score of ≥2. Patients were prescribed 5mg or 10mg of solifenacin once daily for OAB symptoms. Drug persistence, reasons for discontinuation and factors related to the persistence were evaluated. A total of 1018 patients (329 men, 689 women) with a mean age of 59years were included. The 52-week drug persistence rate was 22.1%. The drug persistence rates at 12, 24 and 36weeks were 72.4%, 45.8% and 31.1% respectively. The three most common reasons for discontinuing therapy included symptom improvement in 30.4%, lack of efficacy in 13.4%, and a switch to another antimuscarinic agent in 10.8%. Older patients (odds ratio=1.02, 95% CI: 1.01-1.04), and female patients (odds ratio=1.94, 95% CI: 1.37-2.75) were more likely to continue the medication over the 12-month period than were younger, male patients. The number of nocturia episodes was negatively correlated with drug persistence (odds ratio=0.83, 95% CI: 0.71-0.97). There was low persistence (22%) to solifenacin therapy for OAB symptoms over a 12-month period. Older patients, female patients and those with fewer episodes of nocturia were more persistent to therapy than were others.

Drug persistence and compliance affect patient-reported outcomes in overactive bladder syndrome.

To evaluate persistence and compliance for patients receiving antimuscarinics for overactive bladder (OAB), and to assess patient-reported outcomes (PROs) according to persistence and compliance. This was a 24-week, multicenter, prospective, observational study that included 952 OAB patients who had newly started antimuscarinics. Patients aged ≥18years with a total OAB Symptom Score (OABSS) ≥3 and an urgency score of OABSS ≥2 were eligible for the study. Drug persistence and compliance were evaluated at 4, 12, and 24weeks. Changes in scores on PROs were compared between groups (persistence vs. non-persistence and compliance vs. non-compliance) after 24weeks. Factors contributing to persistence were examined using multivariate logistic regression. After 24weeks, 56.8% of patients remained on treatment. The persistence rates were 85.6 and 71.4% after 4 and 12weeks, respectively. The compliance rates were 75.6, 53.8, and 34.3% after 4, 12, and 24weeks, respectively. Patients who were persistent in taking antimuscarinics resulted in significant improvements in OABSS and OAB questionnaire short form score compared with those who were non-persistent (all p<0.05). Changes from baseline in OABSS (p=0.735) and the EuroQoL five-dimensions score (p=0.384) were not significantly different between compliant and non-compliant groups. Predictors of high persistence included older age (OR 1.017, p=0.007) and dry OAB (OR 1.422, p=0.013). Patients who were persistent with antimuscarinics showed significant improvements in PROs compared to those who were non-persistent.

A Slow Stream Is Pathophysiologically Related to a Poor Response to α1-Adrenoceptor Therapy in the Treatment of Storage Symptoms Associated With Benign Prostatic Hyperplasia

To investigate the etiology of overactive bladder (OAB) symptoms during secondary treatment following initial unsuccessful therapy with α1-blockers in benign prostatic hyperplasia (BPH)/OAB patients. BPH/OAB patients were selected if urinary urgency did not improve with initial α1-blocker therapy and if dose escalation was required as secondary treatment for a period of 8 weeks. The overactive bladder symptom score (OABSS), International Prostate Symptom Score (IPSS), and uroflowmetry were evaluated. On the basis of the OABSS at the end of secondary therapy, we divided patients into two groups: patients in whom OAB symptoms improved ("resolved OAB group") and patients in whom OAB symptoms persisted ("persistent OAB group"). Differences in subjective symptoms and objective parameters between the groups were analyzed. OAB symptoms improved in 33 of 79 patients (42%) after secondary treatment. The changes in the total OABSS and International Prostate Symptom Score from the beginning of the secondary treatment were -2.15 and -3.97, respectively, in the resolved OAB group, indicating a significant decrease in the OABSS compared to that in the persistent OAB group (-0.91 and -1.11, respectively). The change in average flow rate (Qave; +1.34) from the beginning of secondary treatment in the resolved OAB group was significantly greater than the change in the persistent OAB group (+0.58). Improvements in urgency and Qave were significantly correlated (r = -0.264, P = .031). Improvement in urinary stream contributed to the resolution of OAB symptoms in BPH/OAB patients. In the management of OAB symptoms in BPH/OAB patients, examination and therapy for both urinary stream and OAB symptoms could be substantially important.

Does Postoperative Leukocyturia Influence Treatment Outcomes After Photoselective Vaporization of the Prostate (PVP)? A Prospective Short-Term Serial Follow-Up Study

To identify serial changes in the incidence of leukocyturia after photoselective laser-vaporization of the prostate (PVP), to determine whether postoperative leukocyturia could be associated with surgical outcomes, and to identify predictors of persistent leukocyturia after PVP. A total of 102 men without leukocyturia on baseline urinalysis but underwent PVP were included in this prospective study. Treatment outcomes were assessed at 1 week, and 1, 3, 6, and 12 months postoperatively using International Prostate Symptom Score, Overactive Bladder Symptom Score (OABSS), uroflowmetry, postvoid residual, urinalysis, urine culture, and serum prostate-specific antigen (PSA). The incidences of leukocyturia and dysuria at 1 week, and 1, 3, and 6 months postoperatively were 100.0%, 51.0%, 19.6%, and 0.0% and 30.3%, 25.4%, 5.9%, and 0.0%, respectively. Only one case of bacteriuria occurred throughout the entire follow-up period. At 1 month postoperatively, decrease in subtotal storage symptoms score, quality-of-life index, and total OABSS in patients without leukocyturia were significantly greater than in those with leukocyturia. At 3 months postoperatively, patients without leukocyturia showed greater improvement in subtotal storage symptoms score, total OABSS, quality-of-life index, bladder voiding efficiency, and postvoid residual compared with those with leukocyturia. On logistic regression analysis, age, PSA, prostate size, and amount of energy utilized were independent predictors of persistent leukocyturia 3 months after surgery. Leukocyturia is observed in all patients immediately after PVP, but its incidence decreases with time. It may have adverse effects on treatment outcomes. Also, older age, higher serum PSA, larger prostate size, and greater amount of energy utilized may be risk factors of persistent leukocyturia.

Effect of the Continuous Positive Airway Pressure on the Nocturnal Urine Volume or Night-time Frequency in Patients With Obstructive Sleep Apnea Syndrome

To evaluate the effect of continuous positive airway pressure (CPAP) treatment on nocturnal urine volume, night-time urine frequency, and quality of life (QOL) in patients with obstructive sleep apnea syndrome (OSAS). Ninety-eight participants with suspicious diagnosis of OSAS were prospectively enrolled in this study. Before polysomnography, measurement of the International Prostate Symptom Score-QOL score, the Overactive Bladder Symptom score (OABSS), the International Consultation on Incontinence Modular Questionnaire-Nocturia QOL were carried out to evaluate the lower urinary tract symptoms. During polysomnography, nocturnal urine volume and night-time urine frequency were recorded, and the concentrations of electrolytes in urine were determined. OSAS was confirmed in 92 patients, and 63 patients started to undergo CPAP treatment. Change in lower urinary tract symptoms-related QOL was assessed 1month after CPAP treatment in 51 patients. Additionally, urine was collected at the time of CPAP titration in 25 patients. CPAP treatment significantly improved night-time frequency, which resulted in the improvement of total IPSS and QOL score. The night-time frequency questionnaire in OABSS similarly decreased, although total OABSS scores were not significantly improved. The International Consultation on Incontinence Modular Questionnaire-Nocturia QOL showed no significant changes after CPAP treatment. In addition to the night-time frequency, nocturnal urine volume and urine electrolyte contents significantly decreased after CPAP treatment. CPAP treatment decreases night-time urine frequency by reducing nocturnal urine volume and improves QOL in OSAS patients.

A prospective, observational study to assess the association between dry mouth and solifenacin treatment in patients with overactive bladder syndrome.

Dry mouth is among the most common side effects of antimuscarinic therapy. This study evaluated the drug-related change in dry mouth after the solifenacin treatment and the impact of dry mouth on the drug efficacy against overactive bladder syndrome (OAB). OAB patients (n = 331) were enrolled in a prospective, multicenter, 8-week observational study of solifenacin treatment. Participants were >20 years of age and presented with OAB symptoms for ≥3 months, a total overactive bladder symptom score (OABSS) of ≥3, and an urgency score of ≥2. Primary endpoints were changes in dry mouth according to baseline dry mouth status using Xerostomia Inventory (XI) and the effect of dry mouth to the drug efficacy according to improvements in the OABSS. Three hundred and thirty-three patients were initially screened for the study, with 331 actually enrolled. One hundred and ninety-four patients completed the study. Mean total XI scores increased by 2.8 points in the entire patient population, with larger increases for patients stratified into the non-dry mouth group (NDG) versus the dry mouth group (DG) (4.0 vs. 1.9, p = 0.015) at study baseline. Mean total OABSSs decreased by 3.2 points, with no significant differences between the NDG and the DG (-3.4 vs. -3.0 points, p = 0.578). The dry mouth aggravated in 71 patients (29.2 %) (NDG 30.1 % and DG 27.1 %), but only 10/331 individuals (3.0 %) stopped medication due to xerostomia. Dry mouth progressed in approximately 30 % of the OAB patients, regardless of its presence before solifenacin treatment. However, OAB symptoms were well relieved by solifenacin, and the adverse influence of dry mouth on drug persistence was low.

Psychometric Validation of the English Version of the Overactive Bladder Symptom Score

To assess the psychometric properties of the English version of the overactive bladder symptom score (OABSS) among overactive bladder (OAB) patients in the United States. The reliability and validity of the OABSS were examined using data collected online from OAB patients residing in the United States. A total of 199 patients responded to the first questionnaire administration. Of those, 149 completed the second questionnaire. The results of the reliability assessment indicated that the intraclass correlation coefficient of the total OABSS score was 0.74 (weighted kappa coefficients of individual item score, 0.55-0.84) and that the Cronbach α coefficient was 0.56. In the analysis of the validity, the OABSS total score was correlated with all the external criteria (symptom bother of the overactive bladder questionnaire, patient perception of bladder condition, and International Prostate Symptom Score) to a moderate to strong degree. The results of known-group validity showed that the OABSS score tended to increase as the symptom severity increased (trend test; P<.0001). The present study demonstrated the reliability and validity of the English version of the OABSS. It is expected that the English version of the OABSS will be useful in clinical studies and medical practice among English-speaking OAB patients.

Impact of symptom improvement on patients' bother and quality of life in female patients with overactive bladder treated by solifenacin (SET-Q)

To analyze the relationship between symptom improvement and health-related quality of life in female overactive bladder patients treated with solifenacin. We carried out a prospective, multicenter, open-label study. Eligible patients were treatment-naive female patients with overactive bladder, with an urgency episode at least once a week. Symptoms were quantitatively assessed by the Overactive Bladder Symptom Score, and quality of life by the Overactive Bladder questionnaire. Changes of symptom severity, bother, and quality of life were assessed at baseline and 12 weeks after treatment with solifenacin 5, 7.5 or 10 mg once daily. Data from 523 patients (mean age 66 years) were analyzed. Solifenacin significantly improved the total Overactive Bladder Symptom Score and also all subscores for the four symptoms (daytime frequency, urgency, night-time frequency and urgency incontinence). Solifenacin also significantly improved the four quality of life subscales, total quality of life and symptom bother scores of the Overactive Bladder questionnaire. The severity of night-time frequency at baseline positively affected the improvement in the quality of life subscale of Sleep, and the severity of daytime frequency at baseline positively affected the improvement of coping and social interaction. Improvement of severity in various symptoms positively affected the improvement of bother and the quality of life subscales. Solifenacin provides an overall improvement of bother and quality of life in female overactive bladder patients. Symptom severity before treatment and improvement of symptom severity seem to variably affect this improvement.

Clinical Efficacy and Safety of Imidafenacin as Add-on Treatment for Persistent Overactive Bladder Symptoms Despite α-Blocker Treatment in Patients With BPH: The ADDITION STUDY

To evaluate the effects of add-on treatment with an anticholinergic (imidafenacin) on persistent overactive bladder (OAB) symptoms despite α-blocker (tamsulosin) treatment in patients with benign prostatic hyperplasia (BPH). Patients with BPH≥50 years old, with urinary urgency at least once per week and total OAB symptom score (OABSS)≥3 points after≥8-week treatment with tamsulosin were enrolled in a multicenter, open-label study (not double-blinded). Patients were randomized to receive tamsulosin (0.2 mg/day) alone or tamsulosin (0.2 mg/day)+ imidafenacin (0.1 mg 2 times a day). Primary endpoint was 12-week change in OABSS; secondary endpoints were changes in OABSS, International Prostate Symptom Score (IPSS), micturition time chart (MTC), hours of undisturbed sleep (HUS), and quality of life (IPSS-QOL and BPH impact index [BII]). For statistical analysis, a mixed-effects model and t test were used. In total, 308 men were enrolled. The change from baseline to 12 weeks in total OABSS was significantly greater with add-on imidafenacin than tamsulosin alone (2.11, 95% confidence interval [CI] 1.47-2.74, P<.0001). Improvements in frequencies of daytime urination, nighttime urination, urinary urgency, urgency incontinence, IPSS, HUS, IPSS-QOL, and BII, were significantly greater from 4 weeks through 12 weeks in the imidafenacin group. Between-group difference in postvoid residual volume at 12 weeks was not significant (-1.74 mL, 95% CI -8.19 to 4.72), and no events of urinary retention were reported. Combined tamsulosin and imidafenacin treatment is effective and safe in patients with BPH with persistent OAB symptoms after tamsulosin monotherapy. Furthermore the combination treatment improved the QOL in BPH patients with OAB.

Ramelteon combined with an α1-blocker decreases nocturia in men with benign prostatic hyperplasia

BackgroundNocturia is defined as waking one or more times during the night due to the urge to void. Recently, the effectiveness of several sedatives and analgesics for nocturia has been reported. We herein investigated the effects of ramelteon, an antioxidant and sleep inducer, on nocturia unresponsive to α1-blocker monotherapy in males with lower urinary tract symptoms (LUTS) as a pilot study.MethodsSubjects were 19 patients who had LUTS suggestive of benign prostate hyperplasia, received α1-blockers (tamsulosin, silodosin, or naftopidil), and continued to have two or more episodes of nocturia per night before starting ramelteon. Ramelteon at 8 mg once daily for one month was added to the α1-blocker. A self-administered questionnaire including the International Prostate Symptom Score (IPSS), quality of life (QoL) index, Overactive Bladder Symptom Score (OABSS), and Nocturia Quality-of-Life Questionnaire (N-QOL) were assessed before and one month after starting ramelteon.ResultsThe mean score on IPSS question 7 (nocturia) decreased significantly from 2.88 before starting ramelteon to 2.41 one month after starting the medication (P = 0.03). The mean total OABSS decreased significantly from 6.31 to 5.38 (P = 0.03), and the mean for OABSS question 2 (nighttime frequency of nocturia) also significantly decreased from 2.63 to 2.13 (P = 0.01). The mean total N-QOL score did not change significantly. Two patients had dizziness; the remaining patients had no adverse drug-related events.ConclusionsRamelteon in combination with an α1-blocker could be a treatment option for reducing nocturia in men with BPH.

Reproducibility study of Overactive Bladder Symptom Score questionnaire and its response to treatment (RESORT) in Korean population with overactive bladder symptoms

The Overactive Bladder Symptom Score (OABSS) is comprised of 4 items with a single total score for quantification of OAB symptoms and has been reported as sensitive to treatment-related changes. The aim of this study was to assess the psychometric properties of the Korean version in patients with OAB symptoms. Two prospective trials were conducted at two teaching hospitals. The Part I study evaluated the internal consistency and test-retest reliability among 42 enrolled patients, and the Part II trial assessed the construct validity and anticholinergic responsiveness in 50 enrolled patients and 50 controls. Internal consistency was found acceptable, with Cronbach's α of 0.73 for total OABSS score. From a 2-week test-retest, Spearman's rho of each item ranged from 0.53 to 0.82, and the intraclass correlation coefficient of the total score was 0.80, showing the high stability. Acceptable discriminant validity was demonstrated, with substantially different correlations of OABSS scores with an International Prostate Symptom Score-storage and voiding score sum, and significant differences between patients and controls. Convergent validity was acceptable, with moderate correlations between each OABSS item and the corresponding 3-day frequency-volume chart variables. The Korean version was found considerably responsive to symptom changes following 12-week solifenacin treatment, as judged by moderate or large effect sizes, standardized response means, and the Guyatt Responsiveness Index. With good psychometric properties and responsiveness, the Korean version of the OABSS may offer researchers and clinicians a valid and reliable measure for the assessment of OAB symptoms in the Korean population.

Higher glycosylated hemoglobin levels increase the risk of overactive bladder syndrome in patients with type 2 diabetes mellitus

To assess overactive bladder and its component symptoms among patients with type 2 diabetes mellitus and to explore whether higher glycosylated hemoglobin and other factors increase the risk of overactive bladder symptoms. A total of 279 diabetes mellitus patients from our outpatient clinic, and 578 age- and sex-matched subjects without diabetes mellitus from public health centers were enrolled from May to September of 2010. The collected data included overactive bladder and its component symptoms measured by using the Overactive Bladder Symptom Score, and collecting demographic and clinical data. Overactive bladder was defined as total Overactive Bladder Symptom Score ≥3 and urgency score ≥2 (once a week or more). Diabetes mellitus patients had a significantly higher proportion of overactive bladder symptoms/urgency compared with the controls (28.0% vs 16.3%, odds ratio 2.03, 95% confidence interval 1.44-2.86), as well as nocturia (48.0% vs 39.1%, odds ratio 1.44, 95% confidence interval 1.08-1.93). There were no significant effects of diabetes mellitus on urge urinary incontinence (14.0% vs 10.9%, odds ratio 1.32, 95% confidence interval 0.86-2.04) and daytime frequency (26.9% vs 32.4%, odds ratio 0.77, 95% confidence interval 0.56-1.05). After adjusting for all variables, high glycosylated hemoglobin levels were significantly associated with overactive bladder/urgency (odds ratio 1.24, 95% confidence interval 1.06-1.45), urge urinary incontinence (odds ratio 1.20, 95% confidence interval 1.00-1.45) and nocturia (odds ratio 1.17, 95% confidence interval 1.01-1.35). Patients with type 2 mellitus present more overactive bladder symptoms/urgency and nocturia than controls. Among diabetic patients, higher glycosylated hemoglobin level represents an independent predictor of overactive bladder /urgency, urge urinary incontinence and nocturia.

Development and validation of the Chinese Overactive Bladder Symptom Score for assessing overactive bladder syndrome in a RESORT study

This study aimed to develop and validate the Chinese Overactive Bladder Symptom Score (OABSS) for assessing overactive bladder (OAB) symptoms and compare it with a 3-day bladder diary. The Chinese OABSS was developed by linguistic validation of the original version. Its reliability and validity and correlations with a 3-day bladder diary were tested on patients with OAB in a multicenter study conducted in Taiwan (the RESORT study). A total of 60 patients with OAB, either incontinent (OAB wet, n=31) or continent (OAB dry, n=29), were enrolled consecutively in this study. The test-retest reliability of the Chinese OABSS was moderate to good, with weighted kappa coefficients of 0.515-0.721 for each symptom score and 0.610 for the total symptom score. Each symptom score correlated positively with the total OABSS (Spearman's rho 0.365-0.793) and was internally consistent (Cronbach's alpha 0.674). The distribution of the OABSS showed a clear separation between OAB wet (average 11.4, range 7-15) and OAB dry (average 7.97, range 4-10) subgroups (Wilcoxon exact test, p<0.05). In addition, the OABSS items correlated positively with the corresponding bladder diary variables (Spearman's rho 0.504-0.879) and the degrees of agreement improved with study visits except for nighttime frequency. The Chinese OABSS tended to underestimate the frequency of nighttime voiding. The Chinese OABSS has been developed and validated as a reliable instrument for assessing OAB symptoms. OABSS can be an alternative to, but not a replacement for, a 3-day bladder diary for assessing patients.

Randomized, Single-Blind, Parallel Study of the Effectiveness and Safety of Solifenacin versus Propiverine in the Treatment of Overactive Bladder.

To compare the effectiveness and safety of solifenacin versus propiverine in the treatment of overactive bladder (OAB), in a single-blind, randomized parallel study. Sixty-six patients with OAB (14 men and 52 women) were randomly assigned to groups: solifenacin (5 mg/day) or propiverine (20 mg/day) and treated for 8 weeks. The primary outcome variable was mean change from baseline to end of treatment in urgency of the OAB symptom score (OABSS). Secondary outcomes were bladder diary variables: change over 24 h in the mean number of voids (daytime and nighttime), episodes of micturition urgency and incontinence, and mean volume voided. Patients also completed total OABSS and the King's Health questionnaires. Group backgrounds were comparable except for the male to female proportion; 11:22 for solifenacin (n = 33) versus 3:30 for propiverine (n = 33). Adverse events were 6 of 29 (21%) for solifenacin versus 14 of 26 (54%) for propiverine (P = 0.017). Three patients were withdrawn for voiding difficulty (one in solifenacin and two in propiverine) and one patient for dry mouth (propiverine group). Change in OABSS urgency score was -2.3 ± 1.4 for solifenacin (n = 28) versus -1.3 ± 1.7 for propiverine (n = 23), (P = 0.0169). Total OABSS and other individual scores, and voiding diary parameters for both drugs showed improvements; however, between-group difference was not established. Although both solifenacin 5 mg and propiverine 20 mg were effective in the treatment of OAB, solifenacin appeared to be more effective and tolerable.

Prevalence and factors associated with overactive bladder and urinary incontinence in community-dwelling Taiwanese

ObjectiveTo assess the prevalence of and factors associated with overactive bladder (OAB) and urinary incontinence (UI) in the Taiwanese community. Materials and MethodsA cross-sectional design with a participant-administered questionnaire was used in 1011 adults who voluntarily visited any of the four public health centers in Pingtung County, Taiwan, for physical examinations from March to July 2010. Participants who were 40 years of age or older, who agreed to participate, and who were free of severe disabilities related to hearing, vision, speaking, and walking were included in the study. OAB was defined as “urgency” at least once a week and a total overactive bladder symptom score of three or more, while UI was defined as involuntary urine leakage at least once a week. People with an active urinary tract infection (UTI) or had a new onset of UTI symptoms (dysuria, frequency, hesitancy, flank pain) within 4 weeks prior to the study, which could interfere with lower urinary tract function, were excluded from this study. ResultsOAB was reported by 19.8% of participants (n=195; women, 18.7%; men, 19.9%), while UI was reported by 19.5% (n=197; women, 23.0%; men, 15.5%). OAB was significantly associated with heart disease, stroke, constipation, and UTI in the previous year. UI was significantly associated with constipation and UTI in the previous year. ConclusionsSeveral chronic illnesses coexisted with OAB and UI. Healthcare providers need to be aware of an increased risk of OAB or UI among people with certain chronic illnesses, and provide appropriate healthcare.