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Zeng X, Liu MZ, Shen SH, Yang SQ, Zhang J, Shen H, Luo DY, Jin T. The design and evaluation of a quick checklist for urodynamic quality control: A prospective single-center small sample study. Neurourol Urodyn 2024; 43:382-389. [PMID: 38078752 DOI: 10.1002/nau.25357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/23/2023] [Accepted: 11/29/2023] [Indexed: 02/06/2024]
Abstract
PURPOSE To design a quick checklist for urodynamic study (UDS), aiming to reduce the occurrence of errors in the process, which may help to increase the quality of UDS. And further to analyze the effectiveness of this quick checklist for UDS quality control. METHODS First, a quick checklist for uroflow study and pressure-flow study was developed, based on the International Continence Society-Good Urodynamic Practice standards, our previous studies, and recent literature, as well as expert suggestions. Then, patients who underwent UDS between January 2023 to February 2023 were randomly assigned to a study group or a control group. For the study group, the quick checklist was used throughout the UDS process, while the control group did not. The main artefacts were chosen to verify the effectiveness of the quick checklist for improving the UDS quality. RESULTS The quick checklist comprised three subtypes: checklist for patients, checklist for environment and device, and checklist for UDS test process. 38 UDS traces per group were included. The incidence of missing the standard cough test decreased significantly from 18.4% to 0 (p = 0.012), with the checklist implementation. The baseline drift frequency rate also declined significantly from 39.5% to 5.3% (p < 0.05). Volume < 150 mL on uroflow study occurred in 68.4% of cases and its frequency rate decreased significantly with checklist implementation (p < 0.05). CONCLUSION A quick checklist for quality control of UDS was developed. The quick checklist as a convenient, quick, and easy used urodynamic quality control method, may help to reduce the technical artefacts and improve fundamental urodynamic quality control. Future research with a larger sample size is needed to confirm the effectiveness of the checklist.
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Affiliation(s)
- Xiao Zeng
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- Pelvic Floor Diseases Center, West China Tianfu Hospital, Sichuan University, Chengdu, China
| | - Meng-Zhu Liu
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Si-Hong Shen
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Shi-Qin Yang
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Zhang
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- Pelvic Floor Diseases Center, West China Tianfu Hospital, Sichuan University, Chengdu, China
| | - Hong Shen
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- Pelvic Floor Diseases Center, West China Tianfu Hospital, Sichuan University, Chengdu, China
| | - De-Yi Luo
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- Pelvic Floor Diseases Center, West China Tianfu Hospital, Sichuan University, Chengdu, China
| | - Tao Jin
- Laboratory of Reconstructive Urology, Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
- Pelvic Floor Diseases Center, West China Tianfu Hospital, Sichuan University, Chengdu, China
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Kosilov K, Kuzina I, Kuznetsov V, Barabash O, Fedorishcheva E. Efficacy of a combination of dutasteride, tadalafil, and solifenacin in the treatment of previously unsuccessful patients. Asian J Urol 2022; 9:42-50. [PMID: 35198395 PMCID: PMC8841250 DOI: 10.1016/j.ajur.2021.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/15/2020] [Accepted: 09/09/2020] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of simultaneous administration of dutasteride, tadalafil and solifenacin in the treatment of benign prostatic hyperplasia (BPH) with overactive bladder symptoms and lower urinary tract obstruction in previously unsuccessfully treated men. METHODS Patients in Group A (n=97) received dutasteride 0.5 mg/day, tadalafil 2.5 mg/day, and solifenacin 2.5 mg/day; Group B (n=95) received dutasteride 0.5 mg/day, tadalafil 5 mg/day, and solifenacin 5 mg/day; Group C (n=103) received dutasteride 0.5 mg/day, tadalafil 20 mg/day, and solifenacin 10 mg/day. The functional status of the lower urinary tract was assessed using the International Prostate Symptom Score (I-PSS), Overactive Bladder Questionnaire (OABq), International Index of Erectile Function (IIEF), and Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD) as well as uroflowmetry. RESULTS The total score of the sexual function remained unchanged in Group B of patients 81.3 points vs. 80.2 points (p>0.05) according to MSHQ-EjD, 61.4 points vs. 51.2 points (p>0.05) according to IIEF data. The total assessment of symptoms of hyperactivity significantly decreased in Group C according to OABq data after the 4th week of the study (17.5 points vs. 26.1 points, p<0.05) and remained below the baseline until the end of the study (15.2 points). CONCLUSIONS The simultaneous administration of standard doses of dutasteride, solifenacin, and tadalafil for 3 months is safe, effective, and can be recommended for patients with BPH to reduce symptoms of obstruction and hyperactivity of the bladder and maintain sexual function.
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Affiliation(s)
- Kirill Kosilov
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation,Department of Clinical Medicine, School of Medicine, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation,Corresponding author. Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation.
| | - Irina Kuzina
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky region, Russian Federation
| | - Vladimir Kuznetsov
- Department of Public Health, Pacific State Medical University, Vladivostok, Primorsky region, Russian Federation
| | - Olga Barabash
- Department of Physical Culture and Health and Sports Work, Vladivostok State University of Economics and Service, Vladivostok, Primorsky region, Russian Federation
| | - Ekaterina Fedorishcheva
- Department of Public Health, Pacific State Medical University, Vladivostok, Primorsky region, Russian Federation
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Doyle E, Brettkelly J, Buhler R, Lovett T, O’Neil L, Aldabe D. Reliability and validity of outcome measures used for urinary incontinence in patients with stroke: a narrative review. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1832709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Emma Doyle
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Jake Brettkelly
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Rebecca Buhler
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Tim Lovett
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Luke O’Neil
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Daniela Aldabe
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Kosilov KV, Kuzina IG, Kuznetsov V, Kosilova EK. Improvement of the symptoms of lower urinary tract and sexual dysfunction with tadalafil and solifenacin after the treatment of benign prostatic hyperplasia with dutasteride. Prostate Int 2020; 8:78-84. [PMID: 32647644 PMCID: PMC7335965 DOI: 10.1016/j.prnil.2019.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/29/2019] [Accepted: 11/18/2019] [Indexed: 11/21/2022] Open
Abstract
Background The aim of this research is to study the influence of simultaneous taking of tadalafil and solifenacin in standard and double dosage on the lower urinary tract symptoms (LUTS) and sexual dysfunction in men with benign prostatic hyperplasia after the course of dutasteride. Materials and methods The research included 326 patients older than 50 years with benign prostatic hyperplasia coupled with LUTS and sexual dysfunction having undergone the course of treatment with dutasteride. After random division into three groups, patients from the Group A (n = 107) got tadalafil 5 mg/d as monotherapy, from the Group В (n = 107) got tadalafil 5 mg/d and solifenacin 10 mg/d, and from the Group С (n = 112) got tadalafil 5 mg/d and solifenacin 20 mg/d. The duration of treatment was 12 weeks. The rating of sexual function was made with the questionnaires International Index of Erectile Function and other. Results The results of rating of sexual function with the questionnaires MSHQ-EjD and International Index of Erectile Function correlated among themselves. According to MSHQ-EjD, overall rating of the sexual function increased in each of the three groups (A: 67.9 (12.4)/91.5 (10.4), P ≤ 0.05; B: 72.4 (14.5)/102.6 (16.9), P ≤ 0.05; C: 76.6 (16.3)/109.6 (15.6), P ≤ 0.05). The level of hyperactivity symptoms decreased in Groups В and С (В: urgency −2.9 (0.7)/1.1 (0.6), P ≤ 0.05; nocturia 2.7 (1.0)/0.7 (0.5), P ≤ 0.05; C: urgency −2.5 (0.5)/0.8 (0.6), P ≤ 0.05; nocturia −2.8 (0.6)/1.0 (0.5), P ≤ 0.05), and it did not change in the Group A. Conclusions The use of tadalafil as monotherapy significantly improves the sexual function but does not affect overactive bladder symptoms. The combination therapy of tadalafil and solifenacin leads to dramatic improvement of sexual function and reversibility of detrusor hyperactivity symptoms.
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Affiliation(s)
- Kirill V Kosilov
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
| | - Irina G Kuzina
- Department of Social Science, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
| | - Vladimir Kuznetsov
- Department of Public Health, Pacific State Medical University, Vladivostok, Primorsky Region, Russian Federation
| | - Ekaterina K Kosilova
- Pacific State Medical University, Vladivostok, Primorsky Region, Russian Federation
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Mitchell P, Nightingale J, Reeves P. Competence to capability: An integrated career framework for sonographers. Radiography (Lond) 2019; 25:378-384. [PMID: 31582248 DOI: 10.1016/j.radi.2019.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Within the United Kingdom sonographers, with ultrasound as their core role, currently have a primary registration as a radiographer or another health professional. Entering with masters level qualifications, and often exhibiting a higher career banding, the sonographer career structure does not align comfortably with the existing health professional frameworks. This study aimed to explore the attitudes and opinions of a sample of practicing sonographers concerning a potential graduate sonographer role and the development of a clinical competence framework required to provide a skills escalator. METHODS A qualitative study using an interpretative framework was undertaken using semi-structured interviews. A homogeneous sample population of ten participants was selected using theoretical purposive sampling. The interview transcripts were thematically analyzed and coded. RESULTS The themes of implementing change and clinical frameworks were identified along with a sub-theme of clinical competence boundaries. All participants found it challenging to identify a role or clinical competences that a band 5/graduate sonographer could undertake, though more suggestions were offered for a band 6 sonographer. CONCLUSION Whilst, within the literature, clinical competences were agreed to provide the cornerstone for defining clinical roles there was some dispute as to the appropriateness of the use of core clinical competences for defining the scope of practice of health professionals above entry level to the profession. The data collected in this study demonstrated that there were skills development between graduate, specialist, advanced and consultant practitioners. Participants were focussed on clinical skills rather than wider capability skills. It is recommended that in order for advanced practice sonographers to map to the new ACP framework less focus on competence and a greater consideration of capabilities is required.
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Affiliation(s)
- P Mitchell
- Sheffield Hallam University, Sheffield, South Yorkshire, SB10 2BQ, England, UK.
| | - J Nightingale
- Sheffield Hallam University, Sheffield, South Yorkshire, SB10 2BQ, England, UK.
| | - P Reeves
- Sheffield Hallam University, Sheffield, South Yorkshire, SB10 2BQ, England, UK.
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Kosilov K, Loparev S, Kuzina I, Kosilova L, Prokofyeva A. Socioeconomic status and health-related quality of life among adults and older with overactive bladder. Int J Qual Health Care 2019; 31:289-297. [PMID: 30107414 DOI: 10.1093/intqhc/mzy163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 05/20/2018] [Accepted: 07/11/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To study the effect of socioeconomic status (SES) on health-related quality of life (HRQoL) among persons with overactive bladder (OAB). DESIGN A randomized HRQoL study was conducted from the year 2014 until the year 2016 based on the OAB pathology department of the regional clinical diagnostics center. SETTING The medical institutions where the study was conducted had outpatient care. PARTICIPANTS The simple response frequency was 81%. A total of 1893 men and women with OAB aged 35-85 (average 58.3 years) were selected by blind random sampling. Included into the group of examined individuals were persons who diagnosis provided after the examination was OAB. INTERVENTION Evaluation of HRQoL was conducted using the SF-6D questionnaire. The OAB diagnosis was confirmed using the OAB-questionnaire and uroflowmetry. MAIN OUTCOME MEASURE(S) We hypothesized that the impact of SES on the HRQoL of patients with OAB has significant features. RESULTS Described for the first time were HRQoL measures in various SES levels within different ages of people suffering from OAB. The strongest relationship was identified between education level, professional activity and HRQoL measures; meanwhile the weakest relationship was between income and HRQoL measures. We also confirmed the efficiency of evaluating HRQoL while using SF-6D and SRH as an external standard. CONCLUSION The improvement of HRQoL in persons with OAB is contingent upon increment in their level of awareness about the methods of OAB treatment and the effectiveness of treatment for severe symptoms of LUT pathology, increased social support and, possibly, physical activity.
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Affiliation(s)
- Kirill Kosilov
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation.,Department of Fundamental of Medicine, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
| | - Sergay Loparev
- Department of Urology, City Polyclinic No. 3, Vladivostok, Russian Federation
| | - Irina Kuzina
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
| | - Liliya Kosilova
- Department of the Functional Methods of Examination, Med. Association No. 2 of Vladivostok-City, Vladivostok, Russian Federation
| | - Alexandra Prokofyeva
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
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Kosilov K, Kuzina I, Kuznetsov V, Gainullina Y, Kosilova L, Karashchuk E, Prokofyeva A, Loparev S. The Risk of Sexual Dysfunction and Effectiveness of Treatment of Benign Prostatic Hyperplasia With Severe Lower Urinary Tract Dysfunction With Combination of Dutasteride and Solifenacin. J Sex Med 2018; 15:1579-1590. [DOI: 10.1016/j.jsxm.2018.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 11/16/2022]
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Kosilov KV, Loparev SA, Kuzina IG, Shakirova OV, Gainullina YI, Kosilova LV, Prokofyeva AS. A new tool for self-evaluation of adherence to antimuscarinic drugs treatment in patients with urinary incontinence. Arab J Urol 2017; 15:372-379. [PMID: 29234543 PMCID: PMC5717450 DOI: 10.1016/j.aju.2017.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/02/2017] [Accepted: 10/07/2017] [Indexed: 11/18/2022] Open
Abstract
Abstract objective To evaluate the validity of the Medication Adherence Self-Report Inventory (MASRI) questionnaire in determining antimuscarinic drugs adherence in patients with urinary incontinence (UI). Patients and methods In all, 629 patients [355 (56.4%) women and 274 (43.6%) men], aged 18-65 years, were included. All patients were prescribed antimuscarinic drugs and treatment adherence was tested at the start, and after 4, 8 and 12 weeks using the MASRI. The standard of external monitoring was the Brief Medication Questionnaire (BMQ) and visual count of the remaining pills. The functional status of the lower urinary tract was tested using voiding diaries and uroflowmetry. Results The correlation between indicators of adherence according to the MASRI and screen mode of the BMQ was r = 0.84 (P ≤ 0.01), r = 0.72 (P ≤ 0.01), r = 0.7 (P ≤ 0.05) at 4, 8 and 12 weeks of follow-up, respectively, which indicated a satisfactory competitive validity. In the study of the discriminant validity, we found that non-adherent patients were correctly identified according to the MASRI in 96.2%, 96.9% and 96.2% of cases at 4, 8 and 12 weeks of follow-up, respectively. The values of the positive likelihood ratio (7.92, 10.81, and 12.8 at 4, 8 and 12 weeks of follow-up, respectively) were quite acceptable for the adherence forecast. The receiver operating characteristic analysis revealed a failure of the null hypothesis of the excess/insufficient discrimination power of the MASRI. The correlation between the percentage of non-adherent patients and the percentage of patients with impaired lower urinary tract function according to uroflowmetry data was r = 0.55 (P ≤ 0.05) at 4 weeks; r = 0.59 (P ≤ 0.05) at 8 weeks; and r = 0.62 (P ≤ 0.01) at 12 weeks. Conclusion The MASRI questionnaire is highly constructive, competitive, has discriminant validity, and is suitable for self-assessment of treatment adherence in patients with UI taking antimuscarinics. Using the MASRI is less costly and faster compared with other assessment tools.
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Affiliation(s)
- Kirill V. Kosilov
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
- Department of Public Helth, Pacific Medical State University, Vladivostok, Russian Federation
- Corresponding author. Fax: +7 (4232) 457 693.
| | - Sergay A. Loparev
- Department of Urology, City Polyclinic № 3, Vladivostok, Russian Federation
| | - Irina G. Kuzina
- Department of Social Science, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
| | - Olga V. Shakirova
- Department of Theory and Methods of Adaptive Physical Education, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
| | - Yuliya I. Gainullina
- Department of Social Sciences, School of Humanities, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
| | - Liliya V. Kosilova
- Department of Functional Methods of Examination, Med. Association № 2 of Vladivostok City, Vladivostok, Russian Federation
| | - Alexandra S. Prokofyeva
- Department Social Science, Far Eastern Federal University, Vladivostok, Primorsky Region, Russian Federation
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Kosilov K, Loparev S, Kuzina I, Kosilova L, Ivanovskaya M, Prokofyeva A. Effectiveness of a new tool for self-evaluation of adherence to antimuscarinic drug treatment in older patients of both sexes with urge incontinence. Geriatr Gerontol Int 2017; 18:115-122. [PMID: 28921819 DOI: 10.1111/ggi.13150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 06/08/2017] [Accepted: 06/27/2017] [Indexed: 02/05/2023]
Abstract
AIM The present study was a comparison of the validity of the Medication Adherence Self-Report Inventory (MASRI) questionnaire with other methods of assessing adherence to antimuscarinic drugs treatment in older patients with urge incontinence. METHODS The experiment involved 733 men and women aged >65 years who had noted no less than one urge incontinence episode per day. At the beginning of the experiment, and after 4, 8 and 12 weeks, their adherence to treatment was monitored using the MASRI. RESULTS The construct validity of the tool was confirmed by data on the correlation of the percentage of non-adherent patients according to the MASRI and the percentage of patients having a belief barrier on the Brief Medication Questionnaire screen (r = 0.89, P ≤ 0.01; r = 0.91, P ≤ 0.01; and r = 0.91, P ≤ 0.05 at the 4th, 8th and 12th week of the follow up). The hypothesis of competitive validity was supported by comparing the percentage of non-adherent patients according to the MASRI and the number of missed doses on the Brief Medication Questionnaire screen (r = 0.94, P ≤ 0.01; r = 0.85, P ≤ 0.05; and r = 0.7, P ≤ 0.05), and according to a visual count of pills. The area under the curve at the 4th, 8th , and 12th week was 0.95 ± 0.04, 0.92 ± 0.03 and 0.94 ± 0.04, respectively. CONCLUSION The MASRI questionnaire has high validity, and is effective for evaluating adherence to treatment among older patients with urge incontinence taking antimuscarinic drugs. Using the MASRI would imply lower costs and greater availability of diagnostics, and it is the tool of choice in clinical practice. Geriatr Gerontol Int 2018; 18: 115-122.
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Affiliation(s)
- Kirill Kosilov
- Department of Social and Psychological Science, Far Eastern Federal University, Vladivostok, Russian Federation, Russia.,Department of Public Health, Pacific State Medical University, Vladivostok, Russian Federation, Russia
| | - Sergay Loparev
- Department of Urology, City Polyclinic № 3, Vladivostok, Russian Federation, Russia
| | - Irina Kuzina
- Department of Social and Psychological Science, Far Eastern Federal University, Vladivostok, Russian Federation, Russia
| | - Liliya Kosilova
- Department of Functional Diagnostics, Medical Association, № 2, Vladivostok, Russian Federation, Russia
| | - Marina Ivanovskaya
- Department of Law, Far Eastern Fisheries University, Vladivostok, Primorsky Region, Russia
| | - Alexandra Prokofyeva
- Department of Social and Psychological Science, Far Eastern Federal University, Vladivostok, Russian Federation, Russia
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Kosilov K, Loparev S, Kuzina I, Shakirova O, Zhuravskaya N, Lobodenko A. Self-assessment of treatment compliance with antimuscarinic drugs and lower urinary tract condition among women with urinary incontinence. Int Urogynecol J 2017; 28:1663-1669. [PMID: 28429053 DOI: 10.1007/s00192-017-3333-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 03/29/2017] [Indexed: 11/26/2022]
Abstract
AIM Our aim was to determine the efficiency of the Medication Compliance Self-Report Inventory (MASRI) in self-reporting antimuscarinic drug treatment compliance among women with urinary incontinence (UI). MATERIALS AND METHODS The study assessed 347 women aged 18-65 (averaging 49.7) years with more than one urinary incontinence (UI) episode per day. Treatment compliance was tested at the beginning and at weeks 4, 8, and 12 using the MASRI, the Brief Medication Questionnaire (BMQ), and visual pill counts. The MASRI's constructive, concurrent, and discriminate validity was studied in comparison with an external standard that uses the chi-square and Spearman coefficient. Receiver operating characteristic (ROC) analysis was performed to identify optimum MASRI cutoffs that would predict noncompliance. Furthermore, the functional condition of the lower urinary tract was tested using voiding diaries, uroflowmetry, and cystometry. RESULT The correlation between the percentage of noncompliant women according to the MASRI, and individuals with a belief barrier with respect to the BMQ screen was r = 0.81 (p ≤0.05), r = 0.84 (p ≤0.05), and r = 0.79 (p ≤0.05). The correlation between the percentage of noncompliant women according to the MASRI and of women who missed >20% of their doses according to the Regimen Screen of the BMQ was r = 0.79, p ≤0.05, r = 0.82, p ≤0.01, r = 0.77, and p ≤0.05 at the control points. Finally, the percentage of noncompliant patients who self-reported correctly according to the MASRI data compared with the BMQ was 95.6%, 95.7%, and 96.6% at the control points. CONCLUSION The MASRI entails acceptable validity for accurately predicting treatment compliance with antimuscarinic drugs among women who have had UI for >3 months.
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Affiliation(s)
- Kirill Kosilov
- Department of Social and Psychologikal Science, Far Eastern Federal University, Ayax, 10, F733, Vladivostok, Primorsky Region, Russian Federation.
| | - Sergey Loparev
- Department of Urology, City Polyclinic № 3, Lugivaya 50, Vladivostok, Russian Federation
| | - Irina Kuzina
- Department of Social and Psychologikal Science, Far Eastern Federal University, Ayax, 10, F733, Vladivostok, Primorsky Region, Russian Federation
| | - Olga Shakirova
- Department of Theory and Methods of Adaptive Physical Education, Far Eastern Federal University, Ayax, 10, S1, Vladivostok, Russian Federation
| | - Natalya Zhuravskaya
- Department of Theory and Methods of Adaptive Physical Education, Far Eastern Federal University, Ayax, 10, S1, Vladivostok, Russian Federation
| | - Alexandra Lobodenko
- Department of Social and Psychologikal Science, Far Eastern Federal University, Ayax, 10, F733, Vladivostok, Primorsky Region, Russian Federation
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Rosier PF, Schaefer W, Lose G, Goldman HB, Guralnick M, Eustice S, Dickinson T, Hashim H. International Continence Society Good Urodynamic Practices and Terms 2016: Urodynamics, uroflowmetry, cystometry, and pressure-flow study. Neurourol Urodyn 2016; 36:1243-1260. [DOI: 10.1002/nau.23124] [Citation(s) in RCA: 257] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 05/13/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Peter F.W.M Rosier
- Department of Urology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Werner Schaefer
- Department of Medicine (Geriatrics); University of Pittsburgh; Pittsburgh Pennsylvania
| | - Gunnar Lose
- University of Copenhagen Herlev Hospital; Herlev Denmark
| | - Howard B. Goldman
- Glickman Urologic and Kidney Institute Cleveland Clinic; Lerner College of Medicine; Cleveland Ohio
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Caffeine as a Probable Factor for Increased Risk of OAB Development in Elderly People. Curr Urol 2016; 9:124-131. [PMID: 27867329 DOI: 10.1159/000442866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 08/11/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This study was conducted to compare overactive bladder (OAB) prevalence among people greater than 60 years of age who intake various doses of caffeine, as well as those who abstain from caffeine. PATIENTS AND METHODS A randomized observational study was carried out in Vladivostok Gerontological Hospital. A total of 1,098 retired people greater than 60 years of age (659 women and 439 men, average age 67.1 years) took part in the study. They were admitted to the in-patient department with the purpose of annual physical examination performed in accordance with the order of the Ministry of Public Health of the Russian Federation. People over age 60, who at the moment of examination were in satisfactory health condition, were included into the study. People in which OAB had been detected or who used to take antimuscarinic were excluded from the study. Assessment tools for examining the patients' lower urinary tract condition were as follows: OAB-q SF, urination diaries, and uroflowmetry. RESULTS In the course of the experiment conducted, we found that 1/3 of people, both men and women greater than 60 years of age, who did not previously seek medical advice due to urination troubles, had symptoms of detrusor overactivity. These symptoms were moderate and did not bother patients too much in most cases (63.4%). It was also found that most patients consumed no more than 300mg caffeine with beverages per day, with 30% and 10% of patients suffering from OAB or severe detrusor overactivity, respectively. At the same time, almost 50% of patients taking more than 300 mg of caffeine per day suffer from OAB. CONCLUSION 48.1% of people over 60 years of age suffering from overactive detrusor symptoms consume greater than 300 mg caffeine daily, which is significantly higher than that of their peers who do not intake excessive amounts of caffeine.
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Affiliation(s)
- Kirill V Kosilov
- School of Humanities, Far Eastern Federal University, Vladivostok, Russia
| | - Sergay A Loparev
- Department of Urology, Urologist of City Polyclinic № 3, Vladivostok, Russia
| | | | - Liliya V Kosilova
- Department of the Functional Methods of Examination, Med. Association № 2 of Vladivostok-sity, Vladivostok, Russia
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Hilton P, Armstrong N, Brennand C, Howel D, Shen J, Bryant A, Tincello DG, Lucas MG, Buckley BS, Chapple CR, Homer T, Vale L, McColl E. INVESTIGATE-I (INVasive Evaluation before Surgical Treatment of Incontinence Gives Added Therapeutic Effect?): a mixed-methods study to assess the feasibility of a future randomised controlled trial of invasive urodynamic testing prior to surgery for stress urinary incontinence in women. Health Technol Assess 2015; 19:1-273, vii-viii. [PMID: 25714493 DOI: 10.3310/hta19150] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The position of invasive urodynamic testing in the diagnostic pathway for urinary incontinence (UI) is unclear. Systematic reviews have called for further trials evaluating clinical utility, although a preliminary feasibility study was considered appropriate. OBJECTIVES To inform the decision whether or not to proceed to a definitive randomised trial of invasive urodynamic testing compared with clinical assessment with non-invasive tests, prior to surgery in women with stress UI (SUI) or stress predominant mixed UI (MUI). DESIGN A mixed-methods study comprising a pragmatic multicentre randomised pilot trial; economic evaluation; survey of clinicians' views about invasive urodynamic testing; qualitative interviews with clinicians and trial participants. SETTING Urogynaecology, female urology and general gynaecology units in Newcastle, Leicester, Swansea, Sheffield, Northumberland, Gateshead and South Tees. PARTICIPANTS Trial recruits were women with SUI or stress predominant MUI who were considering surgery after unsuccessful conservative treatment. Relevant clinicians completed two online surveys. Subsets of survey respondents and trial participants took part in separate qualitative interview studies. INTERVENTIONS Pilot trial participants were randomised to undergo clinical assessment with non-invasive tests (control arm); or assessment as controls, plus invasive urodynamic testing (intervention arm). MAIN OUTCOME MEASURES Confirmation that units can identify and recruit eligible women; acceptability of investigation strategies and data collection tools; acquisition of outcome data to determine the sample size for a definitive trial. The proposed primary outcome for the definitive trial was International Consultation on Incontinence Modular Questionnaire (ICIQ) Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) (total score) 6 months after surgery or the start of non-surgical treatment; secondary outcomes included: ICIQ-FLUTS (subscales); ICIQ Urinary Incontinence Short Form; ICIQ Lower Urinary Tract Symptoms Quality of Life; Urogenital Distress Inventory; EuroQol-5D; costs, quality-adjusted life-years (QALYs) and incremental cost per QALY, Short Form 12; 3-day bladder diary. RESULTS Of 284 eligible women, 222 (78%) were recruited; 165/219 (75%) returned questionnaires at baseline and 125/200 (63%) who were sent questionnaires at follow-up. There were few missing data items in returned questionnaires, with individual outcome scales calculable for 81%-94%. Most women underwent surgery; management plans were changed in 19 (19%) participants following invasive urodynamic testing. Participant Costs Questionnaires were returned by 53% 6 months after treatment; complete data to undertake cost-utility analysis were available in 27% (intervention) and 47% (control). While insufficient to recommend changes in practice, the results suggest further research would be valuable. All clinicians responding to the survey had access to invasive urodynamic testing, and most saw it as essential prior to surgery in women with SUI with or without other symptoms; nevertheless, 70% considered the research question underlying INVESTIGATE important and most were willing to randomise patients in a definitive trial. Participants interviewed were positive about the trial and associated documentation; the desire of some women to avoid invasive urodynamic testing contrasted with opinions expressed by clinicians through both survey and interview responses. CONCLUSIONS All elements of a definitive trial and economic evaluation were rehearsed; several areas for protocol modification were identified. Such a trial would require to 400-900 participants, depending on the difference in primary outcome sought. FUTURE WORK A definitive trial of invasive urodynamic testing versus clinical assessment prior to surgery for SUI or stress predominant MUI should be undertaken. TRIAL REGISTRATION Current Controlled Trials ISRCTN71327395. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Paul Hilton
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Natalie Armstrong
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Catherine Brennand
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Denise Howel
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jing Shen
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew Bryant
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Douglas G Tincello
- Reproductive Sciences Section, Department of Cancer Studies & Molecular Medicine, University of Leicester, Leicester, UK
| | | | - Brian S Buckley
- School of Medicine, National University of Ireland, Galway, Ireland
| | | | - Tara Homer
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Vale
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine McColl
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
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Townsend J. Developing a nurse-led urodynamics clinic. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2015. [DOI: 10.1111/ijun.12090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Jacinta Townsend
- Counties Manukau District Health Board; Urology Auckland New Zealand
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. The efficacy of different doses of solifenacin in elderly patients after treating a urinary tract infection. Arab J Urol 2015; 13:203-8. [PMID: 26413348 PMCID: PMC4563008 DOI: 10.1016/j.aju.2015.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/29/2015] [Accepted: 07/02/2015] [Indexed: 11/05/2022] Open
Abstract
Objective To determine the efficacy and safety of solifenacin for correcting the residual symptoms of an overactive bladder (OAB) in patients who were treated for a urinary tract infection (UTI). Patients and methods Using random sampling, 524 patients aged >60 years were selected (347 women, 66.2%, and 177 men, 33.8%). They denied the presence of any symptoms of detrusor overactivity in their medical history, but had a diagnosis of a UTI. At least 1 month after the end of treatment and a laboratory confirmation of the absence of infection, each patient completed an OAB-Awareness Tool questionnaire (OAB signs, total score 8 points), and a noninvasive examination of urinary function (uroflowmetry). Each day patients in group A took solifenacin 10 mg and those in group B took 5 mg, with patients in group C being given a placebo. Results During the study 58.8% of patients had symptoms of an OAB at 1 month after the end of the treatment for a UTI, and normal laboratory markers. During treatment with the standard and higher dose of solifenacin, within 8 weeks most variables of the condition of the lower urinary tract reached a normal state or improved. Conclusion Patients aged >60 years who had been treated for a UTI have a high risk of developing symptoms of an OAB. Solifenacin in standard doses is an efficient and safe means of managing overactive detrusor symptoms after a UTI.
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Affiliation(s)
- Kirill V Kosilov
- School of Humanities, Far Eastern Federal University, Russian Federation
| | - Sergay A Loparev
- Department of Urology, City Polyclinic No. 3, Russian Federation
| | | | - Liliya V Kosilova
- Department of the Functional Methods of Examination, Medical Association No. 2 of Vladivostok City, Vladivostok, Primorsky Region, Russian Federation
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Influence of different doses of trospium and solifenacin on manageability of OAB symptoms with different severity in elderly men and women. JOURNAL OF CLINICAL UROLOGY 2015. [DOI: 10.1177/2051415815600970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective: We studied the rationale for using standard and increased dosages of solifenacin and trospium against overactive bladder (OAB) symptoms of different severity among elderly patients. Methods: A total of 327 patients took part in the study: 199 women and 128 men older than 65 years (median age 69.1). The state of the lower urinary tracts was estimated by cystometry, ICIQ-SF and bladder diaries. Frequency of urgency urinary incontinence (UUI) was taken as a criterion of OAB symptom severity. Result: Administration of double-dosed trospium and solifenacin leads to decrease of frequency of UUI both in the group with severe symptoms (B1: 6.1 (0.5) →2.4 (0.9), p ⩽ 0.05), and in the group with moderate symptoms of OAB (A1: 2.8 (0.8) →0.5 (0.4), p ⩽ 0.001). Under a combination of trospium and solifenacin in doses recommended by manufacturers, UUI decreased authentically in the group with moderate symptoms (A2: 2.9 (0.5) →0.9 (0.5), p ⩽ 0.05) and unauthentically in the group with severe symptoms of detrusor dysfunction (B2: 7.0 (1.2) → 4.3 (1.5), p ⩾ 0.05). During the experiment six patients (1.8%) elected not to participate because of intolerable adverse events. Forty-seven more individuals (14.4%) felt adverse effects, among which the most frequent were: xerostomia (15 patients or 4.6%), faintness (nine patients or 3.8%), dryness of integuments (six patients or 1.8%). Conclusion: A standard-dose combination of solifenacin and trospium in older patients with moderate symptoms of OAB enables a good therapeutic effect in a short time without increasing risk of side effects. High therapeutic doses of antimuscarinic drugs are reasonable for older men and women with severe symptoms of OAB. Increasing the dose of simultaneous use of solifenacin and trospium yields a good therapeutic effect to correct UUI; however, it raises the hazard of appearance of adverse effects. The number of side effects in the group of elderly individuals who were taking the combination of increased and standard dosages of solifenacin and trospium does not significantly differ.
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Affiliation(s)
- Kirill V Kosilov
- Far Eastern Federal University, Department of Social Sciences, Russian Federation
| | - Sergey A Loparev
- Department of Urology, City Polyclinic no. 3, Russian Federation
| | | | - Liliya V Kosilova
- Department of the Functional Methods of Examination, Med. Association no. 2 of Vladivostok-City, Russian Federation
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Effectiveness of Solifenacin and Trospium for Managing of Severe Symptoms of Overactive Bladder in Patients With Benign Prostatic Hyperplasia. Am J Mens Health 2015; 10:157-63. [DOI: 10.1177/1557988315595692] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This research is aimed to study the possibility of management of severe symptoms of overactive bladder (OAB) with solifenacin and trospium in patients who receive treatment with tamsulosin due to benign prostatic hyperplasia (BPH). The 338 men more than 50 years old (average age 58.4 years) diagnosed with BPH and severe symptoms of OAB were enrolled in the study. Over three episodes of urinary incontinence per day (registration according to bladder diaries), International Prostate Symptom Score over 19, OAB-V8 questionnaire score over 32, and urodynamic disorders diagnosed using cystometry and uroflowmetry were taken as a criterion of severe symptoms of OAB. Patients of the main group during 2 months received treatment with daily combination of solifenacin 5 mg and trospium 5 mg simultaneously with tamsulosin 0.4 mg. Patients of the control group were treated only with tamsulosin. First endpoint is a quantitative assessment of patients with BPH having severe symptoms of OAB. Second endpoint is a state of the patients’ lower urinary tract after the treatment. In the main group, most of urodynamic indices normalized significantly. Number of episodes of incontinence reduced from middle level 3.4 (0.8) per day to 0.9 (0.7) per day. In the control group changes of urodynamic indices were not significant. Quantity of side effects did not exceed the level which is common for antimuscarinic monotherapy. Therefore, percentage of patients with severe symptoms of OAB is not less than 44% of all cases of prostatic hyperplasia accompanied by OAB symptoms. Combination of trospium and solifenacin in standard doses is an efficient and safe method of management of severe symptoms of OAB in the course of the treatment of with tamsulosin in patients more than 50 years of age.
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Kosilov K, Loparev S, Ivanovskaya M, Kosilova L. A randomized, controlled trial of effectiveness and safety of management of OAB symptoms in elderly men and women with standard-dosed combination of solifenacin and mirabegron. Arch Gerontol Geriatr 2015; 61:212-6. [PMID: 26169181 DOI: 10.1016/j.archger.2015.06.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 06/09/2015] [Accepted: 06/11/2015] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Comparison of effectiveness and safety of solifenacin and mirabegron, as well as their combination, for managing heavy symptoms of overactive bladder. MATERIALS AND METHODS All patients who participated in the examination (average age: 71.2) were split into 4 groups. Patients included in Group А (n=63) were treated with mirabegron 50mg/day/6 weeks, in Group B (n=52)-with solifenacin 10mg/day/6 weeks, in Group С (n=65)-with the same doses of both drugs simultaneously/6 weeks, and in Group D (n=59)-with placebo. Monitoring was carried out using OAB-questionnaires, bladder diaries and urodynamic examination. RESULTS In elderly patients with initial frequency of episodes of incontinence (EI)≥3/day standard doses of mirabegron (50mg/day) and solifenacin 10mg/day administered during 6 weeks result with the decrease in frequency of EI with high correlation (r=0,74, p≤0.05); final results in both groups are significantly different from initial value of p≤0.05. In the group, where patients were taking both drugs simultaneously, final results significantly differ from both initial values of the parameters in these groups (EI: 5.1→1.6 per day, p≤0.01; urination: 9.1→5.3 per day, p≤0.01; post-void residual 19.4→29.9, p≤0.01) and final values in Groups A and B (p≤0.05). The percentage of side effects in this group does not significantly differ from that in the groups, where patients were receiving monotherapy. CONCLUSION Combined treatment for severe symptoms of OAB in elderly men and women with standard doses of solifenacin and mirabegron provides satisfactory therapeutic effect within short period of time without increasing the risk of side effects, which undoubtedly improves quality of life and self-esteem of patients. At the same time, taking any of these drugs separately for the treatment of severe malfunction of lover urinary tracts in elderly people may turn out to be insufficient for effective symptom management.
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Affiliation(s)
- Kirill Kosilov
- School of Humanities, Far Eastern Federal University, Primorsky Region, Ayax 10, F733 Vladivostok, Russian Federation.
| | - Sergay Loparev
- Department of Urology, City polyclinic No. 3, St. Lugovaya 55, Vladivostok, Russian Federation.
| | - Marina Ivanovskaya
- Far Eastern Fisheries University, St. Lugovaya 52a, Vladivostok, Russian Federation.
| | - Liliya Kosilova
- Department of the Functional Methods of Examination, Med. Association No. 2 of Vladivostok-sity, St. Prihodko 4a,Vladivostok, Russian Federation.
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Kosilov K, Loparev S, Kosilova L, Ivanovskaya M. Comparative effectiveness of combined high-dosed Trospium and Solifenacin for severe OAB symptoms in age-related aspect. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2015. [DOI: 10.1111/ijun.12076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Kirill Kosilov
- Far Eastern Federal University, Institute of Physical Health; Ayax 10 F733 Vladivostok Primorsky region Russian Federation
| | - Sergey Loparev
- City Polyclinic No 3; Department of Urology; Lugovaya-st. 55 Vladivostok Russian Federation
| | - Liliya Kosilova
- Far Eastern State University of Fishing; Lugovaya-st. 52b Vladivostok Russian Federation
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Kosilov K, Loparev S, Ivanovskaya M, Kosilova L. Additional correction of OAB symptoms by two anti-muscarinics for men over 50 years old with residual symptoms of moderate prostatic obstruction after treatment with Tamsulosin. Aging Male 2015; 18:44-8. [PMID: 25136746 DOI: 10.3109/13685538.2014.951922] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To study the effectiveness and safety of combined standard-dosed Solifenacin and Trospium for management of symptoms of overactive bladder (OAB) in elderly patients after the treatment with Tamsulosin. PATIENTS AND METHODS A total of 417 men over 50 years of age (average age 57.9 (8.3)) with diagnosed prostatic obstruction (score 8-19 according to I-PSS), who had not taken Tamsulosin before, were enrolled in the study. I-PSS questionnaire (from 8 to 19 - moderate) and Awareness Tool questionnaire for evaluating OAB symptoms (total score for OAB symptoms over 8) were used at the beginning and at the end of the observation. Also, urodynamic parameters were examined. RESULT Percentage of patients with prevalent symptoms of obstruction of urethra decreases after the treatment with Tamsulosin and then rises again (36.2%), but absolute number of patients remains smaller than initial data. Percentage of patients with relative prevalence of symptoms of overactive bladder slightly increases against administration of Tamsulosin and reaches initial values at the time of administration of anti-muscarinic drugs with absolute decrease in number of such patients. CONCLUSION Combination of Trospium and Solifenacin is an effective way to manage residual symptoms of hyperactive bladder during treatment of early obstruction of urinary bladder.
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Affiliation(s)
- Kirill Kosilov
- Department of Social Sciences, Far Eastern Federal University , Vladivostok , RUVVO Russian Federation
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Rantell A, Dolan L, Bonner L, Knight S, Ramage C, Toozs-Hobson P. Minimum standards for continence care in the UK. Neurourol Urodyn 2015; 35:400-6. [PMID: 25597395 DOI: 10.1002/nau.22717] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 11/05/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Angie Rantell
- Lead Nurse Urogynaecology; King's College Hospital; London UK
| | - Lucia Dolan
- Consultant Gynaecologist and Subspecialist in Urogynaecology; Belfast City Hospital; Belfast UK
| | - Liz Bonner
- Lead Nurse Bladder and Bowel service; Haringey, Whittington Health; London UK
| | - Stephanie Knight
- Principal Physiotherapist, Women's Health/Urodynamics; Airedale General Hospital; West Yorkshire UK
| | - Carmel Ramage
- Consultant Urogynaecologist; Bradford Royal Infirmary; West Yorkshire UK
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Randomized controlled trial of cyclic and continuous therapy with trospium and solifenacin combination for severe overactive bladder in elderly patients with regard to patient compliance. Ther Adv Urol 2014; 6:215-23. [PMID: 25435915 DOI: 10.1177/1756287214544896] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES The aim of the study was to increase the efficiency of treatment for severe symptoms of overactive bladder (OAB) with antimuscarinic drugs in elderly men and women. METHODS A total of 341 patients over 65 years of age (average age 69.9; 186 women and 155 men) with severe symptoms of OAB (frequency of incontinence episodes [IEs] ≥ 3/day) underwent examination. Patients were distributed into three main groups: A (n = 58; trospium 60 mg/day + solifenacin 20): three cycles, each cycle 8 weeks, with an 8-week interval; B (n = 55; trospium 30 mg/day + solifenacin 10), regimen was the same as in group A; C (n = 62; trospium 30 mg/day + solifenacin 10) daily during 1 year. RESULTS The most successful treatment for the clinical and urodynamic symptoms of OAB was observed in group A, without an increase in the quantity or intensity of side effects (IEs = 4.8 (0.9) → 1.4 (0.8); p ≤ 0.01). Groups B and C also demonstrated positive effects for most of the markers for lower urinary tract state with statistical significance p ≤ 0.01. Nonparametric correlation between decrease in IEs and relative number of patients who accurately fulfilled prescriptions was in group A, r = 0.53, p ≤ 0.05; in group B, r = 0.61; p ≤ 0.05; in group C, r = 0.55, p ≤ 0.05. CONCLUSIONS Cyclic therapy with two different spectrum antimuscarinics appears to be effective for controlling severe OAB in elderly patients. One-year cyclic therapy with a trospium and solifenacin combination provides a high compliance level (76-84%). However, continuous therapy with standard doses of trospium and solifenacin results in low adherence and high rates of treatment withdrawals (≥ 66%) despite satisfactory clinical and urodynamic results.
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Affiliation(s)
- Kirill V Kosilov
- Department of Adaptive Medicine, Humanities Institute of Social Sciences, Far Eastern Federal University, Ayax 10, corp. F-733, Vladivostok, Russian Federation
| | - Sergay A Loparev
- Department of Urology, City Polyclinic No. 3, Vladivostok, Russian Federation
| | | | - Liliya V Kosilova
- Department of the Functional Methods of Examination, Medical Association No. 2 of Vladivostok-sity, Vladivostok, Russian Federation
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Comparative Effectiveness of Combined Low- and Standard-Dose Trospium and Solifenacin for Moderate Overactive Bladder Symptoms in Elderly Men and Women. Urol Int 2014; 93:470-3. [DOI: 10.1159/000363658] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 05/15/2014] [Indexed: 11/19/2022]
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Kosilov K, Loparev S, Iwanowskaya M, Kosilova L. Effectiveness of combined high-dosed trospium and solifenacin depending on severity of OAB symptoms in elderly men and women under cyclic therapy. Cent European J Urol 2014; 67:43-8. [PMID: 24982780 PMCID: PMC4074719 DOI: 10.5173/ceju.2014.01.art9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 12/19/2013] [Accepted: 01/15/2014] [Indexed: 01/25/2023] Open
Abstract
MATERIAL AND METHODS 313 patients, 196 women and 117 men over 65 (average age 68.6) were included in this study. All patients underwent urodynamic examination before enrollment and after the study was completed. For clinical evaluation of LUT state ICIQ-SF questionnaires and bladder diaries were used. Patients with moderate (А, n = 155) and severe (В, n = 158) symptoms of OAB. Each group was divided into subgroups in which patients received Trospium 60 mg/day and Solifenacin 20 mg/day during two cycles - 1.5 and 1 month with one month interval (А1 and В1); subgroups in which second cycle was substituted with placebo (А2, В2), and control groups (А3, В3). RESULTS In groups with moderate symptoms of OAB ratio of patients demonstrated decrease of frequency of EI ≥1.5 a day remained at the level of 45-60% during all observation period. In subgroups with severe symptoms of OAB percentage of such patients was 55.3% for the subgroup which received two cycle therapy, and decreased to 26% in the subgroup which underwent 1 cycle therapy. Urodynamic indices for state of LUT correlated with clinical indicators (r =0.57-0.71 at p≤ 0.05). CONCLUSIONS Short single cycle of high-dosed Solifenacin and Trospium in elderly patients with moderate symptoms of OAB enables to maintain long therapeutic effect with acceptable level of side effects. This treatment algorithm applied in two cycle course is an effective and safe method for management of severe symptoms of OAB in elderly patients without increased risk of side effects.
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Affiliation(s)
| | - Sergey Loparev
- Department of Urology, City Hospital No. 3, Vladivostok, Russia
| | | | - Liliya Kosilova
- Department of Functional Diagnostics Medical Association No. 2, Vladivostok, Russia
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Kosilov K, Loparev S, Ivanovskaya M, Kosilova L. Maintenance of the therapeutic effect of two high-dosage antimuscarinics in the management of overactive bladder in elderly women. Int Neurourol J 2013; 17:191-6. [PMID: 24466467 PMCID: PMC3895512 DOI: 10.5213/inj.2013.17.4.191] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 12/03/2013] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To improve the long-term efficiency of the pharmacologic management of overactive bladder (OAB) in elderly women. METHODS The study comprised 229 women (mean age, 66.3 years; range, 65-77 years) with urodynamically and clinically confirmed OAB. All patients received the most effective treatment regimen based on the data obtained in the initial part of the study (trospium 60 mg/day + solifenacin 40 mg/day, for 6 weeks), and positive results similar to those in the first phase were obtained. They were then divided into four groups, based on the maintenance therapy: group A (59 women), trospium (60 mg/day) + solifenacin (40 mg/day) for 1 month; group B (51 women), electrical stimulation of the detrusor muscle for 1 month; group C (63 women), laser puncture for 1 month; group D (56 women), placebo. Maintenance therapy was administered 2.5 months after completion of primary treatment. The patients' condition was monitored through the OAB questionnaire for 1 year and by urodynamic examination at months 6 and 7 from the start of the study. RESULTS In group A, the clinical and urodynamic results achieved after the initial + main treatment phase (two high-dosage antimuscarinics of different generations, trospium and solifenacin, for a total of 2.5 months) were maintained for at least 7 months. Electrical stimulation of the urinary bladder as a method of maintenance therapy proved to be less effective. In groups C and D, deterioration in results was observed at 6-8 months, which led us to conclude that laser puncture was an inefficient method of maintenance therapy in elderly women with OAB. CONCLUSIONS Maintenance treatment of OAB in elderly women with a combination of high-dosage antimuscarinics is an effective method for reducing the risk of recurrence of the disease.
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Affiliation(s)
| | - Sergey Loparev
- Department of Urology, City Polyclinic No. 3, Vladivostok, Russia
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Giarenis I, Mastoroudes H, Srikrishna S, Robinson D, Cardozo L. Is there a difference between women with or without detrusor overactivity complaining of symptoms of overactive bladder? BJU Int 2013; 112:501-7. [DOI: 10.1111/j.1464-410x.2012.11652.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ilias Giarenis
- Department of Urogynaecology; King's College Hospital; London; UK
| | | | | | - Dudley Robinson
- Department of Urogynaecology; King's College Hospital; London; UK
| | - Linda Cardozo
- Department of Urogynaecology; King's College Hospital; London; UK
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Ellis-Jones J, Swithinbank L, Abrams P. The bridges and barriers to ‘good’ urodynamic practice: a regional perspective. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2013. [DOI: 10.1111/j.1749-771x.2012.01154.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Giarenis I, Phillips J, Mastoroudes H, Srikrishna S, Robinson D, Lewis C, Cardozo L. Radiation exposure during videourodynamics in women. Int Urogynecol J 2013; 24:1547-51. [DOI: 10.1007/s00192-013-2062-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 01/26/2013] [Indexed: 12/01/2022]
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