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Rocha AK, Monteiro S, Campos I, Volpato M, Verleun D, Valim L, Riccetto C, Botelho S. Isolated bladder training or in combination with other therapies to improve overactive bladder symptoms: a systematic review and meta-analysis of randomized controlled trials. Braz J Phys Ther 2024; 28:101102. [PMID: 39106788 PMCID: PMC11347853 DOI: 10.1016/j.bjpt.2024.101102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 11/23/2023] [Accepted: 07/11/2024] [Indexed: 08/09/2024] Open
Abstract
BACKGROUND Bladder training (BT), the maintenance of a scheduled voiding regime at gradually adjusted intervals, is a common treatment for overactive bladder (OAB). OBJECTIVES To assess the effects of isolated BT and/or in combination with other therapies on OAB symptoms. METHODS A systematic review of eight databases was conducted. After screening titles and abstracts, full texts were retrieved. Cochrane RoB 2 and the GRADE approach were used. RESULTS Fourteen RCTs were included: they studied isolated BT (n = 11), BT plus drug treatment (DT; n = 5), BT plus intravaginal electrical stimulation (IVES; n = 2), BT plus biofeedback and IVES (n = 1), BT plus pelvic floor muscle training and behavioral therapy (n = 2), BT plus percutaneous tibial nerve stimulation, and BT plus transcutaneous tibial nerve stimulation (n = 1). In a meta-analysis of short-term follow-up data, BT plus IVES resulted in greater improvement in nocturia (mean difference [MD]: 0.89, 95% CI: 0.5, 1.20), urinary incontinence (UI; MD: 1.93, 95% CI: 1.32, 2.55), and quality of life (QoL; MD: 4.87, 95% CI: 2.24, 7.50) than isolated BT, while DT and BT improved UI (MD: 0.58, 95% CI: 0.23, 0.92) more than isolated BT. CONCLUSION In the short term, BT plus IVES improves the OAB symptoms of nocturia and UI while improving QoL. The limited number of RCTs and heterogeneity among them provide a low level of evidence, making the effect of BT on OAB inconclusive, which suggests that new RCTs should be performed.
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Affiliation(s)
- A K Rocha
- Postgraduate Program in Rehabilitation Sciences, Institute of Motricity Sciences, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - S Monteiro
- Department of Physiotherapy at Pontifícia Universidade Católica de Minas Gerais (PUC-MINAS), Belo Horizonte, Minas Gerais, Brazil; Postgraduate Program in Surgical Sciences, School of Medicine of the Universidade Estadual de Campinas, (UNICAMP), Campinas, São Paulo, Brazil
| | - I Campos
- Postgraduate Program in Rehabilitation Sciences, Institute of Motricity Sciences, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil
| | - M Volpato
- Postgraduate Program in Surgical Sciences, School of Medicine of the Universidade Estadual de Campinas, (UNICAMP), Campinas, São Paulo, Brazil
| | - D Verleun
- Latu Sensu Postgraduate Program in Physiotherapy in Women's Health and Pelvic Dysfunctions - Faculdade de Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, Minas Gerais, Brazil
| | - L Valim
- Department of Physiotherapy at Pontifícia Universidade Católica de Minas Gerais (PUC-MINAS), Belo Horizonte, Minas Gerais, Brazil
| | - C Riccetto
- Postgraduate Program in Surgical Sciences, School of Medicine of the Universidade Estadual de Campinas, (UNICAMP), Campinas, São Paulo, Brazil
| | - S Botelho
- Postgraduate Program in Rehabilitation Sciences, Institute of Motricity Sciences, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, Minas Gerais, Brazil; Postgraduate Program in Surgical Sciences, School of Medicine of the Universidade Estadual de Campinas, (UNICAMP), Campinas, São Paulo, Brazil.
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Trapani S, Villa G, Poliani A, Gnecchi S, Rosa D, Manara DF. Non-Pharmacological Management of Urge Urinary Incontinence in Women between 40 and 65 Years Old: A Systematic Review. NURSING REPORTS 2024; 14:174-196. [PMID: 38251193 PMCID: PMC10801617 DOI: 10.3390/nursrep14010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/03/2024] [Accepted: 01/06/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Urinary incontinence (UI) has been identified as a World Health Organization health priority. In particular, urge UI (UUI) refers to urine leakage associated with a sudden and compelling desire to void urine. It affects quality of life more than other kinds of UI, but it is not always treated adequately. For these reasons, this study aimed to evaluate the effectiveness of conservative treatment practices to counteract UUI in women aged 40-65 years old. METHODS This systematic review was conducted following the Joanna Briggs Institute (JBI) methodology. According to the protocol registered in PROSPERO, a systematic search was carried out in the CINAHL, Embase, PubMed, PsycInfo, Scopus and Web of Science databases up to October 2022, to find primary studies meeting the inclusion criteria. RESULTS Fourteen studies were included. The scientific literature reported different strategies dealing with the problem of UUI, some purely physical, others physical and psycho-educational and others exclusively psychological. CONCLUSION Conservative treatments are useful to aid the reduction in UUI episodes in middle-aged women. However, none of them can be considered more effective than others due to the impossibility of conducting meta-analytical analyses. Further studies comparing the effectiveness of conservative treatments for UUI are needed.
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Affiliation(s)
- Sara Trapani
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Andrea Poliani
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Silvia Gnecchi
- Department of Onco-Hematology, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | - Debora Rosa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Duilio F. Manara
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
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ÖZGÜRLÜK İ, ÜNLÜBİLGİN E, DÖLEN İ. Comparison of tolterodine, trospium chloride, solifenacin treatments and its side effects on patients with pure urinary and mixed incontinence. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1106031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: Urinary incontinence is defined as urinary incontinence that is a social or hygienic problem and can be objectively demonstrated. It is aimed to compare tolterodine, trospium chloride and solifenacin treatments, and its side effects on patients who have complaints of pure urinary and mixed incontinence.
Material and Method: Totally 98 patients, who applied to Ankara Etlik Zubeyde Hanım Gynecology Training and Research Hospital, Urogynecology Outpatient Clinic between November 2009 and October 2010 with compliants of urinary incontinence and met the criteria to participate in the research, have been included in this study.
Results: A significant improvement in each three of the drug group at third and six months was determined. Solifenacin is generally more effective than the other two treatments. When total values of UDI-6 (Urinary Distress Inventory) survey is analysed, it is seen that each of three antimuscarinic drug group ensured improvement on symptoms at the end of the third month as not to be different from the improvement at the six month. Each three antimuscarinic drug group has a significant therapeutic effect on the IIQ-7 (Incontinence Impact Questionnaire) survey which questions the life quality. Whereas complaints of constipation was seen more at patients that use tolterodine and trospium chloride, there was not a significant difference despite a slight increase in the solifenacin group (p>0.05). It is determined that solifenacin caused desert mouth less than the other two drug groups
Conclusion: Tolterodine, trospium chloride and solifenacin as anticholinergic drugs meaningfully reduced the activity of bladder and increased the quality of life. Drug therapy provided an effective and efficient improvement on incontinence.
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Affiliation(s)
- İzzet ÖZGÜRLÜK
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
| | - Eylem ÜNLÜBİLGİN
- University of Health Sciences, Ankara Etlik Zübeyde Hanım Gynecology Training and Research Hospital, Department of gynecology and obstetrics, Ankara, Turkey
| | - İsmail DÖLEN
- University of Health Sciences, Ankara Etlik Zübeyde Hanım Gynecology Training and Research Hospital, Department of gynecology and obstetrics, Ankara, Turkey
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吉田 正. [Management for lower urinary tract dysfunction in the elderly according to guidelines]. Nihon Ronen Igakkai Zasshi 2022; 59:115-130. [PMID: 35650043 DOI: 10.3143/geriatrics.59.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Steenstrup B, Lopes F, Cornu JN, Gilliaux M. Cognitive-behavioral therapy and urge urinary incontinence in women. A systematic review. Int Urogynecol J 2021; 33:1091-1101. [PMID: 34716765 DOI: 10.1007/s00192-021-04989-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/24/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS UUI co-exists with numerous health conditions, having a substantial negative impact on health-related quality of life and mental health. Cognitive-behavioral therapy (CBT) could help patients manage these problems by changing the way they think and behave. METHODS We carried out a systematic review of the literature assessing the modalities and effects of CBT as a stand-alone strategy, without adding PFMT, on symptoms and clinical signs, in women with UUI. Our secondary objective was to report modalities and effects of CBT on health-related quality of life, psychological symptoms and patient-reported satisfaction. The PRISMA methodology was used to carry out this systematic review. A literature search was conducted in PubMed, PEDro, Web of Science and Cochrane Library databases from inception to December 2020. The PICO approach was used to determine the eligibility criteria. RESULTS Twelve papers were included in the present review which showed beneficial effects on both symptom severity (p < 0.05) and more subjective areas such as quality of life, psychological symptoms or patient satisfaction level (p < 0.05), respectively). However, results on the effectiveness of CBT on clinical signs remains conflicting. CONCLUSION Based on the available literature, this review suggested a high level of evidence for the effectiveness of CBT on symptom severity and a moderate level of evidence for the effectiveness of CBT on quality of life, psychological symptoms and patient satisfaction. However, we highlighted no evidence for the effects of CBT on clinical signs.
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Affiliation(s)
| | - Floriane Lopes
- La Musse Physiotherapy Training Institute, Saint-Sébastien-de-Morsent, France
| | | | - Maxime Gilliaux
- Clinical Research Department, La Musse Hospital, Saint-Sébastien-de-Morsent, France.,CETAPS Laboratory, Rouen University, EA, 3882, Rouen, France
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La Rosa VL, Duarte de Campos da Silva T, Rosa de Oliveira A, Marques Cerentini T, Viana da Rosa P, Telles da Rosa LH. Behavioral therapy versus drug therapy in individuals with idiopathic overactive bladder: A systematic review and meta-analysis. J Health Psychol 2019; 25:573-585. [PMID: 31793816 DOI: 10.1177/1359105319891629] [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] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to systematically review randomized clinical trials comparing the treatment of individuals with overactive bladder syndrome through the use of behavioral therapy versus drug therapy. A systematic electronic search of MEDLINE via PubMed, Embase, and Cochrane Library was performed, including studies indexed until August 2019. Five randomized clinical trials were included. The studies presented a high risk of bias. There was no significant difference between the evaluated treatments. Thus, behavioral therapy and drug therapy also promote the improvement of the symptoms of overactive bladder syndrome, and the behavioral therapy does not have significant adverse effects reported. Due to the high risk of bias in included studies, data should be interpreted with caution. Future studies with more comprehensive protocols may change the effect estimates of behavioral therapy on overactive bladder syndrome.
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Kasman A, Stave C, Elliott CS. Combination therapy in overactive bladder‐untapped research opportunities: A systematic review of the literature. Neurourol Urodyn 2019; 38:2083-2092. [DOI: 10.1002/nau.24158] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 08/18/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Alex Kasman
- Department of UrologyStanford University School of Medicine Stanford California
| | - Christopher Stave
- Department of UrologyStanford University School of Medicine Stanford California
| | - Christopher S. Elliott
- Department of UrologyStanford University School of Medicine Stanford California
- Division of UrologySanta Clara Valley Medical Center San Jose California
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Wolz-Beck M, Reisenauer C, Kolenic GE, Hahn S, Brucker SY, Huebner M. Physiotherapy and behavior therapy for the treatment of overactive bladder syndrome: a prospective cohort study. Arch Gynecol Obstet 2017; 295:1211-1217. [PMID: 28361203 DOI: 10.1007/s00404-017-4357-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine the efficacy of physiotherapy and behavior therapy and to find specific subgroups of women with overactive bladder syndrome that might gain increased benefit from this therapy. METHODS Women with ≥10 micturitions per 24-h period were included. Six to nine therapy sessions were held within a 14-day interval. Efficacy end point was a reduction in micturitions and in episodes of nocturia. Secondary outcomes included ICIQ-OAB, ICIQ-OABqol and visual analog scales. Follow-up was 6 months. Levene test, Student's t test, Pearson´s and Spearman's correlations were utilized as well as the Friedman test and a multivariable-multilevel model. RESULTS 32 women were included. Mean age was 51 ± 15.9 (years ± standard deviation, sd). Mean body mass index (BMI) was 24.4 ± 4.8 (kg/m2 ± sd). There was a 22.9% reduction in the number of micturitions per 24 h (11.7 ± 1.6 vs. 9.0 ± 1.3 p < 0.001), a 21.3% reduction during the day (10.3 ± 1.4 vs. 8.1 ± 1.1 p < 0.001) and a 34.7% reduction in episodes of nocturia (1.5 ± 1.0 vs. 1.0 ± 0.8 p = 0.026). Both ICIQ-OAB (8.7 ± 2.3 vs. 5.8 ± 2.7 vs. 6.3 ± 3.3 p < 0.001) and ICIQ-OABqol (73.4 ± 25.9 vs. 47.5 ± 14.5 vs. 47.7 ± 18.6 p < 0.001) questionnaires as well as VAS (7.5 ± 1.4 vs. 4.1 ± 2.4 vs. 4.2 ± 2.7 p < 0.001) showed significant improvement persisting in the 6-month follow-up. In addition, in a multivariable model controlling for age, women who were overactive bladder syndrome therapy naïve responded significantly better than those who had already been under therapy (p < 0.001). CONCLUSIONS This study shows the efficacy of physiotherapy and behavior therapy in women with overactive bladder syndrome with a post-therapy effect especially for women with no prior treatment.
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Affiliation(s)
- Martina Wolz-Beck
- Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany
| | - Christl Reisenauer
- Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany
| | - Giselle E Kolenic
- Pelvic Floor Research Group, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Sabine Hahn
- Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany
| | - Sara Y Brucker
- Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany.,Research Centre for Women's Health, University Hospital of Tuebingen, Tuebingen, Germany
| | - Markus Huebner
- Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany.
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Wolff A, Joshi RK, Ekström J, Aframian D, Pedersen AML, Proctor G, Narayana N, Villa A, Sia YW, Aliko A, McGowan R, Kerr AR, Jensen SB, Vissink A, Dawes C. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Drugs R D 2017; 17:1-28. [PMID: 27853957 PMCID: PMC5318321 DOI: 10.1007/s40268-016-0153-9] [Citation(s) in RCA: 154] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Medication-induced salivary gland dysfunction (MISGD), xerostomia (sensation of oral dryness), and subjective sialorrhea cause significant morbidity and impair quality of life. However, no evidence-based lists of the medications that cause these disorders exist. OBJECTIVE Our objective was to compile a list of medications affecting salivary gland function and inducing xerostomia or subjective sialorrhea. DATA SOURCES Electronic databases were searched for relevant articles published until June 2013. Of 3867 screened records, 269 had an acceptable degree of relevance, quality of methodology, and strength of evidence. We found 56 chemical substances with a higher level of evidence and 50 with a moderate level of evidence of causing the above-mentioned disorders. At the first level of the Anatomical Therapeutic Chemical (ATC) classification system, 9 of 14 anatomical groups were represented, mainly the alimentary, cardiovascular, genitourinary, nervous, and respiratory systems. Management strategies include substitution or discontinuation of medications whenever possible, oral or systemic therapy with sialogogues, administration of saliva substitutes, and use of electro-stimulating devices. LIMITATIONS While xerostomia was a commonly reported outcome, objectively measured salivary flow rate was rarely reported. Moreover, xerostomia was mostly assessed as an adverse effect rather than the primary outcome of medication use. This study may not include some medications that could cause xerostomia when administered in conjunction with others or for which xerostomia as an adverse reaction has not been reported in the literature or was not detected in our search. CONCLUSIONS We compiled a comprehensive list of medications with documented effects on salivary gland function or symptoms that may assist practitioners in assessing patients who complain of dry mouth while taking medications. The list may also prove useful in helping practitioners anticipate adverse effects and consider alternative medications.
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Affiliation(s)
- Andy Wolff
- Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.
- Saliwell Ltd, 65 Hatamar St, 60917, Harutzim, Israel.
| | - Revan Kumar Joshi
- Department of Oral Medicine and Radiology, DAPMRV Dental College, Bangalore, India
| | - Jörgen Ekström
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | | | - Anne Marie Lynge Pedersen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gordon Proctor
- Mucosal and Salivary Biology Division, Dental Institute, King's College London, London, UK
| | - Nagamani Narayana
- Department of Oral Biology, University of Nebraska Medical Center (UNMC) College of Dentistry, Lincoln, NE, USA
| | - Alessandro Villa
- Division of Oral Medicine and Dentistry, Department of Oral Medicine Infection and Immunity, Brigham and Women's Hospital, Harvard School of Dental Medicine, Boston, MA, USA
| | - Ying Wai Sia
- McGill University, Faculty of Dentistry, Montreal, QC, Canada
| | - Ardita Aliko
- Faculty of Dental Medicine, University of Medicine, Tirana, Albania
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | | | - Siri Beier Jensen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Colin Dawes
- Department of Oral Biology, University of Manitoba, Winnipeg, MB, Canada
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Azuri J, Kafri R, Ziv-Baran T, Stav K. Outcomes of different protocols of pelvic floor physical therapy and anti-cholinergics in women with wet over-active bladder: A 4-year follow-up. Neurourol Urodyn 2016; 36:755-758. [PMID: 27080326 DOI: 10.1002/nau.23016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 03/25/2016] [Indexed: 11/10/2022]
Abstract
AIMS We investigated the 4-year outcomes of three protocols of pelvic floor physical therapy and anticholinergic drug in women with wet over-active bladder (OAB). METHODS One hundred and sixty-four women were randomly allocated to one of four interventions: drug therapy (DT), bladder training (BT), pelvic floor muscle training (PFMT), or combined pelvic floor rehabilitation (CPFR) that includes BT, PFMT, and behavioral advice. The active treatment in each group lasted 3 months. Of the 132 women who completed a 1-year follow-up, 120 women (90%) responded to our questionnaires and therefore were included in this study. Outcome measures were the number of voids per day, number of urgency urinary incontinence (UUI) episodes per week, completely dry rate and Incontinence Quality of Life questionnaire (I-QOL) at 4 years. RESULTS After 4 years of follow-up, the outcome measures improved significantly and equally in all four groups. The median number of UUI episodes/week dropped by 3, 1, 2, and 2 in the DT, BT, PFMT, and CPFR groups, respectively (P = ns). The dry rates were 25%, 31%, 44%, 34% in the DT, BT, PFMT, and CPFR groups, respectively (P = ns). I-QOL scores improved significantly in all four groups. CONCLUSIONS Women who suffer from wet-OAB may experience the same degree of long-term improvement following various pelvic floor physical therapy protocols as they would from drug therapy. Neurourol. Urodynam. 36:755-758, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Joseph Azuri
- Maccabi Healthcare Services, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Rachel Kafri
- Department of Physical Therapy, Maccabi Healthcare Services, Rishon Lezion, Israel
| | - Tomer Ziv-Baran
- Sackler Faculty of Medicine, Department of Epidemiology and Preventive Medicine, School of Public Health, Tel-Aviv University, Tel Aviv, Israel
| | - Kobi Stav
- Department of Urology, Assaf Harofeh Medical Center, Zerifin, Affiliated to Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Kim TH, You HW, Park JH, Lee JG, Choo MS, Park WH, Lee JZ, Park CH, Na YG, Kwon DD, Lee KS. Persistence of solifenacin therapy in patients with overactive bladder in the clinical setting: a prospective, multicenter, observational study. Int J Clin Pract 2016; 70:351-7. [PMID: 27028673 DOI: 10.1111/ijcp.12783] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the persistence with solifenacin therapy over a 12-month period in patients with overactive bladder (OAB). METHODS This is a 52-week long, multicenter, prospective, observational study. The subjects were individuals ≥ 18 years old with OAB symptoms for ≥ 3 months, characterised by a total OAB Symptom Score (OABSS) of ≥ 3 and OABSS urgency item score of ≥ 2. Patients were prescribed 5 mg or 10 mg of solifenacin once daily for OAB symptoms. Drug persistence, reasons for discontinuation and factors related to the persistence were evaluated. RESULTS A total of 1018 patients (329 men, 689 women) with a mean age of 59 years were included. The 52-week drug persistence rate was 22.1%. The drug persistence rates at 12, 24 and 36 weeks 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). CONCLUSIONS 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.
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Affiliation(s)
- T H Kim
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H W You
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J H Park
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J G Lee
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - M-S Choo
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - W H Park
- Department of Urology, Inha University College of Medicine, Incheon, Korea
| | - J Z Lee
- Department of Urology, Pusan National University Hospital, Pusan, Korea
| | - C H Park
- Department of Urology, Keimyung University School of Medicine, Daegu, Korea
| | - Y G Na
- Department of Urology, Chungnam National University School of Medicine, Daejeon, Korea
| | - D D Kwon
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - K-S Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Korea
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12
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Comparative Effectiveness of Anticholinergic Therapy for Overactive Bladder in Women. Obstet Gynecol 2015; 125:1423-1432. [DOI: 10.1097/aog.0000000000000851] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kafri R, Deutscher D, Shames J, Golombp J, Melzer I. Randomized trial of a comparison of rehabilitation or drug therapy for urgency urinary incontinence: 1-year follow-up. Int Urogynecol J 2012; 24:1181-9. [PMID: 23160873 DOI: 10.1007/s00192-012-1992-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 10/27/2012] [Indexed: 12/19/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Our goal was to compare the long-term efficacy of bladder training (BT), pelvic floor muscle training (PFMT), combined pelvic floor rehabilitation (CPFR), and drug therapy (DT) in patients with urgency urinary incontinence (UUI). METHODS This multicenter single-blind randomized controlled trial compared the efficacy of BT, PFMT, DT, and CPFR at baseline and 3- and 12-month follow-ups. Outcome measures included number of voids/24 h, number of UUI episodes, Quality of Life related to UUI (QOL-rUI), urogynecologic visual analog scale, and self-reported function and disability. RESULTS A significant improvement was found for all treatment groups at 3 and 12 months in urinary frequency, UUI episodes, QOL-rUI, and number of daily pads. Only CPFR showed a significant decrease of 4 voids/24 h and a significant increase in self-reported function. CONCLUSIONS The study demonstrated long-term benefits of DT, BT, PFMT, and CPFR in the treatment of UUI with a slight advantage for CPFR.
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Affiliation(s)
- Rachel Kafri
- Department of Physical Therapy, Schwartz Movement Analysis & Rehabilitation Laboratory, Physical Therapy Department, Recanati School for Community Health Professions, Faculty of Health Science, Ben-Gurion University of Negev, PO Box 653, Beer-Sheva 84105, Israel
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Bell ML, Grunwald GK. Small sample estimation properties of longitudinal count models. J STAT COMPUT SIM 2011. [DOI: 10.1080/00949651003674144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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15
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Sexton CC, Notte SM, Maroulis C, Dmochowski RR, Cardozo L, Subramanian D, Coyne KS. Persistence and adherence in the treatment of overactive bladder syndrome with anticholinergic therapy: a systematic review of the literature. Int J Clin Pract 2011; 65:567-85. [PMID: 21489081 DOI: 10.1111/j.1742-1241.2010.02626.x] [Citation(s) in RCA: 196] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Overactive bladder syndrome (OAB) is a chronic condition that has an impact on patients' daily activities and health-related quality of life (HRQL). Anticholinergic therapy is often prescribed following insufficient results with behaviour modification alone; however, rates of treatment discontinuation are consistently high. This study systematically reviewed persistence and adherence data in patients with OAB treated with anticholinergic therapy. A search focused on the intersection of OAB, persistence/adherence, and anticholinergic therapy was conducted in MEDLINE and EMBASE. Articles published after 1998 were reviewed and selected for inclusion based on prespecified criteria. A total of 147 articles and two abstracts were included in the review. Results from 12-week clinical trials showed high rates of discontinuation, ranging from 4% to 31% and 5% to 20% in treatment and placebo groups, respectively. Unsurprisingly, rates of discontinuation found in medical claims studies were substantially higher, with 43% to 83% of patients discontinuing medication within the first 30 days and rates continuing to rise over time. Findings from medical claims studies also suggest that over half of patients never refill their initial prescription and that adherence levels tend to be low, with mean/median medication possession ratio (MPR) values ranging from 0.30 to 0.83. The low levels of persistence and adherence documented in this review reveal cause for concern about the balance between the efficacy and tolerability of anticholinergic agents. Strategies should be identified to increase persistence and adherence. New agents and non-pharmacologic alternatives with good efficacy and minimal side effects should be explored.
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Affiliation(s)
- C C Sexton
- Center for Health Outcomes Research, United BioSource Corporation, Bethesda, MD 20814, USA.
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16
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Majumdar A, Hassan I, Saleh S, Toozs-Hobson P. Inpatient bladder retraining: is it beneficial on its own? Int Urogynecol J 2010; 21:657-63. [PMID: 20119691 DOI: 10.1007/s00192-009-1085-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Accepted: 12/14/2009] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence is a common problem with serious effect on the quality of life. Bladder training aims to increase the interval between voids, either by a mandatory or self-adjustable schedule, so that incontinence is avoided. This study aimed to assess the effectiveness of inpatient bladder retraining. METHODS A retrospective case-note analysis was conducted over a period of 24 months. Outcome measures were decrease in incontinence episode frequency (IEF) and nocturia and increase in interval between voids. Subjective improvement was assessed on a four-point scale. RESULTS The study revealed statistically significant decrease in IEF and nocturia and increase in the interval between voids. Twenty-three percent was cured of their symptoms, 36% reported improvement, 27% did not find any change, whereas 14% reported that they were worse off their after bladder retraining. CONCLUSION The study confirms the usefulness of inpatient bladder retraining as a treatment option, especially in people refractory to outpatient management.
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Affiliation(s)
- Amitabha Majumdar
- Birmingham Women's Healthcare NHS Trust, Metchley Park Road, Birmingham B15 2TG, UK.
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Comparison between oxybutynin, functional electrical stimulation and pelvic floor training for treatment of detrusor overactivity in women: a review. Curr Opin Obstet Gynecol 2009; 21:412-4. [DOI: 10.1097/gco.0b013e32832fd28f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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