The effect of overactive bladder treatment with anticholinergics on female sexual function in women: a prospective observational study

The impact of pharmacotherapy on sexual function in female patients being treated for idiopathic overactive bladder: a systematic review

BACKGROUND

Overactive bladder (OAB) is a condition defined by urgency with or without incontinence which disproportionately affects female patients and has a negative impact on sexual enjoyment and avoidance behaviour. Pharmacotherapy can be considered one of the main options for treating OAB. This research set out to determine the impact of pharmacotherapy on sexual function in females with OAB.

METHODS

This research used the robust methodology of a systematic review. The clinical question was formulated using the PICO (population, intervention, control, and outcomes) format to include females being treated with pharmacotherapy (anticholinergics or beta-3 adrenergic agonists) for idiopathic OAB with the use of a validated questionnaire assessing self-reported sexual function at baseline and post-treatment. The review incorporated the MEDLINE, PubMed and EMBASE databases. The AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) appraisal tool was used to guide the review process. Two reviewers worked independently in screening abstracts, deciding on the inclusion of full-texts, data extraction and risk of bias assessment.

RESULTS

In female patients with OAB, pharmacotherapy does seem to offer at least partial improvement in self-reported sexual function outcomes after 12 weeks of therapy. Still, the value of this finding is limited by an overall poor quality of evidence. Patients with a higher degree of bother at baseline stand to benefit the most from treatment when an improvement within this health-related quality of life domain is sought.

CONCLUSION

This research should form the basis for a well-conducted randomized controlled study to accurately assess sexual function improvements in females being treated with pharmacotherapy for OAB.

Effect of Orthodontic Combined with Implant Repair on Aesthetic Effect and Gingival Crevicular Fluid Factor in Patients with Dentition Defect and Periodontitis

In order to solve the effect of orthodontics combined with implant repair on the aesthetic effect and gingival crevicular fluid factor of patients with dentition defect and periodontitis, 60 patients who met the diagnostic criteria of chronic periodontitis were proposed. They were randomly divided into treatment group (taking Bushen Huoxue Guchi recipe for 3 courses while basic periodontal treatment) and control group (only basic periodontal treatment without taking any drugs). The experimental method of 30 cases in each group showed that PD, Al, and GI in the treatment group and control group decreased to varying degrees compared with those before treatment. The treatment group decreased significantly compared with the control group (P < 0.01). Chronic periodontitis is a common clinical periodontal disease, accounting for up to 95%, local stimulation, a variety of anaerobic bacteria infection, and periodontal plaque, and other factors may cause the occurrence of diseases. Routine treatment mainly includes upper gingival cleaning, lower curettage treatment, and equal root surface treatment. Although the clinical symptoms can be alleviated to a certain extent, the cause cannot be fundamentally excluded, leading to the disease progression in some patients and the formation of aggressive periodontitis and necrotizing periodontal disease.

Injectable, Adhesive, and Self-Healing Composite Hydrogels Loaded With Oxybutynin Hydrochloride for the Treatment of Overactive Bladder in Rats

Object: The aim of this study was to prepare injectable, adhesive, and self-healing composite hydrogels loaded with oxybutynin hydrochloride and verify its function in the treatment of overactive bladder.

Method: The ultraviolet (UV) absorption of oxybutynin (Oxy) in the solution was detected using a UV spectrophotometer at 233 nm, and the cumulative drug release was calculated using Origin software. L929 mouse fibroblasts were used to test cell adhesion to OCP50 and OCP100 hydrogels. Both FT-IR and NMR overactive bladder demonstrated that Dex was oxidized to PDA with aldehyde groups. Urodynamic examinations were performed 24 h after intraperitoneal injection in the rat model. The relative expression levels of Orai1 and STIM1 were detected by western blot (WB) and QPCR.

Results: After loading Oxy, the shear adhesion under the wet conditions of OCP50 and OCP100 was higher than CP50 and CP100 (p < 0.05), and both were suitable for intravaginal administration. After 72 h of release, oxybutynin released 82.8% in OCP100 hydrogel and 70% in OCP50. Compared to the model, OCP50, CP100, and OCP100 relieved the overactive bladder and inhibited the expression of Orail and STIM1.

Conclusions: Oxybutynin hydrogel could provide relief to overactive bladder by decreasing the expression of Orail and STIM1 in rats.

Impact of intravesical onabotulinumtoxinA (Botox) on sexual function in patients with overactive bladder syndrome: a systematic review and meta-analysis

INTRODUCTION AND HYPOTHESIS

The association between overactive bladder (OAB) syndrome and sexual dysfunction is well documented. Intra-detrusor onabotulinumtoxinA (Botox) has proven to be effective treatment for OAB syndrome. Our aim was to examine the impact of intravesical Botox injection on sexual function in patients with OAB, by systematically reviewing the literature.

METHODS

We reviewed the literature for studies that reported a change in sexual function after Botox treatment in patients suffering from OAB. This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement using pre-agreed keywords, from database inception to December 2020. Statistical analyses were performed using Review Manager (RevMan; v.5.4).

RESULTS

Initial results yielded 455 citations. Seven articles met our inclusion criteria. One article was double-reported, leaving 6 studies in the systematic review. Three observational before-and-after studies used the Female Sexual Function Index (FSFI) with sufficient information, and therefore were included in our meta-analysis. The pooled number of participants in all studies was 119 patients. In the meta-analysis, there was significant improvement in the following domains of the FSFI after Botox injection; desire (mean difference (MD) -0.51, p = 0.02), arousal (MD -0.86, p = 0.02), lubrication (MD -0.57, p = 0.03), orgasm (MD -0.65, p = 0.0003) and satisfaction (MD -0.46, p = 0.05). Pain was the only domain that did not show improvement (MD -0.07, p = 0.79). The total FSFI score was reported in 88 patients (two studies) showing significant improvement (MD -0.77, p = 0.006).

CONCLUSIONS

We report a systematic review of the effect of Botox treatment on sexual function in patients with OAB. Although studies are small, the results indicate a positive effect in patients with OAB.

Update on non-invasive treatment for female overactive bladder

Overactive bladder syndrome (OAB) is common chronic medical condition which has a major impact on health and quality of life. This condition affects daily activities, performance and social function and servers as a real challenge for care giver in attempt to treat patients' symptoms. Given the fact that therapy rarely results in cure and the high rate of discontinuation, treatment should primarily aim to reduce social and psychological disability. The purpose of our update is to give an overview of recent data regarding OAB, and to provide practical clinical tools for evaluation and management of OAB syndrome according to current literature evidence.

Overactive Bladder Syndrome Treatments and Their Effect on Female Sexual Function: A Review

Introduction

Overactive bladder (OAB), the most common subtype of urinary incontinence, has a heavy price on quality of life, especially on sexual life. Unfortunately, most women rarely voice the worsening of sexual function, especially those who already suffer from OAB symptoms. It has been demonstrated that patients who suffer from OAB score lower on Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire and Female Sexual Function Index scores, meaning that their sexual function is debilitated. Therapies for OAB begin with traditional pelvic floor physiotherapy, advance to anticholinergic drugs, and become more invasive with intravesical injections of onabotulinumtoxinA (commonly known as Botox). Last, for patients resistant to conservative therapies, sacral neuromodulation is the treatment of choice.

Methods

This article reviews the current literature that sheds light on the above 4 treatments and their effect on sexual function. This topic is of great importance because of the under-reporting of sexual dysfunction in women who suffer from OAB, in hopes of raising awareness of sexual function for clinicians treating patients with OAB.

Results

This review found that the aforementioned 4 treatments for OAB (physiotherapy, anticholinergic drugs, intravesical injections of onabotulinumtoxinA, and sacral neuromodulation) do not have a detrimental affect on sexual function. On the contrary, the little data that do exist show that sexual function increases after these therapies are completed in women with OAB.

Conclusion

This review concludes with a positive outlook: physicians are helping women with OAB syndrome to improve their sexual function. However, not enough data exist, partially due to under-reporting of diminished sexual function.

Levy G, Lowenstein L. Overactive Bladder Syndrome Treatments and Their Effect on Female Sexual Function: A Review. Sex Med 2019;8:1–7.