1
|
Jha S, Jeppson PC, Dokmeci F, Marquini GV, Sartori MGF, Moalli P, Malik SA. Management of mixed urinary incontinence: IUGA committee opinion. Int Urogynecol J 2024; 35:291-301. [PMID: 38252279 PMCID: PMC10908639 DOI: 10.1007/s00192-023-05694-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/06/2023] [Indexed: 01/23/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Mixed urinary incontinence (MUI) is defined by the International Urogynecology Association (IUGA) and International Continence Society as the complaint of involuntary leakage of urine associated with urgency and also with exertion, effort, sneezing or coughing. It therefore implies the coexistence of both stress urinary incontinence (SUI) and urgency urinary incontinence (UUI). MUI is a heterogeneous diagnosis that requires an assessment of its individual components of SUI and UUI. Management requires an individualised approach to the symptom components. The aim of this review is to identify the assessment/investigations and management options for MUI. METHODS A working subcommittee from the IUGA Research & Development (R&D) Committee was created and volunteers invited from the IUGA membership. A literature review was performed to provide guidance focused on the recommended assessment and management of MUI. The document was then evaluated by the entire IUGA R&D Committee and IUGA Board of Directors and revisions made. The final document represents the IUGA R&D Committee Opinion. RESULTS The R&D Committee MUI opinion paper provides guidance on the assessment and management of women with MUI and summarises the evidence-based recommendations. CONCLUSIONS Mixed urinary incontinence is a complex problem and successful management requires alleviation of both the stress and urge components. Care should be individualised based on patient preferences. Further research is needed to guide patients in setting goals and to determine which component of MUI to treat first. The evidence for many of the surgical/procedural treatment options for MUI are limited and needs to be explored in more detail.
Collapse
Affiliation(s)
- Swati Jha
- Department of Urogynecology, Jessop Wing, Sheffield Teaching Hospitals NHS Foundation Trust & University of Sheffield, Sheffield, UK.
| | - Peter C Jeppson
- The Woman's Center for Advanced Pelvic Surgery, The University of Arizona, Phoenix, AZ, USA
| | - Fulya Dokmeci
- Department of Obstetrics & Gynecology, Ankara School of Medicine, Ankara University, Ankara, Türkiye
| | - Gisele V Marquini
- Federal University of Uberlândia (UFU), Minas Gerais, Brazil and Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Marair G F Sartori
- Urogynecology Division, Gynecology Department, Federal University of São Paulo, São Paulo, Brazil
| | - Pamela Moalli
- Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shazia A Malik
- Female Pelvic Medicine & Reconstructive Surgery, Department of Ob/Gyn, University of Arizona COMPhoenix, Tucson, AZ, USA
| |
Collapse
|
2
|
Shi C, Zhou D, Yu W, Jiao W, Shi G, Wang Y. Efficacy of Yun-Type Optimized Pelvic Floor Training Therapy for Middle-Aged Women With Severe Overactive Bladder: A Randomized Clinical Trial. Front Surg 2021; 8:670123. [PMID: 34336915 PMCID: PMC8316598 DOI: 10.3389/fsurg.2021.670123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/16/2021] [Indexed: 12/22/2022] Open
Abstract
Background: This study aimed to evaluate the clinical efficacy of Yun-type optimized pelvic floor training therapy for middle-aged women with severe overactive bladder (OAB). Methods: This randomized, observer-blinded, parallel-group controlled clinical trial included 108 middle-age women with severe OAB and assigned them to the intervention group (treated with combination of Yun-type optimized pelvic floor training with solifenacin for 12 weeks) and control group (treated with solifenacin for 6 weeks and, after 2 weeks of elution, received the combination of Yun-type optimized pelvic floor training and solifenacin for 6 weeks). The outcomes associated with OAB, pelvic floor muscle (PFM) function, and sexual function were compared after 6 and 12/14 weeks of treatment. Results: The primary variables were OAB-associated outcomes, including overactive bladder symptom score (OABSS), urgent urination, urine, nocturia, urge urinary incontinence, patient's perception of bladder condition, urogenital distress inventory-6, incontinence impact questionnaire-7, voiding volume, average flow rate, and maximum flow rate. The secondary variables were indicators related to PFM function and sexual function. These indicators were significantly improved in both groups after interventions. Notably, the improvements in most of these indicators were superior in the intervention group than in the control group after 6 weeks and 12/14 weeks of treatment. Conclusions: The use of Yun-type optimized pelvic floor training adds to the benefits of solifenacin regarding severe OAB-associated outcomes, PMF function, and sexual function in middle-aged women with severe OAB. Combining Yun-type optimized pelvic floor training with traditional drug therapies may improve clinical outcomes in patients with severe OAB. Trial Registration: ChiCTR-INR-17012189.
Collapse
Affiliation(s)
- Chaoliang Shi
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Dan Zhou
- School of Health and Social Care, Shanghai Urban Construction Vocational College, Shanghai, China
| | - Wandong Yu
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Wei Jiao
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Guowei Shi
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Yangyun Wang
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| |
Collapse
|
3
|
Dutoglu E, Soysal P, Smith L, Arik F, Kalan U, Kazancioglu RT, Isik AT. Nocturia and its clinical implications in older women. Arch Gerontol Geriatr 2019; 85:103917. [PMID: 31400648 DOI: 10.1016/j.archger.2019.103917] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 07/08/2019] [Accepted: 07/21/2019] [Indexed: 01/03/2023]
Abstract
The aim of this study is to demonstrate the relationship between nocturia and geriatric syndromes, and comprehensive geriatric assessment parameters (CGA) in older women. 858 older outpatient women were included in this cross-sectional study. For the nocturia variable, the question, "Generally, during the past 30 days, how many times did you usually urinate after you have gone to sleep at night until the time you got up in the morning?'' was used. The relationships between nocturia status and common geriatric syndromes, and CGA parameters were determined. The mean age of patients was 74.1 ± 8.0 years. The prevalence of patients who reported average of 0, ≥1, ≥2, ≥3, and ≥4 nocturnal episodes was 14.7%, 85.3%, 66.3%, 42.13%, and 24.1%, respectively. When all the covariates including age, education, Charlson Comorbidities Index score, glomerular filtration rate, antimuscarinic drugs and alpha-blockers use, diabetes mellitus, chronic obstructive pulmonary disease, and incontinence were adjusted, there were higher rates of insomnia, recurrent falls and higher scores of Timed Up-Go test in older women with ≥2 nocturia episodes (p < 0.05). There was a significant correlation between ≥3 nocturia episodes and lower Instrumental Activities of Daily Living scores and a significant correlation between ≥4 nocturnal episodes and frailty and polypharmacy (p < 0.05). Nocturia is quite common and associated with insomnia, frailty, polypharmacy, incontinence, falls, lower gait speed, and functionality in older women.Therefore, nocturia is very important for geriatric practice and ≥2 nocturia episodes can be a marker of poor health status in older women.
Collapse
Affiliation(s)
- Ekrem Dutoglu
- Kayseri Education and Research Hospital, Department of Geriatric Medicine, Kayseri, Turkey
| | - Pinar Soysal
- Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Ferhat Arik
- Tomarza Yasar Karayel State Hospital, Department of Internal Medicine, Kayseri, Turkey
| | - Ugur Kalan
- Ermenek State Hospital, Department of Internal Medicine, Karaman, Turkey
| | | | - Ahmet Turan Isik
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| |
Collapse
|
4
|
Influence of the Short-term Intake of High Doses of Solifenacin and Trospium on Cognitive Function and Health-Related Quality of Life in Older Women With Urinary Incontinence. Int Neurourol J 2018; 22:41-50. [PMID: 29609422 PMCID: PMC5885132 DOI: 10.5213/inj.1834996.498] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/27/2018] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim of this study was to investigate the safety and the effects of elevated doses of solifenacin and trospium on cognitive function and health-related quality of life (HRQoL) in elderly women receiving treatment for urinary incontinence. Methods The study included 312 women aged 60–83 years (mean age, 69.4 years). All participants had scored at least 24 points on the Mini-Mental State Examination (MMSE) scale, and all of them had been diagnosed with urge urinary incontinence (UUI) or mixed urinary incontinence (MUI). The women were randomly assigned to 3 groups: group A, individuals who were simultaneously administered solifenacin at a high dosage of 20 mg per day and trospium at a high dosage of 60 mg per day; group B, persons taking solifenacin and trospium at the usual dosage of 10 and 30 mg per day, respectively; and group C, persons who received a placebo. Participants’ cognitive status was assessed by the MMSE, Controlled Oral Word Association Test, Wechsler Adult Intelligence Scale-Revised, Wechsler Memory Scale III, Colour Trails Test, and California Verbal Learning Test scales. The HRQoL assessment was performed using the Medical Outcomes Study 36-Item Health Survey. Results The cognitive function parameters did not differ at the start and end of the study across the groups (P>0.05). Additionally, the cognitive function parameters did not differ significantly within each group between the start and end of the study (P>0.05). The values of most HRQoL parameters regarding the functional state of the lower urinary tract (LUT) after the termination of treatment significantly improved in groups A and B (P<0.05). A significant correlation between cognitive status and HRQoL or LUT parameters was absent (r<0.3), while the correlations between HRQoL and LUT parameters were r=0.31–0.83, P<0.05. Conclusions The use of elevated doses of solifenacin and trospium did not increase the risk of cognitive impairment in women with UUI and MUI. The combination of solifenacin and trospium at a double dosage may be recommended to elderly women with treatment-resistant symptoms of UUI and MUI. However, the safety of combining antimuscarinic drugs in women with an increased volume of residual urine requires further study.
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Zhang HL, Huang ZG, Qiu Y, Cheng X, Zou XQ, Liu TT. Tamsulosin for treatment of lower urinary tract symptoms in women: a systematic review and meta-analysis. Int J Impot Res 2017; 29:148-156. [PMID: 28424499 DOI: 10.1038/ijir.2017.12] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 02/13/2017] [Accepted: 03/08/2017] [Indexed: 01/21/2023]
Abstract
Tamsulosin has been used for the off-label treatment of lower urinary tract symptoms (LUTS) in women. Over the past few years, several randomized controlled trials (RCTs) have reported the clinical effectiveness and safety of tamsulosin for LUTS in women. Therefore, the aim of the present study was to perform a meta-analysis to evaluate the safety and efficacy of tamsulosin in treating LUTS in women, which may resolve some of the current controversies over use of the drug and provide more reliable evidence for the use of tamsulosin. A literature review was performed to identify all published RCTs of tamsulosin for the treatment of LUTS in women. The search included the following databases: PUBMED, EMBASE, the Cochrane Controlled Trail Register of Controlled Trials, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chinese Science and Technique Journals Database (VIP) and Wanfang Database. A systematic review and meta-analysis were conducted. Six RCTs studies involving 764 female participants were included in the analysis. Four out of the six RCTs compared tamsulosin with placebo, one RCT compared tamsulosin with prazosin and the other study compared tamsulosin with tamsulosin combined with tolterodine. Two RCTs evaluated total International Prostate Symptom Score (IPSS) and improved total IPSS compared with the placebo (standardized mean difference=-4.08, 95% confidence interval=-5.93 to -2.23, P<0.00001). IPSS (storage symptom score), IPSS (voiding symptom score) and quality-of-life score also showed the similar effects. In addition, tamsulosin improved the Overactive Bladder Questionnaire score when compared with placebo in only one RCT. For urodynamic parameters, tamsulosin improved the average flow rate and the post-void residual volume when compared with prazosin and tolterodine combined with tamsulosin, respectively. Beyond that, the other parameters showed no significant difference between the treatment and control groups. On the basis of the present evidence, tamsulosin is an effective treatment for the relief of LUTS in women when compared with placebo. However, the safety of the tamsulosin remains unknown. Further, well-conducted trials that examine long-term outcomes are required.
Collapse
Affiliation(s)
- H L Zhang
- Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Z G Huang
- Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Y Qiu
- Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - X Cheng
- Department of Pharmacy, Women &Infants Hospital of Zhengzhou, Zhengzhou, China
| | - X Q Zou
- Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - T T Liu
- Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| |
Collapse
|
7
|
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.
Collapse
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.
| |
Collapse
|
8
|
Fujimura M, Izumimoto N, Kanie S, Kobayashi R, Yoshikawa S, Momen S, Hirakata M, Komagata T, Okanishi S, Iwata M, Hashimoto T, Doi T, Yoshimura N, Kawai K. Mechanisms of inhibitory action of TRK-130 (Naltalimide), a μ-opioid receptor partial agonist, on the micturition reflex. Int Urol Nephrol 2017; 49:587-595. [PMID: 28093646 DOI: 10.1007/s11255-017-1509-y] [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: 11/25/2016] [Accepted: 01/06/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE To clarify the mechanism of inhibitory action of TRK-130 (Naltalimide), a unique µ-opioid receptor partial agonist, on the micturition reflex. METHODS The effect of TRK-130 on isovolumetric rhythmic bladder contractions (RBCs) was examined in guinea pigs, the effect of which was clarified by co-treatment with naloxone or in spinal cord transection. The effect of TRK-130 on urodynamic parameters was also observed in guinea pigs. In addition, the effect of TRK-130 on bladder contraction induced by peripheral stimulation of the pelvic nerve was investigated in rats. RESULTS TRK-130 (0.001-0.01 mg/kg, iv) dose-dependently inhibited RBCs, which was dose-dependently antagonized by naloxone; however, the antagonism susceptibility was different from morphine (1 mg/kg, iv). The minimum effective dose (0.003 mg/kg) of TRK-130 remained similar in spinal cord-transected animals. TRK-130 (0.0025 mg/kg, iv) increased bladder capacity without changing the voiding efficiency, maximum flow rate, and intravesical pressure at the maximum flow rate, whereas oxybutynin (1 mg/kg, iv) increased the bladder capacity but affected the other parameters. TRK-130 (0.005 mg/kg, iv) did not produce significant changes on the bladder contractions induced by peripheral stimulation of the pelvic nerve, while oxybutynin (1 mg/kg, iv) significantly suppressed the bladder contractions. CONCLUSIONS These results suggest that TRK-130 enhances the bladder storage function by modulating the afferent limb of the micturition reflex through µ-opioid receptors in the spinal cord. TRK-130 could be a more effective and safer therapeutic agent with a different fashion from antimuscarinics and conventional opioids for overactive bladder.
Collapse
Affiliation(s)
- Morihiro Fujimura
- Pharmaceutical Research Laboratories, Toray Industries, Inc., 6-10-1 Tebiro, Kamakura, Kanagawa, 248-8555, Japan.
| | - Naoki Izumimoto
- Pharmaceutical Research Laboratories, Toray Industries, Inc., 6-10-1 Tebiro, Kamakura, Kanagawa, 248-8555, Japan
| | - Sayoko Kanie
- Pharmaceutical Research Laboratories, Toray Industries, Inc., 6-10-1 Tebiro, Kamakura, Kanagawa, 248-8555, Japan
| | - Ryosuke Kobayashi
- Pharmaceutical Research Laboratories, Toray Industries, Inc., 6-10-1 Tebiro, Kamakura, Kanagawa, 248-8555, Japan
| | - Satoru Yoshikawa
- Pharmaceutical Research Laboratories, Toray Industries, Inc., 6-10-1 Tebiro, Kamakura, Kanagawa, 248-8555, Japan
| | - Shinobu Momen
- Pharmaceutical Research Laboratories, Toray Industries, Inc., 6-10-1 Tebiro, Kamakura, Kanagawa, 248-8555, Japan
| | - Mikito Hirakata
- Pharmaceutical Research Laboratories, Toray Industries, Inc., 6-10-1 Tebiro, Kamakura, Kanagawa, 248-8555, Japan
| | - Toshikazu Komagata
- Pharmaceutical Research Laboratories, Toray Industries, Inc., 6-10-1 Tebiro, Kamakura, Kanagawa, 248-8555, Japan
| | - Satoshi Okanishi
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Fujisawa, Kanagawa, Japan
| | - Masashi Iwata
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Fujisawa, Kanagawa, Japan
| | - Tadatoshi Hashimoto
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Fujisawa, Kanagawa, Japan
| | - Takayuki Doi
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Fujisawa, Kanagawa, Japan
| | - Naoki Yoshimura
- Departments of Urology and Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Koji Kawai
- Pharmaceutical Research Laboratories, Toray Industries, Inc., 6-10-1 Tebiro, Kamakura, Kanagawa, 248-8555, Japan
| |
Collapse
|
9
|
Evaluation of the urinary microbiota of women with uncomplicated stress urinary incontinence. Am J Obstet Gynecol 2017; 216:55.e1-55.e16. [PMID: 27498309 DOI: 10.1016/j.ajog.2016.07.049] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/21/2016] [Accepted: 07/21/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Female urinary microbiota are associated with urgency urinary incontinence and response to medication. The urinary microbiota of women with stress urinary incontinence has not been described. OBJECTIVE We sought to study the cross-sectional relationships between urinary microbiota features and demographic and clinical characteristics of women undergoing stress urinary incontinence surgery. STUDY DESIGN Preoperative urine specimens were collected from women without urinary tract infection and were available from 197 women (174 voided, 23 catheterized) enrolled in a multicenter prospective randomized trial, the Value of Urodynamic Evaluation study. Demographic and clinical variables were obtained including stress and urgency urinary incontinence symptoms, menopausal status, and hormone use. The bacterial composition of the urine was qualitatively assessed by sequencing the bacterial 16S ribosomal RNA gene. Phylogenetic relatedness and microbial alpha diversity were compared to demographics and symptoms using generalized estimating equation models. RESULTS The majority of 197 urine samples (86%) had detectable bacterial DNA. Bacterial diversity was significantly associated with higher body mass index (P = .02); increased Medical, Epidemiologic, and Social Aspects of Aging urge index score (P = .04); and hormonal status (P < .001). No associations were detected with stress urinary incontinence symptoms. Increased diversity was also associated with a concomitant lower frequency of Lactobacillus in hormone-negative women. CONCLUSION Women undergoing stress urinary incontinence surgery have detectable urinary microbiota. This cross-sectional analysis revealed that increased diversity of the microbiota was associated with urgency urinary incontinence symptoms, hormonal status, and body mass index. In contrast, the female urinary microbiota were not associated with stress urinary incontinence symptoms.
Collapse
|
10
|
Cirino LMD, Vergne DMC, Santana PF, Almeida EDE, Costa LPDA, Albuquerque-Júnior RLCDE, Lima-Verde IB, Padilha FF, Cardoso JC. Decreased inflammatory response in rat bladder after intravesical administration of capsaicin-loaded liposomes. AN ACAD BRAS CIENC 2016; 88:1539-47. [PMID: 27598840 DOI: 10.1590/0001-3765201620150309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 11/27/2015] [Indexed: 12/17/2022] Open
Abstract
The objective of this work was to study the reduction in the capsaicin toxicity by encapsulation in liposomes. Capsaicin was extracted from peppers and characterized with high performance liquid chromatography (HPLC). We determined the zeta potential, polydispersivity index (PdI) and vesicle size of liposomes. Wistar rats were submitted to intravesical instillation of liposomes (LIP), capsaicin (CAP) or liposomes with capsaicin (CAPLIP). After 24 hours, bladders were removed for histological analysis. Vesicle size ranged from 68 to 105 nm with PdI smaller than 0.2 and zeta potential around -30 mV. The vesicles maintained stability over the 14-day study. The histological analysis of the CAP group showed intense inflammation in almost all bladder layers, as well as ulcer formation. Conversely, the CAPLIP group showed a smooth inflammatory reaction and hyperemia. In conclusion, the liposomes effectively protected the bladder against the irritative action of capsaicin.
Collapse
Affiliation(s)
- Lorena M D Cirino
- Programa de Pós-Graduação em Saúde e Ambiente e Biotecnologia Industrial, Curso de Farmácia, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil
| | - Daviane M C Vergne
- Programa de Pós-Graduação em Saúde e Ambiente e Biotecnologia Industrial, Curso de Farmácia, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil
| | - Patrícia F Santana
- Programa de Pós-Graduação em Saúde e Ambiente e Biotecnologia Industrial, Curso de Farmácia, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil
| | - Enrik DE Almeida
- Programa de Pós-Graduação em Saúde e Ambiente e Biotecnologia Industrial, Curso de Farmácia, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil
| | - Luiz P DA Costa
- Programa de Pós-Graduação em Saúde e Ambiente e Biotecnologia Industrial, Curso de Farmácia, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil.,Instituto de Tecnologia e Pesquisa, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil
| | - Ricardo L C DE Albuquerque-Júnior
- Programa de Pós-Graduação em Saúde e Ambiente e Biotecnologia Industrial, Curso de Farmácia, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil.,Instituto de Tecnologia e Pesquisa, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil
| | - Isabel B Lima-Verde
- Programa de Pós-Graduação em Saúde e Ambiente e Biotecnologia Industrial, Curso de Farmácia, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil.,Instituto de Tecnologia e Pesquisa, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil
| | - Francine F Padilha
- Programa de Pós-Graduação em Saúde e Ambiente e Biotecnologia Industrial, Curso de Farmácia, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil.,Instituto de Tecnologia e Pesquisa, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil
| | - Juliana C Cardoso
- Programa de Pós-Graduação em Saúde e Ambiente e Biotecnologia Industrial, Curso de Farmácia, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil.,Instituto de Tecnologia e Pesquisa, Universidade Tiradentes, Av. Murilo Dantas, 300, Farolândia, 49032-490 Aracaju, SE, Brasil
| |
Collapse
|
11
|
Ercan Ö, Köstü B, Bakacak M, Aytaç-Tohma Y, Çoşkun B, Avcı F, Efe E. Comparison of solifenacin and fesoterodine in treatment of overactive bladder. Saudi Med J 2016; 36:1181-5. [PMID: 26446328 PMCID: PMC4621723 DOI: 10.15537/smj.2015.10.12016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objectives: To compare the use of solifenacin and fesoterodine in treatment of overactive bladder (OAB). Methods: This prospective study was conducted on patients diagnosed with OAB who presenting to the Department of Obstetrics and Gynecology and Urology, School of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey between October 2013 and August 2014. Patients were randomized into 2 groups. Group 1 (n=60) received 5 mg solifenacin per day, while Group 2 (n=59) received 4 mg fesoterodine per day. All the patients’ OAB symptom scores (OABSS) in weeks 0, 4, and 12 were recorded. In addition, treatment costs and side effects of the drugs were evaluated. Results: Average OABSS (score 1) was determined as: 9.5 ± 2.8 for Group 1 and 10.7 ± 1.8 for Group 2 at week 0; 2.2 ± 1.2 (Group 1) and 2.4 ± 1.3 (Group 2) at week 4 (score 2); and 1.3 ± 0.5 for Group 1 and 1.3 ± 0.6 for Group 2 at week 12 (score 3). In addition, no statistically significant difference was found between the scores (p=0.062 (score 1), p=0.464 (score 2), and p=0.527 (score 3). The discontinuation rate of medication due to its side effects was 0 (0%) for Group 1, and 6 (10.2%) for Group 2. Intragroup changes in the scores 1-2, 1-3, and 2-3 values was statistically significant in both groups (p<0.001). Conclusion: No significant difference was found between the OABSS of these 2 drugs. However, discontinuation of drugs due to side effects was more frequent in fesoterodine.
Collapse
Affiliation(s)
- Önder Ercan
- Department of Obstetrics and Gynecology, School of Medicine, Kahramanmaraş Sütçü Imam University, Kahramanmaraş, Turkey. E-mail.
| | | | | | | | | | | | | |
Collapse
|
12
|
Abstract
Nocturia is a common but overlooked lower urinary tract symptom that substantially reduces patient health and quality of life. Though traditionally viewed as occurring predominantly in males, nocturia has been found to be equally as prevalent in females. The recent emphasis on the importance of nocturia has resulted in a surge of research studies, providing a foundation for current and future management decisions. In this review, we describe the current recommendations for the female patient in light of the most recently published studies, including a unique interest in predicting treatment response.
Collapse
Affiliation(s)
- Andrew Chang
- Medical Scientist Training Program, Stony Brook University School of Medicine, Stony Brook, NY, 11794, USA,
| | | | | |
Collapse
|
13
|
Fujimura M, Izumimoto N, Momen S, Yoshikawa S, Kobayashi R, Kanie S, Hirakata M, Komagata T, Okanishi S, Hashimoto T, Yoshimura N, Kawai K. Characteristics of TRK-130 (Naltalimide), a Novel Opioid Ligand, as a New Therapeutic Agent for Overactive Bladder. J Pharmacol Exp Ther 2014; 350:543-51. [DOI: 10.1124/jpet.114.214031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|