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Hui Z, Zewu Z, Yang L, Yu C. Association between weight-adjusted waist index and overactive bladder: a cross-sectional study based on 2009-2018 NHANES. Front Nutr 2024; 11:1423148. [PMID: 39296511 PMCID: PMC11408301 DOI: 10.3389/fnut.2024.1423148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 08/19/2024] [Indexed: 09/21/2024] Open
Abstract
Background The weight-adjusted waist index (WWI) is a novel obesity indicator that appears to outperform the body mass index (BMI) and waist circumference (WC) in assessing both overweight and obesity. Studies have demonstrated the relationship between obesity and overactive bladder (OAB). The purpose of this study is to examine the correlation between WWI and OAB. Methods This research utilizes data from the National Health and Nutrition Examination Survey (NHANES) collected between 2009 and 2018. Each participant's WWI was calculated as their WC in centimeters by the square root of weight in kilograms. The Overactive Bladder Symptom Score (OABSS) questionnaire is used to determine whether a participant has OAB. Multivariate logistic regression and generalized additive model analysis were employed to investigate the relationship between WWI and OAB. We used smoothing curve fitting to explore non-linear relationships. Additionally, subgroup analysis and interaction tests are conducted. Results In this cross-sectional study involving 35,950 subjects, we found that individuals with a higher WWI have a higher risk of OAB (OR = 1.41, 95% CI: 1.02-1.74). Subgroup analysis and interaction testing showed that the relationship between WWI and OAB is consistent across various population characteristics. Smoothing curve fitting reveals a positive non-linear relationship between WWI and OAB. Furthermore, the association between WWI and OAB is stronger than that of other obesity-related indicators. Conclusion Weight-adjusted waist index may be able to predict the incidence of OAB and that WWI-based obesity management may help to reduce the risk of OAB.
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Affiliation(s)
- Zeng Hui
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhu Zewu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Li Yang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Cui Yu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Syeda F, Pandit U. Urinary Incontinence in Female Athletes: A Systematic Review on Prevalence and Physical Therapy Approaches. Cureus 2024; 16:e64544. [PMID: 39144856 PMCID: PMC11322629 DOI: 10.7759/cureus.64544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2024] [Indexed: 08/16/2024] Open
Abstract
Urinary incontinence (UI) is an involuntary leakage of urine and is classified as stress, mixed, or urge. It is more common in females due to anatomical and physiological body differences. Moreover, the literature remarks an evident presence of UI with high-intensity physical activities. Therefore, the present integrative systematic review focused on the studies aimed at investigating the prevalence of UI in nulliparous sportswomen, studies illustrating sport-specific prevalence of UI, and studies demonstrating the impact of physical therapy intervention on UI. A literature search was carried out systematically on electronic databases consisting of Cochrane and Google Scholar databases from 2018 to December 2023. The keywords utilized to perform the literature search and include relevant articles consisted of "urinary incontinence," AND "nulliparous," AND "sportswomen," OR "female athletes," AND "physical therapy". A total of nine studies were included in the present systematic review. The quality assessment of the studies was performed by using a measurement tool to assess systematic reviews (AMSTAR 2) scale, and the Mixed Methods Appraisal Tool was used for cross-sectional and randomized controlled trial studies. The data extracted included first author and year of publication, study design, sample or number of individuals involved in the study, age range of the participants, type of UI, type of sports involved, purpose of the study, methodological part, outcome measures derived, conclusion, and quality assessment of the studies. The review concluded that nulliparous athletes, especially those participating in high-impact activities, have a significant prevalence of UI. In addition, the physical therapy intervention consisting of pelvic floor muscle training (PFMT) along with education about pertinent pelvic anatomy was mostly performed on female athletes for the prevention and management of UI.
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Affiliation(s)
- Fizzia Syeda
- Department of Community Health Physiotherapy, D. Y. Patil School of Physiotherapy, D. Y. Patil University, Navi Mumbai, IND
| | - Unnati Pandit
- Department of Community Health Physiotherapy, D. Y. Patil School of Physiotherapy, D. Y. Patil University, Navi Mumbai, IND
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Mubaraki AA, Alnemari MA, Aljuaid SO, Altalhi FM, Alamri YM, Altowairqi SO. The Prevalence and Impact of Urinary Incontinence on Multiple Sclerosis Patients in Taif City, Saudi Arabia. Cureus 2024; 16:e57010. [PMID: 38681390 PMCID: PMC11046167 DOI: 10.7759/cureus.57010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Multiple sclerosis (MS) is a chronic inflammatory disease that results in demyelination and progressive loss of nerve cells within the central nervous system. Multiple sclerosis, as well as other neurological diseases that impact brain structures and spinal pathways involved in sphincter control, may cause lower urinary tract symptoms (LUTS) Our aims are to determine the prevalence, severity, and impact on the quality of life of urinary incontinence among MS patients in Taif, Saudi Arabia, as well as its potential association with demographics and clinical features. Method A cross-sectional study included 150 of MS patients aged 18 years and older who completed the validated Arabic versions of both the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). In addition, other clinical parameters were collected from the medical records of patients. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 26 (IBM Inc., Armonk, New York). Qualitative data were expressed as numbers and percentages, and the Chi-squared test (χ2) was employed. Quantitative data were expressed as means with standard deviation (mean ± SD). Result 67.3% of the participants were female; the mean ICIQ UI and ICIQ OAB scores in these MS patients were found to be 6.30 ± 6.26 and 5.32 ± 3.76, respectively. They were significantly higher in progressive MS patients compared to relapsing-remitting MS patients (p<0.05). There was a high positive correlation obtained between ICIQ UI and ICIQ OAB scores (rho=0.801, p<0.001). Conclusion The findings of this study showed that urinary incontinence was a common and distressing symptom experienced by individuals with MS. The severity of UI symptoms was significantly more in progressive multiple sclerosis compared to relapsing-remitting multiple sclerosis.
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Abuorouq S, Al-Zubi M, Al-Ali AM, Aloqaily LH, Talafha MA, Migdadi AM, Serhan HA. The prevalence of probable overactive bladder and associated risk factors among medical students in Jordan: a cross-sectional study. BMC Urol 2024; 24:7. [PMID: 38172746 PMCID: PMC10765841 DOI: 10.1186/s12894-023-01394-4] [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: 04/15/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND To discuss the impact of overactive bladder (OAB) on medical students. overactive bladder. is a chronic condition that causes sudden and intense urges to urinate, which can have significant physical and psychological effects on patients' lives. The prevalence of OAB among medical students is relatively high, with some studies reporting rates as high as 35.4%. This research aims to shed light on the prevalence rates and risk factors associated with OAB among medical students in Jordan. METHODS A cross-sectional study was conducted using an online self-reported questionnaire as the study tool. The questionnaire collected the sociodemographic, health, and academic characteristics of medical students, as well as the new 7-item OABSS score. RESULTS Out of the total sample of medical students surveyed (n = 525), 44.5% reported experiencing symptoms of OAB. Furthermore, the analysis also revealed that there was a significant difference in the prevalence of OAB between the ages of medical students. In addition, the study also found that there was a significant association between OAB symptoms and basic years, positive history of diagnostic UTI, positive history of recent trauma, high stress, and taking certain medications. CONCLUSIONS The study highlights the need for further research in this area and emphasizes the possible implications of OAB for medical students, including the need for additional support and resources to manage the condition.
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Affiliation(s)
- Saleh Abuorouq
- Department of Clinical Medical Sciences, Urology Division, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Mohammad Al-Zubi
- Department of Clinical Medical Sciences, Urology Division, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | | | | | | | | | - Hashem Abu Serhan
- Department of Ophthalmology, Hamad Medical Corporations, Doha, Qatar.
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Shang X, Fu Y, Jin X, Wang C, Wang P, Guo P, Wang Y, Yan S. Association of overweight, obesity and risk of urinary incontinence in middle-aged and older women: a meta epidemiology study. Front Endocrinol (Lausanne) 2023; 14:1220551. [PMID: 37886637 PMCID: PMC10598345 DOI: 10.3389/fendo.2023.1220551] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
Aims The aim of this meta-analysis is to evaluate the potential correlation between obesity and overweight, and the vulnerability to urinary incontinence (UI) in women aged middle-aged and above. Methods We searched PubMed, Cochrane Library, and Embase for observational studies published between the inception of the databases and April 25, 2023. A fixed-effects model was used when the P>0.1 and the I2 ≤ 50%. In cases where I2 ≥ 50% (indicating significant heterogeneity), a random-effects model was applied. For the purpose of evaluating publication bias, a funnel plot and Egger's test were used. Stata 14.0 was used for all statistical analyses. Findings This meta-analysis includes 16 observational studies, covering29,618 individuals. The pooled analysis shows that being overweight(25 kg/m2≤BMI<30kg/m2) in middle-aged and elderly women is more likely to develop UI (OR=1.27; 95% CI: 1.17-1.37; I2 = 51.8%, P=0.013). Middle-aged and elderly women with obesity(30 kg/m2≤BMI<35 kg/m2) are significantly more likely to develop UI (OR=1.60; 95% CI: 1.42-1.81; I2 = 71.8%, P=0.000). In addition, the results indicated a higher probability of UI in middle-aged and older women with obesity class II (BMI≥35 kg/m2) (OR=1.85; 95% CI: 1.59-2.16; I2 = 48.1%, P=0.103). In subgroup analysis, there is no direct relationship between the obesity in middle-aged and elderly women and an increased risk of stress urinary incontinence (SUI) (OR=1.31; 95% CI: 0.99-1.74; I2 = 63.7%, P=0.011). In middle-aged and elderly women with obesity are more likely to develop urgent urinary incontinence (UUI) (OR=2.11; 95% CI: 1.54-2.89; I2 = 80.2%, P=0.000). Conclusion In this meta-analysis, overweight and obesity are associated with an increased risk of UI in middle-aged and elderly women. Obesity and overweight are independent risk factors for UI, as demonstrated by this study. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023421986.
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Affiliation(s)
- Xin Shang
- First School of Clinical Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Yu Fu
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaoqin Jin
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Chenxiao Wang
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Ping Wang
- First School of Clinical Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Panpan Guo
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Ying Wang
- Department of Geriatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shuxun Yan
- Department of Endocrinology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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Güneş Y, Fersahoğlu MM, Bulut NE, Çakmak A, Ergin A, Teke E, Karataş TC, Şahin A, Sancak S. Effects of Sleeve Gastrectomy on Pelvic Floor Disorders in Female Patients with Severe Obesity: a Prospective Study. Obes Surg 2023; 33:3069-3076. [PMID: 37428362 DOI: 10.1007/s11695-023-06725-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Obesity is associated with pelvic floor disorders (PFD). Sleeve gastrectomy (SG) is one of the most effective weight loss methods. Although SG has been found to improve urinary incontinence (UI) and overactive bladder (OAB), its impact on fecal incontinence (FI) remains controversial. MATERIALS AND METHODS This prospective, randomized study involved 60 female patients with severe obesity who were randomly assigned to two groups: the SG group and the diet group. The SG group underwent SG, while the diet group received a low-calorie, low-lipid diet for 6 months. The patients' condition was assessed before and after the study using three questionnaires: the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), the Overactive Bladder 8-Question Awareness Tool (OAB-V8), and the Wexner Score (CCIS). RESULTS After 6 months, the SG group had a significantly higher percentage of total weight loss (%TWL) compared to the diet group (p<0.01). Both groups showed a decrease in the ICIQ-FLUTS, OAB-V8, and CCIS scores (p<0.05). UI, OAB, and FI improved significantly in the SG group (p<0.05), but no improvement was observed in the diet group (p>0.05). The correlation between %TWL and PFD was statistically significant but weak, with the strongest correlation between %TWL and ICIQ-FLUTS score and the weakest correlation between %TWL and CCIS score (p<0.05). CONCLUSIONS We recommend bariatric surgery for the treatment of PFD. However, given the weak correlation between %TWL and PFD after SG, further research should explore factors other than %TWL that are effective in recovery, particularly in relation to FI.
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Affiliation(s)
- Yasin Güneş
- Department of General Surgery, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey.
| | - Mehmet Mahir Fersahoğlu
- Department of General Surgery, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
| | - Nuriye Esen Bulut
- Department of General Surgery, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
| | - Ahmet Çakmak
- Department of General Surgery, Sinop Atatürk State Hospital, 57000, Sinop, Turkey
| | - Anıl Ergin
- Department of General Surgery, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
| | - Emre Teke
- Department of General Surgery, Haydarpaşa Numune Training And Research Hospital, Tıbbiye Cad. No: 23 Üsküdar, 34668, Istanbul, Turkey
| | - Tuğba Caner Karataş
- Department of General Surgery, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
| | - Aytaç Şahin
- Department of Urology, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
| | - Seda Sancak
- Department of Internal Medicine/Endocrinology and Metabolism Disorders, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
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Chen YC, Liang YC, Ho SJ, Chen HW, Juan YS, Tsai WC, Huang SP, Lee JT, Liu YP, Kao CY, Lin YK, Long CY, Wu MN, Chen CJ, Wu WJ. Does COVID-19 Vaccination Cause Storage Lower Urinary Tract Symptoms? J Clin Med 2022; 11:2736. [PMID: 35628863 PMCID: PMC9148126 DOI: 10.3390/jcm11102736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 01/27/2023] Open
Abstract
We investigated the storage lower urinary tract symptoms (LUTS) before and after the first dose of coronavirus disease 2019 (COVID-19) vaccine and the association between pre-vaccinated overactive bladder (OAB) and the worsening of storage LUTS following COVID-19 vaccination. This cross-sectional study in a third-level hospital in Taiwan used the validated pre- and post-vaccinated Overactive Bladder Symptom Score (OABSS). Diagnosis of OAB was made using pre-vaccinated OABSS. The deterioration of storage LUTS was assessed as the increased score of OABSS following vaccination. Of 889 subjects, up to 13.4% experienced worsened storage LUTS after vaccination. OAB was significantly associated with an increased risk of worsening urinary urgency (p = 0.030), frequency (p = 0.027), and seeking medical assistance due to urinary adverse events (p < 0.001) after vaccination. The OAB group faced significantly greater changes in OABSS-urgency (p = 0.003), OABSS-frequency (p = 0.025), and total OABSS (p = 0.014) after vaccination compared to those observed in the non-OAB group. Multivariate regression revealed that pre-vaccinated OAB (p = 0.003) was a risk for the deterioration of storage LUTS. In conclusion, storage LUTS may deteriorate after vaccination. OAB was significantly associated with higher risk and greater changes in worsening storage LUTS. Storage LUTS should be closely monitored after COVID-19 vaccination, especially in those OAB patients.
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Affiliation(s)
- Yu-Chen Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-C.C.); (H.-W.C.); (Y.-S.J.); (S.-P.H.); (Y.-P.L.); (C.-Y.L.); (M.-N.W.); (C.-J.C.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yin-Chi Liang
- School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-C.L.); (S.-J.H.)
| | - Shuo-Jung Ho
- School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-C.L.); (S.-J.H.)
| | - Hao-Wei Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-C.C.); (H.-W.C.); (Y.-S.J.); (S.-P.H.); (Y.-P.L.); (C.-Y.L.); (M.-N.W.); (C.-J.C.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
| | - Yung-Shun Juan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-C.C.); (H.-W.C.); (Y.-S.J.); (S.-P.H.); (Y.-P.L.); (C.-Y.L.); (M.-N.W.); (C.-J.C.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Wei-Chung Tsai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan;
- Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Shu-Pin Huang
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-C.C.); (H.-W.C.); (Y.-S.J.); (S.-P.H.); (Y.-P.L.); (C.-Y.L.); (M.-N.W.); (C.-J.C.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Jung-Ting Lee
- Si Wan College, National Sun-Yat Sen University, Kaohsiung 80424, Taiwan;
| | - Yu-Peng Liu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-C.C.); (H.-W.C.); (Y.-S.J.); (S.-P.H.); (Y.-P.L.); (C.-Y.L.); (M.-N.W.); (C.-J.C.)
| | - Chung-Yao Kao
- Department of Electrical Engineering, National Sun-Yat Sen University, Kaohsiung 80424, Taiwan;
| | - Yen-Ko Lin
- Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Medical Humanities and Education, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Cheng-Yu Long
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-C.C.); (H.-W.C.); (Y.-S.J.); (S.-P.H.); (Y.-P.L.); (C.-Y.L.); (M.-N.W.); (C.-J.C.)
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Meng-Ni Wu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-C.C.); (H.-W.C.); (Y.-S.J.); (S.-P.H.); (Y.-P.L.); (C.-Y.L.); (M.-N.W.); (C.-J.C.)
| | - Chao-Ju Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-C.C.); (H.-W.C.); (Y.-S.J.); (S.-P.H.); (Y.-P.L.); (C.-Y.L.); (M.-N.W.); (C.-J.C.)
| | - Wen-Jeng Wu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (Y.-C.C.); (H.-W.C.); (Y.-S.J.); (S.-P.H.); (Y.-P.L.); (C.-Y.L.); (M.-N.W.); (C.-J.C.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Phé V, Gamé X. [Definition, epidemiology and impact of non-neurogenic overactive bladder]. Prog Urol 2021; 30:866-872. [PMID: 33220814 DOI: 10.1016/j.purol.2020.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Overactive bladder (OAB) is a common condition with a significant functional impact in patients. OBJECTIVE To synthesize current knowledge on the definition, epidemiology and impact of OAB. METHOD A systematic literature review based on Pubmed, Embase, Google Scholar was conducted in June 2020. RESULTS OAB is defined by urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology. In France, OAB affects 14 % of the general population and this prevalence increases with age. This condition is a source of major deterioration in patients' quality of life with a physical (falls, fractures, sleep disorders, fatigue), psychic (anxiety, depression) social (limitation of leisure, isolation) and economic impact. CONCLUSION The definition of OAB is standardized. OAB is a frequent condition and has significant functional consequences with a notable deterioration in quality of life.
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Affiliation(s)
- V Phé
- Sorbonne université, service d'urologie, hôpital Pitié-Salpêtrière, assistance publique-hôpitaux de Paris, Paris, France.
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier, Toulouse, France
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Yoshida M, Takeda M, Gotoh M, Yokoyama O, Kakizaki H, Takahashi S, Masumori N, Nagai S, Minemura K. Cardiovascular safety of vibegron, a new β3-adrenoceptor agonist, in older patients with overactive bladder: Post-hoc analysis of a randomized, placebo-controlled, double-blind comparative phase 3 study. Neurourol Urodyn 2021; 40:1651-1660. [PMID: 34139038 PMCID: PMC8362047 DOI: 10.1002/nau.24732] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 05/10/2021] [Accepted: 05/25/2021] [Indexed: 11/09/2022]
Abstract
AIMS To examine the safety and efficacy of vibegron, a new β3-adrenoceptor agonist, in patients aged ≥65 years, with a focus on the effects on cardiovascular system and overactive bladder (OAB) symptoms. METHODS A post-hoc subgroup analysis was performed of a randomized, placebo-controlled, double-blind comparative phase 3 study of vibegron, including those assigned to receive either vibegron 50 mg (V50), vibegron 100 mg (V100), or placebo for 12 weeks. Subjects were stratified into two subgroups based on age: a <65-year subgroup and a ≥65-year subgroup. Safety (changes in systolic and diastolic blood pressure, pulse rate, and residual urine volume) and efficacy (changes in the numbers of micturitions, urgency episodes, urgency urinary incontinence [UUI] episodes, and the voided volume/micturition) were assessed in the subgroups treated with vibegron vs. placebo. RESULTS There were no significant differences in the cardiovascular outcomes (blood pressure and pulse rate), nor in the changes in residual urine volume, between the V50/100 and placebo groups in the <65-year or ≥65-year subgroup after 12-week treatment. Adverse events were slightly increased in the ≥65-year subgroup. In the efficacy analysis, V50/100 demonstrated similar efficacy in the <65-year and ≥65-year subgroups; an increasing trend in the voided volume/micturition was observed in subjects aged ≥65 years compared to subjects aged <65 years. CONCLUSIONS Vibegron was suggested to be similarly effective in patients ≥65 and <65 years and to have minimal influence on cardiovascular parameters.
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Affiliation(s)
- Masaki Yoshida
- Department of Urology, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Masayuki Takeda
- Department of Urology, University of Yamanashi, Graduate School of Medical Sciences, Yamanashi, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Osamu Yokoyama
- Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Hidehiro Kakizaki
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Hokkaido, Japan
| | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Shinji Nagai
- Medical Affairs, Kyorin Pharmaceutical Co., Ltd., Toyko, Japan
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Elbaset MA, Taha DE, Sharaf DE, Ashour R, El-Hefnawy AS. Obesity and Overactive Bladder: Is It a Matter of Body Weight, Fat Distribution or Function? A Preliminary Results. Urology 2020; 143:91-96. [DOI: 10.1016/j.urology.2020.04.115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 11/26/2022]
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Wei MC, Chou YH, Yang YS, Kornelius E, Wang YH, Huang CN. Osteoporosis and Stress Urinary Incontinence in Women: A National Health Insurance Database Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4449. [PMID: 32575826 PMCID: PMC7344808 DOI: 10.3390/ijerph17124449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/06/2020] [Accepted: 06/18/2020] [Indexed: 12/21/2022]
Abstract
We aimed to determine the influence of osteoporosis and stress urinary incontinence in women. We hypothesized that women with osteoporosis had an increased risk of stress urinary incontinence. This retrospective study used data from the Taiwan Longitudinal Health Insurance database from 2005-2009. The study population was screened to identify women (age ≥ 40 years) newly diagnosed with osteoporosis (ICD-9-CM code = 733.0, 733.1). The osteoporosis cohort included 6125, and the non-osteoporosis cohort included 12,250 participants. The newly diagnosed stress urinary incontinence incidence was calculated to determine the influence of osteoporosis and stress urinary incontinence. We used the Cox proportional hazards model to predict the effects of stress urinary incontinence and the Kaplan-Meier analysis to estimate the cumulative incidence of stress urinary incontinence in women. Participants with osteoporosis experienced a 1.79 times higher risk than that of the non-osteoporosis group (95% CI = 1.28-2.51) for stress urinary incontinence, regardless of age. We did not observe a higher risk of stress urinary incontinence in participants with pathological fractures compared to those with simple osteoporosis. Our data emphasized that physicians and nurses should conduct urinary incontinence screening in women with osteoporosis to recommend proper treatment, medical help or to bring the disorder to light.
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Affiliation(s)
- Ming-Cheng Wei
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Department of Neurosurgery, Lee General Hospital, Yuanli Town, Miaoli 35845, Taiwan
| | - Ying-Hsiang Chou
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Yi-Sun Yang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (Y.-S.Y.); (E.K.)
| | - Edy Kornelius
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (Y.-S.Y.); (E.K.)
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
| | - Chien-Ning Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (Y.-S.Y.); (E.K.)
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Nazari F, Shaygannejad V, Mohammadi Sichani M, Mansourian M, Hajhashemi V. Quality of life among patients with multiple sclerosis and voiding dysfunction: a cross-sectional study. BMC Urol 2020; 20:62. [PMID: 32493262 PMCID: PMC7268392 DOI: 10.1186/s12894-020-00590-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 02/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Evaluating the usefulness of treatment requires a direct measurement of the health-related quality of life (QOL). Therefore, this study was carried out aiming to determine the QOL of patients with MS and voiding dysfunction. METHODS This cross-sectional study was carried out using multi-stage random cluster sampling method on 602 patients with MS in Isfahan, Iran. All data were collected through interviews using standard questionnaires including International Prostate Symptom Score (IPSS), and the Multiple Sclerosis Quality of Life-54 (MSQOL-54). Data were analyzed using descriptive and inferential statistical tests. RESULTS The prevalence rate of mixed, irritative, and obstructive urinary symptoms was 52.2, 25.5, and 6.5%, respectively. The mixed symptom had the highest prevalence among men and women with rates of 56.5 and 51.1%, respectively. The prevalence of irritative and obstructive symptoms was, respectively, higher and statistically significant among women alone and men alone (P < 0.05). The prevalence of irritative symptoms was higher among patients with MS, EDSS score ≤ 3, disease duration of less than 5 years, and with clinically isolated syndrome. In addition, the prevalence of mixed symptoms was higher among patients with MS of over 30 years of age with a Pre-high school degree, severe disability, disease duration of over 10 years, and progressive MS; the difference was statistically significant (P < 0.05). There was a difference in the combined dimensions of physical and mental health of QOL between the two groups with and without urinary symptoms (P < 0.05). Logistic regression analysis revealed that there was a higher probability of a urinary problems among patients with MS and high age [3.273 (1.083-9.860); P = 0.035]. CONCLUSIONS Mixed urinary symptoms are highly prevalent among MS patients and affect QOL dimensions. In order to improve QOL, more attention and focus should be paid to urinary problems in MS patients.
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Affiliation(s)
- Fatemeh Nazari
- Isfahan neurosciences Research center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Adult Health Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vahid Shaygannejad
- Isfahan neurosciences Research center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrdad Mohammadi Sichani
- Isfahan Kidney Transplantation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Department of Epidemiology & Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Valiollah Hajhashemi
- Isfahan Pharmaceutical Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Prevention of Stress Urinary Incontinence in Women. CURRENT BLADDER DYSFUNCTION REPORTS 2020. [DOI: 10.1007/s11884-019-00570-3] [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]
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Abstract
Age and body mass index are associated with increased risks of overactive bladder, whereas employment status is associated with a decreased risk of overactive bladder. Objective The purpose of this study was to investigate the risk factors of overactive bladder (OAB). Methods The PubMed, Embase, and Cochrane Library databases were retrieved through May 2016. Odds ratios (OR) or standard mean differences (SMDs) with 95% confidence intervals (CIs) were used to evaluate the associations between risk factors and OAB. Heterogeneity among studies was examined using χ2 test based on the Q and I2 tests. Results A total of 28 articles were analyzed in our study. The results suggested that age and body mass index were significantly higher in OAB patients than in non-OAB controls (SMDs [95% CIs], 0.30 [0.19–0.41] and 0.39 [0.24–0.53]). A significant negative association was found between employment status and OAB (OR [95% CIs], 0.64 [0.46–0.90]). However, sex, educational level, parity, vaginal delivery, race, menopause, marital status, smoking, and alcohol consumption were not significantly different in OAB and non-OAB control patients (ORs [95% CIs], 0.95 [0.59–1.55], 1.04 [0.82, 1.33], 0.98 [0.56–1.70], 1.66 [0.90–3.07], 0.98 [0.75–1.28], 1.84 [0.23–14.70], 0.97 [0.78–1.19], 0.91 [0.77–1.08], and 0.88 [0.71–1.09], respectively). In addition, the number of parities and vaginal deliveries in OAB patients also showed no significant differences compared with non-OAB control patients (SMDs [95% CI], 0.05 [−0.27 to 0.38] and −0.16 [0.40 to 0.09]). Conclusions This meta-analysis suggests that age and body mass index are associated with increased risks of OAB, whereas employment status is associated with a decreased risk of OAB. Further prospective studies with large sample sizes are needed to confirm this conclusion.
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Cankurtaran V, Ozates S, Ozler S, Dirican E. Association of diabetic retinopathy stage with the severity of female urinary incontinence. Neurourol Urodyn 2019; 38:1883-1888. [DOI: 10.1002/nau.24086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/10/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Veysel Cankurtaran
- Department of OphthalmologyMedical School of Mustafa Kemal University Antakya Hatay Turkey
| | - Serdar Ozates
- Department of OphthalmologyKars Harakani State Hospital Kars Turkey
| | - Serkan Ozler
- Department of UrologyMedical School of Mustafa Kemal University Antakya Hatay Turkey
| | - Emre Dirican
- Department of BiostatisticsMedical School of Mustafa Kemal University Antakya Hatay Turkey
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de Souza AC, Gallo CBM, Passos MCDF, Croccia C, Miranda GL, Sampaio FJB, Gregório BM. Effect of a high-fat diet on the rat bladder wall and bioactive action of Brazil nut oil. Int Braz J Urol 2019; 45:161-168. [PMID: 30556993 PMCID: PMC6442138 DOI: 10.1590/s1677-5538.ibju.2018.0547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/05/2018] [Indexed: 12/28/2022] Open
Abstract
High-fat diet-induced obesity is associated with metabolic disorders. The Brazil nut has bioactive substances and has been used to control the damage caused by obesity in several organs. The work intended to show the damage caused by high-fat diet in the bladder wall and if the Brazil nut oil added to the diet could ameliorate or reverse this effect. Sixty-day-old rats were divided into two groups: C (control, n = 30) and HF (high-fat, n = 30) diets. At 90 days, 10 animals of each group were sacrificed. The others were divided into 4 groups: C and HF (animals that maintained their previous diet, n = 10 for each group) and C / Bno and HF / Bno (animals whose control or high-fat diet was supplemented by Brazil nut oil, n = 10 for each group). Sacrifice occurred at 120 days, and the bladders were removed and analyzed. Epithelial height was increased in the HF compared to the C group. In contrast, the C / Bno had a lower epithelial height compared to the others. The percentage of collagen between the detrusor muscle fibers was significantly greater in C / Bno, HF and HF / Bno than in control group. The HF had a larger muscle fiber diameter than the C group, while the C / Bno presented lower values than the HF and HF / Bno groups. HF diets induced bladder wall damage. These changes in the rat's bladder wall were partially reversed by the Bno.
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Affiliation(s)
- Aline Costa de Souza
- Unidade de Pesquisa Urogenital, Centro Biomédico, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Carla Braga Mano Gallo
- Unidade de Pesquisa Urogenital, Centro Biomédico, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Magna Cottini da Fonseca Passos
- Departamento de Nutrição Aplicada, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Carolina Croccia
- Instituto de Nutrição Josue de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Glauciane Lacerda Miranda
- Instituto de Nutrição Josue de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | - Bianca Martins Gregório
- Unidade de Pesquisa Urogenital, Centro Biomédico, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Mueller ER, van Maanen R, Chapple C, Abrams P, Herschorn S, Robinson D, Stoelzel M, Yoon SJ, Al-Shukri S, Rechberger T, Gratzke C. Long-term treatment of older patients with overactive bladder using a combination of mirabegron and solifenacin: a prespecified analysis from the randomized, phase III SYNERGY II study. Neurourol Urodyn 2019; 38:779-792. [PMID: 30644570 PMCID: PMC6850571 DOI: 10.1002/nau.23919] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 12/11/2018] [Indexed: 12/25/2022]
Abstract
Aims SYNERGY II was a 12‐month phase III trial in patients with overactive bladder (OAB) symptoms that investigated the safety and efficacy of the combination of mirabegron and solifenacin in comparison with each monotherapy. This analysis evaluated the trial findings using four age subgroups (<65, ≥65, <75, and ≥75 years). Methods Eligible patients were ≥18 years with symptoms of “wet” OAB (urinary frequency and urgency with incontinence) for ≥3 months. Patients were randomized to receive once‐daily solifenacin succinate and mirabegron (5 mg/50 mg; combination), solifenacin succinate, or mirabegron (4:1:1). Safety evaluations: treatment‐emergent adverse events (TEAEs), vital signs, and electrocardiogram, post‐void residual volume, and laboratory assessments. Primary efficacy variables: change from baseline to end of treatment in number of incontinence episodes/24 h and micturitions/24 h. Results Of 1794 patients (full analysis set), 614 (34.2%) and 168 (9.4%) were ≥65 and ≥75 years old, respectively. Overall, 856 (47.2%) patients experienced ≥1 TEAE. Higher TEAE incidences were typically observed for the combination versus both monotherapies (eg, constipation) and in the older versus younger age groups (eg, urinary tract infection). Increases in mean pulse rate from baseline of >1 bpm were noted in the combination and mirabegron younger age groups only. No clinically significant findings were observed in the other safety parameters. The efficacy variables improved with all treatments and the greatest improvements were typically observed with combination therapy. Conclusions Mirabegron and solifenacin combination therapy was a well‐tolerated and effective treatment for patients with OAB symptoms irrespective of their age.
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Affiliation(s)
| | - Rob van Maanen
- Astellas Pharma Global Development, Leiden, The Netherlands
| | - Christopher Chapple
- Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Paul Abrams
- Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Sender Herschorn
- University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | | | | | - Sang J Yoon
- Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, South Korea
| | - Salman Al-Shukri
- Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
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Weber-Rajek M, Radzimińska A, Strączyńska A, Podhorecka M, Kozakiewicz M, Perkowski R, Jarzemski P, Kędziora-Kornatowska K, Goch A. A randomized-controlled trial pilot study examining the effect of extracorporeal magnetic innervation in the treatment of stress urinary incontinence in women. Clin Interv Aging 2018; 13:2473-2480. [PMID: 30584287 PMCID: PMC6287547 DOI: 10.2147/cia.s176588] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Introduction Peri- and postmenopausal women frequently suffer from urinary incontinence (UI). Generally, UI becomes more severe with age. It impacts physical, mental, and social functioning as well as the quality of life, often leading to depression. Extracorporeal magnetic innervation (ExMI) is a relatively new conservative treatment method for UI. Objective The aim of the study was to assess the effectiveness of ExMI in the treatment of stress UI in women. Methods A total of 52 women were included in the analysis: 28 participants were allocated to the experimental group (EG) and 24 to the control group (CG). The average age was 65.41 years (±SD 4.08). EG patients completed ExMI therapy. The treatment sessions lasted for 15 minutes, and occurred three times a week, for 4 weeks. No therapeutic intervention was applied to the CG. To objectify the treatment outcomes in both groups before and after the treatment, we measured myostatin concentration and performed the UI severity assessment (The Revised Urinary Incontinence Scale), perceived self-efficacy assessment (General Self-Efficacy Scale), and depression severity assessment (Beck Depression Inventory). Results The authors compared the EG results at the initial and final assessments and found a statistically significant improvement in severity of UI (P=0.001) and depression severity (P=0.006), and a decrease in myostatin concentration (P≤0.001). The authors did not find any statistically significant differences between all measured variables for the CG at the initial and final assessments. Furthermore, there were no statistically significant differences between all measured variables for the EG and the CG at the final assessment. Conclusion Further trials are needed to determine optimal treatment protocols for various UI types and to evaluate long-term outcomes of the ExMI treatment.
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Affiliation(s)
- Magdalena Weber-Rajek
- Department of Physiotherapy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland,
| | - Agnieszka Radzimińska
- Department of Physiotherapy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland,
| | - Agnieszka Strączyńska
- Department of Physiotherapy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland,
| | - Marta Podhorecka
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Mariusz Kozakiewicz
- Department of Food Chemistry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Radosław Perkowski
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Piotr Jarzemski
- Clinic of Urology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | | | - Aleksander Goch
- Department of Physiotherapy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland,
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Lai HH, Helmuth ME, Smith AR, Wiseman JB, Gillespie BW, Kirkali Z. Relationship Between Central Obesity, General Obesity, Overactive Bladder Syndrome and Urinary Incontinence Among Male and Female Patients Seeking Care for Their Lower Urinary Tract Symptoms. Urology 2018; 123:34-43. [PMID: 30393054 DOI: 10.1016/j.urology.2018.09.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/27/2018] [Accepted: 09/15/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To describe the relationship between metabolic factors and lower urinary tract symptoms, overactive bladder syndrome (OAB) and urinary incontinence (UI). METHODS Adult male and female patients who presented to a clinician from the symptoms of lower urinary tract dysfunction research network were recruited. Urinary symptoms (presence of OAB, any UI, stress UI (SUI), urgency UI (UUI), urgency, frequency, and nocturia) were assessed with the lower urinary tract symptoms tool. Metabolic factors assessed included central obesity (waist circumference, using the Adult Treatment Panel III, the International Diabetes Federation thresholds, and waist circumference as a continuous variable), general obesity (body mass index as dichotomous or continuous variables), diabetes mellitus, hypertension, and dyslipidemia. Multivariable logistic regression was used to test for associations. RESULTS 920 participants were studied. In multivariable analyses, central obesity (per 10 cm larger waist) was associated with higher odds of UI in both sexes (odds ratio [OR] = 1.16, P = .008), SUI in females (OR = 1.27, P = .008), UUI in both sexes (OR = 1.24, P = .001), OAB in females (OR = 1.248, P = .003), as well as frequency and nocturia. General obesity (5-unit increase in body mass index) was associated with UI, UUI, urgency and frequency in both sexes, and with SUI and OAB in females. We did not find associations between central or general obesity and OAB in males. Dyslipidemia was associated with nocturia ≥2. CONCLUSION In patients, central and general obesity were key metabolic factors associated with UI in both males and females, and with OAB in females but not in males. The association between dyslipidemia and nocturia ≥2 needs further research.
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Affiliation(s)
- H Henry Lai
- Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO.
| | | | | | | | | | - Ziya Kirkali
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
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Kuo HC. Individualizing medical treatment of overactive bladder. Tzu Chi Med J 2018; 30:195-199. [PMID: 30305780 PMCID: PMC6172903 DOI: 10.4103/tcmj.tcmj_83_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 04/30/2018] [Accepted: 05/13/2018] [Indexed: 12/27/2022] Open
Abstract
Overactive bladder (OAB) syndrome is highly prevalent in both men and women and might have negative impact on quality of life. Clinical trials of OAB usually highly select participants that may not reflect the real-world practice of OAB patients. The spectrum of OAB includes patients with idiopathic, neuropathic, with bladder outlet obstruction, and patients in elderly and medical comorbidities. Patients might have poor response to OAB medication or have adverse events after treatment. Therefore, treatment of OAB should be individualized to obtain therapeutic efficacy and avoid unacceptable adverse events. This article reviews the recently published literature and provides a guide for physicians to choose the appropriate treatment for different OAB patients.
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Affiliation(s)
- Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Department of Urology, School of Medicine, Tzu Chi University, Hualien, Taiwan
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Lower Urinary Tract Symptoms in Elderly Population With Multiple Sclerosis. Int Neurourol J 2018; 22:58-64. [PMID: 29609425 PMCID: PMC5885135 DOI: 10.5213/inj.1835054.527] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 02/22/2018] [Indexed: 12/29/2022] Open
Abstract
Purpose The aim of this study is to compare the clinical and urodynamic characteristics of urinary disorders in multiple sclerosis (MS) patients in a geriatric population with a nongeriatric population. Methods This study was conducted retrospectively between 2010 and 2016. Each patient with MS aged 65 and older was matched with 2 patients with MS aged less than 65 in sex, form of MS, and Expended Disability Status Scale (EDSS). Demographic data, urinary symptoms, treatment, quality of life, repercussion of lower urinary tract symptoms on daily life activities and psychological state and urodynamic parameters were collected. Differences between the 2 populations were evaluated using Student test, chi-square, or Fischer tests. Results Twenty-four patients with MS aged 65 and older (mean age, 69.8 years) were matched with 48 patients aged less than 65 years (mean age, 49.4 years). Maximum urethral closure pressure was lower in the elderly population than in the nongeriatric population (mean±standard deviation [SD]: 35.6±18.5 cm H<sub>2</sub>O vs. 78.2±52.3 cm H<sub>2</sub>O, P<0.001). In the male population, there was no statistical difference in any other clinical or urodynamic endpoints. In the female population, voiding symptoms was more described in the nongeriatric population (Urinary Symptom Profile low stream: 3.4±3.5 vs. 1.7±2.4, P=0.04), geriatric population had less urinary treatment (P=0.05). LUTS had less impact on quality of life (Qualiveen: 1.4±1.0 vs. 2.1±0.9, P=0.02) on the geriatric population than in the nongeriatric of female MS patients. Conclusions Geriatric population of MS has few differences of urinary disorders compared to a nongeriatric population with EDSS, sex, and MS form equal. However, the psychological impact of these urinary disorders is less important in female geriatric population.
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Keller N, Schmid S, Borcard A, Hämmerle B. [Not Available]. PRAXIS 2018; 107:263-269. [PMID: 29486647 DOI: 10.1024/1661-8157/a002901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Zusammenfassung. In der Grundversorgerpraxis ist die überaktive Blase (OAB) bei der älteren, polymorbiden Patientin ein immer häufiger auftretendes Krankheitsbild. Die OAB wird definiert als imperativer Harndrang mit oder ohne Inkontinenz sowie Pollakisurie und Nykturie ohne Harnwegsinfektion oder andere Pathologie. Die Symptomatik schränkt die Betroffenen im Alltag deutlich ein. Das Behandlungskonzept basiert auf einer Stufentherapie. Neben Verhaltensschulung und Beckenbodentherapie gibt es auch die Möglichkeit einer medikamentösen Therapie. Diese ist jedoch wegen häufiger Nebenwirkungen und Wechselwirkungen nicht für alle Patientinnen geeignet. In Kombination mit medikamentöser Therapie oder bei Kontraindikation oder Versagen derselben gibt es die Möglichkeit der perkutanen posterioren tibialen Nervenstimulation (PTNS). Diese Therapieform kann ambulant angewendet werden, ist minimalinvasiv, nebenwirkungsarm und häufig erfolgreich.
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Valentini FA, Marti BG, Robain G. Do urodynamics provide a better understanding of voiding disorders in women over 80? Prog Urol 2018; 28:230-235. [PMID: 29307483 DOI: 10.1016/j.purol.2017.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/14/2017] [Accepted: 12/05/2017] [Indexed: 11/17/2022]
Abstract
AIMS Population ageing has as consequence an increasing number of women older than 80 years with lower urinary tract symptoms (LUTS). Despite old age, urodynamic study is often performed to diagnose the cause of LUTS. Our purpose is to discuss the contribution of urodynamics to manage that population. METHODS Urodynamic studies of 169 consecutive women older than 80 years, respectively 124 non-neurological (non-N) and 45 neurological (N), were retrospectively analysed. RESULTS Number of co-morbidities was lower in non-N (2.5 vs. 3.1) with predominance of cardiovascular and endocrinology while musculo-skeletal, cognitive and previous pelvic surgery predominated in N. Among main complaint, incomplete retention or dysuria was more frequent in N while incontinence and frequency were predominant in non-N. More frequent urodynamic diagnosis (UD) was "normal" i.e. non contributive (25.0%) and intrinsic sphincter deficiency (ISD=21.7%) in non-N, detrusor overactivity (DO=42.2%) and detrusor underactivity (DU=38.8%) in N. In non-N, there were 94 treatment proposals based on the complaint when UD was "normal" and on UD for DO, DU and ISD. In N, treatment proposals were mainly prompted voiding or self-catheterization based on DU diagnosis. CONCLUSION Usefulness of urodynamics to manage LUT dysfunction in women older than 80 y is greatly dependent on their neurological status. In non-neurological women this is non debatable but proposed treatment needs to take into account existing co-morbidities. In neurological women the main usefulness is to unmask DU and to propose the best management in order to avoid complete retention. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- F A Valentini
- Service de médecine physique et de la réadaptation, université Pierre-et-Marie-Curie, hôpital Rothschild, 5, rue Santerre, 75012 Paris, France.
| | - B G Marti
- Hôpital Saint-Antoine, 75012 Paris, France
| | - G Robain
- Service de médecine physique et de la réadaptation, université Pierre-et-Marie-Curie, hôpital Rothschild, 5, rue Santerre, 75012 Paris, France
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Changes of Bladder Function Related to the Effects of Menopause. WOMEN’S HEALTH BULLETIN 2017. [DOI: 10.5812/whb.14390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gibson W, Hunter KF, Camicioli R, Booth J, Skelton DA, Dumoulin C, Paul L, Wagg A. The association between lower urinary tract symptoms and falls: Forming a theoretical model for a research agenda. Neurourol Urodyn 2017; 37:501-509. [PMID: 28471525 DOI: 10.1002/nau.23295] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/31/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is a well-recognised association between falls and lower urinary tract symptoms (LUTS) in older adults, with estimates of odd ratios for falls in the presence of LUTS ranging between 1.5 and 2.3. Falls and LUTS are both highly prevalent among older people and both are markers of frailty, with significant associated morbidity, mortality, and healthcare resource cost. This association is not well examined or explained in the literature. AIMS We aimed to outline current knowledge of the association between falls and lower urinary tract symptoms and suggest a research program to further investigate this. MATERIALS AND METHODS A consensus conference of experts in the field was convened to review the current literature and brainstorm potential future investigative avenues. RESULTS AND DISCUSSION Despite the recognition of this association, there has been little research to examine its potential causes, and no intervention trial has established if reducing LUTS or urinary incontinence can reduce the risk of falls. The commonly held assumption that urgency causes falls through rushing to the toilet is likely incorrect. Falls and LUTS are both symptoms of frailty and have many common causes. Gait, balance, and continence are all processes requiring cognitive input, and the concept of dual tasking may be a further link. CONCLUSION The significant association between lower urinary tract symptoms and falls is currently unexplained, and further research into the potential causes of this association is needed.
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Affiliation(s)
- William Gibson
- Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Camicioli
- Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Joanne Booth
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - Lorna Paul
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Adrian Wagg
- Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada
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Løvvik A, Müller S, Patel HRH. Pharmacological Treatment of Post-Prostatectomy Incontinence: What is the Evidence? Drugs Aging 2016; 33:535-44. [DOI: 10.1007/s40266-016-0388-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Espuña-Pons M, Ros C, Ortega JA, Aliaga F, Pérez-González A, Palau MJ. Prevalence, incidence, and remission rates of urinary incontinence in women attended in gynecological practice. Neurourol Urodyn 2016; 36:1081-1085. [DOI: 10.1002/nau.23042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/06/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Montserrat Espuña-Pons
- Pelvic Floor Unit, ICGON, Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - Cristina Ros
- Pelvic Floor Unit, ICGON, Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | | | | | - Amelia Pérez-González
- Pelvic Floor Unit, ICGON, Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
| | - Maria José Palau
- Pelvic Floor Unit, ICGON, Hospital Clinic de Barcelona; University of Barcelona; Barcelona Spain
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Kushner P. Benefits/risks of sodium-glucose co-transporter 2 inhibitor canagliflozin in women for the treatment of Type 2 diabetes. WOMEN'S HEALTH (LONDON, ENGLAND) 2016; 12:379-88. [PMID: 26928259 PMCID: PMC5384506 DOI: 10.2217/whe-2016-0001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 01/02/2023]
Abstract
Sodium-glucose co-transporter 2 (SGLT2) inhibitors, such as canagliflozin, are used in patients with Type 2 diabetes mellitus (T2DM). In clinical studies, canagliflozin significantly reduced A1C, bodyweight and blood pressure, and was generally well tolerated with no increased risk of hypoglycemia. Most common adverse effects observed were genital mycotic infections and urinary tract infections, and increased urination. Approximately 10% of women treated with canagliflozin experienced a genital mycotic infection compared with 3% treated with placebo; those with a prior history were at greater risk. Approximately 9% of women treated with canagliflozin reported a urinary tract infection compared with 7% treated with placebo. Most adverse events were considered mild to moderate in intensity and responded to standard therapy. Treatment with canagliflozin was effective and generally well tolerated in both women (and men) with T2DM.
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Intravesical OnabotulinumtoxinA Injection for Overactive Bladder Patients with Frailty, Medical Comorbidities or Prior Lower Urinary Tract Surgery. Toxins (Basel) 2016; 8:91. [PMID: 27023603 PMCID: PMC4848618 DOI: 10.3390/toxins8040091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/16/2016] [Accepted: 03/18/2016] [Indexed: 02/01/2023] Open
Abstract
Overactive bladder (OAB) symptoms increase with age and involve several comorbidities. OnabotulinumtoxinA (BoNT-A) intravesical injection is a treatment choice for patients who are intolerant of or refractory to antimuscarinics. However, the increased risk of urinary tract infection and elevated post-void residual (PVR) volume post-treatment require resolution. Male sex, baseline PVR > 100 mL, and comorbidities are independent risk factors of adverse events (AEs) such as acute urinary retention (AUR). Intravesical BoNT-A injection is safe and effective for OAB patients with frailty, medical comorbidities such as Parkinson's disease (PD), chronic cerebrovascular accidents (CVA), dementia, or diabetes, or a history of prior lower urinary tract surgery (prostate or transvaginal sling surgery). Post-treatment, 60% of frail elderly patients had a PVR volume > 150 mL and 11% had AUR. Although intravesical BoNT-A injection is safe for PD patients, CVA patients had higher strain voiding rates. Diabetic patients were at increased risk of large PVR urine volume and general weakness post-treatment. Treatment results were similar between patients with and without a history of prostate or transvaginal sling surgery. Possible AEs and bladder management strategies should be conveyed to patients before treatment. Careful patient selection is important, and therapeutic safety and efficacy should be carefully balanced.
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Chen JL, Chen SF, Jiang YH, Kuo HC. Practical points in the medical treatment of overactive bladder and nocturia in the elderly. Tzu Chi Med J 2016; 28:1-5. [PMID: 28757708 PMCID: PMC5509172 DOI: 10.1016/j.tcmj.2015.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 12/08/2015] [Accepted: 12/10/2015] [Indexed: 11/26/2022] Open
Abstract
The prevalence of overactive bladder (OAB) increases with age. Degeneration of the central nervous system in the elderly has been proposed as one of the pathogenic factors of OAB. Antimuscarinic therapy is effective in the treatment of OAB; however, intolerable systemic adverse events and cognitive dysfunction during treatment with nonselective antimuscarinic agents is of growing concern in elderly patients. The newly developed beta-3 adrenoceptor agonist mirabegron does not adversely affect flow rate and detrusor pressure, and its therapeutic efficacy and tolerability are similar in patients aged > 65 years and > 75 years, suggesting it might be the therapeutic choice in older patients with OAB. Nocturia can cause sleep deprivation at night and increase daytime sleepiness and loss of energy in the elderly. Desmopressin add-on therapy is effective in improving nocturia and storage symptoms. However, elderly patients with a baseline serum sodium level below the normal range are at high risk of developing significant hyponatremia.
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Affiliation(s)
- Jing-Liang Chen
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Sheng-Fu Chen
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Yuan-Hong Jiang
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Kuo HC. OnabotulinumtoxinA Treatment for Overactive Bladder in the Elderly: Practical Points and Future Prospects. Drugs Aging 2015; 33:1-9. [PMID: 26666524 DOI: 10.1007/s40266-015-0335-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Overactive bladder (OAB) increases with age. OAB in the elderly may be associated with increased risks of falls, fractures and mortality. Degeneration of the central nervous system in the elderly is proposed as one of the pathogenic factors for OAB. Recently, onabotulinumtoxinA (BoNT-A) 100 U has been demonstrated to be well tolerated, and it significantly improves all OAB symptoms and health-related quality of life in patients who are inadequately managed with anticholinergics. However, an increased risk of a large post-void residual volume and a lower long-term success rate were noted in frail elderly patients. Careful patient selection for BoNT-A injection treatment is important in elderly OAB patients. Patients who are frail, are elderly, have comorbidity or have a post-void residual volume >100 mL should be monitored carefully after BoNT-A injection treatment to prevent urinary retention and subsequent urinary tract infection. Use of liposomes to carry BoNT-A across the urothelial barrier decreases urgency-frequency episodes without compromising detrusor contractility and might avoid urinary tract infection. This treatment might prevent undesired detrusor underactivity after BoNT-A injection treatment, especially in elderly patients who have low detrusor contractility. For treatment of OAB in the elderly, clinicians should be aware of the balance between therapeutic efficacy and safety.
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Affiliation(s)
- Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital, Tzu Chi University, 707, Section 3, Chung Yang Road, Hualien, Taiwan.
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Ros C, Espuña-Pons M, Ortega J, Aliaga F. Urinary incontinence in gynaecological consultations. Do all women with symptoms wish to be treated? Actas Urol Esp 2015; 39:628-34. [PMID: 26233478 DOI: 10.1016/j.acuro.2015.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 06/16/2015] [Accepted: 06/17/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine the prevalence and symptom severity of urinary incontinence (UI) in women who attend primary care gynaecological consultations, as well as the proportion of women with UI symptoms who wish to be studied and treated. MATERIALS AND METHODS A multicentre, observational, descriptive cross-sectional study was conducted of women who visit the 8 specialised consultations for sexual and reproductive health (SRH) in the 4 Catalan provinces for any reason (except UI, pregnancy and postpartum). We employed the ICQ-UI-SF questionnaire to detect UI symptoms. Women with UI symptoms (ICI-Q-SF>0) were asked whether they wanted specific care for their UI problem. Those who answered "no" were asked why. RESULTS The study included 2840 women, 41.8% of whom reported urine losses, especially mild to moderate symptoms. Some 53.62% of the women with UI responded that they did not wish to be treated. Of these, 75% had mild symptoms, 45% had moderate symptoms, and only 16% and 5% had severe or very severe symptoms, respectively. Fifty-three percent of the women did not want treatment because the UI was not a significant problem for them. CONCLUSIONS Almost half of the women who attended a specialised consultation for SRH for any reason reported UI symptoms, especially mild and moderate. More than half of the patients with UI symptoms did not want to start a diagnostic and treatment process for their problem. Symptom severity is associated with the willingness to be treated.
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Freeman S, Hirdes JP, Stolee P, Garcia J, Smith TF. Correlates and Predictors of Changes in Dyspnea Symptoms Over Time Among Community-Dwelling Palliative Home Care Clients. J Pain Symptom Manage 2015; 50:793-805. [PMID: 26297850 DOI: 10.1016/j.jpainsymman.2015.06.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 06/05/2015] [Accepted: 07/07/2015] [Indexed: 11/16/2022]
Abstract
CONTEXT Dyspnea is a frequently reported and highly distressing symptom for persons nearing end of life, affecting the quality of living and dying. OBJECTIVES This study described health and clinical characteristics of persons experiencing dyspnea who receive palliative home care services and identified factors affecting change in dyspnea over time. METHODS Anonymized assessments (N = 6655 baseline; 959 follow-up) from the interRAI palliative care assessment instrument (interRAI PC) were collected during pilot implementation (2006-2011). Triggering of the interRAI PC dyspnea clinical assessment protocol was used to indicate presence of dyspnea. Bivariate and logistic regression analyses described risk and protective factors for developing new dyspnea and for recovery from dyspnea at follow-up. RESULTS At baseline, 44.9% of persons exhibited dyspnea. Dyspnea was more prevalent among older adults, males, persons with shortened prognoses, and persons without cancer. Persons with dyspnea were more likely to experience functional impairment, moderate cognitive impairment, fatigue, weight loss, and urinary incontinence. Among persons with dyspnea at baseline, 31.5% recovered from dyspnea at follow-up. In contrast, 31% of persons without dyspnea at baseline reported new dyspnea at follow-up. Risk factors for developing new dyspnea included smoking, fatigue, and receiving oxygen therapy. CONCLUSION Results highlight that dyspnea is not inevitable as persons progress toward death. Accordingly, dyspnea should be identified and prioritized during the care planning process. Integrated approaches using the interRAI PC dyspnea clinical assessment protocol may assist clinicians to make informed decisions addressing dyspnea at the person-level and thereby improve quality of life at the end of life.
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Affiliation(s)
- Shannon Freeman
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada.
| | - John P Hirdes
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; interRAI Canada, Waterloo, Ontario, Canada
| | - Paul Stolee
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - John Garcia
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Trevor Frise Smith
- interRAI Canada, Waterloo, Ontario, Canada; Department of Sociology, Nipissing University, North Bay, Ontario, Canada
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Zhu L, Cheng X, Sun J, Lv S, Mei S, Chen X, Xi S, Zhang J, Yang M, Bai W, Yan X. Association between Menopausal Symptoms and Overactive Bladder: A Cross-Sectional Questionnaire Survey in China. PLoS One 2015; 10:e0139599. [PMID: 26448626 PMCID: PMC4598107 DOI: 10.1371/journal.pone.0139599] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 09/14/2015] [Indexed: 11/19/2022] Open
Abstract
Purpose The association between menopause and overactive bladder is controversial. The purpose of this study was to determine the association between menopausal symptoms and overactive bladder, and identify the risk factors for overactive bladder. Methods A cross-sectional study was performed. The study included 403 women aged 36–76 years who visited the menopause clinic at Peking University First Hospital between September 2012 and December 2013. The overactive bladder symptom score and modified Kupperman index questionnaires were used. Differences were assessed using descriptive statistics to determine any association between the overactive bladder symptom score and modified Kupperman index score, and to evaluate the risk factors for overactive bladder. Results A total of 304 women were finally enrolled. The prevalence of overactive bladder was 9.43%, and the modified Kupperman index score; number of sexual problems; and frequency of urinary tract infections, vertigo, melancholia, and mood swings were significantly higher in patients with overactive bladder than in the patients without overactive bladder (p < 0.05). Menopausal symptoms (modified Kupperman index score ≥ 15) (odds ratio: 1.049, 95% confidence interval: 1.006–1.095, p = 0.025) and a low frequency of sexual intercourse in the last 6 months (odds ratio: 2.580, 95% confidence interval: 1.228–5.422, p = 0.012) were identified as independent risk factors for overactive bladder. The frequency of sexual intercourse was found to decrease with an increase in the severity of overactive bladder (p = 0.004, linear-by-linear association = 0.001). Conclusion Menopausal symptoms may be closely associated with overactive bladder, and sexual activity may be associated with the severity of overactive bladder. Moreover, sexual problems, urinary tract infections, vertigo, melancholia, and mood swings may be associated with overactive bladder.
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Affiliation(s)
- Lingping Zhu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Xiaoxia Cheng
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Jiaxin Sun
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Shiyi Lv
- Department of Gynecology and Obstetrics, The Ninth People's Hospital, Shenzhen, Guangdong Province, China
| | - Suzhen Mei
- Department of Gynecology and Obstetrics, Second Hospital of Sanming City, Fujian Province, China
| | - Xing Chen
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Sisi Xi
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Jin Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Mukun Yang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Wenpei Bai
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
- * E-mail:
| | - Xiaoyan Yan
- Peking University Clinical Research Institute, Beijing, China
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Jiang YH, Ong HL, Kuo HC. Predictive factors of adverse events after intravesical suburothelial onabotulinumtoxina injections for overactive bladder syndrome-A real-life practice of 290 cases in a single center. Neurourol Urodyn 2015; 36:142-147. [PMID: 26417884 DOI: 10.1002/nau.22892] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 09/15/2015] [Indexed: 12/13/2022]
Abstract
AIMS Patients often experience adverse events (AEs) after intravesical onabotulinumtoxinA (BoNT-A) treatment for overactive bladder refractory to antimuscarinic agents. We investigated the prevalence and predictive factors of AEs in such patients. METHODS A total of 290 patients underwent intravesical BoNT-A (100 U) suburothelial injection. The age, gender, overactive bladder subtypes, medical co-morbidities, and neurological diseases of the patients were recorded. The maximum flow rate (Qmax ), voided volume, post-void residual (PVR) volume, and voiding efficiency (VE) at baseline were analyzed to identify adverse events within 3 months after treatment. RESULTS Acute urinary retention (AUR) developed in 24 patients (8.3%), and urinary tract infection (UTI) occurred in 44 (15.2%) within 3 months of treatment. Large PVR volume (>200 ml) occurred in 81 (27.9%), 68 (24.3%), and 49 (18.4%) patients 1, 3, and 6 months after treatment, respectively. AUR developed significantly more often in men, patients >61 years old, those with a baseline Qmax ≤15 ml/sec, PVR ≥100 ml, and VE <90%. Patients older than 61 years had a higher incidence of large PVR 1 month after treatment. Female gender and a baseline PVR volume ≥100 ml had a greater incidence of UTI. Age >61 years, low Qmax , low voiding efficiency, and large PVR at baseline were also risk factors for adverse events. CONCLUSION AUR, UTI, and large PVR volume are common AEs after BoNT-A treatment. Patients with overactive bladders that are at risk of developing AEs after BoNT-A injection should be informed of the possible AEs. Neurourol. Urodynam. 36:142-147, 2017. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Yuan-Hong Jiang
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Hueih-Ling Ong
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Postmenopausal overactive bladder. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2015; 13:313-29. [PMID: 26327873 PMCID: PMC4352916 DOI: 10.5114/pm.2014.47984] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/17/2014] [Accepted: 10/27/2014] [Indexed: 11/17/2022]
Abstract
Bladder storage symptoms have a severe impact on many areas as regards the quality of life including health-related, social, psychological and working functions. Pharmacotherapy of lower urinary tract stores (LUTS) has been developed to optimize neural control of the lower urinary tract in pathologic states. The bladder can be overactive or underactive. Overactive bladder (OAB) is highly prevalent and is associated with considerable morbidity, especially in aging population. Therefore, an effective treatment of OAB must result in a meaningful reduction in urinary symptoms. Pharmacotherapy for the OAB must be individualized based on the degree of bother, medication side-effect profile, concomitant comorbidities and current medication regimen. Antimuscarinic agents will continue to represent the current gold standard for the first-line pharmacological management of OAB. Alternatively to antimuscarinic therapy, β3-adrenergic receptor agonists, due to their efficacy and favorable adverse event profile, are a novel and attractive option of pharmacological treatment of overactive bladder symptoms. A combination of selective antimuscarinic and β3-adrenergic receptor agonists, agents with the different mechanism of action, gives a new treatment option for the patient with OAB according to its harms profile. A number of putative novel therapeutic agents is under clinical evaluations that may ultimately provide alternative or combination treatment options for OAB in the nearest future.
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Guerquin B. [Physics of materials and female stress urinary continence: New concepts: I) Elasticity under bladder]. J Gynecol Obstet Hum Reprod 2015; 44:591-596. [PMID: 25865797 DOI: 10.1016/j.jgyn.2015.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 02/26/2015] [Accepted: 03/09/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Improving the understanding of the adaptation to stress of urinary continence. METHOD A transversal analysis between physics of materials and the female anatomy. Laws of physics of the materials and of their viscoelastic behavior are applied to the anatomy of the anterior vaginal wall. RESULT The anterior vaginal wall may be divided into two segments of different viscoelastic behavior, the vertical segment below the urethra and the horizontal segment below the bladder. If the urethra gets crushed on the first segment according to the hammock theory, the crushing of the bladder on the second segment is, on the other hand, damped by its important elasticity. The importance of this elasticity evokes an unknown function: damping under the bladder that moderates and delays the increase of intravesical pressure. This damping function below the bladder is increased in the cystocele, which is therefore a continence factor; on the other hand, it is impaired in obesity, which is therefore a factor of SUI. CONCLUSION It is necessary to include in the theory of stress continence, the notion of a damping function below the bladder.
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Affiliation(s)
- B Guerquin
- Service de gynécologie-obstétrique, centre hospitalier d'Orange (84100), avenue de Lavoisier, CS20184, 84104 Orange cedex, France.
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Bunn F, Kirby M, Pinkney E, Cardozo L, Chapple C, Chester K, Cruz F, Haab F, Kelleher C, Milsom I, Sievart KD, Tubaro A, Wagg A. Is there a link between overactive bladder and the metabolic syndrome in women? A systematic review of observational studies. Int J Clin Pract 2015; 69:199-217. [PMID: 25495905 DOI: 10.1111/ijcp.12518] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 07/07/2014] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To conduct a systematic review to determine whether there is an association between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) or overactive bladder (OAB) in women. METHODS We systematically reviewed English language observational studies on the effect of MetS (or component factors) on the presence of OAB or LUTS in women. We searched PubMed, Web of Science and The Cochrane Library with no date restrictions, checked reference lists and undertook citation searches in PubMed and Google Scholar. Studies were assessed for risk of bias. Because of heterogeneity, results were not pooled, but are reported narratively. RESULTS Of 27 included studies, only three looked at the link between MetS and OAB. The rest looked at links between OAB and components of MetS such as obesity or insulin resistance (n = 10), between MetS and urinary symptoms (n = 3) and between urinary symptoms and components of MetS, such as obesity (n = 14). Evidence is currently limited, but it does suggest that there may be important links between MetS and OAB and components of MetS such as obesity. CONCLUSIONS The literature on MetS and OAB or LUTS in women is limited, and poor quality. However, the evidence available on obesity appears to support MetS as a contributor and predictor of LUTS in women. Many of the women with LUTS will be overweight and will have features of the MetS, if looked for. This provides not only an opportunity to encourage weight loss as an adjunct to therapy for the OAB symptoms but also a window of opportunity to address cardiovascular risk factors and prevent future cardiovascular morbidity and mortality.
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Affiliation(s)
- F Bunn
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, Hertfordshire, UK
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TIAN Y, GUAN Y, WEN J, SHANG X, LI J, WANG Y. Survey and Risk Factors for Lower Urinary Tract Storage Symptoms in Middle-Aged and Older Stroke Patients in Urban China. Low Urin Tract Symptoms 2014; 8:91-9. [PMID: 27111620 DOI: 10.1111/luts.12078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 07/21/2014] [Accepted: 08/06/2014] [Indexed: 12/28/2022]
Affiliation(s)
- Yudong TIAN
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Yanbin GUAN
- School of Medicine, The Henan University of Traditional Chinese Medicine; Zhengzhou China
| | - Jianguo WEN
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Xiaoping SHANG
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Jinsheng LI
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Yan WANG
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
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Urinary incontinence, functional status, and health-related quality of life among Medicare beneficiaries enrolled in the program for all-inclusive care for the elderly and dual eligible demonstration special needs plans. J Ambul Care Manage 2013; 36:35-49. [PMID: 23222011 DOI: 10.1097/jac.0b013e318267470a] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Health Outcomes Survey-Modified is a brief annual survey completed by enrollees in the Program for All-Inclusive Care for the Elderly and selected special needs plans to collect functional status information used to adjust Medicare payments to these plans. We examined the relationship between urinary incontinence, functional limitations, and health-related quality of life among 16 387 respondents to the 2009 Health Outcomes Survey-Modified. Measures were the physical and mental components scores and self-rated general health derived from the Veterans RAND 12-Item Health Survey (VR-12). Urinary incontinence is prevalent among frail community-dwelling adults and has substantial impact on quality of life.
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Oefelein MG, Tong W, Kerr S, Bhasi K, Patel RK, Yu D. Effect of concomitant administration of trospium chloride extended release on the steady-state pharmacokinetics of metformin in healthy adults. Clin Drug Investig 2013; 33:123-31. [PMID: 23325481 PMCID: PMC3561611 DOI: 10.1007/s40261-012-0049-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Overactive bladder (OAB) is often associated with a number of co-morbid medical conditions, including diabetes mellitus. This may necessitate several concomitant treatments, thus creating the potential for drug–drug interactions (DDIs). Trospium is renally eliminated, not metabolized via cytochrome P450; therefore, cytochrome P450 DDIs are unlikely. However, coadministration with another renally eliminated drug (e.g., metformin) may theoretically result in a DDI. Objective The objective of this study was to evaluate the pharmacokinetics (plasma and urine) and safety/tolerability of the coadministration of trospium chloride extended release (XR) and metformin under steady-state conditions in healthy male and female subjects. Methods In a single-centre, randomized, open-label, two-group, two-period study in healthy males and females aged 18–45 years, 44 subjects received oral metformin 500 mg twice daily for 3.5 days during one period, and oral trospium chloride XR 60 mg once daily for 10 days, followed by trospium chloride XR 60 mg once daily for 4 days plus metformin 500 mg twice daily for 3.5 days during the other period. The two periods occurred in a crossover fashion, separated by a 3-day washout period. Results Trospium chloride XR coadministration did not alter metformin steady-state pharmacokinetics. Metformin coadministration reduced trospium steady-state maximum plasma concentration (by 34 %) and area under the concentration–time curve from 0–24 hours (by 29 %). Neither drug’s renal clearance was affected. No safety/tolerability issues of concern were observed with coadministration. Conclusion No dosage adjustment is necessary for metformin when coadministered with trospium chloride XR.
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Oberbach A, Jehmlich N, Schlichting N, Heinrich M, Lehmann S, Wirth H, Till H, Stolzenburg JU, Völker U, Adams V, Neuhaus J. Molecular fingerprint of high fat diet induced urinary bladder metabolic dysfunction in a rat model. PLoS One 2013; 8:e66636. [PMID: 23826106 PMCID: PMC3691244 DOI: 10.1371/journal.pone.0066636] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 05/08/2013] [Indexed: 12/13/2022] Open
Abstract
AIMS/HYPOTHESIS Diabetic voiding dysfunction has been reported in epidemiological dimension of individuals with diabetes mellitus. Animal models might provide new insights into the molecular mechanisms of this dysfunction to facilitate early diagnosis and to identify new drug targets for therapeutic interventions. METHODS Thirty male Sprague-Dawley rats received either chow or high-fat diet for eleven weeks. Proteomic alterations were comparatively monitored in both groups to discover a molecular fingerprinting of the urinary bladder remodelling/dysfunction. Results were validated by ELISA, Western blotting and immunohistology. RESULTS In the proteome analysis 383 proteins were identified and canonical pathway analysis revealed a significant up-regulation of acute phase reaction, hypoxia, glycolysis, β-oxidation, and proteins related to mitochondrial dysfunction in high-fat diet rats. In contrast, calcium signalling, cytoskeletal proteins, calpain, 14-3-3η and eNOS signalling were down-regulated in this group. Interestingly, we found increased ubiquitin proteasome activity in the high-fat diet group that might explain the significant down-regulation of eNOS, 14-3-3η and calpain. CONCLUSIONS/INTERPRETATION Thus, high-fat diet is sufficient to induce significant remodelling of the urinary bladder and alterations of the molecular fingerprint. Our findings give new insights into obesity related bladder dysfunction and identified proteins that may indicate novel pathophysiological mechanisms and therefore constitute new drug targets.
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Affiliation(s)
- Andreas Oberbach
- Department of Cardiac Surgery, University of Leipzig, Heart Center Leipzig, Leipzig, Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Nico Jehmlich
- Department of Functional Genomics, Ernst-Moritz-Arndt-University Greifswald, Interfaculty Institute of Genetics and Functional Genomics, Greifswald, Germany
| | - Nadine Schlichting
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
- Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany
| | - Marco Heinrich
- Department of Cardiac Surgery, University of Leipzig, Heart Center Leipzig, Leipzig, Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Stefanie Lehmann
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Henry Wirth
- Interdisciplinary Centre for Bioinformatics, University of Leipzig, Leipzig, Germany
| | - Holger Till
- Department of Pediatric Surgery, Medical School, University of Graz, Graz, Austria
| | | | - Uwe Völker
- Department of Functional Genomics, Ernst-Moritz-Arndt-University Greifswald, Interfaculty Institute of Genetics and Functional Genomics, Greifswald, Germany
| | - Volker Adams
- Department of Cardiology, University of Leipzig, Heart Center Leipzig, Leipzig, Germany
| | - Jochen Neuhaus
- Department of Urology, University of Leipzig, Leipzig, Germany
- * E-mail:
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Abstract
We performed a critical review focused on the main non-oncologic disorders that have a strong, direct association with obesity: chronic kidney disease, kidney stones and female and male lower urinary tract symptoms/disorders. We discuss the epidemiology, pathogenesis and therapeutic aspects regarding the association between obesity and non-diabetic and non-hypertensive forms of chronic kidney disease directly caused or worsened by weight excess, with particular attention on obesity-related glomerulopathy (ORG), which is typical of severe obesity, and the consequences of intentional weight loss on proteinuria and glomerular filtration rate. The associations of obesity with kidney stones and lower urinary tract conditions are also discussed from the epidemiological, physiopathological and therapeutical points of view, with emphasis on the principal concerns raised by the heterogeneity of study designs and outcome definitions typical of research in these fields. We also call attention to important clinical and scientific questions that should be addressed by future research.
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Affiliation(s)
- Anita Morandi
- Complex Operative Unit of Pediatric Diabetes, Clinical Nutrition and Obesity, Department of Life and Reproduction Sciences, University of Verona, Via Bengasi, 4, 37134 Verona, Italy
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Vaughan CP, Auvinen A, Cartwright R, Johnson TM, Tähtinen RM, Ala-Lipasti MA, Tammela TLJ, Markland AD, Thorlund K, Tikkinen KAO. Impact of obesity on urinary storage symptoms: results from the FINNO study. J Urol 2013; 189:1377-82. [PMID: 23103801 DOI: 10.1016/j.juro.2012.10.058] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 10/17/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Urinary storage symptoms are the most common and most bothersome urinary symptoms. Many studies on the relation between body weight and urinary symptoms have focused on urinary incontinence in women. We evaluated the association of obesity with urinary storage symptoms in a population based study of men and women age 18 to 79 years old. MATERIALS AND METHODS Questionnaires were mailed to 6,000 adults randomly identified from the Finnish Population Register. Self-reported height and weight were used to calculate body mass index. Urinary frequency, nocturia, urgency, stress urinary incontinence and urgency urinary incontinence were assessed using validated instruments. Multivariate logistic regression analyses (adjusted for age, comorbidity and medications, and sociodemographic, lifestyle and reproductive factors) were performed to evaluate associations between body mass index and each symptom. RESULTS Of the 6,000 individuals approached 3,727 participated (62.4% response, 53.7% women). In men and women obesity was associated with nocturia (adjusted OR 2.0, 95% CI 1.2-3.3 for men; OR 2.4, 95% CI 1.5-3.8 for women) but not with urgency (adjusted OR 1.2, 95% CI 0.7-2.3 for men; OR 1.2, 95% CI 0.7-2.1 for women). In men obesity was also associated with urinary frequency (OR 2.0, 95% CI 1.0-3.9), and in women it was associated with stress urinary incontinence (OR 1.9, 95% CI 1.2-3.0) and urgency urinary incontinence (OR 3.0, 95% CI 1.2-7.4). However, the number of men with stress urinary incontinence or urgency urinary incontinence was insufficient for precise analyses. CONCLUSIONS This study extends previous research by providing symptom specific associations between obesity and urinary storage symptoms in a population based sample of men and women. Obesity impacts individual urinary storage symptoms differently and these associations may be influenced by gender.
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Affiliation(s)
- Camille P Vaughan
- Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, and Department of Medicine, Division of General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, Georgia, USA
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Pelvic floor symptoms and bone mineral density in women undergoing osteoporosis evaluation. Int Urogynecol J 2013; 24:1663-9. [PMID: 23389642 DOI: 10.1007/s00192-013-2056-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 01/16/2013] [Indexed: 12/21/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Our aim was to characterize pelvic floor symptoms in postmenopausal women who had undergone osteoporosis evaluation and examine their association with bone mineral density (BMD). METHODS Pelvic floor symptom questionnaires were mailed to 4,026 women. Multivariate logistic regression models controlling for age, race, body mass index (BMI), and chronic obstructive pulmonary disease (COPD) were performed comparing symptoms in women with osteoporosis (T score ≤ -2.5) and osteopenia (T score > -2.5 to < -1) at any site to women with normal BMD (T score: ≥ -1, referent). RESULTS There were 1,774/4,026 (44%) questionnaires returned; 1,655 were included in the analysis (362 osteoporosis, 870 osteopenia, 423 normal BMD). Overall prevalence of any urinary incontinence (UI) was 1,226/1,640 (75%), with UI ≥2-3 times/week in 699/1,197 (58%), fecal incontinence over the past month in 247/1,549 (16%), and prolapse in 162/1,582 (10%). Multivariate analyses revealed that women with osteopenia had increased risk of incontinence of solid stool [adjusted odds ratio (aOR) 1.7, 95% confidence interval (CI) 1.1-2.4). Risk of UI ≥2-3 times/week was not increased in women with osteoporosis (aOR 0.9, CI 0.6-1.3) and was lower in women with osteopenia (aOR 0.7, CI 0.5-0.9). In women with osteoporosis, the odds of moderate- to large-volume urine loss versus small/none was higher for those in the lower T-score quartile (lower BMD; aOR 1.43, CI 1.1-1.9). CONCLUSIONS In women undergoing osteoporosis evaluation, those with osteopenia were at increased risk of fecal incontinence but not UI compared with normal women. Osteoporotic women with the lowest T scores had higher risk of moderate- to large-volume UI. It is unclear whether there is a pathophysiologic link between BMD loss and development of pelvic floor symptoms.
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Tannenbaum C, Gray M, Hoffstetter S, Cardozo L. Comorbidities associated with bladder dysfunction. Int J Clin Pract 2013; 67:105-13. [PMID: 23305472 DOI: 10.1111/ijcp.12085] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- C Tannenbaum
- Faculties of Pharmacy and Medicine, University of Montreal, Montreal, QC, Canada
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[Impact of overactive bladder treatment on associated comorbidities]. Actas Urol Esp 2012; 36:590-6. [PMID: 22365078 DOI: 10.1016/j.acuro.2011.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 11/16/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To analyze the management of patients newly diagnosed with overactive bladder (OAB) and to assess the impact of treatment on associated comorbidities. MATERIAL AND METHODS 1,434 patients over 60 years with newly diagnosed OAB and at least one associated comorbidity (urinary tract infections, genital skin infections, sleep disturbances, depression, and hypertension) were recruited in 300 urology/gynecology surgeries in Spain. In the first visit sociodemographic and clinic data were recorded, and treatment for OAB following usual practice was prescribed. 4-6 months later symptoms were reevaluated. A descriptive statistical analysis was performed, variables were compared by gender (Chi(2)/Mann-Whitney) and between visits (McNemar). RESULTS Data for 1,274 valid patients in visit 1 and 1,153 in visit 2 are presented. Mean age in the sample was 68.17(6.19) years, 71.51% were women. 66.41% presented urgency, with or without urge urinary incontinence, and 33.59% presented urgency related to stress urinary incontinence. The most frequent associated pathologies were sleep disturbances (56.44%) and urinary tract infections (53.14%). Urinary tract infections and genital skin infections and treatment for depression were more frequent in women; sleep disturbances and hypertension in men. Treatments more frequently prescribed were anticholinergics (95.45%) and guidance for lifestyle changes (85.32%). Statistically significant improvement in symptoms of associated comorbidities was detected in visit 2. CONCLUSIONS Detection and treatment of OAB symptoms is relevant to reduce both the impact of the affection and of associated pathologies.
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Cerruto MA, D'Elia C, Aloisi A, Fabrello M, Artibani W. Prevalence, incidence and obstetric factors' impact on female urinary incontinence in Europe: a systematic review. Urol Int 2012; 90:1-9. [PMID: 22868349 DOI: 10.1159/000339929] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES A systematic review of the published data on the prevalence, incidence and risk factors of female urinary incontinence (UI) and obstetric treatment of UI in Europe. DATA SOURCES Epidemiologic studies were sought via PubMed to identify articles published in English, French, Spanish, German and Italian between 2000 and September 30, 2010, in Europe. RESULTS The prevalence of UI ranged from 14.1 to 68.8% and increased with increasing age. Significant risk factors for UI in pregnancy were maternal age ≥35 years and initial body mass index, a family history of UI and parity. UI in women who delivered 'at term' ranged from 26 to 40.2%, with a remission rate of 3 months after childbirth of up to 86.4%. Pelvic floor muscle training may help to prevent postpartum UI in primiparous women without UI during pregnancy. CONCLUSION UI definition, outcome measures, survey methods and validation criteria are still heterogeneous, and thus it is difficult to compare data and impossible to draw definite conclusions.
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