Effects of overactive bladder syndrome on female sexual function

Overactive bladder symptoms experiences of diabetic women in Türkiye: A qualitative study

In diabetic patients, poor management of hyperglycemia and prolonged disease duration may lead to neuropathy-related overactive bladder (OAB) symptoms. To effectively manage OAB symptoms in women with type 2 diabetes, it is essential to know how patients perceive these problems, their lives, and strategies. This study aimed to understand the experience of OAB symptoms in Turkish women with type 2 diabetes from their point of view. A qualitative descriptive design was adopted with individual, semi-structured interviews. Participants were selected by purposive sampling. The data were evaluated by using Van Manen's thematic analysis method. The symptom management theory formed the conceptual framework of this study. The Consolidated Criteria for Reporting Qualitative Research checklist was used. A total of 18 patients were recruited and individually interviewed. Semi-structured interviews were conducted from May to August 2023. The three main themes emerged: (i) the meaning of OAB symptoms; (ii) difficulties caused by OAB symptoms; and (iii) coping with OAB symptoms. The subthemes included the negative effects of OAB symptoms on daily life, difficulties in physical, psychological, and sexual life, and positive and negative behavior in coping with OAB symptoms. OAB symptoms affect the physical, psychosocial, and sexual lives of women with type 2 diabetes. Women with type 2 diabetes try to cope in different ways but often do not receive the support they need from families. Therefore, nurses should integrate the urinary problems of women with type 2 diabetes into routine clinical assessments and provide counseling to women.

Efficacy and Safety of Combination Therapy With Vaginal and Urethral Erbium-Doped Yttrium-Aluminum-Garnet (Er:YAG) Laser for Overactive Bladder With Urinary Incontinence

OBJECTIVE

This retrospective cohort study with propensity score (PS) matching aimed to evaluate the efficacy and safety of a combination therapy with vaginal and urethral erbium:yttrium aluminum garnet laser (VEL+UEL) (SP Dynamis; Fotona d.o.o., Ljubljana, Slovenia) in the treatment of overactive bladder with urinary incontinence (OAB-wet).

METHODS

The study included female OAB-wet patients aged 65 and above who were already taking OAB medication. Data obtained from electronic medical records were subjected to propensity score matching. All patients received instructions on pelvic floor exercises and were prescribed an appropriate dose of OAB medication. The VEL+UEL group (n=30) underwent three monthly laser sessions, while the control group (n=30) did not receive the treatment. Clinical outcomes were evaluated using the Overactive Bladder Symptom Score (OABSS), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), three-day urination diary, and Vaginal Health Index Score (VHIS). Medication usage and adverse events were also assessed. Statistical analysis and R code were performed using the AI chatbot GPT-4.0.

RESULTS

The VEL+UEL group showed significant improvements in OABSS score, ICIQ-SF score, voided volume, daytime frequency, nocturia, and VHIS after 12 months of treatment (p<0.001). Notably, 13.3% of patients transitioned from OAB-wet to OAB-dry. In contrast, the control group did not exhibit significant changes. Medication use was significantly reduced in the VEL+UEL group compared to the control group (p<0.001). No long-term side effects were reported.

CONCLUSION

Combination therapy with VEL+UEL demonstrated efficacy and safety in the treatment of OAB-wet. Improvements in OAB symptoms, voided volume, frequency, nocturia, and vaginal health were observed, with a subset of patients transitioning to OAB-dry. VEL+UEL therapy offers a potential treatment option for OAB-wet, reducing medication use and improving patient outcomes. Further research is warranted to investigate the mechanism, long-term effects, safety, and cost-effectiveness of VEL+UEL therapy.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Risk of overactive bladder after hysterectomy for uterine fibroids

INTRODUCTION AND HYPOTHESIS

We evaluated the association between previous hysterectomy for uterine fibroids and the risk of developing overactive bladder (OAB).

METHODS

We used national health insurance data. The hysterectomy group (aged 40 to 59) comprised patients who underwent hysterectomy for uterine leiomyoma or adenomyosis between 1 January 2011 and 31 December 2014, and the control group (aged 40 to 59) comprised patients who visited a medical facility for a checkup during the same time period. Propensity score matching (PSM, 1:1) was performed to balance confounders. OAB events were defined by drug prescriptions (beta 3 agonist or anticholinergics) for more than 1 month based on previous studies.

RESULTS

After matching, 58,195 cases (hysterectomy group) and 58,195 controls (nonhysterectomy group) were enrolled. The mean follow-up period was 7.9 years in the nonhysterectomy group and 8.0 years in the hysterectomy group. There was no significant difference in the rate of OAB development between the groups (0.3% vs 0.3%; p=0.061). Additionally, compared with the nonhysterectomy group (hazard ratio: 1 (reference)), hysterectomy without adnexal surgery (hazard ratio: 1.169 [0.915-1.493]) and hysterectomy with adnexal surgery (hazard ratio: 1.342 [0.83-2.171]) did not significantly increase the risk of OAB after adjusting for confounders; this relationship remained nonsignificant after stratifying patients according to age group.

CONCLUSIONS

Previous hysterectomy with or without adnexal surgery for the treatment of uterine fibroids did not increase the risk of developing OAB, defined as drug therapy lasting more than 1 month.

Efficacy and Safety of Vibegron for the Treatment of Overactive Bladder in Women: A Subgroup Analysis From the Double-Blind, Randomized, Controlled EMPOWUR Trial

IMPORTANCE

The international phase 3 EMPOWUR trial demonstrated efficacy and safety of vibegron, a newer β 3 -adrenergic receptor agonist, in adults with overactive bladder (OAB). Women are disproportionately affected by OAB, especially those with bothersome symptoms, such as urge urinary incontinence (UUI).

OBJECTIVE

This subgroup analysis from EMPOWUR assessed efficacy and safety of vibegron in women.

STUDY DESIGN

In EMPOWUR, patients with OAB were randomized 5:5:4 to 12 weeks of treatment with once-daily vibegron 75 mg, placebo, or tolterodine 4-mg extended release. Efficacy end points included change from baseline at week 12 in mean daily number of micturitions, UUI episodes, and urgency episodes. Safety was assessed through adverse events (AEs).

RESULTS

Of the patients included in the analysis, 1286 (84.9%) were women (vibegron, n = 463; placebo, n = 459; tolterodine, n = 364). At week 12, women receiving vibegron showed significant reductions (95% confidence intervals of least squares mean differences does not include 0) from baseline versus placebo in mean daily micturitions, UUI episodes, and urgency episodes, with least squares mean differences (95% confidence intervals) of -0.5 (-0.8 to -0.2), -0.7 (-1.0 to -0.4), and -0.8 (-1.3 to -0.4), respectively. Treatment-emergent AE incidence was similar with vibegron (39%) and placebo (35%); the most common AE with incidence higher with vibegron (4.3%) than placebo (2.6%) was headache.

CONCLUSIONS

In this subgroup analysis, women receiving vibegron showed significant reductions in key efficacy end points versus placebo and favorable safety profile, consistent with the overall results from EMPOWUR, suggesting that vibegron is efficacious and safe for the treatment of OAB in this patient population.

Efficacy of Yun-type pelvic floor optimal training therapy and PFMT on middle aged women with mild to moderate overactive bladder: a randomized controlled trial

Background

The symptoms of overactive bladder (OAB) are highly bothersome to patients. In behavioral therapy, traditional pelvic floor muscle training (PFMT) can be boring and monotonous, which can cause poor compliance. It's important to establish a new safe and effective crotch-pelvic floor functional reconstruction training method [Yun-type pelvic floor optimal training (Yun-type training)] for OAB patients.

Methods

This randomized, double-blind, crossover trial recruited a total of 150 women with mild to moderate OAB. Patients were randomly assigned to receive Yun-type training (n=83) or PFMT (n=67). The intervention group was first given Yun-type training for 6 weeks, then switched to PFMT for 6 weeks after 2 weeks of elution. Patients in the control group were first treated with PFMT for 6 weeks, and changed to the use of Yun-type training for 6 weeks after 2 weeks of elution. The primary endpoint was overactive bladder symptom scores (OABSS) after 6 and 14 weeks of Yun-type training and PFMT.

Results

Yun-type training could significantly improve OABSS compared with PFMT after 6 and 14 weeks (P<0.001). Yun-type training was associated with an improvement in urine, urgency, urge urinary incontinence (UUI), urogenital distress inventory-6 (UDI-6), patient's perception of bladder condition (PPBC), voiding volume (VV), incontinence impact questionnaire-7 (IIQ-7), female sexual function index (FSFI), sexual desire, arousal, pain, satisfaction, pelvic floor muscle tone, type I muscle strength, type II muscle strength, and sex partner satisfaction as compared with PFMT after 6 and 14 weeks. Moreover, nocturia, maximum flow rate (Qmax), and climax in the Yun-type training group were significantly improved after 6 weeks, and the average flow rate (Qave) was improved after 14 weeks in the Yun-type training group.

Conclusions

Yun-type training could yield additional benefits on OAB symptoms, sexual function, and sex partner satisfaction as compared with PFMT. The superior sexual function resulting from Yun-type training can be explained by the fact that it can contract deep and superficial muscle layers, resulting in increased vaginal wall pressure and blood flow, which further improves FSFI and sex partner satisfaction. It could lead to a new non-invasive treatment for OAB patients.

Trial Registration

Chinese Clinical Trial Registry ChiCTR-INR-17012192.

Focus on the Analysis of the Effect of Solving the Nursing Mode on the Time of the Production Time of the First Maternity and the Subjective Happiness of the Postpartum

Objective

Focusing to solve the significance of the nursing mode for preliminary maternity care.

Methods

Selected 116 first mothers produced in our hospital from January 2010 to January 2022, which were divided into the control group and research group. The two groups each paid conventional care and focused on solving the nursing mode care. Analyze the two groups of pregnancy endings, self-efficacy, negative emotions, subjective happiness, and analgesics.

Results

The vaginal delivery rate of the research group was higher than that of the control group, and the cesarean section rate, hospitalization time, and delivery process were lower than the control group (P < 0.05); the amount of bleeding in the postpartum groups increased, but compared with the control group, the increase in bleeding in the research group was smaller (P < 0.05); the research group objective, subjective support, self-evaluation, and subjective happiness index were higher than the control group (P < 0.05).

Conclusion

Focusing to solve the nursing model can help the maternal tension relief, the maternal can quickly enter the role, and it plays an important role in establishing a good nursing relationship.

Analysis of Characteristics and Quality of Life of Elderly Women with Mild to Moderate Urinary Incontinence in Community Dwellings

Introduction: The incidence of urinary incontinence (UI) increases with age. Mild and moderate UI have little impact on women and are easily ignored. This study reports the characteristics of non-severe UI and quality of life (QOL) in elderly women using data from a Development and Evaluation of a Senile UI Alert System study. Methods: 926 women aged ≥60 were enrolled from six subcenters across China, among whom 717 SUI patients and 209 UUI/MUI patients were grouped into Group A and Group B, respectively, according to leakage symptoms. Demographic and clinical data, pelvic organ prolapse quantification and pelvic floor muscle strength measurement (PFMS) were collected from participants, followed by evaluation of QOL and sexual life. Result: The major type of UI in community women was SUI (77.4%); MUI and UUI accounted for 20.63% and 1.94%, respectively. Weakened PFMS was detected in 78.2% of the participants. Group B was significantly higher in terms of median age, weight, BMI, waist circumference and menopausal years, and had the greater UI severity and impact on QOL, as well as less active sex live than group A (p < 0.05). Conclusion: SUI distributes dominantly in elderly community women, but UUI/MUI has greater impact on QOL and is related to a less active sex life, which requires more attention from medical staff.