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Bulbul SB, Keser I, Yucesan C, Celenay ST. Effects of pelvic floor muscle training applied with telerehabilitation in patients with multiple sclerosis having lower urinary track symptoms: A randomized controlled trial. Health Care Women Int 2023; 45:731-747. [PMID: 37010419 DOI: 10.1080/07399332.2023.2190593] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/09/2023] [Indexed: 04/04/2023]
Abstract
In this study, the researchers aimed to investigate the effects of pelvic floor muscle training (PFMT) applied with telerehabilitation on urinary symptoms, quality of life, and subjective perception of improvement and satisfaction in multiple sclerosis (MS) patients having lower urinary tract symptoms. Patients were randomly divided into PFMT (n:21) and control (n:21) groups. The PFMT group received PFMT via telerehabilitation for 8 weeks and lifestyle advice, while the control group received only lifestyle advice. Although lifestyle advice alone was not effective, PFMT applied with telerehabilitation was an effective method in the management of lower urinary tract symptoms in MS patients. PFMT applied with telerehabilitation can be considered as an alternative method.
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Affiliation(s)
- Saliha Beste Bulbul
- Physiotherapy and Rehabilitation Graduate Program, Ankara Yildirim Beyazit University, Institute of Health Sciences, Ankara, Turkey
| | - Ilke Keser
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Canan Yucesan
- Faculty of Medicine, Department of Neurology, Ankara University, Ankara, Turkey
| | - Seyda Toprak Celenay
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara Yildirim Beyazit University, Ankara, Turkey
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2
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Tomoe H, Ozaki Y, Yamamoto M, Kuwajima M, Ninomiya N, Sekiguchi Y, Sato Y, Takahashi S, Nagao K. Epidemiological study of genitourinary syndrome of menopause in Japan (GENJA study). Menopause 2023; 30:447-453. [PMID: 36693224 DOI: 10.1097/gme.0000000000002153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE This study aimed to investigate the prevalence of genitourinary syndrome of menopause (GSM) in Japan using the Japanese translation of the Vulvovaginal Symptoms Questionnaire (VSQ) with online survey. In addition, we examined the relationship between sexual activity and GSM symptoms. METHODS An online survey on GSM was conducted with 4,134 women aged 40 to 79 years, who were registered in an online survey company. Several questionnaires with Japanese translations of linguistic validity were used in this study. GSM was defined as a condition in women older than 40 years with vulvovaginal symptoms on the VSQ. RESULTS The percentage of postmenopausal women 40 years and older was 69.6%. The percentage of women with sexual activity was 22%. The prevalence of GSM with vulvovaginal symptoms was 11.6%, and 31.7% in sexually active women. The prevalence of GSM was associated with age and was significantly lower in the 70s age group than in other age groups. Vulvar hurting and dryness were both age-related only in the sexual activity group, with a statistically significantly higher prevalence in the 70s group than in the 40s group. The prevalence of vulvar dryness during sexual activity was significantly lower in the 40s age group. CONCLUSIONS An online epidemiological survey of GSM was conducted for the first time in Japan using the linguistically validated Japanese translation of the VSQ. The prevalence of GSM with genital or sexual symptoms was 11.6% in Japanese women 40 years and older, and 31.7% in sexually active women.
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Affiliation(s)
- Hikaru Tomoe
- From the Department of Urology and Pelvic Reconstructive Surgery, Tokyo Women's Medical University, Adachi Medical Center, Tokyo, Japan
| | - Yumi Ozaki
- Department of Urology, Tokai Central Hospital, Gifu, Japan
| | | | - Mami Kuwajima
- Kobayashi Pharmaceutical Company Limited, Osaka, Japan
| | - Noriko Ninomiya
- Department of Female Urology, Ninomiya Ladies Clinic, Osaka, Japan
| | - Yuki Sekiguchi
- Department of Female Urology, Women's Clinic LUNA Nextstage, Kanagawa, Japan
| | - Yoshikazu Sato
- Department of Urology, Sanjukai Hospital, Sapporo, Japan
| | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo Japan
| | - Koichi Nagao
- Department of Urology, Toho University School of Medicine, Tokyo, Japan
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Yavuz A, Kocaöz S, Kara P, Destegül E. The effects of gestational diabetes on lower urinary tract symptoms of pregnant women: a case-control study. J OBSTET GYNAECOL 2022; 42:3531-3536. [PMID: 36476042 DOI: 10.1080/01443615.2022.2152657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Gestational diabetes mellitus (GDM) and lower urinary tract symptoms (LUTS) are common health problems in pregnant women. The aim of this case-control study was to evaluate the effects of GDM on LUTS in pregnant women. This study was conducted with 44 pregnant women diagnosed with GDM and 44 pregnant without GDM. Patients with GDM had significantly lower likelihood of experiencing urgency (7.069-fold lower likelihood); whereas they had significantly greater likelihoods for urinary incontinence (UI) during sexual intercourse (OR: 0.185; 5.4-fold higher), need for clothing change due to UI (OR: 0.268; 3.7-fold higher), and adverse effects on daily life due to UI (OR: 0.338; 2.9-fold higher) compared to women without GDM (p < .05 for all). Although pregnant women with GDM appear to have a lower likelihood of urgency, this may be associated with the adverse effects of GDM since the likelihoods for UI-related outcomes were increased and quality of life was reduced among pregnant women with GDM compared to those without GDM.Impact statementWhat is already known on this subject? Lower urinary tract symptoms (LUTS) are very common among pregnant women, and negatively affect social, sexual and working life. There are many risk factors that affect the development of LUTS in pregnant women. It is stated that gestational diabetes mellitus (GDM) may be a predisposing factor in the development of LUTS in women.What do the results of this study add? Women with GDM experienced storage symptoms at a lower frequency (especially urgency) compared to the control group. In addition, we determined worse quality of life among women with GDM who experienced a greater frequency of urinary incontinence.What are the implications of these findings for clinical practice and/or further research? It may be beneficial to provide training on the prevention and management of LUTS to all pregnant women, especially women with GDM, and to increase the sensitivity of health professionals on the subject.
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Affiliation(s)
- Adem Yavuz
- Department of Obstetrics and Gynecology, Faculty of Medicine, Niğde Ömer Halisdemir University, Niğde, Turkey
| | - Semra Kocaöz
- Department of Obstetrics and Gynecology Nursing, Niğde Ömer Halisdemir University, Zübeyde Hanım Faculty of Health, Niğde, Turkey
| | - Pınar Kara
- Nursing Department, Faculty of Health, Kahramanmaraş İstiklal University, Kahramanmaraş, Turkey
| | - Emre Destegül
- Department of Obstetrics and Gynecology, Adana City Training and Research Hospital, Adana, Turkey
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The Japanese Herbal Medicine Yokukansan Exerted Antioxidant and Analgesic Effects in an Experimental Rat Model of Hunner-Type Interstitial Cystitis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060810. [PMID: 35744072 PMCID: PMC9230041 DOI: 10.3390/medicina58060810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: The Japanese herbal medicine Yokukansan (YKS) has analgesic properties and is used for various pain disorders. The purpose of the present study was to investigate the effects of YKS in Hunner-type interstitial cystitis (HIC) using an experimental rat model of HIC and to explore its antioxidant activity and role as the underlying mechanism of action. Materials and Methods: The antioxidant capacity of YKS was evaluated by determining its hydroxyl radical (·OH) scavenging capacity using electron spin resonance (ESR). Next, the effects of YKS administration were explored using a toll-like receptor-7 agonist-induced rat model of HIC. The von Frey test was performed to assess bladder pain. Three days after HIC induction, the bladder was removed, and the expression of oxidative stress parameters in the bladder wall was investigated (reactive oxygen metabolites (ROMs), ·OH, and 8-hydroxy-2′-deoxyguanosine (8-OhdG)). Results: YKS had a ·OH scavenging capacity according to the ESR study. In the von Frey test, a significant decrease in the withdrawal threshold was observed in the HIC group compared with the control group; however, the decrease was ameliorated by the administration of YKS. Oxidative stress parameters showed increasing tendencies (ROMs test and 8-OHdG) or a significant increase (·OH) in the HIC group compared with the control group; however, the increase was significantly suppressed by the administration of YKS. Conclusions: These findings suggest that YKS is effective against HIC and that its antioxidant activity is involved in the mechanism of action.
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DEĞİRMENCİOĞLU AZ, KOCAÖZ S, ÇIRPAN R. Prevalence of lower urinary tract symptoms and influencing factors in women. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.908652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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6
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Sun K, Zhang D, Wu G, Wang T, Wu J, Ren H, Cui Y. Efficacy of magnetic stimulation for female stress urinary incontinence: a meta-analysis. Ther Adv Urol 2021; 13:17562872211032485. [PMID: 34345251 PMCID: PMC8283222 DOI: 10.1177/17562872211032485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/25/2021] [Indexed: 11/21/2022] Open
Abstract
Aim: This meta-analysis aimed to evaluate the efficacy of magnetic stimulation (MS) in treating female stress urinary incontinence (SUI) and providing an alternative treatment for patients who are unwilling to undergo surgery. Methods: Randomized controlled trials (RCTs) that evaluated MS as a remedy for female SUI were retrieved from various electronic databases, including MEDLINE, EMBASE, and the Cochrane Controlled Trial Registry system. Moreover, reference lists for related papers were carefully screened for relevant studies. Results: A total of six RCTs evaluating the effect of MS in treating female SUI were included in this study. Compared with the placebo group, the MS group exhibited higher quality-of-life scores [mean difference (MD) 0.59, 95% credibility interval (CI) 0.23–0.95; p = 0.001] and lower International Consultation on Incontinence Questionnaire scores (MD −3.93, 95% CI −5.85 to −2.01; p < 0.0001). Moreover, they exhibited a higher objective cure rate (odds ratio 8.49, 95% CI 3.08–23.37). In addition, MS treatment reduced the number of episodes of urinary incontinence (MD −1.42, 95% CI −2.24 to −0.59; p = 0.0007) and urine loss on pad test (MD −4.67, 95% CI −8.05 to −1.28; p = 0.007). There were no significant treatment-related adverse reactions. Conclusion: This study evaluated the efficacy and safety of MS in the treatment of female SUI. The results have important implications for patients who do not wish to undergo surgical therapy. We found that MS treatment for SUI has positive outcomes, however, future studies should aim at establishing the best protocol for optimizing the therapeutic effect.
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Affiliation(s)
- Kai Sun
- Urology Department, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Dongxu Zhang
- Urology Department, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Gang Wu
- Urology Department, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Tianqi Wang
- Urology Department, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - JiTao Wu
- Urology Department, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Hongxu Ren
- Operation Department, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, No. 20 East Yuhuangding Road, Yantai, Shandong 264000, China
| | - Yuanshan Cui
- Urology Department, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, No. 20 East Yuhuangding Road, Yantai, Shandong 264000, China
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Hip and Pelvic Floor Muscle Strength in Women with and without Urgency and Frequency Predominant Lower Urinary Tract Symptoms. ACTA ACUST UNITED AC 2021; 45:126-134. [PMID: 34366727 DOI: 10.1097/jwh.0000000000000209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Urgency and frequency are common lower urinary tract symptoms (UF-LUTS) in women. There is limited evidence to guide physical therapist-led treatment. Objectives To compare hip and pelvic floor muscle strength between women with and without UF-LUTS. We hypothesized women with UF-LUTS would demonstrate 1) diminished hip external rotator and abductor strength and 2) equivalent pelvic floor strength and diminished endurance compared to controls. Study Design A matched case-control study. Methods Women with UF-LUTS (cases) and controls were matched on age, body mass index (BMI), vaginal parity. Examiner measured participants' 1) hip external rotator and abductor strength via dynamometry (maximum voluntary effort against fixed resistance) and 2) pelvic floor muscle strength (peak squeeze pressure) and endurance (squeeze pressure over a 10 second hold) via vaginal manometry. Values compared between cases and controls with paired-sample t-tests (hip) or Wilcoxon signed rank tests (pelvic floor). Results 21 pairs (42 women): Hip external rotation (67.0 ± 19.0 N vs 83.6 ± 21.5 N; P=0.005) and hip abduction strength (163.1 ± 48.1 N vs 190.1 ± 53.1 N; P=0.04) were significantly lower in cases than controls. There was no significant difference in pelvic floor strength (36.8 ± 19.9 cmH20 vs 41.8 ± 21.0 cmH20; P=0.40) or endurance (234.0 ± 149.6 cmH20*seconds vs 273.4 ± 149.1 cmH20*seconds; P=0.24). Conclusion Women with UF-LUTS had weaker hip external rotator and abductor muscles, but similar pelvic floor strength and endurance compared to controls. Hip strength may be important to assess in patients with UF-LUTS, further research is needed.
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Mukai S, Nomi M, Yamada S, Yanagiuchi A, Sengoku A. The 1-year continuation rate and discontinuation factors of vibegron and mirabegron: A retrospective comparative study in a rehabilitation hospital in Japan. Low Urin Tract Symptoms 2021; 13:448-455. [PMID: 34032007 DOI: 10.1111/luts.12391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/22/2021] [Accepted: 05/05/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To compare the 1-year continuation rate and discontinuation factors between vibegron and mirabegron in patients with neurogenic and nonneurogenic overactive bladder. METHODS Continuation or discontinuation of the target drugs and reasons for discontinuation as well as patients' grounds and adverse effects were evaluated retrospectively from the medical records between September 2018 and December 2020. After selecting patients according to the inclusion and exclusion criteria, 180 cases taking mirabegron and 132 taking vibegron were adjusted for intergroup variability by propensity score matching. We performed Cox proportional hazards regression for the 1-year continuation rate and Fine-Gray proportional hazards regression for the 1-year cumulative incidence of discontinuation events. Subgroup analysis was also performed for the background factors related to the 1-year continuation rate. RESULTS The 1-year continuation rate was 83.8% for vibegron and 58.2% for mirabegron, and the hazard ratio was 0.32 (95% CI: 0.18-0.57, P < .001) as for an incidence of discontinuation events of vibegron against mirabegron. The incidence of discontinuation due to an inadequate efficacy was 8.7% for vibegron and 29.1% for mirabegron, and similarly the hazard ratio was 0.26 (95% CI: 0.12-0.55, P < .001). The subgroup analysis indicated a similar tendency in each subgroup except for that of catheterization, and there was no significant interaction between the groups. CONCLUSIONS It is suggested that vibegron is superior to mirabegron in the continuity of administration in neurogenic and nonneurogenic overactive bladder populations without catheterization with fewer discontinuations due to inadequate efficacy.
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Affiliation(s)
- Shigeto Mukai
- Department of Pharmacy, Hyogo Prefectural Central Rehabilitation Hospital, Kobe, Japan
| | - Masashi Nomi
- Department of Urology, Hyogo prefectural Central Rehabilitation Hospital, Kobe, Japan
| | - Shogo Yamada
- Department of Pharmacy, Hyogo Prefectural Central Rehabilitation Hospital, Kobe, Japan
| | - Akihiro Yanagiuchi
- Department of Urology, Hyogo prefectural Central Rehabilitation Hospital, Kobe, Japan.,Department of Urology, Hyogo Prefectural Nishi-Harima Rehabilitation Hospital, Tatsuno, Japan
| | - Atsushi Sengoku
- Department of Urology, Hyogo prefectural Central Rehabilitation Hospital, Kobe, Japan
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Takahashi S, Takei M, Asakura H, Gotoh M, Ishizuka O, Kato K, Koyama M, Takeyama M, Tomoe H, Yamanishi T, Yokoyama O, Yoshida M, Yoshimura Y, Yoshizawa T. Clinical Guidelines for Female Lower Urinary Tract Symptoms (second edition). Int J Urol 2021; 28:474-492. [PMID: 33650242 DOI: 10.1111/iju.14492] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/13/2020] [Indexed: 12/13/2022]
Abstract
The present article is an abridged English translation of the Japanese Clinical Guidelines for Female Lower Urinary Tract Symptoms (second edition), published in September 2019. These guidelines consist of a total of 212 pages and are unique worldwide in that they cover female lower urinary tract symptoms other than urinary incontinence. They contain two algorithms for "primary treatment" and "specialized treatment," respectively. These guidelines, consisting of six chapters, address a total of 26 clinical questions including: (i) treatment algorithms; (ii) what are female lower urinary tract symptoms?; (iii) epidemiology and quality of life; (iv) pathology and illness; (v) diagnosis; and (vi) treatment. When the patient's symptoms mainly involve voiding and post-micturition symptoms, specialized treatment should be considered. In the event of voiding symptoms concurrent with storage symptoms, residual urine should be measured; if the residual urine volume is <100 mL, then diagnosis and treatment for storage symptoms is prioritized, and if the volume is ≥100 mL, then specialized treatment should be considered. When storage symptoms are the primary condition, then the patient is subject to the primary treatment algorithm. Specialized treatment for refractory overactive bladder includes botulinum toxin injection and sacral nerve stimulation. For stress urinary incontinence, surgical treatment is indicated, such as urethral slings. The two causes of voiding symptoms and post-micturition symptoms are lower urinary tract obstruction and detrusor underactivity (underactive bladder). Mechanical lower urinary tract obstruction, such as pelvic organ prolapse, is expected to improve with surgery.
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Affiliation(s)
- Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Mineo Takei
- Department of Urology, Harasanshin Hospital, Fukuoka, Japan
| | | | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Osamu Ishizuka
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kumiko Kato
- Department of Female Urology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Masayasu Koyama
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masami Takeyama
- Urogynecology Center, First Towakai Hospital, Takatsuki, Japan
| | - Hikaru Tomoe
- Department of Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Tomonori Yamanishi
- Department of Urology, Continence Center, Dokkyo Medical University, Tochigi, Japan
| | - Osamu Yokoyama
- Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Masaki Yoshida
- Department of Urology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yasukuni Yoshimura
- Female Pelvic Health Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Tsuyoshi Yoshizawa
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
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10
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Yono M, Irie S, Gotoh M. TAS-303 effects on urethral sphincter function in women with stress urinary incontinence: phase I study. Int Urogynecol J 2021; 32:673-680. [PMID: 32747975 PMCID: PMC7902327 DOI: 10.1007/s00192-020-04470-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/23/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS TAS-303, which selectively inhibits noradrenaline reuptake, was developed for treating stress urinary incontinence (SUI). The proximal urethra mainly comprises smooth muscle fibers in which α1 adrenergic receptors are abundant. This study was conducted to evaluate the effect of TAS-303 on urethral function and its safety profile in female patients with SUI. METHODS In total, 16 women (age, 20-64 years) with SUI and > 5.0 g of leakage in the 1-h pad test at screening were randomized and administered the assigned treatment in a double-blind manner. The primary end point was change in the maximal urethral closure pressure (MUCP) at 6 h post-dose. The secondary end point was change in the urethral closure pressure of the entire urethra and each urethral region (proximal, middle, and distal) at 6 h post-dose. The results were analyzed using a t-test. RESULTS The mean change ± standard deviation in MUCP at 6 h post-dose was 3.473 ± 12.154 cmH2O for TAS-303 and 2.615 ± 9.794 cmH2O for placebo (between-group difference: 0.858 cmH2O, P = 0.8047). The mean changes ± standard deviation in urethral closure pressure of the proximal urethra at 6 h after the administration of TAS-303 18 mg and placebo were 3.863 ± 10.941 and 1.634 ± 12.093, respectively (between-group difference: 2.229 cmH2O, P = 0.5976). CONCLUSIONS No significant difference in MUCP and urethral closure pressure was found between TAS-303 and placebo. However, the change in the proximal urethral closure pressure with TAS-303 was larger than that with placebo. This suggests that TAS-303 has pharmacological effects on urethral sphincteric function.
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Affiliation(s)
- Makoto Yono
- Department of Urology, Nishi Kumamoto Hospital, Souseikai, Kumamoto, Japan.
- , 1012 Koga, Tomiai-machi, Minami-ku, Kumamoto, 861-4157, Japan.
| | - Shin Irie
- Department of Clinical Pharmacology, Nishi Kumamoto Hospital, Souseikai, Kumamoto, Japan
- Souseikai, Fukuoka, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Aichi, Japan
- Chukyo Hospital, Aichi, Japan
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11
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Yuyama M, Ito T, Arai Y, Kadowaki Y, Iiyama N, Keino A, Hiraoka Y, Kanaya T, Momose Y, Kurihara M. Risk Prediction Method for Anticholinergic Action Using Auto-quantitative Structure-Activity Relationship and Docking Study with Molecular Operating Environment. Chem Pharm Bull (Tokyo) 2021; 68:773-778. [PMID: 32741919 DOI: 10.1248/cpb.c20-00249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Lower urinary tract symptoms (LUTS) induced by anticholinergic drug action impair the QOL of patients and are associated with a poor prognosis. Therefore, it is expedient to develop methods of predicting the anticholinergic side effects of drugs, which we aimed to achieve in this study using a quantitative structure-activity relationship (QSAR) and docking study with molecular operations environment (MOE; Molecular Simulation Informatics Systems [MOLSIS], Inc.) In the QSAR simulation, the QSAR model built using the partial least squares regression (PLS) and genetic algorithm-multiple linear regression (GA-MLR) methods showed remarkable coefficient of determination (R2) and XR2 values. In the docking study, a specific relationship was identified between the adjusted docking score (-S) and bioactivity (pKi) values. In conclusion, the methods developed could be useful for in silico risk assessment of LUTS, and plans are potentially applicable to numerous drugs with anticholinergic activity that induce serious side effects, limiting their use.
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Affiliation(s)
- Materu Yuyama
- Graduate School of Pharmaceutical Sciences, International University of Health and Welfare Graduate School
| | - Takeshi Ito
- Graduate School of Pharmaceutical Sciences, International University of Health and Welfare Graduate School.,Department of Pharmaceutical Sciences, International University of Health and Welfare
| | - Yumiko Arai
- Graduate School of Pharmaceutical Sciences, International University of Health and Welfare Graduate School
| | - Yuki Kadowaki
- Department of Pharmaceutical Sciences, International University of Health and Welfare
| | - Natsumi Iiyama
- Department of Pharmaceutical Sciences, International University of Health and Welfare
| | - Ayako Keino
- Department of Pharmaceutical Sciences, International University of Health and Welfare
| | - Yurina Hiraoka
- Department of Pharmaceutical Sciences, International University of Health and Welfare
| | - Takayuki Kanaya
- Department of Pharmaceutical Sciences, International University of Health and Welfare
| | - Yasuyuki Momose
- Graduate School of Pharmaceutical Sciences, International University of Health and Welfare Graduate School.,Department of Pharmaceutical Sciences, International University of Health and Welfare
| | - Masaaki Kurihara
- Graduate School of Pharmaceutical Sciences, International University of Health and Welfare Graduate School.,Department of Pharmaceutical Sciences, International University of Health and Welfare
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Kilic D, Guler T, Baser E, Kabukcu C, Fenkci V, Sivaslioglu A. Does apical prolapse in addition to early stage anterior prolapse have any effect on lower urinary tract symptoms? J Gynecol Obstet Hum Reprod 2020; 50:101922. [PMID: 32977045 DOI: 10.1016/j.jogoh.2020.101922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/14/2020] [Accepted: 09/20/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate whether apical prolapse in addition to early-stage anterior prolapse has any effect on lower urinary tract symptoms (LUTS). METHODS Patients with early-stage pelvic organ prolapse (POP) were retrospectively analyzed at the urogynecology unit of a tertiary referral center. Cases with posterior POP were excluded, and the remaining women were distributed across four main groups: (1) no determinable anterior and/or apical POP (control); (2) isolated anterior POP; (3) anterior + apical POP; and (4) isolated apical POP. Each LUTS symptom in these groups was recorded. Women with isolated anterior POP and women with anterior + apical POP were then compared to define the additional effects of apical prolapse on LUTS. In order to asses; symptoms of urgency, urinary incontinence, stress urinary incontinence, frequency, abnormal emptying, hesitancy, interrupted stream, nocturia, post-micturition dribble, and dysuria were noted and Incontinence Impact Questionnaire (IIQ-7), and domains of Urinary Distress Inventory (UDI-6) were compared between the groups. RESULTS Of the 225 patients, 66 were excluded from the analysis due to accompanying posterior compartment defect. There was no statistically significant difference for age, systemic disease history, or smoking status between the groups (p > 0.05). However, history of traumatic vaginal delivery was significantly lower in the control group than in the other groups (p = 0.039). The prevalence of hesitancy and interrupted stream were found to be significantly higher in the anterior + apical POP group than in the isolated POP group (p<0.05). Obstructive subscale of the Urinary Distress Inventory was higher both in the isolated anterior POP and anterior + apical POP groups than the control group (p<0.05). CONCLUSION The current study demonstrates that even minimal loss of apical support accompanying anterior prolapse exacerbates LUTS.
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Affiliation(s)
- Derya Kilic
- Department of Obstetrics and Gynecology, Pamukkale University, Denizli, Turkey
| | - Tolga Guler
- Department of Obstetrics and Gynecology, Pamukkale University, Denizli, Turkey.
| | - Emre Baser
- Department of Obstetrics and Gynecology, Bozok University, Yozgat, Turkey
| | - Cihan Kabukcu
- Department of Obstetrics and Gynecology, Pamukkale University, Denizli, Turkey
| | - Veysel Fenkci
- Department of Obstetrics and Gynecology, Pamukkale University, Denizli, Turkey
| | - Akin Sivaslioglu
- Department of Obstetrics and Gynecology, Mugla Sitki Kocman University, Mugla, Turkey
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Aydın A, Kocaöz S, Kara P. Prevalence of Lower Urinary Tract Symptoms in Pregnant Adolescents and the Influencing Factors. J Pediatr Adolesc Gynecol 2020; 33:160-166. [PMID: 31655179 DOI: 10.1016/j.jpag.2019.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 10/11/2019] [Accepted: 10/16/2019] [Indexed: 01/03/2023]
Abstract
STUDY OBJECTIVE To determine the prevalence of lower urinary tract symptoms (LUTS) and associated risk factors in pregnant adolescents. DESIGN Descriptive study. SETTING The obstetrics and gynecology outpatient departments of a training and research hospital in Turkey. PARTICIPANTS Two hundred six pregnant adolescents younger than the age of 19 years. INTERVENTIONS None. Questionnaire-based data and the Bristol Female Lower Urinary Tract Symptoms-Short Form (BFLUTS-SF) were collected from pregnant adolescents. MAIN OUTCOME MEASURES Comparisons were made with independent samples t test, one-way analysis of variance, Mann-Whitney U, and Kruskal-Wallis tests, and linear regression for the analysis of the potential risk factors. RESULTS The prevalence of at least 1 of the LUTS in pregnant adolescents was 78.6% (162/206). The prevalence of storage symptoms was more than those of urinary incontinence and voiding symptoms. Among LUTS, the prevalence of nocturia, urgency, frequency, bladder pain, and urinary incontinence was 59.3% (122/206), 54.4% (112/206), 39.3% (81/206), 37.4% (77/206), and 27.2% (56/206), respectively. Of pregnant adolescents with LUTS, 30.2% (49/162) of pregnant adolescents with LUTS reported seeking treatment for LUTS in this study. The total median scores from the BFLUTS-SF increased with gestational week, but no statistical significant difference was identified (P > .05). According to the results of the linear regression analysis, daily coffee consumption, smoking, chronic coughing, constipation, and urinary tract infection history were found to be associated with the total mean score on the BFLUTS-SF in pregnant adolescents. CONCLUSION LUTS were found to be common among pregnant adolescents, with storage symptoms being the most frequently reported. Prenatal education could increase the number of adolescents who seek treatment, thereby improving the clinical course of LUTS.
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Affiliation(s)
| | - Semra Kocaöz
- Niğde Ömer Halisdemir University, Niğde Zübeyde Hanım School of Health, Nursing Department, Department of Obstetrics and Gynecology Nursing, Niğde, Turkey.
| | - Pınar Kara
- Niğde Ömer Halisdemir University, Niğde Zübeyde Hanım School of Health, Nursing Department, Department of Obstetrics and Gynecology Nursing, Niğde, Turkey
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Gücük S, Ural ÜM, Kayhan M, Gücük A. Lower urinary tract symptoms and related factors in female university students. Low Urin Tract Symptoms 2020; 12:211-217. [PMID: 32110838 DOI: 10.1111/luts.12306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/05/2020] [Accepted: 02/13/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Our study aims to determine the symptoms and frequency of lower urinary tract in female university students and its related factors. METHODS This cross-sectional study was conducted between January and June 2017. To determine their sociodemographic characteristics and toilet habits, the Bristol Female Lower Urinary Tract Symptoms questionnaire, a 21-item questionnaire, was applied to female university students accepting to participate in the study using the face-to-face interview method. RESULTS The study was completed with 1091 individuals. The mean age of the participants was 20.27±1.69 years. The question "Do you feel a sudden urination sensation and run to the toilet?" was answered by 1.1% (n: 12) of the participants with "Always," while 34.8% (n: 380) replied "Never." In terms of feeling a sudden urination sensation, 0.5% (n: 6) of the participants stated that they "always" experience micturition, while 15.0% (n: 164) answered with "Seldom." The complaint of being unable to empty their bladder completely while urinating was higher in students with constipation problems (P .04) and a body mass index (BMI) > 24.9 (P .02). CONCLUSIONS Lower urinary tract complaints are a common problem. We believe that routine medical screening should be performed for female university students whose living conditions change when they start university; besides, we suggest that well-attended and repeatable training programs for healthy living behaviors, urinary habits, and hygiene should be organized for university students.
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Affiliation(s)
- Sebahat Gücük
- Department of Family Medicine, Medical Faculty, Bolu Abant İzzet Baysal University, Bolu, Turkey
| | - Ülkü M Ural
- Department of Obstetrics and Gynecology, Medical Faculty, Bolu Abant İzzet Baysal University, Bolu, Turkey
| | - Mehmet Kayhan
- Department of Family Medicine, Medical Faculty, Bolu Abant İzzet Baysal University, Bolu, Turkey
| | - Adnan Gücük
- Department of Urology, Medical Faculty, Bolu Abant İzzet Baysal University, Bolu, Turkey
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Influence of Circadian Disruption Associated With Artificial Light at Night on Micturition Patterns in Shift Workers. Int Neurourol J 2019; 23:258-264. [PMID: 31905272 PMCID: PMC6944784 DOI: 10.5213/inj.1938236.118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 12/16/2019] [Indexed: 12/15/2022] Open
Abstract
Shift workers often experience problems associated with circadian disruption associated with artificial light at night and nocturia is commonly noted in night-shift workers. Nocturia associated with circadian disruption is due to increased urine production of the kidney and decreased storage function of the bladder. A recent discovery of peripheral clock genes in the bladder and their role in contractile property of the bladder support that micturition is closely related to the circadian rhythm. Moreover, there are clinical studies showed that shift workers more often experienced nocturia due to circadian disruption. However, comparing with other health problems, concerns on nocturia and voiding dysfunction associated with circadian disruption are insufficient. Therefore, further studies about voiding dysfunction associated with the circadian disruption in shift workers are necessary.
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Yang X, Zhang A, Tan Y, Zhang Z, Zhang J. Critical appraisal of clinical practice guidelines for the diagnosis and treatment of stress urinary incontinence using AGREE II instrument: a systematic review protocol. BMJ Open 2019; 9:e030299. [PMID: 31542749 PMCID: PMC6756316 DOI: 10.1136/bmjopen-2019-030299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Stress urinary incontinence is a major health problem, and several clinical guidelines have been formulated and released regarding this in different countries. However, the recommendations in these guidelines formulated by different organisations and countries are inconsistent. This review aims to conduct a critical appraisal of clinical practice guidelines for the diagnosis and treatment of stress urinary incontinence. METHODS AND ANALYSIS We will conduct a comprehensive search in the following databases: PubMed, Embase, Medline, Cochrane Library, three Chinese databases and six guideline databases. The databases will be searched from January 2003, and the comprehensive search will be done again to include all the qualified guidelines before making conclusions. The quality of clinical practice guidelines will be assessed by three appraisers using the Appraisal of Guidelines Research and Evaluation II instrument, and this will be scored. The recommendation available in the guidance will also be summarised in different domains including the diagnosis standard, recommended examination and questionnaire for assessment, conservative treatment and surgical treatment. ETHICS AND DISSEMINATION This review will be disseminated through peer-reviewed publications. The results will help inform the health practitioners about the recommendations in clinical practice guidelines. PROSPERO REGISTRATION NUMBER CRD42018115743.
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Affiliation(s)
- Xiaowei Yang
- King's College London, Florence Nightingale Faculty of Nursing, Midwifery and Palliative care, London, UK
- Nursing department, Nanjing Vocational Health College, Nanjing, China
| | - AiXia Zhang
- Nursing department, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Yanquan Tan
- Rehabilitation department, Jiangsu Health Vocational and Technical School, Nanjing, China
| | - Zhengbao Zhang
- Teaching and Research Division, Jiangsu Health Higher Vocational and Technical School, Nanjing, China
| | - Jie Zhang
- Nursing department, Nanjing Vocational Health College, Nanjing, China
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Matsumoto M, Tsutaoka T, Yabunaka K, Handa M, Yoshida M, Nakagami G, Sanada H. Development and evaluation of automated ultrasonographic detection of bladder diameter for estimation of bladder urine volume. PLoS One 2019; 14:e0219916. [PMID: 31487299 PMCID: PMC6728037 DOI: 10.1371/journal.pone.0219916] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 07/03/2019] [Indexed: 12/01/2022] Open
Abstract
Bladder urine volume has been estimated using an ellipsoid method based on triaxial measurements of the bladder extrapolated from two-dimensional ultrasound images. This study aimed to automate this process and to determine the accuracy of the automated estimation method for normal and small amounts of urine. A training set of 81 pairs of transverse and longitudinal ultrasound images were collected from healthy volunteers on a tablet-type ultrasound device, and an automatic detection tool was developed using them. The tool was evaluated using paired transverse/longitudinal ultrasound images from 27 other healthy volunteers. After imaging, the participants voided and their urine volume was measured. For determining accuracy, regression coefficients were calculated between estimated bladder volume and urine volume. Further, sensitivity and specificity for 50 and 100 ml bladder volume thresholds were evaluated. Data from 50 procedures were included. The regression coefficient was very similar between the automatic estimation (β = 0.99, R2 = 0.96) and manual estimation (β = 1.05, R2 = 0.97) methods. The sensitivity and specificity of the automatic estimation method were 88.5% and 100.0%, respectively, for 100 ml and were 94.1% and 100.0%, respectively, for 50 ml. The newly-developed automated tool accurately and reliably estimated bladder volume at two different volume thresholds of approximately 50 ml and 100 ml.
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Affiliation(s)
- Masaru Matsumoto
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takuya Tsutaoka
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Imaging Technology Center, Research & Development Management Headquarters, FUJIFILM Corporation, Minato-ku, Tokyo, Japan
| | - Koichi Yabunaka
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Mayumi Handa
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Marketing Planning Group, Ultrasound Promotion Department, FUJIFILM Medical Corporation, Minato-ku, Tokyo, Japan
| | - Mikako Yoshida
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Gojiro Nakagami
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiromi Sanada
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Liu AB, Liu Q, Yang CC, Griffith JW, Smith AR, Helmuth ME, Lai HH, Amundsen CL, Erickson BA, Jelovsek JE, Agochukwu NQ, Mueller MG, Andreev VP, Weinfurt KP, Kenton KS, Fraser MO, Cameron AP, Kirkali Z, Gore JL. Patient Characteristics Associated with More Bother from Lower Urinary Tract Symptoms. J Urol 2019; 202:585-591. [PMID: 31063049 PMCID: PMC6697227 DOI: 10.1097/ju.0000000000000324] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Some patients continue to have bothersome lower urinary tract symptoms despite treatment. We examined characteristics associated with bother from lower urinary tract symptoms in a prospective cohort. MATERIALS AND METHODS In this 1-year prospective, observational cohort study we obtained data on patients with lower urinary tract symptoms who were seeking care at a total of 6 tertiary care centers in the United States. Participants answered the AUA-SI (American Urological Association Symptom Index) global urinary bother question at study entry and 12 months later. Multilevel logistic and linear regression was used to identify factors associated with worsening bother and bother at 12 months, respectively. RESULTS Of the 756 participants 121 (16%) had worsened lower urinary tract symptom bother during the study period. When adjusted for other variables, worsened lower urinary tract symptom bother was more likely among men who were nonwhite (OR 1.79, 95% CI 0.94-3.40) or who had diabetes (OR 1.68, 95% CI 0.86-3.27) and among women with diabetes (OR 1.77, 95% CI 0.85-3.67), prior treatment of lower urinary tract symptoms (OR 2.58, 95% CI 1.22-5.46) or a higher depression level (OR 1.29, 95% CI 1.10-1.52). Baseline factors associated with more severe bother at 12 months in men included more severe bother at baseline, nonwhite race, worse urinary frequency and incontinence, and higher levels of stress (p <0.05). Among women more severe bother at baseline, urinary urgency and frequency, and worse physical function were associated with more severe bother at 12 months. CONCLUSIONS Urinary symptom severity at baseline, race, depression and psychological stress were associated with the bother of lower urinary tract symptoms in a prospective cohort of men and women treated at tertiary care facilities. These findings may inform the clinical care of patients with bothersome lower urinary tract symptoms and direct providers to better prognosticate for patients with challenging lower urinary tract symptoms cases.
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Affiliation(s)
- Alice B. Liu
- Department of Urology, University of Washington, Seattle, Washington
| | - Qian Liu
- Arbor Research Collaborative for Health, Ann Arbor, Michigan
| | - Claire C. Yang
- Department of Urology, University of Washington, Seattle, Washington
| | | | | | | | - H. Henry Lai
- Washington University School of Medicine, St Louis, MO
| | | | | | | | | | | | | | | | | | | | | | - Ziya Kirkali
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - John L. Gore
- Department of Urology, University of Washington, Seattle, Washington
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Kamei J, Yazawa S, Yamamoto S, Kaburaki N, Takahashi S, Takeyama M, Koyama M, Arakawa S, Kiyota H. A nationwide surveillance of surgical site infection after mid-urethral slings in Japan. J Infect Chemother 2019; 25:567-570. [PMID: 31005565 DOI: 10.1016/j.jiac.2019.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022]
Abstract
We performed a questionnaire-based, retrospective, nationwide survey on perioperative management and antimicrobial prophylaxis for mid-urethral sling surgery for stress urinary incontinence in Japan to realize the clinical practice and risk factors for SSI. Records of women receiving transobturator tape (TOT) and tension-free vaginal tape (TVT) surgeries from 2010 to 2012 were obtained from hospitals belonging to the Japanese Society of Pelvic Organ Prolapse Surgery. The questionnaire addressed hospital volume, perioperative management, and SSI. Risk factors for SSI were investigated by comparing cases with and without SSI. The data from 97 hospitals and a total 1627 TOT and 1045 TVT surgeries were analyzed. Mean case volumes of TOT and TVT surgeries were 7.3 ± 14.9 and 7.1 ± 17.8 cases per year, respectively. Preoperative hair removal, bowel preparation, and urine culture were routinely performed at 44 (45.3%), 31 (32.0%), and 22 (22.7%) hospitals, respectively. First-generation (51.5%) or second-generation (34.0%) cephalosporin was mostly used for antimicrobial prophylaxis. SSI was reported only in 6 patients (0.22%) and none of them developed abscesses. None of the factors we could evaluate from the questionnaire were found to be significantly associated with SSI. SSI after mid-urethral slings rarely occurred in Japan (0.22%) and no parameters about perioperative managements significantly increased SSI. However, further studies with more detail information of each patient and operation are required to confirm their appropriate perioperative managements for mid-urethral slings.
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Affiliation(s)
- Jun Kamei
- Department of Urology, Jichi Medical University, Tochigi, Japan; The Japanese Research Group for Urinary Tract Infection (JRGU), Japan
| | - Satoshi Yazawa
- Yazawa Clinic, Tokyo, Japan; Department of Urology, Keio University, School of Medicine, Tokyo, Japan; The Japanese Research Group for Urinary Tract Infection (JRGU), Japan
| | - Shingo Yamamoto
- Department of Urology, Hyogo College of Medicine, Hyogo, Japan; The Japanese Research Group for Urinary Tract Infection (JRGU), Japan.
| | - Naoto Kaburaki
- Department of Urology, Tokyo Medical University, Tokyo, Japan; The Japanese Research Group for Urinary Tract Infection (JRGU), Japan
| | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan; The Japanese Society of Pelvic Organ Prolapse Surgery (JPOPS), Japan
| | - Masami Takeyama
- Urogynecology Center, First Towakai Hospital, Osaka, Japan; The Japanese Society of Pelvic Organ Prolapse Surgery (JPOPS), Japan
| | - Masayasu Koyama
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan; The Japanese Society of Pelvic Organ Prolapse Surgery (JPOPS), Japan
| | - Soichi Arakawa
- Department of Urology, Sanda City Hospital, Hyogo, Japan; The Japanese Research Group for Urinary Tract Infection (JRGU), Japan
| | - Hiroshi Kiyota
- Department of Urology, Jikei University School of Medicine, Katsushika Medical Center, Tokyo, Japan; The Japanese Research Group for Urinary Tract Infection (JRGU), Japan
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Wang C, Jiang Y, Kuo H. Higher urge severity score predicts resumption of overactive bladder (OAB) medication following discontinuation of mirabegron treatment in patients with OAB. Low Urin Tract Symptoms 2019; 11:O180-O185. [DOI: 10.1111/luts.12252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/09/2018] [Accepted: 11/27/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Chung‐Cheng Wang
- Department of Urology, En Chu Kong Hospital, College of MedicineNational Taiwan University New Taipei Taiwan
- Department of Biomedical EngineeringChung Yuan Christian University Taoyuan Taiwan
| | - Yung‐Hong Jiang
- Department of UrologyBuddhist Tzu Chi General Hospital and Tzu Chi University Hualien Taiwan
| | - Hann‐Chorng Kuo
- Department of UrologyBuddhist Tzu Chi General Hospital and Tzu Chi University Hualien Taiwan
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Yamaguchi O, Kakizaki H, Homma Y, Igawa Y, Takeda M, Nishizawa O, Gotoh M, Yoshida M, Yokoyama O, Seki N, Okitsu A, Hamada T, Kobayashi A, Kuroishi K. Long-term safety and efficacy of antimuscarinic add-on therapy in patients with overactive bladder who had a suboptimal response to mirabegron monotherapy: A multicenter, randomized study in Japan (MILAI II study). Int J Urol 2018; 26:342-352. [PMID: 30548692 PMCID: PMC7379522 DOI: 10.1111/iju.13868] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/15/2018] [Indexed: 11/30/2022]
Abstract
Objectives To evaluate the long‐term safety (primary objective) and efficacy (secondary objective) of antimuscarinic add‐on therapy in patients receiving mirabegron. Methods During a 2‐week screening period, patients (aged ≥20 years, mirabegron treatment for ≥6 weeks, residual overactive bladder symptoms) received mirabegron 50 mg once daily. These patients were subsequently randomized to 52 weeks’ treatment with mirabegron 50 mg/day plus an antimuscarinic (solifenacin 5 mg, propiverine 20 mg, imidafenacin 0.2 mg, or tolterodine 4 mg) with the potential to double the antimuscarinic dose (except for tolterodine) at week 8. Safety assessments included treatment‐emergent adverse events, vital signs, 12‐lead electrocardiograms, post‐void residual volume, and laboratory evaluations. Efficacy was assessed using changes from baseline in overactive bladder symptom score total score; overactive bladder questionnaire short form score; micturitions, urgency episodes, urinary incontinence episodes, and urgency urinary incontinence episodes/24 h; mean volume voided per micturition; and number of night‐time micturitions. Results Overall, 80.2% of patients (88.1% women, mean age 65 years) experienced at least one treatment‐emergent adverse event, with similar rates for all treatments. The adverse events most commonly reported were dry mouth, nasopharyngitis, and constipation. No marked change was observed in systolic or diastolic blood pressure for any treatment, although pulse rate increased slightly in the mirabegron and propiverine, and mirabegron and tolterodine groups. For all treatments, significant improvements were observed in all efficacy parameters, including overactive bladder symptom score total and questionnaire short form scores. Conclusions Antimuscarinic add‐on therapy is well tolerated and effective after initial treatment with mirabegron in patients with overactive bladder symptoms.
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Affiliation(s)
- Osamu Yamaguchi
- Department of Chemical Biology and Applied Chemistry, Nihon University School of Engineering, Koriyama, Japan
| | - Hidehiro Kakizaki
- Department of Urology, Asahikawa Medical University, Asahikawa, Japan
| | - Yukio Homma
- Department of Urology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yasuhiko Igawa
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Masayuki Takeda
- Department of Urology, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, Chuo, Japan
| | - Osamu Nishizawa
- Department of Urology, North Alps Medical Center, Azumi Hospital, Nagano, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaki Yoshida
- Department of Urology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Osamu Yokoyama
- Department of Urology, University of Fukui Faculty of Medical Sciences, Fukui, Japan
| | - Narihito Seki
- Department of Urology, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
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Kato D, Tabuchi H, Uno S. Three-year safety, efficacy and persistence data following the daily use of mirabegron for overactive bladder in the clinical setting: A Japanese post-marketing surveillance study. Low Urin Tract Symptoms 2018; 11:O152-O161. [PMID: 30079630 PMCID: PMC7379686 DOI: 10.1111/luts.12237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/17/2018] [Accepted: 06/18/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of this study was to report the final 3-year results from a surveillance study evaluating the safety, efficacy, and persistence of mirabegron for treating overactive bladder (OAB) symptoms. METHODS Patients who had started mirabegron for the treatment of urinary urgency, daytime frequency, and urgency urinary incontinence symptoms associated with OAB were followed for 3 years. Adverse drug reactions (ADRs), residual urine volume measurements, OAB symptoms, Overactive Bladder Symptom Scores (OABSS), and treatment discontinuations were evaluated prospectively. Persistence was estimated using the Kaplan-Meier method. RESULTS Of the 1138 patients included in the study (mean ±SD age: 71.9 ± 11.0 years; 574 [50.4%] women), 97 (8.52%) experienced 109 ADRs, with the incidence of ADRs decreasing over time (<1 year: 1.34%-2.37%; ≥1-<2 years: 0.45%-1.60%; ≥2-<3 years: 0.29%-1.10%; 3-monthly interval data). No significant increases in residual urine volume were observed. The investigators considered mirabegron to be an effective treatment for 842 of 1082 (77.8%) patients. Significant decreases in OABSS were reported throughout (P < 0.001), and 321 (65.1%) patients achieved a minimal clinically important change (MCIC) in OABSS. Most patients who achieved an MCIC within ≤1 year continued to maintain an MCIC throughout the study. Treatment persistence rates after 1, 2, and 3 years of mirabegron treatment were 65.8%, 52.9%, and 46.7%, respectively. CONCLUSION Over 3 years, mirabegron was well tolerated and no cumulative events or delayed ADRs were observed. Mirabegron was an effective treatment with early improvements in OABSS being maintained throughout the treatment period. High persistence was observed after the use of mirabegron.
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Affiliation(s)
- Daisuke Kato
- Medical Science, Medical Affairs, Astellas Pharma Inc., Tokyo, Japan
| | - Hiromi Tabuchi
- Medical Science, Medical Affairs, Astellas Pharma Inc., Tokyo, Japan
| | - Satoshi Uno
- Japan-Asia Data Science, Development, Astellas Pharma Inc., Tokyo, Japan
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Lin KY, Siu KC, Lin KH. Impact of lower urinary tract symptoms on work productivity in female workers: A systematic review and meta-analysis. Neurourol Urodyn 2018; 37:2323-2334. [DOI: 10.1002/nau.23744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 06/11/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Kuan-Yin Lin
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science; Monash University; Melbourne Australia
| | - Ka-Chun Siu
- Division of Physical Therapy Education; College of Allied Health Professions; University of Nebraska Medical Center; Omaha Nebraska
| | - Kuan-Han Lin
- Graduate Institute of Medical Education & Bioethics; College of Medicine; National Taiwan University; Taipei Taiwan R.O.C
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Kamei J, Yazawa S, Yamamoto S, Kaburaki N, Takahashi S, Takeyama M, Koyama M, Homma Y, Arakawa S, Kiyota H. Risk factors for surgical site infection after transvaginal mesh placement in a nationwide Japanese cohort. Neurourol Urodyn 2018. [PMID: 29527737 DOI: 10.1002/nau.23416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIMS We conducted a nationwide survey on perioperative management and antimicrobial prophylaxis of transvaginal mesh surgeries for pelvic organ prolapse in Japan to understand the practice and risk factors for surgical site infection (SSI). METHODS Health records of women undergoing tension-free vaginal mesh (TVM) surgeries from 2010 to 2012 were obtained from 135 medical centers belonging to the Japanese Society of Pelvic Organ Prolapse Surgery. The questionnaire addressed hospital volume, perioperative management, and SSI. Risk factors for SSI were investigated by comparing cases with and without SSI. RESULTS The hospital volume among institutions varied from 0 to 248 per year (median 16.7). Preoperative hair removal, bowel preparation, and urine culture were routinely performed at 74 (55%), 66 (49%), and 24 (18%) hospitals, respectively. Prophylactic antimicrobials used were mostly first-generation (43%) or second-generation (42%) cephalosporin. SSI was reported in 86 of 9323 patients (0.92%). A multivariate analysis indicated lower hospital volume (odds ratio [OR], 0.995 [by 1-point increase]; P < 0.001), preoperative bowel preparation (OR, 2.08; P = 0.013), non-routine urine culture (OR, 3.00; P = 0.0006), and the use of antibiotics other than first-generation cephalosporin (OR, 5.29; P = 0.0011) as significant risk factors for SSI. In contrast, the cut-off points of hospital volume for preventing SSI was 116.7 cases (area under curve: 0.61). CONCLUSION The prevalence of SSI in TVM surgeries was 0.92% in Japan. Lower hospital volume, bowel preparation, non-routine preoperative urine culture, and prophylactic antibiotics other than first-generation cephalosporin significantly elevated the incidence of SSI.
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Affiliation(s)
- Jun Kamei
- Department of Urology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.,The Japanese Research Group for Urinary Tract Infection (JRGU), Japan
| | - Satoshi Yazawa
- The Japanese Research Group for Urinary Tract Infection (JRGU), Japan.,Yazawa Clinic, Saitama, Japan.,Department of Urology, School of Medicine, Keio University, Tokyo, Japan
| | - Shingo Yamamoto
- The Japanese Research Group for Urinary Tract Infection (JRGU), Japan.,Department of Urology, Hyogo College of Medicine, Hyogo, Japan
| | - Naoto Kaburaki
- The Japanese Research Group for Urinary Tract Infection (JRGU), Japan.,Department of Urology, School of Medicine, Keio University, Tokyo, Japan
| | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan.,The Japanese Society of Pelvic Organ Prolapse Surgery (JPOPS), Japan
| | - Masami Takeyama
- Urogynecology Center, First Towakai Hospital, Osaka, Japan.,The Japanese Society of Pelvic Organ Prolapse Surgery (JPOPS), Japan
| | - Masayasu Koyama
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.,The Japanese Society of Pelvic Organ Prolapse Surgery (JPOPS), Japan
| | - Yukio Homma
- Department of Urology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Urology, Japan Red Cross Medical Center, Tokyo, Japan
| | - Soichi Arakawa
- The Japanese Research Group for Urinary Tract Infection (JRGU), Japan.,Department of Urology, Sanda City Hospital, Hyogo, Japan
| | - Hiroshi Kiyota
- The Japanese Research Group for Urinary Tract Infection (JRGU), Japan.,Department of Urology, Jikei University School of Medicine, Katsushika Medical Center, Tokyo, Japan
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25
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Abstract
Lower urinary tract symptoms-in particular, storage disorders (for example, urinary incontinence) as well as bladder underactivity-are major health-related problems that increase with age. Yet lower urinary tract symptoms remain under-diagnosed and poorly managed, and incontinence has been cited as the major reason for institutionalization in elderly populations and is one of the most common conditions in primary care practice. Although lifestyle and behavior therapy has been used as a useful treatment regimen for urge incontinence, medications (often used as adjunct) can provide additional benefit. This review will include current therapies used for treatment of urinary incontinence.
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Affiliation(s)
- Bronagh McDonnell
- Department of Medicine, University of Pittsburgh School of Medicine, A 1217 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA
| | - Lori Ann Birder
- Department of Medicine, University of Pittsburgh School of Medicine, A 1217 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA.,Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, A 1217 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA
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26
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Sönmez MG, Göğer YE, Ecer G, Atıcı A, Özkent MS, Öztürk A. Effects of urine alkalinization with sodium bicarbonate orally on lower urinary tract symptoms in female patients: a pilot study. Int Urogynecol J 2017; 29:1029-1033. [PMID: 28975365 DOI: 10.1007/s00192-017-3492-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/13/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND HYPOTHESIS In this study, we planned to explore the effects of sodium bicarbonate orally (NaHCO3) treatment on female patients with lower urinary tract symptoms (LUTS) who have acidic urine pH values (<6). METHODS NaHCO3 was given orally to 33 female patients for 4 weeks at a dose of 2 × 4 g/day. Laboratory values, bladder diary, the Patient Perception of Bladder Condition Score (PPBC), Patient Perception of Intensity of Urgency Scale (PPIUS), Overactive Bladder-Validated 8-question Awareness tool (OAB-V8), Pelvic Pain and Urgency & Frequency Patient Symptom Scale tests (PUFSS), and the King's Health Questionnaire (KHQ) scores before and after treatment were compared. RESULTS A significant increase was detected in urine pH values measured after treatment (5.31 ± 0.52 to 7.2 ± 0.66, p < 0.001), but not in blood pH values (7.369 ± 0.33 to 7.384 ± 0.28, p = 0.14). After treatment, a significant decrease was detected in daily frequency, nocturia, urgency, and urge incontinence prevalence (p < 0.001,p = 0.003, p < 0.001, p = 0.002, respectively) and PPBC, PPIUS, PUFSS, and OAB-V8 symptom scores (p = 0.004, p = 0.002, p < 0.001, p < 0.001, respectively). A significant decrease was detected in all KHQ subunit scores. CONCLUSION Urine alkalinization with NaHCO3 orally in female patients with LUTS and acidic urine pH has a significant level of positive effects on symptoms and symptom scores. Our results show that this new treatment modality-which is inexpensive, easy to use, and has a low side-effect profile is effective in this chronic patient group.
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Affiliation(s)
- Mehmet Giray Sönmez
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey.
| | - Yunus Emre Göğer
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey
| | - Gökhan Ecer
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey
| | - Ahmet Atıcı
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey
| | - Mehmet Serkan Özkent
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey
| | - Ahmet Öztürk
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey
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27
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Yamanishi T, Suzuki T, Sato R, Kaga K, Kaga M, Fuse M. Effects of magnetic stimulation on urodynamic stress incontinence refractory to pelvic floor muscle training in a randomized sham-controlled study. Low Urin Tract Symptoms 2017; 11:61-65. [PMID: 28961380 DOI: 10.1111/luts.12197] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 06/06/2017] [Accepted: 07/11/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of the present study was to evaluate the effect of magnetic stimulation on urodynamic stress incontinence refractory to pelvic floor muscle training in a randomized sham-controlled study. METHODS Female patients with urodynamic stress incontinence who had not been cured by pelvic floor muscle training were randomly assigned at a ratio of 2 : 1 to either active treatment or sham treatment for 10 weeks. The randomization was made using magnetic cards for individuals indicating active or sham stimulation. The primary endpoint was changes in the number of incontinence episodes/week, with secondary endpoints of the degree of incontinence (in g/day; determined using the pad test), the total score on the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), the ICIQ quality of life (QOL) score, and the abdominal leak point pressure (ALPP) on urodynamic study. RESULTS Although 39 patients were enrolled in the study, 9 dropped out, leaving a total patients for analysis (18 in the active treatment group, 12 in the sham treatment group). The number of incontinence episodes/week, the degree of incontinence, total ICIQ-SF score, ICIQ-QOL score, and ALPP were significantly improved after active treatment compared with baseline (all P < .05), but did not change significantly after sham treatment. There was a significant intergroup difference with regard to changes from baseline in the ICIQ-SF and ALPP in favor of the active treatment group (P < .05). There were no significant differences in any other parameters between the 2 groups. Treatment-related adverse events were not found in both groups. CONCLUSION Magnetic stimulation was effective in treating urodynamic stress incontinence.
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Affiliation(s)
- Tomonori Yamanishi
- Department of Urology, Continence Center, Dokkyo Medical University, Mibu, Japan
| | - Tsuneki Suzuki
- Department of Urology, Dokkyo Medical University, Koshigaya Hospital, Koshigaya, Japan
| | - Ryo Sato
- Department of Urology, Dokkyo Medical University, Koshigaya Hospital, Koshigaya, Japan
| | - Kanya Kaga
- Department of Urology, Continence Center, Dokkyo Medical University, Mibu, Japan
| | - Mayuko Kaga
- Department of Urology, Continence Center, Dokkyo Medical University, Mibu, Japan
| | - Miki Fuse
- Department of Urology, Continence Center, Dokkyo Medical University, Mibu, Japan
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Marques AG, Doi AM, Pasternak J, Damascena MDS, França CN, Martino MDV. Performance of the dipstick screening test as a predictor of negative urine culture. EINSTEIN-SAO PAULO 2017; 15:34-39. [PMID: 28444086 PMCID: PMC5433304 DOI: 10.1590/s1679-45082017ao3936] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/13/2017] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate whether the urine dipstick screening test can be used to predict urine culture results. Methods A retrospective study conducted between January and December 2014 based on data from 8,587 patients with a medical order for urine dipstick test, urine sediment analysis and urine culture. Sensitivity, specificity, positive and negative predictive values were determined and ROC curve analysis was performed. Results The percentage of positive cultures was 17.5%. Nitrite had 28% sensitivity and 99% specificity, with positive and negative predictive values of 89% and 87%, respectively. Leukocyte esterase had 79% sensitivity and 84% specificity, with positive and negative predictive values of 51% and 95%, respectively. The combination of positive nitrite or positive leukocyte esterase tests had 85% sensitivity and 84% specificity, with positive and negative predictive values of 53% and 96%, respectively. Positive urinary sediment (more than ten leukocytes per microliter) had 92% sensitivity and 71% specificity, with positive and negative predictive values of 40% and 98%, respectively. The combination of nitrite positive test and positive urinary sediment had 82% sensitivity and 99% specificity, with positive and negative predictive values of 91% and 98%, respectively. The combination of nitrite or leukocyte esterase positive tests and positive urinary sediment had the highest sensitivity (94%) and specificity (84%), with positive and negative predictive values of 58% and 99%, respectively. Based on ROC curve analysis, the best indicator of positive urine culture was the combination of positives leukocyte esterase or nitrite tests and positive urinary sediment, followed by positives leukocyte and nitrite tests, positive urinary sediment alone, positive leukocyte esterase test alone, positive nitrite test alone and finally association of positives nitrite and urinary sediment (AUC: 0.845, 0.844, 0.817, 0.814, 0.635 and 0.626, respectively). Conclusion A negative urine culture can be predicted by negative dipstick test results. Therefore, this test may be a reliable predictor of negative urine culture.
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Kato D, Uno S, Van Schyndle J, Fan A, Kimura T. Persistence and adherence to overactive bladder medications in Japan: A large nationwide real-world analysis. Int J Urol 2017; 24:757-764. [PMID: 28833621 DOI: 10.1111/iju.13422] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/21/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To evaluate persistence and adherence to mirabegron and antimuscarinics in Japan using data from two administrative databases. METHODS The present retrospective study evaluated insurance claims for employees and dependents aged ≤75 years, and pharmacy claims for outpatients. From October 2012 to September 2014, new users of mirabegron or five individual antimuscarinics indicated for overactive bladder in Japan (fesoterodine, imidafenacin, propiverine, solifenacin and tolterodine) were identified and followed for 1 year. Persistence with mirabegron and antimuscarinics were evaluated using Kaplan-Meier methods. Any associations between baseline characteristics (age, sex and previous medication use) and persistence were explored. Adherence was assessed using the medication possession ratio. RESULTS In total, 3970 and 16 648 patients were included from the insurance and pharmacy claims databases, respectively. Mirabegron treatment was associated with longer median persistence compared with antimuscarinics (insurance claims: 44 [95% confidence intervals 37-56] vs 21 [14-28] to 30 [30-33] days, pharmacy claims: 105 [96-113] vs 62 [56-77] to 84 [77-86] days). The results were consistent when patients were stratified by age, sex and previous medication. Persistence rate at 1 year was higher for mirabegron (insurance claims: 14.0% [11.5-16.8%] vs 5.4% [4.1-7.0%] to 9.1% [5.3-14.2%], pharmacy claims: 25.9% [24.6-27.3%] vs 16.3% [14.0-18.6%] to 21.3% [20.2-22.4%]). Compared with each antimuscarinic, a higher proportion of mirabegron-treated patients had medication possession ratios ≥0.8. CONCLUSIONS This large nationwide Japanese study shows that persistence and adherence are greater with mirabegron compared with five antimuscarinics.
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Affiliation(s)
| | | | | | - Alan Fan
- Astellas Pharma, Northbrook, Illinois, USA
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30
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Kato D, Tabuchi H, Uno S. Safety, efficacy, and persistence of long-term mirabegron treatment for overactive bladder in the daily clinical setting: I
nterim (1-year) report from a Japanese post-marketing surveillance study. Low Urin Tract Symptoms 2017; 11:14-23. [DOI: 10.1111/luts.12188] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/10/2017] [Accepted: 05/23/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Daisuke Kato
- Medical Science, Medical Affairs; Astellas Pharma Inc.; Tokyo Japan
| | - Hiromi Tabuchi
- Medical Research, Medical Affairs; Astellas Pharma Inc.; Tokyo Japan
| | - Satoshi Uno
- Japan-Asia Data Science, Development; Astellas Pharma Inc.; Tokyo Japan
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