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Farag F, Sakalis VI, Arteaga SM, Sihra N, Karavitakis M, Arlandis S, Bø K, Cobussen-Boekhorst H, Costantini E, de Heide M, Groen J, Peyronnet B, Phé V, van Poelgeest-Pomfret ML, van den Bos TWL, van der Vaart H, Harding CK, Carmela Lapitan M, Imran Omar M, Nambiar AK. What Are the Short-term Benefits and Potential Harms of Therapeutic Modalities for the Management of Overactive Bladder Syndrome in Women? A Review of Evidence Under the Auspices of the European Association of Urology, Female Non-neurogenic Lower Urinary Tract Symptoms Guidelines Panel. Eur Urol 2023; 84:302-312. [PMID: 37331921 DOI: 10.1016/j.eururo.2023.05.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/28/2023] [Accepted: 05/13/2023] [Indexed: 06/20/2023]
Abstract
CONTEXT Overactive bladder syndrome (OAB) is highly prevalent among women and has a negative impact on their quality of life. The current available treatments for OAB symptoms include conservative, pharmacological, or surgical modalities. OBJECTIVE To provide an updated contemporary evidence document regarding OAB treatment options and determine the short-term effectiveness, safety, and potential harms of the available treatment modalities for women with OAB syndrome. EVIDENCE ACQUISITION The Medline, Embase, and Cochrane controlled trial databases and clinicaltrial.gov were searched for all relevant publications up to May 2022. The risk of bias assessment followed the recommended tool in the Cochrane Handbook for Systematic Reviews of Interventions, and quality of evidence was assessed using the modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. A meta-analysis was performed where appropriate. EVIDENCE SYNTHESIS Antimuscarinics and beta-3 agonists were significantly more effective than placebo across most outcomes, with beta-3 agonists being more effective at reducing nocturia episodes and antimuscarinics causing significantly higher adverse events. Onabotulinumtoxin-A (Onabot-A) was more effective than placebo across most outcomes, but with significantly higher rates of acute urinary retention/clean intermittent self-catheterisation (six to eight times) and urinary tract infections (UTIs; two to three times). Onabot-A was also significantly better than antimuscarinics in the cure of urgency urinary incontinence (UUI) but not in the reduction of mean UUI episodes. Success rates of sacral nerve stimulation (SNS) were significantly higher than those of antimuscarinics (61% vs 42%, p = 0.02), with similar rates of adverse events. SNS and Onabot-A were not significantly different in efficacy outcomes. Satisfaction rates were higher with Onabot-A, but with a higher rate of recurrent UTIs (24% vs 10%). SNS was associated with 9% removal rate and 3% revision rate. CONCLUSIONS Overactive bladder is a manageable condition, with first-line treatment options including antimuscarinics, beta-3 agonists, and posterior tibial nerve stimulation. Second-line options include Onabot-A bladder injections or SNS. The choice of therapies should be guided by individual patient factors. PATIENT SUMMARY Overactive bladder is a manageable condition. All patients should be informed and advised on conservative treatment measures in the first instance. The first-line treatment options for its management include antimuscarinics or beta-3 agonists medication, and posterior tibial nerve stimulation procedures. The second-line options include onabotulinumtoxin-A bladder injections or sacral nerve stimulation procedure. The therapy should be chosen based on individual patient factors.
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Affiliation(s)
- Fawzy Farag
- Department of Urology, Sohag University Hospital, Sohag, Egypt
| | - Vasileios I Sakalis
- Department of Urology, Agios Pavlos General Hospital of Thessaloniki, Thessaloniki, Greece
| | | | - Néha Sihra
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Salvador Arlandis
- Urology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Kari Bø
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | | | | | - Jan Groen
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Veronique Phé
- Department of Urology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Academic Hospital, Sorbonne University, Paris, France
| | | | | | - Huub van der Vaart
- Department of Obstetrics and Gynecology, University Medical Center, Utrecht, The Netherlands
| | - Christopher K Harding
- Department of Urology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Marie Carmela Lapitan
- College of Medicine/Philippine General Hospital/National institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Muhammad Imran Omar
- University of Aberdeen, Aberdeen, UK; European Association of Urology, Arnhem, The Netherlands
| | - Arjun K Nambiar
- Department of Urology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
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Stoniute A, Madhuvrata P, Still M, Barron-Millar E, Nabi G, Omar MI. Oral anticholinergic drugs versus placebo or no treatment for managing overactive bladder syndrome in adults. Cochrane Database Syst Rev 2023; 5:CD003781. [PMID: 37160401 PMCID: PMC10167789 DOI: 10.1002/14651858.cd003781.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Around 16% of adults have symptoms of overactive bladder (OAB; urgency with frequency and/or urge incontinence), with prevalence increasing with age. Anticholinergic drugs are commonly used to treat this condition. This is an update of a Cochrane Review first published in 2002 and last updated in 2006. OBJECTIVES To assess the effects of anticholinergic drugs compared with placebo or no treatment for treating overactive bladder syndrome in adults. SEARCH METHODS We searched the Cochrane Incontinence Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In-Process, MEDLINE Epub Ahead of Print, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched 14 January 2020), and the reference lists of relevant articles. We updated this search on 3 May 2022, but these results have not yet been fully incorporated. SELECTION CRITERIA We included randomised or quasi-randomised trials in adults with overactive bladder syndrome that compared an anticholinergic drug alone with placebo treatment. DATA COLLECTION AND ANALYSIS Two review authors independently assessed eligibility and extracted data from the included studies, including an assessment of the risk of bias. We assessed the certainty of the body of evidence using the GRADE approach. We processed data as described in the Cochrane Handbook for Systematic Reviews of Interventions. MAIN RESULTS We included 104 studies, 71 of which were new or updated for this version of the review. Although 12 studies did not report the number of participants, there were 47,106 people in the remainder of the included studies. The majority of the studies had insufficient information to allow judgement of risk of bias and we judged them to be unclear for all domains. Nine anticholinergic drugs were included in these studies: darifenacin; fesoterodine; imidafenacin; oxybutynin; propantheline; propiverine; solifenacin; tolterodine and trospium. No studies were found that compared anticholinergic drugs to no treatment. At the end of the treatment period, anticholinergics may slightly increase condition-specific quality of life (mean difference (MD) 4.41 lower, 95% confidence interval (CI) 5.28 lower to 3.54 lower (scale range -100 to 0); 12 studies, 6804 participants; low-certainty evidence). Anticholinergics are probably better than placebo in terms of patient perception of cure or improvement (risk ratio (RR) 1.38, 95% CI 1.15 to 1.66; 9 studies, 8457 participants; moderate-certainty evidence), and the mean number of urgency episodes per 24-hour period (MD 0.85 lower, 95% CI 1.03 lower to 0.67 lower; 23 studies, 16,875 participants; moderate-certainty evidence). Compared to placebo, anticholinergics may result in an increase in dry mouth adverse events (RR 3.50, 95% CI 3.26 to 3.75; 66 studies, 38,368 participants; low-certainty evidence), and may result in an increased risk of urinary retention (RR 3.52, 95% CI 2.04 to 6.08; 17 studies, 7862 participants; low-certainty evidence). Taking anticholinergics may be more likely to lead to participants withdrawing from the studies due to adverse events (RR 1.37, 95% CI 1.21 to 1.56; 61 studies, 36,943 participants; low-certainty evidence). However, taking anticholinergics probably reduces the mean number of micturitions per 24-hour period compared to placebo (MD 0.85 lower, 95% CI 0.98 lower to 0.73 lower; 30 studies, 19,395 participants; moderate-certainty evidence). AUTHORS' CONCLUSIONS The use of anticholinergic drugs by people with overactive bladder syndrome results in important but modest improvements in symptoms compared with placebo treatment. In addition, recent studies suggest that this is generally associated with only modest improvement in quality of life. Adverse effects were higher with all anticholinergics compared with placebo. Withdrawals due to adverse effects were also higher for all anticholinergics except tolterodine. It is not known whether any benefits of anticholinergics are sustained during long-term treatment or after treatment stops.
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Affiliation(s)
- Akvile Stoniute
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Priya Madhuvrata
- Obstetrics & Gynaecology, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - Madeleine Still
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Evelyn Barron-Millar
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ghulam Nabi
- Section of Academic Urology, Division of Cancer Research, University of Dundee, Dundee, UK
| | - Muhammad Imran Omar
- Guidelines Office, European Association of Urology, Arnhem, Netherlands
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
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Wang H, Lei X. Acupuncture for Women with Overactive Bladder: Perspective of Traditional Chinese Medicine and Related Mechanism. Int J Gen Med 2023; 16:1137-1148. [PMID: 37013136 PMCID: PMC10066631 DOI: 10.2147/ijgm.s406194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
Purpose Overactive bladder (OAB) syndrome is one of the most common diseases in urology and affects quality of life. Although the current treatment for OAB is based on oral medications, there are limitations and many patients have difficulty accepting drug-induced adverse effects. This review aimed to analyze the efficacy of acupuncture and its related mechanisms and provide a preliminary therapeutic regimen. Methods Two authors independently searched PubMed, Embase, and Cochrane Library up to April 2022. They searched related English literature and extracted the data under a standard form based on the search strategy. Clinical trials which included OAB women with the treatment of acupuncture were included. Common acupuncture alone without other pharmacotherapy, external treatments was in the treatment group. The control interventions may include any active treatments, sham placebo, or no establishment of a control group. Outcomes included 3-day or 24-hour voiding diary, overactive bladder symptom score, etc. The Cochrane risk of bias tool was also used to assess the methodological quality of the randomized controlled trials (RCTs). Results We analyzed five RCTs and one comparative study on acupuncture for OAB to review and discuss the acupoint location, treatment course, and retention time based on clinical evidence and treatment ideas in traditional Chinese medicine. Additionally, we used the available evidence to reveal and discuss the acupuncture mechanisms for OAB. Acupuncture may regulate bladder function by inhibiting C-fibers, modulating nerve growth factors and reducing spontaneous contractions of the detrusor muscle. Conclusion Combined with the available evidence, the combination of local acupoints and distal acupoints should be necessary to consider, especially the lumbosacral acupoints, the small abdomen acupoints and the lower limb acupoints. Among them, acupuncture at SP4, CV4 and KI3 are strongly recommended. The treatment course of acupuncture should be no less than 4 weeks and maintain the frequency of acupuncture no less than once a week. The duration of each session should be no less than 20 minutes. In addition, investigations remain necessary to verify acupuncture's efficacy and precise mechanism for OAB treatment in further exploration.
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Affiliation(s)
- Hao Wang
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Xulu Lei
- Department of Preventive Care Center, Beijing Fengtai Hospital of Integrated Chinese and Western Medicine, Beijing, People’s Republic of China
- Correspondence: Xulu Lei, Department of Preventive Care Center, Beijing Fengtai Hospital of Integrated Chinese and Western Medicine, Beijing, 100072, People’s Republic of China, Email
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Li W, Hu J, Jin Z, Chen Y. Meta-analysis of acupuncture-moxibustion treatment of overactive bladder in adults in the past decade. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2023. [DOI: 10.1007/s11726-023-1361-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Lee JJ, Heo JW, Choi TY, Jun JH, Lee MS, Kim JI. Acupuncture for the treatment of overactive bladder: A systematic review and meta-analysis. Front Neurol 2023; 13:985288. [PMID: 36712423 PMCID: PMC9878288 DOI: 10.3389/fneur.2022.985288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 12/16/2022] [Indexed: 01/15/2023] Open
Abstract
Background Acupuncture (AT) successfully regulates overactive bladder (OAB) symptoms. However, previous systematic reviews and meta-analyses have not provided sufficient evidence. This review presents the current evidence of the efficacy of AT in the management of OAB symptoms. Methods and analyses A total of 12 databases were searched from their inception: PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and AMED databases; five Korean medical databases; and three Chinese medical databases. Study selection, data extraction, and assessment were independently performed by two researchers. The risk of bias was assessed using the Cochrane risk of bias assessment tool. RevMan 5.4.1 software was used for data aggregation, and the Grades of Recommendations, Assessment, Development and Evaluation (GRADE) assessment was used to evaluate the quality of the study outcomes. Results A total of 30 studies were included in this review. Compared with the sham AT group, the AT group exhibited significant effects in reducing overactive bladder symptom scores (OABSS) [mean difference (MD): -1.13, 95% confidence interval (CI): -2.01 to -0.26, p = 0.01 I 2 = 67%] and urinary frequency [standardized mean difference (SMD): -0.35, 95% CI: -0.62 to -0.08, I 2 = 0%]. The AT group showed an equivalent effect as drug therapy in reducing OABSS (MD: -0.39, 95% CI: - 1.92 to 1.13, p = 0.61, I 2 = 94%) and urinary frequency (MD: 0.74, 95% CI: -0.00 to 1.48, p = 0.05, I 2 = 71%) with fewer adverse events [risk ratio (RR): 0.38, 95% CI: 0.16-0.92, p = 0.03, I2 = 58%]. The AT plus drug therapy group had a more favorable effect than drug therapy alone for reducing OABSS (MD: -2.28, 95% CI: -3.25 to -1.31, p < 0.00001, I 2 = 84%) and urinary frequency (MD: -2.34, 95% CI: -3.29 to -1.38, p < 0.00001, I 2 = 88%). The GRADE assessment demonstrated that the level of evidence was mostly low or very low given the high risk of bias and small sample sizes. Conclusion AT had more favorable effects than sham AT in reducing OAB symptoms. AT improved OAB symptoms as effectively as conventional drug therapy, and the combination of AT and drug therapy had more favorable effects than drug therapy alone. However, more rigorous studies are needed to enhance the level of evidence. Systematic review registration http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42014010377, identifier: PROSPERO [CRD42014010377].
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Affiliation(s)
- Jung-Ju Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Jeong-Weon Heo
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Tae-Young Choi
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ji Hee Jun
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jong-In Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
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Hargreaves E, Baker K, Barry G, Harding C, Zhang Y, Kandala NB, Zhang X, Kernohan A, Clarkson CE. Acupuncture for treating overactive bladder in adults. Cochrane Database Syst Rev 2022; 9:CD013519. [PMID: 36148895 PMCID: PMC9502659 DOI: 10.1002/14651858.cd013519.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Overactive bladder is a common, long-term symptom complex, which includes frequency of micturition, urgency with or without associated incontinence and nocturia. Around 11% of the population have symptoms, with this figure increasing with age. Symptoms can be linked to social anxiety and adaptive behavioural change. The cost of treating overactive bladder is considerable, with current treatments varying in effectiveness and being associated with side effects. Acupuncture has been suggested as an alternative treatment. OBJECTIVES To assess the effects of acupuncture for treating overactive bladder in adults, and to summarise the principal findings of relevant economic evaluations. SEARCH METHODS We searched the Cochrane Incontinence Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (including In-Process, Epub Ahead of Print, Daily), ClinicalTrials.gov and WHO ICTRP (searched 14 May 2022). We also searched the Allied and Complementary Medicine database (AMED) and bibliographic databases where knowledge of the Chinese language was necessary: China National Knowledge Infrastructure (CNKI); Chinese Science and Technology Periodical Database (VIP) and WANFANG (China Online Journals), as well as the reference lists of relevant articles. SELECTION CRITERIA: We included randomised controlled trials (RCTs), quasi-RCTs and cross-over RCTs assessing the effects of acupuncture for treating overactive bladder in adults. DATA COLLECTION AND ANALYSIS Four review authors formed pairs to assess study eligibility and extract data. Both pairs used Covidence software to perform screening and data extraction. We assessed risk of bias using Cochrane's risk of bias tool and assessed heterogeneity using the Chi2 testand I2 statistic generated within the meta-analyses. We used a fixed-effect model within the meta-analyses unless there was a moderate or high level of heterogeneity, where we employed a random-effects model. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS We included 15 studies involving 1395 participants in this review (14 RCTs and one quasi-RCT). All included studies raised some concerns regarding risk of bias. Blinding of participants to treatment group was only achieved in 20% of studies, we considered blinding of outcome assessors and allocation concealment to be low risk in only 25% of the studies, and random sequence generation to be either unclear or high risk in more than 50% of the studies. Acupuncture versus no treatment One study compared acupuncture to no treatment. The evidence is very uncertain regarding the effect of acupuncture compared to no treatment in curing or improving overactive bladder symptoms and on the number of minor adverse events (both very low-certainty evidence). The study report explicitly stated that no major adverse events occurred. The study did not report on the presence or absence of urinary urgency, episodes of urinary incontinence, daytime urinary frequency or episodes of nocturia. Acupuncture versus sham acupuncture Five studies compared acupuncture with sham acupuncture. The evidence is very uncertain about the effect of acupuncture on curing or improving overactive bladder symptoms compared to sham acupuncture (standardised mean difference (SMD) -0.36, 95% confidence interval (CI) -1.03 to 0.31; 3 studies; 151 participants; I2 = 65%; very low-certainty evidence). All five studies explicitly stated that there were no major adverse events observed during the study. Moderate-certainty evidence suggests that acupuncture probably makes no difference to the incidence of minor adverse events compared to sham acupuncture (risk ratio (RR) 1.28, 95% CI 0.30 to 5.36; 4 studies; 222 participants; I² = 0%). Only one small study reported data for the presence or absence of urgency and for episodes of nocturia. The evidence is of very low certainty for both of these outcomes and in both cases the lower confidence interval is implausible. Moderate-certainty evidence suggests there is probably little or no difference in episodes of urinary incontinence between acupuncture and sham acupuncture (mean difference (MD) 0.55, 95% CI -1.51 to 2.60; 2 studies; 121 participants; I2 = 57%). Two studies recorded data regarding daytime urinary frequency but we could not combine them in a meta-analysis due to differences in methodologies (very low-certainty evidence). Acupuncture versus medication Eleven studies compared acupuncture with medication. Low-certainty evidence suggests that acupuncture may slightly increase how many people's overactive bladder symptoms are cured or improved compared to medication (RR 1.25, 95% CI 1.10 to 1.43; 5 studies; 258 participants; I2 = 19%). Low-certainty evidence suggests that acupuncture may reduce the incidence of minor adverse events when compared to medication (RR 0.34, 95% CI 0.26 to 0.45; 8 studies; 1004 participants; I² = 51%). The evidence is uncertain regarding the effect of acupuncture on the presence or absence of urinary urgency (MD -0.40, 95% CI -0.56 to -0.24; 2 studies; 80 participants; I2 = 0%; very low-certainty evidence) and episodes of urinary incontinence (MD -0.33, 95% CI -2.75 to 2.09; 1 study; 20 participants; very low-certainty evidence) compared to medication. Low-certainty evidence suggests there may be little to no effect of acupuncture compared to medication in terms of daytime urinary frequency (MD 0.73, 95% CI -0.39 to 1.85; 4 studies; 360 participants; I2 = 28%). Acupuncture may slightly reduce the number of nocturia episodes compared to medication (MD -0.50, 95% CI -0.65 to -0.36; 2 studies; 80 participants; I2 = 0%, low-certainty evidence). There were no incidences of major adverse events in any of the included studies. However, major adverse events are rare in acupuncture trials and the numbers included in this review may be insufficient to detect these events. AUTHORS' CONCLUSIONS The evidence is very uncertain about the effect acupuncture has on cure or improvement of overactive bladder symptoms compared to no treatment. It is uncertain if there is any difference between acupuncture and sham acupuncture in cure or improvement of overactive bladder symptoms. This review provides low-certainty evidence that acupuncture may result in a slight increase in cure or improvement of overactive bladder symptoms when compared with medication and may reduce the incidence of minor adverse events. These conclusions must remain tentative until the completion of larger, higher-quality studies that use relevant, comparable outcomes. Timing and frequency of treatment, point selection, application and long-term follow-up are other areas relevant for research.
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Affiliation(s)
- Emma Hargreaves
- Department of Physiotherapy, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Katherine Baker
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Gill Barry
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Christopher Harding
- Department of Urology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Yingying Zhang
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ngianga-Bakwin Kandala
- Warwick Medical School, University of Warwick, Coventry, UK
- Wits School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Xiaowen Zhang
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ashleigh Kernohan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Carl E Clarkson
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
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Garba K, Avery M, Yusuh M, Abdelwahab O, Harris S, Birch BR, Lwaleed BA. Real world use of oral treatments in interstitial cystitis/bladder pain syndrome in the UK: Outcome of a cross sectional study. Neurourol Urodyn 2021; 41:416-422. [PMID: 34843134 DOI: 10.1002/nau.24840] [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: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND To describe the oral treatments people living with interstitial cystitis/bladder pain syndrome (IC/BPS) are using to treat their urologic condition in the UK. METHOD A questionnaire hyperlink encompassing current and previous medications taken for IC/BPS with other sociodemographic and diagnostic indices was available to the Bladder Health UK website. Interested and fully consented individuals accessed and completed the survey. RESULTS A total of 601 accessed the questionnaire of whom 173 participants responded (response rate: 28.7%) with a mean ± SD O'Leary/Sant scores of 20.12 ± 9.38. A sample size of 171 was estimated to be used in the survey. A fifth of the participants were not on any treatment at all. Amitriptyline was the most prevalent medication in use both alone and in combination. A shift in the use of unapproved (for IC/BPS) antidepressant, smooth muscle relaxant, opioids, gabapentenoids, and antibiotics was observed in the sample. There were no significant differences between the mean (SD) O'Leary/Sant scores of cohorts currently taking oral medications and those not taking it. More than two-thirds of the participants had been diagnosed with the disease more than 5 years. Just under a half (47.4%) of participants reported a history of allergy. CONCLUSION Our study provides contemporary evidence that the treatments used for managing IC/BPS encompass a broad range of medications both recommended and not recommended by current guidelines. The latter suggests patients are willing to try novel treatments when more conventional ones are ineffective.
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Affiliation(s)
- Kamaluddeen Garba
- School of Health Sciences, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Miriam Avery
- School of Health Sciences, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Muhammadbukhoree Yusuh
- School of Health Sciences, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Omar Abdelwahab
- School of Health Sciences, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Scott Harris
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Brian R Birch
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Bashir A Lwaleed
- School of Health Sciences, Southampton General Hospital, University of Southampton, Southampton, UK
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Chen H, Wang C, Zhou M, Yan Chan P, Lo Yam L, Lok Lam W, Leung KP, Li SW, Tsang WY, Fung-Leung Ng B, Tat-Chi Ziea E, Yeung WF, Lao L. Electroacupuncture for post-stroke overactive bladder: a multi-centre pilot randomized controlled trial. Acupunct Med 2020; 39:175-183. [PMID: 32646228 DOI: 10.1177/0964528420925488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although acupuncture has been shown to be effective at treating overactive bladder (OAB) following stroke, to our knowledge, no randomized controlled trial (RCT) examining the effects of acupuncture on patients with post-stroke OAB has been conducted. The aim of this preliminary study was to explore the effects of electroacupuncture (EA) in the treatment of post-stroke OAB. METHODS This study was a multi-site randomized, assessor-blind, controlled pilot trial of patients with post-stroke OAB. In all, 34 post-stroke subjects (mean age: 71.0 years; 32.4% female) with OAB symptoms were randomly assigned to the treatment group or control group in a 1:1 ratio. The subjects in the treatment group were treated with six sessions of EA for 4 weeks, while the subjects in the control group received usual care. The primary outcome measure was the overactive bladder symptom scale (OABSS). Secondary outcome measures included a three day bladder diary and the stroke-specific quality-of-life scale (SSQoL). RESULTS EA showed a moderate effect size (ES) on the perceived severity of OAB symptoms as measured by the OABSS at week 5 (one week post-treatment, ES 0.57; p = 0.034) and week 8 (three weeks post-treatment, ES 0.60; p = 0.021), although the results did not remain statistically significant after Bonferroni correction for multiple testing. No significant differences in bladder diary parameters or SSQoL score were found. The EA treatment was well tolerated by the post-stroke subjects. CONCLUSION A six-session EA treatment was feasible and appeared to reduce OAB symptoms in post-stroke patients. Further fully powered trials are warranted to confirm the efficacy of EA for those with post-stroke OAB.
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Affiliation(s)
- Haiyong Chen
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China.,Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Changde Wang
- Shanghai TCM-integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Minjie Zhou
- Shanghai TCM-integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Pui Yan Chan
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
| | - Lo Lo Yam
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
| | - Wing Lok Lam
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
| | - Kwok-Pui Leung
- Rehabilitation Unit, Department of Medicine, Tung Wah Hospital, Hong Kong, China
| | - Sheung-Wai Li
- Rehabilitation Unit, Department of Medicine, Tung Wah Hospital, Hong Kong, China
| | - Wai-Yin Tsang
- Department of Geriatrics and Rehabilitative Medicine, Tung Wah Eastern Hospital, Hong Kong, China
| | | | - Eric Tat-Chi Ziea
- The Chinese Medicine Department, Hospital Authority, Hong Kong, China
| | - Wing-Fai Yeung
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, China
| | - Lixing Lao
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China.,Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
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Chang YW, Lo TS, Chang HN, Shiao YH, Yeh YC. Laser Acupuncture Alleviates Symptoms and Improves Quality of Life in Women with Overactive Bladder: A Double-Blind, Pilot Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2020; 2020:1705964. [PMID: 32419791 PMCID: PMC7201846 DOI: 10.1155/2020/1705964] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/12/2020] [Accepted: 03/28/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the clinical efficacy of laser acupuncture for the treatment of women with overactive bladder (OAB) in Taiwan. METHODS A double-blind randomized controlled trial was conducted on female patients with OAB symptoms referred from gynecologists, and subjects were divided into two groups using blocked randomization. LaserPan (RJ-Laser, Germany) was applied to seven selected acupuncture points. The subjects received laser acupuncture 3 times per week for 3 weeks, 9 sessions in total. Basic patient data, Overactive Bladder Symptom Score (OABSS), Incontinence Impact Questionnaire (IIQ-7), and Urogenital Distress Inventory (UDI-6) scores were recorded prior to first treatment and at the end of 3rd, 6th, and 9th treatments. RESULTS Thirty patients were enrolled, and twenty-seven patients completed all treatments in this study. The OABSS total score of the experimental group decreased significantly by 3.13 (p ≤ 0.001), 4.60 (p ≤ 0.001), and 3.79 (p ≤ 0.001) after 3rd, 6th, and 9th treatments, respectively, compared with that of the control group. The IIQ-7 score declined significantly from baseline by 4.57 (p=0.003) and 3.63 (p=0.023) after 3rd and 6th treatments, respectively, compared with that of the control group. Similarly, the UDI-6 score of the experimental group exhibited a significant decrease from baseline by 1.90 (p=0.042) and 2.25 (p=0.025) after 6th and 9th interventions, respectively, compared with that of the control group. CONCLUSIONS This study demonstrates that laser acupuncture can alleviate OAB symptoms and improve quality of life. This noninvasive device could be an effective therapy for women with OAB.
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Affiliation(s)
- Yu-Wei Chang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan
| | - Tsia-Shu Lo
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Linkou, Taoyuan, Taiwan
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan
- Chang Gung University, School of Medicine, Taoyuan, Taiwan
| | - Hsin-Ning Chang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan
- Graduate Institute of Clinical Medicine Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsien Shiao
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan
| | - Yuan-Chieh Yeh
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan
- Program in Molecular Medicine, School of Life Sciences, National Yang Ming University, Taipei, Taiwan
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Hargreaves E, Baker K, Barry G, Harding C, Zhang Y, Kandala NB, Clarkson CE. Acupuncture for treating overactive bladder in adults. Hippokratia 2020. [DOI: 10.1002/14651858.cd013519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Emma Hargreaves
- Newcastle upon Tyne Hospitals NHS Foundation Trust; Department of Physiotherapy; Royal Victoria Infirmary Newcastle upon Tyne Tyne and Wear UK NE1 4LP
| | - Katherine Baker
- Northumbria University; Department of Sport, Exercise and Rehabilitation; Coach Lane Campus Newcastle upon Tyne Tyne and Wear UK NE7 7XA
| | - Gill Barry
- Northumbria University; Department of Sport, Exercise and Rehabilitation; Coach Lane Campus Newcastle upon Tyne Tyne and Wear UK NE7 7XA
| | - Christopher Harding
- Newcastle upon Tyne Hospitals NHS Foundation Trust; Department of Urology; Freeman Hospital Newcastle upon Tyne UK NE7 7DN
| | - Yingying Zhang
- Beijing University of Chinese Medicine; Centre for Evidence-Based Chinese Medicine; Beijing China
| | - Ngianga-Bakwin Kandala
- Northumbria University; Department of Mathematics, Physics & Electrical Engineering (MPEE), Faculty of Engineering and Environment; Ellison Building (EBD) Room 2018 Newcastle upon Tyne UK NE1 8ST
| | - Carl E Clarkson
- Northumbria University; Department of Sport, Exercise and Rehabilitation; Coach Lane Campus Newcastle upon Tyne Tyne and Wear UK NE7 7XA
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12
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Liu WM, Hu HY, Xiao W. Therapeutic effect observation on acupuncture plus umbilicus application with Chinese medicine in treating detrusor underactivity. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2018. [DOI: 10.1007/s11726-018-1079-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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13
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Lee HY, Yun YJ, Choi JY, Hong JW, Lee I, Park SH, Kwon JN. Effectiveness and safety of moxibustion for alleviating symptoms of overactive bladder: A prospective, randomized controlled, crossover-design, pilot study. Medicine (Baltimore) 2018; 97:e12016. [PMID: 30142847 PMCID: PMC6113034 DOI: 10.1097/md.0000000000012016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND This study aimed to evaluate trial feasibility and explore the potential efficacy and safety of moxibustion in the treatment of overactive bladder (OAB). METHOD A randomized, controlled, cross-over, assessor blinded design was used. This study was conducted in an outpatient department of a university hospital in Republic of Korea. The overall study period was 8 weeks. Participants were randomly allotted to either Group A or Group B. Group A participants underwent 8 to 12 sessions of moxibustion with behavioral training during the first 4 weeks, while the Group B participants received behavioral training only. Over the next 4 weeks, the treatment offered to the 2 groups was reversed (Group A participants received behavioral training only, while Group B participants underwent the moxibustion session with behavioral training). The OAB-validated 8-question awareness tool (OAB-V8), OAB symptom scores (OABSS), visual analog scale (VAS) for lower urinary tract symptoms, and frequency voiding chart were used to assess outcomes. For analysis, we used effect size, measured as Hedge's g, to present descriptive results indicating the actual difference between the groups. RESULTS Compared to that in Group B, the Hedge's g of OAB-V8 for the former 4 weeks in Group A was -0.248, that of OABSS was -1.531, and that of VAS was -0.713. During the latter 4 weeks, Group B showed similar effect with g = 0.465, 1.207, and 0.427 for OAB-V8, OABSS, and VAS, respectively, compared to Group A. The portion of nocturnal voiding volume decreased (g = -0965), the mean voiding volume increased (g = 0.690), and the voiding frequency decreased (g = -0.498) with moxibustion. CONCLUSIONS Moxibustion might be considered as an alternative for OAB. A full-sized randomized controlled trial may be feasible with minimal modification in outcome measures and comparator population. OTHER INFORMATION This clinical trial has been registered on clinicaltrials.gov (NCT02271607).
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Affiliation(s)
- Hye-Yoon Lee
- Pusan National University Korean Medicine Hospital
| | - Young-Ju Yun
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
| | - Jun-Yong Choi
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
| | - Jin-Woo Hong
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
| | - In Lee
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
| | - Seong-Ha Park
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
| | - Jung-Nam Kwon
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
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14
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Chan YT, Zhang HW, Guo YQ, Chan TNH, Kwan YK, Lee CK, Ngan K, Lin ZX. Effectiveness and safety of acupuncture for elderly overactive bladder population in Hong Kong: study protocol for a randomized controlled trial. Trials 2018; 19:376. [PMID: 30005707 PMCID: PMC6045827 DOI: 10.1186/s13063-018-2706-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 05/24/2018] [Indexed: 12/02/2022] Open
Abstract
Background Overactive bladder (OAB) is defined as “urgency, with or without urge incontinence, usually with frequency and nocturia”. Acupuncture is one of the most popular alternative treatment methods for OAB. Little established evidence is available to support the effectiveness of acupuncture for OAB. This study is a pioneer randomized, double-blinded, sham-controlled trial to assess the effectiveness and safety of acupuncture in the elderly population with overactive bladder in Hong Kong. Methods/design This is a randomized, double-center, patient and outcome assessor blinded, sham-controlled trial. The study sample size is 100 patients. Eligible subjects aged between 60 to 90 years old will be recruited into this study. All subjects will be randomly allocated into the active acupuncture group or sham acupuncture group in a 1: 1 ratio. Participants who are allocated into the active acupuncture group will receive a standardized 30-min real acupuncture treatment session for a total of 16 sessions on the top of standard routine care, whilst those who are randomized to the sham acupuncture arm will receive sham acupuncture in addition to standard routine care. Non-penetrating needles will be utilized as sham acupuncture. The primary outcome measure is the 7-day voiding diary and the secondary outcome measures are urine nerve growth factor (NGF) level, the Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6) and OAB Symptom Score (OABSS). All outcome measures will be collected at baseline, the end of treatment and 3 months after treatment completion. Discussion The objectives of this study include (1) to evaluate the effectiveness and safety of acupuncture treatment in patients with OAB on reduction in the frequency of incontinence episodes as derived from a 7-day voiding diary, (2) to evaluate whether acupuncture treatment could improve subjective symptoms in patients with OAB and (3) to examine the feasibility of using NGF as a biomarker for overactive bladder and test correlation with the effectiveness of acupuncture intervention. The finding of this study will provide preliminary evidence on the effectiveness and safety of acupuncture for treatment of OAB. Trial registration Chinese Clinical Trial Registry, ChiCTR-INR-16010048. Registered on 29 Nov 2016. Electronic supplementary material The online version of this article (10.1186/s13063-018-2706-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yu Tat Chan
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Hong Wei Zhang
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Yuan Qi Guo
- Pok Oi Hospital - The Chinese University of Hong Kong Chinese Medicine Centre for Training & Research (Shatin), New Territories, Hong Kong, China
| | - Tony Ngai Ho Chan
- Department of Medicine & Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, China
| | - Yiu-Keung Kwan
- Department of Medicine & Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong, China
| | - Chun-Kam Lee
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Kit Ngan
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Zhi-Xiu Lin
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China. .,Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
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Jenks J, Kavia R, Pakzad MH, Hamid R, Ockrim JL, Greenwell TJ. Acupuncture is clinically but not yet cost-effective in the treatment of symptomatic idiopathic detrusor overactivity. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2018. [DOI: 10.1111/ijun.12166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Julie Jenks
- Department of Urology; University College London Hospital at Westmoreland Street; London UK
| | - Rajesh Kavia
- Department of Urology; Northwick Park Hospital; Harrow UK
| | - Mahreen H. Pakzad
- Department of Urology; University College London Hospital at Westmoreland Street; London UK
| | - Rizwan Hamid
- Department of Urology; University College London Hospital at Westmoreland Street; London UK
| | - Jeremy L. Ockrim
- Department of Urology; University College London Hospital at Westmoreland Street; London UK
| | - Tamsin J. Greenwell
- Department of Urology; University College London Hospital at Westmoreland Street; London UK
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16
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Yang L, Wang Y, Mo Q, Liu Z. A comparative study of electroacupuncture at Zhongliao (BL33) and other acupoints for overactive bladder symptoms. Front Med 2017; 11:129-136. [DOI: 10.1007/s11684-016-0491-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 09/01/2016] [Indexed: 10/20/2022]
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17
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Tay K, Khan A. Patient Satisfaction on Overactive Bladder Treatment. CURRENT BLADDER DYSFUNCTION REPORTS 2017. [DOI: 10.1007/s11884-017-0403-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Minagawa T, Saitou T, Suzuki T, Domen T, Yokoyama H, Ishikawa M, Hirakata S, Nagai T, Nakazawa M, Ogawa T, Ishizuka O. Impact of ao-dake-humi, Japanese traditional bamboo foot stimulator, on lower urinary tract symptoms, constipation and hypersensitivity to cold: a single-arm prospective pilot study. Altern Ther Health Med 2016; 16:513. [PMID: 27938362 PMCID: PMC5148827 DOI: 10.1186/s12906-016-1494-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 11/24/2016] [Indexed: 12/16/2022]
Abstract
Background Ao-dake-humi is a traditional Japanese bamboo foot stimulator consisting of a half-pipe-shaped step made of bamboo used to stimulate the foot by stepping on it, and is commonly used to promote general health among the elderly in Japan. However, its efficacy has not been reported in the scientific literature. This study was performed to investigate the role of ao-dake-humi focusing on lower urinary tract symptoms (LUTS), constipation, and hypersensitivity to cold (HC). Methods Participants with LUTS, constipation, or HC were enrolled in this study. Ao-dake-humi was used twice a day for 28 days. Before and 28 days after starting ao-dake-humi use, international prostate symptom score (IPSS), quality-of-life (QoL) score, and overactive bladder symptom score (OABSS) were measured to evaluate the efficacy of ao-dake-humi on LUTS. To evaluate the objective efficacy of ao-dake-humi on LUTS, a frequency-volume chart (FVC) was plotted in LUTS patients for 3 days. A visual analogue scale (VAS) was used to evaluate the efficacy of ao-dake-humi on constipation (VAS-constipation) and HC (VAS-HC) in the participants with constipation or HC. Results A total of 24 participants were enrolled in this study. Twenty-one participants had LUTS, 11 had constipation, and 17 participants had HC. IPSS, especially storage-subscore, QoL score and OABSS, decreased significantly after use of ao-dake-humi. The use of ao-dake-humi increased maximal bladder capacity, resulting in a significant decrease in urinary frequency as determined from the FVC. In accordance with the results of VAS-constipation and VAS-HC, both constipation and HC were significantly relieved after ao-dake-humi use. Conclusion The results of this prospective pilot study indicated that ao-dake-humi is safe and has therapeutic efficacy in cases of LUTS, constipation and HC. The possibility of using ao-dake-humi as physical neuromodulation therapy was shown in the management of LUTS, constipation and HC. Trial registration UMIN000019333 (UMIN-CTR, Registered October-15-2015) retrospectively registered.
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Kim JI, Lee JA, Choi TY, Jun JH, Choi J, Shin BC, Lim HJ, Lee MS. Acupuncture for the treatment of overactive bladder: A protocol for systematic review and meta-analysis of randomized controlled trials. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2016.08.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Aydogmus Y, Uzun S, Gundogan FC, Ulas UH, Ebiloglu T, Goktas MT. Is overactive bladder a nervous or bladder disorder? Autonomic imaging in patients with overactive bladder via dynamic pupillometry. World J Urol 2016; 35:467-472. [PMID: 27311587 DOI: 10.1007/s00345-016-1880-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/08/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To evaluate the changes in dynamic pupillometry in patients with idiopathic overactive bladder (OAB). METHODS The study included 40 female patients with idiopathic OAB and 40 healthy female volunteers as a control group. Demographic and clinical data were recorded. Dynamic pupillometric parameters were measured with a commercially available unit (MonPack One, Metrovision, France) at baseline and on the 30th day of treatment with an antimuscarinic treatment (drug-agent) (solifenacin 5 mg daily). Initial, minimum, maximum and mean pupil diameters, the latency and duration of contraction and dilatation of the pupil, the amplitude of contraction and dilatation velocity were automatically measured and compared between the groups. RESULTS There were no significant differences between two groups with respect to age and body mass index (p = 0.288, 0.755, respectively). The measurements of initial, minimum and mean pupil diameters were significantly lower in patients with OAB compared to healthy controls (p = 0.007, 0.002, 0.001, respectively). OAB patients had significantly longer latency of pupil dilatation, latency of pupil contraction and shorter duration of pupil contraction than control group (p = 0.028, 0.029, 0.021, respectively). After the antimuscarinic treatment, latency of pupil contraction, latency of pupil dilatation and duration of pupil contraction shortened significantly (all p < 0.001). Pupil dilatation velocity increased significantly during the treatment (p < 0.001). CONCLUSIONS The dynamic pupillometric findings in this study imply impaired autonomic dysfunction, mostly the increased parasympathetic action, in OAB patients and the modulatory effects of antimuscarinic treatment.
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Affiliation(s)
- Yasin Aydogmus
- Department of Urology, Etimesgut Military Hospital, Ankara, Turkey.
| | - Salih Uzun
- Department of Ophthalmology, Etimesgut Military Hospital, Ankara, Turkey
| | - Fatih C Gundogan
- Department of Ophthalmology, GATA Medical School, Ankara, Turkey
| | - Umit Hidir Ulas
- Department of Neurology, GATA Medical School, Ankara, Turkey
| | - Turgay Ebiloglu
- Department of Urology, Etimesgut Military Hospital, Ankara, Turkey
| | - Mustafa Tugrul Goktas
- Department of Pharmacology, Yildirim Beyazit University Medical School, Ankara, Turkey
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Forde JC, Jaffe E, Stone BV, Te AE, Espinosa G, Chughtai B. The role of acupuncture in managing overactive bladder; a review of the literature. Int Urogynecol J 2016; 27:1645-1651. [PMID: 26740199 DOI: 10.1007/s00192-015-2935-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 12/10/2015] [Indexed: 01/17/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Overactive bladder (OAB) affects a considerable proportion of men and women in the United States and is associated with significant costs and quality of life (QoL) reduction. While medication remains a mainstay of treatment, there is increasing interest in the use of alternative medicine in the form of acupuncture. We reviewed the literature on the role of acupuncture in managing OAB. METHODS A narrative review was compiled after searching electronic databases (PubMed, MEDLINE, Scopus, and EMBASE) for clinical studies involving acupuncture in treating OAB. Databases were searched from the time of inception through September 2015 by a clinician for articles reporting the results related to the use of acupuncture in OAB. Key search terms were acupuncture, overactive bladder, bladder instability, urgency, urinary incontinence. Articles in English or translated into English were included. RESULTS Initial animal studies suggest several biochemical mechanisms of action underlying the effect of acupuncture on OAB suppression. The experience in humans includes two case series and six comparative trials. All studies demonstrated subjective improvement in OAB symptoms, and some reported objective improvement in urodynamic studies. Notably, some comparative trials showed the benefit of acupuncture to be comparable with antimuscarinic treatment. CONCLUSION Despite their limitations, existing studies serve as a promising foundation for suggesting a role for acupuncture as an alternative therapy for OAB. Further well-designed studies are required to investigate optimal technique and their outcomes.
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Affiliation(s)
- James C Forde
- Department of Urology, Weill Cornell Medical College, 425 East 61st Street, 12th Floor, New York, NY, USA
| | - Edward Jaffe
- Department of Urology, Weill Cornell Medical College, 425 East 61st Street, 12th Floor, New York, NY, USA
| | - Benjamin V Stone
- Department of Urology, Weill Cornell Medical College, 425 East 61st Street, 12th Floor, New York, NY, USA
| | - Alexis E Te
- Department of Urology, Weill Cornell Medical College, 425 East 61st Street, 12th Floor, New York, NY, USA
| | - Geo Espinosa
- Department of Urology, Weill Cornell Medical College, 425 East 61st Street, 12th Floor, New York, NY, USA
| | - Bilal Chughtai
- Department of Urology, Weill Cornell Medical College, 425 East 61st Street, 12th Floor, New York, NY, USA.
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Acupuncture for overactive bladder in female adult: a randomized controlled trial. World J Urol 2014; 33:1303-8. [DOI: 10.1007/s00345-014-1440-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 11/06/2014] [Indexed: 10/24/2022] Open
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