Population-Based Survey of Urinary Incontinence, Overactive Bladder, and Other Lower Urinary Tract Symptoms in Five Countries: Results of the EPIC Study

Irwin, Debra E.; Milsom, Ian; Hunskaar, Steinar; Reilly, K; Kopp, Zoë; Herschorn, Sender; Coyne, Karin S.; Kelleher, Con; Hampel, Christian; Artibani, Walter; Abrams, Paul

doi:10.1016/j.eururo.2006.09.019

Cited by 2,268 publications

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“…3 It is unclear whether storage symptoms may develop secondarily to benign prostatic obstruction (BPO) in men. 4 However, storage symptoms often occur independently of BPO and persist in many men, despite pharmacological or surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

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Initial combined treatment with anticholinergics and α-blockers for men with lower urinary tract symptoms related to BPH and overactive bladder: a prospective, randomized, multi-center, double-blind, placebo-controlled study

Lee

Chung

Kim

et al. 2011

Prostate Cancer Prostatic Dis

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Initial combined treatment with anticholinergics and a-blockers for men with lower urinary tract symptoms related to BPH and overactive bladder: a prospective, randomized, multi-center, double-blind, placebo-controlled study We aimed to evaluate the efficacy and safety of combination treatment using anticholinergics with a-blocker for initial treatment of both overactive bladder (OAB) and other lower urinary tract symptoms (LUTS), secondary to BPH. A 12-week, randomized, double-blind, placebo-controlled trial was conducted at four urology clinics in Korea, involving men, aged 50 years or older, with LUTS related to BPH and OAB. A total of 176 patients were randomly assigned to receive doxazosin (4 mg) plus placebo or doxazosin (4 mg) plus tolterodine SR (4 mg), once a day for 12 weeks. Changes from baseline in total International Prostate Symptom Score (IPSS), bladder diary variables, patient perception of bladder condition (PPBC), uroflowmetry, postvoid residual volume and IPSS subscores (voiding and storage) were analyzed. Of the 176 enrolled patients, 91 had doxazosin gastrointestinal therapeutic system (GITS) and placebo, and 85 had combined medication with doxazosin GITS and tolterodine SR. Compared with the doxazosin plus placebo group, the doxazosin plus tolterodine group showed significant reductions in IPSS storage subscore and improvement in the quality of life item, urgency episodes, as well as in micturition frequency at weeks 4 and 12. However, it failed to improve PPBC at week 4 as well as at week 12. Earlier intervention with anticholinergics plus a-blocker was tolerated well, including the questions about urinary retention (n ¼ 1) and dry mouth (n ¼ 2). Initial combination treatment of anticholinergics plus a-blocker showed positive results for men with LUTS related to BPH and OAB symptoms and did not increase the risk of urinary retention.

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Section: Introductionmentioning

confidence: 99%

“…5 Therefore, therapies that target the prostate often fail to alleviate OAB and may not be the most appropriate therapy for men with storage LUTS. 3 If OAB can be detected early, then combination therapy can be instituted and more men can show clinical improvement sooner, with no additional adverse events.…”

Section: Introductionmentioning

confidence: 99%

Initial combined treatment with anticholinergics and α-blockers for men with lower urinary tract symptoms related to BPH and overactive bladder: a prospective, randomized, multi-center, double-blind, placebo-controlled study

Lee

Chung

Kim

et al. 2011

Prostate Cancer Prostatic Dis

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“…OAB is a common condition and its prevalence increases with age [3]. The overall global prevalence of OAB was 10.7% (455 million cases) in 2008, and a 20.1% increase is predicted by 2018 (546 million cases) [4].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of solifenacin compared with oral antimuscarinic agents for the treatment of patients with overactive bladder in the UK

Hakimi

Kelleher

Aballéa

et al. 2018

Journal of Market Access & Health Policy

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Objective: To evaluate the cost-effectiveness of solifenacin 5 mg/day versus other oral antimuscarinic agents used for overactive bladder (OAB) from a UK National Health Service (NHS) perspective. Study design: In a Markov model, hypothetical patients received solifenacin 5 mg/day or a comparator antimuscarinic, after which they could switch to an alternative antimuscarinic. The model estimated incremental cost-effectiveness ratios (ICER), expressed as cost per quality-adjusted life year (QALY) over a 5-year period. Results: Solifenacin 5 mg/day was the dominant treatment strategy (i.e., less costly and more effective) versus tolterodine extended-release (ER) 4 mg/day, fesoterodine 4 and 8 mg/day, oxybutynin ER 10 mg/day and solifenacin 10 mg/day, and was cost-effective (i.e., ICERs below the £30,000 per QALY threshold generally applied in the NHS) versus oxybutynin immediate release (IR) 10 mg/day, tolterodine IR 4 mg/day and trospium chloride 60 mg/day. The probability of solifenacin 5 mg/day being dominant/cost-effective at a willingness-to-pay threshold of £30,000 per QALY was 57–98%. Conclusions: Solifenacin 5 mg/day appears to be a cost-effective strategy for the treatment of OAB over a 5-year timeframe compared with other oral antimuscarinic agents in the UK. These findings are important for decision-makers considering the economic implications of selecting treatments for OAB.

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“…Lower urinary tract symptoms (LUTS) are common in women with a reported prevalence up to 66.6% in large epidemiological studies [1]. They are under-reported and under-treated despite their significant adverse effect on quality of life (QoL) [2].…”

Section: Introductionmentioning

confidence: 99%

Can we predict detrusor overactivity in women with lower urinary tract symptoms? The King's Detrusor Overactivity Score (KiDOS)

Giarenis

Musonda

Mastoroudes

et al. 2016

European Journal of Obstetrics & Gynecology and Reproductiv

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A prediction model is able to predict detrusor overactivity more accurately than a symptomatic diagnosis alone, in women with lower urinary tract symptoms. Abstract ObjectiveTraditionally, urodynamic studies (UDS) have been used to assess lower urinary tract symptoms (LUTS), but their routine use is now discouraged. While urodynamic stress incontinence is strongly associated with the symptom of stress urinary incontinence (SUI) and a positive cough test, there is a weak relationship between symptoms of overactive bladder and detrusor overactivity (DO). The aim of our study was to develop a model to predict DO in women with LUTS. Study DesignThis prospective study included consecutive women with LUTS attending a urodynamic clinic. All women underwent a comprehensive clinical and urodynamic assessment. The effect of each variable on the odds of DO was estimated both by univariate analysis and adjusted analysis using logistic regression. Results1006 women with LUTS were included in the study with 374 patients (37%) diagnosed with DO. The factors considered to be the best predictors of DO were urgency urinary incontinence, urge rating/void and parity (p-value <0.01). The absence of SUI, vaginal Page 3 of 26 A c c e p t e d M a n u s c r i p t 3 bulging and previous continence surgery were also good predictors of DO (p-value < 0.01).We have created a prediction model for DO based on our best predictors. In our scoring system, presence of UUI scores 5; mean urge rating/void ≥ 3 scores 3; parity ≥ 2 scores 2; previous continence surgery scores -1; presence of SUI scores -1; and the complaint of vaginal bulging scores -1. If a criterion is absent, then the score is 0 and the total score can vary from a value of -3 to +10. The Receiver Operating Characteristic (ROC) analysis for the overall cut-off points revealed an area under the curve of 0.748 (95%CI 0.741, 0.755). ConclusionThis model is able to predict DO more accurately than a symptomatic diagnosis alone, in women with LUTS. The introduction of this scoring system as a screening tool into clinical practice may reduce the need for expensive and invasive tests to diagnose DO, but cannot replace UDS completely.

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Population-Based Survey of Urinary Incontinence, Overactive Bladder, and Other Lower Urinary Tract Symptoms in Five Countries: Results of the EPIC Study

Cited by 2,268 publications

References 23 publications

Initial combined treatment with anticholinergics and α-blockers for men with lower urinary tract symptoms related to BPH and overactive bladder: a prospective, randomized, multi-center, double-blind, placebo-controlled study

Initial combined treatment with anticholinergics and α-blockers for men with lower urinary tract symptoms related to BPH and overactive bladder: a prospective, randomized, multi-center, double-blind, placebo-controlled study

Cost-effectiveness of solifenacin compared with oral antimuscarinic agents for the treatment of patients with overactive bladder in the UK

Can we predict detrusor overactivity in women with lower urinary tract symptoms? The King's Detrusor Overactivity Score (KiDOS)

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