Randomized, double-blind, placebo-controlled trial of polyethylene glycol (MiraLAX®) for urinary urge symptoms

Bush, Nicol; Shah, Anjana; Barber, Theodore; Yang, Mary; Bernstein, Ira H.; Snodgrass, Warren

doi:10.1016/j.jpurol.2012.10.011

Cited by 13 publications

(3 citation statements)

References 32 publications

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“…As in a previous trial of polyethylene glycol [ 17 ], the refusal of constipation treatment in 19 patients reflected difficulties in addressing constipation in patients with enuresis. This is related to the fact that no criteria have been generally accepted regarding the institution or discontinuation of constipation treatment in patients with LUTD.…”

Section: Discussionmentioning

confidence: 90%

Time Course of Treatment for Primary Enuresis With Overactive Bladder

Lee

Park

2018

Int Neurourol J

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PurposeTo characterize the course of treatment for nonmonosymptomatic enuresis with overactive bladder (OAB) in a real clinical setting.MethodsData from 111 OAB patients with moderate to severe enuresis were analyzed. The baseline analysis included a questionnaire, voiding diary, uroflowmetry with postvoid residual urine measurement, and plain abdominal radiography of the kidneys, ureters, and bladder (KUB). Following standard urotherapy for 1 month, anticholinergic medication was administered with or without laxatives. Desmopressin was added if there was a partial response to OAB. Patients were followed every 3 months to evaluate the status of OAB and enuresis. Multivariate analysis was performed to identify predictors associated with the lack of complete response (CR) in enuresis at 12 months.ResultsFollowing 12 months of treatment, 64% and 88% of patients experienced at least partial response in enuresis and OAB, respectively. Urgency improved more quickly than enuresis, supporting the need to address daytime symptoms before enuresis. Seventy-nine patients (71%) had fecal impaction on KUB and/or subjective constipation. The combination of anticholinergics with either laxatives or desmopressin fared better than anticholinergics alone. Daytime incontinence and anticholinergics-only treatment were associated with a lack of CR during 12 months of treatment.ConclusionsThe data confirmed the validity of addressing OAB before treating enuresis. The results of this study also highlight the need to address fecal impaction. Patients should be counseled about the need for a prolonged course of treatment before starting treatment. Anticholinergics should be accompanied with either desmopressin or laxatives for better control of enuresis.

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Section: Discussionmentioning

confidence: 90%

Time Course of Treatment for Primary Enuresis With Overactive Bladder

Lee

Park

2018

Int Neurourol J

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“…Some have advocated treating all children with LUT dysfunction for constipation based on the very high rate of coincident constipation among these patients, the unreliability of parent reporting of bowel symptoms, and the low cost and risk associated with this treatment [49]. However, a recent randomized trial comparing polyethylene glycol versus placebo for patients with isolated bladder urgency symptoms found no difference in resolution of bladder symptoms between the two groups [50]. Bowel dysfunction should be identified, quantified using objective metrics, and treated appropriately.…”

Section: Bowel and Bladder Dysfunctionmentioning

confidence: 99%

Contemporary Management of Vesicoureteral Reflux

Johnston

Qureshi

Irvine

et al. 2016

Curr Treat Options Peds

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The past 30 years have seen broad changes in the diagnosis and management of vesicoureteral reflux (VUR). Recently, a clinical debate has generated an open discussion in academic circles. New evidence has shifted treatment patterns away from widespread surgical management and recently brought into question some pharmacologic treatments. VUR is usually not hazardous by itself but is a significant risk factor for urinary tract infection (UTI) and less commonly, renal scarring and insufficiency. Given the costs and morbidity of UTI as well as the potential for significant renal injury, our approach remains conservative. Careful follow-up, parental education about pathophysiology and management of VUR and UTI, and management of bowel and bladder dysfunction (BBD) when present, are the foundation of treatment. Additionally, though we recognize the limitation of continuous antibiotic prophylaxis (CAP), we believe the benefits outweigh the risks and costs for many patients. Careful observation can be considered in patients with a single medical home, parental understanding of what UTI signs and symptoms are, low grade VUR, no history of complicated UTIs and close follow-up. Surgical management remains a relevant option for select patients who fail conservative measures with breakthrough UTIs or failure to resolve. Minimally invasive surgical options are available with acceptable outcomes though open ureteroneocystostomy still carries the highest success rate.

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“…In children with chronic constipation, the mean duration of treatment has been reported 3-30 months. Some studies have reported the recovery rate after 1-year treatment to be 60-90% [11,12].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Polyethylene Glycol Powder and Polyethylene Glycol 40% Syrup in Treatment of Chronic Idiopathic Constipation in Pediatrics

Kasiri

Fekri

Rouhi-Boroujeni

et al. 2019

JPRI

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Introduction: Constipation is one of the most common gastrointestinal complaints in children that can lead to many complications. The aim of this study was to compare the efficacy of polyethylene glycol powder and polyethylene glycol 40% syrup to treat constipation. Materials and Methods: This study was a nonrandomized semi-experimental clinical trial. The current study was conducted on 80 patients with constipation, referring to Imam Ali (PBUH) Clinic, Shahrekord randomly assigned to two groups of 40 each. Subjects were children under 15 years old with functional constipation selected by simple sampling since 2015. Group 1 was treated with polyethylene glycol powder and Group 2 was treated with polyethylene glycol 40% syrup for two months. During the treatment, the patients were examined five times with 2-week intervals and their symptoms consisting of defecation frequency, stool consistency, painful defecation, bloody defecation, and stool incontinence were registered in a checklist. Data were analyzed using SPSS24. Results: The comparison of patients’ total status before and after intervention shows that two groups were assessed in the weak level in the polyethylene glycol powder group 28(0.70%) cases and syrup group 36(0.90%), while after intervention, polyethylene glycol powder group was assessed in the high level 35(87.5%) cases and syrup group 37(92%) cases and most of patients after intervention promoted from weak and intermediate level before intervention to High level. Conclusion: The findings indicated similar efficacy and treatment response of the PEG powder and syrup. However, the PEG syrup can be used instead of its powder because of pleasant taste and ease of use.

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Randomized, double-blind, placebo-controlled trial of polyethylene glycol (MiraLAX®) for urinary urge symptoms

Cited by 13 publications

References 32 publications

Time Course of Treatment for Primary Enuresis With Overactive Bladder

Time Course of Treatment for Primary Enuresis With Overactive Bladder

Contemporary Management of Vesicoureteral Reflux

Comparison of Polyethylene Glycol Powder and Polyethylene Glycol 40% Syrup in Treatment of Chronic Idiopathic Constipation in Pediatrics

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