The Burden of Overactive Bladder on US Public Health

Reynolds, W. Stuart; Fowke, Jay H.; Dmochowski, Roger R.

doi:10.1007/s11884-016-0344-9

Cited by 105 publications

(106 citation statements)

References 32 publications

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Section: Introductionmentioning

confidence: 99%

“…Idiopathic overactive bladder syndrome (OAB) represents a significant public health burden, as it affects one out of six U.S. adults, accounts for $66 billion in total annual U.S. societal costs, and can be difficult to treat effectively. 1 While the etiology of OAB remains unclear, a substantive body of animal and ex vivo research suggests that increased afferent nerve activity (including activation of normally quiescent c-fibers) and altered CNS processing of excitatory signals contribute to OAB pathophysiology. 2,3 However, a reliable means to assess such changes in individuals with OAB has remained elusive, and thus whether and how these pathophysiologic mechanisms might contribute to clinical OAB manifestations, impart resistance to primary and secondary therapies, and influence treatment outcomes are unknown.…”

Section: Introductionmentioning

confidence: 99%

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Temporal summation to thermal stimuli is elevated in women with overactive bladder syndrome

Reynolds

Brown

Danford

et al. 2016

Neurourology and Urodynamics

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Introduction This study sought to provide a preliminary assessment of whether spinally-mediated afferent hyperactivity (i.e. central sensitization) might contribute to manifestations of Overactive Bladder Syndrome (OAB) in women as indexed by elevated temporal summation of evoked heat pain stimuli. Methods We recruited 20 adult women with OAB who were planning to undergo interventional therapy for OAB with either onabotulinumtoxinA injection or sacral neuromodulation and 23 healthy controls without OAB symptoms to undergo quantitative sensory testing with cutaneous thermal pain temporal summation. The primary study outcome was the degree of temporal summation, as reflected in the magnitude of positive slope of the line fitted to the series of 10 stimuli at the 49°C target temperatures. Linear regression and analysis of covariance were utilized to compare the degree of temporal summation between study groups. Results The standardized slope of temporal summation trials for women with OAB was significantly higher than for Controls (beta = 3.43, 95% confidence interval = 0.6 – 6.2, p = .017). The adjusted means ± SE of the standardized temporal summation slopes for the full OAB and Control groups were 3.0 ± .5 (95% confidence interval = 2.0, 4.1) and 1.7 ± .5 (95% confidence interval = .7, 2.7), respectively. Conclusion In this preliminary study, we demonstrated that women with OAB refractory to primary and secondary therapies exhibited greater thermal cutaneous temporal summation than women without OAB symptoms. This suggests that central sensitization, indexed by temporal summation, may be an underlying factor contributing to OAB in some women.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Temporal summation to thermal stimuli is elevated in women with overactive bladder syndrome

Reynolds

Brown

Danford

et al. 2016

Neurourology and Urodynamics

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“…International populationbased studies have reported prevalence rates of OAB approximately 12% (6,7) and it rises 17% in patients aged 40 and over (2). OAB symptoms are not only disturbes patients but also have a significant negative impact on many aspects of the lives of individuals who represent a particularly effective health burden in terms of quality of life and productivity (3). It is known that obesity is a strong risk factor for OAB.…”

Section: Introductionmentioning

confidence: 99%

Visceral adiposity index and overactive bladder in postmenopausal woman: A novel predictive risk factor

Eren¹,

Horsanalı²,

Dil³

et al. 2019

Kocaeli Med J

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ÖZ AMAÇ: 45 yaş üstü postmenopozal kadın hastalarda visseral adipozite indeksi (VAI) ile aşırı aktif mesane semptomları arasındaki ilişkiyi araştırmak. METARYAL ve METOD:Mart 2017-Aralık 2017 tarihleri arasında aşırı aktif mesane semptomları olan 76 postmenopozal kadın hasta değerlendirildi. Antropometrik veriler, serum kolesterol düzeyleri, açlık glukoz seviyeleri, ürodinamik bulgular ve OAB-8 formu kayıt edildi. VAI cinsiyete özgü formüle göre hesaplandı. Hastalar VAI seviyelerine göre üç gruba ayrıldı. VAI ile aşırı aktif mesane semptomları arasındaki ilişki ürodinamik sonuçlar ve OAB-8 skoru açısından istatiksel olarak karşılaştırıldı. BULGULAR: Hastaların yaş ortalaması 57.2 8.3 yıl, ortalama vücut kitle indeksi (VKİ) 32.3 2.8 kg/ m2 idi. Gruplar arasında Pabd, post miksiyonel rezidü idrar miktarı (PMRİ), maksimum mesane kapasitesi (MMK) ve OAB-8 sorgulama formu skoru açısından anlamlı fark bulundu. VAI ile PMRİ, detrüsor aşırı aktivitesi (DAA), idrar sıklığı, urge inkontinans, noktüri ve OAB-8 skoru arasında pozitif korelasyon, MMK ve ilk işeme arzusu açısından negatif korelasyon tesbit edildi. SONUÇ: VAI düzeyi yüksek olan hastalarda daha fazla aşırı aktif mesane semptomu olduğunu ve daha kötü ürodinamik bulguları olduğunu gözlemledik. VAI ayrıca aşırı aktif mesane semptomlarını öngörmede bir belirteç olarak kullanılabilir. Anahtar kelimeler: Obezite; Aşırı aktif mesane; Üriner inkontinans; Visseral Adipozite İndeksi; Bel çevresi; Detrusör aşırı aktivitesi ABSTRACT INTRODUCTION: To investigate the association between visceral adiposity index (VAI) and overactive bladder (OAB) symptoms in postmenopausal female patients aged over 45 years. MATERIALS and METHODS: Between March 2017 andDecember 2017, 76 postmenopausal female patient with OAB symptoms were evaluated. Anthropometric indices serum cholesterol levels, fasting glucose levels, urodynamic findings and OAB-8 scores were recorded. VAI was calculated according to gender-specific formula. Participants were divided into three groups according to VAI levels. The relationship between VAI and OAB symptoms were statistically compared in terms of urodynamic outcomes and OAB-8 scores. RESULTS:Mean age of the patients were 57.2 8.3 years and mean BMI was 32.3 2.8 kg/m2. Statistical significance was observed in terms of abdominal pressure (Pabd), post voiding residual urine mounts (PVR), maximum bladder capasity (MBC) and OAB-8 scores between groups. VAI correlated positively with PVR, detrusor overactivity (DOA), urinary frequency, urge incontinence, nocturia and OAB-8 scores whereas a negative correlation existed MBC and first desire to void. CONCLUSIONS:We observed that patients with higher levels of VAI had more OAB symptoms and worse urodynamic findings.VAI may also be used as a marker for predicting overactive bladder symptoms.

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“…Overactive bladder (OAB) has a deeply negative impact on quality of life, with higher economic costs for patients and the society. 1 The prevalence of this condition is between 11.8% and 16.5% in the USA and Europe, estimated to reach 24% by 2020. [2][3][4] Behavioral and pharmacologic therapies (antimuscarinics or oral ß3-adrenoceptor agonists) are considered the first and second-line therapy.…”

Section: Introductionmentioning

confidence: 99%

A prospective randomized clinical trial comparing two doses of AbobotulinumtoxinA for idiopathic overactive bladder

Bezerra

Toledo

Carramão

et al. 2018

Neurourology and Urodynamics

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Aims To compare 300 U versus 500 U of abobotulinumtoxinA (ABO) intravesical injections for the treatment of idiopathic overactive bladder (OAB) refractory to first and second‐line treatments. Methods A prospective, randomized, single blind study was performed in female patients with symptoms of OAB, who had failed conservative treatment. Patients were treated with 300 or 500 U of ABO injected into 30 sites, avoiding the trigone. All treatments were evaluated by voiding diary, ICIQ‐OAB questionnaire, urodynamic test, visual analogue scale (VAS) for treatment satisfaction and patient global impression of improvement (PGI‐I). The primary outcome was change in maximum cistometric capacity (MCC). Secondary outcome included changes in urgency, complete continence, subjective success (VAS and PGI‐I), and adverse events (urinary retention, UTI, and CIC). Results Twenty‐one patients were included. MCC has increased from 185.0 to 270.9 mL (300 U) and from 240.8 to 311.7 mL (500 U), comparing the baseline with 12 weeks, without statistical difference between the groups (P = 0.270). At 12 weeks, 91% of patients were dry in both groups. At 24 weeks, episodes of incontinence had returned in 50% (300 U) and 0% (500 U) (P = 0.013). Patients were better or much better (PGI‐I) in70% (300 U) and 88.9% (500 U) at 12 w; and 50% (300 U) and 100% (500 U), at 24 w (P = 0.027). The peak of PVR was at 4 w, being 71.7 mL (300 U) and 96.5 mL (500 U). General UTI incidence was 35.7%. One patient (500 U) required CIC for 2 weeks. Conclusions Intravesical ABO injection at 500 U improves symptoms and quality of life for longer period of time than 300 U for idiopathic OAB.

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The Burden of Overactive Bladder on US Public Health

Cited by 105 publications

References 32 publications

Temporal summation to thermal stimuli is elevated in women with overactive bladder syndrome

Temporal summation to thermal stimuli is elevated in women with overactive bladder syndrome

Visceral adiposity index and overactive bladder in postmenopausal woman: A novel predictive risk factor

A prospective randomized clinical trial comparing two doses of AbobotulinumtoxinA for idiopathic overactive bladder

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