The puzzle of overactive bladder: controversies, inconsistencies, and insights

Dmochowski, Roger R.

doi:10.1007/s00192-005-0032-3

Cited by 12 publications

(10 citation statements)

References 96 publications

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“…A significant negative relationship was found between urinary freq/night and QoL at each stage of the program, while a moderate negative correlation was found between inco/week and QoL at the end of intervention and during the follow-up period [7]. Most researchers investigate treatment for UUI in terms of incontinence episodes and micturitions in 24 h [12][13][14][15][16], but in our opinion, nocturnal awaking is of greater importance, especially in the elderly population. Nocturia is often experienced by people with OAB as diminished quality of sleep.…”

Section: Discussionmentioning

confidence: 99%

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Rehabilitation versus drug therapy for urge urinary incontinence: long-term outcomes

Kafri¹,

Shames²,

Raz

et al. 2007

Int Urogynecol J

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The objective of this study was to compare the residual effect of a 3-month rehabilitation treatment and a standard drug treatment for urge urinary incontinence (UUI) 21 months post intervention. Forty-four women (ages 27-68 years) who were diagnosed with overactive bladder (OAB) were divided into 2 treatment groups over 3 months: 24 women received rehabilitation (REH) and 20 women were treated with medication (MED) (oxybutynin ER). Outcomes measures included frequency of urination, quality of life (QoL), and number of side effects (no/SE), which were measured upon entry into the study (entry), completion of the intervention (3 months), and at follow-up 3 and 21 months after completion of treatment. In the follow-up period, there was a significant group-time interaction effect on freq/day and freq/night (p < 0.01). At the end of follow-up, the mean number of no/SE was significantly greater in the MED group compared to the REH group (3.3 +/- 0.5 vs 2.4 +/- 0.4; p < 0.05). A significant negative association was found between the urinary symptoms and the I-QoL at the 21-month follow-up (r (p) = -0.45 to-0.57, p < 0.05). In the long-term, the REH patients maintained and even improved the achievements of the intervention period while the MED patients deteriorated to baseline values in urinary frequency. The suggestion for future work is to investigate the effect of each REH treatment component on UUI symptoms.

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Section: Discussionmentioning

confidence: 99%

“…Other musculoskeletal disorders, such as fibromyalgia and chronic fatigue syndrome, also feature sleep disturbances that adversely impact QoL [12,19]. Involuntary loss of urine appears to be the OAB symptom most responsible for diminished QoL.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation versus drug therapy for urge urinary incontinence: long-term outcomes

Kafri¹,

Shames²,

Raz

et al. 2007

Int Urogynecol J

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“…For these reasons, OAB has an important position in the international drug industry. Although OAB patients show many variable symptoms, the central symptom of OAB is urgency [3,4], which is closely related to detrusor overactivity (DO) during the filling phase in cystometry [5-7]. It was reported that 83% of patients with DO showed urgency, and 64% of patient with urgency showed DO [7].…”

Section: Introductionmentioning

confidence: 99%

Urodynamic Effects of Propiverine on Detrusor Overactivity and Abdominal Straining during Voiding in Awake Rats with Intravesical Prostaglandin E₂Instillation

Lee

Jin

et al. 2010

Korean J Urol

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Purpose:We investigated the effect of propiverine on cystometric parameters based on intraabdominal pressure (IAP) in awake rats in an overactive bladder (OAB) model induced by intravesical instillation of prostaglandin E2 (PGE2). Materials and Methods: Twenty-two female Sprague-Dawley rats were used. Polyethylene catheters were implanted into the bladder to record the intravesical pressure (IVP) and into the femoral artery to administer medication. A balloon-fitted catheter was positioned in the abdominal cavity to record the IAP. Awake cystometries were performed before and after intraarterial administration of propiverine 1 mg/kg (n=6), intravesical administration of 50μM PGE2 only (n=6), or intravesical PGE2 plus 1 mg/kg (n=4) or 3 mg/kg (n=6) of intraarterial propiverine. Cystometric pressure and volume parameters and variables related to detrusor overactivity (DO) were investigated. Results: Rats administered intravesical PGE2 showed increased pressure parameters and decreased volume parameters comparable to the DO model, which was effectively prevented by propiverine (1 or 3 mg/kg). Typical DO shown during the filling phase was decreased by intraarterial propiverine (3 mg/kg) injection. After propiverine (3 mg/kg) injection, IAP was increased at the time of micturition pressure with or without threshold pressure (p＜0.05, p＜0.01) depending on the dose administered. Conclusions: Propiverine improved pressure-and volume-related parameters in an OAB model. Furthermore, it also decreased the frequency of DO. However, higher concentrations of propiverine induced straining voiding.

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“…It is a reasonable treatment of patients impossible to take anticholinergic medication [15–17, 21, 22]. To date several studies tried to elucidate cause and mechanism of OAB, but it is still poorly understood [4, 18, 19, 23]. Up to now a marker for OAB is lacking.…”

Section: Discussionmentioning

confidence: 99%

Changes in prostaglandin E2 in patients with idiopathic overactive bladder syndrome after botulinum toxin type A treatment: is there a clinical benefit?

et al. 2014

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BackgroundThe causality of overactive bladder syndrome (OAB) is still not fully understood. Several studies indicate a significant increase of prostaglandin E2 (PGE2) in patients with OAB. However, in order to clarify whether these compounds can help to objectify the clinical diagnosis, further studies are needed. This prospective study aims to analyze PGE2 blood levels (sPGE2) in patients with OAB before and after botulinum toxin type A (BoNT-A) therapy.MethodsBlood samples were obtained from 56 patients (52y, 18–87) with idiopathic OAB. sPGE2 levels were measured before and 4 weeks after BoNT-A treatment by enzyme linked immunosorbent assay (ELISA). 31 healthy persons with normal bladder function served as control group (59 y, 21–72). sPGE2 was set in relation to clinical data and the severity of OAB (wet/dry). The statistical data analysis was performed by using the non-parametric Mann–Whitney U test and paired t-test.ResultsSignificant higher sPGE2 levels were detected in patients with OAB compared to members of the control group (2750 pg/ml vs. 1674 pg/ml, p < 0.005). Furthermore sPGE2 levels were increased in patients with OAB wet compared to OAB dry (p <0.01). In 30 patients sPGE2 levels decreased significantly after BoNT-A treatment compared to baseline (2995 pg/ml vs. 1486 pg/ml, p <0.005). Patients reported an average drug effect of 9 month (0–19); incontinence pads were needed significantly less frequent (p < 0.05). 3 patients reported no postoperative effect. sPGE2 increased in two patients compared to initial levels, a single patient showed a remotely decreased sPGE2. Six patients were treated repeatedly with BoNT-A after showing an sPGE2 re-rise.ConclusionssPGE2-level is increased in patients with OAB. We could prove a significant decrease of sPGE2 after BoNT-A treatment. In this small cohort we could demonstrate a correlation between OAB and sPGE2, especially in the non-responder group. The use of sPGE2 as a biomarker in diagnostics and follow-up after therapy seems promising. To what extent sPGE2 can be useful as such needs to be examined prospectively in a larger population.

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The puzzle of overactive bladder: controversies, inconsistencies, and insights

Cited by 12 publications

References 96 publications

Rehabilitation versus drug therapy for urge urinary incontinence: long-term outcomes

Rehabilitation versus drug therapy for urge urinary incontinence: long-term outcomes

Urodynamic Effects of Propiverine on Detrusor Overactivity and Abdominal Straining during Voiding in Awake Rats with Intravesical Prostaglandin E₂Instillation

Changes in prostaglandin E2 in patients with idiopathic overactive bladder syndrome after botulinum toxin type A treatment: is there a clinical benefit?

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The puzzle of overactive bladder: controversies, inconsistencies, and insights

Cited by 12 publications

References 96 publications

Rehabilitation versus drug therapy for urge urinary incontinence: long-term outcomes

Rehabilitation versus drug therapy for urge urinary incontinence: long-term outcomes

Urodynamic Effects of Propiverine on Detrusor Overactivity and Abdominal Straining during Voiding in Awake Rats with Intravesical Prostaglandin E2Instillation

Changes in prostaglandin E2 in patients with idiopathic overactive bladder syndrome after botulinum toxin type A treatment: is there a clinical benefit?

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Urodynamic Effects of Propiverine on Detrusor Overactivity and Abdominal Straining during Voiding in Awake Rats with Intravesical Prostaglandin E₂Instillation