ABSTRACT
<p><b>BACKGROUND</b>Overactive bladder (OAB) is a series of symptoms with high prevalence in elderly people. This study was conducted using the overactive bladder symptom score (OABSS) to evaluate the efficacy of solifenacin succinate for the treatment of OAB.</p><p><b>METHODS</b>This was a prospective, multicenter, single-arm, 12-week study that enrolled 241 OAB patients. The patients received 5-10 mg/day solifenacin. Changes in OABSS, symptoms from voiding diary, perception of bladder condition (PPBC) score, international prostate symptom score (IPSS) and quality of life (QOL) were evaluated at weeks 0, 4, and 12. The relationship between OABSS and PPBC score or parameters of voiding diary was also evaluated.</p><p><b>RESULTS</b>At baseline, the mean OABSS for all patients was 9.41 ± 2.40, and was reduced significantly at week 12 (-3.76 points; 61.21%, P < 0.0001). The OABSS subscore, PPBC score, IPSS, and QOL were also significantly reduced during the study (P < 0.0001). The overall incidence of adverse events was 19.91% (44 cases). The gastrointestinal system was the most commonly affected (11.31%). Around 5.88% of the cases had adverse events related to the genitourinary system. There was a strong correlation between OABSS and urinary symptoms that was recorded in the 3-day voiding dairy.</p><p><b>CONCLUSIONS</b>We showed that solifenacin was clinically effective for relieving OAB symptoms, considering the balance between efficacy, patients' well-being, and tolerability. OABSS integrates four OAB symptoms into a single score and can be a useful tool for research and clinical practice.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Muscarinic Antagonists , Therapeutic Uses , Prospective Studies , Quality of Life , Quinuclidines , Therapeutic Uses , Solifenacin Succinate , Tetrahydroisoquinolines , Therapeutic Uses , Treatment Outcome , Urinary Bladder, Overactive , Drug TherapyABSTRACT
ObjectiveTo evaluate the efficacy and safety of tolterodine tartrate in treating patients with early overactive bladder(OAB) symptoms after transurethral resection prostate (TURP).Methods Thirty-one patients who received TURP and were found OAB at recent follow-up were enrolled and divided by random digits table method into study group ( 16 cases) and control group ( 15 cases).The patients in study group were treated with 2 mg tolterodine tartrate twice a day for four weeks,while the changes of OAB in control group were observed.The OAB symptoms score (OABSS),maximum flow rate(Qmax),24 h urination and adverse reactions during the period of medication of two groups before and after treatment were recorded and observed.Results The second evaluation,all the indexes except Qmax in study group improved significantly compared with those of the first evaluation in study group and control group the second evaluation.The indexes included urination times[(6.8 ± 1.0) times vs.( 12.5 ± 1.5) times,(11.8 ± 1.2)times],urgency times[(1.4 ± 1.1) times vs.(4.1 ±2.2) times,(4.1 ±2.3) times],urine volume [(214 ±36) ml vs.( 177 ± 46) ml,( 178 ± 44) ml ],nocturia times [ ( 1.9 ± 0.7) times vs.(2.9 ± 1.3 ) times,(2.8 ±1.4) times ],urge incontinence times [ (0.6 ± 0.5 ) times vs.( 1.6 ± 1.0) times,( 1.5 ± 1.0) times ].OABSS in study group the second evaluation was significantly lower than that in the first evaluation in study group and the second evaluation in control group [ (3.6 ± 1.8 ) scores vs.( 7.6 ± 3.3 ) scores,(7.4 ± 3.2) scores,P ＜ 0.01 or ＜ 0.05 ].There was no statistical significance in all the indexes in control group between the first evaluation and the second evaluation (P ＞ 0.05).There were 2 cases with adverse reactions which performed as dry mouth which could be tolerant.ConclusionTolterodine tartrate is efficient and safe in treating patients with early OAB symptoms after TURP.
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Objective To evaluate the clinical value of fluorescence in situ hybridization (FISH) method for diagnosis of bladder urothelial carcinoma.Methods Urine samples from 81 patients suspected of having bladder urothelial carcinoma were collected for immediate urine cytology and FISH analysis.All patients underwent cystoscopy for identification of bladder lesions.Urine samples from 8 patients with benign disease of urinary system werealso analyzed by means of FISH and cytology.The sensitivity and specificity of FISH were compared with cytology.Results 81 subjects of bladder urothelial carcinoma were verified with pathology,which included 34 non-muscle invasive carcinoma,14 cases with muscle invasive carcinoma,42 cases with high-grade carcinoma,and 24 cases with low-grade carcinoma.Residual cases included 12 verified benign disease of urinary system,and to serve as controls with 8 patients with benign disease of urinary system.The sensitivities of FISH,cytology and cystoscopy were 72.8％,27.2％ and 97.5％.The sensitivity of FISH was superior to cytology,but inferior to cystoscopy.The specificity and diagnostic concordance rate of FISH and cytology were 85.0％,100.0％ and 75.2％,41.6％,respectively.Conclusion FISH analysis as a non-invasive method has good sensitivity and specificity for diagnosing bladder urothelial carcinoma.
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Objective To study the value of the preoperative detrusor contractility to the outcome assessment of prostatectomy for benign prostatic hyperplasia (BPH).Methods A total of 109 patients with BPH were analyzed.Their ages ranged from 62 to 83 years with a mean of 71 years.All patients underwent urodynamic study to confirm a diagnosis of BOO preoperatively.Further more, their BOO was not caused by nervous, endocrine or other diseases.Pateints were divided into two groups based on maximum detrusor contractility.Group Ⅰ (n =61, BPH with maximum detrusor contractility ≥ 40 cm H2O, 1cm H2O =0.098 kPa) underwent TURP or open surgery, respectively.Group Ⅱ (n =48, BPH with maximum detrusor contractility ≤ 20 cm H2O ) underwent TURP and suprapubic punctural cystostomy simultaneously,the bladder fistula was kept open continuously for at least two weeks postoperatively.The difference in outcome between the two grous was assessed by using urodynamic parameters including maximum detrusor contractility, Qmax and residual urine at one and three months postoperatively respectively.Student's t-test was used to compare the result for normally distributed data and Wilcoxon's signed-ranks test for skewed data in this study.Results There was significant difference in preoperative maximum contractility, Qmax between group Ⅰand groupⅡ (78.4 ±37.0 cm H2O) vs (19.2 ±5.4 cm H2O)(P＜0.01), (7.6±2.2 ml/s) vs (2.5 ± 1.1 ) ml/s (P ＜ 0.05) respectively.Although there was significant difference at one month postoperatively in Qmax (17.4 ±2.9)ml/s vs (12.5 ±2.0)ml/s (P＜0.05), no significant difference was found in Qmax between the two groups after three months ( 18.3 ±2.8 ml/s) vs ( 15.2 ± 1.8)ml/s (P ＞ 0.05).Conclusions The Qmax may improve and the impaired detrusor recovered gradually after the BOO was removed.Performing an operation on patients with BOO accompanied with detrusor underactivity may be useful to recover detrusor contractility.