Oxybutynin and tolterodine in a trial for treatment of overactive bladder in Iranian women

Objective: To evaluate the efficacy and side effects of Oxybutinin in comparison to tolterodine in treatment of overactive bladder [OAB] with detrussor overactivity [DOA] in Iranian women

Materials and Methods: One hundred Iranian old women with clinical symptoms of OAB who show IDO in the filling cystometry participated in this randomized double-blinded parallel-group by using two kinds of the drugs for 4- week course [2 mg tolterodine twice-daily, or oxybutinin 5 mg, three times a day] in alike packages. We collected data from 3-day FVC before and after the treatment course. The effectiveness of each drug was studied using the paired t-test and improvement after treatment between two groups was compared by independent T-test

Results: Positive changes in urinary urgency, Frequency and Urge incontinence after treatment in both groups were seen but mean improvements in the all were larger in the patients who treated by oxybutinin especially in terms of urgency and Urge incontinence. Dry mouth was the most common side-effect in two groups. Unlike other studies it was higher in the tolterodine group but the difference was not significant

Conclusion: Four week treatment with oxybutinin was better than tolterodine in improving urgency and urge incontinence but there were not statistically significance between them

frequency of pelvic floor dysfunctions and their risk factors in women aged 40-55

The aims of this study were to determine the frequency of urinary and fecal incontinence and their determinants in pre-menopausal and menopausal women in Iran. This one-year cross-sectional study was performed on 304 women aged 40-55 who were admitted to women's clinic at Imam Khomeini Hospital. Symptoms of urinary, gas, and fecal incontinence and pelvic organs prolapse were diagnosed by a specialist through examination and a questionnaire. Patients were divided into two groups of with and without [urinary, gas, and fecal] incontinence symptoms. The probable risk factors of these disorders were studied and registered in the questionnaire and compared using t-test, chi-squared test, and regression of quantitative and qualitative variables. Generally, 129 [42%] out of 304 women had pelvic floor dysfunction [urinary and fecal incontinence, and pelvic organs prolapse]. Risk factors including menopause, hormone therapy, history of hysterectomy, inactivity, age, BMI, and first child's birth weight were compared between the two groups using chi-squared and t tests. There was a statistically significant difference between the two groups [P=0.000] as risk factors were more frequently observed in women with incontinence symptoms. Some risk factors of pelvic floor dysfunction are menopause, hormone therapy, history of hysterectomy, inactivity, age, BMI, and first child's birth weight. Therefore, some strategies should be included in women's health education programs to prevent the above-mentioned risk factors

[Comparison of efficacy and side-effects of Oxybutynin and Tolterodine in the treatment of overactive bladder]

Overactive bladder [OAB] is one of the most prevalent diseases of lower urinary system. OAB disease is defined by the Standardization Subcommittee of the International Continence Society as urinary urgency, with or without urge incontinence, usually with frequency and nocturia with no proven infection or other obvious pathology. Treatment with the antimuscarinic agents tolterodine and oxybutynin is the mainstay of therapy for overactive bladder. The study was undertaken to compare the efficacy and side-effects of tolterodine and oxybutynin in a number of Iranian women. This study consisted of two trials and done in Imam Khomeini Hospital in 2009; in one trial, 50 patients with overactive bladder were randomized to 4 weeks of treatment with 2 mg of twice-daily tolterodine, and in the other to 5 mg of three times a day oxybutynin. Urodynamic investigations, Episodes of urge urinary incontinence and adverse events were also evaluated. The results showed a good association between the questionnaire and cystometry data but urodynamic studies showed significant differences in efficacy. Tow groups showed significant improvements in all Symptoms, but The results showed that the two drugs had no significant differences in efficacy. The data obtained by questionnaire indicated that both drugs increased quality of life but there were no significant differences between the two in symptom cure. Dry mouth was the most common side-effect in the two groups but unlike other studies it was higher in the tolterodine group. Therefore, our study did not show any preference between oxybutynin and tolterodine

Vaginal symptoms after reconstructive surgery for prolapsed pelvic organ

Pelvic organ prolapse is a common disorder in women over the world and its general treatment is surgery. Therefore it is important to consider if vaginal symptoms, quality of life and sexual function after surgery improve. The purpose of this study was to assess vaginal symptoms in women 3 months after surgery for pelvic organ prolapse. In this study 50 eligible women were evaluated between March 2007 and May 2008. These women underwent physical examination for prolapse staging and medical status and completed the ICIQ-VS questionnaire pre- and post operation 3 months later]. Mean age was 44.86 [31-74] years and%72 were premenopausal. Vaginal symptoms, sexual function and quality of life scores improved in order [8.88 Vs 18.04, 17.16 Vs 34.48, 2.76 Vs 4.8, all P<0.05]. Vaginal symptoms, sexual function and quality of life after surgery improved. It appears that in Iranian patients, the performance of reconstruction surgery alone results in satisfaction

[Comparing sexual function in normal women and women having undergone vaginoplasty for rokitansky syndrome]

Aplasia of the uterus and upper two-thirds of the vagina due to Mayer-Rokitansky-Kuster-Hauser syndrome prevents normal coitus which may lead to anxiety and other psychiatric problems in these women. Vaginal reconstruction improves the patients' quality of life. This study intends to compare sexual function in normal women and women having undergone vaginoplasty for Mayer-Rokitansky-Kuster-Hauser syndrome. This descriptive and analytical study was carried out in the gynecologic clinic of Imam Khomeini Hospital in 2004 to 2008. Nineteen female patients with Mayer-Rokitansky-Kuster-Hauser syndrome and a history of vaginoplasty were compared to 30 women without any anatomical malformations in their genitalia. The female sexual function index [FSFI] was used to evaluate the problem in the two groups. The calculated scores of the two groups were compared and statistically analyzed. The mean age of the patients was 29.57 [SD = 6.11] years. The mean score for sexual desire in individuals with a history of vaginoplasty was 22.84 [SD = 2.5] compared to 24.63 [SD = 2.94] in the healthy women [p = 0.033] and the mean score for sexual arousal in women having undergone vaginoplasty was 13.89 [SD = 2.47] compared to 15.27 [SD = 3.41] in the healthy individuals. Sexual arousal, orgasm and pain were not different between the two groups. Sexual arousal and satisfaction were not different in women having undergone vaginoplasty and women with normal sexual function. It seems that the surgery offers a better quality of life and is acceptable to women with Mayer-Rokitansky-Kuster-Hauser syndrome