Pelvic floor muscle training with and without biofeedback in treatment of overactive bladder

Background: Overactive bladder (OAB) is a commonly encountered problem in gynaecological practice. It has profound effect on quality of life (QOL), affecting simple daily activities as well. Prevalence rates of OAB in Asians are 53.1%. The first line management of OAB is behaviour modification and pelvic floor muscle training (PFMT). Objective of this study was to comparative assessment of biofeedback assisted PFMT (BAPFMT) versus PFMT alone in treatment of OAB using strength of pelvic floor muscle and QOL before and after treatment.Methods: A prospective comparative randomized controlled trial was conducted to compare the effect of PFMT versus BAPFMT on OAB symptoms over period of 12 weeks. Total of 100 patients fulfilling inclusion and exclusion criteria were selected. Randomization of patients was done into two groups of 50 patients each; half of them were subjected to PFMT and other half to BAPFMT. Appropriate statistical test were applied.Results: At the end of 12 weeks of intervention, there was a significant improvement in pelvic floor muscle strength and QOL in both groups (p<0.001). The improvement in pelvic floor muscle strength was more with BAPFMT; however there was no difference in improvement of QOL between the groups.Conclusions: Addition of biofeedback to PFMT may be a useful adjunct in OAB patients.

Seasonal Variation of Overactive Bladder Symptoms in Female Patients / 대한배뇨장애요실금학회지

PURPOSE: To evaluate seasonal variations of overactive bladder (OAB) symptoms in women who visited hospital clinics.METHODS: Medical records of female patients treated for OAB symptoms from January 2011 to December 2017 were retrospectively reviewed. Patients with pyuria at the first visit, those who did not complete the questionnaire, and those with <3 overactive bladder symptom scores (OABSS) were excluded. Uroflowmetric parameters, 3-day micturition diary, and OABSS were analyzed.RESULTS: A total of 582 patients with OAB symptoms who visited the hospital were enrolled in this study. Patients were grouped into 1 of the 3 season groups (cold, intermediate, and hot) depending on the average temperature of the month that the patient first visited the urologic department outpatient clinic. The total OABSS was significantly different between the 3 season groups (cold [7.25±3.20] vs. intermediate [6.24±3.40] vs. hot [5.51±3.20], P=0.001). The proportion of patients who had moderate OAB symptoms (6≤OABSS) was higher in the cold season group (56.2%) than in the other season groups (intermediate, 42.1%; hot, 31.8%; P=0.002). Differences in the number of micturitions (12.12±4.56 vs. 10.95±4.39, P=0.021) and number of urgent urinary incontinence episodes (2.06±0.94 vs. 2.48±0.87, P=0.001) between the cold and hot season groups were also significant. However, differences in the nocturia episode, total daytime voided volume, and mean voided volume between season groups were not significant.CONCLUSIONS: Different urinary symptoms and uroflowmetric parameters were correlated with seasonal variation. OAB symptoms might be worse in cold season than in other seasons.

A clinical research of Lingshao-Zaoren granule for the female with overactive bladder symptom: a randomized, double-blind, placebo-controlled trial / 国际中医中药杂志

Objective To evaluate the effectiveness of Lingshao-Zaoren granule in the treatment of female overactive bladder. Methods A total of 60 female OAB patients who met the inclusion criteria were randomly divided into 2 groups, 30 cases in each group. The control group recieved the Tolterodine Tartrate Sustained Release Tablets and the Lingshao-Zaoren granule placebo, and the treatment group used the Tolterodine Tartrate Sustained Release Tablets and the true Lingshao-Zaoren granule treatment. Both groups were treated for 4 weeks. Overactive bladder symptom scale (OABSS) was used to determine the severity of OAB.Results After treatment 14,28 d,OABSS scores of the treatment group(5.3 ± 2.3,1.4 ± 1.2 vs.8.4 ± 2.4,F=137.209),and control group(7.8 ± 1.9,6.8 ± 1.4 vs.8.6 ± 2.6,F=8.927),were significantly lower than the baseline of each group respectively (P<0.01). Besides, OABSS scores of the treatment group after 14 and 28 d were significantly lower than the control group (t=4.668, 15.678, P<0.01). The pain scores (5.9 ± 1.9, 2.7 ± 1.1 vs.9.5 ±2.3,F=108.819)of treatment group at 14 and 28 d were significantly lower than the baseline(P<0.01);and the pain scores of treatment group at 14 and 28 d were significantly lower than the control group (t=6.342, 14.812,P<0.01).The lower abdomen discomfort scores at 14,28 d in treatment group(1.9 ± 1.4,1.1 ± 1.0 vs. 3.3 ±1.1,F=28.762),and control group(2.7 ±1.0,2.4 ±0.8 vs.3.4 ±1.2,F=12.103)were significantly lower than the baseline of each group (P<0.01); and the abdominal discomfort scores of treatment group at 14, 28 d were significantly lower than the control group (t=2.521, 5.041, P<0.05 or P<0.01). Conclusions The Lingshao-Zaoren granule could decrease OABSS score,pain score,abdominal discomfort symptoms,improve clinical symptoms of the female patients with OAB.

The correlation of diabetic duration with bladder dysfunction among middle-aged or older patients with type 2 diabetes mellitus / 中华泌尿外科杂志

Objective To analyze the overactive bladder symptom score (OABSS) in evaluating bladder dysfunction in the different stages among type 2 diabetes mellitus patients,and to explore the value of bladder hyperactivity symptom score in screening early diabetic bladder dysfunction.Methods A total of 1 157 patients with type 2 diabetes mellitus,aged 40-88 yearswith mean age of 60.2 years,were enrolled from October 2013 to October 2016.The survey included the patients' characteristics,past history,current history,OABSS and quality of life (QOL) index scores.T test,single factor analysis of variance and multiple regression analysis are used to analyze the results.Results As many as 1 157 were qualified for final statistical analysis.OABSS is 1.94 ± 1.23 in group with diabetes duration ＜ 10 years,3.24 ± 1.45in group with diabetes duration 10-20 years,and 4.00 ± 1.72 in group with diabetes duration ＞ 20 years.The differences of OABSS in the different duration of diabetes was statistically significant.As diabetic duration increased,OABSS value increased (F =48.419,P ＜ 0.001).The difference of OABSS in the different HbA1c level,age and concurrent peripheral neuropathy was statistically significant.There was no significant difference of OABSS in the different BMI and distinct therapies.There was no significant difference of OABSS in diabetes with hypertension and without hypertension,with cardiopathy and without cardiopathy,with cerebrovascular disease (CVD) and without CVD,with hyperhpemia and without hyperlipemia.The significant factors were used to make multivariate analysis.The results showed that the duration of diabetes,HbA1 c level,age,peripheral neuropathy were still statistically significant.Standardized partial regression coefficient of diabetic duration was 0.366.OABSS was positively correlated with QOL score (r =0.434,P ＜ 0.001).Conclusions The related symptoms in OABSS with diabetic bladder dysfunction is correlated with the duration of diabetes,HbA1c level,age,concurrent peripheral neuropathy among type 2 diabetes.The duration of diabetes was the most significant factor.OABSS is likely to be one of the tools to assess the early symptoms of diabetic bladder dysfunction.

The correlation of diabetic duration with bladder dysfunction among middle-aged or older patients with type 2 diabetes mellitus / 中华泌尿外科杂志

Objective To analyze the overactive bladder symptom score (OABSS) in evaluating bladder dysfunction in the different stages among type 2 diabetes mellitus patients,and to explore the value of bladder hyperactivity symptom score in screening early diabetic bladder dysfunction.Methods A total of 1 157 patients with type 2 diabetes mellitus,aged 40-88 yearswith mean age of 60.2 years,were enrolled from October 2013 to October 2016.The survey included the patients' characteristics,past history,current history,OABSS and quality of life (QOL) index scores.T test,single factor analysis of variance and multiple regression analysis are used to analyze the results.Results As many as 1 157 were qualified for final statistical analysis.OABSS is 1.94 ± 1.23 in group with diabetes duration ＜ 10 years,3.24 ± 1.45in group with diabetes duration 10-20 years,and 4.00 ± 1.72 in group with diabetes duration ＞ 20 years.The differences of OABSS in the different duration of diabetes was statistically significant.As diabetic duration increased,OABSS value increased (F =48.419,P ＜ 0.001).The difference of OABSS in the different HbA1c level,age and concurrent peripheral neuropathy was statistically significant.There was no significant difference of OABSS in the different BMI and distinct therapies.There was no significant difference of OABSS in diabetes with hypertension and without hypertension,with cardiopathy and without cardiopathy,with cerebrovascular disease (CVD) and without CVD,with hyperhpemia and without hyperlipemia.The significant factors were used to make multivariate analysis.The results showed that the duration of diabetes,HbA1 c level,age,peripheral neuropathy were still statistically significant.Standardized partial regression coefficient of diabetic duration was 0.366.OABSS was positively correlated with QOL score (r =0.434,P ＜ 0.001).Conclusions The related symptoms in OABSS with diabetic bladder dysfunction is correlated with the duration of diabetes,HbA1c level,age,concurrent peripheral neuropathy among type 2 diabetes.The duration of diabetes was the most significant factor.OABSS is likely to be one of the tools to assess the early symptoms of diabetic bladder dysfunction.

Effect of Long-term Exercise on Voiding Functions in Obese Elderly Women / 대한배뇨장애요실금학회지

PURPOSE: An overactive bladder (OAB) may be defined as urgency that is a sudden, compelling, difficult to defer desire to pass urine that is usually accompanied by frequency and nocturia and possibly by incontinence. Obesity and old age are two factors in various causes of OAB. Several epidemiologic studies have identified positive associations among obesity, old age, urinary incontinence, and OAB. However, although exercise has been known to improve obesity and reduce incontinent urine loss, little research has been done in elderly women. Therefore, we investigated the effects of exercise on obesity-related metabolic factors, blood lipid factors, and OAB symptoms in elderly Korean women. METHODS: Twenty-one women aged between 69 and 72 years were recruited from the Seoul senior towers in Korea. All subjects worked out on a motorized treadmill and stationary cycle for 40 minutes, respectively, and performed resistance exercise for 30 minutes once a day for 52 weeks. Body composition, blood pressure, blood lipids, OAB symptom score, and King's health questionnaire were investigated and analyzed. RESULTS: Before performing physical exercise, all subjects showed increased OAB symptoms in association with enhanced body mass index (BMI), percentage fat, and blood lipid profiles. However, physical exercise for 52 weeks suppressed BMI, percentage fat, and blood lipid profiles and thus improved OAB symptoms. CONCLUSIONS: We suggest that long-term physical exercise can be a valuable tool for remarkable improvement of OAB.

Prevalence and risk factors of overactive bladder in middle-aged and senior people / 中华泌尿外科杂志

Objective To study the prevalence,risk factors of overactive bladder (OAB) in middle-aged and senior residents in Zhengzhou China.Methods A randomized,community-based,crosssectional study was performed on 10 160 residents aged 40 or older in urban area of Zhengzhou by using a stratified system sampling approach.A questionnaire including the subjects' basic information,previous history,present history,the Chinese overactive bladder symptom score (OABSS) was filled on site.The diagnostic criteria for OAB was 'an urgency score for Question 3 of 2 or more,and an OABSS of 3 or more'.Chisquare test was used to determine the differences of prevalence between genders,age groups,BMI and people with and without diabetes mellitus (DM).A pairwise comparison was conducted between different age,BMI group by using Bonferroni method.Results A total of 10 160 residents were investigated and finally 9805 (96.5％) were qualified for final statistical analysis.The mean age was (57.9 ± 9.7) years.The overall prevalence of OAB was 2.1％ (209/9805),of which,with OABdry 1.0％,and OABwet 1.1％.Male subjects were more likely suffered from OAB than female,with 2.7％ (84/3129) versus 1.9％ (125/6676).The prevalence of OAB in both male and female increased with age.There was no significant difference in the prevalence of male and female before the age of 60 years (1.2％ versus 1.4％,P ＞ 0.05) and more common in men than in women after the age of 60 years (4.6％ versus 2.6％,P ＜ 0.05).The prevalence of the subjects with DM was significantly higher than those without DM (P ＜ 0.05).The subjects with BMIs of 30 or more were nore likely to have OAB (3.2％ versus 1.8％,P ＜ 0.05).Conclusions The prevalence of OAB increases with advancing age.The prevalence of male is higher than female after the age of 60 years.The diabetics and obese people are more likely to have OAB.

Test-retest reliability of the Overactive Bladder Symptom Score and its correlation with other overactive bladder symptom evaluation tools among Chinese overactive bladder symptom patients / 中华泌尿外科杂志

Objective To assess the test-retest reliability of the Chinese version of Overactive Bladder Symptom Score (OABSS) and its correlation with other overactive bladder symptom (OAB)evaluation tools among Chinese OAB patients. Methods Fifty OAB patients completed the OABSS,PPBC, IPSS forms and a three-day voiding diary card for twice in day 0 and day 14±2, respectively.Test-retest reliability was examined using internal correlation coefficient (ICC) and weighted Kappa coefficients between first and second application of OABSS. The internal reliability was evaluated using Cronbach's α coefficient method. Pearson or/and Spearman correlation coefficients were calculated for testing the correlation between OABSS and IPSS, IPSS QOL, PPBC as well as clinical variables in the three-day voiding diary cards. Results ICC of OABSS total score was 0.9172, weighted Kap-pa coefficients of individual scores in OABSS were 0.5902-0.9274;Cronbach's α coefficients were 0. 3069 and 0. 3285, respectively. In the first and second application of OABSS, the Pearson correlation coefficients were 0. 2643-0. 6900 between OABSS and clinical variables in the three-day voiding diary card (except for average daily frequency of urination);the Pearson correlation coefficients were 0. 4734 and 0. 4929, and the Spearman correlation coefficients were 0. 4133 and 0. 4149 between OABSS and IPSS total score;the Spearman correlation coefficients were 0.4083 and 0.4127 between OABSS and PPBC. Conclusions The Chinese version of OABSS manifest test-retest reliability among Chinese OAB patients. It has also a high correlation with IPSS total score, PPBC and clinical variables in the three-day voiding diary cards.