Efficacy of Solifenacin in Children with Idiopathic Overactive Bladder / 中山大学学报(医学科学版)

ObjectiveTo explore the efficacy of Solifenacin in the treatment of children with idiopathic overactive bladder （OAB）. MethodsThe study included 67 children with idiopathic OAB treated in the urology clinic of our hospital from March 2022 to March 2023. After at least 2-week-long behavioral therapy showed no significant therapeutic effect， 52 of the cases in the trial group were given oral Solifenacin 5 mg once daily and the other 15 cases in the control group continued the behavioral therapy. The cases in trial group were subdivided into OAB-dry group （27 cases without urinary incontinence） and OAB-wet group （25 cases with urinary incontinence）. The 3-day micturition diary， OAB Symptom Scores （OABSS） and the adverse reactions were recorded and analyzed before， at Weeks 2， 4， 8 and 12 after the treatment. ResultsOf all the 67 cases who completed a 3-month follow-up， 44 were cured including 41 in the trial group and 3 in the control group， 4 presented with adverse reactions. After the 3-month follow-up， the OABSS declined markedly in trial group than in control group （Z=4.524， P<0.001）； the cure rates in trial group and control group are 78.8% and 20% respectively， with significant difference （χ2=15.367， P<0.001）. At each follow-up，we found increased mean voided volume （F=9.707， P<0.001）， reduced mean voiding frequency during daytime （F=3.837， P=0.009） and decreased voiding urgency （χ2=482.835， P<0.001）. After the 3-month follow-up， the cure rates in OAB-dry group and OAB-wet group are 81.5% and 76% respectively， with no significant difference （χ2=0.234， P=0.629）. ConclusionsIn children with idiopathic OAB， oral Solifenacin 5 mg once daily could significantly increase mean voided volume， reduce mean voiding frequency during daytime， relieve symptoms of urinary urgency and lead to fewer adverse reactions， but is not significantly effective for the treatment of urinary incontinence in OAB-wet children .

Effect of Solifenacin and Epalrestat combination therapy on type 2 diabetes complicated with overactive bladder / 中国糖尿病杂志

Objective To investigate the effect of solifenacin and epalrestat combination therapy on type 2 diabetes complicated with overactive bladder (OAB).Methods A total of 80 patients with T2DM and OAB were randomly divided into three groups:control group (Con group,n=24),epalrestat group (n=29),and solifenacin combines epalrestat group (n=27).Con group was treated with conventional therapy such as routine bladder training,anti-hyperglycemic,anti-hypertensive,lipid lowering treatment,and nerve nutrition.Epalrestat group was treated with epalrestat 50 mg,3/d orally on the basis of conventional treatment.Solifenacin group was treated with solifenacin 5 mg,1/d,and epalrestat 50 mg,3/d orally.All the subjects were followed up for 12 weeks.Voiding diary,OAB self rating scale (OABSS) score,maximum urinary flow rate (Qmax),average urinary flow rate (Qave),and urine volume(VV) were recorded.Results The daily micturition frequency in 24h,times of nocturia,urgency,frequency,and urinary incontinence,and OABSS scores were lower,while Qmax,Qave,and VV were higher in solifenacin group than in Con group and epalrestat group (P<0.05).The OABSS scores were lower while VV was higher in epalrestat group than in Con group (P<0.05).The total effective rate was higher in solifenacin group than in Con group and epalrestat group (92.6% vs 69% vs 41.7%,P<0.05).Conclusion Solifenacin and epalrestat combination therapy was effective in treating patients with T2DM and OAB.

A retrospective analysis of sacral neuromodulation for female overactive bladder and interstitial cystitis/painful blader syndrome / 中华泌尿外科杂志

Objective To evaluate the effects of sacral neuromodulation (SNM) on female overactive bladder (OAB) and interstitial cystitis/ painful bladder syndrome (IC/PBS).Methods From May 2016 to April 2017,13 patients with OAB or IC/PBS who had been treated with SNM were assessed retrospectively.Among them,6 cases were OAB patients,and 7 cases were IC/PBS patients.The average age was 52.3 (42-67)years old,and the preoperative and postoperative 24 h urine frequency,night urination frequency and average voided volume were compared.Results Totally 13 patients underwent stage Ⅰprocedure.The operation time for stage Ⅰ was 52-125min(average 92 min).After an average follow-up of 3.6 weeks,stage 11 procedures were performed on responders.Four OAB patients accepted stage Ⅱ1 surgery (conversion rate:66.7％),and the 24h frequency and night urination frequency reduced from preoperative 22.5 and 5.2 times to postoperative 14.3 and 2.3 times (P ＜ 0.05) respectively,and average voided volume increased from 120.3ml to 166.4ml (P ＜ 0.05).Among 4 patients presenting IC/PBS who had underwent stage Ⅱ surgery (conversion rate:57.1％),VAS score and 24 h voiding frequency reduced from 7.3 and 21.6 to 3.8 and 16.8 (P ＜ 0.05),respectively.No adverse event,such as wound infection or electrode translocation was detected during an average follow-up of 8.3 months.Conclusions Stage Ⅰ procedure is crucial for the long term efficacy of SNM.Postsurgical wound management and parameter adjustment are equal essential in order to achieve a maximum benefits.SNM has advantages in minimal invasiveness and less bleeding,which provides a minimal invasive approach for the managemem of OAB and IC/PBS.

A retrospective analysis of sacral neuromodulation for female overactive bladder and interstitial cystitis/painful blader syndrome / 中华泌尿外科杂志

Objective To evaluate the effects of sacral neuromodulation (SNM) on female overactive bladder (OAB) and interstitial cystitis/ painful bladder syndrome (IC/PBS).Methods From May 2016 to April 2017,13 patients with OAB or IC/PBS who had been treated with SNM were assessed retrospectively.Among them,6 cases were OAB patients,and 7 cases were IC/PBS patients.The average age was 52.3 (42-67)years old,and the preoperative and postoperative 24 h urine frequency,night urination frequency and average voided volume were compared.Results Totally 13 patients underwent stage Ⅰprocedure.The operation time for stage Ⅰ was 52-125min(average 92 min).After an average follow-up of 3.6 weeks,stage 11 procedures were performed on responders.Four OAB patients accepted stage Ⅱ1 surgery (conversion rate:66.7％),and the 24h frequency and night urination frequency reduced from preoperative 22.5 and 5.2 times to postoperative 14.3 and 2.3 times (P ＜ 0.05) respectively,and average voided volume increased from 120.3ml to 166.4ml (P ＜ 0.05).Among 4 patients presenting IC/PBS who had underwent stage Ⅱ surgery (conversion rate:57.1％),VAS score and 24 h voiding frequency reduced from 7.3 and 21.6 to 3.8 and 16.8 (P ＜ 0.05),respectively.No adverse event,such as wound infection or electrode translocation was detected during an average follow-up of 8.3 months.Conclusions Stage Ⅰ procedure is crucial for the long term efficacy of SNM.Postsurgical wound management and parameter adjustment are equal essential in order to achieve a maximum benefits.SNM has advantages in minimal invasiveness and less bleeding,which provides a minimal invasive approach for the managemem of OAB and IC/PBS.

Fecal Retention in Overactive Bladder (OAB) in Children: Perspective of a Pediatric Gastroenterologist

Coexisting voiding and bowel dysfunction in children are common in the clinic. The idea that overactive bladder (OAB) and constipation arise from one single pathophysiology has been reinforced in many studies. In Korea, a nationwide multicenter study conducted in 2009 showed that overall prevalence of OAB in children, 5-13 years of age, was 16.59% and this number has increased more recently. The initial step to manage coexisting fecal retention and OAB in children is to characterize their bowel and bladder habits and to treat constipation if present. Although diagnosing constipation in children is difficult, careful history-taking using the Bristol Stool Form Scale, and a scoring system of plain abdominal radiography, can help to estimate fecal retention more easily and promptly. Non-pharmacological approaches to manage functional constipation include increasing fluids, fiber intake, and physical activity. Several osmotic laxatives are also effective in improving OAB symptoms and fecal retention. Additionally, correction and education in relation to toilet training is the most important measure in treating OAB with fecal retention.

Fecal Retention in Overactive Bladder (OAB) in Children: Perspective of a Pediatric Gastroenterologist

Coexisting voiding and bowel dysfunction in children are common in the clinic. The idea that overactive bladder (OAB) and constipation arise from one single pathophysiology has been reinforced in many studies. In Korea, a nationwide multicenter study conducted in 2009 showed that overall prevalence of OAB in children, 5-13 years of age, was 16.59% and this number has increased more recently. The initial step to manage coexisting fecal retention and OAB in children is to characterize their bowel and bladder habits and to treat constipation if present. Although diagnosing constipation in children is difficult, careful history-taking using the Bristol Stool Form Scale, and a scoring system of plain abdominal radiography, can help to estimate fecal retention more easily and promptly. Non-pharmacological approaches to manage functional constipation include increasing fluids, fiber intake, and physical activity. Several osmotic laxatives are also effective in improving OAB symptoms and fecal retention. Additionally, correction and education in relation to toilet training is the most important measure in treating OAB with fecal retention.