Comparison of the efficacy and safety of onabotulinum toxin A and mirabegron for overactive bladder in elderly patients.

OBJECTIVE: This study aimed to investigate the efficacy and tolerability of mirabegron and onabotulinum toxin A (BoNT/A) injections for overactive bladders. The treatment we provided was to patients over the age of 65 years who were not satisfied with the results of anticholinergic monotherapy. PATIENTS AND METHODS: This multicenter retrospective observational study was conducted between March 2017 and December 2021. Thirty patients who were unable to take anticholinergics or mirabegron due to side effects received a total of 100-unit intravesical injections of BoNT/A. Furthermore, 30 patients receiving 50 mg of mirabegron daily were compared. Micturition frequency, urgency of urinary incontinence, pad usage, and nocturia were all evaluated for efficacy. Patients' health-related quality of life and subjective satisfaction ratings were assessed before and six months after treatment using an incontinence-quality-of-life questionnaire. We documented all adverse events for all subjects. RESULTS: There was a statistically significant decrease in the frequency, daily pad usage, and incontinence episodes of both groups. The median (interquartile range) voiding frequency after onabotulinum toxin A treatment was lower than that after mirabegron treatment [9.4 (6.83-10.0) vs. 10.5 (8.37-11.67); p = 0.01]. Incontinence episodes showed similar differences [1.3 (1.17-3.67) vs. 2.53 (2.0-5.67); p = 0.05]. There was no significant difference in nocturia or maximum urine flow rate between the groups before and after treatment. CONCLUSIONS: We determined that mirabegron led to lower urinary retention, hematuria, infection and post-void residual urine volume rates than BoNT/A in the older patient population. In addition, mirabegron treatment had comparable incontinence-quality-of-life scores at six months post-treatment.

Effect of premature ejaculation on depression and sexual functions in female partners: A report from Eastern Turkey.

BACKGROUND: Premature ejaculation (PE) is a sexual dysfunction causing female sexual dissatisfaction that eventually leads to poor quality of life in both partners. AIMS: To show the presence of depression, anxiety, sexual function disorders and their prevalence in spouses of males with PE living in Eastern Turkey. MATERIALS AND METHODS: Ninety male patients suffering from PE who referred to the andrology clinic between January 2016 and March 2017 and diagnosed with PE (Acquired Premature ejaculation) according to the DSM-IV criteria and their partners were included in the study. Male patients answered the PE Profile, Arabic Index of PE, PE Diagnostic Tool, and Arizona Sexual Experiences Scale (ASEX) Questionnaires. Spouses of male patients with PE answered the Arizona Sexual Experiences Scale, Beck Depression Inventory, and Beck Anxiety Inventory Questionnaires. SPSS software version 21.0 was used for statistical analysis. RESULTS: Our study revealed a positive correlation between the PE profile and partners' depression levels (P = 0.03). Also, the average ASEX Scale score of the both genders suggest that patients and partners believe they did not have a severe sexual function disorder. CONCLUSIONS: PE can cause psychological problems in both males and females. However, reflection of this pathology can vary from one society to another.

Renal Apparent Diffusion Coefficient Values in Patients with Obstructive Uropathy and High Values of Creatinine.

Purpose: Diffusion weighted magnetic resonance imaging (DW-MRI) of the kidneys provides noninvasive information on renal function in healthy volunteers, and it is feasible in severely ill patients. It may provide information on the degree of kidney dysfunction. The purpose of this study is to evaluate apparent diffusion coefficient (ADC) values using DW-MRI in patients with obstructive uropathy and elevated serum creatinine levels. Methods: Fifty patients with high serum creatinine levels and diagnoses of chronic urinary obstruction detected by ultrasonography were included in this study. DW-MRIs were obtained from 50 patients with hydronephrotic kidneys and 26 healthy volunteers using a 1.5T whole-body MR scanner. Results: ADC measurements of renal parenchyma in hydronephrotic kidneys were significantly lower compared to normal kidneys (p < 001). Conclusion: The measurement of ADC values has potential value in the evaluation of the functional status of hydronephrotic kidneys.