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Efficacy and safety of desmopressin on frequency and urgency in female patients with overactive bladder and nocturia, current clinical features and outcomes: A systematic review

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Asian Journal of Urology 2022年第1期9卷 27-34页

作者： Bara Barakat Knut Franke Matthias May Ulrich Gauger Thomas-Alexander Vogeli Hospital Viersen Department of Urology and Pediatric UrologyViersenGermany Hospital St.Elisabeth Department of UrologyStraubingGermany Institute for Medical Statistics BerlinGermany University Hospital RWTH Aachen Department of Urology and Pediatric UrologyAachenGermany

Objective To evaluate the efficacy and safety of desmopressin on frequency and urgency in female patients with overactive bladder(OAB)and nocturia.Methods A selective database search was conducted to validate the effectiveness of desmopressin in patients with OAB and nocturia.Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were utilised.The meta-analysis included 378 women(five studies)with OAB.The clinical outcomes and adverse events were analysed.Results The treatment strategy of all the studies included can be divided into three categories:(1)The effect of desmopressin compared with baseline,(2)desmopressin compared with placebo,and(3)desmopressin and anticholinergic combination versus desmopressin monotherapy.There was a significant(50%)reduction in nocturia and urgency episodes after using desmopressin alone.Combined desmopressin and anticholinergic led to a decrease in the frequency of nocturia voids when only using anticholinergic(65%vs.33.2%).The time increased in the middle to the first nightly voids in the combination arm(65.11 min;p=0.045).The mean incidence(standard deviation)of leak-free episodes was higher under desmopressin than under placebo in the first 4 h(62%[35%]vs.48%[40%])and in the first 8 h(55%[37%]vs.40%[41%]).The safety profile was comparable between treatments.Conclusion Available data indicate that desmopressin is efficacious in significantly reducing nighttime urine production,episodes of nocturia,and urgency episodes.The affectivity of the combination therapy was very high with least side effects for the treatment of OAB/nocturnal polyuria.

关键词： overactive bladder Nocturia Desmopressin Urinary urgency Lower urinary tract

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overactive bladder symptom score to evaluate efficacy of solifenacin for the treatment of overactive bladder symptoms

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Chinese Medical Journal 2014年第2期127卷 261-265页

作者： Liu Ming Wang Jianye Yang Yong An Ruihua Wen Jianguo Guan Zhichen Zheng Shaobin Wang Dongwen Song Bo Liao Limin Guo Hongqian Xiao Jiaquan Sun Yinghao Shen Zhoujun Kong Chuize He Dalin Huang Yiran Wang Xiaofeng Zhang Xu Li Hanzhong Huang Jian Zhao Xiaokun Zeng Puqing Song Xishuang Ye Zhangqun Department of Urology Beijing Hospital Beijing 100730 China Department of Urology Beijing Chao-Yang Hospital Beijing 100730 China Department of Urology The First Clinical College of Harbin Medical University Harbin Heilongiiang 150001 China Department of Urology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan 450003 China Department of Urology Peking University Shenzhen Hospital Shenzhen Guangdong 518036 China Department of Urology Nan Fang Hospital Guangzhou Guandong 440100 China Department of Urology The First Clinical College of Shanxi Medical University Taiyuan Shanxi 030012 China Department of Urology Southwest Hospital Chongqing 400038 China Department of Urology China Rehabilitation Center Beijing 100068 China Department of Urology Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School Nanjing Jiangsu 210008 China Department of Urology Zhejiang Provincial People's Hospital Hangzhou Zhejiang 310014 China Department of Urology Changhai Hospital of Shanghai Shanghai 200433 China Department of Urology Ruijin Hospital Affiliated to The Shanghai Jiaotong University Medical School Shanghai 200025 China Department of Urology The First Hospital of China Medical University Shenyang Liaoning 110001 China Department of Urology The First Affiliated Hospital of Medical College of Xi'an Jiaotong University Xi'an Shaanxi 710061 China Department of Urology Renji Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200127 China Department of Urology Peking University People's Hospital Beijing 100044 China Department of Urology The General Hospital of the People's Liberation Army Beijing 100039 China Department of Urology Peking Union Medical College Hospital Beijing 100005 China Department of Urology Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou Guangdong 510120 China Department of Urology The Second Xiangya Hospital of Central South University Changsha Hunan 4100

Background 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.Methods 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.Results 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.Conclusions 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.

关键词： overactive bladder muscarinic antagonists symptom score

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A comparative study of electroacupuncture at Zhongliao （BL33） and other acupoints for overactive bladder symptoms

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Frontiers of Medicine 2017年第1期11卷 129-136页

作者： Likun Yang Yang Wang Qian Mo Zhishun Liu Department of Acupuncture Guang'anmen Hospital China Academy of Chinese Medical Sciences Beijing 100053 China Graduate College of Tianjin University of Traditional Chinese Medicine Tianjin 300193 China School of Acupuncture-Moxibustion and Tuina Guiyang College of Traditional Chinese Medicine Guiyang 550025 China Department of Acupuncture the Second Affiliated Hospital of Guiyang College of Traditional Chinese Medicine Guiyang 550003 China

Electroacupuncture （EA） at Zhongliao （BL33） can improve the symptoms of overactive bladder （OAB）, such as urinary frequency, urgency, and incontinence. However, its performance compared with other acupoints remains unclear. This study investigated the effects of EA at BL33 with deep needling on rats with OAB by detecting urodynamics in eight groups： no intervention group, D-BL33 group （deep needling at BL33）, S-BL33 group （shallow needling at BL33）, non-acupoint group （needling at the non-acupoint next to BL33）, Weizhong （BL40） group, Sanyinjiao （SP6） group, Tongtian （BL7） group, and Hegu （LI4） group. Results revealed that EA at BL33 with deep needling, BL40, and SP6 prolonged the intercontraction interval （ICI） of rats with OAB （P= 0.001, P = 0.005, P = 0.046, respectively, post-treatment vs. post-modeling）. Furthermore, the change in ICI from post-modeling in the D-BL33 group was significantly greater than those of the no intervention and other EA groups （all P 〈 0.01）. Significantly shortened vesical micturition time （VMT） and elevated maximum detrusor pressure （MDP） were also observed in the D-BL33 group （P = 0.017 and P = 0.024, respectively, post-treatment vs. post-modeling）. However, no statistically significant differences in the changes of VMT and MDP from post- modeling were observed between D-BL33 and the other EA groups. In conclusion, EA at BL33 with deep needling may inhibit acetic-acid-induced OAB more effectively.

关键词： overactive bladder electroacupuncture acupuncture points

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Association of advanced glycation endproduct accumulation with overactive bladder in community-dwelling elderly: A cross-sectional Sukagawa study

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Asian Journal of Urology 2021年第2期8卷 189-196页

作者： Kenji Omae Noriaki Kurita Sei Takahashi Shingo Fukuma Yosuke Yamamoto Shunichi Fukuhara The Sukagawa Study Group Kyoto University School of Public Health in the Graduate School of MedicineDepartment of Healthcare EpidemiologyYoshida Konoe-choSakyo-kuKyotoJapan Fukushima Medical University Center for Innovative Research for Communities and Clinical Excellence1 HikarigaokaFukushima CityFukushimaJapan Fukushima Medical University Hospital Department of Innovative Research and Education for Clinicians and Trainees1 HikarigaokaFukushima CityFukushimaJapan Tokyo Women’s Medical University Department of Urology8-1 Kawada-choShinjuku-kuTokyoJapan Fukushima Medical University Graduate School of MedicineDepartment of Clinical Epidemiology1 HikarigaokaFukushima CityFukushimaJapan Kyoto University Graduate School of MedicineHuman Health SciencesYoshida Konoe-choSakyo-kuKyotoJapan 不详

Objective:This study aimed to evaluate the influence of advanced glycation end-product(AGE)accumulation on the prevalence and severity of overactive bladder(OAB)in community-dwelling elderly adults.Methods:We conducted a cross-sectional study involving 269 Japanese community dwellers aged≥75 years in 2015.AGE accumulation was non-invasively measured via skin autofluorescence(SAF)values using AGE Reader.The primary and secondary outcomes were the presence and severity of OAB evaluated using the overactive bladder Symptom Score(OABSS).Individuals with an urgency score of≥2 and sum score of≥3 were considered to have OAB.The associations of SAF with the prevalence and severity of OAB were assessed using logistic and linear regression models,respectively,adjusted for clinically important confounders.Results:The median age of participants was 78 years.Of 269 participants,110(40.9%)were men and 75(27.9%)had OAB.The median SAF was 2.2 arbitrary units(AUs).Increasing median SAF was observed with increasing age.Multivariable analysis revealed that SAF was not associated with either the likelihood of having OAB(odds ratio per AU=0.77,95%confidence interval:0.37-1.62)or the natural log-transformed OABSS(0 per AU=-0.07,95%confidence interval:-0.26-0.12).Conclusions:In this study,AGE accumulation,as assessed by SAF,was not associated with the prevalence and severity of OAB in Japanese community-dwelling elderly people aged≥75 years.

关键词： Advanced glycation end-products Elderly overactive bladder Skin autofluorescence Urinary incontinence

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Comparative assessment of efficacy and safety of different treatment for de novo overactive bladder children: A systematic review and network meta-analysis

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Asian Journal of Urology 2019年第4期6卷 330-338页

作者： Shi Qiu Siwei Bi Tianhai Lin Zhuheng Wu Qi’an Jiang Jiwen Geng Liangren Liu Yige Bao Xiang Tu Mingjing He Lu Yang Qiang Wei Department of Urology Institute of UrologyWest China Hospital of Sichuan UniversityChengduChina

Objective:To compare these managements focusing on the efficacy and safety to treat overactive bladder(OAB)in children through network meta-analysis(NMA).Methods:We searched PubMed,Embase,the Cochrane Library Central Register of Controlled Trials(CENTRAL)and the reference lists up to May 1st,2017.Data from eligible randomized controlled trails(RCT)studies including three different treatment options were extracted.The primary outcome was maximal voiding volume(MVV).We performed pairwise metaanalyses by random effects model and NMA by Bayesian model.We used the Grading of Recommendations,Assessment,Development and Evaluations(GRADE)framework to assess the quality of evidence contributing to each network estimate.Results:Six RCTs(462 patients)comparing three different interventions fulfilled the inclusion criteria.A low risk of bias was shown for the majority of the study items.The results of NMA showed that compared with antimuscarinic drugs,Parasacral transcutaneous electrical nerve stimulation was associated with significant improvement in the MVV(mean difference[MD]=58.50,95% confidential interval[CI]:45.95-69.52),followed by urotherapy group(MD=21.03,95%CI:11.85-29.97).When it comes to the constipation,antimuscarinic drugs exerted significant benefit than PTENS(odds ratio[OR]:0.22,95%CI:0.01-0.46).No significant difference was found between other treatments.Conclusion:Compared with antimuscarinic drugs,PTENS was associated with significant better efficacy considering MVV,but more constipation events in de novo OAB children.Antimuscarinic drugs showed remarkably better efficacy considering MVV and comparable safety profile compared with urotherapy.Clinicians should take all known safety and compliance of patients into account when choosing an optimal strategy.

关键词： overactive bladder Meta-analysis Anticholinergics Parasacral transcutaneous electrical nerve stimulation

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Non-invasive transcutaneous electrical stimulation in the treatment of overactive bladder

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Asian Journal of Urology 2015年第2期2卷 92-101页

作者： Martin Slovak Christopher R.Chapple Anthony T.Barker Department of Medical Physics&Clinical Engineering Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK Department of Urology Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK

We reviewed the literature on transcutaneous electrical nerve stimulation(TENS)used as a therapy for overactive bladder(OAB)symptoms,with a particular focus on:stimulation site,stimuli parameters,neural structures thought to be targeted,and the clinical and urodynamic outcomes achieved.The majority of studies used sacral or tibial nerve stimulation.The literature suggests that,whilst TENS therapy may have neuromodulation effects,patient are unlikely to benefit to a significant extent from a single application of TENS and indeed clear benefits from acute studies have not been reported.In long-term studies there were differences in the descriptions of stimulation intensity,strategy of the therapy,and positioning of the electrodes,as well as in the various symptoms and pathology of the patients.Additionally,most studies were uncontrolled and hence did not evaluate the placebo effect.Little is known about the underlying mechanism by which these therapies work and therefore exactly which structures need to be stimulated,and with what parameters.There is promising evidence for the efficacy of a transcutaneous stimulation approach,but adequate standardisation of stimulation criteria and outcome measures will be necessary to define the best way to administer this therapy and document its efficacy.

关键词： overactive bladder Posterior tibial nerve stimulation Sites of stimulation Sacral stimulation Sham stimulation methodology Surface electrodes Transcutaneous electrical nerve stimulation

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A nurse-led long-term pelvic floor muscle training program in the management of female patients with overactive bladder e A study protocol for a randomized controlled trial

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International Journal of Nursing Sciences 2015年第2期2卷 158-166页

作者： Tu-Zhen Xu Qiu-Hua Sun Xiao Huang Bo-Dong Lyu Urology Department Zhejiang Chinese Medical UniversitySecond Affiliated HospitalHangzhouZhejiang 310005China School of Nursing Zhejiang Chinese Medical UniversityHangzhouZhejiang 310053China Urology Department The First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouZhejiang 310009China

Background:Previous research has suggested that pelvic floor muscle training(PFMT)offers a therapeutic benefit in patients with overactive bladder.Methods:Weconducted a single-blind,randomized trial of pelvic floor muscle training(PFMT)as compared with usual care.The intervention group(n=54)received a 6-month a nurse-led long-term pelvic floor muscle training program(three sessions a day,15e20 times per session)and the control group(n?53)received usual care.All patients received 3-month solifenacin succinate tablets(5 mg e once daily).The treatment outcomes were measured by the Modified Oxford Scale(MOS),overactive bladder SymptomScore(OABSS)and the King's Health Questionnaire(KHQ)at baseline,3 months and 6 months respectively.Results:Of the 91 randomly assigned patients,46 patients in the PFMT group and 45 patients in the control group completed the trial.The trial revealed statistically significant differences between groups in pelvic muscle strength at 3 months following the intervention(p0.05).In regards to quality of life,the experimental group showed significant improvements compared to the control group on 6 of 10 domains(p<0.05).At 6 months,there were significant improvements in OABSS scores and quality of life in the experimental group compared to the control group(p<0.05).No adverse events were observed.Conclusion:A nurse-led long-term(6 months)pelvic floor muscle training program may alleviate OAB symptoms effectively and improve the quality of life more than a short term(3 months)pelvic floor muscle training program combined with solifenacin succinate tablets.

关键词： Nurse-led pelvic floor muscle training Symptoms Quality of life Female overactive bladder

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overactive bladder

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Family Medicine and Community Health 2013年第4期1卷 36-39页

作者： Elizabeth Ferry Firouz Daneshgari Urology Institute University Hospitals Case Medical Center and Department of UrologyCase Western Reserve University School of MedicineClevelandOHUSA

overactive bladder(OAB)is known to affect millions of people worldwide,with a subsequent deleterious impact on the quality of life.The clinical diagnosis of OAB requires,at a minimum,a meticulous history,physical examination,and urinalysis.The American Urological Association views OAB as a symptom complex,not a life-threatening disease,and recommends conservative measures and behavioral therapies as first-line treatment,including bladder training,bladder control strategies,pelvic floor muscle training,and fluid management.Current medical management approved by the US FDA include anti-muscarinics and beta3-agonists.Anti-muscarincs should be avoided in patients with narrow-angle glaucoma,and used with extreme caution in patients with impaired gastric emptying or a history of urinary retention.Surgical interventions may be offered,if second-line therapy using medications is not successful in obtaining adequate symptom control of OAB,and the patient is motivated and healthy.In uncomplicated patients,OAB may be clinically diagnosed and treated with conservative measures;however,the armamentarium for the diagnosis and treatment continues to expand for more complicated patients.

关键词： overactive bladder Definition Pathophysiology Diagnosis Treatment

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Prolonged impacts of COVID-19-associated cystitis:A study on longterm consequences

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World Journal of Clinical Cases 2023年第33期11卷 7987-7993页

作者： Sophie Wittenberg Jack Vercnocke Michael Chancellor Sorabh Dhar Aron Liaw Steven Lucas Nivedita Dhar Department of Urology Wayne State University School of MedicineDetroitMI 48201United States Department of Urology Beaumont HospitalRoyal OakMI 48067United States Infectious Disease Wayne State University School of MedicineDetroitMI 48201United States Infectious Disease John D.Dingell VA Medical CenterDetroitMI 48201United States Infectious Disease Detroit Medical CenterDetroitMI 48201United States Department of Urology John D.Dingell VA Medical CenterDetroitMI 48201United States Department of Urology Detroit Medical CenterDetroitMI 48201United States

BACKGROUND The Coronavirus Disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 virus is an international health concern with substantial morbidity and mortality.COVID-associated cystitis(CAC),presents as new onset or exacerbated urinary symptoms,resembling overactive bladder(OAB)symptoms.AIM To examines the long-term outcomes of patients with CAC in the context of Long COVID.METHODS A cohort of 350 patients admitted to Detroit Hospitals with COVID-19 between May and December 2020,displaying CAC symptoms following discharge,was prospectively followed.Initial urologic evaluations occurred at 10-14 wk and were repeated at 21-28 mo postdischarge.Symptoms were managed conservatively,employing behavioral modifications and standard OAB medications.Participants completed surveys assessing urinary symptoms and quality of life(QoL)at both time points.The primary outcome was the Urology Care Foundation overactive bladder Assessment Tool.RESULTS 87%of the final cohort(n=310)reported symptom improvement at 21-28 mo post-discharge.Patients with new onset CAC symptoms showed a median decrease of 9-10 points in OAB and QoL scores,while those with existing symptoms experienced a decrease of 6 points.Overall,95.4%of patients with new onset symptoms reported symptom improvement at follow-up,contrasting with 60.7%among those with existing symptoms.CONCLUSION This study presents the first long-term follow-up of adult patients with CAC,revealing a promising prognosis with conservative management measures in the context of Long COVID.These findings provide reassurance to patients regarding symptom resolution and underscore the need for further research into this evolving aspect of COVID-19's impact on urological health.

关键词： COVID associated cystitis COVID-19 Long COVID overactive bladder

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Clinical and preclinical treatment of urologic diseases with phosphodiesterase isoenzymes 5 inhibitors： an update

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Asian Journal of Andrology 2016年第5期18卷 723-731页

作者： Wen-Hao Zhang Xin-Hua Zhang Department of Urology Zhongnan Hospital of Wuhan University Wuhan City 430071 Hubei Province P.R. China.

Phosphodiesterase isoenzymes 5 inhibitors （PDE5-1s） are the first-line therapy for erectile dysfunction （ED）. The constant discoveries of nitric oxide （NO）/cyclic guanosine monophosphate （cGMP） cell-signaling pathway for smooth muscle （SM） control in other urogenital tracts （UGTs） make PDE5-1s promising pharmacologic agents against other benign urological diseases. This article reviews the literature and contains some previously unpublished data about characterizations and activities of PDE5 and its inhibitors in treating urological disorders. Scientific discoveries have improved our understanding of cell-signaling pathway in NO/cGMP-mediated SM relaxation in UGTs. Moreover, the clinical applications of PDE5-1s have been widely recognized. On-demand PDE5-1s are efficacious for most cases of ED, while daily-dosing and combination with testosterone are recommended for refractory cases. Soluble guanylate cyclase （sGC） stimulators also have promising role in the management of severe ED conditions. PDE5-1s are also the first rehabilitation strategy for postoperation or postradiotherapy ED for prostate cancer patients. PDE5-1s, especially combined with （z-adrenoceptor antagonists, are very effective for benign prostatic hyperplasia （BPH） except on maximum urinary flow rate （Qmax） with tadalafil recently proved for BPH with/without ED. Furthermore, PDE5-1s are currently under various phases of clinical or preclinical researches with promising potential for other urinary and genital illnesses, such as priapism, premature ejaculation, urinary tract calculi, overactive bladder, Peyronie＇s disease, and female sexual dysfunction. Inhibition of PDE5 is expected to be an effective strategy in treating benign urological diseases. However, further clinical studies and basic researches investigating mechanisms of PDE5-1s in disorders of UGTs are required.

关键词： benign prostatic hyperplasia erectile dysfunction overactive bladder phosphodiesterase isoenzymes 5 inhibitor priapism smooth muscle

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