المؤلفون: Chen, Hao Xiang, Chang, Shih‐Hsin, Chen, Der‐Yuan, Lan, Joung‐Liang, Yeo, Kai‐Jieh, Huang, Po‐Hao, Huang, Chung‐Ming, Huang, Chi‐Ping, Chou, Eric Chieh‐Lung, Wu, Po‐Chang

المصدر: LUTS; Jul2023, Vol. 15 Issue 4, p139-147, 9p

مصطلحات موضوعية: OVERACTIVE bladder, SJOGREN'S syndrome, RANDOMIZED controlled trials, ADVERSE health care events, MUSCARINIC antagonists, XEROSTOMIA

مستخلص: Objectives: This study investigates the efficacy and adverse events of beta‐3 agonists and antimuscarinic agents for managing overactive bladder syndrome in Sjogren syndrome. Methods: Sjogren's syndrome patients with an Overactive Bladder Symptom Score (OABSS) >5 were enrolled and were randomly assigned to mirabegron 50 mg/day or solifenacin 5 mg/day. Patients were evaluated on the recruitment day and reassessed at Week 1, 2, 4, and 12. The study's primary endpoint was to have a significant change in OABSS at Week 12. The secondary endpoint was the adverse event and crossover rate. Results: A total of 41 patients were included in the final analysis, with 24 in the mirabegron group and 17 in the solifenacin group. The study's primary outcome was a change of the OABSS at Week 12. We found that both mirabegron and solifenacin significantly reduce patients' OABSS after 12 weeks of treatment. The evolution of the OABSS was −3.08 for mirabegron and −3.71 for solifenacin (p =.56). Six out of 17 patients from the solifenacin group crossed over to the mirabegron arm due to severe dry mouth or constipation, while none from the mirabegron arm crossed over to the solifenacin group. Sjogren's syndrome‐related pain was also improved in the mirabegron group (4.96–1.67, p =.008) compared to the solifenacin group (4.39–3.4, p =.49). Conclusions: Our study showed that mirabegron is equally effective as solifenacin in treating Sjogren's syndrome patients with overactive bladder. Mirabegron is superior to solifenacin in terms of treatment‐related adverse events. [ABSTRACT FROM AUTHOR]

: Copyright of LUTS is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: LIN, Chian‐Shiung¹, WU, Tony T.‐L.^2,3, CHANG, Chin‐Hong^4,5, CHENG, Juei‐Tang^5,6 jtcheng5503@yahoo.com.tw, TONG, Yat‐Ching⁷ yctong@mail.ncku.edu.tw

المصدر: LUTS. Sep2018, Vol. 10 Issue 3, p315-319. 5p.

مصطلحات موضوعية: *MUSCARINIC receptors, *LABORATORY rats, *HIGH-fat diet, *BLADDER physiology, *CONTRACTILE proteins

مستخلص: Objectives: To investigate the effect of high‐fat diet (HFD) on bladder M1,3 muscarinic receptor expression and contractile function in the rat. Methods: Eight‐week‐old male rats were divided into two groups including one with HFD for 8 weeks (short‐term) and the other for 24 weeks (long‐term). Each group was compared to age‐matched rats fed with normal chow as controls. The body weight, food intake amount and blood biochemistry were monitored. Bladder muscle contractile responses to acetylcholine (0.1–10 μM), bethanechol (10 μM) and KCl (50 mM) were studied in an organ bath set‐up. Bladder M1 and M3 muscarinic receptor protein expressions were measured by Western blotting analysis. Results: Increase in body weight as well as blood triglyceride, cholesterol and sugar levels compared to controls were noted in both 8‐ and 24‐week HFD rats. Eating appetite change with increased food and water intakes was noted in the HFD rats. Significantly decreased bladder contractile responses to acetylcholine and bethanechol were shown in both HFD groups. On the other hand, decreased bladder contractile response to KCl was demonstrated in the 24‐week group but not the 8‐week group. The expressions of bladder M1 and M3 muscarinic receptor proteins were significantly and progressively decreased by HFD feeding from 8 to 24 weeks. Conclusions: High‐fat diet induces obesity and polyphagia in rats. Short‐term and long‐term HFD feeding decrease rat bladder M1 and M3 receptor expressions as well as contractile responses to the agonistic stimulation. In addition, bladder muscle dysfunction develops after long‐term HFD feeding. [ABSTRACT FROM AUTHOR]

المؤلفون: KOBAYASHI, Minoru¹ minorukoba@hotmail.com, NUKUI, Akinori², KAMAI, Takao³

المصدر: LUTS. May2018, Vol. 10 Issue 2, p158-166. 9p.

مصطلحات موضوعية: *MUSCARINIC antagonists, *OVERACTIVE bladder, *ADRENERGIC receptors, *SALVAGE therapy, *QUALITY of life, *PATIENTS, *THERAPEUTICS

مستخلص: Objectives: The objective of the present study was to evaluate comparative efficacy and tolerability of antimuscarinics and mirabegron as primary and salvage therapy in patients with overactive bladder (OAB). Methods: Patients ≥50 years with OAB symptoms were enrolled. Patients were initially treated with antimuscrinics or mirabegron for 8 weeks. When patients were refractory or intolerant to an initial treatment, drugs were switched to the other. The initial and second‐line efficacy was assessed at baseline, 4 and 8 weeks after the treatment having the following parameters of the International Prostatic Symptom Score (IPSS), quality of life (QOL) index, Overactive Bladder Symptom Score (OABSS) and post‐void residual (PVR) urine volume. Dry mouth and constipation were evaluated using dry mouth scale and constipation assessment scale, respectively. Results: A total of 117 patients were enrolled. As an initial treatment, 60 patients were given antimuscarinics and 57 patients received mirabegron. Similar initial treatment efficacy was observed between the two drugs in the whole patients. However, mirabegron was more efficacious to men with OAB unresponsive to prior α1‐blocker. Dry mouth and constipation were less burdensome in patients treated with mirabegron. Such differences in efficacy and tolerability were associated with significantly greater persistence of mirabegron. As a second‐line setting, both drugs appear to be equally effective at least to relieve urgency symptoms remaining after an initial therapy. Conclusion: The present study suggests that mirabegron seems to have priority as an initial therapy with a distinct efficacy/tolerability balance. Mirabegron also represents a reasonable alternative to antimuscarinics for patients who had insufficient efficacy and poor tolerability. [ABSTRACT FROM AUTHOR]

المؤلفون: HSIAO, Sheng‐Mou¹, LIN, Ho‐Hsiung², KUO, Hann‐Chorng³ hck@tzuchi.com.tw

المصدر: LUTS. Jan2018, Vol. 10 Issue 1, p21-26. 6p.

مصطلحات موضوعية: *MUSCARINIC antagonists, *PARASYMPATHOLYTIC agents, *NICOTINIC antagonists, *OVERACTIVE bladder, *BLADDER diseases

مستخلص: Objectives: Details on the therapeutic effects of long‐term antimuscarinic therapy have not been reported. Thus, the aim of this study is to evaluate the detailed long‐term therapeutic effect of antimuscarinic therapy. Methods: All consecutive patients who visited the urologic outpatient clinics of a medical center for treatment of overactive bladder syndrome and received antimuscarinic therapy of 12 months or more were retrospectively reviewed. All medical records, including the Overactive Bladder Symptom score (OABSS), the modified Indevus Urgency Severity Scale and the International Prostate Symptoms score (IPSS) questionnaires, and uroflowmetry parameters were reviewed at each visit. Results: A total of 140 patients had received 12 months or more of antimuscarinic therapy. Sustained therapeutic effects were observed by persistent decreases of IPSS‐storage score, IPSS‐total score and OABSS score. Moreover, the maximum flow rate did not change over time. A temporary increase in postvoid residual volume and decrease in voiding efficiency were found, but these parameters improved over long‐term visits. Side‐effects were observed in 81 patients (57.9%) and included dry mouth (n = 58, 41.4%), constipation (n = 48, 34.3%) and blurred vision (n = 4, 2.9%); all side‐effects were tolerable. Patients aged 75 years or more (n = 94) had a higher comorbidity rate (n = 46, 48.9%) before treatment but generally exhibited similar therapeutic effects as overall patients; elderly patients could also tolerate side‐effects. Conclusion: Sustained therapeutic effects were observed in patients who received 12 months or more of antimuscarinic therapy, even in elderly patients. In addition, side‐effects in patients receiving long‐term therapy were also common but tolerable. [ABSTRACT FROM AUTHOR]

المؤلفون: KIM, Aram¹, LEE, Kyu‐Sung², JUNG, Rangrhee³, NA, Selee⁴, KIM, Joon‐chul⁵, KIM, Hyeong Gon⁶, CHOO, Myung‐Soo¹ mschoo@amc.seoul.kr

المصدر: LUTS. Sep2017, Vol. 9 Issue 3, p171-175. 5p.

مصطلحات موضوعية: *OVERACTIVE bladder, *MUSCARINIC antagonists, *DRUG side effects, *HEALTH status indicators, *PATIENT satisfaction, *THERAPEUTICS

مستخلص: Objectives Drug therapy is the mainstay of treatment for overactive bladder ( OAB), but antimuscarinic agents possess side-effects. These side-effects decrease the patients' quality of life. We therefore assessed the impact of side-effects on health-related quality of life ( HR-QoL) through an analysis of EQ-5D questionnaire. Methods This study was designed to investigate the patients' satisfaction by quality weight of health status as affected by the side-effects of OAB medications. Patients who had OAB symptoms lasting longer than 3 months and have experienced side-effects after any antimuscarinic treatments filled in the EQ-5D questionnaire. The enrolled patients had two EQ-5D questionnaires for two different health statuses, i.e., presence or absence of side-effects. Quality weight was calculated using the ED-5D health status score with Korean tariff. Results One hundred patients were enrolled and completed the HR-QoL questionnaire. The most prevalent side-effect was dry mouth (61%) and 28% patients had dry mouth and constipation concurrently. Most of the patients with side-effects tried to endure and overcome these side-effects (79%), but 10% desired a change in medication, and 6% stopped medication altogether. The quality weight of EQ-5D without side-effects was 0.863, while the quality weight with side-effects was 0.666 ( P < 0.001). The VAS score was 79 in patient without side-effects and 57 in those with side-effects, supporting the results of quality weight assessment. Conclusions Overactive bladder patients may enjoy a better quality of life if side-effects associated with antimuscarinic therapy are fewer. [ABSTRACT FROM AUTHOR]

المؤلفون: Okada, Hiroshi, Tokumoto, Tadahiko, Osaka, Akiyoshi, Tanaka, Takashi, Iwahata, Toshiyuki, Kobori, Yoshitomo, Saito, Kazutaka, Sato, Yoko, Ban, Shinichi, Sugimoto, Kouhei

المصدر: LUTS; Oct2021, Vol. 13 Issue 4, p435-439, 5p

مصطلحات موضوعية: MALE reproductive organs, OVERACTIVE bladder, SPERMATOGENESIS, SPINAL cord injuries, XEROSTOMIA, INTERMITTENT urinary catheterization, MUSCARINIC antagonists

مستخلص: Objectives: To evaluate whether the long‐term usage of mirabegron, which was reported to have potential side effects on male reproductive organs in animal studies, was harmful to spermatogenesis in human testis. Methods: Thirty consecutive patients with spinal cord injury (20‐48 years old) who performed clean intermittent catheterization were involved in this study. Ten patients were treated with mirabegron (50 mg/d) for more than 2 years and refrained from using an antimuscarinic agent due to the side effects of constipation and dry mouth. Twenty patients were treated with neither anticholinergic agents nor mirabegron. All underwent conventional testicular sperm extraction. The sperm recovery rate and histopathologic findings of the retrieved testicular tissue were compared between both groups. Results: We found no difference in the sperm recovery rate (P =.083) between both groups. Spinal cord injury patients treated with mirabegron had better spermatogenesis than those not treated with mirabegron (P <.05). Conclusions: From these data, we conclude that the therapeutic dose of mirabegron had no harmful effect on spermatogenesis in spinal cord injury patients of reproductive age. [ABSTRACT FROM AUTHOR]

: Copyright of LUTS is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Hsu, Lin‐Nei, Tsai, Yuh‐Shyan, Tsai, Hsin‐Tzu, Su, Wen‐Pin, Tong, Yat‐Ching

المصدر: LUTS; Jul2021, Vol. 13 Issue 3, p390-399, 10p

مصطلحات موضوعية: URODYNAMICS, URINARY organs, PROSTATE cancer, TRP channels, SYMPTOMS, MUSCARINIC acetylcholine receptors, NEURAL receptors

مستخلص: Objectives: To investigate the pathophysiological mechanism leading to lower urinary tract symptoms in prostate cancer (PCa) by using an animal model. Methods: An orthotopic PCa model in mice was established by injection of human DU145 cells into the prostate gland lateral lobe of NOD.CB17‐Prkdcscid/NcrCrlBltw (NOD‐SCID) mice. Cancer growth was quantified by a luciferase‐based in vivo imaging system (IVIS) serially every 7 days. Comparisons were made for urodynamic parameters, bladder histology, and biological markers until the sixth week. Bladder wall structural changes were assessed by the bladder wall thickness and degree of fibrosis. Biomarker expressions in bladder tissue including muscarinic acetylcholine receptor 2 (M2), transient receptor potential cation channel subfamily V member 4 (TRPV4), BCL2‐associated X protein (Bax), and caspase3 were evaluated by immunohistochemical staining and immunofluorescence confocal laser scanning microscopy. Results: DU145 cell growth in the prostate was successfully monitored by a luciferase‐based IVIS. after orthotopic injection. Using our injection technique, no anatomical obstruction of the bladder outlet and urethra was noted up to 6 weeks after injection. The presence of PCa induced changes in urinary bladder histology, biomarkers, and urodynamic parameters. Cystometry showed features of detrusor overactivity with increased voiding frequency and high‐amplitude voiding contractions from the fourth week onward. Histological analyses 4 weeks after DU145 injection demonstrated detrusor thickening and bladder wall fibrosis. Immunohistochemistry showed increased expressions of bladder M2, TRPV4, Bax, and caspase3 in the PCa mice as early as in the first or second week. Conclusions: PCa can induce bladder microenvironment changes involving neural receptors and biological mediators leading to histological and functional alterations even in the absence of overt anatomical obstruction. [ABSTRACT FROM AUTHOR]

: Copyright of LUTS is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Sugaya, Kimio, Yamagami, Hidetomi, Nishijima, Saori, Kadekawa, Katsumi, Hizue, Masanori, Ito, Yoshihiko, Yamada, Shizuo

المصدر: LUTS; May2020, Vol. 12 Issue 2, p173-179, 7p

مصطلحات موضوعية: TREATMENT effectiveness, IN vivo studies, RATS, MUSCARINIC receptors, MUSCARINIC antagonists

مستخلص: Objectives: To examine the effect of combining a nonselective muscarinic receptor antagonist, 5‐hydroxymethyl tolterodine (an active metabolite of fesoterodine), with a β3 adrenoceptor agonist, mirabegron, in a rat model of pelvic congestion. Methods: The rat pelvic congestion model used female Sprague‐Dawley rats with their bilateral common iliac and uterine veins ligated. Expressions of M2 and M3 receptor subtypes in the urothelium and detrusor were detected by real‐time polymerase chain reaction assays. The effects of both drugs were investigated on isolated bladder strips contracted by electrical field stimulation. in vivo single cystometry was used to assess the effects of 5‐hydroxymethyl tolterodine and mirabegron independently or in combination on bladder capacity, micturition pressure, and threshold pressure. Results: Pelvic congestion rats showed decreased bladder capacity compared with controls, but micturition pressure and threshold pressure were unchanged. Pelvic congestion model rats also demonstrated an approximately two‐fold increase in expression of both M2 and M3 receptor subtypes in the urothelium. Additive relaxant effects of 5‐hydroxymethyl tolterodine and mirabegron were observed in vitro in the electrical field stimulation‐induced contractions of bladder strips from pelvic congestion rats. In vivo, bladder capacity was increased significantly by a combination of 5‐hydroxymethyl tolterodine and mirabegron, with the combined effect exceeding the sum of the effects of monotherapies. Micturition pressure and threshold pressure did not significantly differ between groups. Conclusions: The combination of 5‐hydroxymethyl tolterodine with mirabegron suggests the potential of synergistic effects in a rat pelvic congestion model. [ABSTRACT FROM AUTHOR]

: Copyright of LUTS is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Chen, Li‐Chen, Kuo, Hann‐Chorng

المصدر: LUTS; May2020, Vol. 12 Issue 2, p109-116, 8p

مصطلحات موضوعية: INTRAVESICAL administration, TRPV cation channels, TREATMENT effectiveness, MUSCARINIC antagonists, MYOMECTOMY, NEURAL stimulation, SACRAL nerves, OVERACTIVE bladder, INTERSTITIAL cystitis

الشركة/الكيان: AMERICAN Urological Association

مستخلص: Overactive bladder (OAB) is a common condition affecting one‐sixth to one‐fifth of the global population. The treatment of refractory OAB remains a challenge for urologists. Current treatment options include the use of combination therapy with antimuscarinic agents and beta‐3 adrenoceptor agonists, and treating underlying curable disorders. Intravesical botulinum toxin type A (BoNT‐A) injection, percutaneous tibial nerve stimulation, and sacral nerve stimulation are third‐line management therapies suggested by the American Urological Association/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (AUA/SUFU) guidelines. In rare cases, more invasive surgical interventions can be considered after explaining the benefits and risks to the patients. Augmentation cystoplasty has a high success rate; however, it has also been associated with a high complication rate. In contrast, detrusor myomectomy is an easy procedure, but the treatment outcome remains controversial. Liposome‐encapsulated BoNT‐A is administered via bladder instillation, and promising results have been obtained in preliminary studies. More therapies are currently being investigated, and transient receptor potential vanilloid 1 antagonists may be new type of medication. Radiofrequency ablation and other targets for neuromodulation have also been studied; however, more evidence is needed to confirm their efficacy. [ABSTRACT FROM AUTHOR]

: Copyright of LUTS is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: KINJO, Manami, SEKIGUCHI, Yuki, YOSHIMURA, Yasukuni, NUTAHARA, Kikuo

المصدر: LUTS; May2018, Vol. 10 Issue 2, p148-152, 5p

مصطلحات موضوعية: OVERACTIVE bladder, ADRENERGIC receptors, MUSCARINIC antagonists, WOMEN patients, PERSISTENCE

مستخلص: Objectives: To compare persistence with medication and the reasons for discontinuation of mirabegron or solifenacin therapy up to12 months in women with overactive bladder (OAB). Methods: Female OAB patients who presented to women's urology clinics were enrolled in a prospective, randomized, two‐arm study. Patients were randomized to receive mirabegron at 25–50 mg (n = 76) or solifenacin at 2.5–5 mg (n = 72). The persistence rate and the reasons for discontinuation were investigated up to 12 months. Results: The 12‐month persistence rate was 12.2% in the mirabegron group versus 20.1% in the solifenacin group and there were no significant differences of the persistence rates during the study (n.s). Patients discontinued treatment because of lack of efficacy (21.6%), spontaneous improvement (18.2%), and side‐effects (17.6%), while 19.6% were lost to follow up. Discontinuation due to side‐effects was significantly more frequent in the solifenacin group than the mirabegron group (27.3 vs. 7.9%, P < 0.05). In contrast, discontinuation due to lack of efficacy was significantly more frequent in the mirabegron group than the solifenacin group (36.8 vs. 5.6%, P < 0.05). Conclusions: This study demonstrated low persistence rates over 12 months for both mirabegron and solifenacin, although the reasons for discontinuation were somewhat different. [ABSTRACT FROM AUTHOR]

: Copyright of LUTS is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)