Does local vaginal estrogen after tension-free transobturator vaginal tape reduce overactive bladder symptoms in postmenopausal women? A prospective randomized, controlled study

Objective:We aimed to evaluate the efficacy of topical estrogen after transvaginal tension-free vaginal tape-obturator(TVT-O)in the treatment of de novo overactive bladder symptoms that appear after surgery.Methods:This is a prospective randomized controlled study performed in the Urology and Gynecology Departments,Kasr Al Ainy Hospital,Cairo University,Cairo,Egypt.Two hundred and ten postmenopausal females presenting during the period between January 2017 and November 2020 with stress urinary incontinence were included in the study.Patients were divided into two groups,105 patients in Group A(treatment group)and 105 patients in Group B(control group).Patients in Group A underwent transvaginal TVT-O followed by local vaginal estrogen treatment for 6 months,while patients in Group B underwent transvaginal TVT-O only.The study included any postmenopausal female with urodynamic stress urinary incontinence.All patients had to fulfill a 3-day bladder diary,overactive bladder symptoms score,urine analysis,urodynamic study,and post-voiding residual urine measurement by abdominal ultrasound preoperatively and at 3-month and 6-month follow-ups.Results:At 6-month follow-up,daytime frequency was reduced to 8%in Group A(increased to 21%in Group B)with a statistically significant difference between both groups(p=0.009).At 6-month follow-up,nocturia was 8%in Group A(11%in Group B)with no statistically significant difference between both groups(p=0.469).There was a statistically significant difference between both groups as regards to urinary urgency at 6-month follow-up(p=0.024).There was a statistically significant difference in postoperative wound healing events as regards to cure,hyperemia,gapping,and wound infection 1 week after intervention between both groups(p=0.008).No local or systemic side-effects were reported from local estrogen use.Conclusion:Local vaginal estrogen treatment given to postmenopausal patients after midurethral sling procedures can reduce the symptoms of daytime frequency and urinary urgency.Long-term follow-up is needed.

Pioneering drugs for overactive bladder and detrusor overactivity: Ongoing research and future directions

The ongoing research on pioneering drug candidates for the overactive bladder （OAB） aimed to overcome the limitations of currently licensed pharmacotherapies, such as antimuscarinics, β3-adrenergic agents, and botulinum neurotoxin, has been reviewed performing a systematic literature review and web search. The review covers the exploratory agents alternative to available medications for OAB and that may ultimately prove to be therapeutically useful in the future mana-gement of OAB patients based on preclinical and early clinical data. It emerges that many alternative pharmacological strategies have been discovered or are under investigation in disease-oriented studies. Several potential therapeutics are known for years but still fnd obstacles to pass the clinical stages of development, while other completely novel compounds, targeting new pharmacological targets, have been recently discovered and show potential to translate into clinical therapeutic agents for idiopathic and neurogenic OAB syndrome. The global scenario of investigational drugs for OAB gives promise for the development of innovative thera-peutics that may ultimately prove effective as first, combined or second-line treatments within a realistic timescale of ten years.

Does an “Overactive to Underactive Bladder Transition” Phenomenon Exist in a Rat Lumbar Spinal Canal Stenosis Model?

Purpose: To investigate the association between the maximum cystometric capacity (MCC) and other cystometric parameters in lumbar canal stenosis (LCS) rats. Material and Methods: One small hole was drilled at the fifth lumbar vertebral arch (Sham), and a rectangular piece of silicone rubber was then placed in the epidural space (LCS) of Wister rats. Two weeks after surgery, awake cystometry was performed. LCS rats were divided into three groups: Group A (n = 5, MCC < 0.87 mL), Group B (n = 13, MCC 0.87 - 1.81 mL), and Group C (n = 14, MCC > 1.81 mL). Cystometric parameters were investigated in sham and LCS groups. Results: MCC did not significantly correlate to the frequency of non-voiding contractions (NVCs), voided volume (VV), or maximum intravesical pressure during voiding (Pmax), but significantly positively correlated to postvoid residual urine volume (PVR) and residual urine rate (RUR) (Spearman’s correlation coefficients (ρ) = 0.8973 (p < 0.0001) and 0.4915 (p = 0.0068), respectively). Compared with the sham rats, LCS rats in each group revealed significantly smaller VV, larger RUR, and lower Pmax. On the other hand, among LCS rats, VV, RUR, and Pmax were not significantly different. The frequency of NVCs in each LCS group was not significantly different from that in sham-operated rats (Tukey-Kramer’s HSD test). However, a Jonckheere-Terpstra trend test revealed a significant trend toward higher NVCs in the order of sham, Groups C, B, and A (p = 0.036). Conclusions: LCS rats showed the same degree of detrusor underactivity regardless of MCC. NVCs did not significantly increase in LCS rats with decreased MCC, but the trend toward higher NVCs with smaller MCC was significant.

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

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(p<0.05),but no significant difference was found between two groups in OABSS scores(p>0.05).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.

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

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.

经皮低频神经肌肉电刺激治疗难治性OAB的疗效观察

目的通过经皮低频神经肌肉电刺激治疗难治性膀胱过度活动症(OAB),探讨电生理适宜技术临床应用的实用性、安全性及有效性。方法选取2019年9月至2022年7月暨南大学附属第一医院泌尿外科、下尿路疾病以及男科门诊诊治的难治性OAB患者36例。其中28例女性,8例男性,年龄29~83(43.94±2.68)岁,病程(4.19±2.43)年。女性患者中,盆腔脏器脱垂8例,盆腔手术史合并盆腔脏器脱垂1例,睡眠障碍合并盆腔手术史1例,重度抑郁症1例,高血压2例,糖尿病1例,高血压合并糖尿病1例,急迫性尿失禁3例,单纯性难治性OAB患者10例。男性患者中,慢性前列腺炎2例,急迫性尿失禁1例,单纯性难治性OAB患者5例。所有患者均接受经皮低频神经肌肉电刺激治疗。收集治疗前后生活质量量表评分、膀胱过度活动症症状评分表(Overactive Bladder Symptom Scale,OABSS)评分、排尿日记,对治疗前后的上述指标行统计学分析和疗效评价,分析治疗后1个月、3个月随访数据,分析经皮低频神经肌肉电刺激治疗OAB患者近期临床疗效的持久性、复发率。采用配对t检验、Cox回归分析。结果治疗后,难治性OAB患者生活质量量表评分较治疗前升高,OABSS评分比治疗前降低,差异均有统计学意义(t=1.327、102.244,均P<0.05);排尿次数治疗后较治疗前减少,差异有统计学意义(t=10.246,P<0.05);单次尿量、单次最大尿量均高于治疗前,差异均有统计学意义(t=45.467、103.344,均P<0.05)。29例难治性OAB患者治疗后临床症状改善,临床有效率达到80.55%(29/36)。在1个月与3个月的随访OABSS评分数据中,回归系数呈现水平显著性结果(P=0.033、0.002),表明经皮低频神经肌肉电刺激治疗对难治性OAB患者的近期临床疗效;Cox回归分析结果表明治疗1个月、3个月后OABSS评分越低,其有效期越持久,越不容易复发。所有患者在治疗过程中和治疗后均无不适感觉。结论经皮低频神经肌肉电刺激治疗难治性OAB,可明显提高患者生活质量,降低OABSS评分,减少患者排尿次数、增加单次尿量和单次最大尿量。该治疗安全,有显著的近期临床疗效,远期疗效需随着病例数的增加,长期随访观察。

经皮穴位电刺激治疗女性OAB的临床疗效观察

目的探讨经皮穴位电刺激治疗对女性膀胱过度活动症(OAB)患者症状、生活质量、尿流率、焦虑症状的影响。方法将2019年1月1日至2021年9月30日在本院门诊就诊的女性OAB患者100例,按随机数字法将患者分为对照组和观察组,每组各50例。对照组采用口服酒石酸托特罗定片进行治疗,同时进行行为干预;观察组在此基础上予经皮穴位电刺激疗法,两组患者在治疗前及治疗3周、6周、9周后进行OAB评分(OABSS)、生活质量评分的比较,并在治疗前后进行尿流率测定及焦虑量表的评分比较。结果两组患者的治疗措施与时间在OABSS和生活质量上存在交互作用(P<0.05),且观察组疗效优于对照组(P<0.05);治疗后两组患者尿流率提高,且观察组高于对照组(P<0.05);治疗后焦虑评分下降,观察组下降明显(P<0.05);临床疗效观察组优于对照组。结论患者在采用口服酒石酸托特罗定片治疗、行为干预的基础上予以经皮穴位电刺激疗法,可有效降低OABSS评分,提高生活质量和尿流率,降低焦虑评分,提高疗效。

Very Low, Real-Time Rate of Urinary Retention after Intradetrusor Botox^&regfor Non-Neurogenic Overactive Bladder

Introduction: According to the most recent AUA/SUFU guidelines, intradetrusor onabotulinumtoxinA (BTN/A) is a standard, evidence strength grade B, third line treatment option for refractory non-neurogenic overactive bladder (OAB). Urinary retention is the most common clinically significant reported side effect ranging from 5.4% to 43% in previous studies. The aim of this study was to investigate the real-time rate of urinary retention in patients treated with BTN/A for refractory non-neurogenic OAB in a multi-institutional study. Methods: Retrospective chart review identified 71 patients who were treated with 100U BTN/A for refractory non-neurogenic OAB from August 2011 to July 2015 at two institutions. Using a flexible cystoscope, 100U Botox&reg reconstituted with 10 ml normal saline was administered. Injections of 1 ml (10 units/ mL) were administered in 10 evenly distributed sites sparing the trigone. Pre and post BTN/A post-void residuals (PVR) were reviewed. Urinary retention was defined as PVR > 200 mL requiring clean intermittent catheterization (CIC). Results: After exclusion, the study group consisted of 66 patients with a mean age of 67 years and 30% were men. Mean pre and post-procedural PVR were 14.06 mL and 69.21 mL. Eight patients (12.12%) were noted to have elevated PVR > 200 mL post injection however only one patient (female) required initiation of CIC. The rate of urinary retention was 1.5% (N = 1). There was no correlation with age, history of previous radiation, diabetes or prior use of a neuromodulator device. Conclusions: To the best of our knowledge, this is the first study to demonstrate a very low risk of real-time urinary retention rates in appropriately selected patients treated with BTN/A for refractory non-neurogenic OAB outside of a clinical trial setting.

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

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.

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

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.

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

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.

Efficacy and safety of onabotulinum toxin A for overactive bladder

Overactive bladder(OAB) syndrome is a condition which affects 16.9% of women and 16.2% of men with a significant negative impact on quality of life. It is a condition characterized by urgency, with or without urge incontinence, frequency and nocturia. Behavioral modifications and oral anti-muscurinic medications are first and second-line therapies for OAB but are frequently ineffective or poorly tolerated. For refractory cases of OAB, onabotulinum toxin can be offered and this therapy was approved by the Food and Drug Administration in January of 2013. In this editorial, we will review the indications, usage, efficacy and safety data for intradetrusor injection of onabotulinum toxin A.

Mirabegron, a novel, non-antimuscarinic drug for the overactive bladder: An up-to-dated review

Mirabegron opened a new era in the treatment of overactive bladder(OAB). For the fi rst time physicians dealing with OAB have an effective alternative to the pharmacological mainstay of the therapy for this disorder, the antimuscarinic drugs. This fi rst-in-class, potent β3-adrenoceptors agonist has recently received approval by regulatory authorities in Japan, United States and Europe, based on the favourable efficacy-tolerability profile demonstrated in multiple randomized, multinational, controlled trials, both short and long-term. There is substantial consistency through the studies in reporting the cardiovascular safety of treatment with mirabegron. The main advantage of mirabegron is the placebo-like incidence of classic adverse effects caused by antimuscarinics, dry mouth and constipation, that is expected to improve long-term adherence of patients to treatment. Mirabegron can be used in patients with contraindications to antimuscarinics and in those who discontinued previous antimuscarinic therapy. Herein, we reviewed the published literature on mirabegron, focusing on the rationale of β3-agonism for OAB treatment and on the preclinical and clinical evidence of effi cacy and safety available on this new pharmacological principle.

Effects of solifenacin on overactive bladder patients

Objective To investigate the effects of solifenacin on the detrusor instability of patients with overactive bladder ( OAB ) . Methods A total of 20

Clinical study of combination therapy of tamsulosin and solifenacin for benign prostatic hyperplasia with overactive bladder

Objective To evaluate the efficacy and safety of combination therapy of tamsulosin and solifenacin for benign prostatic hyperplasia ( BPH) with overactive bladder ( OAB) . Methods 82 patients with OAB and coexisting BPH were randomly divided into tamsulosin group ( n

Efficacy of solifenacin with or without tamsulosin in patients with overactive bladder

Objective To evaluate the efficacy of sollfenacin with or without tamsulosin in patients with overactive bladder ( OAB ) . Methods Fifty-three patients with OAB were randomly divided into two groups ( group

The role of botulinum toxin in the management of nonneurogenic overactive bladder in children:Highlights for clinical practice.A systematic review

Overactive bladder(OAB)is the most common voiding dysfunction in children;however,nonneurogenic or idiopathic OAB remains poorly studied.First-line treatment includes conservative measures;however,as many patients are refractory,have adverse effects,or are contraindicated for anticholinergics,new options must be explored.This review covers the use of intravesical botulinum toxin(BoNT)for idiopathic OAB treatment in children,emphasizing its efficacy,safety,differences between toxins,doses,and injection tech-niques.Clinical results were promising,with all 8 studies reporting good results.All authors used BoNT type A(BoNT-A),either onabotulinum or abobotulinum toxin A.Response rates were variable,with full-response percentages of 32%-60%.As proven by the full-response rates of 50%,repeated injections are as safe and effective as first injections.Only a few cases of urinary tract infection,transient urinary retention,and hematuria have been reported,with no major local or systemic adverse effects.Despite these limitations,evidence encourages and supports BoNT-A use as a safe and effective treatment modality for refractory idiopathic OAB in pediatric set-tings,regardless of dosage and target toxin.To the best of our knowledge,this is the first systematic review of the use of intravesical BoNT-A for idiopathic OAB treatment in children.

索利那新联合TURP治疗BPH合并OAB的效果及对尿动力学指标的影响

目的观察索利那新联合经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)合并膀胱过度活动症(OAB)的效果及对尿动力学指标的影响。方法前瞻性选取2017年9月至2023年1月海南省肿瘤医院收治的76例BPH合并OAB患者作为研究对象。按随机数字表法分为观察组和对照组,每组各38例。两组均行TURP,对照组术后予以常规治疗,观察组予以索利那新治疗。比较两组治疗前、治疗8周后国际前列腺症状评分(IPSS)、膀胱过度活动症评分(OABSS)、尿动力学指标[残余尿量(PVR)、膀胱最大容量(MBC)、最大排尿压(MVP)、最大尿流率(Qmax)]、手术时间、置管期排尿指标(膀胱痉挛次数与时间)、自主排尿期排尿指标(排尿次数、急迫性尿失禁次数与每次尿量)、不良反应情况。结果治疗8周后,观察组IPSS、OABSS分别为(11.18±2.16)、(5.67±0.96)分,均显著低于对照组[(15.23±2.89)、(8.23±1.48)分],差异均有统计学意义(P<0.05)。治疗8周后,观察组PVR为(15.83±2.91)mL,明显少于对照组[(18.14±3.52)mL],MBC、Qmax分别为(307.42±56.24)mL、(14.29±2.65)mL/s,均明显大于对照组[(261.73±49.36)mL、(13.05±2.47)mL/s],差异均有统计学意义(P<0.05)。观察组置管期膀胱痉挛次数与时间、自主排尿期排尿次数、急迫性尿失禁分别为(11.25±2.08)次/周、(17.02±3.19)min/次、(8.12±1.48)次/d、(1.32±0.25)次/d,均明显少于对照组[(13.46±2.57)次/周、(19.76±3.72)min/次、(9.45±1.73)次/d、(1.64±0.31)次/d],每次尿量为(204.57±38.6)mL,高于对照组[(179.45±31.90)mL],差异均有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论索利那新联合TURP治疗BPH合并OAB,能够有效减轻患者前列腺及膀胱过度活动症状,改善尿动力学及排尿情况,且安全性好。

前列腺癌根治术后远期膀胱过度活动症的危险因素

目的:分析前列腺癌根治术后膀胱过度活动症(overactive bladder, OAB)的发生及转归情况,并探讨其相关危险因素。方法:选择北京大学第三医院2013年1月至2017年5月住院接受根治性前列腺切除术的263例患者进行回顾性研究,分析并收集患者临床基线信息、计算影像特征、围术期参数、术前患者尿控情况、病理学诊断与术后1年内OAB发生情况的相关性。在影像特征中,定义膀胱壁厚度(bladder wall thickness, BWT)和膀胱黏膜光滑程度(bladder mucosal smoothness, BMS)两个参数,用于预测OAB的发生情况。结果:263例前列腺癌根治术后患者中,术后1年存在OAB状态者共52例,占所有患者的19.8%。术前既往存在OAB症状者40例,术后缓解者17例(42.5%),症状持续者23例(57.5%);术后新发OAB者29例,占术后所有OAB患者的55.77%。单因素分析显示膀胱壁厚度、膀胱黏膜光滑程度、膀胱过度活动症状评分和国际前列腺症状评分均与术后OAB的发生相关。进一步多因素分析发现,BMS是远期OAB的独立危险因素(P<0.001)。结论:根治性前列腺切除术后远期膀胱过度活动症是临床常见的并发症,通过术前磁共振成像测量充盈状态下膀胱壁厚度或膀胱黏膜光滑程度,可以预测根治术后OAB的发生风险。

索利那新治疗儿童特发性膀胱过度活动症的疗效分析

【目的】探讨索利那新改善儿童特发性膀胱过度活动症症状的疗效分析。【方法】收集2022年3月至2023年3月于我院泌尿外科门诊就诊的67例特发性膀胱过度活动症患儿的临床资料,所有患儿均经过至少2周行为治疗症状无明显改善,其中52例予索利那新(每天5 mg)口服(服药组),并根据患儿是否伴有尿失禁症状分为干性组(27例)与湿性组(25例),剩余15例拒绝服药的患儿继续维持行为治疗(观察组)。自服药开始随访3个月,分别收集每名患儿服药前、服药2周、服药4周、服药8周、服药12周连续3 d排尿日记及膀胱过度活动症症状评分表(OABSS),并记录病程中患儿不良反应情况。【结果】67例患儿均完成随访,其中44例患儿治愈(观察组3人治愈,12人未治愈;服药组41人治愈,11人未治愈),4例出现不良反应。(1)服药组较观察组随访末期OABSS评分显著降低(Z=4.524,P<0.001);观察组与服药组的治愈率分别20%、78.8%,存在显著差异(χ^(2)=15.367,P<0.001);(2)随随访时间延长,服药组患儿平均每次排尿量增加(F=9.707,P<0.001)、日平均排尿次数降低(F=3.837,P=0.009)、尿急评分(χ^(2)=482.835,P<0.001)下降;(3)干性组与湿性组随访3个月治愈率分别为81.5%、76%,差异无统计学意义(χ^(2)=0.234,P=0.629)。【结论】特发性膀胱过度活动症患儿口服索利那新(每日5 mg)可显著减少日平均排尿次数,增加平均每次排尿量,缓解尿急症状,不良反应较少。但是对于治愈湿性患儿尿失禁症状疗效不显著。