Background: Overactive bladder (OAB) syndrome correlates with mental disorders, especially depressive disorders and anxiety disorders, and less frequently obsessive-compulsive symptoms, and occurs mostly in older people. Obsessive-compulsive disorder (OCD) is more frequent in OAB patients. Most OCD people are diagnosed at the age of about 19, typically with an earlier age of onset in boys than in girls, but the onset after age 35 does occur less frequently. Objectives: This study aimed to evaluate the relationship between OCD and OAB. Methods: In this case-control study, 1,160 cases who were over 18 years old who were referred to the urodynamic clinic of Shohada-e-Tajrish center from June 2013 to February 2018 in Tehran, Iran, enrolled of whom 580 were considered the control group who were non-OAB patients, and 580 subjects were considered the case group who were OAB patients. The diagnosis of OAB was confirmed by a single urologist. All cases had detrusor overactivity (DO) in urodynamic study (UDS). The OAB-validated 8-questionnaire screen test (OAB-V8) was conducted, and the diagnosis of OCD was confirmed by a single psychiatrist according to DSM-5 criteria. Moreover, the Yale-Brown questionnaire was completed for each patient to rate the severity of OCD symptoms. Results: About the Yale-Brown Obsessive-compulsive Scale (Y-BOCS) total score, there is a significant difference between patients with obsessive traits and the control group (P < 0.001). OCD scores were significantly higher in the OAB group compared to the control group (P < 0.001). Logistic regression analysis showed that the population of the studied patients with OAB was more probable to have OCD than non-OAB control subjects in aged classified groups (OR: 6.23; P < 0.001). Conclusions: The findings of this study showed that OAB patients reported higher obsessive-compulsive scores (Y-BOCS) compared to the controls. There is an independent correlation between OCD and OAB. However, the linkage between OCD and OAB justifies the need for more research.
Introduction: Urinary stone disease is the third most common affliction of the urinary tract that has been associated with an increasing incidence. Over decades, great advances have been made in the minimally invasive treatment of urinary stones. Recently, transurethral lithotripsy (TUL) by holmium laser was introduced as a possible therapeutic option. This study evaluated the effect of propofol on the success rate of TUL by holmium laser. Methods: A double-blind randomized controlled trial was conducted on 180 patients to investigate the effect of propofol on the success and complication rate of TUL by holmium laser. The enrolled patients were divided into two groups: the first group received sodium thiopental (n=89) while the second group received propofol (n=91). The two groups were compared in terms of the fluctuations of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), operation time, future stone-free rate (SFR), stone migration, post-operative fever, and ureteral complications such as perforation and mucosal damage. Other developed complications were also recorded. After data gathering, statistical analysis was performed with SPSS version 21. Results: the patients’ data such as age, sex, stone diameter, stone laterality, duration of stone impaction, primary SBP, DBP and HR were not significantly different between the two groups (P>0.05). TUL and anesthesia duration, first-minute and fifth-minute SBP and DBP, and also changes of HR were significantly lower in the propofol group compared with the sodium thiopental group (P<0.001). Moreover, SFR of TUL was more evident in the propofol group. Ureteral mucosal damage was significantly less in the propofol group. Conclusion: Propofol was associated with a higher reduction in SBP and DBP, decreased duration of TUL, fewer fluctuations in HR, and an increased success rate of stone removal by TUL with holmium laser.
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