Behavioral Intervention versus Pharmacotherapy or Their Combinations in the Management of Overactive Bladder Dysfunction

Tran, Khanh Bao; Levin, Robert M.; Mousa, Shaker A.

doi:10.1155/2009/345324

Cited by 11 publications

(7 citation statements)

References 88 publications

(113 reference statements)

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“…The common treatments for urinary incontinence include surgery, drug therapy, and behavioral interventions. Although surgery and drug therapy used to be the preferred treatments, [2] behavioral interventions are currently recommended as a first line therapy in the treatment of UI [11].…”

Section: Introductionmentioning

confidence: 99%

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The Efficiency of a Behavioral Intervention Program for Urinary Incontinence in Elderly Females

Ghodsbin¹,

Kargar²,

Jahanbin³

et al. 2012

J Nurs Care

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Background: Urinary incontinence (UI) is a women's health problem that imposes major problems for personal quality of life. Objective: The aim is to determine the effect of a Behavioral Intervention Program on the quality of life of the elderly females with urinary incontinence, who referred to Jahandidegan center in Shiraz-Iran, 2011. Material and methods: The participants consisted of 60 women aged 60-74 years with QUID questionnaire's scores for different types of incontinence (stress score ≥ 4, urge score ≥ 6 and mix score ≥ 10). QUID questionnaire was used for patients with urinary incontinence. It also gave us the possibility to determine the types of urinary incontinence. For matching, we placed an equal numbers of each type of urinary incontinence in each group. Ten subjects from each type were placed in two groups of 30 each (intervention and control groups). Then, incontinence quality of life questionnaire (I-QOL) was used to estimate the impact of incontinence on the participants' quality of life. After the completion of a Behavioral Intervention Program and 2 months later, I-QOL questionnaire was completed by the intervention and control groups. Descriptive statistics, paired t-test and repeated measurement were used to analyze the data. Results: Overall, the program was effective in relieving symptoms by improving quality of life related to urinary incontinence, and this effect continued after a 2 months period. Conclusion: Behavioral therapy was an empowerment mechanism for incontinent women in improving their quality of life. Thus, it is suggested that the health care providers pay more attention to this issue and train women regarding the prevention of urinary incontinence.

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Section: Introductionmentioning

confidence: 99%

“…Thus, this type of treatment requires a high level of motivation and encouragement. The advantages of behavioral methods are improved central control of the bladder function, avoidance of the mortality and morbidity of surgery, and no adverse drug reactions [11].…”

Section: Introductionmentioning

confidence: 99%

The Efficiency of a Behavioral Intervention Program for Urinary Incontinence in Elderly Females

Ghodsbin¹,

Kargar²,

Jahanbin³

et al. 2012

J Nurs Care

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show abstract

“…Specifically, for metabolic disease, lifestyle changes focusing on improving dietary quality, physical activity, and sleep habits can serve as a first-line treatment but are often unsuccessful clinically due to poor compliance ( 108 ). Therefore, it is important to develop pharmacological agents, which normally do not require drastic and prolonged lifestyle modification and thus promise greater patient motivation ( 109 ).…”

Section: Modulating Sleep and Circadian Cycles For Metabolic Benefitsmentioning

confidence: 99%

Manipulating the Circadian and Sleep Cycles to Protect Against Metabolic Disease

2015

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Modernization of human society parallels an epidemic of metabolic disorders including obesity. Apart from excess caloric intake, a 24/7 lifestyle poses another important challenge to our metabolic health. Recent research under both laboratory and epidemiological settings has indicated that abnormal temporal organization of sleep and wakeful activities including food intake is a significant risk factor for metabolic disease. The circadian clock system is our intrinsic biological timer that regulates internal rhythms such as the sleep/wake cycle and also responses to external stimuli including light and food. Initially thought to be mainly involved in the timing of sleep, the clock, and/or clock genes may also play a role in sleep architecture and homeostasis. Importantly, an extensive body of evidence has firmly established a master regulatory role of the clock in energy balance. Together, a close relationship between well-timed circadian/sleep cycles and metabolic health is emerging. Exploiting this functional connection, an important holistic strategy toward curbing the epidemic of metabolic disorders (e.g., obesity) involves corrective measures on the circadian clock and sleep. In addition to behavioral and environmental interventions including meal timing and light control, pharmacological agents targeting sleep and circadian clocks promise convenient and effective applications. Recent studies, for example, have reported small molecules targeting specific clock components and displaying robust beneficial effects on sleep and metabolism. Furthermore, a group of clock-amplitude-enhancing small molecules (CEMs) identified via high-throughput chemical screens are of particular interest for future in vivo studies of their metabolic and sleep efficacies. Elucidating the functional relationship between clock, sleep, and metabolism will also have far-reaching implications for various chronic human diseases and aging.

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“…It will discuss hurdles to future commercial drug development in this area and, based on this analysis, will propose future research priorities. The potential of other options, such as behavioral treatment or neuromodulation, will not be discussed here; of note, these other treatment modalities are not necessarily alternatives to medical treatment, but might also be seen as additions.…”

Section: Introductionmentioning

confidence: 99%

Where will the next generation of medical treatments for overactive bladder syndrome come from?

Michel

2020

Int J of Urology

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This review article discusses the medical need for improved medical treatments of overactive bladder syndrome, and the hurdles and research required to address that need. Currently, few overactive bladder syndrome patients stay on long‐term treatment, largely because efficacy expectations are not met, and tolerability is considered insufficient for the chronic treatment of a non‐life‐threatening condition. Therefore, a medical need exists for improved tolerability and, even more importantly, improved efficacy. It is unlikely that major improvements of efficacy and tolerability can be achieved within the currently approved drug classes. Work in experimental animals suggests that many causes of overactive bladder syndrome exist – each with a distinct pathophysiology. This makes it unlikely that a single medication can address the pathophysiology and treatment needs of all overactive bladder syndrome patients; accordingly, any medication will appear to have only moderate efficacy in the overall group of overactive bladder syndrome patients, even if it fully eliminates symptoms within a subset of patients. It is proposed that only identification of subsets of patients with a defined pathophysiology (and biomarkers thereof) will allow the development and use of targeted treatment that can be highly effective in such subsets.

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Behavioral Intervention versus Pharmacotherapy or Their Combinations in the Management of Overactive Bladder Dysfunction

Cited by 11 publications

References 88 publications

The Efficiency of a Behavioral Intervention Program for Urinary Incontinence in Elderly Females

The Efficiency of a Behavioral Intervention Program for Urinary Incontinence in Elderly Females

Manipulating the Circadian and Sleep Cycles to Protect Against Metabolic Disease

Where will the next generation of medical treatments for overactive bladder syndrome come from?

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