Prevention of recurrent lower urinary tract infections in postmenopausal women with genitourinary syndrome: outcome after 6 months of treatment with ospemifene

Schiavi, Michele Carlo; Pinto, Anna Di; Sciuga, Valentina; Faiano, Pierangelo; Tucci, Chiara Di; D’Oria, Ottavia; Prata, Giovanni; Carraro, Carlo; Ostuni, Rosa; Zullo, Marzio Angelo; Muzii, Ludovico; Panici, Pierluigi Benedetti

doi:10.1080/09513590.2017.1370645

Cited by 27 publications

(17 citation statements)

References 23 publications

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“…Either the original English or the translated versions in different languages (Uzbek, Russian, Italian, Chinese) of the UTISA were used as primary or additional symptom-assessment tools in studies [47][48][49][50][51]. Although the authors of the original UTISA did not aim to establish a cutoff value to differentiate between AC and other conditions, Chang et al [51] revealed such a cutoff value using the total summary score in a translated and validated Chinese version of the UTISA, using receiver operating characteristic-curve analysis.…”

Section: Discussionmentioning

confidence: 99%

Reliability of Symptom-Based Diagnosis of Uncomplicated Cystitis

et al. 2018

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Background and Objectives: Acute uncomplicated cystitis (AC) is common among women. Acute onset of specific typical symptoms may serve as reliable criteria for developing a cost-effective strategy to make an accurate diagnosis of AC. We aimed to evaluate the diagnostic values of most common symptoms and signs of AC depending on their presence and severity. Methods: The current trial was designed as a case-control study. Data derived from the Acute Cystitis Symptom Score (ACSS) database were analyzed. Diagnostic values of the symptoms and their severity were assessed via the calculations of the sensitivity and specificity, odds ratio, positive and negative likelihood ratios. The strength of associations was estimated by the coefficient of correlation (Pearson’s R). Results: Data from 819 female subjects (423 Patients, 396 controls) with the mean age of 37.1 ± 15.3 were analyzed. Highest diagnostic values for AC in this study belonged to dysuria, urgency, and frequency. Interestingly, complaints of vaginal discharge was not found to decrease the odds for having AC in the study population. Conclusions: The severity of the symptom is even more essential than just its presence for an accurate diagnosis. The ACSS is an accurate tool and may be recommended for clinical practice and studies for diagnosis of AC in women. Further studies and unification of terms are need.

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Section: Discussionmentioning

confidence: 99%

Reliability of Symptom-Based Diagnosis of Uncomplicated Cystitis

et al. 2018

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“…It is intended to be used to treat moderate-to-severe dyspareunia due to vulvovaginal atrophy and it has no major adverse effects on the breast, bone or cardiovascular systems of patients [44]. Hence, ospemifene could be a promising new non-antibiotic option for UTI prevention in postmenopausal patients, especially in those with additional vulvovaginal atrophy [45]. However, no valid data on its possible preventive effect are available at present.…”

Section: Resultsmentioning

confidence: 99%

Prevention and treatment of uncomplicated lower urinary tract infections in the era of increasing antimicrobial resistance—non-antibiotic approaches: a systemic review

Wawrysiuk

Naber

Rechberger

et al. 2019

Arch Gynecol Obstet

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PurposeUrinary tract infections (UTIs) are one of the more common infections encountered in everyday clinical practice. They account for 10–20% of all infections treated in primary care units and 30–40% of those treated in hospitals. The risk of UTI in the female population is considered to be 14 times higher than in the male population. The prevalence of bacterial etiology results in a large consumption of broad-spectrum antibiotics, which in turn leads to increased rates of resistant uropathogens. Therefore, non-antibiotic prevention and treatment options are now of great importance.MethodsA systematic literature search was performed for the last 20 years (1999–2019) and the efficiencies of these eight different non-antibiotic interventions were analysed and discussed.ResultsThis article provides an overview on non-antibiotic options for management of UTI, including the application of cranberry products, the phytodrug Canephron N, probiotics, nonsteroidal anti-inflammatory drugs (NSAID), d-mannose, estrogens, vitamins, and immunotherapy.ConclusionsThe last 20 years of research on non-antibiotic approaches in UTI have not brought conclusive evidence that antibiotic usage can be replaced completely by non-antibiotic options. Hence, antibiotics still remain a gold standard for UTI treatment and prevention. However, changing the therapeutic strategy by including non-antibiotic measures in the management of UTI could be successful in avoiding antimicrobial resistance at least to some extent.

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“…There is clinical trial evidence to show that ospemifene may prevent recurrent UTIs in postmenopausal women. 15 …”

Section: Clinical Overviewmentioning

confidence: 99%

Experience with ospemifene in patients with vulvar and vaginal atrophy and associated sexual dysfunction: case studies

López¹

2020

DIC

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The pathophysiological changes associated with hypoestrogenism of menopause, a condition known as genitourinary syndrome of menopause, are responsible for the hallmark symptoms of vulvovaginal atrophy (VVA), namely dyspareunia secondary to vaginal dryness. Many postmenopausal women with VVA find sexual relations to be challenging or impossible. Ospemifene has estrogen-like effects on the vaginal epithelium, and is indicated to treat moderate-to-severe symptomatic VVA (Europe) or moderate-to-severe symptomatic dyspareunia and vaginal dryness (United States) in postmenopausal women. The case studies presented in this article follow the progress of two women who began treatment with ospemifene for the main presenting symptom of dyspareunia. Both women had concerns about the impact of their symptomatology on new relationships. The patient in case 1 experienced relevant improvement within 3 months of treatment start and, by 1 year, dyspareunia was absent. Vaginal lubricants were no longer required. The patient in case 2 experienced relevant improvement within 4 weeks of starting ospemifene. At 15 months, with the use of a lubricant for vaginal penetration, she could enjoy sexual intercourse without pain. At the time of writing, she had been receiving ospemifene continuously for more than 2 years with effective symptom relief and good tolerability.

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Prevention of recurrent lower urinary tract infections in postmenopausal women with genitourinary syndrome: outcome after 6 months of treatment with ospemifene

Cited by 27 publications

References 23 publications

Reliability of Symptom-Based Diagnosis of Uncomplicated Cystitis

Reliability of Symptom-Based Diagnosis of Uncomplicated Cystitis

Prevention and treatment of uncomplicated lower urinary tract infections in the era of increasing antimicrobial resistance—non-antibiotic approaches: a systemic review

Experience with ospemifene in patients with vulvar and vaginal atrophy and associated sexual dysfunction: case studies

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