Solifenacin Treatment After Intradetrusor Injections With Botulinum Toxin in Patients With Neurogenic Detrusor Overactivity

Ciofu, Irina; Ceaușu, Iuliana; Chirca, Narcis; Persu, C.

doi:10.1097/mjt.0000000000001531

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…These three separate scores added together result in an overall score between 0 and 21. A lower score indicates a better outcome for symptom severity: mild (1-5), moderate (6)(7)(8)(9)(10)(11)(12), severe (13)(14)(15)(16)(17)(18) and very severe (19)(20)(21) [26]. A similar postoperative ICIQ-UI SF questionnaire was used at follow-up visits.…”

Section: Methodsmentioning

confidence: 99%

“…Treatment for MUI is still challenging and often involves a combination of surgery and medication, depending on the primary complaint [ 1 ]. Weight loss, bladder training and pelvic floor muscle development are all known to help patients regardless of the type of UI [ 16 ]. Weight-loss therapies have been observed to lessen the frequency of UI in obese women [ 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center Study

Persu,

Cartas,

Ciofu

et al. 2023

Life

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There is enough evidence to support weight loss in order to improve urinary incontinence. Nevertheless, weight loss and maintaining a lower weight are not easy to achieve in the general population. Our study aims to evaluate whether bariatric surgery has a positive effect on the symptoms of urinary incontinence in female patients. We performed a prospective study on obese female patients before and after bariatric surgery, over a period of 9 years. Patients with a BMI ≥ 33 kg/m2 were included if they described involuntary loss of urine and no previous surgery for urinary incontinence was performed. The patients underwent laparoscopic surgery, either gastric sleeve, bypass or banding, performed by four surgeons in our hospital. The type of incontinence was not assessed at the initial visit carried out by the surgeon. All patients who declared being incontinent were referred to the urologist where they received the ICIQ—UI-SF questionnaire before their bariatric surgery and during follow -up visits. The sum of points obtained at questions 3, 4 and 5 was used to evaluate the severity of incontinence, as well as the impact on the quality of life. Our evaluation collected data on age, time since onset of symptoms, pad usage, number and type of deliveries, concomitant conditions and medications. The type of incontinence was assessed by the urologist before bariatric surgery as urge, stress or mixed incontinence. At follow-up visits, the patients were also asked to fill out a 10-point VAS questionnaire evaluating their perception on the evolution of incontinence symptoms. Data were analyzed using t-test statistical analysis. Our objective defined changes in incontinence as cure, improved, no change and worse. We included 54 women from whom initial data and at least 18 months of follow-up were available. We observed that about 50% of all women undergoing bariatric surgery have some degree of urinary incontinence. The ICIQ score improved from 13.31 ± 5.18 before surgery to 8.30 ± 4.49 points after surgery (p < 0.0001). Before surgery, 38 patients (70%) described severe incontinence compared to only 20 patients (37%) after surgery. A total of 16 women (31%) reported complete cure of urinary incontinence after bariatric surgery. Data from the VAS questionnaire show improvement in 46 cases (85%). Pad usage improved from 7.04 ± 2.79 to 3.42 ± 2.77 (p < 0.001) per day. The number of patients using more than one pad per day decreased from 35 (65%) to 9 (17%). The type of incontinence did not seem to be relevant, but our sample size was too small to lead to statistically significant results. There was no impact on the outcome of incontinence of number/type of delivery, age or BMI. Our data show that bariatric surgery is able to cure urinary incontinence in one of three obese women. A significant improvement was obtained in more than two-thirds of the patients, regardless of the type of incontinence. For an obese female with urinary incontinence, treatment for obesity should prevail and incontinence should be treated only if symptoms remain.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center Study

Persu,

Cartas,

Ciofu

et al. 2023

Life

Self Cite

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“…Moreover, intravesical onabotulinumtoxin A injection has the potential to improve the urgency symptom for UUI in DHIC [11]. The concurrent administration of intravesical onabotulinumtoxin A injection and solifenacin could alleviate the DO symptom and extend the time between subsequent reinjections [12]. In addition, sacral neuromodulation has the potential to improve UUI and address compromised detrusor contractile function.…”

Section: Introductionmentioning

confidence: 99%

Low-Intensity Extracorporeal Shock Wave Therapy Ameliorates Detrusor Hyperactivity with Impaired Contractility via Transient Potential Vanilloid Channels: A Rat Model for Ovarian Hormone Deficiency

Chueh,

Juan,

et al. 2024

IJMS

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This study explores low-intensity extracorporeal shock wave therapy (LiESWT)’s efficacy in alleviating detrusor hyperactivity with impaired contractility (DHIC) induced by ovarian hormone deficiency (OHD) in ovariectomized rats. The rats were categorized into the following four groups: sham group; OVX group, subjected to bilateral ovariectomy (OVX) for 12 months to induce OHD; OVX + SW4 group, underwent OHD for 12 months followed by 4 weeks of weekly LiESWT; and OVX + SW8 group, underwent OHD for 12 months followed by 8 weeks of weekly LiESWT. Cystometrogram studies and voiding behavior tracing were used to identify the symptoms of DHIC. Muscle strip contractility was evaluated through electrical-field, carbachol, ATP, and KCl stimulations. Western blot and immunofluorescence analyses were performed to assess the expressions of various markers related to bladder dysfunction. The OVX rats exhibited significant bladder deterioration and overactivity, alleviated by LiESWT. LiESWT modified transient receptor potential vanilloid (TRPV) channel expression, regulating calcium concentration and enhancing bladder capacity. It also elevated endoplasmic reticulum (ER) stress proteins, influencing ER-related Ca2+ channels and receptors to modulate detrusor muscle contractility. OHD after 12 months led to neuronal degeneration and reduced TRPV1 and TRPV4 channel activation. LiESWT demonstrated potential in enhancing angiogenic remodeling, neurogenesis, and receptor response, ameliorating DHIC via TRPV channels and cellular signaling in the OHD-induced DHIC rat model.

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“…Treatment with botulinum toxin could be a reasonable alternative to neural stimulation and has only limited side effects, generally related to the surgical procedure [17]. Recently, Ciofu et al revealed that the response to botulinum toxin in patients with neurogenic detrusor overactivity can be improved by additional treatment with solifenacin, a selective antagonist of the M3 muscarinic receptor [18]. Therefore, we decided to analyze the possible association between the ADRB3:rs4994 polymorphism and response at three months to a single intra-detrusor injection of botulinum toxin-A in Polish women with overactive bladder.…”

Section: Introductionmentioning

confidence: 99%

Functional Polymorphism in the ADRB3 Gene, Encoding the Beta-3 Adrenergic Receptor, and Response to Intra-Detrusor Injection of Botulinum Toxin-A in Women with Overactive Bladder

Ciećwież

Lewandowska

Boroń

et al. 2022

JCM

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Background: There are reports suggesting an association between the rs4994 polymorphism in the ADRB3 gene encoding the beta-3 adrenergic receptor and OAB risk in females. The injection of botulinum toxin-A into the bladder wall is recommended as a possible treatment for OAB patients in whom first-line therapies have failed. The aim of our study was to analyze the possible association between the ADRB3:rs4994 polymorphism and the patient-perceived response to a single intra-detrusor injection of botulinum toxin-A in Polish women with overactive bladder. Methods: The study group consisted of 115 consecutive female patients with OAB. The response to botulinum toxin-A was evaluated at three months after injection, as absolute or relative reductions in OAB symptoms or in scores from questionnaires ICIQ-OAB (parts A and B) and ICIQ-LUTS-QoL (parts A and B). ADRB3:rs4994 variants were identified by the sequencing of genomic DNA extracted from buccal swabs. Results: There were no statistically significant differences between ADRB3:rs4994 [T];[T] homozygotes and [T];[C]+[C];[C] subjects for absolute or relative reductions in symptoms or in scores from all four questionnaire parts at three months after the injection of botulinum toxin-A. Conclusions: Our results do not support the hypothesis that ADRB3:rs4994 polymorphism is associated with the response to the intra-detrusor injection of botulinum toxin-A in Polish females with overactive bladder.

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Solifenacin Treatment After Intradetrusor Injections With Botulinum Toxin in Patients With Neurogenic Detrusor Overactivity

Cited by 8 publications

References 10 publications

Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center Study

Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center Study

Low-Intensity Extracorporeal Shock Wave Therapy Ameliorates Detrusor Hyperactivity with Impaired Contractility via Transient Potential Vanilloid Channels: A Rat Model for Ovarian Hormone Deficiency

Functional Polymorphism in the ADRB3 Gene, Encoding the Beta-3 Adrenergic Receptor, and Response to Intra-Detrusor Injection of Botulinum Toxin-A in Women with Overactive Bladder

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