Usefulness of Ospemifene in the treatment of urgency in menopausal patients affected by mixed urinary incontinence underwent mid-urethral slings surgery

Schiavi, Michele Carlo; D’Oria, Ottavia; Aleksa, Natalia; Vena, Flaminia; Prata, Giovanni; Tucci, Chiara Di; Savone, Delia; Sciuga, Valentina; Giannini, Andrea; Meggiorini, Maria Letizia; Monti, Marco; Zullo, Marzio Angelo; Muzii, Ludovico; Panici, Pierluigi Benedetti

doi:10.1080/09513590.2018.1500534

Cited by 36 publications

(17 citation statements)

References 27 publications

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“…Females with an overactive bladder and urinary incontinence had a worsened sexual life, decreased sexual desire, and loss of arousal [ 39 , 40 ]. From previous literature, estrogen supply can not only improve the symptoms of an overactive bladder and urinary incontinence but also increase sexual life [ 40 – 42 ]. In our study, LiESWT had an obvious benefit on lower urinary tract symptoms.…”

Section: Discussionmentioning

confidence: 99%

Low‐Intensity Extracorporeal Shock Wave Therapy Ameliorates the Overactive Bladder: A Prospective Pilot Study

Chuang

Lin

Chen

et al. 2020

BioMed Research International

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Objective. In the present clinical trial, we evaluated the therapeutic effects of low-intensity extracorporeal shockwave therapy (LiESWT) on overactive bladder (OAB). Methods. Female subjects with ages of 20-75 years and who have been clinically diagnosed with OAB were included in the study. The LiESWT (DUOLITH SD1 T-TOP, AG) applicator was placed on the suprapubic skin area and applied with an intensity of 0.25 mJ/mm2, 3000 pulses, and 3 pulses/second. To assess the therapeutic efficacy, all subjects were required to complete the validated OAB symptoms and life bothersome questionnaires, 3-day urinary diary, uroflowmetry, and post-voided residual urine (PVR) measurement at 4 weeks of LiESWT (W4), 8 weeks of LiESWT (W8), 1-month follow-up (F1), and 3-month follow-up (F3) after LiESWT. Result. 82 subjects with the mean age of 56.5±1.2 years were enrolled. The questionnaire scores were significantly improved at W4, W8, F1, and F3 as compared to baseline data (W0). At W8, the mean values of functional bladder capacity were meaningfully increased. According to the 3-day urinary diary, daytime frequency, urgency, and nocturia were significantly decreased. The uroflowmetry results showed that the mean voided urine volume and the maximal flow rate (Qmax) were noticeably increased. PVR volume was also significantly decreased. Conclusions. The data demonstrated that 8-week LiESWT ameliorated the OAB symptoms, promoted the uroflow parameters, and improved the quality of life (QoL) in OAB patients, suggesting that LiESWT might serve as an alternative noninvasive therapy for OAB.

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Section: Discussionmentioning

confidence: 99%

Low‐Intensity Extracorporeal Shock Wave Therapy Ameliorates the Overactive Bladder: A Prospective Pilot Study

Chuang

Lin

Chen

et al. 2020

BioMed Research International

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“…After surgical intervention, 38/81 (47%) patients received Ospemifene (60 mg/day for 3 months), and a significant difference was observed regarding mean number of voids, urgent micturition episodes/24 h, UUI, nocturia events and OAB-QoL symptoms. The authors concluded that Ospemifene is an effective therapy after MUSs in women with MUI, improving urgency symptoms and quality of life [18]. Another study, also published by Schiavi et al, demonstrated that Ospemifene is also an effective therapy for postmenopausal women with VVA affected by OAB, improving sexual function and quality of life [19].…”

Section: Local Estrogen In the Treatment Of Oab Syndromementioning

confidence: 95%

Effectiveness of hormones in postmenopausal pelvic floor dysfunction—International Urogynecological Association research and development—committee opinion

et al. 2019

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Introduction and hypothesis There is clear evidence of the presence of estradiol receptors (ERs) in the female lower urinary and genital tract. Furthermore, it is a fact that estrogen deficiency after menopause may cause atrophic changes of the urogenital tract as well as various urinary symptoms. Moreover, the effect of hormone replacement therapy (HRT) on urinary incontinence (UI) symptoms as well as pelvic organ prolapse (POP), anal incontinence (AI) and vulvovaginal symptoms (VVS) is still a matter of debate. This committee opinion paper summarizes the best evidence on influence of sex steroids as well as hormonal treatment (local and systemic) in postmenopausal women with pelvic floor disorders. Methods A working subcommittee from the International Urogynecology Association (IUGA) Research and Development Committee was formed. A thorough literature search was conducted and an opinion statement expressed. The literature regarding hormones and pelvic floor disorders was reviewed independently and summarized by the individual members of the subcommittee. Results The majority of studies reported that vaginal estrogen treatment when compared with placebo has more beneficial effects on symptoms and signs of vaginal atrophy including sensation of burning, dyspareunia and UI symptoms. Definitive evidence on local estrogen application and prolapse treatment or prevention is lacking. A statistically significant increase in risk of worsening of UI as well as development of de novo incontinence was observed with estrogen-only or combination systemic HRT. Conclusions In summary, local estrogen seems to be safe and effective in the treatment of VVS and can also improve urinary symptoms in postmenopausal patients with UI, but most of these recommendations correspond to evidence level 2C. The evidence in POP is still scarce but not in favor of benefit. Finally, the duration of local estrogen treatment (LET), optimal dosage, long-term effects and cost-effectiveness compared with current practice are still unknown.

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“…Compared with surgery alone, ospemifene significantly improved urgency symptoms and quality of life. 16 …”

Section: Clinical Overviewmentioning

confidence: 99%

Experience with ospemifene in patients with vulvar and vaginal atrophy and urinary incontinence: case studies

Blanco¹,

Lilue²,

Palacios³

2020

DIC

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Pelvic floor muscle atrophy and collagen loss in connective tissue due to declining estrogen production in women as they age may underlie the increasing prevalence of urge and stress incontinence. Estrogen therapy can correct the deficiency of estrogen receptors in genitourinary structures after menopause, but estrogen is not suitable for all women. A series of retrospective studies showed that urinary symptoms improved in women with overactive bladder syndrome who were receiving ospemifene for vulvovaginal atrophy (VVA), a component of genitourinary syndrome of menopause. Two case studies presented in this article support the findings. The woman in case 1 was 76 years old, had a 4-year history of urinary incontinence (UI), and several risk factors for urinary symptoms. During 15 months’ treatment with ospemifene for VVA, her urinary symptoms also improved as evidenced by a reduction (from four/day to one/day) in sanitary pad requirements to manage leakage. The patient in case 2 had predominantly moderate-to-severe VVA and mild mixed UI. During 6 months’ treatment with ospemifene, she experienced marked improvement in VVA symptoms, including normalization of vaginal pH and disappearance of dyspareunia, accompanied by a decrease in urinary symptoms, which allowed her to resume a normal exercise program.

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Usefulness of Ospemifene in the treatment of urgency in menopausal patients affected by mixed urinary incontinence underwent mid-urethral slings surgery

Cited by 36 publications

References 27 publications

Low‐Intensity Extracorporeal Shock Wave Therapy Ameliorates the Overactive Bladder: A Prospective Pilot Study

Low‐Intensity Extracorporeal Shock Wave Therapy Ameliorates the Overactive Bladder: A Prospective Pilot Study

Effectiveness of hormones in postmenopausal pelvic floor dysfunction—International Urogynecological Association research and development—committee opinion

Experience with ospemifene in patients with vulvar and vaginal atrophy and urinary incontinence: case studies

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