Search

The article presents research on the association between the treatment-seeking behavior, healthcare resource utilization (HRU) and incontinence severity of patients with overactive bladder (OAB). Research confirms the consistent and positive correlation between HRU and incontinence severity. Also analyzed are the employment status, demographics and comorbidities through the incontinence severity of the patients.

OBJECTIVE • To evaluate the impact of urisheaths vs absorbent products (APs) on quality of life (QoL) in men with moderate to severe urinary incontinence (UI). PATIENTS AND METHODS • A randomized, controlled, crossover trial in 61 outpatient adult men with stable, moderate to severe UI, with no concomitant faecal incontinence, was conducted from June 2007 to February 2009 in 14 urology centres. • Participants tested Conveen Optima urisheaths (Coloplast, Humlebaek, Denmark) with collecting bags and their usual AP in random order for 2 weeks each. • The impact of each on QoL was measured using the King’s Health Questionnaire (KHQ) and the short form-12 acute questionnaire, and each patient’s preference was recorded. • A 10-item patient questionnaire was also used to assess the product main advantages on an 11 point scale (0: worst; 10: best). A 72-h leakage diary was used to record the number and severity of leaks and daily product consumption. Safety was measured as the number of local adverse events. RESULTS • All dimensions of the KHQ were scored lower with urisheaths, indicating an improvement in QoL. The greatest mean score reductions were in Limitations of Daily Activities ( − 10.24, P= 0.01) and Incontinence Impact ( −7.05, P = 0.045). • The majority (69%) of patients preferred Conveen Optima urisheaths to their usual AP ( P = 0.002). • Urisheaths scored significantly higher for all categories in the patient questionnaire (efficacy, self-image, odour management, discretion, skinintegrity) except ease of use. • Safety was considered to be good. CONCLUSIONS • Conveen Optima urisheaths showed apositive impact on QoL (according to the KHQ results) in moderate to severe incontinent men, who were long-term usersof APs, and participants largely preferred urisheaths. • Conveen Optima urisheaths should be recommended to incontinent men in preference to APs. [ABSTRACT FROM AUTHOR]

The article focuses on improving the treatment of stress urinary incontinence (SUI). In particular, authors examine the respective roles of urethral injection and more invasive surgery for patients failing to respond to conservative treatment or pharmacotherapy. It is generally accepted that both intrinsic sphincter deficiency and hypermobility coexist in patients with SUI. Available clinical evidence supports the use of injection therapy regardless of the underlying pathophysiology.

The epididymal penetration of roxithromycin was studied in order to evaluate the drug for use in the treatment of epididymo-orchitis. Seventeen patients hospitalized for surgery as part of treatment for prostatic adenoma or prostatic cancer were pre medicated orally with roxithromycin 150 mg bd for three days followed by 150 mg pre-operatively (3 h before surgical incision). Roxithromycin concentrations in serum and epididymis were determined by microbiological assay. The mean epidi dymal concentrations were 6·48±4·88 and 5·98±392 mg/kg for left and right epididymis respectively and the corresponding mean tissue/serum ratios 0·88±0·57 and 0·84±0·53. The wide intersubject variation in the concentration of roxithromycin found in serum and tissue is commonly seen with other macrolide antibiotics. The concentrations observed in this study in serum and tissue were greater than the MICs for (0·25 to 1 mg/L), and (0·5 mg/L). [ABSTRACT FROM PUBLISHER]

Objective To report penile integrity measures, including stretched penile length (SPL), from a randomized, double-blind, double-dummy, placebo-controlled trial evaluating treatment with tadalafil initiated after nerve-sparing radical prostatectomy (nsRP). Methods Patients aged ≤68 years were randomized after nsRP 1:1:1 to 9-month double-blind treatment (DBT) with tadalafil 5 mg once daily (OaD), 20-mg tadalafil on-demand (“pro-re-nata”; PRN), or placebo, followed by 6-week drug-free washout and 3-month open-label OaD treatment. Secondary outcome measures included the change in SPL from pre-nsRP to the end of DBT (analysis of covariance adjusting for treatment, country, baseline, age, and nerve-sparing score), responses to Sexual Encounter Profile (SEP) questions 1-3 (mixed models for repeated measures adjusting for treatment, country, visit, visit-treatment-interaction, age), and Standardized Morning Erection Question (Cochran-Mantel-Haenszel test adjusted for age and country). Results Four hundred twenty-three patients were randomized to tadalafil OaD (N = 139), tadalafil PRN (N = 143), and placebo (N = 141). Greater retainment of SPL was observed with tadalafil OaD vs placebo at the end of DBT (least-square mean [95% confidence interval] difference OaD vs placebo, 4.1 mm [0.4 to 7.8 mm]; P = .032). No significant effects on SPL were found for tadalafil PRN vs placebo, or for the nerve-sparing score. Penile tumescence (SEP1) and ability for vaginal insertion (SEP2) significantly improved vs placebo at the end of double-blind and open-label treatment for patients randomized to tadalafil OaD only. The ability for successful sexual intercourse (SEP3) significantly improved with tadalafil OaD vs placebo only during DBT. The distribution of Standardized Morning Erection Question responses was different at the end of DBT ( P = .045); 34.2% of patients on tadalafil OaD, 50.0% on tadalafil PRN, and 56.5% on placebo reported absence of morning erections. Conclusion These data suggest the early initiation of tadalafil OaD protects from penile length loss and may contribute to protection from structural cavernosal changes after nsRP. [ABSTRACT FROM AUTHOR]

Introduction Until now, no questionnaire has been developed to study specific expectations concerning sexual dysfunction management and the availability of information on sexuality in the female population affected by multiple sclerosis ( MS). Understanding and meeting the patient's expectations is an issue of considerable importance in the evaluation of medical care. Aim and Main Outcome Measure We present the development and validation of a specific questionnaire designed for women with MS in order to assess their expectations in terms of sexual dysfunction management: the SEA- MS- F ( Sexual Dysfunction Management and Expectations Assessment in Multiple Sclerosis- Female). Methods This questionnaire was created and validated by an expert panel, using the Delphi method. The psychometric evaluation was obtained with a sample of 40 female MS patients. Cronbach's alpha index and principal component analysis were used to measure the questionnaire's internal consistency. Results A consensus on the questionnaire was reached with the Delphi method. The SEA-MS- F is fully compliant with the criteria for psychometric validation among female MS patients, and its internal consistency is excellent ( Cronbach's alpha 0.948). Conclusion The SEA- MS- F appears to be a useful tool that could be used either in routine medical situations or in prospective studies of MS in order to ascertain women's expectations concerning the management of their sexual dysfunction. B isseriex H , G uinet- L acoste A , C hevret- M éasson M , C osta P , S heikh I smael S , R ousseau A , A marenco G , and SEA - MS - F G roup. Sexual D ysfunction M anagement and E xpectations A ssessment in M ultiple S clerosis- F emale ( SEA - MS - F ): Creation and validation of a specific questionnaire. J Sex Med 2014;11:2955-2965. [ABSTRACT FROM AUTHOR]

Abstract: Background: In the treatment of patients with idiopathic overactive bladder (iOAB), high doses of botulinum toxin type A (BoNTA) were often associated with complications resulting from high postvoid residuals (PVR), leading to clean intermittent catheterisation (CIC) and urinary tract infections (UTI). Objective: Evaluate the efficacy and tolerability of low doses of onabotulinumtoxinA compared to placebo in patients with iOAB. Design, setting, and participants: Between 2005 and 2009, adults with persistent iOAB were included in a prospective, randomised, double-blind, placebo-controlled comparative trial. Intervention: Patients were randomised to undergo a single intradetrusor injection procedure of either placebo or onabotulinumtoxinA (50U, 100U or 150U). Measurements: The initial evaluations (ie, clinical and urodynamic variables as well as quality of life [QoL]) were repeated at day 8 and months 1, 3, 5, and 6. Results and limitations: Ninety-nine patients were included in the efficacy analysis. Three months after the procedure, we observed >50% improvement versus baseline in urgency and urge urinary incontinence (UUI) in 65% and 56% of patients who respectively received 100U (p =0.086) and 150U (p =0.261) BoNTA injections and >75% improvement in 40% of patients of both groups (100U [p =0.058] and 150U [p =0.022]). Complete continence was observed in 55% and 50% patients after 100U and 150U BoNTA treatment, respectively, at month 3. Frequency symptoms and QoL improved up to the 6-mo visit. We observed only three patients with a PVR >200ml in the 150U group and a few UTIs. Conclusions: 100U and 150U BoNTA injections were well tolerated and have both shown to improve symptoms and QoL in patients with iOAB. Nevertheless, 100U injections showed a reasonable efficacy, with a lower risk of high PVR. Trial registration: ClinicalTrials.gov NCT00231491. [Copyright &y& Elsevier]