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      Effectiveness and durability of solifenacin versus percutaneous tibial nerve stimulation versus their combination for the treatment of women with overactive bladder syndrome: a randomized controlled study with a follow-up of ten months

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          ABSTRACT

          Purpose

          To assess effectiveness and durability of Solifenacin (SS) versus tibial nerve stimulation (PTNS) versus combination therapy (PTNS + SS) in women with overactive bladder syndrome (OAB).

          Materials and Methods

          105 women with OAB were divided randomly into three groups of 35 patients each. In group A women received SS, in group B women underwent PTNS, in group C women underwent combination of PTNS + SS. Improvements in OAB symptoms were assessed with OABSS questionnaire; patients’ quality of life was assessed with OAB-q SF questionnaire. Evaluation of effectiveness of treatments was performed with PGI-I questionnaire. OABSS and PGI-I were also assessed monthly for ten months.

          Results

          All treatments were effective on symptoms. PTNS showed a greater effectiveness than SS, but PTNS + SS was more effective than SS and PTNS. Furthermore, PTNS + SS showed a greater duration of effectiveness than PTNS and SS.

          Conclusions

          Combination of PTNS with SS showed more effectiveness and more durability than PTNS and SS alone.

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          Most cited references17

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          The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society.

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            Combination treatment with mirabegron and solifenacin in patients with overactive bladder: efficacy and safety results from a randomised, double-blind, dose-ranging, phase 2 study (Symphony).

            Combining the β3-adrenoceptor agonist mirabegron and the antimuscarinic (AM) agent solifenacin may improve efficacy in the treatment of overactive bladder (OAB) while reducing the AM side effects.
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              Persistence and adherence of medications for chronic overactive bladder/urinary incontinence in the california medicaid program.

              To investigate persistence and adherence of medication treatment in chronic overactive bladder/urinary incontinence (OAB/UI) patients, and to evaluate OAB/UI-related comorbidity events associated with persistence. Pharmaceutical outcomes research with a health-care provider perspective was conducted on a California Medicaid (Medi-Cal) chronic OAB/UI population. The primary end point was medication possession ratio (MPR), which was used to measure refill adherence. Secondary end points measuring persistence patterns included discontinuation of OAB drug therapy (medication-uncovered interval > 30 days) and time to discontinuation (period from the index date until the first discontinuation date). Significant factors on nonpersistence were found by using a Cox Proportional Hazards model. Factors contributing to nonadherence (MPR 80% adherence during the 6-month follow-up-period. Significant predictors of higher persistence included: white ethnicity, previous hospitalization length, starting with tolterodine or oxybutynin extended-release, and previous use of topical drugs or antipsychotics. Nevertheless, previous depression or urinary tract infection (UTI) diagnosis, polypharmacy, significantly increased the odds of early discontinuation. Treatment discontinuation increased the risk of UTI diagnosis by 37% in the post-treatment period (P = 0.03; OR 1.37; 95% CI 1.03-1.84), but had no significant effect on other OAB/UI-related comorbidities. For chronic OAB/UI patients identified in this study, both persistence and adherence with medication treatment were suboptimal. These results suggest that persistence and treatment discontinuation remains problematic for the OAB/UI population.
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                Author and article information

                Journal
                Int Braz J Urol
                Int Braz J Urol
                ibju
                International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology
                Sociedade Brasileira de Urologia
                1677-5538
                1677-6119
                Jan-Feb 2018
                Jan-Feb 2018
                : 44
                : 1
                : 102-108
                Affiliations
                [1 ]Division of Urogynecology, ASUR, Jesi, Italy
                [2 ]Clinical Pathology, ASUR, Jesi, Italy
                Author notes
                Correspondence address: Carlo Vecchioli-Scaldazza, MD, Division of Urogynecology, ASUR, Corso Cavour 66, 62100, Macerata, Italy. E-Mail: cascave@ 123456alice.it

                CONFLICT OF INTEREST

                None declared.

                Article
                S1677-5538.IBJU.2016.0611
                10.1590/S1677-5538.IBJU.2016.0611
                5815539
                29064651
                ac527316-13ad-4b0f-a9fa-3bf145e73f85

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 November 2016
                : 21 June 2017
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 17, Pages: 7
                Categories
                Original Article

                urinary bladder,overactive,combined modality therapy,solifenacin succinate

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