PURPOSE: No studies evaluated the antimuscarinics efficacy in patients with de novo Overactive Bladder (OAB) post midurethral sling (MUS).
We assessed Solifenacin efficacy in women with de novo OAB after TVT-O, in comparison with a control group.
MATERIALS AND METHODS: We prospectively considered all women with de novo OAB symptoms, at 3-month follow-up visit post a TVT-O. Patients with preoperative OAB and with obstructive symptoms or signs were excluded. Women satisfying the inclusion and exclusion criteria (group 1) were compared with a series of consecutive patients "naive" with OAB symptoms, without any previous surgical procedure for stress urinary incontinence (group 2). We prescribed a 12-week antimuscarinic therapy with oral Solifenacin 5 mg once a day. Objective outcomes included changes from baseline in the 3-day voiding diary data. Subjective efficacy was evaluated using the OABq-SF, the USS questionnaire and the PGI-I.
RESULTS: 110 Patients with de novo OAB post TVT-O completed Solifenacin treatment and were included in group 1. They were compared with 120 consecutive naïve women with OAB. Women in group 1 presented at 3-mo follow-up visit significantly lower benefits both in terms of mean reduction in episodes of urgency and urgency urinary incontinence per day (-1.1 vs -2.3, P< 0.0001 and -0.2 vs -1.1, P< 0.0001 respectively). In group 1 we also found a lower Solifenacin subjective effect. Previous TVT-O was independent predictor of Solifenacin treatment failure.
CONCLUSIONS: Antimuscarinics treatment with Solifenacin presents a significantly lower efficacy in women with de novo OAB post MUS in comparison with a control group.
Written by:
Serati M, Braga A, Sorice P, Siesto G, Salvatore S, Ghezzi F. Are you the author?
Department of Obstetrics and Gynecology, University of Insubria, Varese.
Reference: J Urol. 2013 Oct 19. pii: S0022-5347(13)05685-1.
doi: 10.1016/j.juro.2013.10.068
PubMed Abstract
PMID: 24148761
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