To identify incidence and risk factors of recurrence after discontinuation of successful antimuscarinic therapy in patients with overactive bladder (OAB).
This was a prospective, multicenter trial. Patients who had antimuscarinic agents for more than 12 weeks and showed successful response were enrolled. Successful response was defined as answering 'benefit' for patient perception of treatment benefit and answer lesser than 3 points in patient's perception of bladder condition (PPBC). The enrolled patients discontinued the antimuscarinics, and we evaluated their recurrence with PPBC and OAB symptom score (OABSS) at 1, 3, 6, and 12 months. Primary purpose was to identify the recurrence rate and secondary purpose was to reveal risk factors.
Four hundred forty-one patients enrolled and 371 patients completed 6-month follow-up. The enrolled patients showed 1.6 points in PPBC, 2.9 points in OABSS and 1.4 points in IPSS (quality of life) which represented successful response after using antimuscarinics. The cumulative rates of recurrence were 25.6%, 42.3%, and 52.2% at 1, 3, 6 months, respectively. Among 177 patients who did not show recurrence at 6 months, 41 patients were followed up and 4 patients of the 41 patients (9.7%) showed recurrence at 12 months. On univariate and multivariate analyses of recurrence, OAB wet was the risk factor for recurrence after 6 months of discontinuation.
Discontinuation of antimuscarinic therapy after successful treatment resulted in high recurrence rate with time and OAB wet was the independent risk factor for recurrence.
Investigative and clinical urology. 2017 Jan 05 [Epub]
Aram Kim, Kyu-Sung Lee, Tae Beom Kim, Hyung Joon Kim, Eun Sang Yoo, Jong-Hyun Yun, Duk Yoon Kim, Suk Gun Jung, Jun Taik Lee, Jung Man Kim, Cheol Kyu Oh, Ju Hyun Shin, Seung Hyun Jeon, Seong Ho Lee, Chang Hee Han, Dong Hwan Lee, Hyuk Jin Cho, Myung-Soo Choo
Department of Urology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea., Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea., Department of Urology, Gil Medicine Center, Gachon University of Medicine and Science, Incheon, Korea., Department of Urology, Konyang University College of Medicine, Daejeon, Korea., Department of Urology, Kyungpook National University, Daegu, Korea., Department of Urology, Soonchunhyang University Gumi Hospital, Soonchunhyang University School of Medicine, Gumi, Korea., Department of Urology, Catholic University of Daegu School of Medicine, Daegu, Korea., Department of Urology, Daedong Hospital, Busan, Korea., Department of Urology, Busan Saint Mary's Medical Center, Busan, Korea., Department of Urology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea., Department of Urology, Chungnam National University School of Medicine, Daejeon, Korea., Department of Urology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea., Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hallym University School of Medicine, Hwaseong, Korea., Department of Urology, The Catholic University College of Medicine, Seoul, Korea., Department of Urology, Incheon St. Mary's Hospital, The Catholic University College of Medicine, Incheon, Korea., Department of Urology, Seoul St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea.