Hueih-Ling Ong

Predictive factors of adverse events after intravesical suburothelial onabotulinumtoxina injections for overactive bladder syndrome—A real-life practice of 290 cases in a single center

Patients often experience adverse events (AEs) after intravesical onabotulinumtoxinA (BoNT‐A) treatment for overactive bladder refractory to antimuscarinic agents. We investigated the prevalence and predictive factors of AEs in such patients.

PD59-06 TAILORING MEDICATION FOR LOWER URINARY TRACT SYMPTOMS IN MEN BASED ON INTERNATIONAL PROSTATE SYMPTOM SCORE VOIDING TO STORAGE RATIO

OBJECTIVE To investigate therapeutic results of tailoring medication for lower urinary tract symptoms (LUTS) in men according to initial treatment results and International Prostate Symptom Score (IPSS)-voiding to storage subscore (V/S) ratio. METHODS Men with mild-to-moderate LUTS were initially treated for 1 month with doxazosin 4 mg daily for IPSS-V/S >1 or tolterodine 4 mg daily for IPSS-V/S ≤1. They then underwent the Global Response Assessment (GRA) to tailor their medication by changes in IPSS-V/S, uroflow, and GRA, which were compared at baseline, 1, and 3 months post-treatment. RESULTS Upon baseline, 162/374 men had IPSS-V/S ≤1, and 212/374 had an IPSS-V/S >1. Both groups had significant improvement in IPSS-T, IPSS-S, and IPSS-V/S 1 month post-treatment. Of the 162 men initially receiving tolterodine, 102 (63.0%) continued monotherapy; 20 (12.3%) had IPSS-V/S >1.5 and were shifted to doxazosin monotherapy, and 40 (24.7%) had IPSS-V/S >1 but ≤1.5 and added doxazosin. Among the 212 men initially receiving doxazosin, 171 (80.7%) continued monotherapy; 9 with IPSS-V/S <1.5 were switched to tolterodine, and 32 had IPSS-V/S <2 but >1.5 and added tolterodine. Improvement in GRA was remarkable in all subgroups with tailoring the medication to patient symptomatology. CONCLUSION This study reveals that treatment customization according to IPSS-V/S after initial medical therapy provided satisfactory outcomes for men with mild-to-moderate LUTS.

MP65-16 PREDICTOR FACTORS FOR SUCCESSFUL TREATMENT OF SOLIFENACIN IN PATIENTS WITH OVERACTIVE BLADDER

INTRODUCTION AND OBJECTIVES: The impact of delivery mode and number of deliveries on urinary incontinence (UI) has been debated, and vaginal delivery has been suggested as a risk factor for female UI. Other potential factors include age, body mass index (BMI), parity, smoking, diabetes mellitus, and hysterectomy. We investigated whether delivery mode and number of deliveries is associated with UI among Japanese women. METHODS: We investigated 514 women recruited from outpatient departments (except the departments of pediatrics, psychiatry and ophthalmology) at our university hospital, regardless of the reason for visiting, during a 2-week period (from August 6 to August 17, 2007). All participants were asked to answer a standardized self-reported questionnaire. Using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), overactive bladder symptom score (OABSS), and an original questionnaire, we evaluated urinary symptoms and delivery mode history. We analyzed the impact of mode and number of deliveries on UI. The chi-square test and logistic regression modeling were used for statistical analyses. Values of P<0.05 were considered statistically significant. RESULTS: A total of 429 individuals completed the questionnaire (response rate, 83.5%). The mean age of respondents was 51.3 years (range, 23-83 years). The prevalence of each disorder was as follows: stress UI (SUI), 38.5%; urgency UI (UUI), 23.5%. The prevalence of UI tended to increase with age. The mean number of deliveries was 2 (range, 0-6). The prevalence of delivery mode was as follows: vaginal, 76%; caesarean (and/or vaginal), 12%; and no deliveries, 12%. Univariate analysis revealed a significant association between number of deliveries and SUI. Age and BMI were also associated with SUI and UUI. In multivariate analysis, the independent risk factors for SUI were age, BMI and number of deliveries (odds ratios (ORs), 1.03, 1.06, and 1.40, respectively). On the other hand, type of delivery was not a risk factor for SUI (Table). For UUI, only age was identified as an independent risk factor (OR, 1.05; p<0.05). CONCLUSIONS: This study revealed the number of deliveries as an independent risk factor for SUI, but showed no significant relationship between UI and delivery mode among Japanese women.