Jeong Zoo Lee

An epidemiological study of enuresis in Korean children

Objective To estimate the prevalence of enuresis in children of elementary school age, to evaluate the impact of enuresis on these children and their parents, and to identify the methods and effectiveness of managing enuresis.

A Prospective Multicenter Randomized Comparative Study Between the U- and H-type Methods of the TVT SECUR Procedure for the Treatment of Female Stress Urinary Incontinence: 1-Year Follow-Up

BACKGROUNDnNo studies have been published comparing the U- and H-type methods of the TVT SECUR (TVT-S) procedure.nnnOBJECTIVEnOur aim was to compare the efficacy and safety of the two types of TVT-S for female stress urinary incontinence (SUI).nnnDESIGN, SETTING, AND PARTICIPANTSnWomen with urodynamic SUI were enrolled in this 12-mo multicenter randomized study.nnnINTERVENTIONnSubjects were randomly allocated to either the U- or H-type method of TVT-S.nnnMEASUREMENTSnPre- and postoperative evaluations included a standing stress test, the Sandvik questionnaire, the Incontinence Quality of Life (I-QOL) questionnaire, and the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). Patients satisfaction and complications were evaluated. Objective and subjective cures were defined as no leakage on the stress test and responses on the Sandvik questionnaire, respectively. We compared the surgical outcomes between the two methods.nnnRESULTS AND LIMITATIONSnOf 285 women, 144 had the U-type method and 141 had the H-type method. Objective cure rates were 87.5% for the U-type method and 80.1% for the H-type method (p=0.091). Subjective cure rates were 77.1% for the U-type method and 75.7% for the H-type method (p=0.786). Improvement in I-QOL and domain scores of the ICIQ-FLUTS (filling and incontinence sum, QOL score), and patients satisfaction favored the U-type method. There were three cases of intraoperative vaginal wall perforation, one case of increased bleeding, and three cases of temporary postoperative retention. A power calculation was not performed, and some baseline characteristics were not balanced between the two methods.nnnCONCLUSIONSnBoth methods of TVT-S provided comparable cure rates for female SUI. However, QOL and treatment satisfaction favored the U-type method.nnnTRIAL REGISTRATIONnThe protocol of this study was not registered.

Urinary urgency outcomes after propiverine treatment for an overactive bladder: the ‘Propiverine study on overactive bladder including urgency data’

Study Type – Therapy (RCT)u2028Level of Evidenceu20031b

Efficacy and safety of solifenacin succinate in Korean patients with overactive bladder: a randomised, prospective, double-blind, multicentre study.

Purpose:u2002 We assessed the efficacy and safety of solifenacin compared with tolterodine for treatment of overactive bladder (OAB) in Korean patients.

Desmopressin is an Effective Treatment for Mixed Nocturia with Nocturnal Polyuria and Decreased Nocturnal Bladder Capacity

To investigate the efficacy and safety of desmopressin in patients with mixed nocturia, Patients aged ≥18 yr with mixed nocturia (≥2 voids/night and a nocturnal polyuria index [NPi] >33% and a nocturnal bladder capacity index [NBCi] >1) were recruited. The optimum dose of oral desmopressin was determined during a 3-week dose-titration period and the determined dose was maintained for 4 weeks. The efficacy was assessed by the frequency-volume charts and the sleep questionnaire. The primary endpoint was the proportion of patients with a 50% or greater reduction in the number of nocturnal voids (NV) compared with baseline. Among 103 patients enrolled, 94 (79 men and 15 women) were included in the analysis. The proportion of patients with a 50% or greater reduction in NV was 68 (72%). The mean number of NV decreased significantly (3.20 to 1.34) and the mean nocturnal urine volume, nocturia index, NPi, and NBCi decreased significantly. The mean duration of sleep until the first NV was prolonged from 118.4±44.1 to 220.3±90.7 min (P<0.001). The overall impression of patients about their quality of sleep improved. Adverse events occurred in 6 patients, including one asymptomatic hyponatremia. Desmopressin is an effective and well-tolerated treatment for mixed nocturia.

Prevalence of painful bladder syndrome/interstitial cystitis-like symptoms in women: a population-based study in Korea

ObjectiveDespite growing clinical interest in painful bladder syndrome/interstitial cystitis (PBS/IC, also known as bladder pain syndrome), estimating its prevalence is difficult because of its variable presentation and the lack of clear diagnostic criteria. In this study, we estimated the prevalence of PBS/IC-like urinary symptoms in adult women in the general population of South Korea.MethodsA population-based cross-sectional telephone survey was conducted among 2,323 women (18–71xa0years of age), selected by geographically stratified random sampling, based on Korean census data. The survey was performed by trained interviewers between September 22, 2008, and October 6, 2008. All participants were interviewed by telephone using a validated questionnaire, the O’Leary-Sant IC Symptom and Problem (OLS) index. Women with high symptom and problem index scores of 12 or greater and scores of two or greater for pain and nocturia symptoms were considered to have “probable PBS/IC,” according to previously suggested criteria.ResultsAfter exclusions, a total of 2,300 respondents were included. The severity of symptoms increased with age. Eight respondents (0.35%) reported severe symptoms and problems (OLS survey scores of ≥12). Of these, six (261/100,000 or 0.26%, 95% CI 242–278) met previously suggested criteria for probable PBS/IC.ConclusionThe prevalence of PBS/IC-like urinary symptoms in South Korean women appeared to be lower than in Europe and the United States, and similar to that of Japan, according to common criteria. Screening for symptoms that are consistent with the disease may improve our understanding of its true prevalence.

Efficacy and Safety of Desmopressin Add-On Therapy for Men with Persistent Nocturia on α-Blocker Monotherapy for Lower Urinary Tract Symptoms: A Randomized, Double-Blind, Placebo Controlled Study

Purpose: We investigated the efficacy and safety of desmopressin add‐on therapy for men with persistent nocturia on &agr;‐blocker for lower urinary tract symptoms in this placebo controlled study. Materials and Methods: The study included men 40 to 65 years old with lower urinary tract symptoms and persistent nocturia despite &agr;‐blocker therapy for at least 8 weeks. Patients were randomized to once daily placebo or desmopressin 0.2 mg for 8 weeks. The primary end point was to assess changes in the mean number of nocturia episodes from baseline to the final assessment. Other secondary end points and adverse events were evaluated. Results and Limitation: A total of 86 patients were randomized to treatment, including placebo in 39 and desmopressin 0.2 mg in 47. Baseline characteristics were similar in the 2 groups. The desmopressin add‐on group was significantly superior to placebo in terms of the change from baseline in the mean number of nocturia episodes (−1.13 ± 0.92 vs −0.68 ± 0.79, p = 0.034), the changes in nocturnal urine volume (p <0.001), total I‐PSS (International Prostate Symptom Score) (p = 0.041), the nocturnal polyuria index (p = 0.001) and ICIQ‐N (International Consultation on Incontinence Questionnaire‐Nocturia) (p = 0.001), and the willingness to continue (p = 0.025). The incidence of adverse events in the desmopressin add‐on group was similar to that in the placebo group. Most adverse events were mild. Conclusion: Desmopressin add‐on therapy in men 40 to 65 years old with persistent nocturia on &agr;‐blocker monotherapy for lower urinary tract symptoms is effective and well tolerated.

The efficacy and tolerability of tarafenacin, a new muscarinic acetylcholine receptor M3 antagonist in patients with overactive bladder; randomised, double-blind, placebo-controlled phase 2 study

To evaluate the dose–response relationship of tarafenacin, an antimuscarinic agent in development phase, for efficacy and safety, at daily doses of 0.2 and 0.4 mg for the treatment of overactive bladder (OAB)

Safety and efficacy of 8-mg once-daily vs 4-mg twice-daily silodosin in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (SILVER Study): a 12-week, double-blind, randomized, parallel, multicenter study.

OBJECTIVEnTo show the noninferiority of silodosin 8-mg once-daily (QD) to 4-mg twice-daily (BID) in efficacy and safety in patients with lower urinary tract symptoms or benign prostatic hyperplasia in the Korean population.nnnMETHODSnA prospective, multicenter, double-blind, randomized, comparative study was conducted. A total of 532 male patients aged ≥50 years with lower urinary tract symptoms or benign prostatic hyperplasia were included. All patients received silodosin QD or BID for 12 weeks. The primary end point was the change from baseline in total International Prostate Symptom Score (IPSS) at 12 weeks. Adverse drug reactions, vital signs, and laboratory tests were recorded.nnnRESULTSnA total of 424 patients were randomized to the silodosin QD or BID groups. These groups were not significantly different in baseline characteristics. The mean total IPSS change in QD group was not inferior to that in BID group (-6.70 and -6.94, respectively; 95% confidence interval, -0.88 to 1.36). The QD and BID groups did not significantly differ in the following: percentages of patients with ≥25% (63.41% and 67.82%, respectively; P = .349) or ≥4-point improvement in total IPSS (65.85% and 69.31%, respectively; P = .457), maximum urinary flow rate improvement ≥30% (47.32% and 40.59%, respectively; P = .172), changes in IPSS voiding subscore (-4.42 ± 4.93 and -4.65 ± 4.77; P = .641), IPSS storage subscore (-2.05 ± 3.07 and -2.52 ± 2.97; P = .117), quality of life (-1.19 ± 1.49 and -1.40 ± 1.42; P = .136), maximum urinary flow rate (3.55 ± 5.93 and 3.74 ± 6.79 mL/s; P = .768), International Continence Society male questionnaire score, Patient Goal Achievement Score, or Treatment Satisfaction Question. The 2 groups had similar frequencies of adverse drug reactions.nnnCONCLUSIONnQD administration of silodosin was not inferior to BID in efficacy. The 2 groups had similar adverse drug reaction profiles.

Patient‐reported goal achievement after antimuscarinic treatment in patients with overactive bladder symptoms

Aim:u2002 Standardised traditional outcome measures may fail to address factors that are important to patients and address irrelevant factors. Aim of this study was to assess patient‐reported goals and goal achievement (GA) in the antimuscarinic treatment for overactive bladder (OAB) patients.