Orta Derecede Fonksiyonel Bozukluğu Olan Aşırı Aktif Mesane Hastalarında İntravezikal Botulinum Toksin Tedavisinin Yaşam Kalitesini İyileştirmedeki Etkinliğinin Değerlendirilmesi
Yıl 2024,
Cilt: 19 Sayı: 3, 103 - 109, 30.10.2024
Necmi Bayraktar
,
Sadrettin Tuğcu
Öz
Amaç: Aşırı aktif mesane (AAM) yaşam kalitesini önemli ölçüde etkilemekte ve cinsiyetten bağımsız olarak çeşitli yaş gruplarındaki bireyleri etkilemektedir. Konvansiyonel tedaviler mevcut olsa da, Doğu Kooperatif Onkoloji Grubu Performans Skoru (ECOG PS3) ile işaretlenen orta derecede fonksiyonel bozukluğu olan hastalar için genellikle yetersiz kalmaktadır. İntravezikal botulinum toksin tedavisi, özellikle geleneksel farmakoterapiye yanıt vermeyenler için umut verici bir alternatif olarak ortaya çıkmıştır.
Amaç: Bu çalışmada amacımız, daha önce konvansiyonel tedavilere yanıt vermemiş AAM ve Performans Skoru ECOG PS3 olan hastalarda intravezikal botulinum toksin tedavisinin yaşam kalitesini iyileştirmedeki etkinliğini değerlendirmektir.
Gereç ve Yöntem: 2020-2023 yılları arasındaki bu retrospektif çalışmada, AAM için botulinum toksin tedavisi ile tedavi edilen hastalardan elde edilen verileri analiz ettik. Dahil edilen hastalar, mesane kapasitesi en az 200 mililitre olan ECOG PS3 hastalarıydı. Toplanan veriler arasında tıbbi öyküler, işeme günlüğü ve yaşam kalitesi skorları (ICIQ-SF ve I-QOL) yer aldı.
Bulgular: Araştırma 46 kişiyi içeriyordu ve tedaviyi takiben yaşam kalitesinde istatistiksel olarak anlamlı bir ilerleme olduğunu gösterdi. İnkontinans epizodları ve işeme günlüğü skorlarının parametreleri istatistiksel olarak anlamlı artışlar sergiledi. Tedaviyi takiben rezidüel idrar veya idrar yolu enfeksiyonlarında gözlenebilir bir artış olmaması dikkat çekicidir.
Sonuç: İntravezikal botulinum toksin tedavisi, AAM'den muzdarip ve orta derecede fonksiyonel bozukluk sergileyen hastalarda yaşam kalitesinde belirgin bir iyileşme göstermiştir. Bununla birlikte, bulguları doğrulamak ve güvenilirliklerini korumak için çok merkezli randomize çalışmalar şeklinde daha fazla araştırmaya ihtiyaç vardır.
Kaynakça
- 1. Yi Q-T, Gong M, Chen C-H, Hu W, Zhu R-J. Epidemic investigation of benign prostatic obstruction with coexisting overactive bladder in Shanghai Pudong New Area and its impact on the health-related quality of life. BMC Urology. 2019;19(1):82. https://doi.org/10.1186/ s12894-019-0513-1
- 2. Kim S-K, Kim S-H. The impact of overactive bladder on health-related quality of life in Korea: based on the results of a Korean Community Health Survey. Quality of Life Research. 2021;30(4):1017-24. https://doi.org/10.1007/s11136-020-02710-3
- 3. Pyo H, Kim BR, Park M, Hong JH, Kim EJ. Effects of overactive bladder symptoms in stroke patients’ health related quality of life and their performance scale. Annals of Rehabilitation Medicine. 2017;41(6):935-43. https://doi.org/10.5535%2Farm.2017.41.6.935
- 4. Simcock R, Wright J. Beyond Performance Status. Clin Oncol (R Coll Radiol). 2020;32(9):553-61. https://doi. org/10.1016/j.clon.2020.06.016
- 5. Jang H, Lee K, Kim S, Kim S. Unmet needs in palliative care for patients with common non-cancer diseases: a cross-sectional study. BMC Palliative Care. 2022;21(1):151. https://doi.org/10.1186/s12904-022- 01040-0
- 6. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. American journal of clinical oncology. 1982;5(6):649-56. https:// doi.org/10.1097/00000421-198212000-00014
- 7. Brown JS, McGhan WF, Chokroverty S. Comorbidities associated with overactive bladder. Am J Manag Care. 2000;6(11 Suppl):S574-9.
- 8. Lepor H. Challenges in the detection and diagnosis of bladder dysfunction: optimal strategies for the primary care physician. Reviews in Urology. 2004;6(Suppl 1):S1.
- 9. Enemchukwu E, Cameron A. Management of complex OAB patients: A call to action. Neurourol Urodyn. 2022;41(8):1938-9. https://doi.org/10.1002/nau.25048
- 10. Park WH. Urinary incontinence and physician’s attitude. J Korean Med Sci. 2013;28(11):1559-60. https:// doi.org/10.3346/jkms.2013.28.11.1559
- 11. Schnelle JF, Smith RL. Quality indicators for the management of urinary incontinence in vulnerable community-dwelling elders. Ann Intern Med. 2001;135(8 Pt 2):752-8. https://doi.org/10.7326/0003- 4819-135-8_Part_2-200110161-00015
- 12. Truzzi JC, Lapitan MC, Truzzi NC, Iacovelli V, Averbeck MA. Botulinum toxin for treating overactive bladder in men: A systematic review. Neurourol Urodyn. 2022;41(3):710-23. https://doi.org/10.1002/nau.24879
- 13. D’Ancona C, Haylen B, Oelke M, Abranches‐Monteiro L, Arnold E, Goldman H, et al. The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourology and urodynamics. 2019;38(2):433-77. https://doi.org/10.1002/nau.23897
- 14. Ginsberg D, Jen R, Nseyo U. Botulinum Toxin Treatment of Neurogenic Detrusor Overactivity and Overactive Bladder. Textbook of Female Urology and Urogynecology: CRC Press; 2023. p. 490-500. rita-jen-unwanaobong-nseyo. https://doi. org/10.1201/9781003144236-51
- 15. Yi Q-T, Gong M, Chen C-H, Hu W, Zhu R-J. Epidemic investigation of benign prostatic obstruction with coexisting overactive bladder in Shanghai Pudong New Area and its impact on the health-related quality of life. BMC urology. 2019;19:1-8. https://doi.org/10.1186/ s12894-019-0513-1
- 16. Moons KG, Royston P, Vergouwe Y, Grobbee DE, Altman DG. RESEARCH METHODS & REPORTINGPrognosis and prognostic research: what, why, and how?-Doctors have little specific research to draw on when predicting outcome. This first article in a series explains why research into prognosis is important and how to design such research. BMJ (CR)-print. 2009;338(7706):1317. https://doi.org/10.1136/bmj.b375
- 17. Shaban AM, Drake MJ. Botulinum toxin treatment for overactive bladder: risk of urinary retention. Curr Urol Rep. 2008;9(6):445-51. https://doi.org/10.1007/s11934- 008-0077-1
- 18. Shapiro K, Anger J, Cameron AP, Chung D, DaignaultNewton S, Ippolito GM, et al. Antibiotic use, best practice statement adherence, and UTI rate for intradetrusor onabotulinumtoxin-A injection for overactive bladder: A multi-institutional collaboration from the SUFU Research Network (SURN). Neurourol Urodyn. 2024;43(2):407-14. https://doi.org/10.1002/ nau.25334
Assessing the Effectiveness of Intravesical Botulinum Toxin Therapy in Improving Quality of Life for Overactive Bladder Patients with Moderate Functional Impairment
Yıl 2024,
Cilt: 19 Sayı: 3, 103 - 109, 30.10.2024
Necmi Bayraktar
,
Sadrettin Tuğcu
Öz
Objective: Overactive bladder (OAB) significantly impacts the quality of life, affecting individuals across various age groups irrespective of gender. While conventional treatments exist, they often fall short for patients with moderate functional impairment, marked by an Eastern Cooperative Oncology Group Performance Score (ECOG PS3). Intravesical botulinum toxin therapy has emerged as a promising alternative, especially for those unresponsive to traditional pharmacotherapy.
Material and Methods: In this retrospective study from 2020 to 2023, we analyzed data from patients treated with botulinum toxin therapy for AAM. Included patients were ECOG PS3 patients with a bladder capacity of at least 200 milliliters. Data collected included medical histories, voiding diary, and quality of life scores (ICIQ-SF and I-QOL).
Results: The research featured 46 individuals and demonstrated a statistically substantial advancement in quality-of-life following treatment. The parameters of incontinence episodes and voiding diary scores exhibited statistically significant enhancements. It is noteworthy that there was no observable increase in residual urine or urinary tract infections subsequent to treatment.
Conclusion: Intravesical botulinum toxin therapy has demonstrated a marked improvement in the quality of life for patients suffering from AAM and exhibiting moderate functional impairment. Nevertheless, further research is required in the form of multicenter randomized trials to substantiate the findings and maintain their credibility.
Etik Beyan
KKTC Burhan Nalbatoğlu Sitate Hospital Ethic Committee: 03.04.2024 EK:19/24.
Kaynakça
- 1. Yi Q-T, Gong M, Chen C-H, Hu W, Zhu R-J. Epidemic investigation of benign prostatic obstruction with coexisting overactive bladder in Shanghai Pudong New Area and its impact on the health-related quality of life. BMC Urology. 2019;19(1):82. https://doi.org/10.1186/ s12894-019-0513-1
- 2. Kim S-K, Kim S-H. The impact of overactive bladder on health-related quality of life in Korea: based on the results of a Korean Community Health Survey. Quality of Life Research. 2021;30(4):1017-24. https://doi.org/10.1007/s11136-020-02710-3
- 3. Pyo H, Kim BR, Park M, Hong JH, Kim EJ. Effects of overactive bladder symptoms in stroke patients’ health related quality of life and their performance scale. Annals of Rehabilitation Medicine. 2017;41(6):935-43. https://doi.org/10.5535%2Farm.2017.41.6.935
- 4. Simcock R, Wright J. Beyond Performance Status. Clin Oncol (R Coll Radiol). 2020;32(9):553-61. https://doi. org/10.1016/j.clon.2020.06.016
- 5. Jang H, Lee K, Kim S, Kim S. Unmet needs in palliative care for patients with common non-cancer diseases: a cross-sectional study. BMC Palliative Care. 2022;21(1):151. https://doi.org/10.1186/s12904-022- 01040-0
- 6. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. American journal of clinical oncology. 1982;5(6):649-56. https:// doi.org/10.1097/00000421-198212000-00014
- 7. Brown JS, McGhan WF, Chokroverty S. Comorbidities associated with overactive bladder. Am J Manag Care. 2000;6(11 Suppl):S574-9.
- 8. Lepor H. Challenges in the detection and diagnosis of bladder dysfunction: optimal strategies for the primary care physician. Reviews in Urology. 2004;6(Suppl 1):S1.
- 9. Enemchukwu E, Cameron A. Management of complex OAB patients: A call to action. Neurourol Urodyn. 2022;41(8):1938-9. https://doi.org/10.1002/nau.25048
- 10. Park WH. Urinary incontinence and physician’s attitude. J Korean Med Sci. 2013;28(11):1559-60. https:// doi.org/10.3346/jkms.2013.28.11.1559
- 11. Schnelle JF, Smith RL. Quality indicators for the management of urinary incontinence in vulnerable community-dwelling elders. Ann Intern Med. 2001;135(8 Pt 2):752-8. https://doi.org/10.7326/0003- 4819-135-8_Part_2-200110161-00015
- 12. Truzzi JC, Lapitan MC, Truzzi NC, Iacovelli V, Averbeck MA. Botulinum toxin for treating overactive bladder in men: A systematic review. Neurourol Urodyn. 2022;41(3):710-23. https://doi.org/10.1002/nau.24879
- 13. D’Ancona C, Haylen B, Oelke M, Abranches‐Monteiro L, Arnold E, Goldman H, et al. The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourology and urodynamics. 2019;38(2):433-77. https://doi.org/10.1002/nau.23897
- 14. Ginsberg D, Jen R, Nseyo U. Botulinum Toxin Treatment of Neurogenic Detrusor Overactivity and Overactive Bladder. Textbook of Female Urology and Urogynecology: CRC Press; 2023. p. 490-500. rita-jen-unwanaobong-nseyo. https://doi. org/10.1201/9781003144236-51
- 15. Yi Q-T, Gong M, Chen C-H, Hu W, Zhu R-J. Epidemic investigation of benign prostatic obstruction with coexisting overactive bladder in Shanghai Pudong New Area and its impact on the health-related quality of life. BMC urology. 2019;19:1-8. https://doi.org/10.1186/ s12894-019-0513-1
- 16. Moons KG, Royston P, Vergouwe Y, Grobbee DE, Altman DG. RESEARCH METHODS & REPORTINGPrognosis and prognostic research: what, why, and how?-Doctors have little specific research to draw on when predicting outcome. This first article in a series explains why research into prognosis is important and how to design such research. BMJ (CR)-print. 2009;338(7706):1317. https://doi.org/10.1136/bmj.b375
- 17. Shaban AM, Drake MJ. Botulinum toxin treatment for overactive bladder: risk of urinary retention. Curr Urol Rep. 2008;9(6):445-51. https://doi.org/10.1007/s11934- 008-0077-1
- 18. Shapiro K, Anger J, Cameron AP, Chung D, DaignaultNewton S, Ippolito GM, et al. Antibiotic use, best practice statement adherence, and UTI rate for intradetrusor onabotulinumtoxin-A injection for overactive bladder: A multi-institutional collaboration from the SUFU Research Network (SURN). Neurourol Urodyn. 2024;43(2):407-14. https://doi.org/10.1002/ nau.25334