A survey on the management of overactive bladder by Indonesian urologists
Background: Overactive bladder (OAB) is a clinical syndrome consisting of symptom complex of urgency, with or without incontinence which has significant effects on quality of life and has to be managed properly. The aim of this study was to review the management of OAB by Indonesian urologists.
Methods: A self-constructed questionnaires containing diagnostic and treatment options of OAB patients were distributed to Indonesian urologists. This was a cross-sectional study and descriptive analysis method was used to analyze the data.
Results: 129 Indonesian urologists participated in this study. Most of them faced more than 20 OAB cases per year with the most common type was OAB without incontinence or dry OAB (57.4%). Most urologists (34.1%) ordered at least three diagnostic tools to determine OAB. They were bladder diary, urinalysis and scoring system. The most used scoring system (48.9%) was the overactive bladder symptoms score (OABSS). Thirty-five point seven percents (35.7%) of urologists used antimuscarinic and behavioral therapy as initial therapy. Solifenacin 5 mg/day was the most common antimuscarinic prescribed as the first line therapy (48%). Most common items commonly evaluated for follow-up: symptoms (96.9%), bladder diary (72.9%); and drugâs side effect (58.1%). When initial therapy had failed, most of the urologists (54.3%) chose to increase the dose of antimuscarinic. None of them chose bladder botulinum toxin injection as their additional therapy.
Conclusion: OAB is a frequent disorder which remains a challenge for urologists. The management of patients with OAB by Indonesian urologists has been suitable with the previous studies and guidelines.
Robinson D, Cardozo L. Overactive bladder: diagnosis and management. Maturitas. 2012;71(2):188-93. http://dx.doi.org/10.1016/j.maturitas.2011.11.016
Gormley EA, Lightner DJ, Burgio KL, Chai TC, Clemens JQ, Culkin DJ, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol. 2012.188(6Suppl):2455-63. doi: 10.1016/j.juro.2012.09.079
Foon R, Drake MJ. The overactive bladder. Ther Adv Urol. 2010;2(4):147-55. http://dx.doi.org/10.1177/1756287210373757
Mostwin JL. Pathophysiology: the varieties of bladder overactivity. Urology. 2002;60(5Suppl1):22-6. http://dx.doi.org/10.1016/S0090-4295(02)01788-0
Chapple CR, Martinez-Garcia R, Selvaggi L, Toozs-Hobson P, Warnack W, Drogendijk T, et al. A comparison of the efficacy and tolerability of solifenacin succinate and extended release tolterodine at treating overactive bladder syndrome: results of the STAR trial. Eur Urol. 2005;48(3):464-70. http://dx.doi.org/10.1016/j.eururo.2005.05.015
Tubaro A. Defining overactive bladder: epidemiology and burden of disease. Urology. 2004;64(6 Suppl 1):2-6. http://dx.doi.org/10.1016/j.urology.2004.10.047
Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50(6):1306-15. http://dx.doi.org/10.1016/j.eururo.2006.09.019
Sumardi R, Mochtar CA, Junizaf, Santoso BI, Setiati S, Nuhonni SA, et al. Prevalence of urinary incontinence, risk factors and its impact: multivariate analysis from Indonesian nationwide survey. Acta Med Indones. 2014;46(3):175-82.
Freeman RM, Adekanmi OA. Overactive bladder. Best Pract Res Clin Obstet Gynaecol. 2005;19(6):829-41. http://dx.doi.org/10.1016/j.bpobgyn.2005.08.002
Rahardjo HE, Santoso BI, Hakim S, Hasan B, Tjahjodjati, Moegni F. Inkontinensia urin pada perempuan. In: Rahardjo HE. Panduan tata laksana inkontinensia urin pada dewasa. Jakarta: Perkumpulan Kontinensia Indonesia (PERKINA). 2012;6-12. Indonesian.
Setiati S, Istanti R. Survei inkontinensia urin (mengompol) pada usia lanjut di lingkungan pusat santunan keluarga (pusaka). Maj Kedokt Indon. 2003;53:136-9. Indonesian.
Ouslander JG. Management of overactive bladder. N Eng J Med. 2004;350(8):786-99. http://dx.doi.org/10.1056/NEJMra032662
Lucas MG, Bedretdinova D, Bosch JLHR, Burkhard F, Cruz F, Nambiar AK, et al. Guidelines on urinary incontinence. European Association of Urology. 2014. doi:10.1016/j.eururo.2010.11.021
Barry MJ, Fowler FJ Jr, O'Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148(5):1549-57.
Homma Y, Yoshida M, Seki N, Yokoyama O, Kakizaki H, Gotoh M, et al. Symptom assessment tool for overactive bladder syndrome--overactive bladder symptom score. Urology. 2006;68(2):318-23. http://dx.doi.org/10.1016/j.urology.2006.02.042
Homma Y, Kakizaki H, Yamaguchi O, Yamanishi T, Nishizawa O, Yokoyama O, et al. Assessment of overactive bladder symptoms: comparison of 3-day bladder diary and the overactive bladder symptoms score. Urology. 2011;77(1):60-4. http://dx.doi.org/10.1016/j.urology.2010.06.044
Hung MJ, Chou CL, Yen TW, Chuang YC, Meng E, Huang ST, et al. Development and validation of the Chinese Overactive Bladder Symptom Score for assessing overactive bladder syndrome in a RESORT study. J Formos Med Assoc. 2013;112(5):276-82. http://dx.doi.org/10.1016/j.jfma.2011.09.020
Blaivas JG, Panagopoulos G, Weiss JP, Somaroo C. Validation of the overactive bladder symptom score. J Urol. 2007;178(2):543-7. http://dx.doi.org/10.1016/j.juro.2007.03.133
Coyne KS, Zyczynski T, Margolis MK, Elinoff V, Roberts RG. Validation of an overactive bladder awareness tool for use in primary care settings. Adv Ther. 2005;22(4):381-94. http://dx.doi.org/10.1007/BF02850085
Acquadro C, Kopp Z, Coyne KS, Corcos J, Tubaro A, Choo MS, et al. Translating overactive bladder questionnaires in 14 languages. Urology. 2006;67(3):536-40. http://dx.doi.org/10.1016/j.urology.2005.09.035
Chapple CR, Khullar V, Gabriel Z, Muston D, Bitoun CE, Weinstein D. The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Eur Urol. 2008;54(3):543-62. http://dx.doi.org/10.1016/j.eururo.2008.06.047
Chapple CR, Rechberger T, Al-Shukri S, Meffan P, Everaert K, Huang M, et al. Randomized, double-blind placebo- and tolterodine-controlled trial of the once-daily antimuscarinic agent solifenacin in patients with symptomatic overactive bladder. BJU Int. 2004;93(3):303-10. http://dx.doi.org/10.1111/j.1464-410X.2004.04606.x
Chapple C, Van Kerrebroeck P, Tubaro A, Haag-Molkenteller C, Forst HT, Massow U, et al. Clinical efficacy, safety, and tolerability of once-daily fesoterodine in subjects with overactive bladder. Eur Urol. 2007;52(4):1204-12. http://dx.doi.org/10.1016/j.eururo.2007.07.009
Amarenco G, Ismael SS, Even-Schneider A, Raibaut P, Demaille-Wlodyka S, Parratte B, et al. Urodynamic effect of acute transcutaneous posterior tibial nerve stimulation in overactive bladder. J Urol. 2003;169(6):2210-5. http://dx.doi.org/10.1097/01.ju.0000067446.17576.bd
MacDiarmid SA, Peters KM, Shobeiri SA, Wooldridge LS, Rovner ES, Leong FC, et al. Long-term durability of percutaneous tibial nerve stimulation for the treatment of overactive bladder. J Urol. 2010;183(1):234-40. http://dx.doi.org/10.1016/j.juro.2009.08.160
Peters KM, Carrico DJ, Perez-Marrero RA, Khan AU, Wooldridge LS, Davis GL, et al. Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial. J Urol. 2010;183(4):1438-43. http://dx.doi.org/10.1016/j.juro.2009.12.036
Yoong W, Ridout AE, Damodaram M, Dadswell R, et al. Neuromodulative treatment with percutaneous tibial nerve stimulation for intractable detrusor instability: outcomes following a shortened 6-week protocol. BJU Intl. 2010;106(11):1673-6. http://dx.doi.org/10.1111/j.1464-410X.2010.09461.x
Groen J, Blok BF, Bosch JL. Sacral neuromodulation as treatment for refractory idiopathic urge urinary incontinence: 5-year results of a longitudinal study in 60 women. J Urol. 2011;186(3):954-9. http://dx.doi.org/10.1016/j.juro.2011.04.059
Leong RK, Marcelissen TA, Nieman FH, De Bie RA, Van Kerrebroeck PE, De Wachter SG. Satisfaction and patient experience with sacral neuromodulation: results of a single center sample survey. J Urol. 2011;185(2):588-92. http://dx.doi.org/10.1016/j.juro.2010.09.090
Oerlemans DJ, Van Voskuilen AC, Marcelissen T, Weil EH, de Bie RA, Van Kerrebroeck PE. Is on-demand sacral neuromodulation in patients with OAB syndrome a feasible therapy regime?. Neurourol Urodyn. 2011;30(8):1493-6. http://dx.doi.org/10.1002/nau.21070
Vaarala MH, Tammela TL, Perttilä I, Luukkonen P, Hellström P Sacral neuromodulation in urological indications: the Finnish experience. Scand J Urol Nephrol. 2011;45(1):46-51. http://dx.doi.org/10.3109/00365599.2010.523013
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