Wu Jennifer M, Fulton Rebekah G, Amundsen Cindy L, Knight Sharon K, Kuppermann Miriam
From the *Department of Obstetrics and Gynecology, Duke University, Durham, NC; and †Departments of Obstetrics, Gynecology, & Reproductive Sciences, ‡Epidemiology & Biostatistics, and §Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, CA.
Female Pelvic Med Reconstr Surg. 2011 Jul;17(4):184-9. doi: 10.1097/SPV.0b013e318223c8ad.
: Symptoms of overactive bladder (OAB) can have profound effects on women's quality of life. However, quantitative data on how women value these symptoms and their treatments are limited. We sought to assess women's preferences, which are referred to as utilities, for different severities of and treatment options for OAB.
: Eighty women-40 with OAB symptoms and 40 without OAB-were recruited from urogynecology and urology practices at an academic institution from April to November 2009. A single, trained interviewer administered a computerized preference elicitation tool to measure preferences for 4 OAB severity levels (urgency/frequency and mild, moderate, and severe urge incontinence), as well as 3 OAB treatments with and without adverse effects or complications, which included (1) anticholinergic medications, (2) botulinum toxin injection, and (3) sacral neuromodulation. Preferences were assessed using the time trade-off (TTO) method.
: Median TTO scores for OAB decreased as severity increased (urgency/frequency, 0.88; mild, 0.92; moderate, 0.85; severe, 0.73). Median TTO scores assigned to anticholinergic medications were higher (0.93) than those for botulinum (0.88) and sacral neuromodulation (0.85), and adverse effects or complications lowered the utilities for each treatment (anticholinergics, 0.88; botulinum, 0.75; and sacral neuromodulation, 0.78).
: Women view symptoms of OAB, particularly moderate or severe symptoms, as being quite burdensome. The degree of invasiveness and the number of adverse effect/complications are important contributors to the utilities that women assign to the various treatment options.
膀胱过度活动症（OAB）的症状会对女性的生活质量产生深远影响。然而，关于女性如何看待这些症状及其治疗方法的定量数据有限。我们试图评估女性对OAB不同严重程度和治疗方案的偏好，即效用。
2009年4月至11月，从一所学术机构的妇科泌尿学和泌尿学诊所招募了80名女性，其中40名有OAB症状，40名没有OAB症状。由一名经过培训的访谈者使用计算机化的偏好诱导工具，来测量对4种OAB严重程度水平（尿急/尿频以及轻度、中度和重度急迫性尿失禁）以及3种有或无不良反应或并发症的OAB治疗方法的偏好，这3种治疗方法包括：（1）抗胆碱能药物，（2）肉毒杆菌毒素注射，（3）骶神经调节。使用时间权衡（TTO）方法评估偏好。
随着OAB严重程度增加，TTO中位数得分降低（尿急/尿频，0.88；轻度，0.92；中度，0.85；重度，0.73）。赋予抗胆碱能药物的TTO中位数得分（0.93）高于肉毒杆菌毒素（0.88）和骶神经调节（0.85），并且不良反应或并发症降低了每种治疗方法的效用（抗胆碱能药物，0.88；肉毒杆菌毒素，0.75；骶神经调节，0.78）。
女性认为OAB的症状，尤其是中度或重度症状，相当沉重。侵入程度以及不良反应/并发症的数量是女性赋予各种治疗方案效用的重要因素。
