Bulchandani S, Toozs-Hobson P, Parsons M, McCooty S, Perkins K, Latthe P
Birmingham Women's NHS Foundation Trust, Mindelsohn Way, Edgbaston, B15 2TG, Birmingham, UK,
Int Urogynecol J. 2015 Apr;26(4):533-7. doi: 10.1007/s00192-014-2527-2. Epub 2014 Oct 17.
Evidence suggests that OAB (overactive bladder) can occur alongside disorders of the colon, such as irritable bowel syndrome (IBS). Moreover, patients with constipation are more likely to develop OAB symptoms than those without. Anticholinergic medications (AcH) are commonly used for treating OAB, and can result in the unwanted side effects of constipation. We aimed to study the relationship of AcH, and their effects on quality of life using the electronic Personal Assessment Questionnaire (ePAQ) by assessing changes in the bowel and bladder domains, pre- and post-AcH treatment.
Ninety patients completed the ePAQ pre- and post-AcH treatment from January 2011 to April 2014. Data were collected retrospectively and prospectively, and analysed using a paired t test. Effect size (ES) was calculated for OAB and bowel domains to quantify the effect on QoL.
There was a significant improvement in the OAB (p = 0.0005) and bowel domains (p = 0.0005). In the bowel domains, the largest effect size was seen for IBS (0.5) followed by continence (0.4), evacuation (0.375) and a small ES was seen for constipation (0.2). There was a reduction in the "degree of bother" in OAB and bowel domains.
Patients may benefit from the possible effects of AcH on their bowels, and assessment of all aspects of pelvic floor function is important before commencing AcH. This may help to counsel patients, with possibly improved compliance with therapy.
有证据表明,膀胱过度活动症(OAB)可能与结肠疾病如肠易激综合征(IBS)同时出现。此外,便秘患者比无便秘患者更易出现OAB症状。抗胆碱能药物(AcH)常用于治疗OAB,但可能导致便秘这一不良副作用。我们旨在通过评估AcH治疗前后肠道和膀胱领域的变化,利用电子个人评估问卷(ePAQ)研究AcH的关系及其对生活质量的影响。
2011年1月至2014年4月,90例患者在AcH治疗前后完成了ePAQ。数据通过回顾性和前瞻性收集,并采用配对t检验进行分析。计算OAB和肠道领域的效应大小(ES)以量化对生活质量的影响。
OAB(p = 0.0005)和肠道领域(p = 0.0005)均有显著改善。在肠道领域,IBS的效应大小最大(0.5),其次是控便(0.4)、排便(0.375),便秘的效应大小较小(0.2)。OAB和肠道领域的“困扰程度”有所降低。
患者可能受益于AcH对肠道的潜在作用,在开始使用AcH之前评估盆底功能的各个方面很重要。这可能有助于为患者提供咨询,可能提高治疗依从性。