Research Center for Evidence Based-Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
Academic Urology Unit, Royal Hallamshire Hospital, Sheffield, UK.
Neurourol Urodyn. 2019 Jan;38(1):31-62. doi: 10.1002/nau.23869. Epub 2018 Nov 8.
To assess the different treatment methods in management of neurogenic bladder (NGB) in patients with Parkinson's disease (PD).
A systematic search was performed in Cochrane library, EMBASE, Proquest, Clinicaltrial.gov, WHO, Google Scholar, MEDLINE via PubMed, Ovid, ongoing trials registers, and conference proceedings in November 11, 2017. All randomized controlled trials (RCTs) or quasi-RCTs comparing any treatment method for management of NGB in patients with PD were included. The titles and abstracts of all identified studies were evaluated independently by two investigators. Once all of the potential related articles were retrieved, each author separately evaluated the full text of each article and the quality of the methodology of the selected studies using the Cochrane appraisal risk of bias checklist and then the data about the patient's outcomes was extracted. We registered the title in Joanna Briggs Institute (JBI) that is available in http://joannabriggs.org/research/registered_titles.aspx.
We included 41 RCTs or quasi-RCTs or three observational study with a total of 1063 patients that evaluated pharmacological, neurosurgical, botulinum toxin, electrical neuromodulation, and behavioral therapy effects on NGB. Among the included studies only solifenacin succinate double-blind, randomized, placebo-controlled study was assessed as low risk of bias, and treatment led to an improvement in urinary incontinence.
Although several interventions are available for treatment NGB in patients with PD, at present there is little or no evidence that treatment improves patient outcomes in this population. Additional large, well designed, randomized studies with improved methodology and reporting focused on patient-centered outcomes are needed.
评估帕金森病（PD）患者神经源性膀胱（NGB）管理的不同治疗方法。
系统检索 Cochrane 图书馆、EMBASE、Proquest、Clinicaltrial.gov、世界卫生组织、Google Scholar、MEDLINE 通过 PubMed、Ovid、正在进行的试验登记处和会议论文集，检索时间为 2017 年 11 月 11 日。纳入所有比较 PD 患者 NGB 管理中任何治疗方法的随机对照试验（RCT）或准 RCT。由两名研究者独立评估所有确定研究的标题和摘要。一旦检索到所有潜在相关文章，每位作者分别评估每篇文章的全文和所选研究方法的质量，使用 Cochrane 评估风险偏倚清单，然后提取有关患者结局的数据。我们在 Joanna Briggs Institute（JBI）注册了该标题，可在 http://joannabriggs.org/research/registered_titles.aspx 中查看。
我们纳入了 41 项 RCT 或准 RCT 或 3 项观察性研究，共纳入了 1063 例患者，评估了药物治疗、神经外科治疗、肉毒杆菌毒素、电神经调节和行为治疗对 NGB 的影响。在纳入的研究中，只有琥珀酸索利那新双盲、随机、安慰剂对照研究被评估为低风险偏倚，且治疗可改善尿失禁。
尽管有几种干预措施可用于治疗 PD 患者的 NGB，但目前几乎没有或没有证据表明治疗可改善该人群的患者结局。需要开展更多、设计更好、方法学和报告改进、以患者为中心结局为重点的大型、随机研究。
