Department of Women´s and Children´s Health, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.
Gynecol Obstet Invest. 2019;84(5):472-476. doi: 10.1159/000496606. Epub 2019 Mar 21.
To determine if findings at urodynamics prognosticate improvements in overactive bladder symptoms among women receiving mirabegron treatment.
Before treatment, women completed a urodynamic investigation, a micturition diary and the Urinary Distress Inventory (UDI) with the irritative subscale UDIOAB. After 6 months mirabegron treatment, patients were clinically evaluated and completed the UDI. Associations were tested using regression analyses and nonparametric statistics.
Testing urodynamic variables for association with treatment effects in multiple linear regression analysis showed that lower volumes at first sensation to void significantly correlated with greater improvement in the UDIOAB after 6 months mirabegron treatment (B = 0.026, 95% CI 0.002-0.049, p = 0.034). Improvements in UDIOAB showed no correlation with presence of nocturia (p = 0.65), previous use of anticholinergics (p = 1), menopausal status (p = 1), any detrusor overactivity during filling (p = 1), phasic detrusor contractions during filling (p = 1), or detrusor overactivity during inhibition (p = 1).
We found limited support for clinically relevant associations between findings at urodynamics and subsequent treatment outcomes for mirabegron in routine clinical practice. Our findings do not support the role of these investigations as predictors of outcomes in patients with overactive bladder symptoms.
确定尿动力学检查结果是否可以预测接受米拉贝隆治疗的女性膀胱过度活动症症状的改善情况。
在治疗前,女性患者完成尿动力学检查、排尿日记和尿失禁困扰量表(UDI)及其刺激症状亚量表 UDIOAB。米拉贝隆治疗 6 个月后,患者进行临床评估并完成 UDI。使用回归分析和非参数统计检验关联。
在多元线性回归分析中,测试尿动力学变量与治疗效果的关联,发现首次感觉排尿的较低容量与 6 个月米拉贝隆治疗后 UDIOAB 的改善显著相关(B = 0.026,95%CI 0.002-0.049,p = 0.034)。UDIOAB 的改善与夜间多尿(p = 0.65)、之前使用抗胆碱能药物(p = 1)、绝经状态(p = 1)、充盈期任何逼尿肌过度活动(p = 1)、充盈期相收缩性逼尿肌收缩(p = 1)或抑制期逼尿肌过度活动(p = 1)均无相关性。
我们发现,在常规临床实践中,米拉贝隆治疗的尿动力学检查结果与随后的治疗结果之间存在有限的临床相关关联。我们的研究结果不支持这些检查作为膀胱过度活动症症状患者结局预测因素的作用。