Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Climacteric. 2023 Jun;26(3):284-288. doi: 10.1080/13697137.2023.2184251. Epub 2023 Mar 13.
Overactive bladder (OAB) is a complex and multifactorial syndrome associated with urinary frequency, urgency and incontinence. The menopause-associated hormonal changes play a role in the development of this condition. Vaginal estrogens are effective in improving OAB in postmenopausal women (PMW) with vulvovaginal atrophy (VVA). Ospemifene is a selective estrogen receptor modulator licensed for the treatment of VVA. This study aimed to evaluate the effects of ospemifene on OAB symptoms in PMW with VVA.
Forty PMW suffering from OAB and VVA received oral ospemifene (60 mg/day) for 12 weeks. All patients were assessed with a urodynamic study, a 3-day bladder diary and validated questionnaires (International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form [ICIQ-UI SF] and International Consultation on Incontinence Questionnaire - Overactive Bladder [ICIQ-OAB]) at enrollment and at the end of the study.
Cytometric capacity, bladder compliance and verbal sensory threshold responses during bladder filling were improved after treatment. The voiding diary showed a significant reduction of daily voids, urge urinary incontinence episodes and nocturnal events. The median overall scores of the ICIQ-UI and ICIQ-OAB were also significantly improved.
Our study suggest that treatment with ospemifene in PMW suffering from OAB is associated with a reduction of OAB symptoms due to a decreased bladder sensitivity and with an improvement in quality of life.
膀胱过度活动症(OAB)是一种与尿频、尿急和尿失禁相关的复杂多因素综合征。与绝经相关的激素变化在这种疾病的发展中起作用。阴道雌激素可有效改善绝经后妇女(PMW)伴外阴阴道萎缩(VVA)的 OAB 症状。Ospemifene 是一种获批用于治疗 VVA 的选择性雌激素受体调节剂。本研究旨在评估 ospemifene 对 VVA 的 PMW 的 OAB 症状的影响。
40 名患有 OAB 和 VVA 的 PMW 接受 ospemifene(60mg/天)口服治疗 12 周。所有患者在入组时和研究结束时均进行尿动力学研究、3 天膀胱日记和经过验证的问卷(国际尿失禁咨询问卷 - 尿失禁简短表 [ICIQ-UI SF] 和国际尿失禁咨询问卷 - 膀胱过度活动症 [ICIQ-OAB])评估。
治疗后,膀胱容量、顺应性和膀胱充盈期间的言语感觉阈值反应得到改善。排尿日记显示每日排尿次数、急迫性尿失禁发作和夜间事件明显减少。ICIQ-UI 和 ICIQ-OAB 的总体评分中位数也显著改善。
我们的研究表明,ospemifene 治疗 OAB 的 PMW 与降低膀胱敏感性相关,可减少 OAB 症状,并提高生活质量。