Validating 7-items Overactive Bladder Symptom Score (OABSS) through Arabic linguistic version

The scoring of the 7-item Overactive Bladder Symptom Score (OABSS) questionnaire is unusual because its scale varies with the same maximum and minimum scoring values and quantifies all aspects of OAB. The questionnaire also contains a graded response for urgency. The current study is mainly concerned with the development and validation of the OABSS questionnaire for Jordanian patients. The process of translating the English OABSS questionnaire into the Arabic language involved forward and backward translations. Afterward, a prospective study was conducted to validate the Arabic version of the OABSS questionnaire by examining 235 patients from the outpatient clinics of Karak Governorate Teaching Hospital. The Arabic OABSS questionnaire was completed by all the enrolled patients before and after three months of treatment with solifenacin 5 mg taken once daily. The study included 235 regular patients (152 females and 83 males) diagnosed with OAB in accordance with the definition of the International Continence Society (ICS). The results showed major and significant differences on all seven domains of the questions on the OABSS questionnaire before and after receiving treatment (p < 0.05). Confirmatory Factor Analysis was used to measure the reliability and the questionnaire was found to be highly reliable for the construct variables. The findings derived from the current study would be beneficial for local urologists and researchers, as the Arabic version of the OABSS questionnaire was proven to be a reliable instrument for use in the assessment of OAB. Future studies are needed to compare different translated questionnaires relating to OAB.Trial registration number: NCT04309890.

Evaluation of Lower Urinary Tract Symptoms (LUTS): Severity Score and Symptom Association

Introduction: Lower urinary tract symptoms (LUTS) is a group of symptoms relating to stages of micturation such as storage symptoms, voiding dysfunction and post micturation dysfunction. Overactive bladder symptom score (OABSS) is a questionnaires with scores which helps in evaluating the severity of symptoms. Objectives To find the incidence of women visiting with LUTS and to evaluate storage symptoms in LUTS (urgency, urge incontinence, frequency) using OABSS (overactive bladder symptom score) questionnaires. Methodology This is a prospective study done from February 2016 to February 2017. Patients visiting Department of Obstetrics and Gynaecology with lower urinary tract symptoms (LUTS) were enrolled in the study after informed consent. Patients were assessed for types of LUTS and data were filled in the performa. If patients had urgency, urge incontinence, increased day time frequency, then the patients were explained and asked overactive bladder symptom score questionnaire (OABSS) and noted. Patients were then examined for pelvic floor dysfunction and neurological abnormalities for identifying association with the symptoms. Statistical analysis was done using SPSS 11.5. Results Fifty-seven patients were enrolled with lower urinary tract symptoms (LUTS) during study period. Forty-six patients had overactive bladder symptoms (OABS). LUTS were found in age ranging from 21 to 80 years. Majority of patients visiting out-patient department with LUTS were found to have urgency, urge incontinence, increased day time frequency, nocturia. Patients with urgency and urge incontinence showed significant correlation with increasing likert score of OABSS (p<0.05). But the increased day time frequency did not show any correlation with increasing score. The score showed significant correlation with combination of symptoms (urgency, urge incontinence and increased frequency) than patients presenting with single symptom. Conclusion Diagnosis of LUTS with valid assessment tools and treatment benefits patients with chronic urinary symptoms and also helps clinicians to further re-assess the treatment.

Acupuncture for overactive bladder in adults: a systematic review and meta-analysis

Background: Overactive bladder is prevalent in adults over 40 years of age and its prevalence increases with age. The use of acupuncture in adults with overactive bladder is increasing globally. However, its effectiveness/efficacy and safety have not yet been confirmed. Objective: To determine the effectiveness/efficacy and safety of acupuncture and to identify the pattern of commonly used traditional acupuncture points in the management of overactive bladder in adults. Methods: Ten electronic English and Chinese language databases were systematically searched and two English together with four Chinese journals relevant to acupuncture were manually searched in libraries for randomised controlled trials (RCTs) of acupuncture for overactive bladder in adults from their inception to March 2017. The Cochrane risk of bias tool was used to assess the methodological quality of the RCTs. RevMan v.5.3 software was employed for data analysis. Results: Seven eligible trials involving 695 participants were included. Meta-analysis showed that acupuncture was comparable to drugs (tolterodine tartrate/solifenacin) in the reduction of micturition episodes over 24 hours (pooled standardised mean difference (SMD) 0.36, 95% CI −0.23 to 0.95; I2=83%), increase in voided volume of each micturition episode (pooled SMD −0.15, 95% CI −0.36 to 0.05; I2=0%), and reduction of overactive bladder symptom score (pooled SMD −0.23, 95% CI −1.30 to 0.85; I2=91%). In addition, acupuncture was not significantly different compared with placebo in the reduction of overactive bladder symptom score (pooled SMD −2.36, 95% CI −5.64 to 0.93; I2=97%). No serious adverse events were reported. Conclusions: No significant differences in effectiveness or efficacy were found between acupuncture and drug or between verum and sham acupuncture, respectively. Further high-quality studies are required.

Skin Care Using Heparinoid Creams for Long-Term Treatment with Oxybutynin Transdermal Patches without Skin Irritation in Elderly OAB Patients

Background: Overactive bladder is an age-related urologic disease. An oxybutynin transdermal patch is used to treat overactive bladder; however, long-term use is not advised because of potential adverse reactions at the site of application. The present study aimed to investigate the advantages of administering a combination of heparinoid cream and oxybutynin transdermal patch treatment for overactive bladder in elderly patients. Methods: Eight patients (>65 years of age) with overactive bladder were included. The heparinoid cream was applied topically for 1 week, and skin hydration and transepidermal water loss were quantified before and after application. Thereafter, patients were treated with a combination of an oxybutynin transdermal patch and a heparinoid cream for 12 weeks, and the sites of application were monitored for adverse reactions. Clinical effects of the combinatorial treatment were assessed based on the overactive bladder symptom score. Results: Application of the heparinoid cream did not decrease transepidermal water loss, but increased skin hydration and improved dryness. Oxybutynin transdermal patch therapy was not interrupted because no skin irritation was observed at the site of application for 12 weeks, and the overactive bladder symptom score decreased significantly (p<0.05). Conclusions: Combination treatment with an oxybutynin transdermal patch and a heparinoid cream improved treatment outcomes, suggesting that skin hydration with heparinoid cream is a promising treatment method to ensure appropriate use of oxybutynin transdermal patches in elderly patients with overactive bladders.