Comparison of Different Types of Therapy for Overactive Bladder: A Systematic Review and Network Meta-Analysis

To compare the efficacy and safety of different interventions (including Antimuscarinics, Mirabegron, OnabotulinumtoxinA, sacral neuromodulation (SNM) and peripheral tibial nerve stimulation (PTNS)) on idiopathic overactive bladder (OAB). PubMed, Embase, Cochrane library, and other sources were searched for randomized controlled trials (RCTs) comparing interventions of OAB from 1 January 2000 to 19 April 2021. A systematic review and network meta-analysis were performed by two authors independently. 55 RCTs involving 32,507 patients were included in this network. Overall, Antimuscarinics, Mirabegron, OnabotulinumtoxinA, SNM, and PTNS were more efficacious than placebo and SNM showed the best effect for reducing micturition frequency, urgency episodes and urgency urinary incontinence episodes. OnabotulinumtoxinA was the best in achieving reduction of 100% and ≥50% in the number of urinary incontinence episodes /day and PTNS was the best in reducing urinary incontinence episodes. The efficacy of Antimuscarinics, Mirabegron and PTNS were similar in reducing micturition frequency, urinary incontinence episodes and urgency urinary incontinence episodes. The results revealed that all interventions included in the network were efficacious in managing adult OAB syndrome compared with placebo. Furthermore, SNM and OnabotulinumtoxinA were the most efficient treatments for overactive bladder.

Sleep Quality and Fatigue in Women with Overactive Bladder: A Case-Control Study

Background: Overactive bladder (OAB) syndrome, a condition with urgency, is often characterized by increased daytime frequency and nocturia. Overactive bladder is a highly prevalent condition that drastically impacts the quality of patients’ life. Objectives: This study was conducted to investigate sleep disturbance and fatigue in women with OAB by reliance on two validated questionnaires. Methods: This case-control study was performed among 70 patients recognized with OAB and 70 women in a control group. We employed validated questionnaires, namely PSQI and FSS, to comparatively assess sleep disturbance and fatigue symptoms, respectively. Results: The participants’ mean age was 44.50 ± 12.64 years old. The mean PSQI score was 13.24 ± 3.67 (range: 6 to 22), and the mean FSS score was 39.05 ± 15.12 (range: 9 to 63). Furthermore, the mean scores of PSQI (P < 0.001) and FSS (P < 0.001) were significantly higher in OAB women compared to the control group. In women with OAB, there was a significant positive correlation (P = 0.007) between PSQI and FSS scores. Furthermore, this correlation was observed between urgency urinary incontinence at night and PSQI (P = 0.047) and sleep disturbance (P = 0.023) and between nocturia and sleep efficiency (P = 0.012), sleep disturbance (P = 0.001), sleep latency (P = 0.007), and FSS score (P = 0.032). In addition, a significant direct correlation (P = 0.022) was found between urgency urinary incontinence during the day and daytime dysfunction. Conclusions: The study shows that sleep disorder is common in patients with OAB, and it seems that urinary problem assessment is a prerequisite for any sleep medication prescription.