Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0677481 (urinary frequency)
 1,126 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The safety and efficacy of one-year administration of propiverine hydrochloride (BUP-4 tablets) were assessed in facilities affiliated with the Department of Urology of Yokohama City University School of Medicine. Changes in subjective symptoms showed significant improvement in mean frequency of urination in the daytime from 10.3 +/- 4.0 times before administration to 7.1 +/- 2.9 times 1 year after the start of administration, in mean frequency of voiding at night from 4.2 +/- 1.7 times to 2.1 +/- 1.1 times and in mean incidence of urinary incontinence from 2.9 +/- 2.1 times to 0.7 +/- 1.0 times. The final degree of overall improvement rate was 82.0% (41/50 cases). Adverse effects were observed 26 times in 22 patients, the incidence being 15.6% (22/141 cases). They consisted of digestive symptoms in 9.9% (6 events of dry mouth, 4 of constipation, 2 of abdominal discomfort, 2 of diarrhea and 1 of gastritis), urinary tract symptoms in 3.5% (4 of dysuria and 1 of residual urine), abnormal laboratory findings in 1.4% (increase in glutamic-oxaloacetic transaminase, glutamic-pyruvic transaminase or lactate dehydrogenase levels) and others (1.4%). These results provide further evidence of the safety and efficacy of propiverine hydrochloride (BUP-4 tablets) even when administered for a long-term in the treatment of patients with pollakiuria and urinary incontinence.
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PMID:[Long-term administration study of propiverine hydrochloride (BUP-4 tablets) in pollakiuria and urinary incontinence]. 980 79

The term overactive bladder (OAB) is used to describe the symptoms of urinary frequency and urgency with or without urge incontinence. Commonly reported symptoms are nocturia, urgency, frequency, and urge incontinence. However, some of these symptoms may be because of other lower urinary tract conditions or may simply represent a variant of normal physiologic function. Consequently, special considerations need to be made when diagnosing OAB in women. In women of all ages, lower urinary tract infection is the most common cause of irritative urinary symptoms, and midstream urine microscopy and culture should be performed. A chronic urinary residual secondary to voiding difficulties may also result in symptoms of frequency and overflow incontinence and may be diagnosed using a postmicturition ultrasound scan. In premenopausal women, pregnancy should also be excluded. In postmenopausal women, urogenital atrophy can cause irritative symptoms that may be improved with hormone replacement therapy. Vaginal administration has been shown to be most effective and may be used to supplement systemic replacement therapy. In addition, estrogen replacement may be beneficial in the management of OAB as an adjunct to anticholinergic therapy. When investigating elderly women with OAB, special consideration should be given to comorbidities, such as constipation and fecal impaction, mobility problems, and the loss of independence. Concomitant medication, such as diuretics and alpha-adrenergic blockers, should also be noted and the need for therapy reviewed. In conclusion, OAB is a subjective diagnosis that should only be made when other lower urinary tract conditions have been excluded.
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PMID:Special considerations in premenopausal and postmenopausal women with symptoms of overactive bladder. 1249 58

The goals of this study were to describe the pattern of voiding disorders in children in our community, to describe clinical criteria for making the specific diagnoses, and to comment on management. The medical records of 226 children referred because of voiding dysfunction or urinary tract infections (UTI) were evaluated. Children with normal voiding patterns when uninfected, with monosymptomatic nocturnal enuresis, and with known neurologic or anatomic abnormalities were excluded. Detrusor instability, an abnormal voiding pattern characterized by urgency with or without frequency, was the diagnosis in 175 of the 226 children. Children with detrusor instability who used various posturing maneuvers to avoid urinary incontinence had a significantly higher incidence of UTIs than those who did not attempt to obstruct urine outflow. Detrusor instability appeared to be secondary to constipation in 19 of the children. The other diagnoses were extraordinary daytime urinary frequency, infrequent voiding, monosymptomatic daytime wetting, transient voiding dysfunction, giggle incontinence, dysfunctional voiding, and unexplained dysuria. It is concluded that children with detrusor instability who use posturing maneuvers to avoid incontinence are at high risk for recurrent UTIs. Constipation is 1 cause of detrusor instability. Dysfunctional voiding, the form of voiding dysfunction most likely to result in renal damage, was present in only 2 of 226 children seen for voiding disorders.
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PMID:Voiding dysfunction in pediatric patients. 1263 81

Uterine artery embolization is a new method of treating uterine leiomyomata, first carried out in France in the early 90s. The procedures involve placing a small catheter into an artery in the groin and directing it to the blood supply of the fibroid. Little plugs of polyvinyl alcohol are injected through the catheter to block these arteries. This cause the fibroid to shrink. Indications for uterine fibroid embolization include menorrhagia, pelvic pain or pressure, other "bulk" syndrome (low-back pain, urinary frequency and constipation. The fluoroscopic-guided procedure is performed under local anesthesia. Most patients are discharged within 72 hours. Post-embolization syndrome including severe pain is managed with morphine via patient-controlled pump. Paper reviews long term outcomes. Uterine artery embolization has several advantages: high efficacy, less invasiveness, ability to treat multifocal changes, uterine preservation, shorter hospitalisation and recovery (low cost) and disadvantages: postembolic syndrome (pain and fever), unknown relations to pregnancy and lack of long term results.
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PMID:[Uterine arteries embolization as a treatment of uterine leiomyoma]. 1271 43

One hundred forty-four children with a clinical diagnosis of overactive bladder were observed for a mean of 3.15 +/- 1.92 years. Initial management consisted of a behavioral modification program that included increased fluid intake, a timed voiding schedule and, if applicable, treatment of constipation. Those who failed to improve with the preceding intervention within 10 days to 2 weeks received an anticholinergic medication. Follow-up information was obtained by telephone. Caretakers and/or patients were asked a standard set of questions. The outcome with respect to urinary urgency, urinary frequency, daytime incontinence, posturing and urinary tract infections was recorded. After an average follow-up period of 3 years, 68 (47.2%) of the 144 children recovered from all symptoms of overactive bladder and 61 (42.4%) had decreased symptoms. Fifteen of the children, or 10.4%, still had all of the symptoms originally associated with overactive bladder. Children who had posturing as one of their symptoms had a significantly increased risk of urinary tract infection.
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PMID:Outcome of overactive bladder in children. 1292 58

Lower urinary tract symptoms (LUTS) are common in older men and include urinary frequency, urgency, nocturia and slow stream. Traditionally, this symptom complex has been called benign prostatic hypertrophy or prostatism, yet such symptoms may also result from detrusor over-activity and/or excessive urine output. Clinical assessment of older men with LUTS is based on a careful history, a clinical examination and a check of the postvoid residual, with urodynamic studies reserved for select individuals. Factors such as mobility, constipation and fluid balance must also be considered. These combined with a variety of pharmacologic agents (antispasmodics, alpha-antagonists, 5 alpha reductase inhibitors) offer great potential for improving the quality of life of individuals with LUTS.
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PMID:Lower urinary tract symptoms in the older male. 1458 29

The International Continence Society has defined overactive bladder (OAB) as urinary urgency, with or without urge urinary incontinence, usually with urinary frequency and nocturia. Approximately 17% of men and women in the US report OAB symptoms, which can affect quality of life. Trospium chloride, which has recently been introduced in the US as Sanctura, has been prescribed for > 10 years in Europe as, for example, Spasmo-lyt, Regurin and Spasmex. Trospium chloride has been shown to be effective in relieving OAB symptoms, and has a favourable safety profile, showing < 1% difference for all adverse events compared with placebo, except for dry mouth, constipation and headache. Metabolic drug-drug interactions are unlikely, given that trospium chloride is not metabolised by cytochrome P450 isozymes. The fast-acting efficacy of trospium chloride, coupled with its good safety profile and tolerability, make it an important new option for treatment of OAB.
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PMID:Trospium chloride: an anticholinergic quaternary ammonium compound for the treatment of overactive bladder. 1601 90

The safety and efficacy of oxybutynin transdermal delivery system (oxybutynin-TDS) versus placebo in adults with urge and mixed urinary incontinence was investigated using combined results from double-blind stages of 2 phase 3 clinical trials. Study 1: placebo-controlled, parallel-group comparison of 3 oxybutynin-TDS doses in 12-week double-blind and open-label periods, followed by a 28-week open-label extension. Study 2 was a 12-week randomized, double-blind, placebo-controlled comparison of oxybutynin-TDS versus long-acting tolterodine and placebo, followed by a 52-week open-label extension. Efficacy analysis included 241 patients receiving oxybutynin-TDS, 244 receiving placebo. Most participants were Caucasian women (92%). Approximately 60% received prior anticholinergic therapy. Primary outcome was determined by changes from baseline to end of treatment in frequency of incontinence episodes, frequency of urination, and void volume. Oxybutynin-TDS was significantly more effective than placebo in reducing median daily incontinence episodes (-3.0 vs placebo -2.0; P=.00004) and daily urinary frequency (-2.0 vs -1.0; P=.0023), and in increasing void volume (25 mL vs 5.5 mL; P<.00001). Overall rates of anticholinergic adverse events (AEs) were 12.8% for oxybutynin-TDS and 11.0% for placebo (P=0.5421). The most common systemic anticholinergic AEs were dry mouth (7.0% for oxybutynin-TDS vs 5.3% for placebo) and constipation (2.1% vs 2.0%). Application site erythema occurred in 7.0% of participants who received oxybutynin-TDS (3.7% discontinuation rate); pruritus occurred in 16.1% (3.3% discontinuation rate). Transdermal oxybutynin was shown to be efficacious, with a proven safety profile. It may be utilized for patients with overactive bladder as a treatment option that could enhance compliance.
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PMID:Transdermal oxybutynin in the treatment of adults with overactive bladder: combined results of two randomized clinical trials. 1615 16

Overactive bladder (OAB) is the term used to describe the symptom complex of urinary frequency and urgency, with or without urge incontinence. Whilst antimuscarinic drug therapy has proven to be effective in the management of patients with symptoms of the OAB syndrome, compliance with medication is often affected by the bothersome antimuscarinic adverse effects of dry mouth, constipation, somulence and blurred vision. The development of bladder selective M3 specific antagonists offers the possibility of increasing efficacy whilst minimising adverse effects. At present, there are no M3 specific antagonists currently available, although solifenacin and darifenacin are under development and are due to be registered in 2004-2005. The purpose of this article is to review the pharmacology and clinical trial data available for solifenacin in addition to examining its emerging role in the treatment of the OAB syndrome.
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PMID:Solifenacin in the management of the overactive bladder syndrome. 1617 92

Solifenacin is a bladder-selective, muscarinic (M(1) and M(3)) receptor antagonist. In animal studies, the selectivity of solifenacin for the bladder over the salivary glands was greater than that of tolterodine, oxybutynin, darifenacin or atropine. In large, 12-week, randomised, double-blind, multicentre clinical trials, solifenacin 5 and 10mg once daily improved symptoms of overactive bladder syndrome (OAB) [urinary urgency, frequency, incontinence and nocturia] and increased functional bladder capacity to a significantly greater extent than placebo. Solifenacin 5 or 10mg once daily was noninferior to tolterodine extended release (ER) 4mg daily for improving urinary frequency and had significantly greater efficacy than tolterodine ER for improving other symptoms of OAB (episodes of urgency, incontinence and urge incontinence) and increasing functional bladder capacity. At least half of all patients receiving solifenacin who were incontinent at baseline were continent by study end in the three comparative studies reporting this parameter. Health-related quality of life was significantly improved with once-daily solifenacin 5 or 10mg versus placebo, as assessed in two 12-week double-blind studies; the improvement was maintained during a 40-week extension study. Solifenacin was generally well tolerated; the most frequently reported adverse events were dry mouth, constipation and blurred vision.
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PMID:Solifenacin in overactive bladder syndrome. 1636 87


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