Aşırı Aktif Mesane hastalarında semptomları gidermede hangisi daha etkili: Trospium 30 mg 2x1 ya da solifenasin 5 mg 1x1

Amaç: Aşırı Aktif Mesane (AAM) hastalarında trospium ve solifenasinin işeme sayısı, nokturi ve urge inkontinans üzerine etkilerini araştırmak.  Gereç ve Yöntem: Prospektif bir çalışma planlandı. Hastalar tedaviye başlamadan önce AAM farkındalık anketini (AAM-V8) doldurdular. Hastaların 3 günlük işeme günlüğünden günlük işeme, nokturi ve urge inkontinans sayıları belirlendikten sonra trospium 30 mg 2x1 veya solifenasin 5 mg 1x1 den birisi başlandı. Hastalar kontrolde işeme günlüğü ve AAM-V8 formu ile tekrar değerlendirildi. Ayrıca yan etkiler sorgulandı.  Bulgular: Bu çalışma yaş ortalaması 47.8±12.2(18-75 yaş) olan toplam 225 hasta içermektedir. Hastaların 173(76.9%)’sı kadın, 52(23.1%)’si erkektir. Trospium grubunda(n=104, M/F:24/80) yaş ortalaması 47.4±12.7 ve solifenasin grubunda(n=121, M/F:28/93) yaş ortalaması 48.1±11.8 olup gruplar arasında istatistiksel farklılık izlenmedi (p=0.657). Validasyon ölçeği anketinde azalmada iki molekül arasında istatistiksel farklılık izlenmedi. Hem 4.hafta hemde 12.haftada işeme sayısı trospium molekülünde solifenasin den daha fazla azalmıştır ve bu azalmalar istatistiksel olarak anlamlıdır (sırasıyla p<0.027, p<0.045 ). Nokturi ve urge inkontinans sayıları azaldı fakat trospium ve solifenasin molekülleri arasında farklılık izlenmedi. En sık izlenen yan etkiler ağız kuruluğu, kabızlık ve bulanık görmedir.  Sonuç: Her iki molekülde AAM hastalarında 4.hafta ve 12.haftalarda validasyon ölçeğini, işeme sayısı, nokturi ve urge inkontinans sayılarını azaltır. İşeme sayısını trospium molekülü solifenasin den daha fazla azaltmıştır ve bu azalma istatistiksel olarak anlamlıdır. Özellikle işeme sayısı fazlalığından yakınan AAM hastalarında trospium molekülü solifenasinden daha etkili olabilir. 

Which one is more effective for symptom relief in overactive bladder patients: Trospium 30 mg 2x1 or solifenacin 5 mg 1x1

Aim: To investigate the effect of trospium and solifenacin on the micturition, nocturia and urge incontinence numbers in overactive bladder (OAB). Material and Method: A prospective study was planned. The patients completed the OAB awareness survey (OAB-V8) before starting the treatment. The patient’s daily micturition, nocturia and urge incontinence numbers were recorded from the 3-day voiding diaries and one of trospium 30 mg bd or solifenacin 5 mg od was started. The patients were evaluated again at follow-up using the voiding diary and the OAB-V8 form. Results: The study included a total of 225 subjects aged 18-75 years with a mean age of 47.8±12.2 years. There were 173 (76.9%) females and 52 (23.1%) males. The mean age was 47.4±12.7 in the trospium (n=104, M/F:24/80) and 48.1±11.8 years in the solifenacin (n=121, M/F:28/93) with no statistically significant difference (p=0.657). No statistically significant difference was found between the two molecules regarding the decrease in the validation scale. The micturition number at both the 4th and 12th weeks decreased more markedly with trospium then solifenacin and the difference was statistically significant (p<0.027 and p<0.045 respectively). The nocturia and urge incontinence numbers decreased as well but without a statistically significant difference between the trospium and solifenacin. The most common side effects were dry mouth, constipation and blurred vision.  Conclusions: Both molecules decreased the micturition, nocturia and urge incontinence numbers in addition to the validation scale values at the 4th and 12th weeks in OAB patients. There was no difference between the two molecules as regards decreasing the nocturia and urge incontinence numbers and validation scale values. The trospium decreased micturition numbers more than the solifenacin and this difference was statistically significant. Trospium could be more effective than solifenacin in the treatment of OAB patients, especially those complaining of increased micturition numbers. 

___

  • Jain D, Dhua A, Ravisankar V, Chellam L, Joshi M.J. Acute angle closure gloucoma after hypospadias surgery: A vision- threatening complication of oxybutyning. J Indian Assoc Pediatr Surg 2015;20: 161-2.
  • 2. Zumrutbas AE, Bozkurt AI, Tas E, Acar CI, Alkis O, Coban K, Cetinel B, Aybek Z. Prevalence of lower urinary tract symptoms, overactive bladder and urinary incontinence in western Turkey: results of a population-based survey. Int J Urol 2014;21:1027-33.
  • 3. Homma Y, Kakizaki H, Gotoh M. Epidemiologic survey on urination. J Jpn Neurogenic Bladder Soc 2003;14:266-77.
  • 4. Andersson K-E, Yoshida M. Antimuscarinics and the overactive detrusorwhich is the main mechanism of action? Eur Urol 2003;43:1-5.
  • 5. Doroshyenko O, Jetter A, Odenthal KP, Fuhr U. Clinical pharmacokinetics of trospium. Clin Pharmacokinet 2005;44:701-20.
  • 6. Mansfield KJ, Liu L, Mitchelson FJ, Moore KH, Millard RJ, Burcher E. Muscarinic receptor subtypes in human bladder detrusor and mucosa, studied by radioligand binding and quantitative competitive RT-PCR: changes in ageing. Br J Pharmacol 2005;144:1089-91.
  • 7. Wang P, Luthin GR, Ruggieri MR. Muscarinic acetylcholine receptor subtypes mediating urinary bladder contractility and coupling to GTP binding proteins. J Pharmacol Exp Ther 1995;273:959-66.
  • 8. Lai HH, Boone T, Appell RA. Selecting a medical therapy for overactive bladder. Rev Urol 2002;4:28-37.
  • 9. Coyne K, Revicki D, Hunt T et al. Psychometric validation of an overactive bladder symptom and health-related quality of life questionnaire: the OAB-q. Qual Life Res 2002;11:563-74.
  • 10. Acquadro C, Kopp Z, Coyne KS et al. Translating overactive bladder questionnaires in 14 languages. Urology 2006;67:536-40.
  • 11. Tarcan T, Mangır N, Özgür MO, Gümrah A, Akbal C. Constitution and Validation of a New Symptom Assessment Tool for Overactive Bladder: Marmara Overactive Bladder Questionnaire (M-OBQ). Journal of Urological Surgery 2014; 1: 24-27.
  • 12. Garnett S, Swithinbank L, Ellis-Jones J, Abrams P. The long-term natural history of overactive bladder symptoms due to idiopathic detrusor overactivity in women. BJU Int 2009;104:948-53.
  • 13. Sexton CC, Coyne KS, Vats V, Kopp ZS, Irwin DE, Wagner TH. Impact of overactive bladder on work productivity in Yeni Üroloji Dergisi - The New Journal of Urology 2018; 13 (1): 39-45 45
  • the United States: results from EpiLUTS. Am J ManagCare 2009;15:98-107.
  • 14. Hartmann KE, McPheeters ML, Biller DH, Ward RM, McKoy JN, Jerome RN. Treatment of overactive bladder in women. Evid Rep Technol Assess 2009; 187:1.
  • 15. Andersson KE, Wein AJ. Pharmacologic Management of Lower Urinary Tract Storage and Emptying Failure. Campbell’s Urology (Kavoussi LR, Partin AW, Novick AC, Peters CA, ed). Tenth edition. Saunders Elsevier. Vol 3, Section XIV 2012; p 1967-2002.
  • 16. Chapple CR, Khullar V, Gabriel Z, Muston D, Bitoun CE, Weinstein D. The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Eur Urol 2008;54: 543-62.
  • 17. Junemann KP, Al-Shukrı S. Efficacy and tolerability of trospium and tolterodine in 234 patients with urge syndrome: a double-blind, placebo-controlled, multicentre clinical trial. Neurourol. Urodyn 2000;19:488-90.
  • 18. Halaska M, Ralph G, Wiedemann A et al. Controlled, double- blind, multicentre clinical trial to investigate long-term tolerability and efficacy of trospium in patients with detrusor instability. World J. Urol 2003;20:392-9.
  • 19. Dugan E, Cohen SJ, Bland DR et al. The association of depressive symptoms and urinary incontinence among older adults. J. Am. Geriatr. Soc 2000; 48:413-6.
  • 20. Irwin DE, Abrams P, Milsom I, Kopp Z, Reilly K; EPIC Study Group. Understanding the element of overactive bladder: questions raised by the EPIC study. BJU Int 2008;101:1381-7.
  • 21. Herschorn S, Gajewski J, Schulz J, Corcos J. A populationbased study of urinary symptoms and incontinence: the Canadian urinary bladder survey BJU Int 2008;101:52-8.
  • 22. Basra R, Kelleher C. Disease burden of overactive bladder: quality-of-life data assessed using ICI-recommended instruments. Pharmacoeconomics 2007;25:129-42.
  • 23. Zınner N, Geıttelman M, Harrıs R, Susset J, Kanellos A, Auerbach S. Trospium chloride improves overactive bladder symptoms: a multicenter Phase III trial. J.Urol 2004;171:2311-5.
  • 24. Yoshida A, Fujino T, Maruyama S, Ito Y, Yamada S. The forefront for novel therapeutic agents based on the pathophysiology of lower urinary tract dysfunction: bladder sensitivity based on in vivo drug-receptor binding characteristics of antimuscarinic agents for treatment of over active bladder. J Pharmacol Sci 2010; 112: 142-50.
  • 25. Lam S, Hilas O. Pharmacologic management of overactive bladder. Clin Int Aging 2007; 2:337-45.
  • 26. Garely AD, Kaufman JM, Sand PK, Smith N, Andoh M. Symptom bother and health-related quality of life outcomes following solifenacin treatment for overactive bladder: the VESIcare Open-Label Trial (VOLT). Clin Ther 2006;28:1935–46.
Yeni Üroloji Dergisi-Cover
  • ISSN: 1305-2489
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2005
  • Yayıncı: Avrasya Üroonkoloji Derneği
Sayıdaki Diğer Makaleler

Varikoselektomi sonrası gelişen testis torsiyonu

Güner Kemal ÖZGÜR, Hasan TURGUT

Alt üriner sistem semptomları ile tarafımıza başvuran hastadaki mesane leiyomiyomunun başarılı rezeksiyonu: Olgu Sunumu

Bülent EROL, Pınar Engin ZERK, Berrin GÜÇLÜER, Asıf YILDIRIM, Turhan ÇAŞKURLU, Yavuz Onur DANACIOĞLU

Fournier gangreni tedavisinde çok basamaklı yaklaşım: Seri cerrahi debridman, koruyucu kolostomi, vakum yardımlı kapatma ve hiperbarik oksijen tedavisi

ENGİN KAYA, Sercan YILMAZ, Turgay EBİLOĞLU, Kubra Ozgok KANGAL, SELAHATTİN BEDİR, MURAT ZOR

Nötrofil lenfosit oranının lokalize böbrek tümörlerinde tümör özellikleri ile ilişkisi

SEMİH TANGAL, Kutsal ONAL, Ahmet Hakan HALİLOĞLU, Metin YIĞMAN

Erkek üriner traktında enterobius vermicularıs

Ali YILDIZ, Tümay İPEKÇİ, Mustafa YÜKSEL, Hatice YAZISIZ, Gülsüm KOÇLAR

Adrenal kitleyi taklit eden fokal ksantogranülomatöz pyelonefrit: Olgu sunumu

Mesude TOSUN, Demet DOĞAN, Özgür ÇAKIR, Nagihan İNAL, Hasan Tahsin SARISOY, Ali DEMİRCİ, Nuri GÖNÜLLÜ, Bahar MÜEZZİNOĞLU, Doğukan SÖKMEN

Erkek üriner traktında enterobius vermicularıs: Olgu sunumu

TÜMAY İPEKÇİ, Mustafa YÜKSEL, HATİCE YAZISIZ, Gülsüm KOÇLAR, ALİ YILDIZ

Cinsel memnuniyet amacıyla penil cilt altına tesbih boncuğu yerleştirilmesi: Nadir bir olgu sunumu

Önder KAYIGİL, EMRAH OKULU, FATİH AKDEMİR

Forniere Gangreni Tedavisinde Çok Basamaklı Yaklaşım: Seri Cerrahi Debridman, Koruyucu Kolostomi, Vakum Yardımlı Kapatma Ve Hiperbarik Oksijen Tedavisi

Murat ZOR, Engin KAYA, Sercan YILMAZ, Turgay EBİLOĞLU, Kübra Özgök KANGAL, Selahattin BEDİR

Rektoüretral fistül tedavisinde arka üretraya perineal yaklaşım

Bülent ERKURT, Mustafa Yücel BOZ, Selami ALBAYRAK, BÜLENT ALTAY