Pharmacological treatment of lower urinary tract symptoms in men: Implementation of recommendations in clinical practice

Aim. Lower urinary tract symptoms (LUTS) frequently affect patients immediately after midurethral sling (MUS) placement. The objective of the study was to assess if solifenacin or mirabegron decreases incidence of LUTS in women who underwent transobturator MUS. Methods. A prospective randomized trial was conducted on patients undergoing ambulatory transobturator midurethral sling due to stress urinary incontinence (SUI). All participants were questioned before and after surgery for occurrence of bothersome LUTS. A total of 328 patients who underwent transobturator MUS were randomly assigned to one of three groups: prophylaxis with 10 mg of solifenacin, prophylaxis with 50 mg of mirabegron, or without any additional treatment. LUTS evolution and efficacy of solifenacin and mirabegron were analyzed based on results of assessments made during follow-up visits at 1 and 6 weeks after surgery. Comparison of the prevalence of LUTS was done using chi2 test. Results. Prevalence of urgency and frequency episodes increased notably 1 week after sling placement and then came down to baseline levels. Solifenacin and mirabegron significantly reduced the incidence of urgency after 1 week, but after 6 weeks the beneficial effect was observed only in case of solifenacin. Treatment with mirabegron reduced the percentage of patients suffering from frequency after 6 weeks. Although prevalence of nocturia did not raise after sling placement, both treatments significantly reduced the incidence of this complaint after 6 weeks. Pharmacological treatment did not modulate the course of hesitancy and terminal dribbling. Conclusions. Treatment with solifenacin or mirabegron may significantly reduce the incidence of undesired LUTS after MUS.

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Nova generacija stentova uretre-Allium u terapiji simptomatskog uvecanja prostate razlicite etiologije

Acta chirurgica iugoslavica ◽

10.2298/aci0703071m ◽

2007 ◽

Vol 54 (3) ◽

pp. 71-76 ◽

Cited By ~ 1

Author(s):

B.B. Markovic ◽

Z. Markovic ◽

D. Yachia ◽

J. Hadzi-Djokic

Keyword(s):

Clinical Practice ◽

Urinary Tract ◽

Clinical Application ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Vascular Stent ◽

Triangular Shape ◽

Urinary Tract Symptoms ◽

Urethral Stent ◽

Lower Urinary

A number of urethral stents made of different materials, with different time of indwelling and different designs, primarily based on the vascular stent concept, have been applied in the clinical practice so far. According to the published studies, urethral stents have justified their clinical application, however with certain limitations. Within an attempt to overcome the limitations, a covered, temporary urethral stent was initially designed by Daniel Yachie and ljko Markovi in Allium corporation from Israel. With its triangular shape, the stent is a replica of the obstructive prostatic urethral lumen. In has been applied in a series of 14 patients with lower urinary tract symptoms caused by the obstruction at the level of the prostatic urethra. The subjects were averagely aged 77.4 + 5.1 years. Allium prostatic stent remained in place in the patients for 4.93+ 3.17 months, at the average.

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