The use of Mono- and Combination Pharmacotherapy in Men and Women with Lower Urinary Tract Symptoms (LUTS) in the UK: A Retrospective Observational Study

2021 ◽  
Author(s):  
Mahmood Ali ◽  
Margarita Landeira ◽  
Patrick J O Covernton ◽  
Nurul Choudhury ◽  
Ashley Jaggi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Lower Urinary Tract ◽  
Index Date ◽  
Antimuscarinic Agent ◽  
Men And Women ◽  
Male And Female ◽  
Urinary Tract Symptoms ◽  
Combination Pharmacotherapy ◽  
The Uk ◽  
Lower Urinary

Abstract Background: Combination pharmacotherapy for lower urinary tract symptoms (LUTS) is beneficial to selected patients and recommended by guidelines. Patterns of real-world LUTS drug use, especially combination pharmacotherapy, have not been studied extensively. Moreover, further understanding of the recent landscape is required following the introduction of the beta-3-adrenoceptor agonist mirabegron in the UK in 2013 for overactive bladder (OAB). The objective was to describe mono- and combination pharmacotherapy use for LUTS in patients in UK clinical practice. Methods: This was a retrospective, descriptive, observational database study using UK Clinical Practice Research Datalink GOLD and linked databases. Men and women ≥ 18 years with a first prescription for any LUTS drug from 2014–2016 with ≥ 12 months continuous enrolment pre- and post-index date were included. Primary endpoints were mono- or combination pharmacotherapy use for LUTS in male and female cohorts. Secondary endpoints were description of treatment prescribed, treatment persistence and patient demographics. Data were analyzed descriptively. Sub-cohorts were defined by drugs prescribed at index date.Results: 79,472 patients (61.3% male) were included, based on index treatments. Of all men, 82.5% received any benign prostatic obstruction (BPO) drug, 25.4% any OAB drug, and 7.9% any BPO drug plus any OAB drug. As either mono- or combination pharmacotherapy, 77.1% received an alpha-blocker, 18.9% a 5-alpha reductase inhibitor, 23.9% an antimuscarinic agent, and 2.1% mirabegron. Of all women, 94.5% received any OAB drug, 6.0% duloxetine, and 0.5% any OAB drug plus duloxetine. As either mono- or combination pharmacotherapy, 87.7% received an antimuscarinic, and 9.7% mirabegron. In men or women receiving OAB treatment, approximately 2.5% received combination pharmacotherapy with an antimuscarinic agent and mirabegron. For OAB drug monopharmacotherapies, mirabegron had the highest persistence in both male and female cohorts. Conclusions: This study provides a better understanding of the recent landscape of LUTS drug use in UK clinical practice. It highlights potential undertreatment of storage symptoms in men and the low use of combination OAB treatments.

scholarly journals The use of mono- and combination drug therapy in men and women with lower urinary tract symptoms (LUTS) in the UK: a retrospective observational study

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahmood Ali ◽  
Margarita Landeira ◽  
Patrick J. O. Covernton ◽  
Nurul Choudhury ◽  
Ashley Jaggi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Drug Therapy ◽  
Lower Urinary Tract ◽  
Index Date ◽  
Combination Drug Therapy ◽  
Combination Drug ◽  
Antimuscarinic Agent ◽  
Urinary Tract Symptoms ◽  
The Uk ◽  
Lower Urinary

Abstract Background Combination drug therapy for lower urinary tract symptoms (LUTS) is beneficial to selected patients and recommended by guidelines. Patterns of real-world LUTS drug use, especially combination drug therapy, have not been studied extensively. Moreover, further understanding of the recent landscape is required following the introduction of the beta-3-adrenoceptor agonist mirabegron in the UK in 2013 for overactive bladder (OAB). The objective was to describe mono- and combination drug therapy use for LUTS in patients in UK clinical practice. Methods This was a retrospective, descriptive, observational database study using UK Clinical Practice Research Datalink GOLD and linked databases. Men and women ≥ 18 years with a first prescription for any LUTS drug from 2014 to 2016 with ≥ 12 months continuous enrollment pre- and post-index date were included. Primary endpoints were mono- or combination drug therapy use for LUTS in male and female cohorts. Secondary endpoints were description of treatment prescribed, treatment persistence and patient demographics. Data were analyzed descriptively. Sub-cohorts were defined by drugs prescribed at index date. Results 79,472 patients (61.3% male) were included, based on index treatments. Of all men, 82.5% received any benign prostatic obstruction (BPO) drug, 25.4% any OAB drug, and 7.9% any BPO drug plus any OAB drug. As either mono- or combination drug therapy, 77.1% received an alpha-blocker, 18.9% a 5-alpha reductase inhibitor, 23.9% an antimuscarinic agent, and 2.1% mirabegron. Of all women, 94.5% received any OAB drug, 6.0% duloxetine, and 0.5% any OAB drug plus duloxetine. As either mono- or combination drug therapy, 87.7% received an antimuscarinic, and 9.7% mirabegron. In men or women receiving OAB treatment, approximately 2.5% received combination drug therapy with an antimuscarinic agent and mirabegron. For OAB drug monotherapies, mirabegron had the highest persistence in both male and female cohorts. Conclusions This study provides a better understanding of the recent landscape of LUTS drug use in UK clinical practice. It highlights potential undertreatment of storage symptoms in men with LUTS and the low use of combination OAB treatments.

scholarly journals Surveying the Prevalence of Lower Urinary Tract Symptoms Based on Individual and Clinical Parameters in Patients with Multiple Sclerosis

2019 ◽  
Author(s):  
Fatemeh Nazari ◽  
Vahid Shaygannejad ◽  
Mehrdad Mohammadi Sichani ◽  
Marjan Mansourian Gharaagozlou ◽  
Valiollah Hajhashemi
Keyword(s):  
Multiple Sclerosis ◽  
Urinary Tract ◽  
Symptom Score ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Statistical Tests ◽  
Men And Women ◽  
Urinary Tract Symptoms ◽  
Significant Difference ◽  
Lower Urinary

Abstract Background Most patients with multiple sclerosis (MS) suffer from bladder dysfunction during the course of the disease. This study was conducted to examine the prevalence of these complications among patients with MS. Methods This cross-sectional study was performed on 603 patients with MS who referred to the neurology clinics of Kashani and Alzahra Hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. The sampling was performed by multi-stage random cluster sampling method and the informed consent form was filled in by the subjects. Then, all the data were collected through interviews using the Lower Urinary Tract Symptom Score (LUTSS) developed in accordance with the definitions presented by the International Continence Society (ICS) and the International Prostate Symptom Score (I-PSS). The data were analyzed using descriptive and inferential statistical tests in SPSS and the significance level was considered to be less than 0.050. Results The prevalence rate of lower urinary tract symptoms (LUTS) was 87.6% among all the subjects, with a similar rate among women (88.0%) and men (86.0%). There was a significant difference between the two groups of men and women in terms of the prevalence of stress urinary incontinence (SUI), intermittent urine flow, hesitancy, straining, and dribbling (P < 0.050). There was no significant difference between the two groups of women and men in terms of the prevalence of other symptoms (P > 0.050). Moreover, there was a significant difference between the degree of LUTS with age, marital status, education, duration of illness, clinical course, and disability (P < 0.05). Conclusions A high prevalence of LUTS was found among patients with MS, with similar rates in men and women, and the nature of the urinary complaints and LUTS was different among men and women with MS. Therefore, it is recommended that the health system take necessary measures regarding timely detection and treatment of LUTS among these patients in order to prevent secondary outcomes and improve the quality of life (QOL) of patients with MS.

scholarly journals Endothelial dysfunction, abnormal vascular structure and lower urinary tract symptoms in men and women

2018 ◽  
Vol 261 ◽  
pp. 196-203 ◽  
Author(s):  
Shogo Matsui ◽  
Masato Kajikawa ◽  
Tatsuya Maruhashi ◽  
Yumiko Iwamoto ◽  
Nozomu Oda ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Endothelial Dysfunction ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Vascular Structure ◽  
Men And Women ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

scholarly journals Giant anterior urethra stones combined with a diverticulum: a case report

2019 ◽  
Vol 101 (6) ◽  
pp. e139-e141
Author(s):  
S Chen ◽  
X Su ◽  
M Jiang ◽  
H Mi
Keyword(s):  
Case Report ◽  
Clinical Practice ◽  
Urinary Tract ◽  
Connective Tissue ◽  
Lower Urinary Tract ◽  
Urethral Diverticulum ◽  
Urinary Frequency ◽  
Anterior Urethra ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Urethral diverticulum is a condition where the urethra or the periurethral glands push into the connective tissue layers that surround it. Patients of urethral diverticulum present with nonspecific symptoms such as incontinence, urinary frequency and urgency, and pain during sexual intercourse and urination. The incidence of this condition is low. We report a case of giant anterior urethra stones combined with a diverticulum with no lower urinary tract symptoms. We believe that this case is extremely rare, and the process of diagnosis and treatment is of great significance in clinical practice.

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