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• W2149114901 abstract "No AccessJournal of UrologyAdult Urology1 May 2014Solifenacin in Women with De Novo Overactive Bladder after Tension-Free Obturator Vaginal Tape—Is it Effective? Maurizio Serati, Andrea Braga, Paola Sorice, Gabriele Siesto, Stefano Salvatore, and Fabio Ghezzi Maurizio SeratiMaurizio Serati Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy More articles by this author , Andrea BragaAndrea Braga Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy More articles by this author , Paola SoricePaola Sorice Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy More articles by this author , Gabriele SiestoGabriele Siesto Department of Gynecology, Istituto di Ricovero e Cura a Carattere Scientifico Humanitas Clinical Institute, Rozzano, Italy More articles by this author , Stefano SalvatoreStefano Salvatore Department of Obstetrics and Gynecology, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital, Milan, Italy More articles by this author , and Fabio GhezziFabio Ghezzi Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.10.068AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To our knowledge no group has evaluated antimuscarinic efficacy in patients with de novo overactive bladder after mid urethral sling placement. We assessed solifenacin efficacy in women with de novo overactive bladder after obturator tension-free vaginal tape placement compared to a control group. Materials and Methods: We prospectively considered all women with de novo overactive bladder symptoms at a 3-month followup visit after placement of obturator tension-free vaginal tape. Patients with overactive bladder preoperatively and those with obstructive symptoms or signs were excluded from analysis. Women who satisfied inclusion and exclusion criteria (group 1) were compared with a series of consecutive naïve patients with overactive bladder symptoms without a previous surgical procedure for stress urinary incontinence (group 2). We prescribed 12-week antimuscarinic therapy with oral solifenacin 5 mg once daily. Objective outcomes included changes from baseline in 3-day voiding diary data. Subjective efficacy was evaluated using the Overactive Bladder Questionnaire Short Form, Urgency Severity Scale and Patient Global Impression of Improvement questionnaires. Results: A total of 110 patients with de novo overactive bladder after obturator tension-free vaginal tape placement completed solifenacin treatment and were included in group 1. They were compared with 120 consecutive naïve women with overactive bladder (group 2). Group 1 presented at the 3-month followup visit with significantly less benefit in the mean decrease in urgency and urgency urinary incontinence episodes daily (−1.1 vs −2.3 and −0.2 vs −1.1, respectively, each p <0.0001). In group 1 we also found a lower subjective solifenacin effect. Previous obturator tension-free vaginal tape placement was an independent predictor of failed solifenacin treatment. Conclusions: Antimuscarinic treatment with solifenacin had significantly lower efficacy in women with de novo overactive bladder after mid urethral sling placement than in controls. References 1 : Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. Eur Urol2010; 58: 218. Google Scholar 2 : Tension-free vaginal tape for the treatment of urodynamic stress incontinence: efficacy and adverse effects at 10-year follow-up. Eur Urol2012; 61: 939. Google Scholar 3 : TVT-O for the treatment of pure urodynamic stress incontinence: efficacy, adverse effects, and prognostic factors at 5-year follow-up. Eur Urol2013; 63: 872. Google Scholar 4 : Difference in quality of life in women with urge urinary incontinence compared to women with stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct2009; 20: 781. 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Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 191Issue 5May 2014Page: 1322-1326Supplementary Materials Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.Keywordsdrug evaluationsolifenacinurinary bladderurethrasuburethral slingsoveractiveMetricsAuthor Information Maurizio Serati Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy More articles by this author Andrea Braga Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy More articles by this author Paola Sorice Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy More articles by this author Gabriele Siesto Department of Gynecology, Istituto di Ricovero e Cura a Carattere Scientifico Humanitas Clinical Institute, Rozzano, Italy More articles by this author Stefano Salvatore Department of Obstetrics and Gynecology, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital, Milan, Italy More articles by this author Fabio Ghezzi Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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