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[PMID]: 29329895
[Au] Autor:Cho MC; Song WH; Park J; Cho SY; Jeong H; Oh SJ; Paick JS; Son H
[Ad] Address:Department of Urology, Seoul National University Boramae Medical Center, Seoul, Korea.
[Ti] Title:Long-Term Outcomes of Laser Prostatectomy for Storage Symptoms: Comparison of Serial 5-Year Followup Data between 120 W High Performance System Photoselective Vaporization of the Prostate and Holmium Laser Enucleation of the Prostate.
[So] Source:J Urol;, 2018 Jan 09.
[Is] ISSN:1527-3792
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: We compared long-term storage symptom outcomes between photoselective laser vaporization of the prostate with a 120 W high performance system and holmium laser enucleation of the prostate. We also determined factors influencing postoperative improvement of storage symptoms in the long term. MATERIALS AND METHODS: Included in our study were 266 men, including 165 treated with prostate photoselective laser vaporization using a 120 W high performance system and 101 treated with holmium laser enucleation of the prostate, on whom 60-month followup data were available. Outcomes were assessed serially 6, 12, 24, 36, 48 and 60 months postoperatively using the I-PSS (International Prostate Symptom Score), uroflowmetry and the serum prostate specific antigen level. Postoperative improvement in storage symptoms was defined as a 50% or greater reduction in the subtotal storage symptom score at each followup visit after surgery compared to baseline. RESULTS: Improvements in frequency, urgency, nocturia, subtotal storage symptom scores and the quality of life index were maintained up to 60 months after photoselective laser vaporization or holmium laser enucleation of the prostate. There was no difference in the degree of improvement in storage symptoms or the percent of patients with postoperative improvement in storage symptoms between the 2 groups throughout the long-term followup. However, the holmium laser group showed greater improvement in voiding symptoms and quality of life than the laser vaporization group. On logistic regression analysis a higher baseline subtotal storage symptom score and a higher BOOI (Bladder Outlet Obstruction Index) were the factors influencing the improvement in storage symptoms 5 years after prostate photoselective laser vaporization or holmium laser enucleation. CONCLUSIONS: Our serial followup data suggest that storage symptom improvement was maintained throughout the long-term postoperative period for prostate photoselective laser vaporization with a 120 W high performance system and holmium laser enucleation without any difference between the 2 surgeries. Also, more severe storage symptoms at baseline and a more severe BOOI predicted improved storage symptoms in the long term after each surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29220526
[Au] Autor:Zhao C; Tella SH; Del Rivero J; Kommalapati A; Ebenuwa I; Gulley J; Strauss J; Brownell I
[Ad] Address:Hematology Oncology Fellowship Program, National Institutes of Health, Bethesda, Maryland.
[Ti] Title:Anti-PD-L1 Treatment Induced Central Diabetes Insipidus.
[So] Source:J Clin Endocrinol Metab;103(2):365-369, 2018 Feb 01.
[Is] ISSN:1945-7197
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Context: Immune checkpoint inhibitors, including anti-programmed cell death protein 1 (PD-1), anti-programmed cell death protein ligand 1 (PD-L1), and anti-cytotoxic T-lymphocyte antigen 4 (anti-CTLA4) monoclonal antibodies, have been widely used in cancer treatment. They are known to cause immune-related adverse events (irAEs), which resemble autoimmune diseases. Anterior pituitary hypophysitis with secondary hypopituitarism is a frequently reported irAE, especially in patients receiving anti-CTLA4 treatment. In contrast, posterior pituitary involvement, such as central diabetes insipidus (DI), is relatively rare and is unreported in patients undergoing PD-1/PD-L1 blockade. Case Description: We describe a case of a 73-year-old man with Merkel cell carcinoma who received the anti-PD-L1 monoclonal antibody avelumab and achieved partial response. The patient developed nocturia, polydipsia, and polyuria 3 months after starting avelumab. Further laboratory testing revealed central DI. Avelumab was held and he received desmopressin for the management of central DI. Within 6 weeks after discontinuation of avelumab, the patient's symptoms resolved and he was eventually taken off desmopressin. The patient remained off avelumab and there were no signs or symptoms of DI 2 months after the discontinuation of desmopressin. Conclusion: To our knowledge, this is the first report of central DI associated with anti-PD-L1 immunotherapy. The patient's endocrinopathy was successfully managed by holding treatment with the immune checkpoint inhibitor. This case highlights the importance of early screening and appropriate management of hormonal irAEs in subjects undergoing treatment with immune checkpoint inhibitors to minimize morbidity and mortality.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1210/jc.2017-01905

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[PMID]: 29508556
[Au] Autor:Kurdoglu M; Unlu S; Antonetti-Elford M; Kurdoglu Z; Kilic GS
[Ad] Address:Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas, USA.
[Ti] Title:Short-term results of changes in existing and de novo lower urinary tract symptoms after robot-assisted laparoscopic uterosacral ligament suspension and sacrocolpopexy.
[So] Source:Low Urin Tract Symptoms;, 2018 Mar 06.
[Is] ISSN:1757-5672
[Cp] Country of publication:Australia
[La] Language:eng
[Ab] Abstract:OBJECTIVE: This study presents short-term outcomes related to changes in existing and de novo lower urinary tract symptoms (LUTS), pelvic pain, and bowel function following robot-assisted laparoscopic uterosacral ligament suspension (RALUSLS) and sacrocolpopexy (RALSC). METHODS: Observational data for RALUSLS (n = 23) and RALSC (n = 25) collected between August 2014 and March 2016 from a single institute (The University of Texas Medical Branch) were evaluated retrospectively. Patient characteristics, concomitant procedures, and the occurrence of lower urinary tract, pelvic pain, and bowel symptoms were compared between patients undergoing RALUSLS and RALSC. RESULTS: There was no significant difference in background characteristics between the 2 groups, except for parity, which was high in the RALUSLS group. In the RALUSLS group, patients experienced significant resolution of urinary urgency (P < .001) and frequency, urge and mixed incontinence, and pelvic pain (P < .05). In the RALSC group, there was significant resolution of nocturia, mixed incontinence, pelvic pain, and dyspareunia (P < .05). There was no significant difference in the occurrence of de novo symptoms in the RALUSLS and RALSC groups (P > .05), although newly appearing urinary urgency or frequency and stress or urge incontinence were more common after RALSC. CONCLUSION: Mixed incontinence and pelvic pain improved significantly in patients after RALUSLS or RALSC. In RALUSLS patients, urgency, frequency, and urge incontinence also improved, whereas additional improvement in nocturia and dyspareunia was evident only in RALSC patients. De novo LUTS developing after these procedures, especially after RALSC, necessitate careful patient consultation prior to surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1111/luts.12219

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[PMID]: 29508046
[Au] Autor:Furtado-Albanezi D; Jürgensen SP; Avila MA; Correia GN; Driusso P
[Ad] Address:Physical Therapy Graduate Program, Federal University of São Carlos, Rodovia Washington Luis, Km 235, São Carlos, SP, 13565-905, Brazil.
[Ti] Title:Effects of two nonpharmacological treatments on the sleep quality of women with nocturia: a randomized controlled clinical trial.
[So] Source:Int Urogynecol J;, 2018 Mar 06.
[Is] ISSN:1433-3023
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION AND HYPOTHESIS: The objective was to check the effects of two nonpharmacological treatments on the sleep quality of women with nocturia. METHODS: A randomized controlled clinical trial in which 40 women with nocturia were randomized into two groups; one was subjected to tibial nerve stimulation (GTNS) and the other received pelvic floor muscle training associated with behavioral therapy (GPFMT). Both groups were followed for 12 weeks, with one session/week; evaluated by the Pittsburgh Sleep Quality Index (PSQI), King's Heath Questionnaire (KHQ), and Epworth Sleepiness Scale (ESS). The Wilcoxon test was used to compare intra-group data and the Mann-Whitney test for intergroup results. Effect size and confidence interval were calculated, and the level of significance was set at 5%. RESULTS: Both groups showed improvements in quality of sleep, observed by the PSQI total score (GTNS from 9 ± 0.88 to 7 ± 0.94, p = 0.002; GPFMT from 8 ± 0.80 to 5 ± 0.94, p < 0.001) and the sleep/energy domain of the KHQ (GTNS from 66.66 ± 9.03 to 16.66 ± 7.20, p = 0.002; GPFMT from 66.66 ± 9.30 to 0.00 ± 7.26, p = 0.001). CONCLUSIONS: Both nonpharmacological treatments proposed (TNS or PFMT) were equally able to improve quality of sleep of women with nocturia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1007/s00192-018-3584-8

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[PMID]: 29385990
[Au] Autor:Schoendorfer N; Sharp N; Seipel T; Schauss AG; Ahuja KDK
[Ad] Address:School of Medicine, University of Queensland, Herston, Australia.
[Ti] Title:Urox containing concentrated extracts of Crataeva nurvala stem bark, Equisetum arvense stem and Lindera aggregata root, in the treatment of symptoms of overactive bladder and urinary incontinence: a phase 2, randomised, double-blind placebo controlled trial.
[So] Source:BMC Complement Altern Med;18(1):42, 2018 Jan 31.
[Is] ISSN:1472-6882
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Storage lower urinary tract symptoms (LUTS) including overactive bladder (OAB) and urinary incontinence (UI) affect millions of people worldwide, significantly impacting quality of life. Plant based medicines have been documented both empirically and in emerging scientific research to have varying benefits in reducing bladder symptoms. We assessed the efficacy of Urox®, a proprietary combination of phytomedicine extracts including, Cratevox™ (Crataeva nurvala) stem bark, Equisetem arvense stem and Lindera aggregata root, in reducing symptoms of OAB and UI. METHODS: Efficacy of the herbal combination on a variety of bladder symptoms compared to an identical placebo, were documented in a randomised, double-blind, placebo controlled trial conducted at two primary care centres. Data were collected at baseline, 2, 4 and 8 weeks, with the primary outcome being self-reported urinary frequency. Statistical analysis included mixed effects ordered logistic regression with post hoc Holm's test to account for repeated measures, and included an intention-to-treat analysis. RESULTS: One hundred and fifty participants (59% female, aged; mean ± SD; 63.5 ± 13.1 years) took part in the study. At week 8, urinary day frequency was significantly lower (OR 0.01; 95%CI 0.01 to 0.02; p < 0.001) in response to treatment (mean ± SD; 7.69 ± 2.15/day) compared to placebo (10.95 ± 2.47/day). Similarly, episodes of nocturia were significantly fewer (OR 0.03; 95%CI 0.02 to 0.05) after 8 weeks of treatment (2.16 ± 1.49/night) versus placebo (3.14 ± 1.36/night). Symptoms of urgency (OR 0.02; 95%CI 0.01 to 0.03), and total incontinence (OR 0.03; 95% CI 0.01 to 0.06) were also lower (all p < 0.01) in the treatment group. Significant improvements in quality of life were reported after treatment in comparison to placebo. No significant side effects were observed resulting in withdrawal from treatment. CONCLUSIONS: The outcome of this study demonstrated both statistical significance and clinical relevance in reducing symptoms of OAB, urinary frequency and/or urgency and incontinence. The demonstrated viability of the herbal combination to serve as an effective treatment, with minimal side-effects, warrants further longer term research and consideration by clinicians. TRIAL REGISTRATION: NCT02396160 (registered on 17 March 2015 - before any statistical analyses commenced).
[Mh] MeSH terms primary: Plant Extracts/therapeutic use
Urinary Bladder, Overactive/drug therapy
Urinary Incontinence/drug therapy
Urological Agents/therapeutic use
[Mh] MeSH terms secundary: Aged
Capparaceae
Equisetum
Female
Humans
Lindera
Male
Medical Records
Middle Aged
Phytotherapy
Plant Extracts/pharmacology
Urination/drug effects
Urological Agents/pharmacology
[Pt] Publication type:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Name of substance:0 (Plant Extracts); 0 (Urological Agents)
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:IM
[Da] Date of entry for processing:180202
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1186/s12906-018-2101-4

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[PMID]: 29493044
[Au] Autor:Mantovani S; Smith SS; Gordon R; O'Sullivan JD
[Ad] Address:Faculty of Medicine, The University of Queensland, UQ Centre for Clinical Research, Herston, QLD, Australia.
[Ti] Title:An overview of sleep and circadian dysfunction in Parkinson's disease.
[So] Source:J Sleep Res;, 2018 Mar 01.
[Is] ISSN:1365-2869
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Sleep and circadian alterations are amongst the very first symptoms experienced in Parkinson's disease, and sleep alterations are present in the majority of patients with overt clinical manifestation of Parkinson's disease. However, the magnitude of sleep and circadian dysfunction in Parkinson's disease, and its influence on the pathophysiology of Parkinson's disease remains often unclear and a matter of debate. In particular, the confounding influences of dopaminergic therapy on sleep and circadian dysfunction are a major challenge, and need to be more carefully addressed in clinical studies. The scope of this narrative review is to summarise the current knowledge around both sleep and circadian alterations in Parkinson's disease. We provide an overview on the frequency of excessive daytime sleepiness, insomnia, restless legs, obstructive apnea and nocturia in Parkinson's disease, as well as addressing sleep structure, rapid eye movement sleep behaviour disorder and circadian features in Parkinson's disease. Sleep and circadian disorders have been linked to pathological conditions that are often co-morbid in Parkinson's disease, including cognitive decline, memory impairment and neurodegeneration. Therefore, targeting sleep and circadian alterations could be one of the earliest and most promising opportunities to slow disease progression. We hope that this review will contribute to advance the discussion and inform new research efforts to progress our knowledge in this field.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:Publisher
[do] DOI:10.1111/jsr.12673

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[PMID]: 29492635
[Au] Autor:Mühlstädt S
[Ad] Address:Universitätsklinik für Urologie und Nierentransplantation, Martin-Luther-Universität, Ernst-Grube-Straße 40, 06120, Halle/Saale, Deutschland. uroevidence@dgu.de.
[Ti] Title:Therapie der männlichen Nykturie mit Desmopressin. [Treatment of nocturia in men with desmopressin].
[So] Source:Urologe A;, 2018 Feb 28.
[Is] ISSN:1433-0563
[Cp] Country of publication:Germany
[La] Language:ger
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:Publisher
[do] DOI:10.1007/s00120-018-0612-8

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SciELO Brazil full text

[PMID]: 29489983
[Au] Autor:Fitz F; Sartori M; Girão MJ; Castro R
[Ad] Address:Department of Gynecology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
[Ti] Title:Pelvic floor muscle training for overactive bladder symptoms - A prospective study.
[So] Source:Rev Assoc Med Bras (1992);63(12):1032-1038, 2017 Dec.
[Is] ISSN:1806-9282
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Pelvic floor muscle training (PFMT) involves the contraction of the puborectal, anal sphincter and external urethral muscles, inhibiting the detrusor contraction, what justify its use in the treatment of overactive bladder (OAB) symptoms. OBJECTIVE: To verify the effects of isolated PFMT on the symptoms of OAB. METHOD: Prospective clinical trial with 27 women with mixed urinary incontinence (MUI), with predominance of OAB symptoms and loss ≥ 2 g in the pad test. It was evaluated: pelvic floor muscles (PFMs) function (digital palpation and manometry); urinary symptoms (nocturia, frequency and urinary loss); degree of discomfort of OAB symptoms; and quality of life (Incontinence Quality-of-Life Questionnaire [I-QoL]). The PFMT program consisted of 24 outpatient sessions (2x/week + home PFMT). The Mann-Whitney and Wilcoxon tests (with a significance level of 5%) were used to analyse the data. RESULTS: There was a significant improvement of the urinary symptoms to the pad test (5.8±9.7, p<0.001), urinary loss (0.7±1.1, p=0.005) and nocturia (0.8±0.9, p=0.011). Reduction in the degree of discomfort of urinary symptoms was observed according to OAB-V8 questionnaire (10.0±7.7, p=0.001). There were also significant results in PFMs function: Oxford (3.6±0.9, p=0.001), endurance (5.2±1.8, p<0.001), fast (8.9±1.5, p<0.001) and manometry (26.6±15.8, p=0.003). In addition, quality of life had a significant improvement in the three domains evaluated by I-QoL. CONCLUSION: The PFMT without any additional guidelines improves the symptomatology, the function of PFMs and the quality of life of women with OAB symptoms.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:In-Process

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[PMID]: 29241263
[Au] Autor:Santos TGD; Miranda IAS; Nygaard CC; Schreiner L; Castro RA; Haddad JM
[Ad] Address:School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
[Ti] Title:Revisão sistemática sobre terapia oral para tratamento dos sintomas da síndrome da bexiga dolorosa: as diretrizes brasileiras. Systematic Review of Oral Therapy for the Treatment of Symptoms of Bladder Pain Syndrome: The Brazilian Guidelines.
[So] Source:Rev Bras Ginecol Obstet;40(2):96-102, 2018 Feb.
[Is] ISSN:1806-9339
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:Interstitial cystitis (IC), including bladder pain syndrome (BPS), is a chronic and debilitating disease that mainly affects women. It is characterized by pelvic pain associated with urinary urgency, frequency, nocturia and negative urine culture, with normal cytology. In 2009, the Society for Urodynamics and Female Urology (SUFU) defined the term IC/BPS as "an unpleasant sensation (pain, pressure, and discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms for more than 6 weeks duration, in the absence of infection or other identifiable causes." This is the definition used by the American Urological Association (AUA) in the most recent guidelines on IC/BPS. Interstitial cystitis may be sufficiently severe to have a devastating effect on the quality of life, but it may also be associated with moderate symptoms whose effects are less debilitating. Although there are several clinical trials to assess oral and intravesical therapies, the treatment for IC remains far from ideal. This systematic assessment evaluates published randomized clinical trials on oral medications used to treat symptoms of BPS. This study was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method. Two independent reviewers screened the studies to determine their inclusion or exclusion and to perform the methodological analysis. The inclusion criteria included randomized studies published between April of 1988 and April of 2016 that used oral medications to treat symptoms of BPS or IC. According to the systematic review performed, we should consider pentosan polysulfate as one of the best options of oral drugs for the treatment of BPS symptoms. However, this drug is not an available option in Brazil. Orally administered amitriptyline is an efficacious medical treatment for BPS, and it should be the first treatment offered.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:In-Process
[do] DOI:10.1055/s-0037-1609049

  10 / 2958 MEDLINE  
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[PMID]: 29489052
[Au] Autor:Han J; Jung JH; Bakker CJ; Ebell MH; Dahm P
[Ad] Address:Department of Urology, University of Florida, Gainesville, Florida, USA.
[Ti] Title:Desmopressin for treating nocturia in men.
[So] Source:BJU Int;, 2018 Feb 28.
[Is] ISSN:1464-410X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: To assess the effects of desmopressin as compared to other interventions in the treatment of nocturia in men. PATIENTS AND METHODS: We performed a comprehensive search using multiple databases and abstract proceedings with no restrictions on the language of publication or publication status, up until August 2017. We included randomized or quasi-randomized trials. Inclusion criteria were men with nocturia defined as one or more voids per night. Two review authors independently examined full-text reports, identified relevant studies, assessed the eligibility of studies for inclusion, extracted data and assessed risk of bias. We performed statistical analyses using a random-effects model and assessed the quality of the evidence (QoE) according to GRADE. RESULTS: We included 14 studies with 2966 randomized men across five comparisons (we did not include one comparison (desmopressin versus behavior modification) in the abstract due to lack of the data with regard to primary outcomes). DESMOPRESSIN VERSUS PLACEBO: based on short-term follow-up (up to three months), desmopressin may have a similar effect on the number of nocturnal voids (mean difference (MD) -0.46, 95% confidence interval (CI) -0.94 to 0.01; low QoE). We are uncertain about the effect of desmopressin on major adverse events (risk ratio (RR) 0.97, 95% CI 0.10 to 9.03; very low QoE). For intermediate-term follow-up (three to 12 months), desmopressin may reduce the number of nocturnal voids in an appreciable number of participants (MD -0.85, 95% CI -1.17 to -0.53; low QoE). Desmopressin may result in little or no difference in major adverse events (RR 3.05, 95% CI 0.13 to 73.39; low QoE). We found no evidence on quality of life. DESMOPRESSIN VERSUS ALPHA-BLOCKER (AB): based on short-term follow-up, desmopressin likely has a similar effect on the number of nocturnal voids (MD 0.30, 95% CI -0.20 to 0.80; moderate QoE) and quality of life (MD 0.00, 95% CI -0.35 to 0.35; moderate QoE). There were no major adverse events in either study group. DESMOPRESSIN PLUS AB VERSUS AB ALONE: based on short-term follow-up, combination therapy likely results in a small, unimportant reduction in the number of nocturnal voids (MD -0.47, 95% CI -0.73 to -0.21; moderate QoE) and quality of life (MD -0.29, 95% CI -0.51 to -0.07; moderate QoE). The risk of major adverse events may be similar (RR 0.30, 95% CI 0.01 to 7.32; low QoE). DESMOPRESSIN PLUS AB VERSUS AB PLUS AN ANTICHOLINERGIC: based on short-term follow-up, combination therapy likely results in little or no difference in the number of nocturnal voids (MD -0.43, 95% CI -0.97 to 0.11; moderate QoE). We found no evidence on quality of life. There were no major adverse events in either study group. CONCLUSIONS: Desmopressin may reduce the number of nocturnal voids compared to placebo up to 12 months follow-up without increase in major adverse events. The effect on the number of nocturnal voids is likely similar to that of ABs with very infrequent major adverse events. There appears to be no added benefit in the combined use of an AB or an anticholinergic with desmopressin. This article is protected by copyright. All rights reserved.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:Publisher
[do] DOI:10.1111/bju.14183


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