PURPOSE: OnabotulinumtoxinA has demonstrated efficacy and safety in the treatment of urinary incontinence (UI) associated with neurogenic detrusor overactivity (NDO) and idiopathic overactive bladder (OAB); however, real-world evidence is limited. This postmarketing surveillance study aimed to assess the effectiveness and safety of onabotulinumtoxinA in Korean patients with UI associated with NDO or OAB with an inadequate response or intolerance to anticholinergics. METHODS: Patients received 200 U (NDO) or 100 U (OAB) of onabotulinumtoxinA. Effectiveness (assessed using the validated International Consultation on Incontinence Questionnaire-Short Form [ICIQ-SF]) and safety were assessed for 1–4 months after onabotulinumtoxinA administration. RESULTS: Overall, 686 patients (NDO, 161; OAB, 525) comprised the safety population; of these, 612 patients were analyzed for effectiveness. There was a significant decrease (P<0.0001) in the mean (standard deviation) ICIQ-SF scores in the NDO (–6.8±5.5) and OAB (–6.0±6.4) groups after onabotulinumtoxinA administration. A decrease of >5 points from baseline in the ICIQ-SF score was observed in 64.9% and 47.3% of patients in the NDO and OAB groups, respectively. Following treatment, 59.9% in the NDO group and 43.0% in the OAB group were dry. There was no effect of age on effectiveness in either group. Only 10 adverse drug reactions (ADRs) were reported in 5.6% of NDO patients and 20 ADRs in 3.2% of OAB patients. Most ADRs in both groups were related to the lower urinary tract such as dysuria (NDO, 1.2%; OAB, 0.6%) and urinary retention (NDO, 0.6%; OAB, 1.5%). CONCLUSIONS: Effectiveness and safety of onabotulinumtoxinA in Korea in a real-world setting was demonstrated.
Cholinergic Antagonists ; Drug-Related Side Effects and Adverse Reactions ; Dysuria ; Humans ; Korea ; Outcome Assessment (Health Care) ; Urinary Bladder, Neurogenic ; Urinary Bladder, Overactive ; Urinary Incontinence ; Urinary Retention ; Urinary Tract

BACKGROUNDOnabotulinumtoxinA is widely used in treating neurogenic detrusor overactivity (NDO). We carried out a systematic review and meta-analysis to assess the efficacy and safety of the drug for treating NDO.

METHODSWe searched the following databases: Medline, EMBASE, and the Cochrane Controlled Trials Register. All published randomized double-blind, placebo-controlled trials of onabotulinumtoxinA for the treatment of NDO were identified in the analysis. The reference lists of the retrieved studies were also investigated.

RESULTSFour publications involving a total of 807 patients were identified in the analysis, which compared onabotulinumtoxinA with placebo. The changes of the mean number of urinary incontinence per week (the standardized mean difference [SMD] = -10.91, 95% confidence intervals [CIs] = -14.18--7.63, P < 0.0001); maximum cystometric capacity (SMD = 146.09, 95% CI = 126.19-165.99, P < 0.0001) and maximum detrusor pressure (SMD = -32.65, 95% CI = -37.83--27.48, P < 0.0001) indicated that onabotulinumtoxinA was more effective than the placebo, despite the doses of onabotulinumtoxinA. Safety assessments primarily localized to the urinary tract indicated onabotulinumtoxinA were often associated with more complications. Urinary tract infections (relative risk [RR] =1.48, 95% CI = 1.20-1.81, P = 0.0002); hematuria (RR = 1.81, 95% CI = 1.00-3.24, P = 0.05) and urinary retention (RR = 5.87, 95% CI = 3.61-9.56, P < 0.0001).

CONCLUSIONSThis meta-analysis indicates that onabotulinumtoxinA to be an effective treatment for NDO with side effects primarily localized to urinary tract.

Botulinum Toxins, Type A ; adverse effects ; therapeutic use ; Humans ; Urinary Bladder, Overactive ; drug therapy

Aged ; China ; Humans ; Ileum ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Urinary Bladder Neoplasms ; surgery ; Urinary Diversion ; adverse effects ; Urinary Incontinence ; diagnosis ; drug therapy ; surgery ; therapy ; Urinary Reservoirs, Continent

OBJECTIVETo provide more information for rational evaluation of potential risks of terephthalic acid (TPA), we studied the effects of TPA on rats' bladders in 90 days after TPA exposure.

METHODSSprague Dawley rats were subdivided into five groups, ingesting 0%, 0.04%, 0.2%, 1%, and 5% TPA respectively for a sub-chronic feeding study lasting for 90 days. Urine, serum and samples of brain, liver, lung, kidney, bladder, etc. were collected and analyzed.

RESULTSTPA ingesting decreased the value of urinary pH, and increased the contents of Ca2+, Zn2+, Mg2+, Na+, K+ in urine. The volume of 24 h urine was significantly increased in male rats in the 1% and 5% TPA groups. Urinary white sediment was found in both sexes, and its formation in male rats seemed more susceptible than that in female rats. Alpha 2u-globulin (AUG) in serum and urine of male rats was markedly increased in a dose-dependent manner. Fifteen cases of hyperplasia (simple or atypical) were determined in the 5% TPA ingesting group, 14/52 in male rats and 1/23 in female rats. Among them 3 male rats had no stone or calculus. Those with either bladder stones or hyperplasia were accompanied with urinary white sediments.

CONCLUSIONWhite sediment accompanied with elevated urine AUG is the basis of TPA induced urolith formation, and is also associated with TPA induced bladder epithelial cell proliferation. It can act as an early biomarker for the potential toxic effect of TPA.

Alpha-Globulins ; urine ; Animals ; Biomarkers ; urine ; Female ; Hyperplasia ; chemically induced ; Male ; Phthalic Acids ; toxicity ; Rats ; Rats, Sprague-Dawley ; Urinary Bladder ; drug effects ; pathology ; Urinary Bladder Calculi ; chemically induced

OBJECTIVETo evaluate the toxicity of Radix Aristolochiae supplied experimental evidence of rational use of drug in clinic.

METHODAfter treatment with small dose Radix Aristolochiae, Guanxin Suhe Wan (with Radix Aristolochiae) and Guanxin Suhe Wan (without Radix Aristolochiae) in different group for a long- term, respectively, the biochemical indicator of PT, ALT, AST, ALB, ALP, Crea and BUN were detected, and the kidney, liver, stomach and urinary bladder were examined by pathologic assaying.

RESULTIn Radix Aristolochiae group and Guanxin Suhe Wan (with Radix Aristolochiae) group, all of biochemical indicator were changed significantly, and hepatonecrosis, renal tubular necrosis, gastric carcinoma and bladder carcinoma were discovered.

CONCLUSIONRadix Aristolochiae and Guanxin Suhe Wan (with Radix Aristolochiae) can damage kidney and liver, and cause gastric carcinoma and bladder carcinoma by intensive toxicity.

Animals ; Aristolochia ; chemistry ; toxicity ; Drugs, Chinese Herbal ; toxicity ; Kidney ; drug effects ; metabolism ; pathology ; Liver ; drug effects ; metabolism ; pathology ; Male ; Rats ; Rats, Sprague-Dawley ; Stomach Neoplasms ; chemically induced ; Urinary Bladder ; drug effects ; metabolism ; pathology ; Urinary Bladder Neoplasms ; chemically induced

Prolonged bladder catheterization, the conventional management of urinary bladder dysfunction secondary to radical hysterectomy for gynecologic malignancies, is associated with patient discomfort, higher incidence of urinary tract infection, delayed ambulation and moderate cost.
OBJECTIVE: This study aimed to determine the efficacy and safety of solifenacin succinate in the decreasing mean duration of indwelling catheterization after radical hysterectomy.
METHODS: In this non-blinded, no placebo, randomized controlled trial, patients 19 years old and above, diagnosed with early stage cervical cancer and stage II endometrial cancer were randomized to 2 arms: control arm and treatment arm (given solifenacin succinate 5 mg once a day after radical hysterectomy). Bladder function testing on the 3rd postoperative day and weekly thereafter was done on all patients. The primary endpoint was the mean duration of indwelling catheterization until bladder function recovery was obtained. Patients were monitored for adverse drug reactions and development of urinary tract infection.
RESULTS: Each arm had 18 patients. The clinicopathologic profiles of the patients in the 2 arms were comparable. The mean duration of indwelling catheterization was significantly shorter in the treatment arm (13.33 days ± 10.50 SO) than in the control arm (21.33 days ± 11.66 SO) (P = 0.046). No adverse drug reactions were noted.
CONCLUSION: Solifenacin succinate effectively and safely reduced mean duration of indwelling catheterization among patients who underwent radical hysterectomy. Human ; Female ; Aged ; Middle Aged ; Adult ; Urinary Bladder ; Solifenacin Succinate ; Uterine Cervical Neoplasms ; Urinary Catheterization ; Hysterectomy ; Urinary Tract Infections ; Endometrial Neoplasms ; Drug-related Side Effects And Adverse Reactions

OBJECTIVETo establish a simple and efficient method for establishing a mouse model of orthotopic superficial bladder cancer.

METHODSC57BL/6 mice were anesthetized with sodium pentobarbital and catheterized with modified IV catheter (24 G). The mice were intravesically pretreated with HCl and then with NaOH, and after washing the bladders with phosphate-buffered saline (PBS), 100 microl (1 x 10(7)) MB49 cells were infused and allowed to incubate in the bladder for 2 h followed intravesical mitomycin C (MMC) administration. The tumor formation rate, survival, gross hematuria, and bladder weight were determined as the outcome variables, and the pathology of the bladders was observed.

RESULTSInstillation of MB49 tumor cells resulted in a tumor formation rates of 100% in all the pretreated groups while 0% in the control group without pretreatment. MMC significantly reduced the bladder weight as compared to PBS.

CONCLUSIONWe have successfully established a stable, reproducible, and reliable orthotopic bladder cancer model in mice.

Animals ; Cell Line, Tumor ; Cell Transformation, Neoplastic ; Disease Models, Animal ; Female ; Mice ; Mice, Inbred C57BL ; Mitomycin ; pharmacology ; Organ Size ; drug effects ; Urinary Bladder ; drug effects ; pathology ; Urinary Bladder Neoplasms ; pathology

Acetylcholine ; metabolism ; physiology ; Animals ; Cholinergic Agonists ; pharmacology ; Male ; Muscle Contraction ; drug effects ; physiology ; Muscle Relaxation ; drug effects ; physiology ; Muscle, Smooth ; drug effects ; pathology ; physiopathology ; Rabbits ; Random Allocation ; Receptors, Cholinergic ; physiology ; Synaptic Transmission ; drug effects ; Urinary Bladder ; drug effects ; innervation ; physiopathology

OBJECTIVETo discuss the influence of Suoquan capsule (SQJN) on the detrusor of D-galactose mimetic rats, and to explore the mechanism of reducing urine.

METHODInvestigate the enzymes (ATPase, SDH, SOD, MDA, Na+ -K+ -ATPase, Ca2+ - Mg2+ -ATPase) which influence the production and excretion of urine and the reactivity of urinary detrusor strips to different concentrations of ISO and ATP.

RESULTCompared with the model group, the activity of SOD, Na+ -K+ -ATPase, Ca2+ -Mg2+ -ATPase and SDH increased significantly in aging rats after administrating SQJN (P < 0.01); the complaisance and elasticity of bladder also increased (P < 0.05). The frequency of spontaneous contraction and the MDA decreased significantly (P < 0.05-0.01). The decreased relaxation response to ISO and increased contractile response to ATP were also changed after administrating SQJN.

CONCLUSIONSQJN can regulate the metabolism of fluid through recovering the normal physiologic function of the detrusor of bladder.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Galactose ; adverse effects ; Humans ; Male ; Muscle Contraction ; Muscle, Smooth ; physiology ; Rats ; Urinary Bladder ; drug effects ; metabolism ; physiopathology ; Urinary Incontinence, Urge ; chemically induced ; drug therapy ; metabolism ; physiopathology ; Urination ; drug effects

No abstract available.
Anti-Bacterial Agents/*adverse effects ; Cystitis/*chemically induced ; Female ; Hemorrhage/*chemically induced ; Humans ; Penicillin G/*adverse effects ; Urinary Bladder/*drug effects