Hypothesis / aims of study One of the challenges in health care today is providing affordable care for those in need, and identifying a reasonable level of care for care-seekers. Many women with u ...

Irregular or infrequent voiding due to avoiding school toilets can contribute to a number of urinary problems among school children. There is, however, a lack of studies on younger women. The aim of this study was to investigate toileting behavior and the correlation to lower urinary tract symptoms (LUTS) among young women (age 18–25 years). A further aim was to validate the Swedish version of the Toileting Behavior scale (TB scale).

Objective: The objective of this study was to assess the resource use of treating overactive bladder (OAB) patients in real-world clinical practice and to evaluate whether there is external validity in the treatment of OAB in clinical practice.Materials and methods: The study included 55 patients suffering from OAB and treated with BOTOX (R) at two Swedish clinics. The study was conducted as an anonymized retrospective chart review study.Results: The estimated yearly direct cost of BOTOX treatment was Euro902. The mean age of patients in the study was 60 years, and 85% were women. The severity of OAB before BOTOX treatment, given by the mean number of daily leakages, equalled 4.8. The median interval between treatments was 210 days.Conclusions: Patient characteristics in the real world were similar to those in the clinical trials, showing a high degree of external validity. Treatment intervals were longer in the real world than in clinical trials, indicating that treatment cost could be lower when patients are treated as observed in real-world clinical practice.

Slutsatser Godartad prostataforstoring (benign prostatahyperplasi, BPH) ar ett vanligt tillstand som med stigande alder drabbar i princip alla man. En del av dessa man far urineringsproblem och cirka 4 500 opereras varje ar for en forstorad prostata. Manga med lindrigare besvar behandlas med lakemedel eller behover ingen behandling alls. Avflodeshinder kan obehandlat ge allvarlig urinretention som skadar njurarna, och en urinstamma kan vara livshotande. For att avgransa den grupp av man dar problemen med urineringen beror pa en forstorad prostata anvands ett tiotal olika diagnostiska metoder. Nar det galler behandling finns det flera olika kirurgiska metoder, varav nagra ar val etablerade och andra av mer experimentell karaktar. Under 1990-talet har ocksa flera lakemedel introducerats. SBU har darfor bedomt att det funnits ett behov av att gora en systematisk genomgang av den vetenskapliga grunden for dessa olika metoder. Nedan foljer de viktigaste slutsatserna av arbetet.

Aims: This study looked at whether oral desmopressin, by decreasing kidney urine production, would prolong bladder filling-time thereby increasing the time to reach maximum capacity, thus reducing overactive bladder (OAB) symptoms, and providing an alternative method of treatment to OAB sufferers. Methods: An investigator-initiated, 2-week, multi-national, multi-centre, "proof-of-concept," phase IIb, double-blind, placebo-controlled, prospective, randomized, cross-over study was conducted using 0.2 mg of oral desmopressin in adults suffering with OAB. Patients were included in the trial period if they had >= 4 voids in the first 8-hr of the day after rising, excluding the first morning void. The primary endpoint was evaluation of effectiveness of desmopressin in increasing the time to the first OAB symptom episodes during the first 8-hr following treatment. Results: Time to first void was 8-min later on the drug than on placebo (P = 0.27). However, the drug led to one less void (3.2 vs. 4.2) in the same period (P < 0.001). There was an increase in the time to first urgency episode with a decrease in the number of urgency episodes in the drug days compared to placebo (P < 0.003). There was a subjective improvement in frequency and urgency and overall quality-of-life as measured by the ICIQ-OAB. Twenty-seven people reported adverse events which were all mild, headache being the commonest and no hyponatremia was recorded. Conclusions: Antidiuresis, using oral desmopressin tablets, is a novel, feasible and safe (short-term basis) method of treatment for adults with OAB, and could be considered in the armamentarium of drugs available for the treatment of OAB. Neurourol. Urodynam. 28:40-46, 2009. (C) 2008 Wiley-Liss, Inc.

Hypothesis / aims of study The majority of patients with symptomatic, neurogenic detrusor overactivity is successfully treated with anticholinergics and/or clean intermittent catheterisation. Studies have shown excellent effects with repeated Botulinum toxin A (BTX-A) injection therapy on neurogenic urinary incontinence in patients who fail maximum conservative treatment. Our observational study evaluates treatment results in patients with neurogenic urinary incontinence and/or frequency/urgency in a clinical setting at a single institution.

Abnormalities of micturition occur in many different diseases, have a variety of causes and take several forms. This review will focus exclusively on those abnormalities in which antidiuretic therapy may be of benefit. These conditions are primarily characterized by an increase in the total amount of urine produced (polyuria) or a circadian shift in the control of urine production and/or voiding (nocturnal enuresis, nocturia).