Overactive bladder (OAB) is associated with an increased likelihood of nocturia in patients with type 2 diabetes, researchers reported online ahead of print inInternational Urology and Nephrology. Min-Shen Chung, MD, of Chang Gung University College of Medicine in Kaohsiung, Taiwan, and colleagues studied 1,301 type 2 diabetics, of whom 59.6% had nocturia (2 or more voids per night) and 25.3% had severe nocturia (3 or more voids per night). OAB was associated with a significant 2.2 times increased risk of nocturia after adjusting for age and diabetes duration. Severe nocturia increased the risk of death nearly twofold independent of age and diabetes duration. Patients with severe nocturia had a higher mortality rate compared with those who did not have severe nocturia (6.1% vs. 2.4%). Other risk factors for nocturia and severe nocturia included stroke, hypertension, calcium channel blocker use, higher serum creatinine level, after adjusting for age, diabetes duration, and presence of OAB. Male gender, higher estimated glomerular filtration rate, hemoglobin levels, and serum albumin were associated with a lower risk of nocturia.
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Elderly patients with overactive bladder (OAB) that does not respond sufficiently to dose-escalated antimuscarinic monotherapy may benefit from combined high-dosage antimuscarinics, researchers reported online in the UroToday International Journal. They studied 81 OAB patients older than 65 years who previously received double-dose antimuscarin monotherapy with trospium. After at least six months of such treatment with no or short-lived symptom improvement, patients were treated with two antimuscarinics. Significant improvements were seen at a six-week follow-up, with the average number of daily incontinence events declining from six to two, average maximum bladder capacity increasing from 177 to 356 mL, average reflex volume rising from 149 to 284 mL, and average detrusor compliance improving from 16 to 37 mL/cm H2O. Side effects were comparable to that of normal-dosed antimuscarinics. |
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