Background: Bethanechol chloride, a cholinergic agonist, is often prescribed in suspected underactive bladders to improve detrusor contractility, despite its limited clinical efficacy. We investigated the usage patter...Background: Bethanechol chloride, a cholinergic agonist, is often prescribed in suspected underactive bladders to improve detrusor contractility, despite its limited clinical efficacy. We investigated the usage pattern of bethanechol in actual practice with the understanding that it would enable the physicians to make an informed decision on the coherent use of bethanechol. Methods: A nation-wide survey was carried out to obtain the responses of the urologists. Out of the 755 urologists approached, 630 survey responses were considered for analysis. Results: Usage of bethanechol was advocated as very common [318 (50.48%)], common [200 (31.75%)], not so common [107 (16.98%)], and rare [5 (0.79%)] in postoperative urinary retention, where it was preferred either exclusively [255 (40.48%)] or along with alpha blockers [247 (39.21%)]. Predilection to use alpha-blocker [247 (39.21%)], alpha-blocker plus naloxone [4 (0.64%)], naloxone [1 (0.16%)], alpha-blocker plus bethanechol plus naloxone [1 (0.16%)] was also observed. It was also preferred individually in pathologies causing urinary retention such as benign prostatic hyperplasia [125 (19.84%)], diabetic neuropathy [82 (13.02%)], neurological diseases [69 (10.95%)], senile bladder [14 (2.22%)], drugs [13 (2.06%)], and infective/inflammatory conditions [6 (0.95%)]. Other [321 (50.95%)] physicians opted to prescribe bethanechol in two or more of the enumerated indications. Bethanechol was prescribed orally as 25 mg thrice daily [441 (70.00%)], 50 mg thrice daily [86 (13.65%)], 25 mg four times daily [59 (9.37%)], and many “strongly agree” and “agree” that its sustained release formulation may offer better treatment compliance [565 (89.68%)], safety [548 (86.99%)], and efficacy [544 (86.35%)]. Conclusion: Bethanechol was the most prescribed drug for the management of postoperative urinary retention and other pathologies suspected to cause underactive bladder.展开更多
Underactive bladder(UAB)is a voiding disorder which generates disabling lower urinary tract symptoms(LUTS)due to the inability to produce an effective voiding contraction sufficient to empty the bladder.The underlying...Underactive bladder(UAB)is a voiding disorder which generates disabling lower urinary tract symptoms(LUTS)due to the inability to produce an effective voiding contraction sufficient to empty the bladder.The underlying abnormality,that is usually appreciated when performing urodynamic studies,has been defined by the International Continence Society(ICS)as detrusor underactivity(DUA).DUA is a common yet under-researched bladder dysfunction.The prevalence of DUA in different patient groups suggests that multiple aetiologies are implicated.Currently there is no effective therapeutic approach to treat this condition.An improved understanding of the underlying mechanisms is needed to facilitate the development of new advances in treatment.The purpose of this review is to discuss the epidemiology,pathophysiology,common causes and risk factors potentially leading to DUA;to aid in the appropriate diagnosis of DUA to potentially improve treatment outcomes.展开更多
Objective: Exploring the clinical efficacy of transurethral plasma enucleation of the prostate in the treatment of benign prostatic hyperplasia with underactive bladder detrusor contractility. Methods: Retrospective a...Objective: Exploring the clinical efficacy of transurethral plasma enucleation of the prostate in the treatment of benign prostatic hyperplasia with underactive bladder detrusor contractility. Methods: Retrospective analysis of the clinical data of 68 patients with benign prostatic hyperplasia and underactive detrusor muscle contractility treated by our department from July 2021 to July 2022. The above patients all met the diagnosis of benign prostatic hyperplasia, excluding prostate cancer and urethral stricture. Urodynamics showed a decrease in the contractile force of the bladder detrusor muscle, and the surgical equipment used Olympus bipolar plasma resection equipment method. Divide the above patients into two groups: the experimental group of 34 patients who underwent transurethral plasma enucleation of the prostate and the control group of 34 patients who underwent transurethral plasma resection of the prostate. Evaluate the preoperative clinical baseline level and postoperative observation indicators of the two groups of patients, and compare the statistical differences between the two groups. Results: Both groups of patients successfully completed the surgery, and there were no serious complications such as rectal or bladder perforation during the surgery, with less bleeding. The postoperative QOL, IPSS, Qmax, and residual urine volume of patients undergoing transurethral plasma enucleation and resection of the prostate were significantly improved compared to those before surgery (P 0.05). Conclusion: Transurethral enucleation of the prostate has good efficacy and safety in the treatment of benign prostatic hyperplasia combined with weakened detrusor muscle contractility. Compared with traditional electric resection surgery, the efficacy is more significant. In terms of the main complications of the surgery, although there are slightly more patients with temporary urinary incontinence after prostate enucleation, there is no statistically significant difference compared to after electric resection, and they can recover to normal in the short term.展开更多
文摘Background: Bethanechol chloride, a cholinergic agonist, is often prescribed in suspected underactive bladders to improve detrusor contractility, despite its limited clinical efficacy. We investigated the usage pattern of bethanechol in actual practice with the understanding that it would enable the physicians to make an informed decision on the coherent use of bethanechol. Methods: A nation-wide survey was carried out to obtain the responses of the urologists. Out of the 755 urologists approached, 630 survey responses were considered for analysis. Results: Usage of bethanechol was advocated as very common [318 (50.48%)], common [200 (31.75%)], not so common [107 (16.98%)], and rare [5 (0.79%)] in postoperative urinary retention, where it was preferred either exclusively [255 (40.48%)] or along with alpha blockers [247 (39.21%)]. Predilection to use alpha-blocker [247 (39.21%)], alpha-blocker plus naloxone [4 (0.64%)], naloxone [1 (0.16%)], alpha-blocker plus bethanechol plus naloxone [1 (0.16%)] was also observed. It was also preferred individually in pathologies causing urinary retention such as benign prostatic hyperplasia [125 (19.84%)], diabetic neuropathy [82 (13.02%)], neurological diseases [69 (10.95%)], senile bladder [14 (2.22%)], drugs [13 (2.06%)], and infective/inflammatory conditions [6 (0.95%)]. Other [321 (50.95%)] physicians opted to prescribe bethanechol in two or more of the enumerated indications. Bethanechol was prescribed orally as 25 mg thrice daily [441 (70.00%)], 50 mg thrice daily [86 (13.65%)], 25 mg four times daily [59 (9.37%)], and many “strongly agree” and “agree” that its sustained release formulation may offer better treatment compliance [565 (89.68%)], safety [548 (86.99%)], and efficacy [544 (86.35%)]. Conclusion: Bethanechol was the most prescribed drug for the management of postoperative urinary retention and other pathologies suspected to cause underactive bladder.
文摘Underactive bladder(UAB)is a voiding disorder which generates disabling lower urinary tract symptoms(LUTS)due to the inability to produce an effective voiding contraction sufficient to empty the bladder.The underlying abnormality,that is usually appreciated when performing urodynamic studies,has been defined by the International Continence Society(ICS)as detrusor underactivity(DUA).DUA is a common yet under-researched bladder dysfunction.The prevalence of DUA in different patient groups suggests that multiple aetiologies are implicated.Currently there is no effective therapeutic approach to treat this condition.An improved understanding of the underlying mechanisms is needed to facilitate the development of new advances in treatment.The purpose of this review is to discuss the epidemiology,pathophysiology,common causes and risk factors potentially leading to DUA;to aid in the appropriate diagnosis of DUA to potentially improve treatment outcomes.
文摘Objective: Exploring the clinical efficacy of transurethral plasma enucleation of the prostate in the treatment of benign prostatic hyperplasia with underactive bladder detrusor contractility. Methods: Retrospective analysis of the clinical data of 68 patients with benign prostatic hyperplasia and underactive detrusor muscle contractility treated by our department from July 2021 to July 2022. The above patients all met the diagnosis of benign prostatic hyperplasia, excluding prostate cancer and urethral stricture. Urodynamics showed a decrease in the contractile force of the bladder detrusor muscle, and the surgical equipment used Olympus bipolar plasma resection equipment method. Divide the above patients into two groups: the experimental group of 34 patients who underwent transurethral plasma enucleation of the prostate and the control group of 34 patients who underwent transurethral plasma resection of the prostate. Evaluate the preoperative clinical baseline level and postoperative observation indicators of the two groups of patients, and compare the statistical differences between the two groups. Results: Both groups of patients successfully completed the surgery, and there were no serious complications such as rectal or bladder perforation during the surgery, with less bleeding. The postoperative QOL, IPSS, Qmax, and residual urine volume of patients undergoing transurethral plasma enucleation and resection of the prostate were significantly improved compared to those before surgery (P 0.05). Conclusion: Transurethral enucleation of the prostate has good efficacy and safety in the treatment of benign prostatic hyperplasia combined with weakened detrusor muscle contractility. Compared with traditional electric resection surgery, the efficacy is more significant. In terms of the main complications of the surgery, although there are slightly more patients with temporary urinary incontinence after prostate enucleation, there is no statistically significant difference compared to after electric resection, and they can recover to normal in the short term.
