Treatment for overactive bladder: A meta-analysis of transcutaneous tibial nerve stimulation versus percutaneous tibial nerve stimulation.

BACKGROUND: We aim to compare the safety and effectiveness of transcutaneous tibial nerve stimulation (TTNS) versus percutaneous tibial nerve stimulation (PTNS) in treating overactive bladder. METHODS: A systematical search on PubMed, Embase, clinicalTrial.gov, and Cochrane Library Central Register of Controlled Trials from January 1, 1999 to November 1, 2020 was performed. The primary outcomes were the changes in a 3-day voiding diary. Quality of life scores were also evaluated. Review Manager 5.3 (Cochrane Collaboration, Oxford, UK) was applied to conduct all statistical analyses. RESULTS: A total of 4 trials (2 randomized controlled trials, 1 retrospective study, and 1 before-after study) with 142 patients were eventually enrolled. Compared with PTNS, TTNS had a similar performance in the voiding frequency in 24 hours (mean difference [MD] = -0.65, 95% confidence interval [CI]: -1.35 to 0.05, P = .07), the number of urgency episodes in 24 hours (MD = 0.13, 95% CI: -0.36 to 0.62, P = .60), the number of incontinence episodes in 24 hours (MD = 0.01, 95% CI: -0.13 to 0.14, P = .93), as well as in the nocturia frequency (MD = -0.14, 95% CI: -0.52 to 0.24, P = .47). Moreover, comparable results were observed regarding HRQL scores (P = .23) and incontinence quality of life scores (P = .10) in both groups. The total complication rate in the current study was 2.1% (3/142). No adverse events were identified in the TTNS group. CONCLUSION: Current data supported that TTNS is as effective as PTNS for the treatment of overactive bladder, moreover, with no reported adverse events. However, the evidence is low-grade and well-designed prospective studies with a large sample size are warranted to verify our findings.

Impact of serum vitamin D level on risk of bladder cancer: a systemic review and meta-analysis.

Vitamin D has important biological functions including modulation of the immune system and anti-cancer effects. There was no conclusive finding of the impact of serum vitamin D level on bladder cancer risk. A systemic review and meta-analysis was performed to assess the impact of serum 25-hydroxyvitamin D level on bladder cancer risk. The pooled relative risk (RR) with 95% confidence interval (95%CI) was used to assess the impact of serum 25-hydroxyvitamin D level on bladder cancer risk. A total of 89,610 participants and 2238 bladder cancer cases were finally included into the meta-analysis. There was no obvious heterogeneity among those included studies (I(2) = 0%). Meta-analysis total included studies which showed that a high serum 25-hydroxyvitamin D level could obviously decrease risk of bladder cancer (RR = 0.75, 95%CI 0.65-0.87, P < 0.001). In addition, the pooled RRs were not significantly changed by excluding any single study. The findings from the meta-analysis suggest an obvious protective effect of vitamin D against bladder cancer. Individuals with higher serum 25-hydroxyvitamin D levels suffer from less risk of subsequent bladder cancer.

[A multi-center clinical trial of Qianlieantong tablets for chronic prostatitis].

OBJECTIVE: To observe the efficacy and safety of Qianlieantong Tablets in the treatment of chronic prostatitis. METHODS: A multi-center, self-controlled open clinical trial was conducted. A total of 280 subjects with chronic prostatitis were enrolled and treated by Qianlieantong Tablets, 3 times a day, 5 tablets each time. Before and after 2 and 4 weeks after the administration, NIH-CPSI scores and white blood cell counts in the prostate secretion were recorded. RESULTS: Of the 273 subjects evaluated, the rates of excellence, effectiveness and ineffectiveness were 35.2% (n = 96), 47.6% (n = 130) and 17.2% (n = 47), respectively, with a total effectiveness rate of 82.8%. After 4 weeks'medication, the scores of the subjects on NIH-CPSI pain, voiding and quality of life and white blood cell counts in prostate secretion were significantly decreased compared with pre-treatment (P < 0.01). No adverse events or laboratory abnormality related to the medication were observed. CONCLUSION: Qianlieantong Tablets has a significant effect on chronic prostatitis with high safety, particularly indicated in chronic prostatitis with pelvic pain.

[Qingrelishi-category Chinese medicine for chronic prostatitis: a systematic review].

OBJECTIVE: To evaluate the efficacy and safety of the Qingrelishi-category Chinese medicine (for dispelling heat and resolving dampness) in the treatment of chronic prostatitis. METHODS: Randomized clinical trials or controlled clinical trials comparing Qingrelishi with plant america, other herbal medicine and Western medicine in the treatment of chronic prostatitis were identified by electronic and manual retrieval and analysis. The methodological quality of the included trials was assessed and Meta-analysis was performed with Revman 4. 2 software. RESULTS: Forty-four randomized clinical trials or controlled clinical trials (n=5746) were identified. The methodological quality ranked high in three double-blind trials and the others ranked low. Meta-analysis indicated that Qingrelishi was more effective than Nankangpian( RR 1.22, 95% CI 1.10-1.35) and Prostate( RR 1.26, 95% CI 1.13-1.41) in the treatment of chronic prostatitis. Subgroup analysis revealed that Qingrelishi was more effective than Qianliekang (RR 1.32, 95% CI 1.19-1.45) and quinolones antibiotic (RR 1.34, 95% CI 1.15-1.57). There were no significant differences in efficacy either between Qingrelishi and a-receptor blocker and Puleanpian or between Qingrelishi plus quinolone antibiotics and quinolone antibiotics alone. Eighteen articles reported side effects and no serious adverse events were reported. CONCLUSION: Qingrelishi may be effective in the treatment of chronic prostatitis. However, the evidence is not strong due to the generally low methodological quality and the variations of the herbs. More randomized clinical trials are required.