ABSTRACT
AIM: To evaluate the benefits of a newly established checklist form of behavioral therapy for overactive bladder (OAB). METHODS: Of a total of 180 patients suffering eight or more micturitions, two or more nocturia, seven or more urgency, or four more urinary urgency incontinence (UUI) episodes per day according to a 3-day bladder diary, 155 were randomly divided into four groups. Group I (n = 29) patients were instructed to apply only behavioral therapy as a written guideline and group II (n = 27) patients were instructed to apply behavioral therapy with a written checklist. Group III (n = 26) patients received medical treatment plus behavioral therapy without a checklist. Group IV (n = 28) patients received medical treatment with a written checklist over a 6-month period. RESULTS: A total of 110 participants completed the study period. The demographic data and baseline voiding parameters such as frequency, urgency, nocturia, and UUI of the participants in all four groups were similar (P > 0.05 for all). At the end of the study period, the highest rates of treatment response (64.3%) and adherence (85.7%) were determined for the patients with antimuscarinic drugs plus checklist. The persistence rate of patients using antimuscarinics with the checklist was higher than that of those using antimuscarinics plus a written guideline of behavioral therapy (75.4% vs 60.2%). CONCLUSION: The effectiveness of behavioral therapy for OAB can be improved with this newly designed checklist. In addition, the adherence and persistence rate of medical treatment may also improve with the checklist used.
Subject(s)
Behavior Therapy , Checklist , Urinary Bladder, Overactive/therapy , Urination , Adult , Aged , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Muscarinic Antagonists/therapeutic use , Patient Compliance , Prospective Studies , Treatment Outcome , Urinary Bladder, Overactive/drug therapy , Urinary Bladder, Overactive/psychologyABSTRACT
BACKGROUND: Male anterior urethral strictures can be treated successfully with the help of optical internal urethrotomy (OIU) and is usually performed under general or regional anesthesia. In this study, we determined the efficacy of intraurethral lidocaine in OIU for anterior urethral stricture in an outpatient setting. METHODS: A total 157 patients with anterior urethral strictures underwent OIU under local urethral anesthesia with lidocaine. Optical urethrotomy was performed with a cold-cutting knife. Visual analogue scale (VAS) was used to evaluate patient discomfort and pain levels. RESULTS: Using local anesthesia with lidocaine 2%, internal urethrotomy under vision was successfully completed in 151 of 157 patients. The overall success rate 96.1%. A total of 125 patients experienced mild, 26 patients moderate and 6 patients severe pain. The procedure was not completed in six patients because of severe pain. These patients went on OIU under general anesthesia. 18 (11.4%) recurrent strictures were seen during at least 6 months of follow-up. CONCLUSIONS: Topical intraurethral lidocaine is a simple and efficacious anesthesia technique for surgical procedures on the anterior urethra. It is a safe, cost-effective and a well tolerated procedure. OIU under topical anesthesia can be easily performed and satisfactorily completed in an outpatient setting. It is anesthetic efficacy and reasonable success rate when compared with the other anesthetic techniques may provide an alternative approach in the management of urethral strictures.