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Efficacy of Botulinum toxin in women with overactive bladder according to the dose injected
206
Abstracts / Maturitas 81 (2015) 191–236
P166
ENDOCRINOLOGY
Efficacy of Botulinum toxin in women with overactive bladder according to the dose injected
P167
Álvaro J. Virseda-Rodríguez 1 , Cristina Salvatierra-Pérez 1 , Bárbara Padilla-Fernández 2,∗ , Ramón Romaní-Castro 3 , Miguel Á. Adriazola-Semino 3 , Miguel Á. García-García 1 , María F. Lorenzo-Gómez 1,4 1 University Hospital of Salamanca, Urology, Salamanca, Spain 2 University Hospital of the Canary Islands Complex, Urology, La Laguna, Spain 3 Health Complex of Palencia, Urology, Palencia, Spain 4 University of Salamanca, Surgery, Salamanca, Spain
Introduction and objectives: Overactive bladder has a high prevalence among women, generating a deep damage of their quality-of-life. With the intravesical injection of botulinum toxin, positive responses have been reported of 70–90% using 100–200 U for an average duration of 9 months. We contribute with the results of a series of 79 women treated with intravesical botulinum toxin with special attention to the response regarding the dosage and the medical background and second diagnoses. Material and methods: Retrospective study of 79 women with was treated with intravesical botulinum toxin between January 2011 and March 2014. Study groups: Group A: injection of 100 U (n = 23), Group B: injection of 150 U (n = 35), Group C: injection of 200 U (n = 21). Age, surgical background, and urodynamics (UDyn). Control at 6, 12 months and yearly, results. Results: Median age 67.40 years, no differences between groups was found. Follow-up 16.55 months (6–60), which was higher in Group A than in Groups B and C. Symptoms-control time 12.11 months (0–30). Relapses in Group A: 38%; average time to relapse: 8.86 months. Relapses in Group B: 8.33%; average time to relapse: 6 months. In Group C no relapses were found. Previous pelvic-floor surgeries in 56.52% of Group A, 29% of Group B, 57.14% of Group C. No severe adverse events were identified. Conclusions: Botulinum toxin is more effective when the injection includes 200 U than with 150 U or 100 U in women with overactive bladder without remarkable adverse events. The effect remains 12 months in average. It is effective in patients with previous surgical treatments for urinary incontinence or prolapse. http://dx.doi.org/10.1016/j.maturitas.2015.02.307
Testosterone might be influenced by co-morbidities, not by aging Kwangmin Kim 1,∗ , Youngsang Kim 2 , Kyunam Kim 1 , Namseok Joo 1 1 Ajou University School of Medicine, Family Medicine, Suwon, Republic of Korea 2 CHA Bundang Medical Center, CHA University, Family Medicine, Seongnam, Republic of Korea
Background: Observations on aging-related decrease in total testosterone (TT) are not consistent. The aim of this study is to seek the relationship between testosterone and health status and investigate the influence of the chronic disease to testosterone level. Methods: A total of 4284 aged ≥40-year-old men were included between 2008 and 2013. The subjects divided into two groups (chronic disease group versus normal group). Blood tests results and clinical data, including serum total testosterone, were checked and compared between the groups. Results: This study showed that 2041 subjects had chronic diseases (47.6%), and 2243 were normal (52.4%). Total testosterone and age (r = 0.032, P = 0.034), HDL (r = 0.133, P < 0.001) had positive correlation, respectively. On the other hand, BMI (r = −0.198, P < 0.001), waist circumference (r = −0.184, P < 0.001), blood pressure, ALT (r = −0.132, P < 0.001), fasting sugar (r = −0.105, P < 0.001), triglyceride (r = −0.119, P < 0.001) and albumin (r = −0.108, P < 0.001) showed negative correlation with total testosterone, respectively. Total testosterone level did not decrease with age. People who had metabolic syndrome, hypertension and diabetes were had lower total testosterone than normal population. Odds ratio of the hypogonadism in chronic disease group compared to normal group was 1.595 (95% CI: 1.355–1.876, P < 0.001). Conclusion: The total testosterone level was lower in chronic disease group compared to healthy subjects. Total testosterone level might be influenced by disease status, not by aging. http://dx.doi.org/10.1016/j.maturitas.2015.02.308 P168 Subcutaneous pellet testosterone replacement therapy: The “First steps” in treating men with spinal cord injuries Angela DeRosa ∗ , Kendra Gray DeRosa Medical, Scottsdale, PC„ United States The author describe the case of a 36-year-old man who presented with hormone levels concerns 6 months after a rock climbing accident that resulted in paraplegia. Hypogonadism was diagnosed and the patient received subcutaneous pellet testosterone replacement therapy. Within six months, the patient had substantial improvements in muscle function and was able to take several steps with assistance of crutches or a walker. This case highlights the potential improvement in quality of life and overall prognosis resulting from subcutaneous pellet form of testosterone when used as a part of overall treatment plans in such patients. This also illustrates the importance of screening paraplegic patients for hypogonadism. The pathophysiologic process of low testosterone in patients with spinal cord injuries is uncertain, but there is mounting evidence pointing to altered neural or hormonal pathways causing this syndrome and decreasing the quality
Abstracts / Maturitas 81 (2015) 191–236
P166
ENDOCRINOLOGY
Efficacy of Botulinum toxin in women with overactive bladder according to the dose injected
P167
Álvaro J. Virseda-Rodríguez 1 , Cristina Salvatierra-Pérez 1 , Bárbara Padilla-Fernández 2,∗ , Ramón Romaní-Castro 3 , Miguel Á. Adriazola-Semino 3 , Miguel Á. García-García 1 , María F. Lorenzo-Gómez 1,4 1 University Hospital of Salamanca, Urology, Salamanca, Spain 2 University Hospital of the Canary Islands Complex, Urology, La Laguna, Spain 3 Health Complex of Palencia, Urology, Palencia, Spain 4 University of Salamanca, Surgery, Salamanca, Spain
Introduction and objectives: Overactive bladder has a high prevalence among women, generating a deep damage of their quality-of-life. With the intravesical injection of botulinum toxin, positive responses have been reported of 70–90% using 100–200 U for an average duration of 9 months. We contribute with the results of a series of 79 women treated with intravesical botulinum toxin with special attention to the response regarding the dosage and the medical background and second diagnoses. Material and methods: Retrospective study of 79 women with was treated with intravesical botulinum toxin between January 2011 and March 2014. Study groups: Group A: injection of 100 U (n = 23), Group B: injection of 150 U (n = 35), Group C: injection of 200 U (n = 21). Age, surgical background, and urodynamics (UDyn). Control at 6, 12 months and yearly, results. Results: Median age 67.40 years, no differences between groups was found. Follow-up 16.55 months (6–60), which was higher in Group A than in Groups B and C. Symptoms-control time 12.11 months (0–30). Relapses in Group A: 38%; average time to relapse: 8.86 months. Relapses in Group B: 8.33%; average time to relapse: 6 months. In Group C no relapses were found. Previous pelvic-floor surgeries in 56.52% of Group A, 29% of Group B, 57.14% of Group C. No severe adverse events were identified. Conclusions: Botulinum toxin is more effective when the injection includes 200 U than with 150 U or 100 U in women with overactive bladder without remarkable adverse events. The effect remains 12 months in average. It is effective in patients with previous surgical treatments for urinary incontinence or prolapse. http://dx.doi.org/10.1016/j.maturitas.2015.02.307
Testosterone might be influenced by co-morbidities, not by aging Kwangmin Kim 1,∗ , Youngsang Kim 2 , Kyunam Kim 1 , Namseok Joo 1 1 Ajou University School of Medicine, Family Medicine, Suwon, Republic of Korea 2 CHA Bundang Medical Center, CHA University, Family Medicine, Seongnam, Republic of Korea
Background: Observations on aging-related decrease in total testosterone (TT) are not consistent. The aim of this study is to seek the relationship between testosterone and health status and investigate the influence of the chronic disease to testosterone level. Methods: A total of 4284 aged ≥40-year-old men were included between 2008 and 2013. The subjects divided into two groups (chronic disease group versus normal group). Blood tests results and clinical data, including serum total testosterone, were checked and compared between the groups. Results: This study showed that 2041 subjects had chronic diseases (47.6%), and 2243 were normal (52.4%). Total testosterone and age (r = 0.032, P = 0.034), HDL (r = 0.133, P < 0.001) had positive correlation, respectively. On the other hand, BMI (r = −0.198, P < 0.001), waist circumference (r = −0.184, P < 0.001), blood pressure, ALT (r = −0.132, P < 0.001), fasting sugar (r = −0.105, P < 0.001), triglyceride (r = −0.119, P < 0.001) and albumin (r = −0.108, P < 0.001) showed negative correlation with total testosterone, respectively. Total testosterone level did not decrease with age. People who had metabolic syndrome, hypertension and diabetes were had lower total testosterone than normal population. Odds ratio of the hypogonadism in chronic disease group compared to normal group was 1.595 (95% CI: 1.355–1.876, P < 0.001). Conclusion: The total testosterone level was lower in chronic disease group compared to healthy subjects. Total testosterone level might be influenced by disease status, not by aging. http://dx.doi.org/10.1016/j.maturitas.2015.02.308 P168 Subcutaneous pellet testosterone replacement therapy: The “First steps” in treating men with spinal cord injuries Angela DeRosa ∗ , Kendra Gray DeRosa Medical, Scottsdale, PC„ United States The author describe the case of a 36-year-old man who presented with hormone levels concerns 6 months after a rock climbing accident that resulted in paraplegia. Hypogonadism was diagnosed and the patient received subcutaneous pellet testosterone replacement therapy. Within six months, the patient had substantial improvements in muscle function and was able to take several steps with assistance of crutches or a walker. This case highlights the potential improvement in quality of life and overall prognosis resulting from subcutaneous pellet form of testosterone when used as a part of overall treatment plans in such patients. This also illustrates the importance of screening paraplegic patients for hypogonadism. The pathophysiologic process of low testosterone in patients with spinal cord injuries is uncertain, but there is mounting evidence pointing to altered neural or hormonal pathways causing this syndrome and decreasing the quality