Predictive Factors for Recurrence of Overactive Bladder after Discontinuation of an Antimuscarinic Agent
Songyos Tangmesang MD¹, Wit Viseshsindh MD¹
Affiliation : ¹ Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : Overactive bladder (OAB) is a common disease. However, the patients who stop taking medicines after clinical improvement are
at risk for symptom recurrence.
Objective : To determine the disease recurrence rates and evaluate the potential predictive factors for recurrent OAB symptoms after discontinuation of an antimuscarinic drug. Materials and Methods : The OAB patients who discontinued antimuscarinic drugs after symptom improvement were studied prospectively. The OAB symptoms were evaluated by the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) questionnaire. The symptom scores were evaluated at the time of recruitment and at 1, 3, 6, and 12 months after drug discontinuation. The curve of time to symptom recurrence was plotted. The factors associated with symptom recurrence were analyzed and compared.
Results : Eighty-two patients including 40 (48.78%) males and 42 (51.22%) females, were included in the present study. Forty-one (50.0%) patients experienced recurrent symptoms within 12 months. The median time to symptom recurrence was 3.01 months (interquartile range [IQR] 1.0, 6.0). The mean symptom scores in the recurrent group at 1, 3, and 6 months were significantly higher than those in the non-recurrent group (10.75±7.39 versus 22.76±13.10, p<0.001; 10.89±8.93 versus 16.41±11.70, p=0.040; and 10.51±8.03 versus 22.33±14.59, p=0.001, respectively). The results of the univariate analyses indicated that other factors were not associated with recurrence.
Conclusion : Symptom recurrence after antimuscarinic discontinuation is common in OAB patients. The high ICIQ-OAB score might be the predictive factor for recurrence. Most of the cases of symptom recurrence were observed within three months.
Received 10 March 2020 | Revised 4 June 2020 | Accepted 12 June 2020
doi.org/10.35755/jmedassocthai.2021.05.11218
Keywords : Muscarinic Antagonists, Overactive bladder, Predictive factors, Recurrence
