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文献詳細

雑誌文献

臨床泌尿器科76巻3号

2022年03月発行

特集 Female Urologyの蘊奥―積み重ねられた知恵と技術の活かし方

〈難治性過活動膀胱〉

難治性過活動膀胱の治療

著者: 関戸哲利1

所属機関: 1東邦大学医療センター大橋病院泌尿器科

ページ範囲:P.186 - P.192

文献概要

▶ポイント

・難治性過活動膀胱(rOAB)に対する薬物療法としては,抗コリン薬とβ3受容体作動薬の併用療法を考慮するべきである.

・磁気刺激療法は,有効性と安全性の観点から併用療法の次に試みてよい治療と考えられるが,残念ながら普及しているとは言い難い.

・併用療法を行っても改善が認められない場合には,仙骨神経刺激療法あるいはA型ボツリヌス毒素膀胱壁内注入手術のいずれかを検討すべきである.

参考文献

1) 日本排尿機能学会 (編) : 過活動膀胱診療ガイドライン [第2版]. pp208-215, リッチヒルメディカル, 東京, 2015
2) Chancellor MB, et al : Limitations of Anticholinergic Cycling in Patients with Overactive Bladder (OAB) with Urinary Incontinence (UI) : Results from the CONsequences of Treatment Refractory Overactive bLadder (CONTROL) Study. Int Urol Nephrol 48 : 1029-1036, 2016
3) Abrams P, et al : Combination Treatment with Mirabegron and Solifenacin in Patients with Overactive Bladder : Efficacy and Safety Results from a Randomised, Double-Blind, Dose-Ranging, Phase 2 Study (Symphony). Eur Urol 67 : 577-588, 2015
4) Drake MJ, et al : Efficacy and Safety of Mirabegron Add-on Therapy to Solifenacin in Incontinent Overactive Bladder Patients with an Inadequate Response to Initial 4-Week Solifenacin Monotherapy : A Randomised Double-blind Multicentre Phase 3B Study (BESIDE). Eur Urol 70 : 136-145, 2016
5) Herschorn S, et al : Efficacy and Safety of Combinations of Mirabegron and Solifenacin Compared with Monotherapy and Placebo in Patients with Overactive Bladder (SYNERGY Study). BJU Int 120 : 562-575, 2017
6) Gratzke C, et al : Long-term Safety and Efficacy of Mirabegron and Solifenacin in Combination Compared with Monotherapy in Patients with Overactive Bladder : A Randomised, Multicentre Phase 3 Study (SYNERGY II). Eur Urol 74 : 501-509, 2018
7) Yamaguchi O, et al : Safety and Efficacy of Mirabegron as ‘add-on’ Therapy in Patients with Overactive Bladder Treated with Solifenacin : A Post-Marketing, Open-Label Study in Japan (MILAI Study). BJU Int 116 : 612-622, 2015
8) Yamaguchi O, et al : Long-Term Safety and Efficacy of Antimuscarinic Add-On Therapy in Patients with Overactive Bladder Who Had a Suboptimal Response to Mirabegron Monotherapy : A Multicenter, Randomized Study in Japan (MILAIcII Study). Int J Urol 26 : 342-352, 2019
9) 日本排尿機能学会 (編) : 過活動膀胱診療ガイドライン [第2版]. pp35-37, リッチヒルメディカル, 東京, 2015
10) Yamanishi T, et al : Multicenter, Randomized, Sham-Controlled Study on the Efficacy of Magnetic Stimulation for Women with Urgency Urinary Incontinence. Int J Urol 21 : 395-400, 2014
11) Marcelissen T, et al : Management of Idiopathic Overactive Bladder Syndrome : What Is the Optimal Strategy After Failure of Conservative Treatment? Eur Urol Focus 4 : 760-767, 2018
12) Amundsen CL, et al : OnabotulinumtoxinA vs Sacral Neuromodulation on Refractory Urgency Urinary Incontinence in Women : A Randomized Clinical Trial. JAMA 316 : 1366-1374, 2016
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15) Tutolo M, et al : Efficacy and Safety of Sacral and Percutaneous Tibial Neuromodulation in Non-neurogenic Lower Urinary Tract Dysfunction and Chronic Pelvic Pain : A Systematic Review of the Literature. Eur Urol 73 : 406-418, 2018
16) Gill BC, et al : Real-Time Changes in Brain Activity During Sacral Neuromodulation for Overactive Bladder. J Urol 198 : 1379-1385, 2017
17) Noblett K, et al : Detailed Analysis of Adverse Events and Surgical Interventions in a Large Prospective Trial of Sacral Neuromodulation Therapy for Overactive Bladder Patients. Neurourol Urodyn 36 : 1136-1139, 2017
18) A型ボツリヌス毒素製剤添付文書 https://www.info.pmda.go.jp/go/pack/1229404D1020_1_12/ (2022年3月10日閲覧)
19) 関戸哲利 : フラボキサート, エストロゲン腟内投与, A型ボツリヌス毒素膀胱壁内注入療法. 泌外32 (特別号) : 218-223, 2019
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27) Reynolds WS, et al : Incomplete Bladder Emptying and Urinary Tract Infections After Botulinum Toxin Injection for Overactive Bladder : Multi-Institutional Collaboration from the SUFU Research Network. Neurourol Urodyn, 2022 [Online ahead of print]
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掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1332

印刷版ISSN:0385-2393

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