文献詳細
特集 徹底解説! 過活動膀胱(OAB)の診療ストラテジー
〈過活動膀胱の標準的治療〉
文献概要
▶ポイント
・過活動膀胱(OAB)の保存的治療として行動療法と薬物療法がある.
・行動療法は,過活動膀胱診療ガイドラインで一次治療法とされており,すべての患者に対し実施すべきである.
・薬物療法は,前立腺肥大症(BPH)のあるなしで治療選択肢が変わりうる.
・抗コリン薬を使用する際には他科からの薬も含めた抗コリン負荷に注意を要する.
・過活動膀胱(OAB)の保存的治療として行動療法と薬物療法がある.
・行動療法は,過活動膀胱診療ガイドラインで一次治療法とされており,すべての患者に対し実施すべきである.
・薬物療法は,前立腺肥大症(BPH)のあるなしで治療選択肢が変わりうる.
・抗コリン薬を使用する際には他科からの薬も含めた抗コリン負荷に注意を要する.
参考文献
1) 日本排尿機能学会, 他 (編) : 過活動膀胱診療ガイドライン [第3版]. リッチヒルメディカル, 東京, 2022
2) Subak LL, et al : Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women. N Engl J Med 360 : 481-490, 2009
3) Hagovska M, et al : Effect of an Exercise Programme for Reducing Abdominal Fat on Overactive Bladder Symptoms in Young Overweight Women. Int Urogynecol J 31 : 895-902, 2020
4) 日本排尿機能学会, 他 (編) : 過活動膀胱診療ガイドライン [第2版]. リッチヒルメディカル, 東京, 2015
5) Rogo-Gupta LJ, et al : Low-Fat Dietary Pattern Reduces Urinary Incontinence in Postmenopausal Women : Post Hoc Analysis of the Women's Health Initiative Diet Modification Trial. AJOG Glob Rep 2 : 100044, 2022
6) Markland AD, et al : Comparing vitamin D supplementation versus placebo for urgency urinary incontinence : a pilot study. J Am Geriatr Soc 67 : 570-575, 2019
7) Swithinbank L, et al : The Effect of Fluid Intake on Urinary Symptoms in Women. J Urol 174 : 187-189, 2005
8) Azuri J, et al : Outcomes of Different Protocols of Pelvic Floor Physical Therapy and Anti-Cholinergics in Women with Wet Over-Active Bladder : A 4-Year Follow-Up. Neurourol Urodyn 36 : 755-758, 2017
9) Iwatsubo E, et al : Individually Tailored Ultrasound-Assisted Prompted Voiding for Institutionalized Older Adults with Urinary Incontinence. Int J Urol 21 : 1253-1257, 2014
10) Colling J, et al : The Effects of Patterned Urge-Response Toileting (PURT) on Urinary Incontinence Among Nursing Home Residents. J Am Geriatr Soc 40 : 135-141, 1992
11) Herderschee R, et al : Feedback or Biofeedback to Augment Pelvic Floor Muscle Training for Urinary Incontinence in Women. Cochrane Databas Syst Rev 7 : CD009252, 2011
12) Campbell NL, et al : Association of Anticholinergic Burden with Cognitive Impairment and Health Care Utilization Among a Diverse Ambulatory Older Adult Population. Pharmacotherapy 36 : 1123-1131, 2016
13) Yoshida, et al : Anticholinergic Burden in the Japanese Elderly Population : Use of Antimuscarinic Medications for Overactive Bladder Patients. Int J Urol 25 : 855-862, 2018
14) Abrams P, et al : Safety and Tolerability of Tolterodine for the Treatment of Overactive Bladder in Men with Bladder Outlet Obstruction. J Urol 175 : 999-1004, 2006
15) Masumori N, et al : Evaluation of Usefulness of Propiverine Hydrochloride in Poor Responders to Previous Anticholinergics. Low Urin Tract Symptoms 10 : 116-121, 2018
16) Choi JB, et al : Treatment Satisfaction with Flexible-dose Fesoterodine in Patients with Overactive Bladder Who Were Dissatisfied with Previous Anticholinergic Therapy : A Multicenter Single-Arm Clinical Study. Urol J 17 : 97-101, 2020
17) Chancellor, 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
and β-Adrenoceptor Subtypes and Their Functional Roles in Human Normal and Obstructed Bladders. J Urol 170 : 649-653, 2003
19) Hoffman V, et al : Cardiovascular Risk in Users of Mirabegron Compared with Users of Antimuscarinic Treatments for Overactive Bladder : Findings from a Non-Interventional, Multinational, Cohort Study. Drug Saf 44 : 899-915, 2021
-Adrenoceptor Agonist Mirabegron in Males with Lower Urinary Tract Symptoms and Bladder Outlet Obstruction. J Urol 190 : 1320-1327, 2013
21) Shin DG, et al : Mirabegron as a Treatment for Overactive Bladder Symptoms in Men (MIRACLE Study) : Efficacy and Safety Results from a Multicenter, Randomized, Double-Blind, Placebocontrolled, Parallel Comparison Phase IV Study. Neurourol Urodyn 38 : 295-304, 2019
22) 日本排尿機能学会, 他 : 過活動膀胱・神経因性膀胱に対するボツリヌス療法 適正使用指針作成委員会 : 過活動膀胱・神経因性膀胱に対するボツリヌス療法 適正使用指針2021 http://japanese-continence-society.kenkyuukai.jp/images/sys/information/20210412175051-A77C5635487F5038C1A2E5939CE5604151BD17C1128DB274AC89A450C62FDA7E.pdf (2022年12月1日閲覧)
掲載誌情報