iOAB= Idiopathic Overactive Bladder Clinical Trial
Official title:
Retrospective Study of Prescribed Physical Activity in Patients With Overactive Bladder Syndrome Monitored Within the Pelvi-perineology Network in Dijon: Evaluation of Prescription Compliance and Impact on Quality of Life
Overactive bladder (OAB) is a clinical syndrome defined by the International Continence
Society (ICS) and the International Urogynecological Association (IUGA) as urinary urgency
(sudden and uncontrollable urge to urinate) possibly associated with urinary frequency
(urination greater than 8 times per day), nocturia (2 or more urinations per night) or
urinary incontinence (UI). In most cases no root cause is found, so it is referred to as
idiopathic overactive bladder (iOAB).
The treatment of iOAB is based primarily on hygiene and dietary measures and perineal
rehabilitation. If these are insufficient, medical anticholinergic treatment is offered.
Second-line therapies are based on percutaneous neuromodulation of the tibial nerve,
neuromodulation of the sacral roots S3 and intra-detrusor injection of botulinum-A toxin.
iOAB has a significant negative impact on patients' quality of life, particularly in cases of
associated urinary incontinence. It is at the origin of low self confidence.
A significant proportion of patients with iOAB are not managed or are not satisfied with
treatment.
A strong epidemiological correlation between AVH and metabolic syndrome (MS) was demonstrated
in a literature review of 119 articles. MS is a clinical-biological syndrome defined by the
National Cholesterol Education Program Adut Treatment Panel III (NCEP ATP III). The
prevalence of OAB increases with that of obesity but only from a waist circumference of at
least 100cm. S. Boudokhane showed in a prospective study of 34 patients with MS defined by
the NCEP ATP III criteria that waist circumference, BMI and post prandial glucose were
positively correlated with the presence of OAB measured by the PSU score (p<0.05).
Physical activity (PA) is defined as any body movement produced by skeletal muscles resulting
in a substantial increase in energy expenditure above rest energy expenditure (WHO). The
efficacy of AP on MS has been demonstrated in primary prevention and treatment of MS by the
HERITAGE study and the controlled trial established under the Diabetes Prevention Program
(DPP). The follow-up was conducted over 3.2 years and showed a significant decrease in the
incidence of MS in the PA group by 41% compared to placebo (p<0.001). The action of PA on
iOAB has not been directly studied but some studies have shown that PA and pelvic floor
muscle strengthening significantly and respectively decrease the number of mixed (p< 0.0001)
(14) or urgency (p=0.009) UI episodes. Since March 2017, the prescription of modified PA is
possible.
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