Overactive Bladder, Underactive Bladder
Conditions
Keywords
neural prolotherapy, detrusor underactivity, overactive bladder
Brief summary
Voiding dysfunction including overactive bladder, underactive bladder, and neuropathic bladder. Voiding dysfunction has a great impact on life quality, especially in the elderly society. The current medication for overactive bladder has limited efficacy and the patient easily to dropout the medication because of its side-effects. The underactive bladder is a new entity of voiding dysfunction, its optimal is still unknown. Sacral neuromodulation(SNM) and posterior tibial nerve stimulation(PTNS) have been applied for both overactive bladder and underactive bladder treatment and the results is promising, but the equipment of SNM or PTNS is not available in most places. Prolotherapy using glucose local injection causing inflammatory reaction to stimulate cytokine and growth factors release. Investigators combined the concepts of posterior tibial nerve stimulation and prolotherapy to treat voiding dysfunction. Investigators anticipate it maybe a new promising treatment for voiding dysfunction.
Detailed description
Inclusion criteria:1. Adults over 20 years-old. 2. The patient who meets the diagnostic criteria of overactive bladder or underactive bladder. 3. The patient who capable to complete 3-days voiding diary and the questionnaire. Exclusion criteria: 1. The patient has severe stress urinary incontinence, severe pelvic organ prolapse, acute urinary tract infection, urolithiasis, or urinary tract malignancy. 2. The patient who has active skin disease on legs or not suitable for leg local injection. 3. Pregnant women. Method: 40 overactive bladder patients and 40 underactive bladder patients. The patients will receive 5% glucose 10ml local injection peripheral to posterior tibial nerve near ankle under ultrasound guidance once a week for 4 weeks, then the patients will be followed up once-a-month for 3 months. OverActive Bladder Symptom Score(OABSS), Core Lower Urinary Tract Symptom score(CLSS) questionnaire, 3-days voiding diary, and urine nerve growth factor are used for assessment.
Interventions
PROCEDUREprolotherapy
5% glucose 10ml local injection peripheral to posterior tibial nerve near ankle under ultrasound guidance once a week for 4 weeks.
Sponsors
Taichung Armed Forces General Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Adults over 20 years-old. 2. The patient who meets the diagnostic criteria of overactive bladder or underactive bladder. 3. The patient who capable to complete 3-days voiding diary and the questionnaire.
Exclusion criteria
1. Severe stress urinary incontinence or severe pelvic organ prolapse. 2. Acute urinary tract infection. 3. Active hematuria, urolithiasis, or neoplasm of urinary tract. 4. Acute skin lesion over the ankle injection site or the patient who could not tolerate ankle injection. 5. Pregnant women.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overactive Bladder Symptom Score | Week 0 | The improvement of overactive bladder symptom score (OABSS), OABSS ranged from 0 to 15, the higher score means more severity of overactive bladder. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cystometric bladder capacity | Week0 | Cystometric bladder capacity: the volume of water instilled into bladder while performing cystometry examination. |
Other
| Measure | Time frame | Description |
|---|---|---|
| The improvement of Patient Perception of Bladder Condition (PPBC) | Week 0 | The PPBC measures the patients' perception of their urinary (bladder) problems. Ranged from 1 to 6. The core 1 means no bother from bladder condition, higher score means more bother form bladder condition. |
| The improvement of Patient Perception of Bladder Condition | Week1 | The PPBC measures the patients' perception of their urinary (bladder) problems. Ranged from 1 to 6. The core 1 means no bother from bladder condition, higher score means more bother form bladder condition. |
Countries
Taiwan
Contacts
Primary ContactJing-dung Shen, MD
Outcome results
None listed