title: Frequent nocturia episodes, a suboptimal response to treatment, and small bladder capacity predict the need for persistent antimuscarinic therapy or re-treatment after discontinuation of antimuscarinics in female overactive bladder.
abstract: The aim of the study was to investigate predictive factors of the need for persistent antimuscarinic therapy or re-treatment (PR) after discontinuation of antimuscarinic therapy for women with overactive bladder syndrome (OAB).
  
  
  
  All consecutive OAB women were enrolled in a prospective cohort study, and treated with solifenacin for 12 weeks in a University Hospital. Factors affecting PR were analyzed by Cox regression analysis.
  
  
  
  A total of 122 women were enrolled, and 107 women underwent 12-week solifenacin treatment. The dropout rate was 12.3%. The median follow-up period was 20.4 weeks (25-75 interquartile range: 16-102.3 wk). Twenty-seven (25%) women had PR. The median PR-free interval was 125.4 weeks (95% CI = 58.4 to - wk). Nocturia episodes (hazard ratio = 1.54), a suboptimal response (hazard ratio = 2.53), and the strong-desire volume (hazard ratio = 0.992) were independent predictors of PR by Cox backward stepwise regression analysis. The areas under the receiver-operating characteristic curves for nocturia episodes, a suboptimal response, and the strong-desire volume to predict PR were only 0.65, 0.63, and 0.59, respectively. In addition, normalized urinary nerve growth factor level was not significant (hazard ratio = 1.005, P = 0.68) for predicting PR. Furthermore, normalized urodynamic findings did not correlate with PR, a suboptimal response, or changes of Overactive Bladder Symptom Score and urinary nerve growth factor level.
  
  
  
  Frequent nocturia episodes, a suboptimal response, and small bladder capacity may predict PR after solifenacin treatment. These findings may serve as an initial guide in consultation regarding the treatment of OAB.
authors.affiliation: 1Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan 2Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Sheng-Mou
authors.initials: SM
authors.lastname: Hsiao
authors.forename: Ting-Chen
authors.initials: TC
authors.lastname: Chang
authors.forename: Chi-Hau
authors.initials: CH
authors.lastname: Chen
authors.forename: Wen-Yih
authors.initials: WY
authors.lastname: Wu
authors.forename: Ho-Hsiung
authors.initials: HH
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000652:urine; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage*; D020932:Nerve Growth Factor / Q000652:urine; D053158:Nocturia / Q000188:drug therapy*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D000069464:Solifenacin Succinate / Q000008:administration & dosage*; D001743:Urinary Bladder / Q000473:pathology; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*
chemical_list: D015415:Biomarkers; D018727:Muscarinic Antagonists; C502240:NGF protein, human; D020932:Nerve Growth Factor; D003404:Creatinine; D000069464:Solifenacin Succinate