Behavioral Versus Drug Treatment for Overactive Bladder in Men: The Male Overactive Bladder Treatment in Veterans (MOTIVE) Trial

被引：69

作者：

Burgio, Kathryn L. ^{[1
,2
]}

Goode, Patricia S. ^{[1
,2
]}

Johnson, Theodore M., II ^{[1
,5
]}

Hammontree, Lee ^{[1
,3
]}

Ouslander, Joseph G. ^{[6
]}

Markland, Alayne D. ^{[1
,2
]}

Colli, Janet ^{[1
,3
]}

Vaughan, Camille P. ^{[1
,5
]}

Redden, David T. ^{[1
,4
]}

机构：

[1] Birmingham Atlanta Geriatr Res Educ & Clin Ctr, Dept Vet Affairs, Birmingham, AL USA

[2] Univ Alabama Birmingham, Dept Med, Birmingham, AL 35294 USA

[3] Univ Alabama Birmingham, Dept Surg, Birmingham, AL 35294 USA

[4] Univ Alabama Birmingham, Dept Biostat, Birmingham, AL 35294 USA

[5] Emory Univ, Atlanta, GA 30322 USA

[6] Florida Atlantic Univ, Charles E Schmidt Coll Biomed Sci, Dept Clin Biomed Sci, Miami, FL USA

来源：

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY | 2011年 / 59卷 / 12期

关键词：

overactive bladder; behavioral treatment; drug therapy; lower urinary tract symptoms; urinary incontinence; URINARY-TRACT SYMPTOMS; SIDED TESTS PROCEDURE; OLDER WOMEN; INCONTINENCE; MANAGEMENT; THERAPY; COMBINATION; EFFICACY; TAMSULOSIN; NOCTURIA;

D O I：

10.1111/j.1532-5415.2011.03724.x

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

OBJECTIVES: To compare the effectiveness of behavioral treatment with that of antimuscarinic therapy in men without bladder outlet obstruction who continue to have overactive bladder (OAB) symptoms with alpha-blocker therapy. DESIGN: The Male Overactive Bladder Treatment in Veterans (MOTIVE) Trial was a two-site randomized, controlled, equivalence trial with 4-week alpha-blocker run-in. SETTING: Veterans Affairs Medical Center outpatient clinics. PARTICIPANTS: Volunteer sample of 143 men aged 42 to 88 who continued to have urgency and more than eight voids per day, with or without incontinence, after run-in. INTERVENTIONS: Participants were randomized to 8 weeks of behavioral treatment (pelvic floor muscle exercises, urge suppression techniques, delayed voiding) or drug therapy (individually titrated, extended-release oxybutynin, 5-30 mg/d). MEASUREMENTS: Seven-day bladder diaries and a validated urgency scale were used to calculate changes in 24-hour voiding frequency, nocturia, urgency, and incontinence. Secondary outcomes were global patient ratings and American Urological Association Symptom Index. RESULTS: Mean voids per day decreased from 11.3 to 9.1 (- 18.8%) with behavioral treatment and 11.5 to 9.5 (- 16.9%) with drug therapy. Equivalence analysis indicated that posttreatment means were equivalent (P <.01). After treatment, 85% of participants rated themselves as much better or better; more than 90% were completely or somewhat satisfied, with no betweengroup differences. The behavioral group showed greater reductions in nocturia (mean = -0.70 vs - 0.32 episodes/ night; P =.05). The drug group showed greater reductions in maximum urgency scores (mean = -0.44 vs -0.12; P =.02). Other between-group differences were nonsignificant. CONCLUSION: Behavioral and antimuscarinic therapy are effective when added to alpha-blocker therapy for OAB in men without outlet obstruction. Behavioral treatment is at least as effective as antimuscarinic therapy. J Am Geriatr Soc 59: 2209-2216, 2011.

引用

页码：2209 / 2216

页数：8