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Effect of Pharmacotherapy for Overactive Bladder on the Incidence of and Factors Related to Urinary Tract Infection: A Systematic Review and Meta-analysis

膀胱过度活动 排尿困难 医学 泌尿科 泌尿系统 安慰剂 下尿路症状 药物治疗 科克伦图书馆 内科学 入射(几何) 随机对照试验 病理 替代医学 前列腺 癌症 物理 光学
作者
Kazuna Tsubouchi,Hisatomi Arima,Makiko Abe,Hiroshi Matsuzaki,Kosuke Tominaga,Aiko Fujikawa,Naotaka Gunge,Takeshi Miyazaki,Yu Okabe,Nobuyuki Nakamura,Hirofumi Matsuoka,Shota Okutsu,Kazuhiro Tada,Nobuhiro Haga
出处
期刊:The Journal of Urology [Lippincott Williams & Wilkins]
卷期号:209 (4): 665-674 被引量:5
标识
DOI:10.1097/ju.0000000000003209
摘要

The aim of this meta-analysis was to investigate the effect of pharmacotherapy for overactive bladder on the pathogenesis of urinary tract infection.A comprehensive search was performed in MEDLINE and the Cochrane Library using terms for overactive bladder, antimuscarinic agents, and beta 3-adrenoceptor agonists. The primary end point was the emergence of urinary tract infection after pharmacotherapy for overactive bladder. The secondary end point was the emergence of urinary retention, dysuria, and/or increased residual urine volume after overactive bladder treatment. Meta-analyses were conducted using random-effects models.A total of 35,939 patients in 33 trials (29 trials of antimuscarinic agents vs placebo, and 9 trials of beta 3-adrenoceptor agonists vs placebo) that included patients with overactive bladder were identified. At 1-3 months after treatment, the incidence of urinary tract infections was statistically significantly higher in the patients treated with antimuscarinic agents (RR: 1.23, 95% CI: 1.04, 1.45; P = .013) than in the placebo control group. The incidence of urinary tract infections was not increased in the patients treated with beta 3-adrenoceptor agonists (RR: 1.04, 95% CI: 0.76, 1.42; P = .796). Antimuscarinic agents also statistically significantly increased the risks of urinary retention, dysuria, and/or increased residual urine volume (RR: 2.88, 95% CI: 1.79, 4.63; P < .001), whereas beta 3-adrenoceptor agonists did not (RR: 1.26, 95% CI: 0.38, 4.14; P = .708).This meta-analysis showed that antimuscarinic agents statistically significantly increased the incidences of urinary tract infection and lower urinary tract symptoms and dysfunction, but beta 3-adrenoceptor agonists did not. To prevent urinary tract infection emergence, beta 3-adrenoceptor agonists might be safer than antimuscarinic agents.
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