Background: Bethanechol chloride, a cholinergic agonist, is often prescribed in suspected underactive bladders to improve detrusor contractility, despite its limited clinical efficacy. We investigated the usage patter...Background: Bethanechol chloride, a cholinergic agonist, is often prescribed in suspected underactive bladders to improve detrusor contractility, despite its limited clinical efficacy. We investigated the usage pattern of bethanechol in actual practice with the understanding that it would enable the physicians to make an informed decision on the coherent use of bethanechol. Methods: A nation-wide survey was carried out to obtain the responses of the urologists. Out of the 755 urologists approached, 630 survey responses were considered for analysis. Results: Usage of bethanechol was advocated as very common [318 (50.48%)], common [200 (31.75%)], not so common [107 (16.98%)], and rare [5 (0.79%)] in postoperative urinary retention, where it was preferred either exclusively [255 (40.48%)] or along with alpha blockers [247 (39.21%)]. Predilection to use alpha-blocker [247 (39.21%)], alpha-blocker plus naloxone [4 (0.64%)], naloxone [1 (0.16%)], alpha-blocker plus bethanechol plus naloxone [1 (0.16%)] was also observed. It was also preferred individually in pathologies causing urinary retention such as benign prostatic hyperplasia [125 (19.84%)], diabetic neuropathy [82 (13.02%)], neurological diseases [69 (10.95%)], senile bladder [14 (2.22%)], drugs [13 (2.06%)], and infective/inflammatory conditions [6 (0.95%)]. Other [321 (50.95%)] physicians opted to prescribe bethanechol in two or more of the enumerated indications. Bethanechol was prescribed orally as 25 mg thrice daily [441 (70.00%)], 50 mg thrice daily [86 (13.65%)], 25 mg four times daily [59 (9.37%)], and many “strongly agree” and “agree” that its sustained release formulation may offer better treatment compliance [565 (89.68%)], safety [548 (86.99%)], and efficacy [544 (86.35%)]. Conclusion: Bethanechol was the most prescribed drug for the management of postoperative urinary retention and other pathologies suspected to cause underactive bladder.展开更多
目的 构建能综合评价膀胱出口梗阻情况及逼尿肌收缩功能的尿动力学诊断列线图,以期区分逼尿肌活动低下（DU）、膀胱出口梗阻（BOO）及DU合并BOO,为临床决策提供参考。方法 回顾性研究在行压力-流率测定（PFS）的男性下尿路症状（LUTS）...目的 构建能综合评价膀胱出口梗阻情况及逼尿肌收缩功能的尿动力学诊断列线图,以期区分逼尿肌活动低下（DU）、膀胱出口梗阻（BOO）及DU合并BOO,为临床决策提供参考。方法 回顾性研究在行压力-流率测定（PFS）的男性下尿路症状（LUTS）患者。通过数据挖掘与统计分析,寻找研究人群PFS参数的分布规律及差异,并构建诊断列线图。列线图制作由MATLAB软件完成,统计分析使用SPSS软件。结果 1 278例患者纳入统计。根据数学模型将患者分组比较：〈10%分位数组与10%-25%分位数组患者大部分PFS参数差异无统计学意义;〈25%分位数组与25%-50%分位数组患者大部分PFS参数差异有统计学意义（P〈0.001）,其中膀胱剩余尿量（86.4 m L vs.61.4 m L）、膀胱测压容量（275.9 m L vs.241.9 m L）、膀胱排空率（40.3%vs.75.4%）可能与DU相关。故以25%分位数为界限区分DU,从而得到诊断列线图。结论 基于临床尿动力学数据构建的评价膀胱出口梗阻-逼尿肌收缩功能的列线图,有助于区分诊断DU、BOO及DU合并BOO的男性LUTS患者,为临床治疗决策提供有价值的参考。展开更多
文摘Background: Bethanechol chloride, a cholinergic agonist, is often prescribed in suspected underactive bladders to improve detrusor contractility, despite its limited clinical efficacy. We investigated the usage pattern of bethanechol in actual practice with the understanding that it would enable the physicians to make an informed decision on the coherent use of bethanechol. Methods: A nation-wide survey was carried out to obtain the responses of the urologists. Out of the 755 urologists approached, 630 survey responses were considered for analysis. Results: Usage of bethanechol was advocated as very common [318 (50.48%)], common [200 (31.75%)], not so common [107 (16.98%)], and rare [5 (0.79%)] in postoperative urinary retention, where it was preferred either exclusively [255 (40.48%)] or along with alpha blockers [247 (39.21%)]. Predilection to use alpha-blocker [247 (39.21%)], alpha-blocker plus naloxone [4 (0.64%)], naloxone [1 (0.16%)], alpha-blocker plus bethanechol plus naloxone [1 (0.16%)] was also observed. It was also preferred individually in pathologies causing urinary retention such as benign prostatic hyperplasia [125 (19.84%)], diabetic neuropathy [82 (13.02%)], neurological diseases [69 (10.95%)], senile bladder [14 (2.22%)], drugs [13 (2.06%)], and infective/inflammatory conditions [6 (0.95%)]. Other [321 (50.95%)] physicians opted to prescribe bethanechol in two or more of the enumerated indications. Bethanechol was prescribed orally as 25 mg thrice daily [441 (70.00%)], 50 mg thrice daily [86 (13.65%)], 25 mg four times daily [59 (9.37%)], and many “strongly agree” and “agree” that its sustained release formulation may offer better treatment compliance [565 (89.68%)], safety [548 (86.99%)], and efficacy [544 (86.35%)]. Conclusion: Bethanechol was the most prescribed drug for the management of postoperative urinary retention and other pathologies suspected to cause underactive bladder.
文摘目的 构建能综合评价膀胱出口梗阻情况及逼尿肌收缩功能的尿动力学诊断列线图,以期区分逼尿肌活动低下（DU）、膀胱出口梗阻（BOO）及DU合并BOO,为临床决策提供参考。方法 回顾性研究在行压力-流率测定（PFS）的男性下尿路症状（LUTS）患者。通过数据挖掘与统计分析,寻找研究人群PFS参数的分布规律及差异,并构建诊断列线图。列线图制作由MATLAB软件完成,统计分析使用SPSS软件。结果 1 278例患者纳入统计。根据数学模型将患者分组比较：〈10%分位数组与10%-25%分位数组患者大部分PFS参数差异无统计学意义;〈25%分位数组与25%-50%分位数组患者大部分PFS参数差异有统计学意义（P〈0.001）,其中膀胱剩余尿量（86.4 m L vs.61.4 m L）、膀胱测压容量（275.9 m L vs.241.9 m L）、膀胱排空率（40.3%vs.75.4%）可能与DU相关。故以25%分位数为界限区分DU,从而得到诊断列线图。结论 基于临床尿动力学数据构建的评价膀胱出口梗阻-逼尿肌收缩功能的列线图,有助于区分诊断DU、BOO及DU合并BOO的男性LUTS患者,为临床治疗决策提供有价值的参考。
