Duration of Antimuscarinic Administration for Treatment of Overactive Bladder Before Which One Can Assess Efficacy: An Analysis of Predictive Factors

Sheng-Mou Hsiao,Chun-Hou Liao,Ho-Hsiung Lin,Hann-Chorng Kuo 대한배뇨장애요실금학회 2015 International Neurourology Journal Vol.19 No.3

Purpose: To determine the duration of antimuscarinic therapy for overactive bladder syndrome (OAB) appropriate for assessment of the efficacy of treatment, and to evaluate the possible predictive factors for response to therapy. Methods: All OAB patients who visited a urology outpatient clinic of a tertiary referral center and who were prescribed 5 mg of solifenacin or 4 mg of tolterodine extended release capsules daily were enrolled in the study. Patients were asked to continue therapy for 6 months. All enrolled patients completed the patient perception of bladder condition, overactive bladder symptom score (OABSS), and the modified Indevus Urgency Severity Scale questionnaires. All patients underwent uroflowmetry. Results: A total of 164 patients were enrolled and 125 patients (76%) had at least one follow-up visit. The mean follow-up interval was 1 month (range, 0.5–6 months). Sixty-two patients (49.6%; 95% confidence interval [CI], 40.7–58.5) responded to antimuscarinic treatment. The median time for the onset of response was 3 months (95% CI, 1–6). Multivariate Cox proportional- hazards model revealed that elevated baseline OABSS was an independent predictor of responsiveness to therapy. Receiver operating characteristic (ROC) curve analysis revealed an optimal OABSS cutoff value of ≥7, with an area under the ROC curve of 0.79 (95% CI, 0.70–0.88; sensitivity, 91.9%; specificity, 60.7%). Conclusions: The median time for a therapeutic response was 3 months, and OABSS was the only predictor for responsiveness. These findings may serve as a guideline when prescribing antimuscarinic treatment for OAB patients.

Urodynamic and Bladder Diary Factors Predict Overactive Bladderwet in Women: A Comparison With Overactive Bladder-dry

Sheng-Mou Hsiao,Pei-Chi Wu,Ting-Chen Chang,Chi-Hau Chen,Ho-Hsiung Lin 대한배뇨장애요실금학회 2019 International Neurourology Journal Vol.23 No.1

Purpose: To identify factors predicting the presence of overactive bladder syndrome (OAB)-wet, compared with OAB-dry. Methods: Between September 2007 and September 2013, the medical records of 623 women with OAB who completed a 3-day bladder diary and underwent urodynamic studies in a medical center were retrospectively reviewed. OAB-wet was diagnosed in patients who complained of at least one episode of urgency incontinence in the previous month; otherwise, OABdry was diagnosed. Multivariable logistic regression analysis was used to predict the presence of OAB-wet. Results: Age (odds ratio [OR], 1.05; P<0.001), maximal flow rate (Qmax) (OR,1.06; P<0.001), voided volume (OR, 0.996; P=0.001), detrusor pressure at maximal flow rate (PdetQmax) (OR, 1.02; P=0.003), urgency episodes (OR, 1.04; P<0.001) and urodynamic stress incontinence (OR,1.78; P=0.01) were independent predictors for the presence of OAB-wet vs. OABdry. If we use bladder contractility index as a variable for multivariable logistic regression analysis, bladder contractility index (OR, 1.012; P<0.001) become an independent predictor for OAB-wet. Conclusions: A smaller bladder capacity and more frequent urgency episodes were predictors of OAB-wet, and the above findings indicate that OAB-wet and OAB-dry might be a continuum of OAB. Old age, high Qmax, high PdetQmax and urodynamic stress incontinence were also predictors for OAB-wet, and the above results reveal that OAB-wet and OAB-dry have partially different clinical and urodynamic features. Further studies might be performed to elucidate whether different treatment strategies between OAB-dry and OAB-wet can improve treatment efficacy.

Osteonecrosis of the Hip

Hou, Sheng-Mou Medical Publications Korea 2002 Medical Progress Vol.24 No.8

Sociable Kitchen: Interactive Recipe System in Kitchen Island

Tsai-Yun Mou,Tay-Sheng Jeng,Chun-Heng Ho 보안공학연구지원센터 2009 International Journal of Smart Home Vol.3 No.2

Kitchen as a space for social interaction and communication has been neglected in current HCI design. Most researches on kitchen mainly focus on cooking activities, so to correct human’s frailties become main development in HCI research. Here instead of creating some artifact to improve working activities in the kitchen, we direct our study to design a system that aims to increase social interactions and communications among people. A tangible interactive recipe system embedded in kitchen island was introduced and evaluated. The results indicate that visual representation of dishes could facilitate people’s share of experiences and positive responses toward each other. A record of people’s favorite foods could also make food preparation easier and understand others’ preferences. Moreover, people enjoyed the intuitive way of the system’s interaction. Nevertheless, although people made some flavor changes in their final decision, people commented on lacking of personal creativity in current system. Further implications on sociable design are discussed in this study.

The Overactive Bladder Symptom Score, International Prostate Symptom Score–Storage Subscore, and Urgency Severity Score in Patients With Overactive Bladder and Hypersensitive Bladder: Which Scoring System is Best?

Fei-Chi Chuang,Sheng-Mou Hsiao,Hann-Chorng Kuo 대한배뇨장애요실금학회 2018 International Neurourology Journal Vol.22 No.2

Purpose: To evaluate the correlations among the Overactive Bladder Symptom Score (OABSS), International Prostate Symptom Score–Storage Subscore (IPSS-S), and the modified Urgency Severity Scale (USS) in patients with overactive bladder (OAB) and hypersensitive bladder (HSB) and to identify the most useful diagnostic tool for classifying the severity of OAB. Methods: We retrospectively reviewed the charts of consecutive patients with OAB who visited our urologic clinics for treatment. All patients underwent a detailed history, physical examination, urinalysis, uroflowmetry, and postvoid residual volume measurement, and completed a 3-day voiding diary. All patients answered the Chinese versions of the IPSS, OABSS, and USS, according to which they were classified as having wet or dry OAB based on whether their chief complaint was urgency urinary incontinence or urgency without incontinence. HSB was defined as a functional bladder capacity <350 mL and a USS of 0 or 1. Results: The records of 325 OAB patients (99 women and 226 men) were reviewed. The OAB subgroups included HSB (n=31), OAB-dry (n=74), and OAB-wet (n=220). One-way analysis of variance showed significant differences among the OAB subgroups evaluated using each scoring system. Each scoring system was significantly correlated with the OAB subgroups. The Spearman rho was 0.983 for the USS, 0.651 for the OABSS, and 0.428 for the IPSS-S. Conclusions: The IPSS-S, OABSS, and USS showed good correlations with the OAB subgroups. Their ranking in terms of discriminant ability for classifying OAB severity as HSB, OAB-dry, and OAB-wet was USS>OABSS>IPSS-S. The simplest survey, the USS, with a single item scored from 0 to 4, had the strongest correlation with the OAB severity subgroups.

Comparison of the clinical outcomes of manual syringe infusion and pump infusion of distending media for hysteroscopic procedures: a preliminary report of a randomized controlled trial

( Wan-hua Ting ),( Sheng-mou Hsiao ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

Objectives: Adverse events associated with large volumes of distending media in hysteroscopic procedures can be life-threatening. Manual syringe infusion (MI) may have potential benefit according to our previous study [1]. The aim of this prospective randomized controlled study was to compare the clinical outcomes of MI and pump infusion (PI) of distending media for hysteroscopic procedures. Methods: Between December 2013 and April 2016, women who had hysteroscopic procedures and gave their informed written consent to participate in the study were randomly assigned to two groups: MI and PI. Women’s characteristics, the volume of distending media used, perioperative data, baseline and postoperative serum electrolyte levels and values of blood osmolarity were recorded. The Wilcoxon rank-sum test and the Chi-square test were employed for statistical analysis. Results: Baseline characteristics were similar between the groups (Table 1). The PI group was associated with a higher volume of infused fluid and collected fluid, and a lower postoperative pain score (Table 2). There is a tendency to be well correlated between the infused fluid and fluid deficit (Spearman’s rho = 0.21, p=0.058). Almost all serum electrolyte levels differed significantly between the baseline and postoperative values in both groups; however, no significant differences were noted between groups (Table 3). The postoperative sodium level (Spearman rho = -0.26, p=0.03, Table 4) and the change of potassium level (Spearman rho = -0.26, p=0.03, Table 5) were significantly correlated to the volume of fluid deficit. The postoperative phosphate level (Spearman rho = 0.31, p=0.03, Table 4) were significantly correlated to the volume of infused fluid. None have significant adverse effects. Conclusions: The MI method was associated with a lower volume of infused fluid than the PI method. Thus, the MI method may be superior to PI method in reducing media related hysteroscopic complications.

Realizing Ultrathin Silica Membranes with Straight-Through Channels for High-Performance Nanofiltrations

Kuo-Lun Tung,Geng-Sheng Lin,Jingling Yang,Chung-Yuan Mou 한국막학회 2020 한국막학회 총회 및 학술발표회 Vol.2020 No.11

Clinical and Urodynamic Predictors of the Q-Tip Test in Women With Lower Urinary Tract Symptoms

Chin-Jui Wu,Wan-Hua Ting,Ho-Hsiung Lin,Sheng-Mou Hsiao 대한배뇨장애요실금학회 2020 International Neurourology Journal Vol.24 No.1

Purpose: The Q-tip test is used to measure urethral hypermobility and can predict surgical outcomes. However, certain factors may affect the reliability of this test. Our aim was to identify independent clinical and urodynamic predictors of the results of the Q-tip test. Methods: Between January 2014 and June 2019, 176 consecutive women with lower urinary tract symptoms who underwent the Q-tip test and urodynamic studies were included in this retrospective study. Results: Multivariable regression analysis revealed that age (regression coefficient, -0.55), point Ba (regression coefficient, 4.1), urodynamic stress incontinence (regression coefficient, 9.9), maximum flow rate (Qmax) (regression coefficient, 0.13), pressure transmission ratio (PTR) at maximum urethral pressure (MUP) (regression coefficient, -0.14), and the score on the fifth question of the Incontinence Impact Questionnaire (IIQQ5; “Has urine leakage affected your participation in social activities outside your home?”; regression coefficient, -4.1) were independent predictors of the Q-tip angle, with a constant of 87.0. The following Spearman rank correlation coefficients were found between the Q-tip angle and the following variables: age, -0.38; point Ba, 0.34; urodynamic stress incontinence, 0.32; Qmax, 0.28; PTR at MUP, -0.28; and IIQQ5, -0.23. A receiver operating characteristic curve (ROC) analysis for the prediction of urodynamic stress incontinence found that the optimum cutoff for PTR at MUP was <81%, with an area under the ROC curve of 0.70. Conclusions: Age, point Ba, urodynamic stress incontinence, Qmax, PTR at MUP, and IIQQ5 were independent predictors of the Q-tip angle. However, none of these could be used as effective surrogates for the Q-tip test due to their lack of a sufficient correlation.

Treatment outcomes of patients with stage II pure endometrioid-type endometrial cancer: a Taiwanese Gynecologic Oncology Group (TGOG-2006) retrospective cohort study

Hung-Chun Fu,Jen-Ruei Chen,Min-Yu Chen,Keng-Fu Hsu,Wen-Fang Cheng,An Jen Chiang,Yu-Min Ke,Yu-Chieh Chen,Yin-Yi Chang,Chia-Yen Huang,Chieh-Yi Kang,Yuan-Yee Kan,Sheng-Mou Hsiao,Ming-Shyen Yen 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.5

Objective: Choice of hysterectomy and adjuvant treatment for International Federation of Gynecology and Obstetrics (FIGO) 2009 stage II endometrioid endometrial cancer (EEC) is still controversial. Aims of this study were to evaluate survival benefits and adverse effects of different hysterectomies with or without adjuvant radiotherapy (RT), and to identify prognostic factors. Methods: The patients at 14 member hospitals of the Taiwanese Gynecologic Oncology Group from 1992 to 2013 were retrospectively investigated. Patients were divided into simple hysterectomy (SH) alone, SH with RT, radical hysterectomy (RH) alone, and RH with RT groups. Endpoints were recurrence-free survival (RFS), overall survival (OS), disease-specific survival (DSS), adverse effects and prognostic factors for survival. Results: Total of 246 patients were enrolled. The 5-year RFS, OS, DSS and recurrence rates for the entire cohort were 89.5%, 94.3%, 96.2% and 10.2%, respectively. Patients receiving RH had more adverse effects including blood loss (p<0.001), recurrent urinary tract infections (p=0.013), and leg lymphedema (p=0.038). Age over 50-year (HR=9.2; 95% confidence interval [CI], 1.2–70.9) and grade 3 histology (HR=7.28; 95% CI, 1.45–36.6) were independent predictors of OS. Grade 3 histology was an independent predictor of RFS (HR=5.13; 95% CI, 1.38–19.1) and DSS (HR=5.97; 95% CI, 1.06–58.7). Patients receiving adjuvant RT had lower locoregional recurrence (p=0.046), but no impact on survival. Conclusion: Different treatment modalities yield similar survival outcomes. Patients receiving SH with RT had lower locoregional recurrent with acceptable morbidity. Age and tumor grading remained significant predictors for survival among patients with FIGO 2009 stage II EEC.