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Abstrak :
Tesis ini disusun untuk mengetahui efektivitas stimulasi elektrik saraf tibialis posterior pada pasien overactive bladder (OAB). Penelitian ini menggunakan desain uji eksperimental Randomized Control Trial. Subjek penelitian merupakan pasien OAB diatas usia 18 tahun. Dua puluh pasien dibagi secara acak menjadi 2 kelompok yaitu kelompok perlakuan dan kontrol. Semua subjek dari kedua kelompok mendapatkan tatalaksana standar berupa terapi perilaku, latihan otot dasar panggul dan pemberian antimuskarinik imidafenacine 2 x 0,1 mg. Sebagai tambahan, kelompok perlakuan diberikan stimulasi elektrik saraf tibialis posterior secara transkutan 10 Hz, 200 us, dengan intensitas yang masih dapat ditoleransi pasien, dilakukan 2x/minggu selama 8 minggu. Hasil keluaran penelitian ini berupa Overactive Bladder Symptom Score (OABSS) dan parameter catatan berkemih sebelum intervensi (T0), setelah 4 minggu (T1) dan setelah 8 minggu intervensi (T2). Analisis statistik dilakukan untuk membandingkan perubahan nilai OABSS dan parameter catatan berkemih sesudah intervensi pada kelompok perlakuan dan kontrol. Hasil penelitian menyatakan bahwa stimulasi elektrik saraf tibialis posterior efektif dalam menurunkan frekuensi berkemih pada pasien OAB setelah diberikan intervensi selama 8 minggu. Rerata penurunan frekuensi berkemih pada kelompok perlakuan dan kontrol masing-masing sebesar 6,81±3,09 dan 3,74±1,83 dan didapatkan perbedaan signifikan dengan nilai p = 0,009. Diperlukan penelitian lebih lanjut dengan waktu intervensi yang lebih lama untuk menilai efektivitas stimulasi elektrik saraf tibialis posterior pada pasien OAB. ......This thesis was aimed to determine the effectiveness of posterior tibial nerve stimulation in overactive bladder (OAB). This study design was randomized control trial. The subjects were OAB patients aged over 18 years old. Twenty subjects were randomly divided into 2 groups: intervention and control groups. The subjects from both groups received standard therapy consist of : behavioral therapy, pelvic floor exercise and antimuscarinic (imidafenacine 0,1 mg twice daily). In addition, the intervention group was given transcutaneous posterior tibial nerve stimulation of 10 Hz, 200 us, 30 minutes, with an intensity tolerable pain, 2 times/ week for 8 weeks. The Overactive Bladder Symptom Score (OABSS) and voiding diary parameters were used to measure before the intervention (T0), after 4 weeks (T1) and after 8 weeks of intervention(T2). Statistical analysis was performed to compare changes in OABSS and voiding diary between the intervention and control groups. The results stated that the posterior tibial nerve stimulation was effective in reducing the frequency of urination in OAB patients after being given an intervention for 8 weeks. The mean reduction in voiding frequency in the intervention and control groups was 6.81 ± 3.09 and 3.74 ± 1.83, respectively, and a significant difference was obtained with a value of p = 0.009. Further studies are needed with longer intervention times to assess the effectiveness of posterior tibial nerve electrical stimulation in OAB patients

Abstrak :
ABSTRACT
Background: urinary tract infection (UTI) is often treated in daily practice as overactive bladder (OAB) by giving anticholinergic, the recommended treatment options of OAB. However, anticholinergic application for UTI symptoms relief has never been investigated. To our knowledge, this study was the first randomized trial which investigate anticholinergic use for UTI treatment. This study aimed to evaluate whether additional anticholinergic is beneficial alongside an empiric antibiotic therapy in reducing symptoms and tolerable for females with uncomplicated UTI. Methods: this was a randomized double-blind controlled trial that included female aged >18 y.o with uncomplicated lower UTI. Patients were randomly assigned to either solifenacin succinate 5 mg (group 1) or placebo (group 2) in addition to empiric levofloxacin 500 mg treatment for 3 days. Those with structural and/or functional abnormalities of the urinary tract and allergic reaction history were excluded. We observed changes in overactive bladder symptom score (OABSS), patient perception of bladder condition (PPBC) score, patient-reported symptoms and adverse events. Results: a total of 126 patients, 63 for each group, initiated the trial with median age of 44 (19-67) y.o. There were no differences of age, OABSS, and PPBC score between the 2 groups at baseline. We found significant (p<0.05) reduction of OABSS and PPBC score in both groups at the end of therapy; however the amount of reduction were not different between groups. In group 1 we found 22.2% of patients complained of dry mouth and 25.4%, 4.7%, 3.2% of patients complained of nausea, somnolence and constipation respectively. In group 2 we found 20.0%, 21.7% and 3.3% patients who complained of dry mouth, nausea, and somnolence respectively. One patient in group 2 experienced allergic reaction and was dropped out. Conclusion: we found no significant difference in OABSS and PPBC score reduction by adding anticholinergic to antibiotic therapy for females with uncomplicated UTI. There was no serious adverse event recorded.