塩酸プロピベリンによる頻尿・尿失禁の治療効果とKHQ,ICIQ-SFを用いたQOLスコア改善度との相関性

Abstract

キング健康調査票(KHQ), international consultation on incontinence-questionnaire:short form(ICIQ-SF)を用いて, 塩酸プロピベリンの頻尿・尿失禁に対する治療効果とQOLスコアの改善度との相関性を検討した.1)評価可能であった68例で, 8週間の投与後, 頻尿・尿失禁が有意に改善されていた.投与後, 尿意切迫感の有症状患者数は有意に減少し, 切迫感の強さも84%が改善した.2)尿失禁の形態では, 腹圧性の症状よりも切迫性尿失禁と考えられる症状の改善傾向が明らかになった.3)有害事象は32%に認められたが, 重篤なものはなかった.4)治療8週後の昼間尿失禁回数の治療効果と, KHQスコアの「仕事・家事の制限」の改善度, および「心の問題」の向上との間, 治療4週後の昼間尿失禁回数の治療効果とICIQスコアの「生活への影響」の改善度との間に相関関係を認めた.5)治療8週後の昼間排尿回数の治療効果と, ICIQスコアの「尿失禁の量」「生活への影響」「合計スコア」の改善度との間にはそれぞれ相関関係が認められた

To investigate how urinary frequency and incontinence affect the patient's subjective quality of life (QOL) and whether an improvement in objective findings by medical treatment affects his/her subjective QOL, a voiding diary using the King's Health Questionnaire (KHQ) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) was delivered to patients with urinary frequency and/or incontinence before and after treatment with propiverine hydrochloride for 8 weeks. Sixty-eight patients completed the diary and the questionnaires. Objective symptoms decreased significantly with respect to the mean frequency of urination and to the mean incidence of urinary incontinence. The KHQ and ICIQ-SF scores improved significantly with respect to all domains except personal relationships in the KHQ. In the KHQ, furthermore, a significant correlation was found between decreased incidence of urinary incontinence and improvement in role limitations and between decreased incidence of urinary incontinence and improvement in emotional problems. In the ICIQ-SF, a significant correlation was found between decreased incidence of urinary frequency and subjective improvement in quantity of leakage, between decreased incidence of urinary frequency and improvement in subjective QOL scores, between decreased incidence of urinary frequency and improvement in the total ICIQ-SF score, and between decreased incidence of urinary incontinence and improvement in subjective QOL scores. Thirty-two episodes of adverse reactions were observed. None of them were serious. These results suggest that an improvement in objective symptoms with propiverine hydrochloride favorably improves subjective QOL of the patient, and provide further evidence about the safety and efficacy of propiverine hydrochloride.