Urogynecology (Hagerstown, Md.)最新文献

{"title":"Individual Factors in Young Female Athletes' Bladder Health (the Y-FAB Study).","authors":"Stacey Bennis, Cara Joyce, Elizabeth R Mueller, Colleen M Fitzgerald","doi":"10.1097/SPV.0000000000001576","DOIUrl":"10.1097/SPV.0000000000001576","url":null,"abstract":"<p><strong>Importance: </strong>Bladder health in high school and collegiate females is not well understood.</p><p><strong>Objective: </strong>The objective of this study was to compare toileting behaviors, lower urinary tract symptoms (LUTSs), and fluid intake in female athletes and nonathletes.</p><p><strong>Study design: </strong>English-speaking nulliparous females aged 13-23 years were recruited. Participants completed the Toileting Behaviors: Women's Elimination Behaviors Scale, Bristol Female LUTS Questionnaire, and Beverage Questionnaire. Statistical analysis included univariable analyses and multivariable comparisons of athletes to nonathletes adjusting for age and fluid intake.</p><p><strong>Results: </strong>One hundred athletes and 98 nonathletes participated (mean age 20 ± 2, mean body mass index 23 ± 4). Athletes' sports were predominantly high impact. Dysmenorrhea and anxiety were higher in nonathletes ( P < 0.01) versus more stress fractures in athletes ( P < 0.001). Problematic toileting behaviors were prevalent regardless of athletic status; nonathletes were more likely to hold urine until home and empty away from home without the urge (both P = 0.04). Lower urinary tract symptoms were prevalent regardless of athletic status, including frequency (34.2%), hesitancy (33.3%), urgency (32.8%), stress incontinence (15.3%), and urgency incontinence (11.8%). Athletes had significantly more stress incontinence and urgency and higher incontinence subscores on univariable analysis, although the difference was attenuated after multivariable adjustment. Athletes consumed lower total fluids ( P = 0.03).</p><p><strong>Conclusions: </strong>Problematic toileting behaviors and LUTSs were prevalent in high school and collegiate females, regardless of athletic status. Athletes had higher stress urinary incontinence and urgency and lower fluid intake. These findings support future work toward enhancing early bladder health interventions (screening, education, and LUTS prevention) among high school and collegiate females.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"91-100"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninferiority Randomized Clinical Trial: KIM Sling With Reusable Trocars Versus TVT Exact Sling.","authors":"Samantha L Margulies, Anna E Osment, Adele Bernard, Michelle N Schroeder, Amy L Askew, Ijeoma S Agu, Christina A Kunycky, Elizabeth J Geller, Marcella Willis-Gray, Christine M Chu, Jennifer M Wu","doi":"10.1097/SPV.0000000000001596","DOIUrl":"10.1097/SPV.0000000000001596","url":null,"abstract":"<p><strong>Importance: </strong>The Neomedic Knotless Incontinence Mesh (KIM) sling with sterilizable trocars decreases medical waste versus midurethral slings with disposable trocars. Limited comparative data exist.</p><p><strong>Objective: </strong>The aim of the study was to assess to the success of the retropubic KIM sling compared to the Gynecare TVT Exact sling.</p><p><strong>Study design: </strong>This was a single-center, randomized noninferiority trial comparing outcomes of 2 retropubic slings-KIM sling and TVT Exact sling-in women with stress urinary incontinence from August 2021 to May 2023. Primary outcome was subjective success at 6 weeks defined by a composite outcome of the response to the question #17 on the The Pelvic Floor Distress Inventory-20 questionnaire and no retreatment of stress urinary incontinence. Secondary outcomes included rates of urinary retention, mesh erosion, and reoperation for mesh complications. Sample size estimate based on noninferiority margin of 14%, equal success of 90%, alpha 0.05, and 80% power with a 20% dropout was 72 per group.</p><p><strong>Results: </strong>Among 147 patients, 74 (50.3%) were randomized to KIM sling versus 73 (49.7%) to TVT exact. The rates of 6-week success were 68.5% for the KIM sling and 83.3% for the TVT exact with a risk difference 14.8% (95% confidence interval, 1.1-28.5). The KIM sling is not noninferior to the TVT Exact sling. There were no differences in secondary outcomes.</p><p><strong>Conclusions: </strong>The KIM sling is not noninferior to the TVT Exact sling for success at 6 weeks based on a composite outcome score. This clinical trial is ongoing to assess outcomes at 6 months and 1 year. ( Clinicaltrials.gov NCT04985799).</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"101-107"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resolution of Overactive Bladder Symptoms After Anterior and Apical Prolapse Repair.","authors":"Megan Abrams, Sarah Sears, Susan Wherley, Stephen Rhodes, Jeffrey Mangel, David Sheyn","doi":"10.1097/SPV.0000000000001502","DOIUrl":"10.1097/SPV.0000000000001502","url":null,"abstract":"<p><strong>Importance: </strong>Patients often present with both overactive bladder (OAB) and pelvic organ prolapse (POP) concerns. It is unknown whether treatment of POP improves OAB.</p><p><strong>Objective: </strong>This study aimed to evaluate whether OAB improves after anterior/apical POP repair for anterior wall prolapse.</p><p><strong>Study design: </strong>This was a prospective study of women with anterior/apical prolapse at or beyond the hymen and concomitant OAB symptoms, undergoing apical repair. Overactive bladder severity was evaluated with the Urogenital Distress Inventory-6 (UDI-6) questionnaire and the Incontinence Impact Questionnaire-7 preoperatively and 2, 6, 12, and 24 weeks postoperatively. The primary outcome was a reduction of ≥11 points or greater on the UDI-6 at 6 months. Those who reported an ≥11-point reduction were termed responders. Multivariable regression analyses were performed to evaluate factors associated with reduction in OAB symptoms after POP surgery.</p><p><strong>Results: </strong>A total of 117 patients met the criteria for analysis, with 79.5% reporting improved OAB symptoms after POP repair at 6 months. There were no preoperative differences between groups. The mean preoperative UDI-6 and Incontinence Impact Questionnaire-7 scores were higher in the responder group (51.1 ± 16.8 vs 26.4 ± 15.1 [ P < 0.001] and 44.6 ± 23.8 vs 22.8 ± 21.4 [ P = 0.001], respectively), and the presence of detrusor overactivity was lower (29.0% vs 54.2%, P = 0.02). After regression, a higher preoperative UDI-6 total was associated with an increased likelihood of symptom improvement at 6 months (adjusted odds ratio, 1.14 per point [1.08-1.19]), whereas detrusor overactivity on preoperative urodynamics was associated with a decreased likelihood of OAB symptom improvement (adjusted odds ratio, 0.10 [0.02-0.44]).</p><p><strong>Conclusion: </strong>Overactive bladder symptoms improve in the majority of patients undergoing apical repair for anterior/apical prolapse beyond the hymen.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"147-153"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Clinical Correlates of Endometriosis in Patients With IC/BPS.","authors":"Mary Namugosa, Amr El Haraki, Rory Ritts, Kaylee Ferrara, Gopal Badlani, Robert Evans, Stephen J Walker","doi":"10.1097/SPV.0000000000001589","DOIUrl":"10.1097/SPV.0000000000001589","url":null,"abstract":"<p><strong>Importance: </strong>Interstitial cystitis/bladder pain syndrome (IC/BPS) presents as a complex heterogeneous disorder that poses a significant clinical challenge both for diagnosis and treatment. The identification of patient subgroups with significant overlap in their nonurological associated symptoms, including endometriosis, may enable a more targeted therapeutic approach.</p><p><strong>Objective: </strong>This study investigated the prevalence, clinical correlates, and clinical sequelae associated with concurrent endometriosis in patients with IC/BPS.</p><p><strong>Study design: </strong>Demographic, clinical, surgical, and questionnaire data from female patients (n = 533) with a diagnosis of IC/BPS were evaluated in this retrospective cohort study. Surgical history was obtained from patient electronic medical records, using Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes. Data from participants with and without concurrent endometriosis were compared using univariate analysis, followed by binary logistic regression to identify associated variables.</p><p><strong>Results: </strong>Of 533 participants, 108 (20.3%) reported a history of endometriosis. Those with concurrent endometriosis were younger, had a larger bladder capacity, and had a higher number of nonurological associated symptoms. Patients with concurrent endometriosis were less likely to have a history of cystectomy (the surgical removal of the bladder) and report allergies but more prone to report comorbidities such as chronic pelvic pain, chronic fatigue, fibromyalgia, migraines, and pelvic floor dysfunction. Binary logistic regression identified a positive association between endometriosis and chronic pelvic pain, and a negative association between allergies and low bladder capacity for those with concurrent endometriosis.</p><p><strong>Conclusions: </strong>Endometriosis is common in younger female patients with IC/BPS and is associated with a non-bladder-centric (ie, systemic pain disorder) phenotype.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"131-138"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mark Cuban Cost Plus Drug Company Effect on Urogynecologic Drugs.","authors":"Raymond Xu, Megan Escott, Amr Sherif El Haraki","doi":"10.1097/SPV.0000000000001653","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001653","url":null,"abstract":"<p><strong>Importance: </strong>The Mark Cuban Cost Plus Drug Company (ie, Cost Plus Drugs) is a service that makes generic drugs affordable. Cortese et al recently published the top 9 most commonly used oral medications in treatment of urologic conditions and showed that Cost Plus Drugs would have provided an estimated $1.29 billion reduction in 2020 costs if they replaced the Medicare prices.</p><p><strong>Objectives: </strong>We sought to investigate the savings for all drugs commonly used in urogynecology.</p><p><strong>Study design: </strong>We reviewed the generic drugs provided by Cost Plus Drugs and selected those commonly used for the treatment of urogynecologic conditions (N = 16). For each of the 16 drugs we identified the Cost Plus Drugs prices for the 30- and 90-count quantities. We then also calculated the 2021 Medicare spending for the 16 drugs. The potential savings were calculated as the difference between Cost Plus Drugs and Medicare 30- and 90-count prices, multiplied by the volume-adjusted number of units dispensed to Medicare beneficiaries in 2021.</p><p><strong>Results: </strong>The total estimated savings when using Cost Plus Drugs compared to Medicare was $462,375,491.53 and $618,833,850.34 for 30- and 90-count pricing, respectively. The price of a 42.5-gram tube of vaginal estrogen cream was $22.48 on Cost Plus Drugs, compared to $293.66 through Medicare Part D.</p><p><strong>Conclusions: </strong>Cost Plus Drugs is a novel program that has tremendous implications on costs savings in the context of prescription drugs and is particularly true for drugs used in the treatment of urogynecologic conditions, specifically vaginal estrogen.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetric Anal Sphincter Injury: Vaginal Birth After Cesarean Versus First Vaginal Delivery.","authors":"Brigid S Mumford, Lara Lemon, John Harris, Lauren E Giugale","doi":"10.1097/SPV.0000000000001647","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001647","url":null,"abstract":"<p><strong>Importance: </strong>Modern data regarding the relationship between vaginal birth after cesarean (VBAC) and obstetric anal sphincter injury (OASI) are minimal with mixed results.</p><p><strong>Objective: </strong>The aim of the study was to determine if VBAC is associated with an increased risk of OASIs.</p><p><strong>Study design: </strong>This was a retrospective cohort study of liveborn deliveries from 2018 to 2022 within a large, multihospital academic health system. The primary outcome was the proportion of OASIs compared between patients who underwent a first vaginal delivery (primiparous vaginal delivery group) versus patients who underwent a first VBAC (VBAC group).</p><p><strong>Results: </strong>A total of 17,044 patients were included. A total of 16,208 had a primiparous vaginal delivery and 836 underwent VBAC. Vaginal birth after cesarean patients were older (29.9 vs 27.0 years, P < 0.01), more likely to self-identify as Black or Asian race (26.1% vs 18.0%, P < 0.01), and had lower maternal weight (182.7 vs 187.2 lbs, P < 0.01). The proportion of OASIs was significantly higher in the VBAC group (6.9% vs 5.1%, P = 0.02). Vacuum-assisted vaginal deliveries were more common in the VBAC group (7.7% vs 5.4%, P < 0.01).On multivariable logistic regression, VBAC was not significantly associated with OASIS (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 0.75-1.36, P = 0.95). Operative vaginal delivery (OR = 6.44, CI = 5.51-7.52, P < 0.01), older maternal age (OR = 1.05, CI = 1.03-1.07), and Asian race (OR 2.62, CI = 2.10-3.26) demonstrated increased odds of OASIs. Patients who identified as Black demonstrated lower odds of OASIs (OR = 0.68, CI = 0.50-0.93).</p><p><strong>Conclusions: </strong>While there was a greater proportion of OASIs in the VBAC group compared to the primiparous vaginal delivery group, VBAC was not an independent risk factor.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do you solve a problem like mirabegron?","authors":"Lauren A Cadish, Jonathan P Shepherd","doi":"10.1097/SPV.0000000000001662","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001662","url":null,"abstract":"","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why wasn't mirabegron chosen for the first year of the CMS negotiation program?","authors":"Lauren A Cadish, Jonathan P Shepherd","doi":"10.1097/SPV.0000000000001663","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001663","url":null,"abstract":"<p><strong>Abstract: </strong>Importance: The most used overactive bladder (OAB) medications are anticholinergics, which professional societies recommend avoiding in older patients given dementia risk. Cost prevents patients from switching to preferred beta-3 agonists. Mirabegron was the only beta-3 agonist eligible for the Centers for Medicare/Medicaid Services (CMS) 2023 Drug Negotiation Program (DNP). While mirabegron's price would be markedly reduced by inclusion in the DNP, only ten drugs were chosen in its first year.Objectives: We sought to explain mirabegron's absence from CMS's 2023 DNP and estimate the percentage of anticholinergic to mirabegron conversions needed to merit DNP inclusion.Study design: We modeled CMS's 2023 selection process using publicly available dashboards from 2017-2021. Among the 20 costliest drugs, we excluded ineligible drugs and categorized the remainder as DNP chosen/not chosen. For drugs not chosen, we used price inflation and beneficiary utilization trends to project total 2023 costs.Results: In 2021, mirabegron was the 14th most costly drug overall-9th when excluding ineligibles-and the only top-20 drug eligible but not selected for the 2023 DNP. We estimated mirabegron to be 96.7% the cost of the 10th most costly drug. Switching 1.2% of 2021 anticholinergic prescriptions to mirabegron would have led to DNP inclusion, presenting an interesting dilemma where more patients would use mirabegron if it were cheaper, but insufficient patients used it for DNP inclusion to make it cheaper.Conclusions: Mirabegron came exceedingly close to DNP selection in 2023, and its future inclusion in the DNP would likely herald a massive shift of Medicare patients away from anticholinergics.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypes of Pelvic Organ Prolapse.","authors":"Zoe Sayler, Katie Weston, Colin M Johnson, Victoria Cunningham, Catherine S Bradley, Kimberly A Kenne, Linder Wendt, Patrick Ten Eyck, Joseph T Kowalski","doi":"10.1097/SPV.0000000000001640","DOIUrl":"https://doi.org/10.1097/SPV.0000000000001640","url":null,"abstract":"<p><strong>Importance: </strong>The Pelvic Organ Prolapse Quantification (POP-Q) stages do not correlate with symptoms or characterize important prolapse subtypes.</p><p><strong>Objectives: </strong>We hypothesize that clinically meaningful prolapse \"phenotypes\" utilizing POP-Q measurements can be defined. The primary aim was to define the phenotypes and their frequency. Secondary aims were to compare demographics, medical characteristics, and symptoms between phenotypes.</p><p><strong>Study design: </strong>Patients who previously underwent prolapse surgery were retrospectively categorized into 1 of 8 phenotypes based on 2 principles: (1) prolapse exists when the anterior or posterior vaginal wall descend to the hymen or the apex descends half total vaginal length, and (2) prolapse may exist in anterior, posterior, and/or apical compartments. Demographics, medical characteristics, and Pelvic Floor Distress Inventory-20 (PFDI-20) responses were compared. Linear and logistic regression models were used for comparisons.</p><p><strong>Results: </strong>The AC (anterior-predominant and apical) phenotype was most common (231 of 501 patients, 46.1%) and served as the reference for comparisons. The no prolapse, P (isolated posterior), C (isolated apical), and PC (posterior-predominant and apical) phenotypes were younger. The A (isolated anterior) phenotype was older. P, PC, and APC (anterior and posterior and apical) phenotypes had greater body mass index. The P phenotype Colorectal-Anal Distress Inventory scores were higher. Similarly, the PC phenotype had higher scores for bowel splinting and rectal prolapse. Conversely, the C phenotype total PFDI-20 scores were lower (P = 0.01). Only the APC phenotype had no significant differences in any PFDI-20 question compared with the AC phenotype.</p><p><strong>Conclusion: </strong>These phenotypes may allow for improved understanding, communication, and counseling about prolapse and prolapse treatment.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of Overactive Bladder Medications on Cognition.","authors":"Darlene Vargas Maldonado, Phillip J Schulte, Laureano Rangel Latuche, Maria Vassilaki, Ronald C Petersen, John A Occhino, Brian J Linder","doi":"10.1097/SPV.0000000000001522","DOIUrl":"10.1097/SPV.0000000000001522","url":null,"abstract":"<p><strong>Importance: </strong>Emerging literature has associated the use of anticholinergic medications to cognitive decline.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the association of overactive bladder medications on cognitive function with prospective longitudinal cognitive assessments.</p><p><strong>Study design: </strong>A population-based cohort of individuals 50 years and older who had serial validated cognitive assessment, in accordance with the Mayo Clinic Study of Aging, was evaluated from October 2004 through December 2021. Anticholinergic overactive bladder medications were grouped by traditional anticholinergic medications and central nervous system (CNS)- sparing anticholinergic medications and compared to no medication exposure. A linear mixed effects model with time-dependent exposures evaluated the association between overactive bladder anticholinergic medication exposure and subsequent trajectories of cognitive z-scores.</p><p><strong>Results: </strong>We included 5,872 participants with a median follow-up of 6.4 years. Four hundred forty-three were exposed to traditional anticholinergic medications, 60 to CNS-sparing medications, and 5,369 had no exposure. On multivariable analyses, exposure to any anticholinergic overactive bladder medication was significantly associated with deterioration in longitudinal cognitive scores in the language and attention assessments compared to the control cohort. Traditional anticholinergic medication exposure was associated with worse attention scores than nonexposed participants. Exposure to CNS-sparing anticholinergic medications was associated with a deterioration in the language domain compared to those unexposed. Among women, traditional anticholinergic medication exposure was associated with worse global and visuospatial scores than nonexposed participants, but this association was not identified in the CNS-sparing group.</p><p><strong>Conclusion: </strong>Exposure to anticholinergic overactive bladder medications was associated with small but significantly worse decline in cognitive scoring in the language and attention domains when compared to nonexposed individuals.</p>","PeriodicalId":75288,"journal":{"name":"Urogynecology (Hagerstown, Md.)","volume":" ","pages":"10-17"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}