Presentation Authors: Marilena Gubbiotti*, Perugia, Italy, Maurizio Serati, Varese, Italy, Antonella Giannantoni, Siena, Italy
Introduction: Mirabegron has been demonstrated to be effective and safe in the treatment of idiopathic Overactive Bladder (iOAB) but there is limited knowledge about an eventual effect on female sexual dysfunction (FSD). We investigated the impact of Mirabegron on sexual function in a group of women with iOAB.
Methods: An observational, prospective study was conducted in 2 Italian centers. Fifty sexually active, iOAB women were enrolled. At baseline, all patients underwent urogynecologic assessment (physical examination, 3- day voiding diary and uroflowmetry with post- void residual volume -PVR- measurement). Patients completed the Female Sexual Function Index (FSFI) questionnaire, the International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF) and VAS to score the impact of urinary symptoms on Quality of Life (QoL; 0= worse; 10= best). Patients started assuming Mirabegron 50 mg once daily. Clinical evaluation and questionnaires were repeated again at 12 wks follow- up. Side effects were also noted.
Results: All patients completed the study. Mean Â± SD age was 49.3 Â± 11.3 yrs. At baseline, all patients presented with increased day-time and night-time urinary frequencies and urgency, and 47/50 (94%) had urgency urinary incontinence. At the 12 wks follow-up 28/50 patients (56%) became completely continent and symptoms improved in all cases. No increase in PVR was detected. At baseline 49/50 patients (98%) presented with FSD. At 12 wks follow- up, 42/50 patients (84%) reported improvements in FSFI Total Score and 16 patients (32%) presented with no FSD. (Table) Mean Â± SD ICIQ-SF score significantly increased from 17.1 Â± 5 (pathologic value) to 7.9 Â± 4.8 (normal value; p < 0.0001). Most importantly, the mean Â± SD VAS score significantly increased from 3.9 Â± 1.2 to 6.9 Â± 1.2 (p < 0.0001). We did not observe any intolerable side effects.
Conclusions: The observed ability of Mirabegron in improving FSD in our patients with iOAB, can be explained by the overall amelioration in OAB symptoms. Indeed, it can be also hypothesized that, like in males, Mirabegron improved SD in our patients by inducing a cGMP dependent vasorelaxation of female genitalia. This could explain the significant improvement observed particularly in arousal and orgasm domains of FSFI.