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  • Review Article

    Mirabegron and Anticholinergics in the Treatment of Overactive Bladder Syndrome: A Meta-analysis

    Rev Bras Ginecol Obstet. 2023;45(6):337-346

    Summary

    Review Article

    Mirabegron and Anticholinergics in the Treatment of Overactive Bladder Syndrome: A Meta-analysis

    Rev Bras Ginecol Obstet. 2023;45(6):337-346

    DOI 10.1055/s-0043-1770093

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    Abstract

    Objective

    To compare the use of mirabegron with anticholinergics drugs for the treatment of overactive bladder (OB).

    Data Source

    Systematic searches were conducted in EMBASE, PUBMED, Cochrane, and LILACS databases from inception to September 2021. We included RCTs, women with clinically proven OB symptoms, studies that compared mirabegron to antimuscarinic drugs, and that evaluated the efficacy, safety or adherence.

    Data Collection

    RevMan 5.4 was used to combine results across studies. We derived risk ratios (RRs) and mean differences with 95% CIs using a random-effects meta-analytic model. Cochrane Collaboration Tool and GRADE was applied for risk of bias and quality of the evidence.

    Data Synthesis

    We included 14 studies with a total of 10,774 patients. Fewer total adverse events was reported in mirabegron group than in antimuscarinics group [RR 0.93 (0.89–0.98)]. The risk of gastrointestinal tract disorders and dry mouth were lower with mirabegron [RR 0,58 (0.48–0.68); 9375 patients; RR 0.44 (0.35–0.56), 9375 patients, respectively]. No difference was reported between mirabegron and antimuscarinics drugs for efficacy. The adherence to treatment was 87.7% in both groups [RR 0.99 (0.98–1.00)].

    Conclusion

    Mirabegron and antimuscarinics have comparable efficacy and adherence rates; however, mirabegron showed fewer total and isolated adverse events.

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    Mirabegron and Anticholinergics in the Treatment of Overactive Bladder Syndrome: A Meta-analysis
  • Review Article

    Sexual Function of Patients with Deep Endometriosis after Surgical Treatment: A Systematic Review

    Rev Bras Ginecol Obstet. 2023;45(11):729-744

    Summary

    Review Article

    Sexual Function of Patients with Deep Endometriosis after Surgical Treatment: A Systematic Review

    Rev Bras Ginecol Obstet. 2023;45(11):729-744

    DOI 10.1055/s-0043-1772596

    Views21

    Abstract

    Objective

    To review the current state of knowledge on the impact of the surgical treatment on the sexual function and dyspareunia of deep endometriosis patients.

    Data Source

    A systematic review was conducted in accordance with the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. We conducted systematic searches in the PubMed, EMBASE, LILACS, and Web of Science databases from inception until December 2022. The eligibility criteria were studies including: preoperative and postoperative comparative analyses; patients with a diagnosis of deep endometriosis; and questionnaires to measure sexual quality of life.

    Study Selection

    Two reviewers screened and reviewed 1,100 full-text articles to analyze sexual function after the surgical treatment for deep endometriosis. The risk of bias was assessed using the Newcastle-Ottawa scale for observational studies and the Cochrane Collaboration's tool for randomized controlled trials. The present study was registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration CRD42021289742).

    Data Collection

    General variables about the studies, the surgical technique, complementary treatments, and questionnaires were inserted in an Microsoft Excel 2010 (Microsoft Corp., Redmond, WA, United States) spreadsheet.

    Synthesis of Data

    We included 20 studies in which the videolaparoscopy technique was used for the excision of deep infiltrating endometriosis. A meta-analysis could not be performed due to the substantial heterogeneity among the studies. Classes III and IV of the revised American Fertility Society classification were predominant and multiple surgical techniques for the treatment of endometriosis were performed. Standardized and validated questionnaires were applied to evaluate sexual function.

    Conclusion

    Laparoscopic surgery is a complex procedure that involves multiple organs, and it has been proved to be effective in improving sexual function and dyspareunia in women with deep infiltrating endometriosis.

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    Sexual Function of Patients with Deep Endometriosis after Surgical Treatment: A Systematic Review

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