Sacral neuromodulation and Botulinum toxin A for refractory idiopathic overactive bladder: a cost-utility analysis in the perspective of Italian Healthcare System.

Objectives: To assess the relative cost-effectiveness of two therapeutic strategies: one starting with sacral neuromodulation (SNM) versus one starting with Botulinum toxin A (BTX-A) for the management of refractory incontinent idiopathic overactive bladder (OAB) patients, from the perspective of the Italian National Health Service (INHS).

Methods: Direct medical costs (2011) and benefits (quality-adjusted life years-QALYs) were assessed over a ten-year time frame adapting to the Italian practice a published Markov model. Clinical inputs were based on the published literature and on the expert opinion.

[Standard pharmacological treatment and new therapies for overactive bladder].

The prevalence of overactive bladder (OAB) in adult males varies from 10.2% to 17.4%, and in females from 7.

Treating erectile dysfunction and central neurological diseases with oral phosphodiesterase type 5 inhibitors. Review of the literature.

Introduction: Erectile dysfunction (ED) is reported in a high percentage of patients with central neurological disorders (CND).

Aim:   An up-to-date review on oral phosphodiesterase 5 inhibitors (PDE5): sildenafil, tadalafil, and vardenafil for individuals with CND and ED.

Main Outcome Measures: Various questionnaires on ED, such as the International Index of Erectile Function composed of 15 questions.