Electromotive drug administration for treatment of therapy-refractory overactive bladder

Abstract

Purpose: Evaluate the benefits of electromotive drug administration (EMDA) as an alternative technique in patients with chronic overactive bladder in terms of improvement of symptoms, quality of life, and sexuality. Material and Methods: A total of 72 patients with therapy-refractory overactive bladder according to the ICS (International Continence Society) definition, were treated by EMDA. The regimen consisted of three treatment cycles, each with 3 instillations at 2-week intervals. The solution instilled consisted of 100 mL 4% lidocaine, 100 mL distilled water, 40 mg dexamethasone, and 2 mL epinephrine. Peri-interventionally, a urine test and close circulatory monitoring were performed. All women underwent urodynamic testing and cystoscopy and kept a voiding diary. A comprehensive history was obtained, a quality of life questionnaire administered, and a gynecologic examination performed before initiation of therapy. The women underwent follow-up at 12 months after the end of therapy. Results: The patients had a mean age of 63 (± 11.2) years. Bladder capacity improved significantly by 109 mL (± 55 mL) in 51 (71%) patients (p = 0.021). The number of micturitions/day decreased significantly to 7 (± 2) (p = 0.013). Quality of life was improved in 54 patients (75%); p = 0.024) and sexuality in 39 (54%); p = 0.020). Conclusions:The results suggest that EMDA can improve both quality of life and sexuality in patients with therapy-refractory chronic overactive bladder.

Social, economic, and health utility considerations in the treatment of overactive bladder

“… 95 It has been shown to be effective in patients diagnosed with OAB using lidocaine and dexamethasone as instilled drugs; however investigations of a larger group of patients are needed to provide sufficient evidence for the effectiveness of EMDA. 96 …”