409Evaluation of the effectiveness of the combination of two anticholinergic drugs to treat severe cases of neurogenic bladder

Schaefer, T.; Horstmann, Marcus; Nagele, Udo; Ma, Kewei; Stenzl, A.; Sievert, K.D.

doi:10.1016/s1569-9056(05)80415-4

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2006

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“…Before classifying a patient as having refractory NDO, one must recall that very often neurogenic patients tend to tolerate anticholinergics or much higher doses than those recommended by manufacturers without significant side effects (1–3). Moreover, if an anticholinergic becomes ineffective, the addition of a second one can still improve symptoms in the patients with severe NDO (4).…”

Section: Introductionmentioning

confidence: 99%

Refractory neurogenic detrusor overactivity

Cruz

Martins-Silva

2006

International Journal of Clinical Practice

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Refractory neurogenic detrusor overactivity refers to the clinical condition that is no longer manageable by anticholinergic therapy. This condition represents a formidable task to caregivers because the treatment of urinary incontinence and adequate protection of the upper urinary tract become extremely difficult. Treatment options for refractory neurogenic detrusor overactivity include detrusor injections of botulinum toxin and intravesical instillation of vanilloid compounds, mainly resiniferatoxin, or anticholinergic drugs. If these options fail, bladder augmentation or sacral anterior root stimulation offers excellent outcomes, although at much higher costs and risks to the patients.

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Section: Introductionmentioning

confidence: 99%