Medical Treatment of Overactive Bladder: An Overview

Gupta, Kumkum; Kaushal, Sandeep

doi:10.2174/157488412800958721

Cited by 7 publications

(6 citation statements)

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“…On these grounds we assume that in case of severe disorder of LUT combination of standard‐dosed antimuscarinics in patients below 65 years of age can increase activity of muscarinic receptors preserved in relatively ‘younger’ bladder probably through activation of functional reserves and suppression of excessive ‘afferent noise’ as reported by Andersson (), Yoshida et al (), Giannitsas and Athanasopoulos (). In order to obtain such effect in ‘elder’ bladder standard doses of even two antimuscarinic drugs having different action spectrum are insufficient as reported by Erdem and Chu (), Wu et al (), Gupta and Kaushal (). In this case double escalation of dose proves itself to be rational, especially because it does not cause significant increase of side effects.…”

Section: Discussion Of Resultsmentioning

confidence: 99%

Comparative effectiveness of combined high‐dosed Trospium and Solifenacin for severe OAB symptoms in age‐related aspect

Kosilov

Loparev

Kosilova³

et al. 2015

Int J of Uro Nursing

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Increase of effectiveness of treatment for severe overactive bladder (OAB) symptoms in patients 40–65 and 66–80 years of aged with combined antimuscarinic drugs. This placebo‐controlled longitudinal study was performed on the basis of Regional Diagnostic Centre (Vladivostok city, Russian Federation) from 1 June 2011 to 30 December 2012. Assignment of patients (n = 299, average age: 67·1; women: 174 or 58·2%, men: 125 or 41·8%) was random blind. All patients were distributed into two age groups 40–65 and 66–80 years, and then into groups in accordance with treatment algorithm. Group A1 – patients below 65 years old treated with Trospium 60 mg/day + Soilfenacin 20 mg/day, Group A2 (n = 51; also below 65 years old): Trospium 30 mg/day + Soilfenacin 10 mg/day, Group A3 (n = 45, below 65 years old): Placebo. Group B1(n = 52; over 65 years old): Trospium 60 mg/day + Soilfenacin 20 mg/day, Group B2 (n = 54; over 65 years old): Trospium 30 mg/day + Soilfenacin 10 mg/day, Group B3 (n = 49, over 65 years old): Placebo. Period of treatment in all groups was 2 months. All patients underwent urodynamic examination at the beginning and at the end of the study. International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF) questionnaires and bladder diaries were used for evaluating clinical effectiveness of treatment and patients' satisfaction. Frequency of episodes of incontinence (EI) per day was taken as basis for clinical evaluation of treatment effectiveness. Value EI >3/day was considered as severe dysfunction of lower urinary tract (LUT). Patients below 65 years of age treated with double‐dosed antimuscarinics showed the best results both for improvement of main urodynamic and clinical parameters and for number of persons completely or partially satisfied with effect of the treatment (81·2/12·5%). In the group of patients over 65 years of age treated with standard‐dosed Trospium and Solifenacin 74·5/17·6% of patients were completely or partially satisfied with effect of the treatment and experienced significant improvement of main clinical and urodynamic indexes. Comparison of pattern of urodynamic indices, decrease of frequency of EI, correlation of Bladder capacity let us suppose that effectiveness of treatment algorithms is similar in all groups. All urodynamic and clinical indices in the group of patients over 65 years of age, who were treated with double‐dosed antimuscarinics, were significantly different from initial data, and majority of patients were completely or partially satisfied (76·9/5·8%) with results of the treatment. Clinical observation indexes, including EI, and urodynamic examination of the group of elderly patients, who were treated with standard‐dosed Trospium and Solifenacin, showed absence of significant result, and number of patients satisfied with the treatment was minimal. For effective management of overactive bladder with severe symptoms in 40 to 65‐year‐old patients prescription of two standard‐dosed antimuscarinic drugs, preferentially with different spectrum, is suf...

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Section: Discussion Of Resultsmentioning

confidence: 99%

Comparative effectiveness of combined high‐dosed Trospium and Solifenacin for severe OAB symptoms in age‐related aspect

Kosilov

Loparev

Kosilova³

et al. 2015

Int J of Uro Nursing

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“…M2 receptors are the most intensive muscarinic receptor types in the bladder and mostly M2 and M3 receptors play a role in OAB physiopathology (21). It is known that darifenacin and solifenacin are more selective for M3 than M2 receptors (6).…”

Section: Discussionmentioning

confidence: 99%

Comparision effects of solifenacin, darifenacin, propiverine on ocular parameters in eyes: A prospective study

et al. 2020

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Objective: To evaluate the effects of solifenacin, darifenacin, and propiverine on nasal-, subfoveal-, temporal choroidal thicknesses (NCT, SFCT, TCT), intraocular pressure (IOP) and pupil diameter (PD). Materials and Methods: Patients with overactive bladder (OAB) diagnosed according to The International Continence Society were administered with solifenacin, darifenacin or propiverine on a daily basis between November 2017 and May 2018. NCT, SFCT, TCT, IOP, and PD of these patients were measured and compared as initial, fourth and twelfth weeks. Results: A total of 165 patients (330 eyes) with OAB were evaluated. Solifenacin (n=140) signifi cantly reduced IOP from 17.30±2.72 mmHg to 16.67±2.56 mmHg (p=0.006) and 16.57±2.41 mmHg (p=0.002), at the fourth and twelfth weeks, respectively. Darifenacin (n=110) signifi cantly reduced NCT from 258.70±23.96 μm to 257.51±22.66 μm (p=0.002) and 255.36±19.69 μm (p=0.038), at the fourth and twelfth weeks, respectively. Propiverine (n=80) signifi cantly increased PD from 4.04±0.48 mm to 4.08±0.44 mm (p=0.009) and 4.09±0.45 mm (p=0.001), at the fourth and twelfth weeks, respectively. Conclusion: These fi ndings can help to decide appropriate anticholinergic drug choice in OAB patients. We fi nally suggest further well-designed randomized prospective studies with a larger population to evaluate the anticholinergic-related complications in eyes.

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“…Antimuscarinics are widely used; however, they are frequently discontinued due to insufficient effect or bothersome side-effects. They act by antagonizing the response to acetylcholine and other parasympathomimetics that are mediated by activation of muscarinic receptors (mostly M2 and M3) in the bladder [3]. Muscarinic receptors exist not only in the urinary bladder but also in the brain, eyes, salivary glands, and gastrointestinal tract.…”

Section: Introductionmentioning

confidence: 99%

Oral Pharmacologic Management of Overactive Bladder Syndrome: Where Do We Stand?

Marcelissen

Rashid

Lopes

et al. 2019

European Urology Focus

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Overactive bladder syndrome (OAB) is a prevalent disorder with a significant impact on quality of life. Despite this high prevalence, there is significant underdiagnosis and undertreatment due to several barriers, including embarrassment, poor communication and low patient adherence. Currently, various antimuscarinic are available in the treatment of OAB. The introduction of mirabegron has broadened the therapeutic approach and combination therapy of both agents can be valuable in clinical practice. Yet, patient adherence to most drugs for OAB is still relatively poor. Healthcare providers need to identify and utilise strategies to improve treatment adherence by defining clear treatment goals, implement educational methods and frequently communicate with patients to identify problems with adherence. The elderly population form need special attention as in these patients, anticholinergics should be prescribed with care and adequate knowledge regarding pharmacokinetics and drug interactions in essential. Furthermore, patient expectations should be clearly discussed. In this narrative review, the current advances in oral pharmacotherapy are evaluated and the most important factors involved in the management of OAB are discussed.

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Medical Treatment of Overactive Bladder: An Overview

Abstract: MEDLINE, Medscape, and Google scholar databases were searched using the relevant terms. Full text articles in English regarding the current literature on the management of OAB with major emphasis on pharmacotherapy were selected for reference.

Cited by 7 publications

References 0 publications

Comparative effectiveness of combined high‐dosed Trospium and Solifenacin for severe OAB symptoms in age‐related aspect

Comparative effectiveness of combined high‐dosed Trospium and Solifenacin for severe OAB symptoms in age‐related aspect

Comparision effects of solifenacin, darifenacin, propiverine on ocular parameters in eyes: A prospective study

Oral Pharmacologic Management of Overactive Bladder Syndrome: Where Do We Stand?

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