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

Marcelissen, Tom; Rashid, Tina; Lopes, Teresa da Silva; Delongchamps, Nicolas Barry; Geavlete, B.; Rieken, Malte; Cornu, Jean‐Nicolas; Rahnama’i, Mohammad Sajjad

doi:10.1016/j.euf.2018.03.011

Cited by 14 publications

(11 citation statements)

References 60 publications

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“…Current guidelines suggest a linear step‐up treatment pathway with behavioral therapy including bladder training, pelvic floor muscle training, and fluid management, as initial treatment 7,9 . Pharmacotherapy is considered second‐line treatment for OAB with an anti‐muscarinic or a β3‐agonist at our disposal 6 . However, conservative treatments often prove to be insufficient due to unsatisfactory response and intolerability.…”

Section: Introductionmentioning

confidence: 99%

Sacral neuromodulation in patients with refractory overactive bladder symptoms after failed Botulinum toxin therapy: Results in a large cohort of patients

Reekmans

Janssen

Vrijens

et al. 2021

Neurourology and Urodynamics

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Aims Sacral neuromodulation (SNM) and Botulinum toxin A (BoNT‐A) injections are well‐known third‐line treatment options in patients with refractory overactive bladder (OAB). Our aim is to evaluate the success rate of SNM in patients who received prior therapy with BoNT‐A injections. Methods All patients with OAB symptoms referred for SNM between 2006 and 2019 were included. History taking and 3‐day voiding diaries assessed the complaints and suitability for SNM. The success rate of SNM in patients who received prior BoNT‐A was compared with BoNT‐A naive patients. Success was defined as an improvement of 50% or greater in voiding diary parameters. Satisfaction was registered at their most recent visit. Results A total of 263 patients underwent SNM test stimulation, of which 75 (16 male/57 female) received prior BoNT‐A and 188 (46 male/142 female) were BoNT‐A naive. Success rate for SNM in BoNT‐A naive patients was 72.9% and in BoNT‐A patients 66.7% (p = 0.316). Success rate after ≤2 BoNT‐A injections was 68.5%, compared to 61.1% after ≥3 injections (p > 0.05). Success rate in patients perceiving lack of efficacy of BoNT‐A was 67.4% (p > 0.05), subjected to temporary CISC was 73.7% (p > 0.05) and with temporary effect of BoNT‐A was 50% (p > 0.05). In 86% of BoNT‐A patients the system was still activated and used to their satisfaction at their last follow‐up visit (mean FU, 40.70 months). Conclusion SNM in patients with refractory OAB who failed prior BoNT‐A is an excellent approach. The number of injections nor reason of BoNT‐A discontinuation have predictive value for success with SNM.

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Section: Introductionmentioning

confidence: 99%

Sacral neuromodulation in patients with refractory overactive bladder symptoms after failed Botulinum toxin therapy: Results in a large cohort of patients

Reekmans

Janssen

Vrijens

et al. 2021

Neurourology and Urodynamics

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“…It is known that darifenacin and solifenacin are more selective for M3 than M2 receptors (6). Propiverine, oxybutynin, fesoterodine, and trospium are nonselective anticholinergics (22,23). It has also been reported propiverine serves as a calcium channel blocker and increases relaxation in smooth muscles, making it more efficient in treating symptoms of OAB (23).…”

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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“…Once this initial line of treatment is complete, if symptoms persist, individualized management is required, with the type of treatment depending on the kind of dysfunctional voiding present. For those with genuine OAB in whom initial behavioral therapy failed, anticholinergics are the first line of choice for pharmacological therapy (32), and neuromodulation (transcutaneous parasacral or posterior tibial nerve stimulation) is the best non-pharmacological option (14). However, OAB often presents in association with other types of LUTD, such as voiding postponement and dysfunctional voiding.…”

Section: Treatmentmentioning

confidence: 99%

Diagnosis and Management of Bladder Dysfunction in Neurologically Normal Children

2019

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Normal bladder and urethral sphincter development as well as neural/volitional control over bladder-sphincter function are essential steps for regular lower urinary tract function. These maturational sequences are clinically evident by the age of 5 years. However, in 17–22% of children, symptoms persist beyond that age, characterizing lower urinary tract dysfunction (LUTD). The clinical spectrum is wide and includes overactive bladder, voiding postponement, underactive bladder, infrequent voiding, extraordinary daytime only urinary frequency, vaginal reflux, bladder neck dysfunction, and giggle incontinence. LUTD may lead to vesicoureteral reflux and recurrent urinary tract infections, increasing the likelihood of renal scarring. LUTD is often associated with constipation and emotional/behavioral disorders such as anxiety, depression, aggressiveness, and social isolation, making diagnosis, and treatment imperative. Diagnosis of LUTD is essentially based on clinical history, investigation of bladder storage, voiding symptoms (urinary frequency, daytime incontinence, enuresis, urgency) and constipation. Dysfunctional Voiding Score System (DVSS) is a helpful tool. Physical examination focuses on the abdomen to investigate a distended bladder or palpable fecal mass, the lumbosacral spine, and reflex testing. Bladder diaries are important for recording urinary frequency and water balance, while uroflowmetry is used to assess voided volume, maximum flow, and curve patterns. Bladder ultrasonography to measure post-void residual urine volume and urodynamics are used as supplemental tests. Current first line treatment is urotherapy, a combination of behavioral measures to avoid postponing micturition, and a restricted diet for at least 2 months. Anticholinergics, β3 agonists and neuromodulation are alternative therapies to manage refractory overactive bladder. Cure rates, at around 40%, are considered satisfactory, with daytime symptoms improving in 32% of cases. Furthermore, children who are also constipated need treatment, preferentially with polyethylene glycol at doses of 1–1.5 g/kg in the 1st 3 days and 0.25–0.5 g/kg thereafter until the 2-month period of behavioral therapy is complete. If urotherapy fails in cases of dysfunctional voiding, the next step is biofeedback to teach the child how to relax the external urethral sphincter during micturition. Success rate is around 80%. Children with underactive bladder usually need a combination of clean intermittent catheterization, alpha-blockers, biofeedback and neuromodulation; however, cure rates are uncertain.

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

Cited by 14 publications

References 60 publications

Sacral neuromodulation in patients with refractory overactive bladder symptoms after failed Botulinum toxin therapy: Results in a large cohort of patients

Sacral neuromodulation in patients with refractory overactive bladder symptoms after failed Botulinum toxin therapy: Results in a large cohort of patients

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

Diagnosis and Management of Bladder Dysfunction in Neurologically Normal Children

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