Reduced Perception of Urgency in Treatment of Overactive Bladder With Extended-Release Tolterodine

Qualidade de vida de mulheres com bexiga hiperativa refratária tratadas com estimulação elétrica do nervo tibial posterior

“…One of the clinical conditions associated with UI is overactive bladder (OAB) 4,5 , which often involves multiple symptoms including urgency, urge incontinence, nocturia and pollakiuria 3,6,7 .The latter is characterized by an increase in the daily frequency of urination, which under normal conditions does not exceed eight times, but can exceed 20 times in patients with OAB 8 . Although OAB is the second leading cause of UI in women 5,6,8 , it is very challenging to establish its true incidence because of the difficulty in reaching a diagnosis, mainly due to the embarrassment of patients to talk about UI and the lack of in-depth clinical research [4][5][6] . The two main approaches to the treatment of OAB are drug treatment and physical therapy.…”

“…The two main approaches to the treatment of OAB are drug treatment and physical therapy. The drug therapies are based on the use of anticholinergics and are only partially effective 3,8,9 . Published data demonstrate that the use of such medication has only 50% to 70% efficiency and is accompanied by adverse side effects such as dry mouth, constipation and blurred vision 8 .…”

“…The drug therapies are based on the use of anticholinergics and are only partially effective 3,8,9 . Published data demonstrate that the use of such medication has only 50% to 70% efficiency and is accompanied by adverse side effects such as dry mouth, constipation and blurred vision 8 . As a result of this, only 18% of patients continue the drug treatment after the first six months 3,8,9 .…”

“…Published data demonstrate that the use of such medication has only 50% to 70% efficiency and is accompanied by adverse side effects such as dry mouth, constipation and blurred vision 8 . As a result of this, only 18% of patients continue the drug treatment after the first six months 3,8,9 . Behavioral therapy and physical therapy may be as effective as, or even more effective than, drug treatment 9 .…”

Comparison of Receptor Binding Characteristics of Commonly Used Muscarinic Antagonists in Human Bladder Detrusor and Mucosa

“…However, at therapeutic doses, muscarinic antagonists do not seem to inhibit bladder contractility (Andersson and Yoshida, 2003;Finney et al, 2006), and it is now considered that muscarinic antagonists act mainly during bladder filling to increase bladder capacity and to decrease urgency (Andersson and Yoshida, 2003). Clinical trials with some of the newer antagonists have demonstrated a beneficial effect on urgency (Freeman et al, 2003;Chapple et al, 2004;Zinner et al, 2004;Millard and Halaska, 2006;Wagg et al, 2006); this symptom is not attributable to activation of muscarinic receptors on the detrusor. Furthermore, the efficacy of intravesically applied antimuscarinic agents strengthens the case for a role for muscarinic receptors associated with the bladder mucosa (Madersbacher and Jilg, 1991;Enzelsberger et al, 1995;Fröhlich et al, 1998;Walter et al, 1999).…”