Top

Archives of Gynecology and Obstetrics

Published in:

01-03-2013 | General Gynecology

What is the success of drug treatment in urge urinary incontinence? What should be measured?

Authors: Hulya Dede, İsmail Dolen, F. Suat Dede, A. Akin Sivaslioglu

Published in: Archives of Gynecology and Obstetrics | Issue 3/2013

Abstract

Purpose

The aim of this study is to evaluate the efficacy and the tolerability of three classic antimuscarinic drugs used in the treatment of over active bladder syndrome using clinical data and quality of life tests, and to evaluate the parameters affecting the success of these drugs.

Methods

A total of 90 patients with urge urinary incontinence were randomly allocated into three groups either to receive tolterodine (group A), trospium chloride (group B) or oxybutynin (group C). Urogenital distress inventory short form (UDI-6) and Incontinence impact questionnaire short form (IIQ-7) of the Turkish Urogynecology and Pelvic Reconstructive Surgery Association were performed to each patient before and after treatment to evaluate the effectiveness and tolerability of the antimuscarinic drugs. Adverse events were also recorded during treatment.

Results

Improved urodynamic test values were recorded after 6 weeks of treatment in each group. Similarly, statistically significant differences were observed in UDI-6 and IIQ-7 test scores before and after treatment. Complete cure was achieved in 86 % of patients in group A; however, complete cure rates were 67 and 80 % in group B and C, respectively. Although, patients reported comparable tolerability against trospium chloride (77 %) and tolterodine (80 %), only 23 % of patients using oxybutynin considered the drug as tolerable. The most common side effect was dry mouth, followed by insomnia. Both dry mouth and insomnia was highest in group C (50 %). One patient (0.3 %) in group B and two patients (0.7 %) in group C reported that they did not want to continue to use the drug.

Conclusion

Antimuscarinic medications are very successful in the treatment of urge urinary incontinence; however, the success of treatment is not only limited to clinical improvement. Patients do not regard a drug as successful unless it is tolerable, easy to adapt to the daily life and improve the quality of life even it has very successful clinical outcomes.

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Neurourol Urodyn 21(2):167–178. doi:10.1002/nau.10052 PubMedCrossRef

Milsom I, Abrams P, Cardozo L, Roberts RG, Thuroff J, Wein AJ (2001) How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int 87(9):760–766PubMedCrossRef

Jackson S (1997) The patient with overactive bladder-symptoms and quality-of-life issues. Urology 50(Suppl 6A):18–22PubMedCrossRef

Kelleher C (2000) Quality of life and urinary incontinence. Baillieres Best Pract Res Clin Obstet Gynaecol 14(2):363–379PubMedCrossRef

Shumaker SA, Wyman JF, Uebersax JS, McClish D, Fantl JA (1994) Health-related quality of life measures for women with urinary incontinence: the incontinence impact questionnaire and the urogenital distress inventory. Continence Program in Women (CPW) Research Group. Qual Life Res 3(5):291–306PubMedCrossRef

Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA (1995) Short forms to assess life quality and symptom distress for urinary incontinence in women: the incontinence impact questionnaire and the urogenital distress inventory. Continence Program for Women Research Group. Neurourol Urodyn 14(2):131–139PubMedCrossRef

Madersbacher H, Stohrer M, Richter R, Giannetti BM, Murtz G (1991) High-dose trospium chloride in therapy of detrusor hyperreflexia. Urologe A 30(4):260–263PubMed

Madersbacher H, Stohrer M, Richter R, Burgdorfer H, Hachen HJ, Murtz G (1995) Trospium chloride versus oxybutynin: a randomized, double-blind, multicentre trial in the treatment of detrusor hyper-reflexia. Br J Urol 75(4):452–456PubMedCrossRef

Nabi G, Cody JD, Ellis G, Herbison P, Hay-Smith J (2006) Anticholinergic drugs versus placebo for overactive bladder syndrome in adults. Cochrane Database Syst Rev (4):CD003781. doi:10.1002/14651858.CD003781.pub2

10.

Cardozo L (1990) Detrusor instability–current management. Br J Obstet Gynaecol 97(6):463–466PubMedCrossRef

11.

Wein AJ (1995) Pharmacology of incontinence. Urol Clin N Am 22(3):557–577

12.

FitzGerald MP, Brubaker L (2002) Urinary incontinence symptom scores and urodynamic diagnoses. Neurourol Urodyn 21(1):30–35. doi:10.1002/nau.2116 PubMedCrossRef

13.

Seckiner I, Yesilli C, Mungan NA, Aykanat A, Akduman B (2007) Correlations between the ICIQ-SF score and urodynamic findings. Neurourol Urodyn 26(4):492–494. doi:10.1002/nau.20389 PubMedCrossRef

14.

Zinner N, Gittelman M, Harris R, Susset J, Kanelos A, Auerbach S (2004) Trospium chloride improves overactive bladder symptoms: a multicenter phase III trial. J Urol 171(6 Pt 1):2311–2315 (quiz 2435)PubMedCrossRef

15.

Diokno AC, Appell RA, Sand PK, Dmochowski RR, Gburek BM, Klimberg IW, Kell SH (2003) Prospective, randomized, double-blind study of the efficacy and tolerability of the extended-release formulations of oxybutynin and tolterodine for overactive bladder: results of the OPERA trial. Mayo Clin Proc 78(6):687–695PubMedCrossRef

16.

Hofner K, Oelke M, Machtens S, Grunewald V (2001) Trospium chloride–an effective drug in the treatment of overactive bladder and detrusor hyperreflexia. World J Urol 19(5):336–343PubMedCrossRef

17.

Scheife R, Takeda M (2005) Central nervous system safety of anticholinergic drugs for the treatment of overactive bladder in the elderly. Clin Ther 27(2):144–153. doi:10.1016/j.clinthera.2005.02.014 PubMedCrossRef

18.

Stohrer M, Bauer P, Giannetti BM, Richter R, Burgdorfer H, Murtz G (1991) Effect of trospium chloride on urodynamic parameters in patients with detrusor hyperreflexia due to spinal cord injuries. A multicentre placebo-controlled double-blind trial. Urol Int 47(3):138–143PubMedCrossRef

19.

Frohlich G, Bulitta M, Strosser W (2002) Trospium chloride in patients with detrusor overactivity: meta-analysis of placebo-controlled, randomized, double-blind, multi-center clinical trials on the efficacy and safety of 20 mg trospium chloride twice daily. Int J Clin Pharmacol Ther 40(7):295–303PubMed

20.

Horstmann M, Schaefer T, Aguilar Y, Stenzl A, Sievert KD (2006) Neurogenic bladder treatment by doubling the recommended antimuscarinic dosage. Neurourol Urodyn 25(5):441–445. doi:10.1002/nau.20289 PubMedCrossRef

21.

Jonas U, Hofner K, Madersbacher H, Holmdahl TH (1997) Efficacy and safety of two doses of tolterodine versus placebo in patients with detrusor overactivity and symptoms of frequency, urge incontinence, and urgency: urodynamic evaluation. The International Study Group. World J Urol 15(2):144–151PubMedCrossRef

22.

Rudy D, Cline K, Harris R, Goldberg K, Dmochowski R (2006) Multicenter phase III trial studying trospium chloride in patients with overactive bladder. Urology 67(2):275–280. doi:10.1016/j.urology.2005.08.017 PubMedCrossRef

23.

Tapp AJ, Cardozo LD, Versi E, Cooper D (1990) The treatment of detrusor instability in post-menopausal women with oxybutynin chloride: a double blind placebo controlled study. Br J Obstet Gynaecol 97(6):521–526PubMedCrossRef

Title: What is the success of drug treatment in urge urinary incontinence? What should be measured?
Authors: Hulya Dede
İsmail Dolen
F. Suat Dede
A. Akin Sivaslioglu
Publication date: 01-03-2013
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 3/2013
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-012-2596-8

At a glance: The STEP trials

Springer Medicine

What is the success of drug treatment in urge urinary incontinence? What should be measured?

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2013

Can leukocyte count during the first trimester of pregnancy predict later gestational complications?

Assessing menstrual tampon irritation using the “Behind-The-Knee” test

Spontaneous viable birth in a case of stage III pelvic endometriosis with bilateral tubal damage following diagnostic intervention: who deserves the credit?

Human papillomavirus early proteins and apoptosis

Uterine perforation with omentum incarceration after dilatation and evacuation/curettage

Effect of counseling on quality of marital relationship of infertile couples: a randomized, controlled trial (RCT) study