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Purpose: We evaluated the efficacy and safety of a combination of 2 mg tolterodine and 9 mg pilocarpine, vs tolterodine monotherapy in patients with overactive bladder.
Materials And Methods: We enrolled patients with overactive bladder symptoms in a multicenter, randomized, double-blind, parallel, active control study. Patients were randomized to the combination or 2 mg tolterodine twice daily for 12 weeks. After the double-blind period finished all patients were started on the combination for 12 weeks. Study co-primary end points were the change from baseline in the mean number of daily micturitions and cumulative incidence of dry mouth at the end of 12 weeks. Secondary end points were other overactive bladder symptoms, the total xerostomia inventory score and results of a visual analogue scale for dry mouth at the end of 12 and 24 weeks.
Results: The mean change in the number of daily micturitions from baseline to 12 weeks was -1.49 and -1.74 in the combination and tolterodine monotherapy groups, respectively. The mean difference was -0.26 (95% CI -0.79-0.27), confirming noninferiority. At 12 weeks the incidence of dry mouth was lower in the combination group than in the tolterodine monotherapy group (30.0% vs 42.9%, p = 0.009). All secondary and other efficacy outcomes related to overactive bladder symptoms improved in each group with no significant differences between the groups at 12 weeks. Changes from baseline in the total xerostomia inventory score and the visual analogue scale for dry mouth were significantly lower in the combination group than in the tolterodine monotherapy group.
Conclusions: Tolterodine and pilocarpine alleviated dry mouth in patients with overactive bladder while maintaining anticholinergic efficacy similar to that of tolterodine.
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http://dx.doi.org/10.1097/JU.0000000000000281 | DOI Listing |
Urogynecology (Phila)
December 2024
Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA.
Importance: Functional near-infrared spectroscopy (fNIRS) is a noninvasive technique used to quantify prefrontal cortex (PFC) neuroexcitation. The PFC is involved in the decision to void, and dysfunction in the region has been associated with overactive bladder (OAB). This study demonstrates neuroexcitation differences in the brain region associated with the decision to void (prefrontal cortex) using noninvasive fNIRS.
View Article and Find Full Text PDFFr J Urol
December 2024
Sorbonne University, GRC 01, GREEN Group of clinical REsEarch in Neurourology, AP-HP, Hôpital Pitié Salpétrière, F-75013 Paris, France.
Purpose: This study aimed to assess the relationship between kinetics of bladder sensations perception, detrusor overactivity (DO), and severity of overactive bladder (OAB) symptoms in patients with multiple sclerosis (PwMS).
Methods: All PwMS who underwent urodynamic assessment including three cystometries (20 ml/min, 100 ml/min, and 100 ml/min with 4°C fluid) between June 2020 and October 2022 were included in this retrospective study. Data collected were bladder diaries, symptoms assessed with Urinary Symptoms Profile (USP), bladder sensations with first desire to void (FDV) and strong desire to void (SDV) during the 20ml/min cystometry, and presence of DO.
Neurourol Urodyn
December 2024
Desai Sethi Institute of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Aims: To answer the question of whether the bladder itself can to any extent control or modulate the initiation of voiding.
Methods: This subject was discussed at the International Consultation on Incontinence-Research Society (ICI-RS) 2024 conference in Bristol, UK in a proposal session.
Results: Cells in the bladder wall sense the local environment via a diverse array of ion channels and receptors which together provide input to motor-sensory and signal transduction mechanisms.
Purpose: To assess efficacy and safety of URO-902, an investigational gene therapy expressing the α subunit of the large-conductance Ca-activated K channel, in a phase 2a placebo-controlled trial in women with overactive bladder (OAB).
Materials And Methods: Women, 40‒79 years, with OAB and urge urinary incontinence (UUI) who were refractory to OAB medications were randomized to single-dose URO-902 24 and 48 mg or placebo administered by intradetrusor injection via cystoscopy under local anesthesia. Efficacy endpoints included change from baseline to week 12 in mean daily micturitions, urgency episodes, UUI episodes, and patient-reported outcomes.
Eur Urol Focus
December 2024
Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, China. Electronic address:
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