新型抗胆碱能药物托特罗定治疗膀胱过度活动症的临床研究

目的　评价新型抗胆碱药物托特罗定治疗膀胱过度活动症的有效性和安全性。　方法　采用随机、双盲、双模拟、平行对照的方法对207例膀胱过度活动症患者进行托特罗定与奥昔布宁的对比研究,服药方法每日2次,每次托特罗定2mg或奥昔布宁5mg。　结果　治疗6周后,托特罗定组(103例)24h平均排尿次数减少(3.0±3.4)次,其中尿失禁患者的平均尿失禁次数减少(1.5±1.8)次;奥昔布宁组(104例)治疗后24h平均排尿次数减少(4.6±6.4)次,平均尿失禁次数减少(2.4±2.1)次,两组间差别无显著性意义(P>0.05)。托特罗定组患者副作用发生率66.9%,其中口干为55.3%;而奥昔布宁组发生率为87.5%,口干为76.9%,两组间差别有显著性意义(P<0.05)。　结论　托特罗定是治疗膀胱过度活动症的有效药物,疗效与奥昔布宁相同,但不良反应明显低于奥昔布宁。     

Safety and Efficacy of Mirabegron: Analysis of a Large Integrated Clinical Trial Database of Patients with Overactive Bladder Receiving Mirabegron,Antimuscarinics, or Placebo

BackgroundMirabegron, a β3-adrenoreceptor agonist, is an alternative drug to antimuscarinics for overactive bladder (OAB) symptoms.ObjectiveTo summarise safety and efficacy reporting of mirabegron treatment for OAB symptoms.Design, setting, and participantsPooled data analysed from 10 phase 2–4, double-blind, 12-wk mirabegron monotherapy studies in adults with OAB who had received one or more doses of study drug.InterventionMirabegron: 25 and 50 mg; antimuscarinics: solifenacin (2.5, 5, and 10 mg) and tolterodine extended release (4 mg).Outcome measurements and statistical analysisBaseline OAB-related characteristics, intrinsic and extrinsic factors, and analyses by age (<65 vs ≥65 yr and <75 vs ≥75 yr) and sex were assessed. Solifenacin 2.5 and 10 mg groups were not included in the efficacy analyses (small patient numbers). Safety was evaluated using the proportion of treatment-emergent adverse events. Efficacy variables were derived from bladder diaries (baseline and week 12).Results and limitationsBaseline hypertension and diabetes were more frequent across treatment groups in the older versus younger age groups and in men versus women. Within sexes, frequencies were similar between treatment groups. Some differences were observed in baseline characteristics, including type of incontinence and medical history between sexes. No previously unreported safety concerns were identified. Improvements in efficacy (mean number of incontinence episodes/24 h, micturitions/24 h, urgency episodes/24 h, volume voided/micturition, and nocturia episodes) versus placebo were observed in all treatment groups. Significant treatment-by-subgroup interactions included change from baseline in the mean number of incontinence episodes/24 h by age (<65 vs ≥65 yr), nocturia by age (<65 vs ≥65 yr and <75 vs ≥75 yr), and urgency episodes by previous OAB medication.ConclusionsData from this integrated database of 10 mirabegron studies reaffirm the safety and efficacy profiles of mirabegron, solifenacin, and tolterodine in adults of different age groups and sexes.Patient summaryOveractive bladder is a complex of symptoms including a compelling desire to pass urine that leads to increased frequency, which may lead to a degree of incontinence if you do not reach the toilet in time and may wake you from sleep. We pooled data from 10 different studies of mirabegron in patients with overactive bladder symptoms, and looked at the effect in the total number of patients who received the treatment, as well as in different age groups and between men and women. No new safety concerns were identified, and mirabegron improved the symptoms of overactive bladder.     

Comparison of the efficacy of tolterodine and oxybutynin in different urodynamic severity grades of idiopathic detrusor overactivity

OBJECTIVE: To compare the efficacy of tolterodine and oxybutynin in the treatment of specific, according to their urodynamic grade of severity, populations with overactive detrusor. METHODS: In this open, randomized, two-way crossover study 128 women with urodynamically confirmed, idiopathic detrusor overactivity were recruited. Patients were categorized in 4 grades of severity groups, according to the characteristics of the first overactive detrusor contraction during filling cystometrogram: high volume-low pressure (grade-group I), high volume-high pressure (grade-group II), low volume-low pressure (grade-group III) and low volume-high pressure (grade-group IV). The primary outcome measure was average volume of voided urine per micturition. RESULTS: 107 patients successfully completed the study protocol and were included in the analyses: 40 in group IV, 36 in III, 25 in II and 6 in group I. In groups IV and III both oxybutynin and tolterodine significantly increased the average volume of voided urine per micturition but the differences between the drugs were not significant (p > 0.05). In group II neither of the drugs achieved significant changes in the outcome measure (p > 0.05). CONCLUSIONS: Tolterodine and oxybutynin are clinically equipotent in treating detrusor overactivity in specific severity groups of patients, although urodynamic effects are somewhat different.     

托特罗定联合硝苯地平治疗女性膀胱过度活动症的疗效观察

目的探讨托特罗定联合硝苯地平治疗女性膀胱过度活动症（OAB）的疗效。方珐女性OAB患者60例,随机分为2组：A组（30例,托特罗定片2mg,2次／d,连服4周）,B组（30例,托特罗定片并硝苯地平片,5mg,3次／d,连用4周）。治疗前及结束后行ABSS评分。结果A组患者治疗前后尿急评分分别为（3．6±1．O）与（1．8±O．5）分,OABSS评分分别为（10．9±4．8）与（5．3±1．8）分;B组患者治疗前后尿急评分分别为（3．7±0．9）与（O．8±0．1）分,OABSS评分分别为（10．8±1．8）与（3．8±1．7）分,2组治疗前后差异均有统计学意义（P〈0．05）,2组治疗后尿急评分和OABSS评分差异有统计学意义（P〈0．05）。结论托特罗定联合硝苯地平治疗女性膀胱过度活动症效果较好。     

Efficacy and Adverse Events of Antimuscarinics for Treating Overactive Bladder: Network Meta-analyses

Context

Millions of people worldwide experience overactive bladder (OAB), and antimuscarinics are the pharmacologic treatment of choice. Several conventional meta-analyses have been published, but they fail to quantify efficacy and adverse events across drugs, dosages, formulations, and pharmaceutical forms.

Objective

To perform two network meta-analyses summarizing the efficacy and adverse events of antimuscarinics in the treatment of OAB.

Evidence acquisition

Medline and Scopus searches, previous systematic reviews, conference abstracts, book chapters, and the reference lists of relevant articles were searched. Trialists were contacted. Eligible studies were randomized trials that compared at least one antimuscarinic for treating OAB with placebo or with another antimuscarinic, and that reported efficacy and/or adverse event outcomes. Efficacy was assessed for six outcomes (perception of cure or improvement, urgency episodes per 24 h, leakage episodes per 24 h, urgency incontinence episodes per 24 h, micturitions per 24 h, and nocturia episodes per 24 h). Adverse events were assessed in seven categories according to the Common Terminology Criteria for Adverse Events. Across all outcomes, a summary efficacy and an adverse event score were computed. Two authors independently extracted data.

Evidence synthesis

For the comparison of the efficacy, 76 trials enrolling 38 662 patients were included; for adverse events, 90 trials enrolling 39 919 patients were included. In the subset of studies reporting on treatments and dosages as used in clinical practice, 40 mg/d trospium chloride, 100 mg/g per day oxybutynin topical gel, and 4 mg/d fesoterodine had the best efficacy, while higher dosages of orally administered oxybutynin and propiverine had the least favorable relationship of efficacy and adverse events.

Conclusions

This is the first study allowing trade-offs between efficacy and adverse events of various drugs and dosages in the treatment of patients with OAB. Differences among the various antimuscarinics call for careful, patient-centered management in which regimen changes should be considered.     

Effectiveness and tolerability of extended-release oxybutynin vs extended-release tolterodine in women with or without prior anticholinergic treatment for overactive bladder

The efficacy and the tolerability of extended-release oxybutynin chloride, 10 mg daily, and extended-release tolterodine tartrate, 4 mg daily, in women with or without prior anticholinergic treatment for overactive bladder (OAB) were compared in a post-hoc analysis of data from the Overactive Bladder: Performance of Extended Release Agents (OPERA) trial. The patient population and study methods have been described previously (Diokno et al., for the OPERA Study Group, Mayo Clin Proc 78:687–695, 2003). Among the group with anticholinergic experience, extended-release oxybutynin was significantly more effective than extended-release tolterodine in reducing micturition frequency at last observation (p=0.052). Complete freedom from urge incontinence was reported by significantly more patients taking oxybutynin than tolterodine at last observation (23.6 vs 15.1%, p=0.038). In addition, among patients completing a full 12 weeks of oxybutynin treatment, significantly greater reductions were observed compared with those taking tolterodine on the primary efficacy variable, number of urge incontinence episodes (p=0.049), and the combined total of urge and non-urge episodes (p=0.012), although the differences between treatment groups were not significant at last observation. In the anticholinergic-naïve group, efficacy and tolerability outcomes were similar across treatments, except that oxybutynin was associated with a significantly lower frequency of micturition at last observation (p=0.035). No efficacy differences favoring tolterodine were observed, and tolerability of the treatments was comparable. Dry mouth (mostly mild to moderate in severity) was reported significantly more often among participants taking extended-release oxybutynin than extended-release tolterodine (32.2 vs 19.2%, p=0.004), but only among those with previous anticholinergic experience. Discontinuation rates were comparably low across groups. The results demonstrate the appropriateness of initiating treatment for OAB with extended-release oxybutynin, particularly in women presenting with incontinence.     

Pilot Study of Liposome-encapsulated OnabotulinumtoxinA for Patients with Overactive Bladder: A Single-center Study

Background

Intradetrusor onabotulinumtoxinA (BoNT-A) injection benefits overactive bladder (OAB) patients, but increased postvoid residual (PVR) urine volume and urinary tract infection (UTI) remain risks. Intravesical instillation of liposomal BoNT-A instead of injection could prevent such adverse events.

Objective

To evaluate instillation of liquid liposomal BoNT-A (Lipotoxin) for the treatment of OAB and to determine its mechanism of action.

Design, setting, and participants

A double-blind randomized parallel controlled pilot trial in 24 OAB patients at a single tertiary center.

Intervention

Patients were randomly assigned to intravesical instillation of Lipotoxin containing 80 mg liposomes and 200 U BoNT-A or normal saline (N/S). Patients were retreated with Lipotoxin 1 mo later if they failed the first treatment.

Outcome measurement and statistical analysis

Voiding diaries, OAB symptom scores, urodynamic studies, and adverse events were monitored. The primary end point was change of total urinary frequency per 3 d at 1 mo after treatment. Immunohistochemistry and Western blotting for synaptic vesicle glycoprotein 2A (SV2A) and synaptosomal-associated protein, 25 kDa (SNAP25) were performed at baseline and 3 mo after treatment. The Wilcoxon rank sum test and Wilcoxon signed rank test were used for statistical analysis.

Results and limitations

At 1 mo after treatment, the change of urinary frequency per 3 d significantly improved in the Lipotoxin group (n = 12; median: −6.50; interquartile range [IQR]: −18.3 to −0.25; p = 0.008) but not in the N/S group. (n = 12.0; IQR: −7.75 to 8.0; p = 0.792). Urgency episodes also showed a significant decrease in the Lipotoxin group (−12.0; IQR: −20.3 to −2.75; p = 0.012) but not in the N/S group (−1.0; IQR: −11.0 to 2.5; p = 0.196). SV2A and SNAP25 were expressed in urothelial cells and suburothelial tissues. However, the protein expression did not significantly differ between responders and nonresponders at 3 mo after treatment.

Conclusions

Intravesical Lipotoxin instillation effectively reduced frequency episodes 1 mo after treatment in OAB patients without any increase in PVR or risk of UTI.

Patient summary

We demonstrated that intravesical Lipotoxin instillation reduced frequency episodes at 1 mo in overactive bladder patients. This procedure is safe, without an increase in postvoid residual or the risk of urinary tract infection.     

OnabotulinumtoxinA 100 U Significantly Improves All Idiopathic Overactive Bladder Symptoms and Quality of Life in Patients with Overactive Bladder and Urinary Incontinence: A Randomised,Double-Blind,Placebo-Controlled Trial

Background

Overactive bladder (OAB) syndrome with urinary incontinence (UI) is prevalent in the population and impairs health-related quality of life (HRQOL).

Objective

To assess the impact on efficacy, safety, and HRQOL of onabotulinumtoxinA (BOTOX^®, Allergan, Inc.) treatment in patients with OAB with UI.

Design, setting, and participants

This pivotal, multicentre, double-blind, randomised, placebo-controlled, phase 3 study enrolled patients with idiopathic OAB with ≥3 urgency UI episodes over 3 d and ≥8 micturitions per day who were inadequately managed by anticholinergics.

Intervention

OnabotulinumtoxinA at a 100 U dose (n = 277) or placebo (n = 271), administered as 20 intradetrusor injections of 0.5 ml.

Outcome measurements and statistical analysis

Co–primary end points were change from baseline in the number of UI episodes per day and proportion of patients reporting positive treatment response on the treatment benefit scale (TBS) at week 12. Additional end points included other OAB symptoms (episodes of urinary urgency incontinence, micturition, urgency, and nocturia) and HRQOL (Incontinence Quality of Life [I-QOL], King's Health Questionnaire [KHQ]). Safety assessments included adverse events (AEs), postvoid residual (PVR) urine volume, and initiation of clean intermittent catheterisation (CIC).

Results and limitations

OnabotulinumtoxinA significantly decreased UI episodes per day at week 12 (−2.95 for onabotulinumtoxinA versus −1.03 for placebo; p < 0.001). Reductions from baseline in all other OAB symptoms were also significantly greater following onabotulinumtoxinA compared with placebo (p ≤ 0.01). Patients perceived a significant improvement in their condition, as measured by patients with a positive treatment response on the TBS (62.8% for onabotulinumtoxinA versus 26.8% for placebo; p < 0.001). Clinically meaningful improvements from baseline in all I-QOL and KHQ multi-item domains (p < 0.001 versus placebo) indicated positive impact on HRQOL. AEs were mainly localised to the urinary tract. Mean PVR was higher in the onabotulinumtoxinA group (46.9 ml versus 10.1 ml at week 2; p < 0.001); 6.9% of onabotulinumtoxinA patients versus 0.7% of placebo patients initiated CIC.

Conclusions

OnabotulinumtoxinA 100 U was well tolerated and demonstrated significant and clinically relevant improvements in all OAB symptoms, patient-reported benefit, and HRQOL in patients inadequately managed by anticholinergics.

Trial registration

ClinicalTrials.gov: NCT00910520.     

Randomised,Multicentre, Placebo-controlled,Double-blind Crossover Study Investigating the Effect of Solifenacin and Oxybutynin in Elderly People with Mild Cognitive Impairment: The SENIOR Study

Background

Compared with younger people, the elderly are more likely to suffer from overactive bladder (OAB) and to have other chronic conditions that affect physical or cognitive function. Despite this, there are few data on the cognitive safety of antimuscarinic agents in older patients and none that examine the effect of these agents on those with mild cognitive impairment (MCI).

Objective

To evaluate cognitive effects during chronic stable dosing with solifenacin and oxybutynin versus placebo in older (≥75 yr) subjects with MCI.

Design, setting, and participants

A randomised, double-blind, triple-crossover trial in 26 elderly volunteers with MCI. Cognitive function was assessed using Cognitive Drug Research (CDR) computerised testing.

Intervention

Three treatment periods of 21 d each with solifenacin 5 mg once daily, oxybutynin 5 mg twice daily, or placebo, separated by 21-d washout periods.

Outcome measurements and statistical analysis

The primary end point was change from baseline in cognitive function with solifenacin at 6 h postdose and oxybutynin at 2 h postdose (time points close to their predicted time to peak concentration). Secondary end points included change in cognitive function at additional time points, and safety and tolerability assessments.

Results and limitations

Neither agent was associated with significant changes from baseline in any of the five standard, composite outcomes of cognitive function (power of attention, continuity of attention, quality of working memory, quality of episodic memory, and speed of memory). In a secondary analysis, oxybutynin was associated with significant decreases in power and continuity of attention versus placebo at 1–2 h postdose. Both agents were well tolerated, with the most frequently reported adverse event being mild or moderate dry mouth.

Conclusions

Solifenacin had no detectable effect on cognition in this group of elderly people with MCI.     

Comparative Efficacy and Safety of Medical Treatments for the Management of Overactive Bladder: A Systematic Literature Review and Mixed Treatment Comparison

ContextOveractive bladder (OAB) treatment guidelines recommend antimuscarinics as first-line pharmacologic therapy. Mirabegron is a first-in-class β3-adrenoceptor agonist licensed for the treatment of OAB and has shown to be well tolerated and effective in the treatment of OAB symptoms.ObjectiveTo assess the relative efficacy and tolerability of OAB medications, specifically mirabegron 50 mg versus antimuscarinics in patients with OAB.Evidence acquisitionA systematic literature search was performed on published peer-reviewed articles from 2000 to 2013. This review included randomised controlled trials (RCTs) studying changes in symptoms (micturition frequency, incontinence, and urgency urinary incontinence [UUI] episodes) and incidence of the most frequently reported adverse events (dry mouth, constipation) associated with current OAB medications. The following drugs were considered in addition to mirabegron: darifenacin, tolterodine immediate release (IR) and extended release (ER), oxybutynin IR/ER, trospium, solifenacin, and fesoterodine. Bayesian mixed treatment comparisons (MTCs) were performed for efficacy (micturition, incontinence, UUI) and tolerability (dry mouth, constipation, blurred vision).Evidence synthesisOverall, 44 RCTs involving 27 309 patients were included. The MTCs showed that mirabegron 50 mg was as efficacious as antimuscarinics in reducing the frequency of micturition incontinence and UUI episodes, with the exception of solifenacin 10 mg that was more efficacious than mirabegron 50 mg in improving micturition frequency and frequency of UUI. Mirabegron 50 mg had an incidence of dry mouth similar to placebo and significantly lower than all included antimuscarinics.ConclusionsMirabegron 50 mg had similar efficacy to most antimuscarinics and lower incidence of dry mouth, the most common adverse event reported with antimuscarinics and one of the main causes of discontinuation of treatment. Despite being a powerful tool for evidence-based health care evaluation, the Bayesian MTC method has limitations. Further head-to-head comparisons between mirabegron and antimuscarinics should be conducted to confirm our results.     

Vibegron (RVT-901/MK-4618/KRP-114V) Administered Once Daily as Monotherapy or Concomitantly with Tolterodine in Patients with an Overactive Bladder: A Multicenter,Phase IIb,Randomized, Double-blind,Controlled Trial

Background

Antimuscarinics have shown modest efficacy with unwanted side effects in patients with overactive bladder (OAB). Efficacy of vibegron, a new β3-adrenergic receptor agonist, for OAB is unknown.

The Overlap of Interstitial Cystitis/Painful Bladder Syndrome and Overactive Bladder

Objective:

We evaluated the prevalence of positive potassium sensitivity and cystoscopy with hydrodistention findings in patients with overactive bladder.

Method:

This was a prospective cohort study of 98 patients who presented with overactive bladder symptoms. The diagnosis of overactive bladder is established by the presence of irritable voiding symptoms. All patients completed a PUF questionnaire and underwent potassium sensitivity testing. Eighty patients underwent urodynamic testing, and 42 patients underwent cystoscopic hydrodistention while under general anesthesia.

Results:

The Potassium Sensitivity Test was positive in 59 (60.2%) of the 98 patients, 37 (56%) of wet overactive bladder patients, and 22 (68.8%) of dry overactive bladder patients. Their mean PUF score was 7. Thirty-three (78.5%) of the patients who underwent cystoscopic hydrodistention had glomerulations consistent with NIH criteria for interstitial cystitis, and 26 of these patients tested positive for potassium sensitivity. Fifty-one (63.8%) of the patients who underwent urodynamics tested positive for potassium sensitivity.

Conclusion:

Many patients with symptoms of overactive bladder with little or no pain have cystoscopic evidence of interstitial cystitis and a positive Potassium Sensitivity Test. Therapies directed toward the uroepithelial dysfunction and neural upregulation associated with interstitial cystitis/painful bladder syndrome may be an important adjunct for patients who have failed or have had a partial response to anticholinergic therapy and behavior modification.     

联合应用托特罗定与多沙唑嗪治疗TURP术后膀胱过度活动症的临床疗效分析

目的 分析联合应用托特罗定与多沙唑嗪治疗TURP术后膀胱过度活动症的临床疗效.方法 80例行TURP的前列腺增生患者按就诊顺序随机分为4组,每组20例,自手术当日起分别单纯给予口服托特罗定、多沙唑嗪、安慰剂及托特罗定联合多沙唑嗪直至拔除导尿管后1周.于拔除尿管后第1天,第7天检测各组最大尿流率(Qmax),并通过调查问卷的形式,记录各组IPSS储尿期分数,以及各组平均每天发生的尿急次数,24小时排尿次数,夜尿次数及用药后不良反应.结果 拔除导尿管后第1天、第7天各组平均Qmax无显著性差异(P>0.05);拔除导尿管后第1天、第7天托特罗定联合多沙唑嗪组及托特罗定组平均IPSS储尿期分数、平均尿急次数、24小时排尿次数与安慰剂组相比均有明显改善(P<0.05);拔除导尿管后第7天托特罗定联合多沙唑嗪组平均夜尿次数与托特罗定组、安慰剂组相比有显著改善(P<0.05),各组不良反应均可耐受.结论 托特罗定联合多沙唑嗪对于治疗TURP术后的膀胱过度活动症临床疗效确切,其效果优于单独应用托特罗定,且治疗过程中无严重不良反应发生,是一种安全、有效的治疗方案.     

生物反馈／电刺激联合托特罗定治疗女性膀胱过度活动症

目的：评价生物反馈／电刺激联合托特罗定治疗女性膀胱过度活动症（OAB）的疗效。方法：60例女性OAB患者采用生物反馈／电刺激（20天）联合口服托特罗定（4周）进行治疗,结束后3个月评价疗效并追踪观察。结果：60例女性OAB患者中,治愈32例（53．3％）,有效22例（36．7％）,无效6例（10．0％）,总有效率达90％。54例获6个月追踪观察,无复发。结论：生物反馈／电刺激联合托特罗定是治疗女性OAB的一种有效方法。     

Comparison of Dry Mouth in Women Treated with Extended-Release Formulations of Oxybutynin or Tolterodine for Overactive Bladder

The incidence, severity and tolerability of dry mouth was compared in 790 women with overactive bladder who were treated with extended-release oxybutynin chloride 10 mg/day or extended-release tolterodine tartrate 4 mg/day for 12 weeks in a multicenter, double-blind, parallel-group study. Dry mouth was the most common adverse event associated with treatment, with an incidence rate of 28.1% in the oxybutynin group and 21.6% in the tolterodine group (P = 0.039). The majority of dry mouth events were mild in both treatment groups. Severe dry mouth occurred in 1.5% and 0.5% of patients in the oxybutynin and tolterodine groups, respectively (P = 0.173). Seven patients on extended-release oxybutynin and 4 patients on extended-release tolterodine discontinued treatment due to dry mouth (P = 0.380). The results of this analysis showed that dry mouth was common with both treatments, but most events were mild; there was no difference in the rate of severe dry mouth or in the rate of withdrawal due to dry mouth.     

Bladder Wall Thickness in Overactive Bladder: Does It Have a Role?

ContextOveractive bladder syndrome (OAB) is a highly prevalent condition. Urodynamics have long been the only option, and still remain the gold standard, for examining people with OAB complaints and composing an appropriate treatment plan. Alternatives for this invasive, expensive, and time-consuming examination have been explored.ObjectiveTo review if bladder wall thickness (BWT) could be a more objective and easier measurement that potentially could diagnose OAB and be used to analyse treatment response.Evidence acquisitionProposed and opposed arguments on the role of BWT in OAB were discussed during the seminar, “The Great Bladder Wall Thickness Debate: Tearing It Down Brick by Brick,” at the 2nd World Congress on Controversies in Urology (CURy) in Lisbon, Portugal. Those arguments are summarised in this paper.Evidence synthesisThe assessment of BWT (ie, the thickness of the mucosa layer, detrusor muscle, and adventitia) is an indirect measure of detrusor muscle thickness. There is no standard method of measuring BWT. In a Web-based survey conducted before the congress, 49% of the physicians who participated agreed that BWT has a role in OAB; at the end of the debate, the survey question was repeated to the participants of the session and only 20% agreed that BWT has a role in OAB in clinical practice today.ConclusionsAt the moment, there is no standardised method of measuring BWT. Assessing BWT with ultrasonography is a very appealing concept for research purposes, but more studies are needed before it will become a tool in daily clinical practice.     

托特罗定治疗女性膀胱过度活动症26例疗效分析

目的探讨女性膀胱过度活动症的治疗方法。方法回顾性分析采用托特罗定治疗26例女性膀胱过度活动症患者的临床资料,并结合文献复习。结果本组26例治疗6～8周后,获得随访21例。随访时间3～12个月,平均6.5个月。其中18/21例有效(85.7%),10/21例症状完全消失(47.6%),8/21症状明显好转(38.1%);3/21例无效(14.5%)。仅少数患者有轻微口干和排尿费力不适反应。结论初步观察,托特罗定是一种治疗女性膀胱过度活动症耐受性好、安全有效的药物。