ArticleCanadian Urological Association journal = Journal de l'Association des urologues du Canada2014
Double anticholinergic therapy for refractory neurogenic and nonneurogenic detrusor overactivity in children: Long-term results of a prospective open-label study.
Article in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- A randomized, controlled trial of transcutaneous tibial nerve stimulation to treat overactive bladder and neurogenic bladder patients.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2020Article
- Effects of Dietary Vitamin E Supplementation in Bladder Function and Spasticity during Spinal Cord Injury.Brain sciences · 2018Article
- Pharmacotherapy for Pediatric Neurogenic Bladder.Paediatric drugs · 2017Review
- Recent advances in pharmacological management of urinary incontinence.F1000Research · 2017Review
- Early Fesoterodine Fumarate Administration Prevents Neurogenic Detrusor Overactivity in a Spinal Cord Transected Rat Model.PloS one · 2017Article
- Refractory overactive bladder: a common problem?International urogynecology journal · 2015Review
- Opening the door to new therapeutic options with open label studies for children with detrusor overactivity.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2014Article
- Neuropathic bladders: Investigation and treatment through their lifetime.Canadian Urological Association journal = Journal de l'Association des urologues du CanadaReview
- Overactive bladder in children.Canadian Urological Association journal = Journal de l'Association des urologues du CanadaReview
- Management of neurogenic bladder dysfunction in children update and recommendations on medical treatment.International braz j urol : official journal of the Brazilian Society of UrologyReview
Corrections and comments
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Authors and funding
8 authors.
Funding
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Abstract
introductionIn this study, we optimize pharmacotherapy in children who failed anticholinergic monotherapy by simultaneous administration of 2 anticholinergics (oxybutynin and/or tolterodine and/or solifenacin).
methodsThis report is an update of our previously published study on double anticholinergic regimen in children with refractory incontinence due to neurogenic (NDO) and non-neurogenic (DO) detrusor overactivity. Patients with an insufficient response (clinically/urodynamically) to an optimized dose of a single anticholinergic (oxybutynin or tolterodine) received a second anticholinergic (tolterodine or solifenacin), in addition to the pre-existing medication. The primary end-point was efficacy (continence) and the secondary end-points were tolerability and safety. The Patient Perception of Bladder Condition (PPBC) scale was used to rate subjective improvement of patients.
resultsIn total, 56 patients with DO (n = 31) or NDO (n = 25) were enrolled at a mean age of 11.4 ± 3.5 years and were followed for a minimum of 3 months. The duration of double treatment was 36 ± 23 months. Our results found that 23 patients became dry, 18 improved significantly and 15 improved moderately. Urodynamic capacity improved from 158 ± 87 mL to 359 ± 148 mL and maximal pressure of contractions decreased from 76 ± 24 to 22 ± 22 cmH2O (p < 0.0001). The overall success rate was 82%, since 10 patients discontinued treatment for unsatisfactory clinical response or bothersome side effects. No side effects were reported by 28 patients, mild side effects by 20, moderate side effects by 8; 2 patients withdrew from the study due to their side effects. Of the 35 patients who voided spontaneously, 8 developed post-void residuals (>20%).
conclusionsWith a larger cohort and prospective follow-up, we reiterated that double anticholinergic regimen in children with DO or NDO refractory to anticholinergic monotherapy is a feasible and efficient approach.
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