ArticleInternational urology and nephrology2026
Long-term clinical efficacy and cognitive impact of medications for overactive bladder related to the central nervous system.
Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study evaluated the long-term clinical efficacy and cognitive impact of medications for central nervous system (CNS)-related overactive bladder (OAB).
methodsA retrospective cohort of 170 patients with cerebrovascular accident (CVA), dementia, or Parkinson's disease (PD) was analyzed between February 2019 and July 2024. Urinary symptoms were assessed with the Overactive Bladder Symptom Score (OABSS) and Urgency Severity Score (USS), and cognitive function with the Mini-Mental State Examination (MMSE). Outcomes were measured at baseline, 12, 24, and 36 months. OAB improvement was defined as a ≥ 3-point reduction in OABSS. A decline of more than 3 points in the MMSE score indicated cognitive deterioration.
resultsBaseline characteristics differed significantly among subgroups; dementia patients were older, more often female, and had lower MMSE scores. Medication discontinuation was higher in dementia (69.8%) and PD (62.5%) compared with CVA (40%, p = 0.002). Symptom improvement (12.4%) and global response assessment (GRA) scores at one year were modest and similar among groups. Severe cognitive impairment was associated with higher discontinuation, poorer symptom improvement (5.9%), lower GRA scores, and greater cognitive decline (25%, p = 0.049). Among medications, solifenacin showed the highest discontinuation (77.8%, p = 0.002), whereas tolterodine SR had the lowest (36.4%). Cognitive function remained generally stable across medications, but patients with cognitive deterioration had worse urinary outcomes and GRA scores.
conclusionsOAB medication efficacy was comparable across medication types, but tolerability varied significantly, with the dementia, PD and solifenacin groups showing higher discontinuation rates. Cognitive impairment significantly influenced treatment outcomes, underscoring the need for tailored therapeutic strategies and regular cognitive assessments to optimise treatment effectiveness and maintain quality of life in patients with CNS-related OAB.
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