PURPOSE: To improve the long-term efficiency of the pharmacologic management of overactive bladder (OAB) in elderly women.
METHODS: The study comprised 229 women (mean age, 66.3 years; range, 65-77 years) with urodynamically and clinically confirmed OAB. All patients received the most effective treatment regimen based on the data obtained in the initial part of the study (trospium 60 mg/day + solifenacin 40 mg/day, for 6 weeks), and positive results similar to those in the first phase were obtained. They were then divided into four groups, based on the maintenance therapy: group A (59 women), trospium (60 mg/day) + solifenacin (40 mg/day) for 1 month; group B (51 women), electrical stimulation of the detrusor muscle for 1 month; group C (63 women), laser puncture for 1 month; group D (56 women), placebo. Maintenance therapy was administered 2.5 months after completion of primary treatment. The patients' condition was monitored through the OAB questionnaire for 1 year and by urodynamic examination at months 6 and 7 from the start of the study.
RESULTS: In group A, the clinical and urodynamic results achieved after the initial + main treatment phase (two high-dosage antimuscarinics of different generations, trospium and solifenacin, for a total of 2.5 months) were maintained for at least 7 months. Electrical stimulation of the urinary bladder as a method of maintenance therapy proved to be less effective. In groups C and D, deterioration in results was observed at 6-8 months, which led us to conclude that laser puncture was an inefficient method of maintenance therapy in elderly women with OAB.
CONCLUSIONS: Maintenance treatment of OAB in elderly women with a combination of high-dosage antimuscarinics is an effective method for reducing the risk of recurrence of the disease.
Written by:
Kosilov K, Loparev S, Ivanovskaya M, Kosilova L. Are you the author?
Far Eastern Federal University, Vladivostok, Russia; Department of Urology, City Polyclinic No. 3, Vladivostok, Russia; Far Eastern State University of Fishing, Vladivostok, Russia; Medical Alliance No. 2, Vladivostok, Russia.
Reference: Int Neurourol J. 2013 Dec;17(4):191-6.
doi: 10.5213/inj.2013.17.4.191
PubMed Abstract
PMID: 24466467
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