Do patient characteristics predict responsiveness to treatment of overactive bladder with antimuscarinic agents? Time to onset of improvement in symptoms of overactive bladder using antimuscarinic treatment Transcutaneous posterior tibial nerve stimulation for treatment of the overactive bladder syndrome in multiple sclerosis: results of a multicenter prospective study. Impact of a health education intervention in overactive bladder patients. Role of percutaneous posterior tibial nerve stimulation either alone or combined with an anticholinergic agent in treating patients with overactive bladder. Do oral antimuscarinic drugs carry an increased risk of acute urinary retention? Is there a synergistic effect of topical oestrogens when administered with antimuscarinics in the treatment of symptomatic detrusor overactivity? Randomized, double‐blind, placebo‐ and propiverine‐controlled trial of the once‐daily antimuscarinic agent solifenacin in Japanese patients with overactive bladder OnabotulinumtoxinA 100U provides significant improvements in overactive bladder symptoms in patients with urinary incontinence regardless of the number of anticholinergic therapies used or reason for inadequate management of overactive bladder Posterior tibial nerve stimulation for treating neurologic bladder in women: a randomized clinical trial. Transcutaneous posterior tibial nerve stimulation: evaluation of a therapeutic option in the management of anticholinergic refractory overactive bladder [Posterior tibial nerve stimulation in the management of overactive bladder: a prospective and controlled study]. 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. Effect of bothersome overactive bladder symptoms on health-related quality of life, anxiety, depression, and treatment seeking in the United States: results from EpiLUTS. OnabotulinumtoxinA for the Treatment of Patients with Overactive Bladder and Urinary Incontinence: Results of a Phase 3, Randomized, Placebo Controlled Trial OnabotulinumtoxinA for the treatment of patients with overactive bladder and urinary incontinence: results of a phase 3, randomized, placebo controlled trial. Percutaneous tibial nerve stimulation in the treatment of refractory overactive bladder syndrome: is maintenance treatment necessary?
OBJECTIVE To determine clinical and demographic characteristics associated with antimuscarinic treatment response using a regression model . METHODS Adults with overactive bladder ( OAB ) symptoms for > 3 months and ≥ 1 urgency urinary incontinence ( UUI ) episode and ≥ 8 micturitions per 24 hours at baseline were r and omized to fesoterodine ( 8 mg ) , tolterodine extended-release ( 4 mg ) , or placebo in two 12-week , double-blind , head-to-head studies . Fesoterodine-treated patients received 4 mg/d during the first week and 8 mg/d thereafter . Patients completed 3-day bladder diaries and the Overactive Bladder Question naire at baseline and week 12 . Pooled data for changes from baseline to week 12 in winsorized UUI episodes , micturitions , and urgency episodes per 24 hours and Overactive Bladder Question naire Symptom Bother and health-related quality of life scores were analyzed posthoc using a regression model that selects outcome predictors from baseline values and patient characteristics while retaining baseline values and treatment , with stepwise inclusion of significant covariates and assessment of treatment interactions . Logistic regression was used for analysis of diary-dry rates . RESULTS Younger age , lack of previous antimuscarinic treatment , shorter duration of OAB diagnosis , and female gender were common predictors of larger changes in outcomes from baseline to week 12 . Baseline measures often interacted with treatment , such that poorer baseline outcomes were predictive of larger treatment differences . Longer duration since OAB diagnosis predicted greater treatment differences for UUI episodes and in diary-dry rate , and increased age predicted greater treatment differences for micturitions . CONCLUSION Symptom severity and duration , age , gender , and previous antimuscarinic pharmacotherapy impact the response to antimuscarinic treatment To evaluate the time to onset of statistically significant and clinical ly meaningful effects of trospium chloride in patients with an overactive bladder ( OAB ) AIMS Electrostimulation is an established therapeutic option for neurogenic urinary disorders . The aim of this study was to investigate the efficacy of the noninvasive technique of transcutaneous posterior tibial nerve stimulation ( TPTNS ) in patients with multiple sclerosis ( MS ) and troublesome symptoms of an overactive bladder ( OAB ) . METHODS A multicentric study enrolled 70 MS patients , suffering from OAB for a 3-month study period . INTERVENTION Daily sessions of 20 min of TPTNS were provided . No change of associated treatments during the study period . The primary outcome measurement was Urgency and Frequency reported by bladder diary and symptom score performed before the treatment ( Day 0 , D0 ) and at D30 and D90 . The secondary outcomes measurements were continence , symptom score , quality of life , psychosocial burden at DO , D30 , and D90 and cystometry at baseline , with and without TPTNS and at D90 . RESULTS Clinical improvement of OAB was shown in 82.6 % and 83.3 % of the patients on D30 and D90 , respectively , with significant improvement of primary and secondary outcomes compared to baseline . The initial acute cystometric response to TPTNS was positive in 51.2 % of the patients ( increase of > 30 % of cystometric capacity and /or reflex volume ) , without correlation with TPTNS clinical efficiency . The procedure was well tolerated . CONCLUSIONS Chronic TPTNS appears to be effective in the management of severe OAB in MS , without compromising bladder emptying or inducing side effect . Treatment may be effective even in the absence of an acute cystometric effect . Additional works are required to demonstrate long-term efficacy of TPTNS OBJECTIVE To assess a st and ardized and simple educational intervention in overactive bladder ( OAB ) patients to improve compliance with anticholinergic medication , increase the use of concomitant behavioral treatments , and improve patients ' perception of bladder symptoms . MATERIAL S AND METHODS This is a 16-week open-label r and omized trial of tolterodine combined with an education intervention for the experimental group versus tolterodine alone ( no intervention ) for the control group . The setting was in family medicine and urology clinics in Ontario . The participants were male and female adults with OAB symptoms . Both groups received tolterodine prescriptions . The intervention patients received printed information and an explanation about OAB , medication use , and behavioral treatments ( kegel exercise , bladder stretching , fluid regulation ) . The primary outcomes were medication compliance and persistence at 16 weeks . Secondary outcomes were use of behavioral treatments and self-reported severity of symptoms . RESULTS More patients in the intervention group ( experimental ) purchased their prescriptions ( p<0.05 ) . Compliance rate was greater for the intervention group ( 39 % ) , versus the control group ( 31 % ) at 16 weeks although the difference was not significant ( p>0.05 ) . Significantly more patients started and /or continued non-drug treatments in the intervention group ( 82 % ) compared to the control group ( 53 % ) ( p<0.05 ) . Furthermore , more patients in this group reported improvement in severity of bladder symptoms ( p<0.05 ) . CONCLUSIONS The simple education intervention result ed in a greater , but not significant , increase in compliance with medication compared to the control group . It also result ed in a significantly increased use of behavior modification therapies and better self-perception of treatment outcome OBJECTIVE To evaluate the efficacy of percutaneous tibial nerve stimulation ( PTNS ) , either alone or combined with an anticholinergic agent , in treating patients with an overactive bladder ( OAB ) in whom previous conservative treatment failed . MATERIAL AND METHODS In this study , we included a total of 30 female patients with OAB in whom all conventional therapies failed between January 2010 and April 2011 . Patients were r and omly divided into three groups : Group 1 , PTNS group ; Group 2 , patients receiving an anticholinergic agent ; and Group 3 , patients receiving both PTNS and anticholinergic agent . PTNS treatment continued for 12 weeks with each session lasting 30 min . RESULTS All parameters of the bladder diary significantly improved in all groups ( p<0.05 ) . Similarly , all scores measured by question naires ( UDI-6 , IIQ-7 , and OABSS ) revealed significant improvements in all groups . When the improvements in symptoms were compared among the groups , there was a statistically significantly higher improvement in groups 1 and 3 than in Group 2 . CONCLUSION PTNS is a safe , simple , and minimally invasive treatment modality in patients with OAB , and it may be suggested either alone or in combination with anticholinergics when conventional treatments fail PURPOSE We determined whether men treated with oral antimuscarinics  are at increased risk for acute urinary retention . MATERIAL S AND METHODS In this population based , retrospective cohort study using a nested case-control design we analyzed data from a large primary care data base containing patient information entered by general practitioners in the United Kingdom . Our study cohort comprised men 20 to 84 years old . Cases of acute urinary retention were identified by review ing diagnostic codes and were confirmed in a r and om sample through question naires sent to the treating physician . RESULTS The overall incidence of acute urinary retention in the study cohort ( 1,844 ) was 1.0 per 1,000 person-years , with the incidence rate increasing with age . The first 30 days ( early treatment ) of antimuscarinic use was associated with a relative risk of acute urinary retention of 8.3 ( 95 % CI 4.8 - 14.2 ) and with longer term use ( more than 30 days ) the relative risk was 2.0 ( 95 % CI 1.2 - 3.1 ) . The relative risk of acute urinary retention was similar for low/medium and high antimuscarinic doses ( relative risk 2.8 vs 3.0 , 95 % CI 2.1 - 3.8 and 1.3 - 6.8 , respectively ) . The relative risk of acute urinary retention was highest during early treatment for a urogenital indication ( relative risk 14.2 , 95 % CI 6.8 - 29.6 ) . The risk of acute urinary retention was not increased when antimuscarinics were used as antispasmodics or for drug induced parkinsonism . CONCLUSIONS Men prescribed antimuscarinics  , particularly for a urogenital condition , should be closely monitored during the first 30 days of treatment for signs or symptoms of urinary retention BACKGROUND No authors have investigated whether the administration of local oestrogens in addition to antimuscarinics could have a synergistic effect in the therapy of overactive bladder ( OAB ) . OBJECTIVES To compare the efficacy of antimuscarinics alone versus antimuscarinics in combination with local oestrogens for OAB ; to verify whether risk factors for lower antimuscarinic efficacy can be overcome by the concomitant use of local oestrogens . DESIGN , SETTING , AND PARTICIPANTS Some 229 postmenopausal women with symptomatic urodynamically proven detrusor overactivity were prospect ively enrolled at a tertiary level urogynaecology centre and divided into two groups . INTERVENTION Women in group 1 ( n=129 ) were prescribed tolterodine extended release ( ER ) 4 mg once daily ; women in group 2 ( n=100 ) were prescribed both tolterodine ER 4 mg and concomitant oestriol cream application once daily . MEASUREMENTS All women underwent clinical evaluation and urodynamics in accordance with the Good Urodynamic Practice s Guidelines . After 12 wk of treatment the two groups were compared in terms of subjective efficacy for OAB symptom improvement using a three-point scale . Nonresponders were compared to the patients who improved or were cured in order to identify risk factors for resistance to therapy . RESULTS AND LIMITATIONS There was no significant difference between the two groups in terms of efficacy of therapy : 80.6 % in group 1 versus 82 % in group 2 ( p=0.86 ) . Patients with urodynamically proven detrusor overactivity ( DO ) occurring during provocative manoeuvres and patients with coital incontinence during orgasm reported a higher failure rate both in the overall study population and in group 2 . A possible limitation of the study is the nonr and omised design . CONCLUSIONS No synergistic effect of local oestrogens and antimuscarinics in the treatment of OAB was found . Antimuscarinic treatment has lower cure rates in women with symptomatic DO complaining of incontinence at orgasm or in patients with DO following provocative manoeuvres . The association of local oestrogens does not influence the role of the two mentioned risk factors To compare solifenacin succinate ( 5 and 10 mg once‐daily ) to placebo and propiverine hydrochloride ( 20 mg once‐daily ) , respectively , in Japanese patients with overactive bladder syndrome ( OAB ) Introduction A prespecified pooled analysis of two placebo-controlled , phase 3 trials evaluated whether the number of prior anticholinergics used or reason for their discontinuation affected the treatment response to onabotulinumtoxinA 100U in overactive bladder ( OAB ) patients with urinary incontinence ( UI ) . Methods Patients with symptoms of OAB received intradetrusor injections of onabotulinumtoxinA 100U or placebo , sparing the trigone . Change from baseline at week 12 in UI episodes/day , proportion of patients reporting a positive response ( ‘ greatly improved ’ or ‘ improved ’ ) on the treatment benefit scale ( TBS ) , micturition and urgency were evaluated by number of prior anticholinergics ( 1 , 2 or ≥ 3 ) and reason for their discontinuation ( insufficient efficacy or side effects ) . Adverse events ( AE ) were assessed . Results Patients had taken an average of 2.4 anticholinergics before study enrolment . OnabotulinumtoxinA reduced UI episodes/day from baseline vs. placebo , regardless of the number of prior anticholinergics ( −2.82 vs. −1.52 for one prior anticholinergic ; −2.58 vs. −0.58 for two prior anticholinergics ; and −2.92 vs. −0.73 for three or more prior anticholinergics ; all p < 0.001 ) . The proportion of TBS responders was higher with onabotulinumtoxinA vs. placebo ( 69.0 % vs. 37.2 % for one prior anticholinergic ; 58.8 % vs. 24.8 % for two prior anticholinergics and 56.4 % vs. 22.5 % for three or more prior anticholinergics ; all p < 0.001 ) . Similar results were observed regardless of the reason for discontinuation . OnabotulinumtoxinA reduced the episodes of urgency and frequency of micturition vs. placebo in all groups . AEs were well tolerated , with a comparable incidence in all groups . Conclusion In patients with symptoms of OAB who were inadequately managed by one or more anticholinergics , onabotulinumtoxinA 100U provided significant and similar treatment benefit and safety profile regardless of the number of prior anticholinergics used or reason for inadequate management of OAB . Clinical Trials.gov : NCT00910845 , NCT00910520 Overactive bladder ( OAB ) is a disabling disorder . Treatment of cases with OAB includes behavioral , pharmacological , surgical interventions and peripheral electrical stimulation . The goal of this study was to determine effects of posterior tibial nerve stimulation on sexual function and pelvic disorders in women with Overactive bladder ( OAB ) . Fifty women were r and omly assigned to PTNS ( posterior tibial nerve stimulation ) plus tolterodine or tolterodine alone treatment . Tolterodine group received 4 mg tolterodine daily for three months while the other group received this treatment plus percutaneous tibial nerve stimulation for 12 consequence weeks . Two in PTNS group and 8 in the control group withdrew from the study . Age , education level , and occupation status were not significantly different between two groups . Mean total FSFI and its subscales were not significantly different before and after treatment between two groups . Urine leakage associated with a feeling of urgency and loss of stool or gas from the rectum beyond patient 's control became significantly different after treatment between two groups . Posterior tibial nerve stimulation could help urinary problems in women with a neurologic bladder Introduction and hypothesisThis study evaluated the efficacy and tolerability of transcutaneous posterior tibial nerve stimulation ( TPTNS ) in the treatment of overactive bladder ( OAB ) after failure of a first-line anticholinergic treatment . Material s and methods We performed a prospect i ve observational study and included all patients treated in a single center for OAB persisting after first-line anticholinergic treatment from November 2010 to May 2013 . The protocol consisted of daily stimulation at home . The efficacy end point was defined as improvement on the Urinary Symptom Profile ( USP ) and the French-vali date d urinary symptom score Mesure du H and icap Urinaire ( MHU ) . Results We assessed 43 consecutive patients . TPTNS was successful following 1 month of treatment in 23 ( 53 % ) patients . Bladder capacity was the only predictive factor for treatment success ( p = 0.044 ) . For patients who showed improved symptoms ( n = 23 ; 53 % ) , mean MHU and USP decreased significantly , from 11.8 ± 2.8 to 5.6 ± 3 ( p < 0.001 ) and from 14 ± 3.3 to 6.9 ± 3.2 ( p < 0.001 ) , respectively . After a mean follow-up of 10.8 ± 1.6 months , 21 ( 49 % ) patients continued the TPTNS . Mean MHU and USP scores were 4.4 ± 2.8 and 5.4 ± 3.5 , respectively , and stayed lower than baseline ( p < 0.001 ) . Patients reported no adverse events . Conclusion TPTNS is well tolerated and is effective in one half of the patients studied after they failed anticholinergic treatment . TPTNS could become a second therapeutic option before surgical treatment in the management strategy of OAB UNLABELLED The aim of this study was to evaluate the efficacy of the Posterior Tibial Nerve stimulation in women with overactivity bladder symptoms and the impact in the quality of life using the Overactivity Bladder Question naire ( OABq ) . METHODS thirty seven women from female urology outpatient clinic of the Hospital das Clinicas de Campinas ( HC/UNICAMP ) were enrolled in this prospect i ve , controlled and r and omized clinical trial . The patients were r and omly placed in one of two groups : TREATMENT GROUP : patients were su bmi tted to tibial posterior nerve electrical stimulation ( n=21 ) and Sham group : patients had electrodes placed without electricity ( n = 16 ) . After informed consent the patients underwent a physiotherapeutic evaluation , that included voiding diary and the overactivity bladder question naire ( OABq ) . The treatment schedule included eight sessions of electrical stimulation in the posterior tibial nerve , twice a week . RESULTS there were significant changes in symptoms such as frequency and nocturia ( p=0,003 and p=0,001 ) . The urgency and quality of life was improved in both group after treatment . CONCLUSION The posterior tibial nerve electrical stimulation is an effective treatment in overactive bladder 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 , r and omised , 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 100U 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 Question naire [ KHQ ] ) . Safety assessment s 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 ) . Clinical ly 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 clinical ly relevant improvements in all OAB symptoms , patient-reported benefit , and HRQOL in patients inadequately managed by anticholinergics . TRIAL REGISTRATION Clinical Trials.gov : NCT00910520 OBJECTIVE To determine the bother associated with overactive bladder ( OAB ) symptoms and its influence on health-related quality of life ( HRQL ) , anxiety , depression , and treatment seeking in adults in the United States . METHODS Data from U.S. respondents aged ≥ 40 years participating in the Epidemiology of Lower Urinary Tract Symptoms survey , a population -based , cross-sectional Internet survey , were analyzed to assess OAB prevalence , OAB-associated bother , and effect of OAB on HRQL , anxiety , depression , and healthcare use . Likert data were categorized as no/minimal OAB symptoms , OAB without bother , and OAB with bother at least " somewhat . " RESULTS Of 31 588 completed surveys , 20 000 participants ( 9416 men and 10 584 women ) were r and omly selected and matched to U.S. census demographics . Of the respondents with OAB at least " sometimes , " the women were more likely than the men to be bothered by OAB , with 68 % of the women and 60 % of the men bothered at least " somewhat . " Men and women with OAB with bother were more likely to report that their bladder condition caused at least some problems ; had worse scores on HRQL , anxiety , and depression assessment s ; and had the greatest number of healthcare visits annually compared with those with OAB without bother and those with no/minimal symptoms . The strongest correlation between bother and symptom frequency was seen for urinary urgency , followed by urgency urinary incontinence and nocturia . CONCLUSION OAB symptoms can be quite bothersome , especially for women , and can negatively affect HRQL , increase anxiety and depression , and increase healthcare usage . In the present study , the strongest predictor of OAB-associated bother was urinary urgency Purpose : Overactive bladder affects 12 % to 17 % of the general population and almost a third experience urinary incontinence , which may severely impact health related quality of life . Oral anticholinergics are the mainstay of pharmacological treatment but they are limited by inadequate efficacy or side effects , leading to a high discontinuation rate . We report the results of the first large ( 557 patients ) , phase 3 , placebo controlled trial of onabotulinumtoxinA in patients with overactive bladder and urinary incontinence inadequately managed with anticholinergics . Material s and Methods : Eligible patients with overactive bladder , 3 or more urgency urinary incontinence episodes in 3 days and 8 or more micturitions per day were r and omized 1:1 to receive intradetrusor injection of onabotulinumtoxinA 100 U or placebo . Co‐ primary end points were the change from baseline in the number of urinary incontinence episodes per day and the proportion of patients with a positive response on the treatment benefit scale at posttreatment week 12 . Secondary end points included other overactive bladder symptoms and health related quality of life . Adverse events were assessed . Results : OnabotulinumtoxinA significantly decreased the daily frequency of urinary incontinence episodes  vs placebo ( −2.65 vs −0.87 , p < 0.001 ) and 22.9 % vs 6.5 % of patients became completely continent . A larger proportion of onabotulinumtoxinA than placebo treated patients reported a positive response on the treatment benefit scale ( 60.8 % vs 29.2 % , p < 0.001 ) . All other overactive bladder symptoms improved vs placebo ( p ≤0.05 ) . OnabotulinumtoxinA improved patient health related quality of life across multiple measures ( p < 0.001 ) . Uncomplicated urinary tract infection was the most common adverse event . A 5.4 % rate of urinary retention was observed . Conclusions : OnabotulinumtoxinA 100 U showed significant , clinical ly relevant improvement in all overactive bladder symptoms and health related quality of life in patients inadequately treated with anticholinergics and was well tolerated PURPOSE Overactive bladder affects 12 % to 17 % of the general population and almost a third experience urinary incontinence , which may severely impact health related quality of life . Oral anticholinergics are the mainstay of pharmacological treatment but they are limited by inadequate efficacy or side effects , leading to a high discontinuation rate . We report the results of the first large ( 557 patients ) , phase 3 , placebo controlled trial of onabotulinumtoxinA in patients with overactive bladder and urinary incontinence inadequately managed with anticholinergics . MATERIAL S AND METHODS Eligible patients with overactive bladder , 3 or more urgency urinary incontinence episodes in 3 days and 8 or more micturitions per day were r and omized 1:1 to receive intradetrusor injection of onabotulinumtoxinA 100 U or placebo . Co- primary end points were the change from baseline in the number of urinary incontinence episodes per day and the proportion of patients with a positive response on the treatment benefit scale at posttreatment week 12 . Secondary end points included other overactive bladder symptoms and health related quality of life . Adverse events were assessed . RESULTS OnabotulinumtoxinA significantly decreased the daily frequency of urinary incontinence episodes vs placebo ( -2.65 vs -0.87 , p < 0.001 ) and 22.9 % vs 6.5 % of patients became completely continent . A larger proportion of onabotulinumtoxinA than placebo treated patients reported a positive response on the treatment benefit scale ( 60.8 % vs 29.2 % , p < 0.001 ) . All other overactive bladder symptoms improved vs placebo ( p ≤ 0.05 ) . OnabotulinumtoxinA improved patient health related quality of life across multiple measures ( p < 0.001 ) . Uncomplicated urinary tract infection was the most common adverse event . A 5.4 % rate of urinary retention was observed . CONCLUSIONS OnabotulinumtoxinA 100 U showed significant , clinical ly relevant improvement in all overactive bladder symptoms and health related quality of life in patients inadequately treated with anticholinergics and was well tolerated To determine the effect of a pause in percutaneous tibial nerve stimulation ( PTNS ) in successfully treated patients with an overactive bladder ( OAB ) , and the reproducibility of successful treatment when restored
Data from 12-week , r and omised , double-blind , placebo-controlled trials of tolterodine extended release ( ER ) , oxybutynin and solifenacin show that combined antimuscarinic+α-blocker treatment is generally more effective than monotherapy or placebo in men with OAB symptoms .
The efficacy and safety  of tolterodine ER+α-blocker treatment was not affected by prostate size or prostate-specific antigen ( PSA ) level .
In men meeting entry criteria for OAB and benign prostatic obstruction trials  , tolterodine ER alone was effective selectively in men with prostate size or PSA level below study medians .
Post hoc analyses from double-blind , placebo-controlled trials and prospect i ve studies of fesoterodine , oxybutynin , propiverine , solifenacin and tolterodine also suggest that antimuscarinics are generally safe and efficacious in men .
A retrospective data base study found that risk of AUR in men was the highest in the first month of treatment and decreased considerably thereafter .
Antimuscarinics , alone or with an α-blocker , appear to be efficacious and safe in many men with predominant OAB symptoms or persistent OAB symptoms despite α-blocker or 5-α-reductase inhibitor treatment .
Despite potential benefits , primary care clinicians may avoid using antimuscarinics in men with overactive bladder ( OAB ) symptoms because of safety concerns .