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• W2079785628 abstract "No AccessJournal of UrologyInternational Children's Continence Society1 Oct 2009Double Anticholinergic Therapy for Refractory Overactive Bladder Stéphane Bolduc, Katherine Moore, Sylvie Lebel, Pascale Lamontagne, and Micheline Hamel Stéphane BolducStéphane Bolduc More articles by this author , Katherine MooreKatherine Moore More articles by this author , Sylvie LebelSylvie Lebel More articles by this author , Pascale LamontagnePascale Lamontagne More articles by this author , and Micheline HamelMicheline Hamel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2009.05.099AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Using 2 anticholinergic medications simultaneously (10 to 30 mg oxybutynin, 4 mg tolterodine and/or 5 to 10 mg solifenacin) we optimized the medical therapy for children in whom single agent anticholinergic therapy failed. We evaluated efficacy, tolerability and safety. Materials and Methods: Children with refractory overactive bladder and incontinence were included in a prospective, open label protocol. Study inclusion criteria were persistent symptoms on medical and behavioral therapy, absence of correctable neurological anomalies, and partial clinical and urodynamic responses on an optimal dose of 1 well tolerated, long acting anticholinergic. Patients were followed prospectively every 3 months. The primary end point was efficacy for continence and the secondary end points were tolerability and safety. Results: We enrolled 14 girls and 19 boys in the study, and followed 19 patients with neurogenic bladder and 14 with overactive bladder a minimum of 3 months. Mean age at enrollment was 12 years and double medication was given for a mean of 16 months (range 3 to 42). Mean ± SD urodynamic capacity improved from 192 ± 92 to 380 ± 144 ml, no deterioration in compliance was noted and maximal contraction pressure decreased from 77 ± 27 to 18 ± 15 cm H2O. Continence improved in all patients, of whom 17 were dry, and 14 and 2 were significantly and moderately improved, respectively. No, mild and moderate side effects were reported by 12, 16 and 5 patients, respectively. In 3 of the 17 patients who voided greater than 20% post-void residual urine developed. Blood tests and electrocardiogram remained normal. Conclusions: In children with refractory overactive bladder double anticholinergic therapy is an efficient and serious alternative to surgery. Patients and families were satisfied with this nonoperative, innovative approach. References 1 : Clinical pharmacokinetics of drugs used to treat urge incontinence. Clin Pharmacokinet2003; 42: 1243. 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J Pediatr Urol2008; 4: 381. Google Scholar 16 : Long-term followup of augmentation enterocystoplasty and continent diversion in patients with benign disease. J Urol2005; 173: 1631. Link, Google Scholar 17 : Intravesical oxybutynin for children with poorly compliant neurogenic bladder: a systematic review. J Urol2008; 180: 1091. Link, Google Scholar 18 : Effective treatment of neurogenic detrusor dysfunction by combined high-dosed antimuscarinics without increased side-effects. Eur Urol2008; 53: 1021. Google Scholar 19 : Safety of anticholinergics in patients with benign prostatic hyperplasia. Expert Opin Drug Saf2008; 7: 473. Google Scholar Division of Urology, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Québec, Canada© 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited byMorin F, Blais A, Nadeau G, Moore K, Genois L and Bolduc S (2018) Dual Therapy for Refractory Overactive Bladder in Children: A Prospective Open-Label StudyJournal of Urology, VOL. 197, NO. 4, (1158-1163), Online publication date: 1-Apr-2017.Wyndaele J (2018) ProJournal of Urology, VOL. 187, NO. 6, (1962-1963), Online publication date: 1-Jun-2012. Volume 182Issue 4SOctober 2009Page: 2033-2039 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordscholinergic antagonistscombinationoveractivedrug therapyurinary bladdertolterodineoxybutyninMetricsAuthor Information Stéphane Bolduc More articles by this author Katherine Moore More articles by this author Sylvie Lebel More articles by this author Pascale Lamontagne More articles by this author Micheline Hamel More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2079785628 title "Double Anticholinergic Therapy for Refractory Overactive Bladder" @default.
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