Maintenance of the Therapeutic Effect of Two High-Dosage Antimuscarinics in the Management of Overactive Bladder in Elderly Women
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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 А (59 women), trospium (60 mg/day) + solifenacin (40 mg/day) for 1 month; group В (51 women), electrical stimulation of the detrusor muscle for 1 month; group С (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.
Abstract
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 А (59 women), trospium (60 mg/day) + solifenacin (40 mg/day) for 1 month; group В (51 women), electrical stimulation of the detrusor muscle for 1 month; group С (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.
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