ReviewDrug therapy of urinary urge incontinence: a systematic review
Section snippets
Sources
In October 1999, the medical databases MEDLINE (since 1966), EMBASE (since 1989), and Cochrane Controlled Trials Register were searched to identify all literature included under “urge incontinence,” “therapy,” and “prospective study.” The following criteria were used to select studies: article; original published English-language report; study design; placebo-controlled, double-blind, randomized clinical trial; population; patients with urge incontinence, confirmed by urodynamic assessment and
Study selection
We scanned all abstracts from the computer printouts and retrieved full-text reports and the references from each retrieved report to determine whether studies met the inclusion criteria.
All trials included were reviewed systematically to evaluate the quality of the trials and to determine the clinical homogeneity of the study populations. To evaluate the quality of each trial, we compared the following characteristics: randomization process, numbers of patients excluded after randomization,
Results
Forty-seven trials satisfying the selection criteria were identified, among them 24 trials evaluating anticholinergic drugs,9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 12 trials evaluating agents with anticholinergic and calcium antagonistic properties,16, 21, 22, 31, 32, 33, 34, 35, 36, 37, 38, 39 and 11 trials investigating alternative regimens.6, 7, 19, 40, 41, 42, 43, 44, 45, 46, 47 Because terodiline, an agent with anticholinergic and calcium
Conclusion
Urge incontinence is a common and troublesome problem considerably reducing the quality of life of affected individuals. Various drugs are currently available for the alleviation of signs and symptoms of the overactive bladder. Urge incontinence, however, remains a clinical challenge to treating physicians. Treatment of patients with urge incontinence continues to be unsatisfying in light of a lack of bladder-specific medications. Although considerable improvements are seen in patients on drug
References (49)
Drug therapy for urinary incontinence
Baillieres Best Pract Res Clin Obstet Gynaecol
(2000)- et al.
Doxepin in the treatment of female detrusor overactivityA randomized double-blind crossover study
J Urol
(1989) - et al.
Randomized, double-blind, multicenter trial on treatment of frequency, urgency and incontinence related to detrusor hyperactivityOxybutynin versus propantheline versus placebo
J Urol
(1991) - et al.
Clinical efficacy and safety of tolterodine compared to placebo in detrusor overactivity
J Urol
(1999) - et al.
The use of scopolamine in the treatment of detrusor instability
J Urol
(1996) - et al.
The effect of terodiline treatment in women with motor urge incontinence. Results from a double-blind study and long-term treatment
Am J Obstet Gynecol
(1985) - et al.
TerodilineA dose titrated, multicenter study of the treatment of idiopathic detrusor instability in women
J Urol
(1989) Discovery & development of selective M3 antagonists for clinical use
Life Sci
(1997)The standardisation of terminology of lower urinary tract function
Scand J Urol Nephrol
(1988)- et al.
Prevalence and risk factors for urinary incontinence in Italy
Eur Urol
(2000)
Surgical and medical treatment options for urge incontinence
J Am Osteopath Assoc
A double blind trial of bromocryptine in the treatment of idiopathic bladder instability
Br J Urol
Methods for combining randomized clinical trialsStrengths and limitations
Stat Med
The urodynamic and subjective results of treatment of detrusor instability with oxybutynin chloride
Br J Urol
Oxybutynin chloride for geriatric urinary dysfunctionA double-blind placebo-controlled study
Age Ageing
The treatment of detrusor instability in post-menopausal women with oxybutynin chlorideA double blind placebo controlled study
Br J Obstet Gynaecol
The treatment of detrusor instability in postmenopausal women with oxybutynin chlorideA double blind controlled study
Br J Obstet Gynaecol
Does oxybutynin add to the effectiveness of prompted voiding for urinary incontinence among nursing home residents? A placebo-controlled trial
J Am Geriatr Soc
Oxybutynin with bladder retraining for detrusor instability in elderly peopleA randomized controlled trial
Age Ageing
A placebo-controlled, multicentre study comparing the tolerability and efficacy of propiverine and oxybutynin in patients with urgency and urge incontinence
BJU Int
Tolterodine, a new antimuscarinic agentAs effective but better tolerated than oxybutynin in patients with an overactive bladder
Br J Urol
Urinary incontinence in old age. A controlled clinical trial of emepronium bromide
Br J Urol
Placebo—the drug of choice in female motor urge incontinence?
Br J Urol
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