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Antimuscarinic drugs in detrusor overactivity and the overactive bladder syndrome: motor or sensory actions?

Finney, Steven M. ; Andersson, Karl-Erik LU orcid ; Gillespie, James I. and Stewart, Laurence H. (2006) In BJU International 98(3). p.503-507
Abstract
Antimuscarinic drugs are generally thought to exert their therapeutic action on detrusor overactivity by reducing the ability of the detrusor muscle to contract. We review currently available published data to establish whether there is any evidence to support this contention. Using a PubMed data search, only 14 original articles (including two abstracts) were found that contained cystometric data for both filling and voiding phases and where the actions of antimuscarinic drugs have been reported in detail. These articles were separated into three groups dealing with neuropathic patients (three papers), patients with idiopathic overactive bladder (four papers) and a group whose aetiology was unclear (seven papers). Variables relating to... (More)
Antimuscarinic drugs are generally thought to exert their therapeutic action on detrusor overactivity by reducing the ability of the detrusor muscle to contract. We review currently available published data to establish whether there is any evidence to support this contention. Using a PubMed data search, only 14 original articles (including two abstracts) were found that contained cystometric data for both filling and voiding phases and where the actions of antimuscarinic drugs have been reported in detail. These articles were separated into three groups dealing with neuropathic patients (three papers), patients with idiopathic overactive bladder (four papers) and a group whose aetiology was unclear (seven papers). Variables relating to bladder function during the filling phase (time of first desire to void, time to first unstable contraction, and bladder capacity) were identified. Similarly, variables relating to voiding were identified and compared (e.g. maximum detrusor pressure and detrusor pressure at maximum flow rate). The antimuscarinic drugs have a clearly significant effect on sensations of urge, time to first sensation to void, maximum bladder capacity, decrease in voiding frequency and reduction in incontinence episodes. However, only one article (studying neuropaths) reported a significant reduction of the variables associated with detrusor contraction. The remaining four studies (idiopaths/not stated), reported no change in bladder contractility with antimuscarinic drugs. Thus the available data do not support the conclusion that antimuscarinic drugs at doses used in current clinical practice exert their therapeutic action by inhibiting detrusor contractility, but they suggest effects on variables associated with sensation. (Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
anticholinergic drugs, bladder overactivity, urinary urge
in
BJU International
volume
98
issue
3
pages
503 - 507
publisher
Wiley-Blackwell
external identifiers
  • pmid:16925744
  • wos:000240199500008
  • scopus:33746905087
ISSN
1464-4096
DOI
10.1111/j.1464-410X.2006.06258.x
language
English
LU publication?
yes
id
bbcc1123-f4b2-45a5-9686-4ef5fc0b8fc3 (old id 394844)
date added to LUP
2016-04-01 12:00:14
date last changed
2021-01-06 06:52:02
@article{bbcc1123-f4b2-45a5-9686-4ef5fc0b8fc3,
  abstract     = {Antimuscarinic drugs are generally thought to exert their therapeutic action on detrusor overactivity by reducing the ability of the detrusor muscle to contract. We review currently available published data to establish whether there is any evidence to support this contention. Using a PubMed data search, only 14 original articles (including two abstracts) were found that contained cystometric data for both filling and voiding phases and where the actions of antimuscarinic drugs have been reported in detail. These articles were separated into three groups dealing with neuropathic patients (three papers), patients with idiopathic overactive bladder (four papers) and a group whose aetiology was unclear (seven papers). Variables relating to bladder function during the filling phase (time of first desire to void, time to first unstable contraction, and bladder capacity) were identified. Similarly, variables relating to voiding were identified and compared (e.g. maximum detrusor pressure and detrusor pressure at maximum flow rate). The antimuscarinic drugs have a clearly significant effect on sensations of urge, time to first sensation to void, maximum bladder capacity, decrease in voiding frequency and reduction in incontinence episodes. However, only one article (studying neuropaths) reported a significant reduction of the variables associated with detrusor contraction. The remaining four studies (idiopaths/not stated), reported no change in bladder contractility with antimuscarinic drugs. Thus the available data do not support the conclusion that antimuscarinic drugs at doses used in current clinical practice exert their therapeutic action by inhibiting detrusor contractility, but they suggest effects on variables associated with sensation.},
  author       = {Finney, Steven M. and Andersson, Karl-Erik and Gillespie, James I. and Stewart, Laurence H.},
  issn         = {1464-4096},
  language     = {eng},
  number       = {3},
  pages        = {503--507},
  publisher    = {Wiley-Blackwell},
  series       = {BJU International},
  title        = {Antimuscarinic drugs in detrusor overactivity and the overactive bladder syndrome: motor or sensory actions?},
  url          = {http://dx.doi.org/10.1111/j.1464-410X.2006.06258.x},
  doi          = {10.1111/j.1464-410X.2006.06258.x},
  volume       = {98},
  year         = {2006},
}