Intravesically administered ketoprofen in treatment of detrusor instability: cross-over study.
OBJECTIVE
To evaluate the therapeutic efficacy of intravesically administered ketoprofen in patients with urodynamically verified detrusor instability.


METHODS
This double-blind randomized placebo-controlled cross-over study included 30 patients with urodynamically verified detrusor instability. Their mean age was 44+/-3.6 years (range 37-49) and the median of the parity was 2 years (1-3). The mean duration of symptoms was 18.3+/-3.1 months (range 14-23). After a 6-week screening, patients were randomized to receive ketoprofen or placebo once a day for 4 weeks. Out of 30 patients, 16 started with ketoprofen, and 14 received placebo. After a week of washing period, 16 patients received placebo, and 14 received ketoprofen. The solution for intravesical application was 50 mL of saline with 2 mL (100 mg) of ketoprofen warmed to 37 degrees C. The placebo solution contained 2 mL of distilled water instead of ketoprofen. The assessment including micturition diaries, cystometric measurements, and bacteriological analysis of urine specimens was performed at the beginning of the study and after the treatment.


RESULTS
The subjective cure rate was 18/30 after ketoprofen. The instability index was lower after ketoprofen than before treatment or after placebo (p<0.001). Maximal cystometric capacity and the urinary bladder volume at which the patients felt urgency to void were larger after ketoprofen than before it (p<0.001) or after placebo (p<0.001). The number of patients with uninhibited bladder contractions decreased significantly after ketoprofen, but not after placebo (p<0.001). No side effects were observed.


CONCLUSIONS
Intravesically administrated ketoprofen is a feasible and effective treatment for detrusor instability.
Sprem
M
M
Department of Gynecology and Obstetrics, Zagreb University School of Medicine, Petrova 13, 10000 Zagreb, Croatia. dusko.milicic@med-fakzg.tel.hr
Milicić
D
D
Oresković
S
S
Ljubojević
N
N
Kalafatić
D
D
D000283:Administration, Intravesical; D000328:Adult; D016009:Chi-Square Distribution; D018592:Cross-Over Studies; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007660:Ketoprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000188:drug therapy* / Q000503:physiopathology; D014555:Urination Disorders / Q000188:drug therapy* / Q000503:physiopathology; D014563:Urodynamics
D016861:Cyclooxygenase Inhibitors; D007660:Ketoprofen