[Intravesical therapy for overactive bladder].
BACKGROUND
Despite recent advances in the field of anticholinergic drugs, lack of efficiency and side effects are still the main reasons for discontinuation of treatment. The introduction of botulinum A toxin was a milestone in the treatment of detrusor overactivity. The treatment, however, is invasive, the duration of the treatment effects is limited, and long-term results are not yet available. The following addresses therapeutic alternatives to local treatment of overactive bladder.


METHODS
A total of 52 patients received intravesical oxybutynin. In 16 patients, capsaicin was instilled in the bladder and 28 patients were treated with EMDA.


RESULTS
Intravesical oxybutynin was successful in 86%; the success rate of capsaicin instillation was 47%. EMDA was successful in 78%. Two transient ischemic attacks following EMDA were observed as significant side effects.


CONCLUSIONS
Besides botulinum A toxin, several effective treatment options are available for patients with detrusor overactivity refractory to oral anticholinergic treatment. Therefore, in each individual patient, possible risks and complications of the different treatment options should be considered thoroughly to find the optimal method in each case.
Pannek
J
J
Schwerpunkt Neuro-Urologie, Urologische und Neuro-Urologische Klinik, Ruhr-Universität Bochum, Marienhospital, Herne. juergen.pannek@marienhospital-herne.de
Grigoleit
U
U
Wormland
R
R
Goepel
M
M
D000283:Administration, Intravesical; D000293:Adolescent; D000328:Adult; D002211:Capsaicin / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D016503:Drug Delivery Systems / Q000379:methods*; D005260:Female; D006801:Humans; D007478:Iontophoresis / Q000379:methods*; D008297:Male; D008333:Mandelic Acids / Q000008:administration & dosage*; D008875:Middle Aged; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000188:drug therapy*
D008333:Mandelic Acids; C005419:oxybutynin; D002211:Capsaicin