Comparison of electric stimulation and oxybutynin chloride in management of overactive bladder with special reference to urinary urgency: a randomized placebo-controlled trial.
OBJECTIVE
To compare the efficacy of electric stimulation (ES), oxybutynin, and placebo in managing the symptom complex of overactive bladder (OAB), particularly urgency.


METHODS
A randomized placebo-controlled trial was conducted for 68 patients with OAB, placing emphasis on urinary urgency. The interventions for the 12-week treatment period, conducted by the physiotherapist, who was unaware of the progress and outcome, included a vaginal ES program using biphasic symmetric, pulsed current with a 10-Hz frequency, 400-micros pulse width, 10/5 duty cycle, and varying intensity; and oxybutynin (2.5 mg) or placebo three times per day. Identical preintervention and postintervention assessments included the measurement of warning time, urodynamics, voiding diaries, and King's Health Questionnaire.


RESULTS
Of the 68 women who completed this study, 24 were in the ES, 23 in the oxybutynin, and 21 in the placebo group. The between-group comparison showed that significant improvements in daily voided volume, pad count, number of urgency and nocturia episodes, and the domain 2 score and total score of the King's Health Questionnaire existed between the ES and the other groups (all P < or = 0.050). The changes in warning time, maximal voided volume, number of urgency episodes, and frequency were significantly improved between oxybutynin and placebo (all P < 0.013). Additionally, a comparison of the voided volume in uroflowmetry between the ES and placebo groups revealed a greater difference after treatment (P = 0.013). The reduction rate of OAB was 58.4% for the ES, 39.1% for the oxybutynin, and 9.5% for the placebo group (P = 0.036).


CONCLUSIONS
ES had the greatest subjective outcome for OAB and was the most effective of the three treatments. Oxybutynin was more effective than placebo.
Wang
Alex C
AC
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics/Gynecology, Chang Gung University Hospital, Taoyuan, Taiwan. alexwang@cgmh.org.tw
Chih
Shu-Yun
SY
Chen
Min-Chi
MC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008333:Mandelic Acids / Q000627:therapeutic use*; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy / Q000628:therapy*; D014549:Urinary Incontinence / Q000188:drug therapy / Q000628:therapy*
D008333:Mandelic Acids; D018727:Muscarinic Antagonists; C005419:oxybutynin