Electromotive drug administration for treatment of therapy-refractory overactive bladder.
OBJECTIVE
Evaluate the benefits of electromotive drug administration (EMDA) as an alternative technique in patients with chronic overactive bladder in terms of improvement of symptoms, quality of life, and sexuality.


METHODS
A total of 72 patients with therapy-refractory overactive bladder according to the ICS (International Continence Society) definition, were treated by EMDA. The regimen consisted of three treatment cycles, each with 3 instillations at 2-week intervals. The solution instilled consisted of 100 mL 4% lidocaine, 100 mL distilled water, 40 mg dexamethasone, and 2 mL epinephrine. Peri-interventionally, a urine test and close circulatory monitoring were performed. All women underwent urodynamic testing and cystoscopy and kept a voiding diary. A comprehensive history was obtained, a quality of life questionnaire administered, and a gynecologic examination performed before initiation of therapy. The women underwent follow-up at 12 months after the end of therapy.


RESULTS
The patients had a mean age of 63 (+/- 11.2) years. Bladder capacity improved significantly by 109 mL (+/- 55 mL) in 51 (71%) patients (p = 0.021). The number of micturitions/day decreased significantly to 7 (+/- 2) (p = 0.013). Quality of life was improved in 54 patients (75%); p = 0.024) and sexuality in 39 (54%); p = 0.020).


CONCLUSIONS
The results suggest that EMDA can improve both quality of life and sexuality in patients with therapy-refractory chronic overactive bladder.
Gauruder-Burmester
A
A
German Pelvic Floor Center, Urogynecology Section, St. Hedwig Hospital Berlin, Berlin, Germany. a.gauruder@googlemail.com
Biskupskie
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A
Rosahl
A
A
Tunn
R
R
D003907:Dexamethasone / Q000008:administration & dosage / Q000031:analogs & derivatives; D053672:Electrochemotherapy; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012725:Sexual Behavior; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000523:psychology
C004180:dexamethasone 21-phosphate; D003907:Dexamethasone; D008012:Lidocaine; D004837:Epinephrine