title: The effect of solifenacin on urethral sphincter morphology.
abstract: OBJECTIVE
  The aim of the study was to determine whether a 6-week course of 5 mg of solifenacin succinate used to treat mixed incontinence, produces measurable changes in the appearance of the urethral sphincter.
  
  
  METHODS
  Twenty-six women undergoing treatment for mixed incontinence were recruited from a urogynaecology unit after failing to improve with conservative treatments and bladder drill. All underwent dual channel subtracted cystometry, which showed mixed urodynamic stress incontinence and detrusor overactivity. All patients underwent a 3D transperineal ultrasound before solifenacin therapy was started and after 6 weeks of treatment. The urethral length, width and volume of the smooth muscle and total sphincter volume were compared before and after the treatment.
  
  
  RESULTS
  Clinically, 13 reported no improvement in either stress or urge incontinence. Eight women reported improvement in their urgency symptoms but no benefit in their stress leakage. Four women reported resolution of both stress and urge incontinence. One woman reported worsening of her bladder symptoms. There was no significant change in the urethral length (p = 0.27), width (p = 0.50), volume of smooth muscle (p = 0.87) or total sphincter volume (p = 0.60) before and after treatment with solifenacin.
  
  
  CONCLUSIONS
  A 6-week course of solifenacin resulted in no measurable changes in the appearance of the urethral sphincter.
authors.affiliation: Medway NHS Foundation Trust, Windmill Road, Gillingham, Kent, ME7 5NY, UK. jraduckett@hotmail.com
authors.forename: Jonathan
authors.initials: J
authors.lastname: Duckett
authors.forename: Maya
authors.initials: M
authors.lastname: Basu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D009929:Organ Size; D011812:Quinuclidines / Q000494:pharmacology* / Q000627:therapeutic use; D000069464:Solifenacin Succinate; D044005:Tetrahydroisoquinolines / Q000494:pharmacology* / Q000627:therapeutic use; D016896:Treatment Outcome; D014463:Ultrasonography; D014521:Urethra / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000187:drug effects*; D014550:Urinary Incontinence, Stress / Q000188:drug therapy* / Q000473:pathology; D053202:Urinary Incontinence, Urge / Q000188:drug therapy* / Q000473:pathology
chemical_list: D018727:Muscarinic Antagonists; D011812:Quinuclidines; D044005:Tetrahydroisoquinolines; D000069464:Solifenacin Succinate