title: An overview on mixed action drugs for the treatment of overactive bladder and detrusor overactivity.
abstract: OBJECTIVE
  To provide an overview on the efficacy, tolerability, safety and health-related quality of life (HRQoL) of drugs with a mixed action used in the treatment of overactive bladder (OAB).
  
  
  METHODS
  MEDLINE database and abstract books of the major conferences were searched for relevant publications from 1966 to 2011 and using the key words 'overactive bladder', 'detrusor overactivity', 'oxybutynin', 'propiverine', and 'flavoxate'. Two independent reviewers considered publications for inclusion and extracted relevant data, without performing a meta-analysis.
  
  
  RESULTS
  Old and conflicting data do not support the use of flavoxate, while both propiverine and oxybutynin were found to be more effective than placebo in the treatment of OAB. Propiverine was at least as effective as oxybutynin but with a better tolerability profile even in the pediatric setting. Overall, no serious adverse event for any product was statistically significant compared to placebo. Improvements were seen in HRQoL with treatment by the oxybutynin transdermal delivery system and propiverine extended release.
  
  
  CONCLUSIONS
  While there is no evidence to suggest the use of flavoxate in the treatment of OAB, both oxybutynin and propiverine appear efficacious and safe. Propiverine shows a better tolerability profile than oxybutynin. Both drugs improve HRQoL of patients affected by OAB. Profiles of each drug and dosage differ and should be considered in making treatment choices.
authors: UOC of Urology, Department of Surgery, University of Rome Tor Vergata, Policlinico Casilino, Rome, Italy. tasospao2003@yahoo.com
authors: A D
authors: AD
authors: Asimakopoulos
authors: M A
authors: MA
authors: Cerruto
authors: G
authors: G
authors: Del Popolo
authors: M
authors: M
authors: La Martina
authors: W
authors: W
authors: Artibani
authors: R
authors: R
authors: Carone
authors: E
authors: E
authors: Finazzi-Agrò
mesh_terms: D001561:Benzilates / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005422:Flavoxate / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008333:Mandelic Acids / Q000627:therapeutic use; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D010276:Parasympatholytics / Q000627:therapeutic use; D061214:Patient Safety; D010919:Placebos; D011788:Quality of Life; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*
chemical_list: D001561:Benzilates; D008333:Mandelic Acids; D018727:Muscarinic Antagonists; D010276:Parasympatholytics; D010919:Placebos; D005422:Flavoxate; C015586:propiverine; C005419:oxybutynin