title: [Drug therapy of bladder dysfunction].
abstract: OBJECTIVE
  To describe drugs targeting urinary bladder to treat bladder dysfunctions such as OAB, NDO and bladder pain syndrome.
  
  
  METHODS
  Pubmed search for efficacy, mode of action and side effects for each molecule. Additional data were searched from the French regulatory agencies web sites (HAS and ANSM).
  
  
  RESULTS
  Anticholinergics antimuscarinics remain the first-line treatment option for both OAB and NDO. Beta-3 adrenergics emerges as a new therapeutic class for OAB. Post approval safety as well as association with other micturition cycle's drugs need to be evaluated. Phosphodiesterase 5 inhibitors are effective to treat BPH-related LUTS including storage symptoms. Botulinum toxin type A injections within the detrusor are effective and approved to treat NDO in MS and spinal cord injured patients voiding with clean intermittent catheterization. Evaluation of such approach to treat OAB is ongoing. Drug therapy for bladder pain syndrome has limited efficacy including pentosan polyphosphate despite it has a temporary autorisation. There is no drug treatment to restore or improve bladder contraction.
  
  
  CONCLUSIONS
  Armamenterium to treat bladder dysfunction has recently increased. Three new therapeutic classes emerged. Careful post approval evaluation is mandatory and study of these drugs' combination is expected. Results should drive changes in bladder dysfunction treatment algorithms.
authors.affiliation: Service d'urologie, pavillon Derocque, CHU Charles-Nicolle, 76031 Rouen cedex, France.
authors.forename: R
authors.initials: R
authors.lastname: Caremel
authors.forename: J-N
authors.initials: JN
authors.lastname: Cornu
authors.forename: J
authors.initials: J
authors.lastname: Kerdraon
authors.forename: E
authors.initials: E
authors.lastname: Castel-Lacanal
authors.forename: C
authors.initials: C
authors.lastname: Bastide
authors.forename: F
authors.initials: F
authors.lastname: Bruyere
authors.forename: L
authors.initials: L
authors.lastname: Guy
authors.forename: G
authors.initials: G
authors.lastname: Karsenty
mesh_terms: D000083:Acetanilides / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D002927:Cimetidine / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D009465:Neuromuscular Agents / Q000627:therapeutic use; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D013844:Thiazoles / Q000627:therapeutic use; D001743:Urinary Bladder / Q000502:physiology; D001745:Urinary Bladder Diseases / Q000188:drug therapy*; D014554:Urination / Q000502:physiology; D014563:Urodynamics / Q000502:physiology
chemical_list: D000083:Acetanilides; D000893:Anti-Inflammatory Agents; D018680:Cholinergic Antagonists; D006635:Histamine H2 Antagonists; D007166:Immunosuppressive Agents; D018727:Muscarinic Antagonists; D009465:Neuromuscular Agents; D010726:Phosphodiesterase Inhibitors; D013844:Thiazoles; D002927:Cimetidine; D016572:Cyclosporine; D019274:Botulinum Toxins, Type A; C520025:mirabegron; D004121:Dimethyl Sulfoxide
keywords: Anticholinergic; Anticholinergiques; Beta-3 adrenergic; Bladder pain syndrome; Botulinum toxin; Bêta-3 agonistes; Incontinence urinaire; Inhibiteur des phosphodiestérases; Neurogenic detrusor overactivity; Overactive bladder; Syndrome clinique d’hyperactivité vésicale; Syndrome de la douleur vésicale; Toxine botulinique; Urinary incontinence