title: Considering the prominent complaint as a guide in medical therapy for overactive bladder syndrome in women over 45 years.
abstract: OBJECTIVE
  The aim of this study was to evaluate the response of women over 45 years with overactive bladder and detrusor overactivity to a 12-week course of oxybutynin or tolterodine treatment.
  
  
  METHODS
  A total of 301 eligible Iranian women were studied. In this double-blinded trial, data were analyzed from 3-day urinary diaries from before and after 12 weeks of treatment in which patients were randomly assigned to receive oxybutynin or tolterodine in recommended doses. Patients' convenience and the drugs' side-effects were assessed by a monthly clinical appointment. End-points were changed from baseline to week 12 in bladder-diary variables and all observed or reported adverse events. The effectiveness of each drug was studied using the paired t-test and improvement after treatment between the two groups was compared by independent t-test.
  
  
  RESULTS
  Mean improvements in the terms of urgency (P = 0.64) and urge incontinence (P = 0.75) showed an insignificantly larger score in patients who were treated by oxybutynin. Improvement in night-time urinary urgency and nocturia (41.2% and 54.3% vs 39.7% and 40.1% in oxybutynin vs tolterodine groups, respectively) were shown to be more improved by tolterodine in comparison to oxybutynin (P = 0.72 and 0.04 for night-time urinary urgency and nocturia, respectively). Discontinuation of treatment due to adverse events was not significantly different in the two groups.
  
  
  CONCLUSIONS
  Oxybutynin and tolterodine showed similar efficacy on daytime symptoms of overactive bladder and similar side-effects in perimenopausal patients. For patients with the chief complaint of nocturnal frequency, prescription of tolterodine is preferably suggested.
authors.affiliation: Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mina
authors.initials: M
authors.lastname: Jafarabadi
authors.forename: Ladan
authors.initials: L
authors.lastname: Jafarabadi
authors.forename: Mamak
authors.initials: M
authors.lastname: Shariat
authors.forename: Gelareh
authors.initials: G
authors.lastname: Rabie Salehi
authors.forename: Fedyeh
authors.initials: F
authors.lastname: Haghollahi
authors.forename: Batool Hossein
authors.initials: BH
authors.lastname: Rashidi
mesh_terms: D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008333:Mandelic Acids / Q000627:therapeutic use*; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D000068737:Tolterodine Tartrate / Q000627:therapeutic use*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*
chemical_list: D008333:Mandelic Acids; D018727:Muscarinic Antagonists; D000068737:Tolterodine Tartrate; C005419:oxybutynin
keywords: overactive bladder; oxybutynin; perimenopause; tolterodine