Prominent complaint: a guide to medical therapy of overactive bladder syndrome in older women.
To evaluate Overactive bladder (OAB) with detrusor overactivity (DOA) following oxybutynin or tolterodine treatment in recommended doses at a four-week course. A total of 100 Iranian women 45 years or older with urgency that also showed idiopathic detrusor overactivity (IDO) in the filling phase of their cystometry were included in the current study. In this double-blinded trial two parallel groups were randomized by using two kinds of the antimuscarinic drugs for a four- week course [oxybutinin 5mg, t.d.s. or Tolterodin 2mg, b.i.d.] in the same  packages. Data were collected from three-day frequency volume chart (FVC) one month before and after the treatment course. The effectiveness of each drug was compared using the paired, samples t-test. Patients' improvement regarding urinary urgency, frequency and urge incontinence after treatment in both groups was seen, but mean improvements in the terms of urgency and urge incontinence were larger in patients who were treated by oxybutynin. Night-time frequency was shown to be improved by a significantly larger score by tolterodine. Discontinuation of treatment due to adverse events had no significant difference in two groups. Four-week treatment with oxybutynin was better than tolterodine IR in improving urgency and urge incontinence, but there were not statistically significant difference between them. In planning a course of treatment especially in the elderly, the difference in the group of symptoms that reduce patients' quality of life should be considered. Physicians should consider the patient's prominent symptom in selection of anti-muscarinic drugs for the treatment of overactive bladder syndrome especially in elderly patients.
Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran. minajaf@yahoo.com.
Mina
M
Jafarabadi
Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran. drz_ghanbari@yahoo.com.
Zinat
Z
Ghanbari
Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran. drjafarabadi@yahoo.com.
Shahrzad
S
Hashemi
Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran. mertanem@yahoo.co.uk.
Maryam
M
Nemati
Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran. fedyeh_hagh@yahoo.com.
Fedyeh
F
Haghollahi
Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran. drjafarabadi@yahoo.com.
Elham
E
Azimi Nekoo
D000368:Aged; D001559:Benzhydryl Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D003408:Cresols / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007492:Iran; D008333:Mandelic Acids / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D010665:Phenylpropanolamine / Q000009:adverse effects / Q000627:therapeutic use*; D011788:Quality of Life; D013577:Syndrome; D000068737:Tolterodine Tartrate; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*
D001559:Benzhydryl Compounds; D003408:Cresols; D008333:Mandelic Acids; D018727:Muscarinic Antagonists; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; C005419:oxybutynin