title: A prospective randomized trial comparing the use of tolterodine or weighted vaginal cones in women with overactive bladder syndrome.
abstract: OBJECTIVE
  To compare the efficacy of pelvic floor muscle exercises (PFME) using weighted vaginal cones (WVC) on the symptoms, clinical findings, urodynamic findings and quality of life (QoL) in overactive bladder (OAB) patients with tolterodine.
  
  
  METHODS
  Thirty-nine patients with urinary frequency (≥ 8/day), nocturia (≥ 2/night), urgency and a total score of ≥ 8 to the overactive bladder-awareness tool (OAB-V8) were diagnosed as OAB and were randomized into two treatment groups; WVC and extended release tolterodine (tolterodine ER) 4 mg/day for 8 weeks. Results of the clinical findings, 3-day urinary diary, validated questionnaires for symptom bother and QoL (Urinary distress inventory (UDI-6), incontinence impact questionnaire (IIQ-7), OAB-V8, Wagner questionnaire) and urodynamic examination before and after treatment were compared.
  
  
  RESULTS
  A reduction of frequency, nocturia and urinary incontinence was observed in WVC group (p=0.006, p=0.034 and p=0.008, respectively) and in tolterodine group (p<0.001, p=0.002 and p=0.035, respectively). 24-h dry pad test results were improved significantly in both groups (p=0.003 and p=0.001, respectively). Pelvic muscle strength was significantly improved in WVC group but not in tolterodine group (p=0.010 and p=0.180, respectively). UDI-6, IIQ-7, OAB-V8 scores were improved significantly in both groups. Improvements in Wagner questionnaire were observed in WVC group but not in tolterodine group (p=0.002 and p=0.591, respectively). First sensation of bladder filling was significantly improved after WVC treatment but not in tolterodine group (p=0.035 and p=0.550, respectively). After treatment, detrusor overactivity (DO) resolved in 8 patients in the WVC group (p=0.003) and in 2 patients in the tolterodine group (p=0.426).
  
  
  CONCLUSIONS
  WVC treatment seems to be an efficacious therapeutic option for the improvement of overactive bladder syndrome (OABS).
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Ankara University, Ankara, Turkey. Electronic address: drtuncayyuce@gmail.com.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Yüce
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Ankara University, Ankara, Turkey.
authors.forename: Fulya
authors.initials: F
authors.lastname: Dökmeci
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Ankara University, Ankara, Turkey.
authors.forename: Şerife Esra
authors.initials: ŞE
authors.lastname: Çetinkaya
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D053158:Nocturia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D017773:Pelvic Floor; D026741:Physical Therapy Modalities; D011788:Quality of Life; D011795:Surveys and Questionnaires; D000068737:Tolterodine Tartrate / Q000627:therapeutic use*; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics; D014621:Vagina
chemical_list: D018727:Muscarinic Antagonists; D000068737:Tolterodine Tartrate
keywords: Efficacy; Overactive bladder; Pelvic floor exercise; Tolterodine; Vaginal cone