title: The concomitant use of fesoterodine and topical vaginal estrogen in the management of overactive bladder and sexual dysfunction in postmenopausal women.
abstract: OBJECTIVE
  The objective of this study is to investigate the combination effect of anti-muscarinic medication and topical vaginal estrogen in the treatment of overactive bladder (OAB) and female sexual dysfunction in postmenopausal women.
  
  
  METHODS
  After IRB approval, 23 female subjects who met the entry criteria were randomized into two groups: (1) fesoterodine (Toviaz®, Pfizer, NY) with topical vaginal estrogen (Premarin®, Pfizer, NY) once daily or (2) fesoterodine once daily alone. If 4 mg fesoterodine was tolerated at 1-week, the dose was increased to 8 mg.
  
  
  METHODS
  Primary endpoints were improvement in OAB symptom severity (Overactive Bladder Questionnaire, OAB-Q SF), improvement in OAB health-related quality of life (HRQL) (OAB-Q SF), and sexual function (Sexual Quality of Life-Female, SQOL-F) after 12 weeks. Secondary endpoint was change in total number of micturitions.
  
  
  RESULTS
  After 12-weeks, the combination group had a significant improvement in OAB symptom severity (p = 0.006), HRQL (p = 0.029), and SQOL-F (0.0003). The fesoterodine alone group also had significant improvement in OAB symptom severity (p < 0.0001), HRQL (p = 0.0002), and SQOL-F (p = 0.02). When compared directly to the fesoterodine alone group, the combination group after 12-weeks had a reduced OAB symptom severity (10 versus 23.3; p = 0.35), higher HRQL (96.9 versus 84.6; p = 0.75), and higher SQOL-F (99 versus 81; p = 0.098). The total number of micturitions over 3 d was significantly reduced in the combination group (45-26, p = 0.03) between baseline and 12-weeks.
  
  
  CONCLUSIONS
  The combined effect of fesoterodine and topical vaginal estrogen improved OAB symptoms and sexual function in postmenopausal women.
authors.affiliation: Department of Urology, Weill Cornell Medical College/New York Presbyterian Hospital, NY, USA bic9008@med.cornell.edu.
authors.forename: Bilal
authors.initials: B
authors.lastname: Chughtai
authors.affiliation: Department of Urology, Weill Cornell Medical College/New York Presbyterian Hospital, NY, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Forde
authors.affiliation: Department of Urology, Weill Cornell Medical College/New York Presbyterian Hospital, NY, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Buck
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medical College/New York Presbyterian Hospital, NY, USA.
authors.forename: Tirsit
authors.initials: T
authors.lastname: Asfaw
authors.affiliation: Department of Urology, Weill Cornell Medical College/New York Presbyterian Hospital, NY, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Lee
authors.affiliation: Department of Urology, Weill Cornell Medical College/New York Presbyterian Hospital, NY, USA.
authors.forename: Alexis E
authors.initials: AE
authors.lastname: Te
authors.affiliation: Department of Urology, Weill Cornell Medical College/New York Presbyterian Hospital, NY, USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Kaplan
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D000368:Aged; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004967:Estrogens / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D017698:Postmenopause; D011788:Quality of Life; D012720:Severity of Illness Index; D020018:Sexual Dysfunctions, Psychological / Q000188:drug therapy* / Q000209:etiology; D019529:Sexuality; D011795:Surveys and Questionnaires; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000188:drug therapy*
chemical_list: D001559:Benzhydryl Compounds; D004967:Estrogens; D018727:Muscarinic Antagonists; C526675:fesoterodine
keywords: Overactive bladder; female sexual dysfunction; fesoterodine; postmenopausal; topical vaginal estrogen