title: Cholinergic Antagonists Combined with Electrical Stimulation or Bladder Training Treatments for Overactive Bladder in Female Adults: A Meta-Analysis of Randomized Controlled Trials.
abstract: OBJECTIVE
  The therapeutic effects of cholinergic antagonists combined with non-drug therapy compared with cholinergic antagonist therapy alone for overactive bladder in adult women are unclear. Thus, we conducted a meta-analysis of randomized controlled trials to compare the therapeutic effects of cholinergic antagonists plus non-drug therapy (electrical stimulation and bladder training) with cholinergic antagonist therapy alone among female overactive bladder patients.
  
  
  METHODS
  Pertinent studies were identified by searching PubMed, Web of Science, and the Chinese Biological Medicine databases to May 31, 2016. Study-specific standardized mean differences were combined using fixed- or random-effects models depending on whether significant heterogeneity was detected.
  
  
  RESULTS
  Ten randomized controlled trials were identified. A total of 485 female overactive bladder patients were treated with the combined therapy and 497 were treated with the cholinergic antagonists alone. For the cholinergic antagonists combined with electrical stimulation treatment compared with cholinergic antagonist therapy alone, there were statistically significant reductions of average frequency of urination, incontinence, and urgency, with pooled standardized mean differences of -2.38, -1.32, and -0.87, respectively. There was also a statistically significant reduction of average frequency of urination (pooled standardized mean difference = - 0.30; 95 % confidence interval: -0.52 to -0.08) for the cholinergic antagonists combined with bladder training treatment compared with cholinergic antagonist therapy alone.
  
  
  CONCLUSIONS
  This study indicated that female overactive bladder patients with cholinergic antagonists combined with electrical stimulation or bladder training treatment may lower the average frequency of urination, incontinence, and urgency when compared with those who received isolated drug therapy.
authors.affiliation: Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1930 Dongfang Road, Shanghai, 200127, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1930 Dongfang Road, Shanghai, 200127, China.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Lv
authors.affiliation: Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1930 Dongfang Road, Shanghai, 200127, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1930 Dongfang Road, Shanghai, 200127, China.
authors.forename: Jiayi
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1930 Dongfang Road, Shanghai, 200127, China. lengjing1688@163.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Leng
mesh_terms: D000328:Adult; D018680:Cholinergic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004558:Electric Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D053201:Urinary Bladder, Overactive / Q000188:drug therapy / Q000628:therapy*
chemical_list: D018680:Cholinergic Antagonists