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Minerva Urologica e Nefrologica 2010 December;62(4):355-61


language: English

Overactive bladder syndrome: what is the role of evidence of detrusor overactivity in the cystometric study?

Vecchioli-Scaldazza C. 1, Grinta R. 2

1 Division of Urology, ASUR, N. 5, Jesi, Ancona, Italy; 2 Pharmacoeconomic Assessment Service, ASUR, N. 5, Jesi, Ancona, Italy


AIM: A prospective study was conducted on 62 female patients with overactive bladder syndrome, to check for differences in clinical profiles, subjective symptoms and urodynamic findings, between patients with or without cystometric evidence of detrusor overactivity (DO). Later both groups of women were assessed for the effect of an antimuscarinic agent, solifenacin succinate (SS), on the considered parameters.
METHODS: Each patient underwent a full history, a physical examination, urinalysis and a urodynamic study. Provocative manoeuvres – cough, postural changes – were used when the cystometric study was performed. Hence two groups of patients were formed, divided according to the presence or absence of DO at the cystometric study: patients with overactive bladder syndrome (OAB) with DO (29), patients with OAB without DO (33). The two groups were compared before and after treatment with SS.
RESULTS: When we compared the two groups, before treatment with SS, we saw statistically significant differences in just a few of the parameters assessed in the clinical profiles: patients with DO had a higher rate of constipation; whereas patients without DO had a higher rate of stress incontinence and a larger number of deliveries. Following treatment with SS, in both groups, significant differences were shown in subjective symptoms and urodynamic findings, with a reduction of the numbers of voids and incontinence episodes and an improved urge score. A significant increase in bladder capacity during the cystometric study was shown only in patients with DO. Whereas no statistically significant improvement was shown in patients without DO. Treatment with SS was connected with delayed involuntary detrusor contractions during cystometry and a reduction of their number and amplitude. Finally, SS did not produce any significant negative effects on detrusor function during voiding.
CONCLUSION: The findings of this study suggest that it is important to conduct a urodynamic study in patients with OAB, to check for DO. In our experience, treatment with SS was shown to be effective only in patients with involuntary detrusor contractions at the cystometric study.

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