The overactive bladder: review of current pharmacotherapy in adults. Part 2: treatment options in cases refractory to anticholinergics

Arun Sahai, Mohammed Shamim Khan, Manit Arya, Jason John, Rajinder Singh, Hitendra R H Patel

    Research output: Contribution to journalReview articlepeer-review

    10 Citations (Scopus)

    Abstract

    In the first part of this review the potential pathophysiological factors involved in the overactive bladder were outlined, and the wide range of first-line anticholinergic pharmacotherapies available for such patients were reviewed. The second part will focus on the intravesical instillation of resiniferatoxin and injections of botulinum toxin into the bladder to treat overactive bladder and detrusor overactivity. Resiniferatoxin has been shown to increase bladder capacity and improve incontinence in patients with neurogenic and non-neurogenic detrusor overactivity. Botulinum toxin has successfully been used to treat neurogenic and idiopathic detrusor overactivity, with improvements observed in bladder capacity, decreases in detrusor pressures on filling and voiding, and increased volumes at first contraction. Further validation is required for both treatments, in the form of large randomised controlled trials, before their use can be considered routine, with particular focus on dosing required.

    Original languageEnglish
    Pages (from-to)529-38
    Number of pages10
    JournalExpert opinion on pharmacotherapy
    Volume7
    Issue number5
    DOIs
    Publication statusPublished - Apr 2006

    Keywords

    • Administration, Intravesical
    • Botulinum Toxins/administration & dosage
    • Cholinergic Antagonists/therapeutic use
    • Diterpenes/administration & dosage
    • Dose-Response Relationship, Drug
    • Drugs, Investigational/therapeutic use
    • Humans
    • Neurotoxins/administration & dosage
    • Practice Guidelines as Topic
    • Randomized Controlled Trials as Topic
    • Treatment Failure
    • Urinary Bladder, Neurogenic/diagnosis
    • Urinary Incontinence/diagnosis

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