International Urogynecology Journal

, Volume 6, Issue 2, pp 63–67 | Cite as

Oxybutynin and bladder training in the management of female urinary urge incontinence: A randomized study

  • M. Colombo
  • G. Zanetta
  • S. Scalambrino
  • R. Milani
Original Article

Abstract

A randomized trial of 81 women with detrusor instability, low-compliance or sensory bladder was undertaken to compare the effects of 6 weeks' treatment with oxybutynin (5 mg t.i.d.) or bladder training for urge incontinence. Cystometry was repeated after treatment. Ten per cent of the 42 patients on oxybutynin discontinued the therapy; the cure rate decreased from 74% to 42% during the 6-month period following the treatment (from 93% to 57% in case of detrusor instability). The cure rate of bladder training remained quite high, being reduced only from 73% to 70% (from 81% to 75% in the case of sensory bladder). Twelve of the 13 patients with late relapse of incontinence were on oxybutynin. It was concluded that oxybutynin was not well tolerated and gave only early good results. Bladder training was well accepted and provided persistent results; it may be suggested as the first-line treatment for urge incontinence.

Keywords

Bladder training Cystometry Detrusor instability Drugs Motor urge incontinence Sensory urge incontinence 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Aitchison M, Carter R, Paterson P, Ferrie B. Is the treatment of urgency incontinence a placebo response?Br J Urol 1989;64:478–480PubMedGoogle Scholar
  2. 2.
    Webb RJ, Ramsden PD, Neal DE. Ambulatory monitoring and electronic measurement of urinary leakage in the diagnosis of detrusor instability and incontinence.Br J Urol 1991;68:148–152PubMedGoogle Scholar
  3. 3.
    Arnold E. Cystometry-postural effects in incontinent women.Urol Int 1974;29:185–189PubMedGoogle Scholar
  4. 4.
    Hebert DB, Ostergard DR. Vesical instability: urodynamic parameters by microtip transducer catheters.Obstet Gynecol 1982;60:331–337PubMedGoogle Scholar
  5. 5.
    Moore KH, Hay DM, Imrie AE, Watson A, Goldstein M. Oxybutynin hydrochloride (3 mg) in the treatment of women with idiopathic detrusor instability.Br J Urol 1990;66:479–485PubMedGoogle Scholar
  6. 6.
    Fantl JA, Wyman JF, McClish DK et al. Efficacy of bladder training in older women with urinary incontinence.JAMA 1991;265:609–613CrossRefPubMedGoogle Scholar
  7. 7.
    Fantl JA. Behavioral therapy for detrusor instability of idiopathic etiology. In: Ostergard DR, ed. Gynecologic urology and urodynamics, theory and practice. Baltimore: Williams & Wilkins, 1985;371–377Google Scholar
  8. 8.
    Cardozo LD. Commentary. Detrusor instability, current management.Br J Obstet Gynaecol 1990;97:463:466PubMedGoogle Scholar
  9. 9.
    Coolsaet BLRA, Elhilali MM. Detrusor overactivity.Neurourol Urodyn 1988;7:541–561Google Scholar
  10. 10.
    Abrams PP, Blaivas JG, Stanton SL, Anderson JT. The standardization of terminology of lower urinary tract function.Int Urogynecol J 1990;1:45–58CrossRefGoogle Scholar
  11. 11.
    Thüroff JW, Bunke B, Ebner A et al. Randomized double-blind multicenter trial on treatment of frequency, urgency and incontinence related to detrusor hyperactivity: oxybutynin versus propantheline versus placebo.J Urol 1991;145:813–817PubMedGoogle Scholar
  12. 12.
    Gu J, Restorick JM, Blank MA et al. Vasoactive intestinal polypeptide in the normal and unstable bladder.Br J Urol 1983;55:645–647PubMedGoogle Scholar
  13. 13.
    Frewen WK. Urgency incontinence.J Obstet Gynaecol Br Commonw 1972;79:77–79PubMedGoogle Scholar
  14. 14.
    Sutherst JR. Sexual dysfunction and urinary incontinence.Br J Obstet Gynaecol 1979;86:387–388PubMedGoogle Scholar
  15. 15.
    Barrington FJ. The component reflexes of micturition in the cat.Brain 1931;54:177–180Google Scholar
  16. 16.
    Beck RP, Armach D, King L. Results in treating 210 patients with detrusor overactivity incontinence of urine.Am J Obstet Gynecol 1976;125:593–596PubMedGoogle Scholar
  17. 17.
    Kulseng-Hanssen S. Prevalence and pattern of unstable urethral pressure in 174 gynecologic patients referred for urodynamic investigation.Am J Obstet Gynecol 1983;146:895–900PubMedGoogle Scholar
  18. 18.
    Penders L, Vanstalle-Nelissen G. Instabilité vésicale et kinésithérapie. Concept de l'instabilité vésicale déficitaire.J Urol (Paris) 1990;96:335–342Google Scholar

Copyright information

© The International Urogynecology Journal 1995

Authors and Affiliations

  • M. Colombo
    • 1
  • G. Zanetta
    • 1
  • S. Scalambrino
    • 1
  • R. Milani
    • 1
  1. 1.Department of Obstetrics and GynecologyUniversity of Milan, San Gerardo HospitalMonzaItaly

Personalised recommendations