The effect of solifenacin on postvoid dribbling in women: results of a randomized, double-blind placebo-controlled trial
Introduction and hypothesis
To determine the effectiveness of the muscarinic receptor antagonist solifenacin (VESIcare®) in the treatment of postvoid dribbling (PVD).
We carried out a multicenter, 12-week, double-blind, randomized, placebo-controlled, parallel design study. Between 2012 and 2015, a total of 118 women (age 18–89 years) with PVD at least twice/weekly, were randomized to receive solifenacin (5 mg; n = 58) or placebo (n = 60) once daily. The primary outcome was the percentage reduction in PVD episodes. Secondary outcomes included the percentage of patients with ≥50% reduction in PVD episodes and changes in quality of life.
There were no differences in either the primary or secondary outcome variables. Subgroup analysis, based on those with more severe disease (>10 PVD episodes/week), showed a greater and significant percentage reduction in the frequency of PVD episodes per day (60.3% vs 32.1%; p = 0.035) and a higher percentage of patients showing ≥50% reduction in the frequency of PVD episodes with solifenacin (68.1% vs 45.8%; p = 0.0476). A significant solifenacin effect occurred at week 2 and continued through week 12 for the subgroup. For solifenacin, PVD reduction was the same for the entire cohort and subgroup, whereas for placebo, it was 10% lower in the subgroup, declining from 42% to 32%.
There were no differences in PVD outcomes between the solifenacin and placebo groups. Solifenacin may play a role in treating women with the most severe symptoms. Because of the powerful placebo response seen in this study, behavior-based interventions may be useful for treating PVD.
KeywordsPostmicturition dribbling Randomized controlled trial Urinary incontinence VESIcare® Muscarinic antagonists Anticholinergic
Lower urinary tract symptoms
The authors would like to acknowledge the University of Wisconsin Madison and Marshfield Clinic Institute for Clinical and Translational Research and the Wisconsin Network for Health Research for assistance with data collection.
Financial support (and/or study drug) for this study was provided by Astellas Pharma.
Compliance with ethical standards
Conflicts of interest
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