Skip to main content
SpringerLink
Log in

Other Treatments for Overactive Bladder, Including Intravesical

  • Chapter
  • First Online:
Contemporary Pharmacotherapy of Overactive Bladder

  • 494 Accesses

Abstract

Some patients with overactive bladder do not respond to adequate trials of first-, second-, and third-line therapies or experience adverse effects that prevent continuation of treatment. Alternatives must be considered for this cohort to achieve satisfactory symptom control. A wide range of oral and intravesical therapies have been tested, many with positive results. In this chapter, we will present scientific trials of agents that have been tested in human subjects. Familiarity with these studies will expand the treatment armamentarium for practicing urologists, better enabling them to treat this challenging group of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Steers WD, Lee K. Depression and incontinence. World J Urol. 2001;19:351–7.

    Article  CAS  Google Scholar 

  2. Kafri R, Kodesh A, Shames J, Golomb J, Melzer I. Depressive symptoms and treatment of women with urgency urinary incontinence. Int Urogynecol J. 2013;24:1953–9.

    Article  Google Scholar 

  3. Millard RJ, Moore K, Rencken R, Yalcin I, Bump RC. Duloxetine vs placebo in the treatment of stress urinary incontinence: a four-continent randomized clinical trial. BJU Int. 2004;93(3):311–8.

    Article  CAS  Google Scholar 

  4. Steers WD, Herschorn S, Kreder KJ, Moore K, Strohbehn K, Yalcin I, et al. Duloxetine compared with placebo for treating women with symptoms of overactive bladder. BJU Int. 2007;100(2):337–45.

    Article  CAS  Google Scholar 

  5. Di Rezze S, Frasca V, Inghilleri M, Durastanti V, Cortese A, Giacomelli E, et al. Duloxetine for the treatment of overactive bladder syndrome in multiple sclerosis: a pilot study. Clin Neuropharmacol. 2012;35(5):231–4.

    Article  Google Scholar 

  6. Efficacy and safety of selective serotonin reuptake inhibitor (SSRI) in overactive bladder patients [Internet]. National Library of Medicine 2009. Available from: https://clinicaltrials.gov/ct2/show/NCT00902421.

  7. Besipirdine: Adis Insight Springer International; http://adisinsight.springer.com/drugs/800001339. Accessed 28 Apr 2018.

  8. Andersson K-E, Cardozo L, Cruz F, Lee KS, Sahai A, Wein AJ. Incontinence. In: Abrams P, Cardozo L, Wagg A, Wein AJ, editors. Incontinence. 6th ed. Tokyo: International Consultation on Incontinence; 2016.

    Google Scholar 

  9. Kwon WA, Ahn SH, Oh TH, Lee JW, Han DY, Jeong HJ. Effect of low-dose triple therapy using gabapentin, amitriptyline, and a nonsteroidal anti-inflammatory drug for overactive bladder symptoms in patients with bladder pain syndrome. Int Neurourol J. 2013;17(2):78–82.

    Article  Google Scholar 

  10. Cole AT, Fried FA. Favorable experiences with imipramine in the treatment of neurogenic bladder. J Urol. 1972;107(1):44–5.

    Article  CAS  Google Scholar 

  11. Tamsulosin [Internet]. Truven Health Analytics, Inc. http://www.micromedexsolutions.com/. Accessed 9 Jan 2018.

  12. Gacci M, Novara G, De Nunzio C, Tubaro A, Schiavina R, Brunocilla E, et al. Tolterodine extended release in the treatment of male OAB/storage luts: a systematic review. BMC Urol. 2014;14(1):84.

    Article  Google Scholar 

  13. Robinson D, Cardozo L, Terpstra G, Bolodeoku J, Tamsulosin Study G. A randomized double-blind placebo-controlled multicentre study to explore the efficacy and safety of tamsulosin and tolterodine in women with overactive bladder syndrome. BJU Int. 2007;100(4):840–5.

    Article  CAS  Google Scholar 

  14. Low BY, Liong ML, Yuen KH, Chee C, Leong WS, Chong WL, et al. Terazosin therapy for patients with female lower urinary tract symptoms: a randomized, double-blind, placebo controlled trial. J Urol. 2008;179(4):1461–9.

    Article  CAS  Google Scholar 

  15. Zhang HL, Huang ZG, Qiu Y, Cheng X, Zou XQ, Liu TT. Tamsulosin for treatment of lower urinary tract symptoms in women: a systematic review and meta-analysis. Int J Impot Res. 2017;29(4):148–56.

    Article  CAS  Google Scholar 

  16. Wein AJ, Kavoussi LR, Partin AW, Peters CA, editors. Campbell-Walsh urology. 11th ed. Philadelphia: Elsevier; 2016.

    Google Scholar 

  17. Matsukawa Y, Majima T, Matsuo K, Funahashi Y, Kato M, Yamamoto T, et al. Effects of tadalafil on storage and voiding function in patients with male lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a urodynamic-based study. Int J Urol. 2017;198:905.

    CAS  Google Scholar 

  18. Chen H, Wang F, Yu Z, Zhang Y, Liu C, Dai S, et al. Efficacy of daily low-dose tadalafil for treating overactive bladder: results of a randomized, double-blind, placebo-controlled trial. Urology. 2017;100:59–64.

    Article  Google Scholar 

  19. Truss MC, Stief CG, Ückert S, Becker AJ, Schultheiss D, Mchtens S, et al. Initial clinical experience with the selective phosphodiesterase-I isoenzyme inhibitor vinpocetine in the treatment of urge incontinence and low compliance bladder. World J Urol. 2000;18:439–43.

    Article  CAS  Google Scholar 

  20. Darblade B, Behr-Roussel D, Oger S, Hieble JP, Lebret T, Gorny D, et al. Effects of potassium channel modulators on human detrusor smooth muscle myogenic phasic contractile activity: potential therapeutic targets for overactive bladder. Urology. 2006;68(2):442–8.

    Article  Google Scholar 

  21. Chapple CR, Patroneva A, Raines SR. Effect of an ATP-sensitive potassium channel opener in subjects with overactive bladder: a randomized, double-blind, placebo-controlled study (ZD0947IL/0004). Eur Urol. 2006;49(5):879–86.

    Article  CAS  Google Scholar 

  22. Digesu GA, Verdi E, Cardozo L, Olivieri L, Khullar V, Colli E. Phase IIb, multicenter, double-blind, randomized, placebo-controlled, parallel-group study to determine effects of elocalcitol in women with overactive bladder and idiopathic detrusor overactivity. Urology. 2012;80(1):48–54.

    Article  Google Scholar 

  23. Kim YT, Kwon DD, Kim J, Kim DK, Lee JY, Chancellor MB. Gabapentin for overactive bladder and nocturia after anticholinergic failure. Int Braz J Urol. 2004;30(4):275–8.

    Article  Google Scholar 

  24. Carbone A, Palleschi G, Conte A, Bova G, Iacovelli E, Bettolo CM, et al. Gabapentin treatment of neurogenic overactive bladder. Clin Neuropharmacol. 2006;29(4):206–14.

    Article  Google Scholar 

  25. Chua ME, MCt S, Esmena EB, Balingit JC, Morales ML. Efficacy and safety of gabapentin in comparison to solifenacin succinate in adult overactive bladder treatment. Low Urin Tract Symptoms. 2017;10:135.

    Article  Google Scholar 

  26. United State Department of Justice. Drug Enforcement Administration. Diversion Control Division. https://www.deadiversion.usdoj.gov/. Accessed 18 Apr 2018.

  27. Marencak J, Cossons NH, Darekar A, Mills IW. Investigation of the clinical efficacy and safety of pregabalin alone or combined with tolterodine in female subjects with idiopathic overactive bladder. Neurourol Urodyn. 2011;30(1):75–82.

    Article  Google Scholar 

  28. Taylor MC, Bates CP. A double-blind crossover trial of baclofen - a new treatment for the unstable bladder syndrome. BJU Int. 1979;51:504–5.

    Article  CAS  Google Scholar 

  29. Xu D, Qu C, Meng H, Ren J, Zhu Y, Min Z, et al. Dysfunctional voiding confirmed by transdermal perineal electromyography, and its effective treatment with baclofen in women with lower urinary tract symptoms: a randomized double-blind placebo-controlled crossover trial. BJU Int. 2007;100(3):588–92.

    Article  CAS  Google Scholar 

  30. Loutochin O, Afraa TA, Campeau L, Mahfouz W, Elzayat E, Corcos J. Effect of the anticonvulsant medications Pregabalin and lamotrigine on urodynamic parameters in an animal model of neurogenic detrusor overactivity. Neurourol Urodyn. 2012;31(7):1197–202.

    Article  CAS  Google Scholar 

  31. Kalinichev M, Palea S, Haddouk H, Royer-Urios I, Guilloteau V, Lluel P, et al. ADX71441, a novel, potent and selective positive allosteric modulator of the GABA(B) receptor, shows efficacy in rodent models of overactive bladder. Br J Pharmacol. 2014;171(4):995–1006.

    Article  CAS  Google Scholar 

  32. Lecci A, Maggi CA. Tachykinins as modulators of the micturition reflex in the central and peripheral nervous system. Regul Pept. 2001;101(1–3):1–18.

    Article  CAS  Google Scholar 

  33. Green SA, Alon A, Ianus J, McNaughton KS, Tozzi CA, Reiss TF. Efficacy and safety of a neurokinin-1 receptor antagonist in postmenopausal women with overactive bladder with urge urinary incontinence. J Urol. 2006;176(6 Pt 1):2535–40. discussion 40.

    Article  CAS  Google Scholar 

  34. Frenkl TL, Zhu H, Reiss T, Seltzer O, Rosenberg E, Green S. A multicenter, double-blind, randomized, placebo controlled trial of a neurokinin-1 receptor antagonist for overactive bladder. J Urol. 2010;184:616–22.

    Article  CAS  Google Scholar 

  35. Haab F, Braticevici B, Krivoborodov G, Palmas M, Zufferli Russo M, Pietra C. Efficacy and safety of repeated dosing of netupitant, a neurokinin-1 receptor antagonist, in treating overactive bladder. Neurourol Urodyn. 2014;33(3):335–40.

    Article  CAS  Google Scholar 

  36. Zat'ura F, Vsetica J, Abadias M, Pavlik I, Schraml P, Brod'ak M, et al. Cizolirtine citrate is safe and effective for treating urinary incontinence secondary to overactive bladder: a phase 2 proof-of-concept study. Eur Urol. 2010;57(1):145–52.

    Article  CAS  Google Scholar 

  37. Chapple CR, Abrams P, Andersson KE, Radziszewski P, Masuda T, Small M, et al. Phase II study on the efficacy and safety of the EP1 receptor antagonist ONO-8539 for nonneurogenic overactive bladder syndrome. J Urol. 2014;191(1):253–60.

    Article  CAS  Google Scholar 

  38. Kavia RB, De Ridder D, Constantinescu CS, Stott CG, Fowler CJ. Randomized controlled trial of Sativex to treat detrusor overactivity in multiple sclerosis. Mult Scler. 2010;16(11):1349–59.

    Article  CAS  Google Scholar 

  39. Maniscalco GT, Aponte R, Bruzzese D, Guarcello G, Manzo V, Napolitano M, et al. THC/CBD oromucosal spray in patients with multiple sclerosis overactive bladder: a pilot prospective study. Neurol Sci. 2017;39:97.

    Article  Google Scholar 

  40. Cheng CL, Li JR, Lin CH, de Groat WC. Positive association of female overactive bladder symptoms and estrogen deprivation: a nationwide population-based cohort study in Taiwan. Medicine (Baltimore). 2016;95(28):e4107.

    Article  CAS  Google Scholar 

  41. Robinson D, Cardozo L, Milsom I, Pons ME, Kirby M, Koelbl H, et al. Oestrogens and overactive bladder. Neurourol Urodyn. 2014;33(7):1086–91.

    Article  CAS  Google Scholar 

  42. Lin YH, Hsieh WC, Huang L, Liang CC. Effect of non-ablative laser treatment on overactive bladder symptoms, urinary incontinence and sexual function in women with urodynamic stress incontinence. Taiwan J Obstet Gynecol. 2017;56(6):815–20.

    Article  Google Scholar 

  43. Perino A, Cucinella G, Gugliotta G, Saitta S, Polito S, Adile B, et al. Is vaginal fractional CO2 laser treatment effective in improving overactive bladder symptoms in post-menopausal patients? Preliminary results. Eur Rev Med Pharmacol Sci. 2016;20(12):2491–7.

    CAS  PubMed  Google Scholar 

  44. Evans RJ. Intravesical therapy for overactive bladder. Curr Urol Rep. 2005;6:429–33.

    Article  Google Scholar 

  45. Brendler CB, Radebaugh LC, Mohler JL. Topical oxybutynin chloride for relaxation of dysfunctional bladders. J Urol. 1989;141(6):1350–2.

    Article  CAS  Google Scholar 

  46. Schröder A, Albrecht U, Schnitker J, Reitz A, Stein R. Efficacy, safety, and tolerability of intravesically administered 0.1% oxybutynin hydrochloride solution in adult patients with neurogenic bladder: a randomized, prospective, controlled multi-center trial. Neurourol Urodyn. 2016;35(5):582–8.

    Article  Google Scholar 

  47. Lose G, Nørgaard JP. Intravesical oxybutynin for treating incontinence resulting from an overactive detrusor. BJU Int. 2001;87:767–73.

    Article  CAS  Google Scholar 

  48. Gittelman M, Weiss H, Seidman L. A phase 2, randomized, double-blind, efficacy and safety study of oxybutynin vaginal ring for alleviation of overactive bladder symptoms in women. J Urol. 2014;191(4):1014–21.

    Article  CAS  Google Scholar 

  49. Glickman S, Tsokkos N, Shah PJ. Intravesical atropine and suppression of detrusor hypercontractility in the neuropathic bladder. A preliminary study. Paraplegia. 1995;33(1):36–9.

    CAS  PubMed  Google Scholar 

  50. Deaney C, Glickman S, Gluck T, Malone-Lee JG. Intravesical atropine suppression of detrusor hyperreflexia in multiple sclerosis. J Neurol Neurosurg Psychiatry. 1998;65(6):957.

    Article  CAS  Google Scholar 

  51. Fader M, Glickman S, Haggar V, Barton R, Brooks R, Malone-Lee J. Intravesical atropine compared to oral oxybutynin for neurogenic detrusor overactivity: a double-blind, randomized crossover trial. J Urol. 2007;177(1):208–13. discussion 13.

    Article  CAS  Google Scholar 

  52. Yokoyama O, Ishiura Y, Nakamura Y, Kunimi K, Mita E, Namiki M. Urodynamic effects of intravestical instiallation of lidocaine in patients with overactive detrusor. J Urol. 1997;157:1826–30.

    Article  CAS  Google Scholar 

  53. de Seze M, Wiart L, de Seze MP, Soyeur L, Dosque JP, Blajezewski S, et al. Intravesical capsaicin versus resiniferatoxin for the treatment of detrusor hyperreflexia in spinal cord injured patients: a double-blind, randomized, controlled study. J Urol. 2004;171(1):251–5.

    Article  Google Scholar 

  54. Phe V, Schneider MP, Peyronnet B, Abo Youssef N, Mordasini L, Chartier-Kastler E, et al. Intravesical vanilloids for treating neurogenic lower urinary tract dysfunction in patients with multiple sclerosis: a systematic review and meta-analysis. A report from the neuro-urology promotion Committee of the International Continence Society (ICS). Neurourol Urodyn. 2017;37:67.

    Article  Google Scholar 

  55. De Ridder D, Baert L. Vanilloids and the overactive bladder. BJU Int. 2000;86:172–80.

    Article  Google Scholar 

  56. de Seze M, Wiart L, Ferrière J, de Seze MP, Joseph PA, Barat M. Intravesical instillation of capsaicin in urology: a review of the literature. Eur Urol. 1999;36(4):267–177.

    Article  Google Scholar 

  57. de Seze M, Gallien P, Denys P, Labat JJ, Serment G, Grise P, et al. Intravesical glucidic capsaicin versus glucidic solvent in neurogenic detrusor overactivity: a double blind controlled randomized study. Neurourol Urodyn. 2006;25(7):752–7.

    Article  Google Scholar 

  58. Lazzeri M, Calo G, Spinelli M, Guerrini R, Beneforti P, Sandri S, et al. Urodynamic and clinical evidence of acute inhibitory effects of intravesical nociceptin/orphanin FQ on detrusor overactivity in humans: a pilot study. J Urol. 2001;166:2237–40.

    Article  CAS  Google Scholar 

  59. Lazzeri M, Calò G, Spinelli M, Guerrini R, Salvadori S, Beneforti P, et al. Urodynamic effects of intravesical nociceptin/orphanin FQ in neurogenic detrusor overactivity: a randomized, placebo-controlled, double-blind study. Urology. 2003;61(5):946–50.

    Article  Google Scholar 

  60. Lazzeri M, Calo G, Spinelli M, Malaguti S, Guerrini R, Salvadori S, et al. Daily intravesical instillation of 1 mg nociceptin/orphanin FQ for the control of neurogenic detrusor overactivity: a multicenter, placebo controlled, randomized exploratory study. J Urol. 2006;176(5):2098–102.

    Article  CAS  Google Scholar 

  61. Tyagi P, Hsieh VC, Yoshimura N, Kaufman J, Chancellor MB. Instillation of liposomes vs dimethyl sulphoxide or pentosan polysulphate for reducing bladder hyperactivity. BJU Int. 2009;104(11):1689–92.

    Article  CAS  Google Scholar 

  62. Chuang YC, Kaufmann JH, Chancellor DD, Chancellor MB, Kuo HC. Bladder instillation of liposome encapsulated onabotulinumtoxina improves overactive bladder symptoms: a prospective, multicenter, double-blind, randomized trial. J Urol. 2014;192(6):1743–9.

    Article  CAS  Google Scholar 

  63. Kuo HC, Liu HT, Chuang YC, Birder LA, Chancellor MB. Pilot study of liposome-encapsulated onabotulinumtoxina for patients with overactive bladder: a single-center study. Eur Urol. 2014;65(6):1117–24.

    Article  CAS  Google Scholar 

Suggested Readings

  • Sacco E, Recupero S, Bientinesi R, Palermo G, D'Agostino D, Currò D, et al. Pioneering drugs for overactive bladder and detrusor overactivity: ongoing research and future directions. World J Obstet Gynecol. 2015;4(2):24–39.

    Article  Google Scholar 

  • Ellington DR, Szychowski JM, Malek JM, Gerten KA, Burgio KL, Richter HE. Combined tolterodine and vaginal estradiol cream for overactive bladder symptoms after randomized single-therapy treatment. Female Pelvic Med Reconstr Surg. 2016;22(4):254–60.

    Article  Google Scholar 

  • Sacco E, Bientinesi R. Innovative pharmacotherapies for women with overactive bladder: where are we now and what is in the pipeline? Int Urogynecol J. 2015;26(5):629–40.

    Article  Google Scholar 

  • Weber MA, Kleijn MH, Langendam M, Limpens J, Heineman MJ, Roovers JP. Local oestrogen for pelvic floor disorders: a systematic review. PLoS One. 2015;10(9):e0136265.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Lahey Hospital and Medical Center, Burlington, MA, USA

    Alison C. Levy & Lara S. MacLachlan

Authors
  1. Alison C. Levy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lara S. MacLachlan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lara S. MacLachlan .

Editor information

Editors and Affiliations

  1. Department of Urology, Medical University of South Carolina, Charleston, SC, USA

    Lindsey Cox

  2. Department of Urology, Medical University of South Carolina, Charleston, SC, USA

    Eric S. Rovner

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Levy, A.C., MacLachlan, L.S. (2019). Other Treatments for Overactive Bladder, Including Intravesical. In: Cox, L., Rovner, E. (eds) Contemporary Pharmacotherapy of Overactive Bladder. Springer, Cham. https://doi.org/10.1007/978-3-319-97265-7_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-97265-7_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-97264-0

  • Online ISBN: 978-3-319-97265-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation