The effect of extended release tolterodine used for overactive bladder treatment on female sexual function

ABSTRACT Introduction Overactive bladder (OAB) is a common condition, especially in middle aged women, requiring long term therapy with anticholinergics to maintain symptoms relief. The aim of the study was to determine the effect of tolterodine extended release (ER) used for OAB treatment on the sexual function of women. Materials and Methods Between August 2010 and August 2014, 220 women with confirmed OAB, attended Urogynecology Outpatient Clinic and were prospectively enrolled in this study. 158 women were evaluated, with a comprehensive history, physical examination, urodynamic studies and Female Sexual Function Index (FSFI) questionnaire. 73 patients of group A (control group) received no treatment and 85 patients of group B received an anticholinergic regimen - tolterodine ER 4mg once daily. Data were evaluated again in accordance with FSFI after three months, using SPSS software. Results A statistically significant increase was noted in group B in domains of desire (pre-treatment 2.5±0.2 to 4.5±0.2 post-treatment), arousal (3.1±0.2 to 3.1±0.2 respectively), lubrication (3.4±0.3 to 4.3±0.3 respectively), orgasm (3.5±0.3 to 4.5±0.3 respectively), satisfaction (2.6±0.2 to 4.2±0.3 respectively) and pain (2.4±0.2 to 4.6±0.4 respectively) after three months treatment with tolterodine ER. In group A there were no statistically significant changes in pre and post treatment values (p>0.05). Total FSFI score for group B was significantly higher after tolterodine treatment (26.5±1.5) compared to pre-treatment values (17.4±1.4, p<0.01) and to control group A (17.7±1.2 and 17.9±1.5, p>0,05) respectively. Conclusions This preliminary study demonstrates that treatment of OAB with tolterodine ER was found to have positive effect on sexual function of patients with OAB.

The clinical efficacy ofNingmitai capsule combined with tolterodine in the treatment of overactiver bladder after transurethral resection of the prostate / 国际中医中药杂志

Objective To observe the clinical efficacy of Ningmitai capsule combined with Tolterodine in the treatment of overactiver bladder after transurethral resection of the prostate(TURP).Methods 63 TURP patients with bladder disease (OAB) in our hospital from October 2012 to October 2012 were selected and randomly divided into a treatment group (n=32) and a control group (n=31). From the date of operation, the control group was treated with tolterodine 2 mg, 2 times a day, while the treatment group was additional treated with Ningmitai capsule 4mg, 3 times a day based on the control group. All patients stopped to take medicine 5 days after catheter removal. The pain frequency and duration of bladder spasm after TURP in catheterization period and the urine volume per time, the number of urgent incontinence, and the number of urgent micturition average day in automatic micturition period were scored by OABSS.Results The number of bladder spasm in the first postoperative day(3.5 ± 0.5vs.4.4 ± 0.8,t=2.650), the second day(1.5 ± 0.9vs.1.8 ± 0.2,t=2.350) and the third day (0.4 ± 1.6vs. 1.1 ± 1.8,t=2.210) of the treatment group were all less than the control group (P>0.05). The 24 h average frequency of urination after catheter removal (6.2 ± 1.3vs. 9.4 ± 1.8,t=2.710), the average number of nocturia (1.5 ± 0.4vs. 3.9 ± 1.0,t=2.580), the average number of 24h urinary urgency (1.1 ± 0.3vs. 3.2 ± 0.8,t=2.660), the average number of incontinence in 24 h (0.5 ± 0.2vs. 2.4 ± 0.6,t=2.700) and OABSS total score  (4.6 ± 1.2vs. 6.9 ± 2.1,t=2.470) of the treatment group were all better than the control group (P<0.05). Conclusion Ningmitai capsule combined with tolterodine in the treatment of overactiver bladder after TURP has significant clinical effect, helping patients recovery and improving quality of life.

Randomized controlled clinical trials of solifenacin on urination in patients with overactivity bladder / 中国医师进修杂志

Objective To investigate the effect and safety of solifenacin on urination in patients with overactivity bladder (OAB) by randomized controlled clinical trials. Methods One hundred and eight patients with OAB were randomized divided into observation group and control group, each with 54 patients. The patients in two groups were respectively treated by solifenacin and tolterodine. After treatment for 8 weeks, the curative effect, urination and adverse reaction were compared between two groups. Results The total effective rate in observation group was 85.19%(46/54), in control group was 68.52%(37/54), there was significant difference (P<0.05). After treatment for 8 weeks, the frequency of urination for 24 h in observation group was less than that in control group [(7.2 ±3.1) times vs. (9.7 ±3.2) times], the levels of initial micturition desir bladder volume, maximum bladder pressure volume, maximum urine flow rate in observation group were better than those in control group:(215.4±34.6) ml vs. (184.1±42.1) ml, (341.6±24.5) ml vs. (283.4±24.8) ml, (20.4±5.8) ml/s vs. (16.8±7.1) ml/s, there were significant differences (P<0.05). The total scores and urgency scores of OAB symptom score (OABSS) in observation group were significantly lower than those in control group: (3.7±2.5) scores vs.(4.9±2.1) scores, (0.4±0.1) scores vs. (0.7±0.4) scores, P<0.05. The adverse reaction rate in observation group was 18.52%(10/54), in control group was 48.15%(26/54), there was significant difference ( P<0.01). Conclusions Solifenacin can improve urination in OAB patients, and compared with tolterodine, it has higher efficacy and less adverse reaction. It is worthy of clinical application.

Determination of Eight Residual Organic Solvents in Tolterodine Tartrate by Capillary Gas Chromatography / 中国药师

Objective:To establish a method for the determination of 8 residual organic solvents in tolterodine tartrate by capillary GC. Methods: The determination of methanol, ethanol, acetonitrile, acetone, ethyl acetate, trichloromethane and tetrahydrofuran in tolterodine tartrate dissolved in the solution of N, N-dimethylformamide-water ( 1∶ 4 ) was carried out on a CP-sil 5CB ( 60. 0 m × 0. 32 mm,5μm)column. The inlet temperature was 200℃ and the FID detector temperature was 250℃. The flow rate of carrier gas was 1. 2 ml·min-1 . The column temperature was 120℃. The headspace vial temperature was 85℃ and the time was 30min. The determina-tion of pyridine in tolterodine tartrate dissolved in the solution of dimethylsulfoxide-sodium hydroxide (17∶13) was carried out on an HP-1(30. 0 m × 0. 53 mm,5 μm) column. The inlet temperature was 220℃ and the FID detector temperature was 250℃. The column tem-perature was 80℃. The flow rate of carrier gas was 3. 0 ml·min-1 . The headspace vial temperature was 85℃ and the time was 30 min. Results:All peaks could be separated from each other under the chromatographic conditions. The linearity of the eight solvents was falrly good (r>0. 999). The average recovery was ranged from 86. 0% to 100. 2% with RSD of 1. 7%-3. 5% (n=9). The limit of detection was 0. 63, 0. 43, 0. 30, 0. 18, 0. 079, 0. 36, 0. 18 and 0. 89 μg·ml-1 , respectively. Conclusion:The methods can be applied in the determination of the eight residual organic solvents in tolterodine tartrate.

In vitro- In vivo Correlation Studies of Modified Release Tolterodine Tablet Dosage form in Rabbits.

Tolterodine is an antimuscarnic drug that is used for sympathetic treatment of urinary incontinence. Tolterodine modified release tablet, was investigated in rabbit for pharmacokinetic and in vitro–in vivo correlation studies. Tablets were prepared and in vitro release was studied in simulated gastric fluid at 150RPMs. New Zealand albino male rabbits have been used as animal model for in vivo study. A sensitive and simple HPLC method was developed for the determination of Tolterodine content in rabbit plasma. In vitro release studies showed that release patterns followed zero order for around 24h. The in vivo–in vitro correlation coefficients obtained from point-to-point analysis were greater than 99% between concentrations at certain time points obtained from release study in simulated gastric fluid and HPLC analysis of rabbit’s plasma. From the in vitro–in vivo correlation prediction it was evident that the Tolterodine matrix assisted tablet is a good for controlled delivery of Tolterodine.

Clinical observation of tolterodine combined with flupentixol melitracen in the treatment of patients with overactive bladder / 中国基层医药

Objective To investigate the clinical efficacy and safety of tolterodine combined with flupentixol melitracen in the treatment of women with overactive bladder (OAB).Methods 84 female patients with OAB were chosen and randomly divided into the observation group and the control group.42 cases in observation group were treated with tolterodine combined with flupentixol melitracen.42 cases in control group were only treated with tolterodine.The clinical efficacy was recorded and compared after treatment for 4 weeks.Results The total effective rate of the observation group was higher than the control group (95.24％ vs 76.19％,x2 =6.291,P ＜ 0.05).The 24h frequency of urination,the average 24h number of incontinence episodes,initial urinate capacity and maximum bladder pressure capacity had statistically significant differences between the two groups (all P ＜ 0.05).Conclusion Tolterodine combined with flupentixol melitracen in the treatment of women with OAB has advantages of short course of treatment,excellent efficacy,and few side effects.

Combination ofLingshao-Zaoren particle and Tolterodine Tartrate tablets for the treatment of overactive bladder in women / 国际中医中药杂志

Objective To evaluate the efficacy ofLingshao-Zaoren particle combined with Tolterodine Tartrate tablet in the treatment of overactive bladder in women.Methods A total of fifty female patients diagnosed with overactive bladder were randomized to receivingLingshao-Zaoren particle combined with Tolterodine Tartrate tablet group(treatment group,n=25) or only Tolterodine Tartrate tablet group(control group, n=25). Both groups were treated for 4 weeks. Changes of scores from the Overactive Bladder Symptom Scale (OBASS) and the Urgent Urination Scale were assessed.Results The scores from the OBASS improved significantly after treatment than those before treatment in both groups(in the treatment group: 3.24±0.61vs.12.16± 1.39,P<0.01; in the control group: 8.81±1.55vs.13.12±1.45,P<0.01) and so did the Urgent Urination Scale (in the treatment group: 1.04±0.72vs. 3.99±0.78,P<0.01; in the control group: 2.61±0.88vs.4.01±0.71,P<0.01) . There were significantly greater improvements in the scores from the OBASS and the Urgent Urination Scale in the treatment group than those in the control group(allP<0.01).ConclusionLingshao-Zaoren particle combined with Tolterodine Tartrate tablet was superior to only Tolterodine Tartrate tablet for the treatment of overactive bladder in women.

Synergistic effect of iontophoresis and chemical enhancers on transdermal permeation of tolterodine tartrate for the treatment of overactive bladder

Purpose The objective of the study was to evaluate the synergistic transdermal permeation effect of chemical enhancers and iontophoresis technique on tolterodine tartrate (TT) transdermal gel and to evaluate its pharmacokinetic properties. Materials and Methods Taguchi robust design was used for optimization of formulations. Skin permeation rates were evaluated using the Keshary-chein type diffusion cells in order to optimize the gel formulation. In-vivo studies of the optimized formulation were performed in a rabbit model and histopathology studies of optimized formulation were performed on rats. Results Transdermal gels were formulated successfully using Taguchi robust design method. The type of penetration enhancer, concentration of penetration enhancer, current density and pulse on/off ratio were chosen as independent variables. Type of penetration enhancer was found to be the significant factor for all the responses. Permeation parameters were evaluated when maximum cumulative amount permeated in 24 hours (Q24) was 145.71 ± 2.00µg/cm2 by CIT4 formulation over control (91.89 ± 2.30µg/cm2). Permeation was enhanced by 1.75 fold by CIT4 formulation. Formulation CIT4 containing nerolidol (5%) and iontophoretic variables applied (0.5mA/cm2 and pulse on/off ratio 3:1) was optimized. In vivo studies with optimized formulation CIT4 showed increase in AUC and T1/2 when compared to oral suspension in rabbits. The histological studies showed changes in dermis indicating the effect of penetration enhancers and as iontophoresis was continued only for two cycles in periodic fashion so it did not cause any skin damage observed in the slides. Conclusion Results indicated that iontophoresis in combination with chemical enhancers is an effective method for transdermal administration of TT in the treatment of overactive bladder. .

Clinical research of sacral nerve stimulation combined with tolterodine in patients with female idiopathic overactive bladder / 中国医师进修杂志

Objective To study the efficacy of sacral nerve stimulation combined with tolterodine in patients with female idiopathic overactive bladder (IOAB).Methods A total of 200 female patients diagnosed with IOAB from January 2005 to January 2011 were included in the study,and according to random number table method were divided into treatment group and control group with 100 cases in each.Each group was divided into 3 subgroups according to urinary frequency and urgency,urge incontinence,and both of them together.In the treatment group,patients received percutaneous sacral nerve stimulation and tolterodine 2 mg orally,1 time/d,while in the control group,only given tolterodine 2 mg orally,1 time/d,treatment for 3 months.The voiding diary and urodynamics parameters were observed between the two groups before and after treatment and application of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) to evaluate the psychology of concomitant depression and anxiety score.Results After treatment,the average number of urination,daily average unit urine,the single biggest urine and urine feel capacity (FDV),the maximum capacity of the bladder pressure (MCBC),maximum urinary flow rate (Qmax) in two groups were improved,and the daily average unit urine,single biggest urine and FDV,MCBC,Qmax in treatment group after treatment were higher than those in control group [daily average unit urine:urinary frequency and urgency (248 ± 46) ml/times vs.(150 ± 77) ml/times,urge incontinence (249 ± 69) ml/times vs.(144 ± 81) ml/times,both of them together (247 ± 69) ml/times vs.(170 ± 46) ml/times; the single biggest urine:(320 ± 87) ml/times vs.(212 ± 44) ml/times,(315 ± 65) ml/times vs.(211 ± 56) ml/times,(333 ±59) ml/times vs.(201 ±66) ml/times;FDV:(176 ±64) ml vs.(142 ±44) ml,(190 ±69) ml vs.(142±55) ml,(188 ±60) mlvs.(138 ±49) ml;MCBC:(265 ±46) ml vs.(203 ±50) ml,(288 ±48) ml vs.(197 ± 41)ml,(287 ± 43) ml vs.(189 ± 44) ml],there were significant statistical differences (P ＜ 0.01).The SDS and SAS scores were reduced in two groups after treatment,and the SDS and SAS scores in treatment group after treatment were significantly lower than those in control group [SDS scores:urinary frequency and urgency (33.0 ± 6.2) scores vs.(44.0 ± 5.9) scores,urge incontinence(31.1 ± 6.2) scores vs.(41.6 ± 6.1) scores,both of them together(33.4 ± 7.2) scores vs.(44.5 ± 5.0)scores;SAS scores:(30.3 ± 4.4) scores vs.(41.3 ±4.4) scores,(33.3 ±5.8) scores vs.(42.5 ±6.4) scores,(31.9 ±4.7) scores vs.(43.5 ± 5.6) scores],there were significant statistical differences (P＜ 0.01).Conclusions The combined treatment of tolterodine and sacral nerve stimulation can not only improve the voiding dysfunctions symptoms but also the concomitant depression and anxiety in patients with female IOAB,thus improving the patient's quality of life.

Effect of tolterodine on catheter-related bladder discomfort after general aneathesia operation / 中华泌尿外科杂志

Objective To determine whether a prophylactic tolterodine administration before surgical operation on non-urologic patients under general aneathesia can prevent the occurrence of catheter-related bladder discomfort (CRBD) ; and to assess patients’ tolerance to the symptoms as well as the impact on related consultation work of urologic surgeons.Methods One hundred and eighty cases of non-urology patients who need general aneathesia operations were divided into 2 groups:90 cases in tolterodine group and 90 in control group.The assessment of CRBD is categorized into 4 steps and statistics for adverse events ( dry mouth,dizzyness and facial flushing) was also conducted.A record of the patients’ needs for urologic surgical consultation during their reservation of catheter was also kept.SPSS 13.0 used in the statistical analysis of data in terms of X2 examination,where the divergence P ＜ 0.05 was regarded statisticly valid.Results 82 cases were followed up in the tolterodine group with a 24.4％ CRBD occurrence,which included 7.2％ shows moderate and severe symptoms,and there were also 23 cases with dry mouth ( 28.0％ ),4 cases with dizzyness (4.8％),13 cases with facial flussing ( 15.8％ ),and 1 case who needs further consultation (1.2％).In the 86 followed-up cases in control group,CRBD occurance rate was 54.7％,with 30.2％ showed moderate and severe symptoms,plus 2 cases suffered from severe consequences.Nine cases ( 10.5％) in control group requires further consultation ( X2 =19.499,P =0.000 ＜ 0.05 ).Conclusions A prophylactic tolterodine administration before surgery to the patients underwent general aneathesia can prevent the occurrence ofcatheter-related bladder discomfort (CRBD) and reduce the consultation work of urologic surgeons.Patients using tolterodine show a higher rate of adverse events,yet to which most patients can tolerate.

Clinical effects of tolterodine with pelvic floor electrical stimulation in the treatnent of female OAB patients / 中国综合临床

Objective To investigate whether tolterodine combined with pelvic floor electrical stimulation is more effective than tolterodine alone in the treatment of wonen with overactive bladder(OAB) and the underlying mechanism.Methods Seventy-three female patients with OAB were recruited from our hospital during Oct.2009 to Dec.2010 and prospectively studied,of whom 39 cases were given tolterodine(2 mg each time,twice daily for4 weeks)alone while the other 34 cases were given tolterodine combined with pelvic floor electrical stimulation for the treatment of OAB.Data on urgency,incontinence,micturition frequency,nocturia episodes and voided volume were collected before and after 4 weeks' treatment using a week micturition diary.Results The differences of changes of OAB symptoms between the 2 groups had statistical significance (P ＜ 0.05).Patients in the tolterodine combined with pelvic floor electrical stimulation group reported treatment benefit than the tolterodine group in the micturitions and the volume voided per micturition(P ＜ 0.05).There were no difference in the number of urgency episodes per 24 hours,incontinence episodes and nocturnal episodes (P ＞ 0.05).Conclusion A combination of toterodine with pelvic floor electrical stimulation could significantly improve the OAB symptoms,and is a potential therapy for female patients with OAB.

Application of solifenacin for female overactive bladder failed in tolterodine treatment / 中华泌尿外科杂志

ObjectiveTo investigate the clinical efficacy and safety of solifenacin for female overactive bladder (OAB) who failed in toherodine treatment. MethodsFrom Jan 2010 to Oct 2010,48 cases of female OAB were treated with 5 mg/d solifenacin for 4 weeks after the failure of tolterodine treatment.The improvement of the perception of bladder condition as well as the mean numbers of day-time micturition,urgency episodes,urge incontinence episode per day,nocturia and pads usage were used as objective indexes for the evaluation of therapeutic effect. ResultsAfter 4-week solifenacin treatment,the mean numbers of day-time micturition,urgency episodes,urge incontinence episode per day,nocturia and pads usage were respectively decreased from the baselines ( 8.7 ± 1.5),(3.4 ± 2.1 ),( 2.4 ± 1.8 ),(2.1 ± 1.8 ) and (2.2 ±1.6) to be (7.2 ±2.5),(2.0 ±1.8),(1.5 ±1.2),(1.2 ±0.8) and (1.4 ±0.8).The perception of bladder condition was improved in 42 cases.The withdrawal from the treatment was seen in 3 cases due to headache and dry mouth.No severe adverse event was found in the rest 45 patients. Conclusion Solifenacin might be an effective and safe alternative agent in the treatment of female OAB who failed in tolterodine treatment.

Effect of Double Dosage Tolterodine on Detrusor Overactivity after Spinal Cord Injury / 中国康复理论与实践

@#ObjectiveTo evaluate the effect of double dosage tolterodine (4 mg/d) on patients with detrusor overactivity after spinal cord injury (SCI).Methods30 patients with detrusor overactivity after SCI who poorly responsed to tolterodine (2 mg/d) were treated with double dosage tolterodine. Urine leakage and quality of life by ICI-Q-SF was used to assess the treatment effect.Results28 of 30 patients completed this study after 4 weeks. 2 patients quited for dry mouth. After treatment with double dosage tolterodine, bladder capacity increased significantly from (196.3±44.7) ml to (393.5±54.3) ml, urine leakage decreased from (4.96±2.15) to (3.92±2.14) times per day. 25 of the 28 patients showed improvement in quality of life by ICI-Q-SF. ConclusionTreatment with double dosage tolterodine showed improvements in bladder capacity and urine leakage in patients with detrusor overactivity after SCI if the patients could tolerate the dry mouth and other side effects.

The Effect of tolterodine Via Oral and Intravenous Administrations on Voiding in Awake Spontaneously Hypertensive Rats as an Overactive Bladder Model

PURPOSE: We investigated the effect of oral or intravenous tolterodine on cystometric parameters in awake spontaneously hypertensive rats (SHRs) as a model of overactive bladder (OAB). The aim of our study was to observe the experimental conditions required to reproduce the clinical pharmacological effects of tolterodine, as seen in humans, to decrease bladder pressure or increase bladder capacity. MATERIALS AND METHODS: We studied the effects of the most widely used antimuscarinic drug, tolterodine, on cystometric parameters via two different administrations (oral and intravenous) in awake SHRs. RESULTS: Oral administration of tolterodine 10 mg/kg(-1) body weight in awake rats did not change any cystometric parameters significantly. Intravenous administration of tolterodine 0.3 mg/kg(-1) body weight significantly decreased basal pressure (BP) and micturition pressure (MP), but showed no effect on micturition interval (MI) or bladder capacity (BC). CONCLUSION: Despite a high dose of tolterodine via an oral or an intravenous route, a decrease in BP or MP was the only effect on cystometrographic parameters in awake rats, whereas MI and BC were not significantly affected. Therefore, it is difficult to reproduce in awake rats as an acute response the cystometric increase in the MI that is observed in humans after chronic administration of antimuscarinic agents.

The Effect of Tolterodine and Oxybutyninin on Nocturia in Patients with Benign Prostatic Hyperplasia

PURPOSE: Nocturia has been one of the most bothersome symptoms in benign prostatic hyperplasia (BPH) patients. Therefore, the authors evaluated the effect of tolterodine and oxybutyninin on nocturia in BPH patients. MATERIALS AND METHODS: From September 2006 to March 2007, 82 patients who presented over than 2 in nocturnal bladder capacity index (NCBI) in spite of having alpha blockers for 6 months were enrolled. Group I (n=38) took alpha blocker with tolterodine, group II (n=44) took alpha blocker with oxybutynin. The number of their nocturia episodes was separately evaluated by the time before and after the medication. The complications were assessed using a questionnaire. RESULTS: The number of nocturia episodes decreased by at least 1 in 68.4% (26/38), 84.1% (37/44) of patients in group I, II, respectively, and decreased by 2 or more, 1 and were unchanged or increased were 36.8, 31.6, 31.6% in group I patients and 45.5, 38.6, 15.9% in group II patients, respectively. In baseline nocturia > or =6 group, the nocturia decreased by 1 or more in 66.7%, 77.8% in group I, II, respectively. Adverse events, including dry mouth, dizziness, headache, etc, occurred in 21.1% (8/38) in group I and 27.3% (12/44) in group II patients. The complications between two groups showed no significant differences. CONCLUSIONS: Alpha blockers with tolterodine or oxybutynin can be effectively combined as a treatment option for patients with BPH complaining of unresolved nocturia.

Tolterodine to prevent and treat bladder spasm around the operation to BPH / 中华泌尿外科杂志

Objective To evaluate the efficacy of tolterodine in preventing bladder spasm during the operation to BPH.Methods One hundred and twelve cases of BPH patients were randomized to two groups:56 cases in one group were prescribed tolterodine 4-5 d before operation and 3-4 d after operation (2 mg twice daily),another 56 cases did not take any anti-spasm drugs.The bladder spasm occurring or not,frequency and continuing time of bladder were evaluated and recorded.Results In the controlling group:the non bladder spasm in 12.5% (7/56),mild bladder spasm in 14.3% (8/56),severe bladder spasm in 73.3% (41/56),In the treatment group:non bladder spasm in 87.5% (49/ 56),mild bladder spasm in 8.9% (5/56),severe bladder spasm in 3.6% (2/56).There was signifi-cant difference between the 2 groups (P<0.001).Conclusion Tolterodine could alleviate bladder spasm around the operation to BPH.

Effects of combination of tolterodine and tamsulosin on BPH induced LUTS in rats / 中国基层医药

Objective To investigate the efficacy of tolterodine plus tamsulosin in rats with benign prostatic hyperplasia(BPH)induced low urinary tract syndrome(LUTS).Methods Male rats were castrated,then testosterone propionate were given by subcutaneous injection to induce BPH/LUTS model.Model rats were intragastrically administrated with 0.4mg/kg of tolterodine,0.04mg/kg of tamsulosin or(0.4+0.04)mg/kg of tolterodine plus tamsulosin for 14 days and urodynamics,residual urine volume and volume of bladder were mearsured.Results Tolterodine plus tamsulosin could simultaneously shorten the micturition duration,prolong the interval duration between micturition,decrease the threshold intravesical pressure at micturition and the max intravesical Pressure at micturition significantly.The combined-therapy method could also decrease the residual urine volume to a certein extent and had no obvious influence on enlarging the volume of bladder(P＜0.05 or P＜0.01).Conclusion Combination treatment with tolterodine and tamsulosin may efficiently ameliorate bladder outlet obstrution and overactive bladder simultaneously,with no extra danger of uroschesis.

Effects of Bladder Training and/or Tolterodine in Female Patients with Overactive Bladder Syndrome: A Prospective, Randomized Study

We compared the effects of bladder training and/or tolterodine as first line treatment in female patients with overactive bladder (OAB). One hundred and thirty-nine female patients with OAB were randomized to treatment with bladder training (BT), tolterodine (To, 2 mg twice daily) or both (Co) for 12 weeks. Treatment efficacy was measured by micturition diary, urgency scores and patients' subjective assessment of their bladder condition. Mean frequency and nocturia significantly decreased in all treatment groups, declining 25.9% and 56.1%, respectively, in the BT group; 30.2% and 65.4%, respectively, in the To group; and 33.5% and 66.3%, respectively in the Co group (p<0.05 for each). The decrease in frequency was significantly greater in the Co group than in the BT group (p<0.05). Mean urgency score decreased by 44.8%, 62.2% and 60.2% in the BT, To, and Co groups, respectively, and the improvement was significantly greater in the To and Co groups than in the BT group (p<0.05 for each). Although BT, To and their combination were all effective in controlling OAB symptoms, combination therapy was more effective than either method alone. Tolterodine alone may be instituted as a first-line therapy, but may be more effective when combined with bladder training.

Efficacy and Tolerability of Tolterodine Compared to Oxybutynin in Children with a Neurogenic Bladder / 대한비뇨기과학회지

PURPOSE: The aim of this study was to investigate the efficacy and adverse effects of oral tolterodine compared to oxybutynin in children with a neurogenic bladder. MATERIALS AND METHODS: 16 patients, with persistent daytime or nighttime wetting after oxybutynin medication for the treatment of a neurogenic bladder, were enrolled. All 16 patients had been crossed-over from oxybutynin to tolterodine due to serious side effects or lack of improvement. The mean age was 6.4 years (range 3 to 11), and the mean body weight was 22kg (range 16 to 33). All patients were initially treated with oral tolterodine, 2mg, twice daily. The efficacy of tolterodine was assessed in comparison to oxybutynin, and considered as improved with a greater than 50% reduction in wetting episodes, as stationary with a less than 50% reduction or as increased or aggravated with a greater than 50% increase. The tolerability was also assessed using a questionnaire for adverse events. RESULTS: The mean duration of tolterodine treatment was 193 days (range 14 to 940). After treatment with an initial tolterodine dose of 2mg bid, 5 patients (31%) were improved, 8 (50%) were stationary and 3 (19%) were aggravated. Overall, the initial tolterodine dose showed equal efficacy to that of oxybutynin (p=0.483). Of the 16 patients, side effects developed in 12 (75%) during the oxybutynin treatment, whereas only 2 (13%) developed side effects during the tolterodine treatment (p=0.001). CONCLUSIONS: Compared to oxybutynin, tolterodine was well tolerated in children, allowing greater compliance and offering an equally effective treatment for neurogenic incontinence in children with a neurogenic bladder. Therefore, it seems that tolterodine can be safely and effectively used to replace oxybutynin in children with a neurogenic bladder.

Effects of tolterodine on detrusor hyperreflexia for patients with spinal cord injury / 中国康复理论与实践

@#ObjectiveTo evaluate the efficacy and tolerance of tolterodine in treating detrusor hyperreflexia in patients with spinal cord injury.Methods50 patients of spinal cord injury patients with detrusor hyperreflexia were involved in this study.The data from voiding diary were evaluated 7 days before and after the patients being treated with tolterodine 2 mg twice daily.ResultsAfter 12 weeks of treatment,the functional bladder volume increased from(114.0±44.3) ml to(207.7±54.9) ml,the mean frequency of micturition decreased from(8.9±2.7) /d to(4.6±2.5) /d,the mean volume of incontinence decreased from(646.7±348.9) ml to(426.6±291.3) ml,the mean frequency of incontinence decreased from(7.8±3.1) /d to(4.8±3.2) /d,which were all statistically different before and after treatment.5 patients felt dry mouth,but they could tolerated it.ConclusionTolterodine is an effective and well tolerable antimuscarinic agent for treating detrusor hyperreflexia after spinal cord injury.