The Effects of Bladder Training, Tolterodine and Bladder Training with Tolterodine in Female Patients with Overactive Bladder: Prospective, Randomized Study / 대한비뇨기과학회지

ABSTRACT

PURPOSE: There are few reports concerning the first-line treatment of choice for an overactive bladder. The aim of this study was to compare the effects of bladder training, tolterodine, and bladder training with tolterodine, as first-line treatments in patients with an overactive bladder. MATERIALS AND METHODS: A prospective randomized study was conducted on 99 female patients with overactive bladders. The patients were treated with bladder training, tolterodine (2mg twice daily), and bladder training with tolterodine, as first-line treatments, for 12 weeks. Of the 99 patients, 74 (bladder training 24, tolterodine 24, combined 26) were followed up for 12 weeks. The treatment efficacy was measured by a micturition diary, subjective urgency scores and subjective perception of bladder condition at the end of the treatment. The safety and tolerability were assessed from adverse events and treatment withdrawals. RESULTS: After 12 weeks of treatment, the mean frequency of micturition and nocturia decreased by 27.1 and 55.8% in the bladder training group, 30.3 and 61.9% in the tolterodine group and 32.6 and 63.2% in the combined therapy group. The subjective mean urgency score decreased by 48.4, 62.5 and 63.2% in the three respective groups. The subjective perception of bladder symptom scores at the end of the treatments were 1.5, 1.42 and 1.31, with significant improvement rates of 50.0, 58.3 and 69.3% in the bladder training, tolterodine and combined therapy groups, respectively. Adverse events, and withdrawals due to adverse events, were 23.1 and 7.7% in the tolterodine and 28.6 and 7.1% in the combined therapy groups, but there were none in the bladder training group. CONCLUSIONS: Bladder training, tolterodine and combined therapy are all effective first-line treatments in female patients with overactive bladders. There are some enhanced effects with the combined therapy than with the bladder training and tolterodine monotherapies. Because of its high success rate, relatively low cost and absence of adverse events, bladder training should be included as a first-line treatment.