ABSTRACT
OBJECTIVE: Evaluate the effect of the treatment with fesoterodine fumarate in patients with overactive bladder, as an alternative in case of failure of the usual anticholinergic treatment, due to either lack of therapeutic efficacy or due to intolerance to side effects. MATERIAL AND METHOD: A retrospective review of 158 patients with overactive bladder was carried out. The patients were divided into two groups; the first group; 56 patients where the anticholinergic treatment showed to be ineffective, and the second group; 102 patients who presented intolerance to anticholinergic side effects. RESULTS: For the first group where fesoterodine fumarate was used to improve effectiveness of the anticholinergics, improvement in the components of urinary urgency (p=0.001), insufficient emptying (p=0.001), incontinence (p=0.009), and in the number of pads/day (p<0.001) was detected. As to the second group where fesoterodine fumarate was used as an alternative to anticholinergics to avoid side effects, a high reduction in the incidence of dry mouth (p<0.001) and constipation (p=0.015) was seen, as well as a significant clinical improvement. CONCLUSION: Fesoterodine fumarate is an optimal treatment option when the clinical response to anticholinergics has not been satisfactory, either by the lack of therapeutic action or by intolerance to side effects, and especially when the treatment is expected to be long.
Subject(s)
Benzhydryl Compounds/therapeutic use , Muscarinic Antagonists/therapeutic use , Urinary Bladder, Overactive/drug therapy , Cholinergic Antagonists/adverse effects , Female , Humans , Middle Aged , Retrospective StudiesABSTRACT
Objetivos: Valorar el efecto del empleo del fumarato de fesoterodina como rescate ante un tratamiento previo fallido con anticolinérgicos en pacientes con vejiga hiperactiva, por falta de efectividad terapéutica o por intolerancia a los efectos secundarios. Material y métodos: Revisión retrospectiva de 158 pacientes afectos de vejiga hiperactiva que se distribuyeron en 2 grupos, uno donde el fumarato de fesoterodina se empleó como rescate ante una inefectividad del anticolinérgico previo (n=56) y otro donde se empleó ante una intolerancia manifiesta al mismo (n = 102). Resultado: sEn el grupo en el que se empleó como rescate a una inefectividad, se apreció una mejoría en los componentes de urgencia miccional (p = 0,001), vaciado insuficiente (p = 0,001) e incontinencia de esfuerzo (p = 0,009), y en el número de compresas/día (p<0,001). En el grupo en el que se empleó como fármaco de segunda línea ante efectos secundarios a otros anticolinérgicos se apreció una reducción en la incidencia de sequedad de boca (p<0,001) y de estreñimiento (p = 0,015), además de una mejora clínica significativa. Conclusiones: El fumarato de fesoterodina es una alternativa de tratamiento válida si los resultados con otros anticolinérgicos previamente no han sido satisfactorios, bien sea por falta de efecto terapéutico esperado, bien por intolerancia a los efectos secundarios, sobre todo cuando el tratamiento se plantea prolongado (AU)
Objective: Evaluate the effect of the treatment with fesoterodine fumarate in patients with overactive bladder, as an alternative in case of failure of the usual anticholinergic treatment, due to either lack of therapeutic efficacy or due to intolerance to side effects. Material and method: A retrospective review of 158 patients with overactive bladder was carried out. The patients were divided into two groups; the first group; 56 patients where the anticholinergic treatment showed to be ineffective, and the second group; 102 patients who presented intolerance to anticholinergic side effects. Results: For the first group where fesoterodine fumarate was used to improve effectiveness of the anticholinergics, improvement in the components of urinary urgency (p=0.001), insufficient emptying (p=0.001), incontinence (p=0.009), and in the number of pads/day (p<0.001) was detected. As to the second group where fesoterodine fumarate was used as an alternative to anticholinergics to avoid side effects, a high reduction in the incidence of dry mouth (p<0.001) and constipation (p=0.015) was seen, as well as a significant clinical improvement. Conclusion: Fesoterodine fumarate is an optimal treatment option when the clinical response to anticholinergics has not been satisfactory, either by the lack of therapeutic action or by intolerance to side effects, and especially when the treatment is expected to be long (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Urinary Bladder, Overactive/diagnosis , Urinary Bladder, Overactive/drug therapy , Fumarate Hydratase/administration & dosage , Fumarate Hydratase/therapeutic use , Urinary Bladder, Overactive/physiopathology , Retrospective Studies , Cholinergic Antagonists/therapeutic use , Surveys and QuestionnairesABSTRACT
A case of complete testicular feminization (Morris syndrome) in a male pseudohermaphrodite is described. The results of the hormone analyses and the histological features of the resected gonad are presented. The literature is reviewed with special reference to whether gonadectomy should be performed in the pre or post-pubertal period. We advocate early castration because of the high incidence of germ cell neoplasia and the possibility of virilization in case of incomplete androgenic resistance. Our approach is based on the satisfactory feminization achieved by exogenous estrogen therapy.
