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Efficacy and safety of combination therapy in patients with detrusor overactivity and impaired contractility |
| 동아대학교병원 의과대학 비뇨기과학교실, 동아대학교병원¹, 한양대학교 구리병원², 한양대학교병원 의과대학 비뇨기과학교실³ |
| 고혁준¹, 김규식, 문홍상², 김용태, 조정기³ |
Introduction: We investigated the efficacy and safety of combination therapy of alpha blocker, bethanechol and beta 3 agonist in patients with detrusor overactive and impaired contractility (DOIC) diagnosed with urodynamic studies.
Methods: Urodynamic reports were reviewed, and a total of 90 patients with proven DOIC. We included only patients with combination therapy of alpha blocker, bethanechol and beta 3 agonist for treatment of DOIC. We excluded patients who lost follow up (n=45) and patients underwent operation (n=4). We also excluded patients with medication except above combination therapy for treatment of DOIC (n=22). We investigated the IPSS, overactive bladder symptom score and uroflowmetry and procedure-related adverse events (AE) at baseline and after treatment were assessed.
Results: The results showed that the subjective symptom scores improved significantly in both groups, and the scores did not differ between the groups. The decrease in urgency episodes and urgency urinary incontinence were noted in OAB patients but not in DOIC patients. Although the incidence of AEs was comparable between the groups, the therapeutic efficacy lasted for a mean of 4.9 ˘ 4.8 months in DOIC patients and 7.2 ˘ 3.3 months in OAB patients (p = 0.03). We concluded that the efficacy of the combination therapy of alpha blocker, bethanechol and beta 3 agonist for DOIC patients was limited and short-term. Nevertheless, AEs did not increase in DOIC.
Conclusion: The combination therapy of alpha blocker, bethanechol and beta 3 agonist might not be a good indication in patients with DOIC and high post-voiding residual urine. Physicians should inform patients of the potential benefits and risks of combination therapy for treatment of DHIC.
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keywords : underactive detrusor; overactive bladder, detrusor overactive and impaired contractility |
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