Urodynamic approach to female urinary incontinence refractory to treatment with anticholinergics
The administration of empirical anticholinergic treatment is widespread in women with urinary incontinence and has produced varied results. The objective of our paper is to determine the effectiveness of anticholinergics for the treatment of female urinary incontinence and to determine by urodynamic...
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| Veröffentlicht in: | Archivos españoles de urología 2012-12, Vol.65 (10), p.879-886 |
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| creator | Naranjo-Ortiz, Cristina Clemente-Ramos, Luis Miguel Salinas-Casado, Jesús Méndez-Rubio, Santigo |
| description | The administration of empirical anticholinergic treatment is widespread in women with urinary incontinence and has produced varied results. The objective of our paper is to determine the effectiveness of anticholinergics for the treatment of female urinary incontinence and to determine by urodynamics the possible causes that may explain the resistance to anticholinergics to obtain urodynamic predictors of success or failure.
We evaluated 182 women over 14 years of age with urinary incontinence that had previously been treated with anticholinergics for at least three months. The patients underwent a complete medical history including clinical history, physical examination, and urodynamic and lower urinary tract video-radiologic studies. Statistical analysis was performed using SPSS 17.0 for Windows.
Clinical therapeutic efficacy was demonstrated in 39.6% of cases. Cystometric bladder capacity was decreased in 89.2%of patients that did not improve clinically with anticholinergics (p=0.01). Detrusor overactivity was urodynamically demonstrated in 51% of cases (p=0.05) among patients without clinical improvement with anticholinergic treatment. This hyperactivity was demonstrated during early bladder filling ( |
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We evaluated 182 women over 14 years of age with urinary incontinence that had previously been treated with anticholinergics for at least three months. The patients underwent a complete medical history including clinical history, physical examination, and urodynamic and lower urinary tract video-radiologic studies. Statistical analysis was performed using SPSS 17.0 for Windows.
Clinical therapeutic efficacy was demonstrated in 39.6% of cases. Cystometric bladder capacity was decreased in 89.2%of patients that did not improve clinically with anticholinergics (p=0.01). Detrusor overactivity was urodynamically demonstrated in 51% of cases (p=0.05) among patients without clinical improvement with anticholinergic treatment. This hyperactivity was demonstrated during early bladder filling (<100ml). Urodynamic stress urinary incontinence (SUI) was demonstrated in 26.5% of patients without clinical improvement after treatment (p=0.04). Lower urinary tract obstruction was urodynamically demonstrated in 20.6% of patients with no clinical improvement (p=0.05). Urodynamic data did not demonstrate a relationship between detrusor overactivity, a high-grade cystocele ( 37.4% of total), and irregular bladder morphology (11.5% of total).
It is important to conduct urodynamic study before starting anticholinergic treatment of females with urinary incontinence to identify therapeutic data of poor prognosis, such as SUI and lower urinary tract obstruction, thus optimizing the therapeutic efficacy of anticholinergics.</description><identifier>EISSN: 1576-8260</identifier><identifier>PMID: 23269334</identifier><language>eng ; spa</language><publisher>Spain</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cholinergic Antagonists - therapeutic use ; Drug Resistance ; Female ; Humans ; Middle Aged ; Prognosis ; Urinary Bladder Neck Obstruction - complications ; Urinary Bladder Neck Obstruction - diagnosis ; Urinary Bladder, Overactive - drug therapy ; Urinary Incontinence - diagnosis ; Urinary Incontinence - drug therapy ; Urinary Incontinence - physiopathology ; Urinary Incontinence, Stress - diagnosis ; Urinary Incontinence, Stress - drug therapy ; Urinary Incontinence, Stress - physiopathology ; Urodynamics</subject><ispartof>Archivos españoles de urología, 2012-12, Vol.65 (10), p.879-886</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23269334$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Naranjo-Ortiz, Cristina</creatorcontrib><creatorcontrib>Clemente-Ramos, Luis Miguel</creatorcontrib><creatorcontrib>Salinas-Casado, Jesús</creatorcontrib><creatorcontrib>Méndez-Rubio, Santigo</creatorcontrib><title>Urodynamic approach to female urinary incontinence refractory to treatment with anticholinergics</title><title>Archivos españoles de urología</title><addtitle>Arch Esp Urol</addtitle><description>The administration of empirical anticholinergic treatment is widespread in women with urinary incontinence and has produced varied results. The objective of our paper is to determine the effectiveness of anticholinergics for the treatment of female urinary incontinence and to determine by urodynamics the possible causes that may explain the resistance to anticholinergics to obtain urodynamic predictors of success or failure.
We evaluated 182 women over 14 years of age with urinary incontinence that had previously been treated with anticholinergics for at least three months. The patients underwent a complete medical history including clinical history, physical examination, and urodynamic and lower urinary tract video-radiologic studies. Statistical analysis was performed using SPSS 17.0 for Windows.
Clinical therapeutic efficacy was demonstrated in 39.6% of cases. Cystometric bladder capacity was decreased in 89.2%of patients that did not improve clinically with anticholinergics (p=0.01). Detrusor overactivity was urodynamically demonstrated in 51% of cases (p=0.05) among patients without clinical improvement with anticholinergic treatment. This hyperactivity was demonstrated during early bladder filling (<100ml). Urodynamic stress urinary incontinence (SUI) was demonstrated in 26.5% of patients without clinical improvement after treatment (p=0.04). Lower urinary tract obstruction was urodynamically demonstrated in 20.6% of patients with no clinical improvement (p=0.05). Urodynamic data did not demonstrate a relationship between detrusor overactivity, a high-grade cystocele ( 37.4% of total), and irregular bladder morphology (11.5% of total).
It is important to conduct urodynamic study before starting anticholinergic treatment of females with urinary incontinence to identify therapeutic data of poor prognosis, such as SUI and lower urinary tract obstruction, thus optimizing the therapeutic efficacy of anticholinergics.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cholinergic Antagonists - therapeutic use</subject><subject>Drug Resistance</subject><subject>Female</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Urinary Bladder Neck Obstruction - complications</subject><subject>Urinary Bladder Neck Obstruction - diagnosis</subject><subject>Urinary Bladder, Overactive - drug therapy</subject><subject>Urinary Incontinence - diagnosis</subject><subject>Urinary Incontinence - drug therapy</subject><subject>Urinary Incontinence - physiopathology</subject><subject>Urinary Incontinence, Stress - diagnosis</subject><subject>Urinary Incontinence, Stress - drug therapy</subject><subject>Urinary Incontinence, Stress - physiopathology</subject><subject>Urodynamics</subject><issn>1576-8260</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kM1KxDAYRYMgzjj6CpKlm0LSNE26lME_GHDjrGuafLGRNqlJiszbG3BcXbgcLpx7gbaUi7aSdUs26DqlL0KYpJxfoU3N6rZjrNmij2MM5uTV7DRWyxKD0iPOAVuY1QR4jc6reMLO6-Cz8-A14Ag2Kp1D6QuZI6g8g8_4x-URq4LpMUyFjZ9Opxt0adWU4PacO3R8enzfv1SHt-fX_cOhWmhDcyWkAavFoKVtJAzdIAkloqlNzVsjhRGUMEtaa0tHGNCms4RxUzxgkIxbtkP3f7vF4XuFlPvZJQ3TpDyENfW0lrxpKeGkoHdndB1mMP0S3Vwk-_9X2C9mRV8A</recordid><startdate>201212</startdate><enddate>201212</enddate><creator>Naranjo-Ortiz, Cristina</creator><creator>Clemente-Ramos, Luis Miguel</creator><creator>Salinas-Casado, Jesús</creator><creator>Méndez-Rubio, Santigo</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201212</creationdate><title>Urodynamic approach to female urinary incontinence refractory to treatment with anticholinergics</title><author>Naranjo-Ortiz, Cristina ; Clemente-Ramos, Luis Miguel ; Salinas-Casado, Jesús ; Méndez-Rubio, Santigo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p141t-78defc7bc8f48eb9b8010742d256d87d7103f06ff74203e149f035d326eb835f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng ; spa</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cholinergic Antagonists - therapeutic use</topic><topic>Drug Resistance</topic><topic>Female</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Urinary Bladder Neck Obstruction - complications</topic><topic>Urinary Bladder Neck Obstruction - diagnosis</topic><topic>Urinary Bladder, Overactive - drug therapy</topic><topic>Urinary Incontinence - diagnosis</topic><topic>Urinary Incontinence - drug therapy</topic><topic>Urinary Incontinence - physiopathology</topic><topic>Urinary Incontinence, Stress - diagnosis</topic><topic>Urinary Incontinence, Stress - drug therapy</topic><topic>Urinary Incontinence, Stress - physiopathology</topic><topic>Urodynamics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Naranjo-Ortiz, Cristina</creatorcontrib><creatorcontrib>Clemente-Ramos, Luis Miguel</creatorcontrib><creatorcontrib>Salinas-Casado, Jesús</creatorcontrib><creatorcontrib>Méndez-Rubio, Santigo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Archivos españoles de urología</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Naranjo-Ortiz, Cristina</au><au>Clemente-Ramos, Luis Miguel</au><au>Salinas-Casado, Jesús</au><au>Méndez-Rubio, Santigo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Urodynamic approach to female urinary incontinence refractory to treatment with anticholinergics</atitle><jtitle>Archivos españoles de urología</jtitle><addtitle>Arch Esp Urol</addtitle><date>2012-12</date><risdate>2012</risdate><volume>65</volume><issue>10</issue><spage>879</spage><epage>886</epage><pages>879-886</pages><eissn>1576-8260</eissn><abstract>The administration of empirical anticholinergic treatment is widespread in women with urinary incontinence and has produced varied results. The objective of our paper is to determine the effectiveness of anticholinergics for the treatment of female urinary incontinence and to determine by urodynamics the possible causes that may explain the resistance to anticholinergics to obtain urodynamic predictors of success or failure.
We evaluated 182 women over 14 years of age with urinary incontinence that had previously been treated with anticholinergics for at least three months. The patients underwent a complete medical history including clinical history, physical examination, and urodynamic and lower urinary tract video-radiologic studies. Statistical analysis was performed using SPSS 17.0 for Windows.
Clinical therapeutic efficacy was demonstrated in 39.6% of cases. Cystometric bladder capacity was decreased in 89.2%of patients that did not improve clinically with anticholinergics (p=0.01). Detrusor overactivity was urodynamically demonstrated in 51% of cases (p=0.05) among patients without clinical improvement with anticholinergic treatment. This hyperactivity was demonstrated during early bladder filling (<100ml). Urodynamic stress urinary incontinence (SUI) was demonstrated in 26.5% of patients without clinical improvement after treatment (p=0.04). Lower urinary tract obstruction was urodynamically demonstrated in 20.6% of patients with no clinical improvement (p=0.05). Urodynamic data did not demonstrate a relationship between detrusor overactivity, a high-grade cystocele ( 37.4% of total), and irregular bladder morphology (11.5% of total).
It is important to conduct urodynamic study before starting anticholinergic treatment of females with urinary incontinence to identify therapeutic data of poor prognosis, such as SUI and lower urinary tract obstruction, thus optimizing the therapeutic efficacy of anticholinergics.</abstract><cop>Spain</cop><pmid>23269334</pmid><tpages>8</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Cholinergic Antagonists - therapeutic use Drug Resistance Female Humans Middle Aged Prognosis Urinary Bladder Neck Obstruction - complications Urinary Bladder Neck Obstruction - diagnosis Urinary Bladder, Overactive - drug therapy Urinary Incontinence - diagnosis Urinary Incontinence - drug therapy Urinary Incontinence - physiopathology Urinary Incontinence, Stress - diagnosis Urinary Incontinence, Stress - drug therapy Urinary Incontinence, Stress - physiopathology Urodynamics |
| title | Urodynamic approach to female urinary incontinence refractory to treatment with anticholinergics |
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