Bethanechol: Is it still being prescribed for bladder dysfunction in women?

Gaitonde, Shivani; Malik, Rena D.; Christie, Alana

doi:10.1111/ijcp.13248

Cited by 14 publications

(9 citation statements)

References 16 publications

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“…Int Neurourol J May 31, 2021 metics and alpha blockers have been attempted to help urination; however, inconsistent results have been reported regarding the effects of these treatments, and there is no clear evidence that they improve bladder contractility [8][9][10][11]. Some patients showed improvement of LUTS and the ability to urinate by themselves, but most patients continue to need indwelling urethral and suprapubic catheters to expel urine from their bladder due to an irreversible loss of bladder contractility [12][13][14][15].…”

Section: Injmentioning

confidence: 99%

Irreversible Bladder Remodeling Induced by Fibrosis

Kim

et al. 2021

Int Neurourol J

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Underactive bladder and impaired bladder compliance are irreversible problems associated with bladder fibrosis. Remodeling of the extracellular matrix is regarded as an important mechanism associated with bladder fibrosis. However, various risk factors and conditions contribute to the functional impairment of the bladder associated with fibrosis, and there is limited knowledge about bladder fibrosis-associated problems in the field of neurourology. Further studies are thus necessary to elucidate the underlying mechanism of bladder fibrosis and to identify effective treatment.

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Section: Injmentioning

confidence: 99%

Irreversible Bladder Remodeling Induced by Fibrosis

Kim

et al. 2021

Int Neurourol J

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“…However, parasympathomimetics are not recommended for UAB due to their potential adverse effects and unproven clinical efficacy [30]. Although parasympathomimetics such as bethanechol continue to be prescribed for UAB in elderly women [31], there is insufficient evidence for a role of bethanechol in UAB patients with incontinence.…”

Section: Pharmacotherapymentioning

confidence: 99%

Management of Urinary Incontinence With Underactive Bladder: A Review

Cho

Kim

2020

Int Neurourol J

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Urinary incontinence is caused by storage function failure, while underactive bladder (UAB) is caused by a decline in detrusor contractility and voiding dysfunction. As the treatment mechanisms for incontinence and UAB are contrary to each other, it is difficult to treat both incontinence and UAB, and the patient’s quality of life can be further degraded. Conventional midurethral sling (MUS), such as transobturator tape or retropubic MUS, introduces a risk of postoperative voiding dysfunction in stress urinary incontinence with UAB. However, there have been several reports about the efficacy and safety of conventional MUS. Adjustable sling procedures, such as transobturator adjustable tape or the Remeex system, have better outcomes than conventional MUS because they control tension both during and after surgery. When voiding dysfunction occurs after incontinence treatment with UAB, voiding symptoms can be improved by various therapeutic modalities. Clean intermittent catheterization is recommended for patients with significant increased postvoid residual volumes or urinary retention. Although pharmacotherapy such as with alpha-blockers or parasympathomimetics can be considered for UAB, there is insufficient evidence of their effect on incontinence with UAB. Future therapies, such as stem cell therapy or gene therapy, may be used to treat incontinence with UAB. The possibility of management urgency urinary incontinence that related to detrusor hyperactivity with impaired contractility using sacral neuromodulation has been suggested. Further research is needed to establish evidence for the efficacy and safety of treatments for incontinence with UAB and improve patient quality of life.

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“…The only study in women involved over 30 years old patients with elevated PVR and showed no advantage of bethanachol chloride over placebo [27]. In a recent study, Gaitonde and colleagues looked at the National ambulatory care survey in the USA in the decade 2003 to 2013 [28]. A sample of 17,321,630 patient visits of women > 18 years with LUTS or urinary retention was assessed.…”

Section: Pharmacotherapymentioning

confidence: 99%

Detrusor Underactivity and Underactive Bladder in Women: What Is New?

Osman

Pang

Martens

et al. 2019

Curr Bladder Dysfunct Rep

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Purpose of Review Detrusor underactivity (DU) and its symptom-based correlation, the underactive bladder (UAB), are common problems encountered in urological practice. Whilst DU has been defined for many years, only recently has UAB received a formal definition and there is now accumulating literature based on this condition. In this article, we reviewed the recent literature on the aetiology, pathogenesis, diagnosis and management of DU/UAB in women. Recent Findings Detrusor underactivity is diagnosed on urodynamic studies but there still remains a lack of widely recognised and accepted diagnostic criteria. Commencing treatment based on the diagnosis of UAB, with or without a PVR measurement, is perhaps feasible due to the lower occurrence of BOO in women and specific clinical features that may distinguish this group. Prospective studies attempting to correlate UAB with the underlying DU are needed before this approach could be considered. Summary Detrusor underactivity/UAB in women requires a separate consideration from men due to the anatomical and functional differences in the lower urinary tracts between both genders and consequent differences in pathologies affecting them. The aetiology of DU remains largely unknown, but is probably multifactorial, including myogenic, neurogenic and vasculogenic factors. There remains a lack of any simple effective drug treatments, whilst apart from sacral neuromodulation for the specific subgroup with non-obstructive urinary retention, no safe and effective surgical treatment is currently available. Often, permanent or intermittent bladder drainage with a catheter is the final solution.

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Bethanechol: Is it still being prescribed for bladder dysfunction in women?

Abstract: Bethanechol continues to be prescribed in elderly women primarily for detrusor atony, urinary retention, or incomplete bladder emptying.

Cited by 14 publications

References 16 publications

Irreversible Bladder Remodeling Induced by Fibrosis

Irreversible Bladder Remodeling Induced by Fibrosis

Management of Urinary Incontinence With Underactive Bladder: A Review

Detrusor Underactivity and Underactive Bladder in Women: What Is New?

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