Effect of hydramitrazine (Lisidonil) in the treatment of neurogenic bladder dysfunction.

Pedersen, Ejner; Grynderup, Vagn

doi:10.1136/bmj.2.5508.271

Cited by 13 publications

(9 citation statements)

References 6 publications

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“…We did not com pare the bladder capacity because we find it impossible to define the bladder capacity in detrusor hyperreflexia. Contrary to a former report by Pedersen and Grynderup (1966), methantheline bromide does not increase residual urine in our study. This result may be influenced by the exclusion of patients with severe intravesical obstruction.…”

Section: Discussioncontrasting

confidence: 56%

“…Cystometric record ings showed that both drugs increased the bladder capacity. Pedersen and Grynderup (1966) found meladrazine tartrate very suited in the treatment of frequen cy, urgency and urge incontinence associated with the uninhibited neurogenic bladder. Their cystometric recordings did not reflect this effect, while the com pared drug, methantheline bromide showed an increase of the bladder volume at first desire to void, a reduction in amplitude of bladder contractions and an increase in the amount of residual urine.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Detrusor Hyperreflexia in Multiple Sclerosis

Hebjorn¹

1977

Urol Int

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34 patients suffering from detrusor hyperreflexia due to multiple sclerosis entered the trial and 32 patients accomplished. The patients received each drug for a period of 14 days. The patients made records of relevant symptoms, urgency and urge incontinence and compared the treatment periods according to these symptoms. Registration of the number of micturitions was also made. Furthermore, the patients underwent cystometric studies. The following parameters were recorded and compared: residual urine, volume at the first bladder contraction, effective volume and amplitude of the first bladder contraction. The study showed that the patients preferred methantheline bromide. The entire cystometric pattern changed statistically significant with methantheline bromide, but only with concordance to the patients preferences in 60%. Decrease in number of micturitions and volume at the first bladder contraction were the only parameters showing accordance with the preferences. The drugs caused many various side effects. 12 treatment periods were discontinued due to side effects of meladrazine tartrate. The cystometric recordings seem to be of little use in evaluation of a drugs therapeutic effect, and it is difficult to find parameters which reflect the patients preference of the drugs.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Treatment of Detrusor Hyperreflexia in Multiple Sclerosis

Hebjorn¹

1977

Urol Int

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“…Blockade of parasympathetic activity may be insufficient and, furthermore, systemic anticholinergic effects often give rise to complaints and withdrawal of therapy.' 4 Consequently, there is a need for a new pharmacological approach to the treatment of bladder hyperreflexia. Calcium blocking agents with smooth muscle relaxing properties might well be such an alternative.…”

mentioning

confidence: 99%

“…I Paired observations ofbladder volume atfirst detrusor contraction during cystometry and the amplitude of the contractions in 21 patients treated with placebo (left) and terodiline (right).Side-effects Subjective side-effects are shown in table4. In addition three patients reported nausea and two complained of weight gain during the period of active drug treatment and one during the placebo period.…”

mentioning

confidence: 99%

A calcium blocking and anticholinergic agent (terodiline) in the treatment of detrusor hyperreflexia: a placebo-controlled, cross-over trial.

Petersen

Jakobsen²

1987

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY In 25 neurological patients with detrusor hyperreflexia terodiline reduced the number of total micturitions during daytime. Bladder capacity was increased and amplitude of the bladder contractions was reduced. An increase in residual urine was also observed. Mild anticholinergic side-effects were measured on pupillary motility and on heart rate variation. It is concluded that terodil:ne is a useful alternative in treatment of patients with detrusor hyperreflexia.Pharmacological treatment of urinary frequency and incontinence due to detrusor hyperreflexia by anticholinergic agents is often unsuccessful. Blockade of parasympathetic activity may be insufficient and, furthermore, systemic anticholinergic effects often give rise to complaints and withdrawal of therapy.' 4 Consequently, there is a need for a new pharmacological approach to the treatment of bladder hyperreflexia. Calcium blocking agents with smooth muscle relaxing properties might well be such an alternative. Recently compounds have been developed that combine an anticholinergic effect with calcium blockade. This combination could possibly improve bladder function in patients with detrusor hyperreflexia without giving rise to more systemic anticholinergic side-effects. Terodiline has shown this combined anticholinergic and calcium blocking effect in in vitro studies of muscle strip preparations' and a therapeutic clinical effect has been obtained in patients with idiopathic detrusor instability.6 In clinical studies it has proved to be safe with only mild anticholinergic side-effects7 and systemic bioavailability of the drug is high.8We have conducted a randomised, placebocontrolled, double-blind, cross-over study of the effect of terodiline on bladder function in patients with detrusor hyperreflexia. Also the effect on cholinergic functions, that is, pupil motility and heart rate, as well as a possible therapeutic effect on lower limb spasticity have been evaluated. Materials and methodsPatients with neurological diseases, urinary frequency and/or incontinence and with detrusor hyperreflexia, as defined by the International Continence Society,9 were eligible for study. Frequency was defined as eight or more passages of urine per day. Overall disability score was rated according to a previous report'0 and recorded together with body weight and blood pressure before entrance to the study and at follow-up examinations. The study was approved by the Ethical Committee and informed consent was obtained from the patients before start of the study. Exclusions Patients with urinary tract infection and patients with suspected prostatic enlargement, as evaluated from the urethral pressure profile and from the maximal urinary flow, were excluded. Patients with glaucoma, severe urinary retention, decreased liver and kidney function, and pregnant patients were also excluded. Design of study After 1 week without any medication for bladder dysfunction the patients were allocated at random to terodiline 25mg or identical placebo tablets twice daily for 4 week...

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“…They attributed improvement in incontinence to this effect. Pedersen and Grynderup (1966) showed improvement in the symp toms of the uninhibited neurogenic bladder in about 80% of a series of fifty patients with multiple sclerosis using hydramitrazide. They showed some increase in bladder capacity cystometrographically with increase in volume at first uninhibited contraction.…”

Section: Studies Of the Female Bladder In Old Age1mentioning

confidence: 99%