Effects of Bladder Training and/or Tolterodine in Female Patients with Overactive Bladder Syndrome: A Prospective, Randomized Study

Abstract

We compared the effects of bladder training and/or tolterodine as first line treatment in female patients with overactive bladder (OAB). One hundred and thirty-nine female patients with OAB were randomized to treatment with bladder training (BT), tolterodine (To, 2 mg twice daily) or both (Co) for 12 weeks. Treatment efficacy was measured by micturition diary, urgency scores and patients' subjective assessment of their bladder condition. Mean frequency and nocturia significantly decreased in all treatment groups, declining 25.9% and 56.1%, respectively, in the BT group; 30.2% and 65.4%, respectively, in the To group; and 33.5% and 66.3%, respectively in the Co group (p<0.05 for each). The decrease in frequency was significantly greater in the Co group than in the BT group (p<0.05). Mean urgency score decreased by 44.8%, 62.2% and 60.2% in the BT, To, and Co groups, respectively, and the improvement was significantly greater in the To and Co groups than in the BT group (p<0.05 for each). Although BT, To and their combination were all effective in controlling OAB symptoms, combination therapy was more effective than either method alone. Tolterodine alone may be instituted as a first-line therapy, but may be more effective when combined with bladder training.

Nocturia: Current Levels of Evidence and Recommendations From the International Consultation on Male Lower Urinary Tract Symptoms

“…Song et al randomized 139 women with OAB and nocturia to 12 weeks of bladder training, tolterodine, or both. 11 Nocturia decreased by 56% in the bladder training group, 65% in the tolterodine group, and 66% for both (P <.05; LOE 3).…”

Efficacy of simplified bladder training in patients with overactive bladder receiving a solifenacin flexible‐dose regimen: results from a randomized study

“…For example, it is possible that bladder training would have a beneficial effect on increased voiding frequency that was due mainly to an adaptive coping mechanism, whereas antimuscarinics would have a greater effect on urgency and urgency incontinence, which might have a different underlying pathological process. Results from the few studies that have assessed the use of antimuscarinic agents in combination with bladder training tend to support the concept for multiple mechanisms [18,19]. Mattiasson et al [18] compared the efficacy of tolterodine 2 mg twice daily with or without simplified bladder training in 505 patients with OAB, using a study design similar to that of the SOLAR study.…”

Effects of Bladder Training and Pelvic Floor Muscle Training in Female Patients with Overactive Bladder Syndrome: A Randomized Controlled Trial

“…During their assessment of symptoms, we asked them to fill 24-h bladder diary fortnightly, and they were followed in clinic after every 2 weeks for 12 weeks; hence, by the end of study, each patient was asked to fill at least 7 days bladder diary including first as a baseline, and the progressive changes in patients’ symptoms were assessed. Percentage reduction in frequency and urgency incontinence was assessed using urgency score (0 indicating no urgency, 1 rarely, 2 occasionally, 3 often, and 4 all the times) [18]. …”