Gabapentin Treatment of Neurogenic Overactive Bladder

Carbone, Antonio; Palleschi, Giovanni; Conte, Antonella; Bova, G.; Iacovelli, Elisa; Chiara, Marini Bettolo; Pastore, Antonio Luigi; Inghilleri, Maurizio

doi:10.1097/01.wnf.0000228174.08885.ab

Cited by 56 publications

(16 citation statements)

References 28 publications

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“…Gabapentin is also widely used not only for seizures and neuropathic pain, but for many other indications, such as anxiety and sleep disorders, because of its apparent lack of toxicity. Carbone et al [2006] reported on the effect of gabapentin on neurogenic DO. They found a positive effect on symptoms and significant improvement in urodynamic parameters, and suggested that the effects of the drug should be explored in further controlled studies in both neurogenic and non-neurogenic DO.…”

Section: Gabapentinmentioning

confidence: 99%

Prospective pharmacologic therapies for the overactive bladder

Andersson

2009

Therapeutic Advances in Urology

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Lower urinary tract symptoms (LUTS), overactive bladder syndrome (OAB) and detrusor overactivity (DO) are all conditions that can have major effects on quality of life and social functioning. Antimuscarinic drugs are first-line treatment-they often have good initial response rates, but adverse effects and decreasing efficacy cause long-term compliance problems, and alternatives are needed. The recognition of the functional contribution of the urothelium, the spontaneous myocyte activity during bladder filling, and the diversity of nerve transmitters has sparked interest in both peripheral and central modulation of LUTS/OAB/DO pathophysiology. There may be several new possibilities to treat LUTS/OAB/DO. 3 -AR agonists (YM178), PDE 5 inhibitors (sildenafil, tadalafil, vardenafil), vitamin D analogs (elocalcitol), combinations ( 1 -AR antagonist þ antimuscarinic), and drugs with a central mode of action (tramadol, aprepitant) all have Randomized controlled trial (RCT) documented efficacy. Which of these therapeutic principles will be developed to clinically useful treatments remains to be established.

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Section: Gabapentinmentioning

confidence: 99%

Prospective pharmacologic therapies for the overactive bladder

Andersson

2009

Therapeutic Advances in Urology

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“…Surprisingly, gabapentin did not significantly change the urodynamic outcomes compared to the baseline before treatment. It is also believed that gabapentin reduces the pain sensation and bladder hyperalgesia by suppressing the C fibers hypersensitivity [4,5]. After nerve lesions or repeated stimulation, C fibers become abnormally sensitive and cause pathological neuronal responses to a noxious stimulus.…”

Section: Discussionmentioning

confidence: 99%

Investigations of urethral sphincter activity in mice with bladder hyperalgesia before and after drug administration of gabapentin

Yeh

Choi

et al. 2018

Int Urol Nephrol

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Purpose: This study investigated the effect of gabapentin on lower urinary tract dysfunction focusing on urethral activities and cystitis-induced visceral hyperalgesia in a mouse model of painful bladder syndrome/ interstitial cystitis (PBS/IC). The electromyography of urethral sphincter was difficult to obtain, but contained useful information to examine the drug effect in mice. Methods: Female C57BL/6J mice were intraperitoneally (ip) dosed with either saline or 200 mg/kg of cyclophosphamide (CYP) 48 hours before experimental evaluation. Cystitis mice were treated with administration of Gabapentin (25 or 50 mg/kg, ip). Bladder and external urethral sphincter (EUS) functions were obtained and analyzed during continuous bladder infusion. The visceral pain-related visceromotor reflex (VMR) was recorded in response to isotonic bladder distension. Results: Cystitis mice showed shorter inter-contraction intervals and increased occurrence of non-voiding contractions during bladder infusion, with increased VMR during IBD, indicating cystitis-induced bladder hyperalgesia. Gabapentin (50 mg/kg) suppressed effects of CYP on cystometry, but not on EUS activity, during bladder infusion. The effect on urodynamic recordings lasted 4 hours. VMR was significantly reduced by gabapentin. Conclusions: The present study showed that CYP-induced cystitis in mice is a model of visceral hyperalgesia affecting detrusor contractions, not urethral activations. The technique of using EUS electromyography to evaluate the drug effects on urethral activities is novel and useful for future investigations. Gabapentin can be as a potential treatment for detrusor overactivity and PBS/IC.

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“…The detrusor contraction decreases with the declination of calcium current. According to Antonio et al, gabapentin decreases the detrusor hyperactivity by reducing the afferent signaling of the C- and A- δ fibers responsible for filling sensation [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Gabapentin-Induced Urinary Incontinence: A Rare Side Effect in Patients with Neuropathic Pain

Kibar¹,

Demir²,

Sezer³

et al. 2015

Case Reports in Neurological Medicine

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Gabapentin is a first-line agent for neuropathic pain management and has a favorable safety profile. The literature includes a few cases of gabapentin-induced incontinence, and most of them involved patients with epilepsy who were between the ages of 12 and 43 years. Herein, we present three patients with neuropathic pain due to different diagnoses, and, to our knowledge, these are the oldest reported cases of urinary incontinence caused by gabapentin therapy. A 56-year-old female patient who underwent hip arthroplasty developed a sciatic nerve injury and neuropathic pain postoperatively. Ten days after she began taking gabapentin to relieve her pain, she experienced daily urinary incontinence. In another instance, a 63-year-old female patient was diagnosed with complex regional pain syndrome, and seven days after the initiation of gabapentin therapy, urinary incontinence developed. In addition, a 66-year-old male patient with neuropathic pain due to cervical disc pathology complained of urinary incontinence after the onset of gabapentin therapy. After discontinuing this drug, the incontinence symptoms resolved in these patients on the seventh, the first, and the second days, respectively. Physicians who administer gabapentin should inform their patients about the potential risk of gabapentin-induced incontinence and its negative impact on quality of life.

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Gabapentin Treatment of Neurogenic Overactive Bladder

Abstract: These data support the rationale that detrusor overactivity may be controlled by modulating the afferent input from the bladder and the excitability of the sacral reflex center and suggest a novel method to treat overactive bladder patients.

Cited by 56 publications

References 28 publications

Prospective pharmacologic therapies for the overactive bladder

Prospective pharmacologic therapies for the overactive bladder

Investigations of urethral sphincter activity in mice with bladder hyperalgesia before and after drug administration of gabapentin

Gabapentin-Induced Urinary Incontinence: A Rare Side Effect in Patients with Neuropathic Pain

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