Prospective randomized comparison of oxybutynin, functional electrostimulation, and pelvic floor training for treatment of detrusor overactivity in women

Abstract

The purpose of this study is to compare the effectiveness of oxybutynin, functional electrostimulation (FES), and pelvic floor training (PFT) for treatment of women with detrusor overactivity. Sixty-four subjects were randomized to oxybutynin (n=22), FES (n=21), or PFT (n=21). Women were evaluated before and after completion of 12 weeks of treatment by subjective response, voiding diary, and urodynamic test. There was subjective symptomatic improvement in 77% of the women treated with oxybutynin, 52% with FES, and 76% with PFT. Urgency resolved in 64% of women treated with oxybutynin, 52% with FES, and in 57% with PFT. Urodynamic evaluation was normal in 36% treated with oxybutynin, 57% with FES, and 52% with PFT. Maximum detrusor involuntary contraction pressure decreased in all groups (p<0.05). All treatments were equally effective. Subjective reduction of urge-incontinence episodes was associated with symptomatic improvement.

Electrical Stimulation for Urinary Incontinence in Women: A Systematic Review

“…Nine trials to treat urge urinary incontinence were included with total of 534 patients (25,26,(28)(29)(30)(31)(32)(33)(34). Most patients in the trials were close to 55 years of age.…”

“…Five trials compared IVES and anticholinergic drugs (26,(29)(30)(31)(32). All reported significant improvement related to baseline in both groups; however, Wang et al found significant improvement in IVES related to Oxybutinin and placebo.…”

Neuromodulation in Management of Overactive Bladder

“…Superiority of clinical efficacy between oxybutynin and electrical stimulation (intravaginal or TENS) in controversial (Soomro et al, 2001;Wang et al, 2006), but the prevalence of electrical stimulation devices might not enough (Walsh et al, 1999). Arruda RM et al reported the effectiveness of oxybutynin, functional electrostimulation (transvaginal) and pelvic floor training for treatment of 64 women with DO after completion of 12 weeks of treatment and resulted all three treatments were equally effective for improvement rate of subjective symptoms, urgency and urodynamic cure (Arruda et al, 2008).…”

Anticholinergika bei OAB-Syndrom

“…Arruda et al [12] stellten eine Untersuchung vor, in der an einer allerdings kleinen Patientengruppe mit Oxybutinin 2-mal 5 mg/Tag untersucht wurde gegen die funktionelle Elektrostimulation und ein Beckenbodentraining. Nach 12 Wochen zeigte sich eine gebesserte Symptomatik unter der Oxybutinin in 77%, in der Elek trostimulationsgruppe von 52% und in der Beckenbodengymnastikgruppe von 76%.…”