The Efficacy of Tolterodine for Prevention of Catheter-Related Bladder Discomfort: A Prospective, Randomized, Placebo-Controlled, Double-Blind Study

Abstract

Bladder discomfort secondary to an indwelling urinary catheter is distressing to patients. In the present study, we observed that tolterodine (2 mg), a competitive muscarinic receptor antagonist administered 1 h before surgery, reduced both the incidence and severity of bladder discomfort secondary to bladder catheterization.

The effect of sevoflurane versus desflurane on postoperative catheter-related bladder discomfort in patients undergoing transurethral excision of a bladder tumour: a randomized controlled trial

“…17 In previous studies, various agents with antimuscarinic properties, such as gabapentin, oxybutynin, tolterodine, and tramadol, were found to reduce the incidence and severity of postoperative CRBD. 1,2,[7][8][9][18][19][20] In this study, use of sevoflurane resulted in a greater reduction in the incidence of CRBD when compared with desflurane by 24%, 33%, and 26% at zero, one, and six hours after surgery, respectively. This preventive effect of sevoflurane on CRBD is similar to that of antimuscarinic agents reported in previous studies in which tolterodine and gabapentin reduced the incidence of CRBD by 19-30% until six hours postoperatively.…”

“…This preventive effect of sevoflurane on CRBD is similar to that of antimuscarinic agents reported in previous studies in which tolterodine and gabapentin reduced the incidence of CRBD by 19-30% until six hours postoperatively. 1,18 The use of antimuscarinic agents for the treatment of CRBD increased the incidence of postoperative side effects, including dry mouth, nausea, vomiting, and sedation. 1,7,8,18,19 For example, the use of antimuscarinic agents tolterodine and oxybutynin increased the incidence of dry mouth (59%), while the use of tramadol increased the incidences of sedation (92%), nausea (56%), and vomiting (40%).…”

“…1,18 The use of antimuscarinic agents for the treatment of CRBD increased the incidence of postoperative side effects, including dry mouth, nausea, vomiting, and sedation. 1,7,8,18,19 For example, the use of antimuscarinic agents tolterodine and oxybutynin increased the incidence of dry mouth (59%), while the use of tramadol increased the incidences of sedation (92%), nausea (56%), and vomiting (40%). 1,8,19 In this study, the incidences of dry mouth, nausea, and vomiting were within 10% in both the sevoflurane and desflurane groups during the entire study period.…”

“…1 This uncomfortable symptom can increase postoperative distress and agitation. [2][3][4][5] The mechanism of CRBD is similar to that of overactive bladder syndrome in which activation of muscarinic receptors, especially the type 3 muscarinic (M3) receptor, results in the frequent urge to void.…”

“…6 A variety of agents with antimuscarinic properties, such as ketamine, tolterodine, tramadol, and butylscopolamine, have been investigated for their ability to prevent or treat CRBD. 1,[7][8][9] Although these agents reduced the incidence and severity of CRBD, they carried additional side effects, including nausea, vomiting, sedation, and dry mouth.…”