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首页> 外文期刊>Canadian Urological Association Journal >Efficacy and tolerability of combined medication of two different antimuscarinics for treatment of adults with idiopathic overactive bladder in whom a single agent antimuscarinic therapy failed
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Efficacy and tolerability of combined medication of two different antimuscarinics for treatment of adults with idiopathic overactive bladder in whom a single agent antimuscarinic therapy failed

机译：两种不同抗毒蕈碱药物联合用药治疗单发抗毒蕈碱药物治疗失败的特发性膀胱过度活动症成人的疗效和耐受性

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Objective Recent studies have investigated a combination of two antimuscarinics for adult neurogenic bladder managed with clean intermittent catheterization or pediatric refractory overactive bladder (OAB). We assessed the efficacy and tolerability of this strategy in adults with idiopathic OAB. Methods: We reviewed 49 patients with idiopathic OAB who received combined antimuscarinic medication. Patients had serially received different kinds of antimuscarinics as monotherapy, but wished to take combined medication due to a lack of sufficient subjective improvement in urgency, even with dosage escalation. Efficacy was measured by changes of episodes of urgency, daytime voiding, nocturia and mean voided volume before and after the addition of the second antimuscarinic. Results: The mean duration of combined medication was 9.3 months. After adding the second antimuscarinic, urgency per day decreased from 3.8 to 1.9 ( p < 0.001) and daytime voiding decreased from 10.4 to 7.4 ( p < 0.001). The number of nocturia episodes and the mean voided volume also improved, although there was no statistical significance. Efficacy did not differ between the 29 cases, with non-selective and non-selective drugs and 20 cases with non-selective and M3 selective drugs. Thirty-three (67.3%) patients reported to have benefited from combined medication. Maximal flow rate and post-void residual volume did not change in either of the sexes. Eleven (22.4%) patients discontinued the combination due to continued ineffectiveness and dry mouth. Conclusion: This retrospective study suggests that combined medication can help adults with refractory idiopathic OAB. Combined medication was tolerated in most of our patients.
机译：目的近期研究已经研究了两种抗毒蕈碱药物联合用于成人神经源性膀胱的方法，该治疗采用清洁的间歇性导管插入术或小儿难治性过度活动性膀胱（OAB）进行。我们评估了这种策略在成人特发性OAB中的疗效和耐受性。方法：我们回顾了49例接受联合抗毒蕈碱药物治疗的特发性OAB患者。患者已连续接受不同种类的抗毒蕈碱类药物作为单一疗法，但由于即使在剂量增加的情况下也缺乏足够的主观紧急性，因此希望采取联合用药。通过在添加第二种抗毒蕈碱药物前后的尿急，白天排尿，夜尿症和平均排尿量的变化来衡量疗效。结果：联合用药的平均持续时间为9.3个月。加入第二种抗毒蕈碱剂后，每天的尿急从3.8降低至1.9（p <0.001），日间排尿从10.4降低至7.4（p <0.001）。夜尿发作次数和平均排尿量也有所改善，尽管没有统计学意义。非选择性和非选择性药物的29例疗效与非选择性和M3选择性药物的20例疗效无差异。据报告有33名（67.3％）患者受益于联合用药。两种性别中最大流量和排尿后残留量均未改变。由于持续无效和口干，有11名（22.4％）患者停用了该组合。结论：这项回顾性研究表明，联合用药可以帮助患有难治性特发性OAB的成年人。我们的大多数患者都接受联合用药。

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