Michel Martin C, de la Rosette Jean J M C H, Piro Maria, Schneider Tim
Department of Pharmacology and Pharmacotherapy, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.
Eur Urol. 2005 Jul;48(1):110-5. doi: 10.1016/j.eururo.2004.11.012. Epub 2004 Dec 15.
Two thirds of patients with overactive bladder (OAB) are continent, but our knowledge on the treatment of the syndrome is largely based on studies with incontinent patients. Therefore, we have explored baseline symptoms and treatment responses to tolterodine in continent relative to incontinent OAB patients.
Data from an open-label, observational study involving 3824 patients with OAB symptoms were analyzed for baseline symptoms and alterations thereof upon a 9 months treatment with 4 mg q.d. tolterodine ER.
Baseline symptoms (number of urgency episodes, total urination frequency, daytime frequency, nocturia, and three scales of OAB severity) were similar in 1147 continent and 2571 incontinent patients, the latter having 4.8+/-3.7 incontinence episodes per 24 h. Tolterodine ER-induced reduction of OAB symptoms was very similar in both groups of patients.
The severity of OAB in continent patients can be similar to that in incontinent ones. Symptom improvement upon treatment with tolterodine ER is very similar in both groups. We propose that continent patients may similarly deserve treatment with a muscarinic receptor antagonist as incontinent ones.
三分之二的膀胱过度活动症（OAB）患者为尿控正常者，但我们对该综合征治疗的了解很大程度上基于对尿失禁患者的研究。因此，我们探讨了相对于尿失禁的OAB患者，尿控正常的OAB患者的基线症状以及对托特罗定的治疗反应。
对一项涉及3824例有OAB症状患者的开放标签观察性研究的数据进行分析，以了解基线症状以及在接受每日4毫克托特罗定缓释制剂治疗9个月后的症状变化。
1147例尿控正常患者和2571例尿失禁患者的基线症状（尿急发作次数、总排尿频率、日间排尿频率、夜尿症以及OAB严重程度的三个量表）相似，后者每24小时有4.8±3.7次尿失禁发作。两组患者中托特罗定缓释制剂引起的OAB症状减轻非常相似。
尿控正常患者的OAB严重程度可能与尿失禁患者相似。两组患者使用托特罗定缓释制剂治疗后的症状改善非常相似。我们认为，尿控正常的患者可能与尿失禁患者一样，同样值得使用毒蕈碱受体拮抗剂进行治疗。
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