Salvatore S, Serati M, Ghezzi F, Uccella S, Cromi A, Bolis P
Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
BJOG. 2007 Nov;114(11):1436-8. doi: 10.1111/j.1471-0528.2007.01399.x. Epub 2007 Sep 17.
The aim of this study was to assess the efficacy of tolterodine in women with overactive bladder (OAB) and concomitant anterior vaginal prolapse. In this prospective study, 235 consecutive women with OAB symptoms and urodynamic diagnosis of detrusor overactivity who either had no prolapse or had pure anterior vaginal prolapse were included: 184 women (group 1) had no prolapse and 51 women (group 2) had anterior prolapse greater than and equal to stage IIa. Tolterodine 4 mg slow release once a day was prescribed. After 12 weeks, women were reassessed using a 3-point scale (no change, improvement and cured). A total of 158 (85.9%) women in group 1 and 31 (60.8%) women in group 2 reported improvement or cure (P = 0.0002). Women with OAB and significant anterior vaginal prolapse should be informed of a reduced efficacy of antimuscarinics in treating their urinary symptoms.
本研究旨在评估托特罗定对膀胱过度活动症（OAB）合并阴道前壁脱垂女性的疗效。在这项前瞻性研究中，纳入了235例有OAB症状且经尿动力学诊断为逼尿肌过度活动的连续女性，她们要么没有脱垂，要么仅有单纯阴道前壁脱垂：184例女性（第1组）没有脱垂，51例女性（第2组）阴道前壁脱垂大于或等于IIa期。给予托特罗定4mg缓释片，每日1次。12周后，采用3分制量表（无变化、改善和治愈）对女性进行重新评估。第1组共有158例（85.9%）女性和第2组31例（60.8%）女性报告症状改善或治愈（P = 0.0002）。应告知患有OAB和明显阴道前壁脱垂的女性，抗毒蕈碱药物治疗其泌尿系统症状的疗效会降低。
