The Efficacy of the Antimuscarinic Drug Oxybutynin in the Treatment Women with Overactive Bladder (OAB) Symptoms

Abstract

ABSTRACT: INTRODUCTION:Overactive bladder is a symptom basedsyndrome and defined by the InternationalContinence Society (ICS) as urgency, with orwithout urgency incontinence, usually withfrequency and nocturia, if there is no proveninfection or other obvious pathology (1). * Department of Urology, Al-Karama TeachingHospital; Baghdad. ** Department of Gynecology and Obstetrics,Ibn Al-Baladi Hospital; Baghdad. BACKGROUND: Overactive bladder (OAB) is a symptom based syndrome. These symptoms include: urgency, withor without urgency incontinence, usually with frequency and nocturia with no proven infection orother pathology. It is encountered in women visiting urodynamic units as part of mixed urinaryincontinence (MUI). It greatly affects physical and social activities. Incontinence is often the keysymptom for the assessment of OAB symptoms and the decision to treat patients. Antimuscarinicdrugs are the main agents used to treat this condition. Oxybutynin (immediate-release) 5 mg orallyis the main available form in our clinical practice. OBJECTIVE: The objective of this study is to assess the efficacy of Oxybutynin immediate-release (OXY-IR) 5mg oral tablets, in the treatment of women with overactive bladder, i.e. reduction in episodes ofurge incontinence, total incontinence, and micturition frequency. MATERIALS AND METHODS: Twenty-five patients, age range from 18-75 years, diagnosed as having overactive bladdersymptoms were treated with Oxybutynin immediate-release (IR) 5 mg tablets 2-3 times daily for 8weeks period. Homma OAB symptom score system was used for assessment of treatment efficacy.Cystometry was done in all patients to look for detrusor overactivity. RESULTS:After Oxybutynin treatments, all the parameters in micturition patterns improved significantly:frequency, nocturia, urgency (p value < 0.005). Homma overactive bladder symptoms scores alsoimproved following the treatment (p value <0.001). Cystometric examination revealed the presenceof detrusor overactivity in 20 of the 25 (80%) patients at presentation. This was reduced to 4/25(16%) following treatment. About two-thirds (64%) of the patients reported good to great benefitfrom the treatment and had a positive effect on their life concerning physical and social activity,sleep and feeling of well-being. CONCLUSION: The selective antimuscarinic agent Oxybutynin (OXY-IR) 5 mg 2-3 times orally is effective intreating overactive bladder symptoms in these women by reducing incontinence attacks, urgency,micturition times and nocturia; consequently, it improves their life quality. We recommenddevising a score system for OAB suiting Iraqi patients