Combination Therapy for Bladder Dysfunction in Patients with Neurogenic Detrusor Overactivity

AbstractPurpose of ReviewNeurogenic bladder is a common condition and top health priority present in 20 –70% of patients with neurologic diseases including multiple sclerosis (MS), Parkinson’s disease (PD), spinal cord injury (SCI), and cerebrovascular accidents (CVA). Current gold-standard medications for overactive bladder (OAB), such as anti-muscarinics, have undesirable side effects, or have l imited data in neurogenic patients. Combining therapy for urinary urge incontinence (UUI) has shown the potential to increase efficacy while maintaining or improving tolerability of treatment. Our objective was to review and synthesize recent combination therapy studies for UUI in patients with neur ogenic detrusor overactivity (NDO).Recent FindingsNon-pharmacologic and pharmacologic combination therapies have been investigated for UUI in patients with NDO. Adding intravaginal neuromuscular electrical stimulation (IVES) or transcutaneous tibial stimulation (TTNS) may not be superior to pelvic floor muscle training (PFMT) on its own. Recent studies on dual therapies have focused on combining drugs with different mechanisms. In adults, a combination of desmopressin with mirabegron showed superior efficacy compared to either drug alone or solifenacin. In children, combination studies have focused on adding gabapentin to drug regimens with promising safety and efficacy. Overall, there are few combination therapy trials for OAB in neurogenic patients compared to those in patients wit...
Source: Current Bladder Dysfunction Reports - Category: Urology & Nephrology Source Type: research