Clinical Experience of the Use of Tolterodine in Patients with Overactive Bladder at Siriraj Hospital

Abstract

Objective : To determine the efficacy of tolterodine in patients with overactive bladder.
Design : Open study.
Setting : Gynaecological Outpatient Clinic, Department of Obstetrics & Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University.
Subjects : From August 2000 to June 2001, thirty patients who met the symptomatic definition of overactive bladder without local or metabolic causes were enrolled in this study.
Intervention : Tolterodine 2 mg bid were given to the patients for 12 weeks.
Main outcome measurement : Patients' global opinion on results of treatment , change in voiding frequency, urgency episodes, urge incontinence episodes, and adverse events from medication.
Results : Patients' global opinion showed a marked improvement in the condition in 6 cases (4 cases showed improvement in 2 weeks while the other 2 cases within 4 weeks of treatment), some improvement in 20 cases and failure of treatment in 4 cases (1 case discontinued at 2 weeks due to severe headache, 2 cases at 4 and 8 weeks due to lack of improvement and 1 case at 4 weeks due to economic problems).

The mean number of voids per 24 hours showed a trend to decrease since the start of treatment from 12 times per 24 hours to 6 times per 24 hours after 12 weeks of treatment.

The mean number of days with urgency per week showed a decreasing trend since the start of treatment from 2.8 days per week to less than 1 day per week after 12 weeks of treatment.

The mean number of days with incontinence per week decreased from 3.5 days per week at the start of treatment to less than 1 day per week after 12 weeks of treatment.

The adverse events from medication included a dry mouth in 15 cases (12 cases with mild degree and 3 cases with moderate degree ), 5 cases had flatulence, 5 cases had a slow urinary stream and 5 cases had a headache ( including 1 case who discontinued the treatment after 2 weeks).
Conclusion : Tolterodine is effective in improving patient's view of their bladder condition, decreasing urinary frequency, urgency episodes and urge incontinence episodes. It is also well-tolerated by the patients.