Volume 5, Supplement 8SupplementTransdermal Systems for Overactive Bladder: Principles and PracticeDavid R StaskinOveractive bladderOxybutyninTransdermal delivery system
Volume 9, Number 4Review ArticlesAnticholinergics and Central Nervous System Effects: Are We Confused?Treatment UpdateDavid R StaskinEdward ZoltanThe central nervous system (CNS) effects of anticholinergic agents have been documented in various patient populations and to varying degrees in case reports, brain-activity surrogates, and computerized cognitive testing. The older patient population with overactive bladder represents a group at increased risk of cognitive impairment and other CNS side effects associated with antimuscarinic agents. The complexity of the effect of anticholinergic agents on CNS function requires an increased level of careful investigation. Studies need to be performed in the at-risk population with multiple, validated tests at clinically prescribed doses in acute and chronic situations. These studies need to take into account the effect of commonly prescribed dosing regimens, with doses selected to represent with equivalent bladder potency. The alterations in the serum levels and parent/metabolite effects contributed by metabolic issues or drug delivery systems require special attention. [Rev Urol. 2007;9(4):191-196]Overactive bladderElderlyAntimuscarinic drugsCNS adverse eventsCognitive impairment
Volume 12, Number 3Review ArticlesSurgical Options for Drug-Refractory Overactive Bladder PatientsTreatment UpdateJonathan S StarkmanDavid R StaskinChristopher P SmithOveractive bladder (OAB) is a symptom complex of urinary frequency, urinary urgency, and nocturia, with or without urgency incontinence. This syndrome is idiopathic in most instances without clearly defined pathophysiology. Studies clearly show that OAB negatively impacts health-related quality of life and impairs daily functioning in a large proportion of patients. Despite recent advances in drug delivery and improved tolerability of antimuscarinic drug class, a large percentage of patients remain refractory to conventional pharmacological therapy for this chronic condition. There are several unique and effective treatments that are available for this difficult population. We review the various surgical options within the urological armamentarium to treat patients with refractory OAB. [Rev Urol. 2010;12(2/3):e97-e110 doi:10.3909/riu0468]