Volume 10, Number 3Review ArticlesOveractive Bladder: Pharmacologic Treatments in the Neurogenic PopulationTreatment UpdateMichael J KennellyWilliam B DeVoePatients with neurologic disease commonly develop overactive bladder (OAB) symptoms of urgency, frequency, and/or urge incontinence. Although treatment for idiopathic OAB has been extensively studied, therapy for those individuals with neurogenic-mediated OAB has not been thoroughly evaluated. Included in the present article is a description of micturition neurophysiology and a neurourologic evaluation scheme. The pharmacologic treatment options for neurogenic OAB, mainly antimuscarinics and chemical denervation, are reviewed and important studies are discussed. Management of OAB in the neurogenic population is a complex issue with no uniform treatment strategy, and individualized treatment with first-line pharmacologic therapy is often recommended. [Rev Urol. 2008;10(3):182-191]Overactive bladderNeurogenic bladderDetrusor overactivity
Volume 12, Number 1Review ArticlesA Comparative Review of Oxybutynin Chloride Formulations: Pharmacokinetics and Therapeutic Efficacy in Overactive BladderTreatment UpdateMichael J KennellyAntimuscarinic agents remain the mainstay of treatment of overactive bladder. However, the utility of some of these agents is limited due to tolerability concerns, multiple daily dosage regimens, lack of formulary coverage, and high cost. This can lead to problems with long-term compliance and may preclude optimal management. Oxybutynin has been the most widely prescribed antimuscarinic agent for more than 30 years. To meet the needs of tolerability and compliance, oxybutynin has evolved from an immediate-release pill to a once-daily oral dose and is now available as a topical gel. This review compares the various oxybutynin formulations in terms of pharmacokinetics, efficacy, and tolerability issues.[Rev Urol. 2010;12(1):12-19 doi: 10.3909/riu0484]Overactive bladderUrge incontinenceOxybutyninN-desethyloxybutynin
Volume 13, Number 1Review ArticlesPostprostatectomy Erectile Dysfunction: The Role of Penile RehabilitationManagement UpdateBrian P DeFadeCulley C CarsonMichael J Kennelly"Radical prostatectomy has become the gold standard for the treatment of prostate cancer in patients who have a longer than 10-year life expectancy. Surgical treatment has led to severe quality-of-life issues in these patients, especially urinary incontinence and erectile dysfunction (ED). This article reviews the etiology and pathophysiology of postprostatectomy ED, and current management strategies for these patients. [Rev Urol. 2011;13(1):6-13 doi: 10.3909/riu0501]"Erectile dysfunctionPenile rehabilitationProstatectomy