Volume 5, Supplement 8SupplementAntimuscarinic Therapy for the Treatment of Mixed IncontinenceScott MacDiarmidAntimuscarinic agentsTolterodineMixed incontinenceSurgical therapy
Volume 9, Number 1Review ArticlesDiagnosis of Interstitial Cystitis/ Painful Bladder Syndrome in Patients With Overactive Bladder SymptomsDiagnosis UpdateScott MacDiarmidPeter K SandOveractive bladder (OAB) and interstitial cystitis (IC) have similar symptoms, including urinary urgency/frequency and nocturia, making them difficult to differentiate on the basis of clinical presentation alone. Both conditions may represent a clinical manifestation of a hypersensitive bladder and should be included in the differential diagnosis for patients who present with urgency/ frequency. It is especially important that IC be considered in patients with OAB that is refractory to treatment. The proposed diagnostic framework may be useful for differentiating IC from OAB and for facilitating appropriate treatment. [Rev Urol. 2007;9(1):9-16]Overactive bladderInterstitial cystitisPainful bladder syndrome
Volume 10, Number 2Review ArticlesConcomitant Medications and Possible Side Effects of Antimuscarinic AgentsTreatment UpdateScott MacDiarmidAntimuscarinic agents are the treatment of choice for overactive bladder syndrome; clinical experience and the literature support their efficacy, tolerability, and safety. The most common side effects experienced include dry mouth and constipation. Many commonly prescribed drugs have anticholinergic effects that could increase the anticholinergic “load” or “burden” in patients with overactive bladder, potentially increasing the frequency and severity of side effects. In addition, the adverse events associated with antimuscarinics may be more pronounced in the elderly, especially those taking multiple medications. Knowledge regarding the potential side effects associated with antimuscarinics is important so that patients can be advised and effectively treated. [Rev Urol. 2008;10(2):92-98]Overactive bladderOxybutyninAntimuscarinic agentsElderlySide effectsTolterodineSolifenacinDarifenacinTrospium chloride
Volume 10, Number 1Review ArticlesMaximizing the Treatment of Overactive Bladder in the ElderlyTreatment UpdateScott MacDiarmidOveractive bladder syndrome affects millions of elderly people in the United States and is equally prevalent in men and women. Its impact on quality of life can be devastating, especially to elderly patients with other medical comorbidities. In order to maximize care, health care providers must be able to make the correct diagnosis and have a working knowledge of available therapies. Data exist supporting the efficacy and safety of nonpharmacologic and pharmacologic therapies. [Rev Urol. 2008;10(1):6-13]IncontinenceOveractive bladder syndromeAntimuscarinic agentsBehavioral therapyElderly
Volume 11, Number 1Review ArticlesThe Evolution of Transdermal/Topical Overactive Bladder Therapy and Its Benefits Over Oral TherapyTreatment UpdateScott MacDiarmidMultiple antimuscarinic agents are available for the treatment of overactive bladder. Many of the agents have undergone reformulation in an attempt to improve patient adherence and drug tolerability. Oxybutynin evolved from an immediate-release pill to a once-daily oral preparation, and is now available as a transdermal patch and gel. This article discusses the clinical impact of oxybutynin reformulation and reviews the evolution and benefits of transdermal therapy.[Rev Urol. 2009;11(1):1-6]OxybutyninReformulationTransdermal therapy