Content area
Full text
Published online: 4 January 2013
© Springer International Publishing Switzerland 2012
Abstract Propiverine is a well established antimuscarinic agent with a mixed mode of action in the treatment of symptoms associated with overactive bladder (OAB). As well as blocking muscarinic receptors in the detrusor muscle, the drug also inhibits cellular calcium influx, thereby diminishing muscle spasm. In patients with symptoms of OAB resulting from idiopathic detrusor overactivity (IDO) or neurogenic detrusor overactivity (NDO), propiverine demonstrated dose-dependent efficacy and tolerability, with adverse events consistent with those associated with all antimuscarinic agents. In adults with IDO, propiverine demonstrated similar efficacy to that of other antimuscarinic agents (including solifenacin, tolterodine, oxybutynin and imidafenacin) and, in adults with NDO, propiverine and oxybutynin demonstrated similar efficacy. Propiverine was generally well tolerated in these patient populations, with a lower incidence of dry mouth than that associated with oxybutynin. In men with lower urinary tract symptoms (LUTS), and in whom the presence of benign prostatic enlargement (BPE) was implicated, propiverine administered as add-on therapy to an a1-adrenoceptor antagonist demonstrated similar or superior efficacy to that achieved with an a1-adrenoceptor antagonist alone, and combination therapy was particularly effective in patients with urinary storage symptoms. Combination therapy was generally well tolerated, but was associated with a higher incidence of adverse events than an a1-adrenoceptor antagonist alone. In children and adolescents with IDO/OAB or NDO, propiverine was generally more effective and better tolerated than oxybutynin. In conclusion, propiverine provides a valuable option for the treatment of adults and children with OAB associated with IDO or NDO, and in men with storage LUTS.
1 Introduction
Overactive bladder (OAB) refers to a complex of urinary symptoms defined by the International Continence Society (ICS) as urgency, with or without urgency incontinence, usually accompanied by frequency and nocturia and without proven infection or other obvious pathology [1]. The symptom complex is suggestive of detrusor overactivity, which can be further defined as being of unknown cause (idiopathic detrusor overactivity [IDO]) or due to a neurological condition (neurogenic detrusor overactivity [NDO]) [1]. Men with OAB and lower urinary tract symptoms (LUTS) experience urinary storage symptoms (urgency, frequency and urgency incontinence), which are also suggestive of detrusor overactivity that may or may not be due to benign prostatic enlargement (BPE)...