Cholinergic antagonists Archives - Revista Brasileira de Ginecologia e Obstetrícia

PURPOSE: to evaluate and to compare the effectiveness of oxybutynin, electrostimulation (ES) and pelvic floor training (PFT) in the management of women with detrusor overactivity. METHODS: a total of 64 women, 35 to 80 years old, were enrolled in this randomized prospective trial. Patients were randomized in three groups: Oxybutynin (n=22), ES (n=21) and PFT (n=21). There were no statistical differences between the three groups with regards to race (p=0.948), age (p=0.747), hormonal status (p=0.813), time of symptomatology (p=0.789), previous surgery for urinary incontinence (p=0.993), or body mass index (p=0.897). Patients were assessed before and after treatment by urodynamic test, a seven-day voiding diary, and subjective response. The duration of the treatment was twelve weeks. For statistical analyses, the Pearson chi2, analysis of variance (ANOVA) and the paired t-test were used. RESULTS: there was a decrease in the urge-incontinence episodes and in the number of pads required in all groups (p<0.05). There was reduction in the frequency of micturition in the Oxybutynin Group (p=0.014). Oxybutynin and ES Groups had reduction in nocturia episodes (p=0.003 and p=0.036, respectively). There were no significant differences in improvement between the three groups (p>0.05). Urgency was resolved in 14 (63.6%), 11 (52.4%) and 12 (57.1%) patients of the Oxybutynin, ES and PFT Groups, respectively, without differences among the groups (p=0.754). Subjectively, 17 (77.3%), 11 (52.4%) and 16 (76.2%) women who had accomplished oxybutynin, ES and PFT, respectively, were satisfied, without differences among the groups (p = 0.142). Urodynamic was normal in 8 (36.4%), 12 (57.1%) and 11 (52.4%) patients of the Oxybutynin, ES and PFT Groups, respectively. This urodynamic analysis revealed no differences between the three groups (p=0.358). The reduction of urge-incontinence correlated with patient satisfaction (p<0.05). CONCLUSIONS: treatments were equally effective; reduction of urge-incontinence was correlated with patient satisfaction.