EFFICACY AND SAFETY OF PROPIVERINECHLORIDE FLEXIBLE DOSEIN FEMALE MIXED URINARY INCONTINENCE PATIENTS
H. YOON1, H. LEE 2,Y. PARK 2, M. OH 3;
1Urology,Ewha Womans Univ. Sch. of Med., Seoul, Korea, Republic of, 2Urology,Ewha Womans Univ. Seoul Seonam Hosp., Seoul, Korea, Republic of,3Korea Univ. Guro Hosp., Seoul, Korea, Republic of.
Introduction: Treatment with ananticholinergic agent has been advocated as a reversible first-linetherapy for the patients with mixed urinary incontinence, based onthe confirmed efficacy of anticholinergic therapy in patients withOAB alone. Propiverine hydrochloride (referred to in the following aspropiverine) has been shown to combine both anticholinergic andcalcium channel blocking actions and reported to be effective for thetreatment of stress incontinence as well as detrusoroveractivity.
Objective: We investigated the efficacy andsafety of propiverine chloride (BUP-4) flexible dose in femalepatient with mixed urinary incontinence.
Methods: :The participants were women with mixed incontinence, includingurgency (grade 3 or more, one or more episodes per day) or mildstress incontinence (grade I) or both. The subjects were received 4weeks of treatment with propiverine 20mg once daily. If the responseof the 4-wk treatment was insufficient, the dose was increased to30mg/day. The patient who satisfied with initial treatment sustainedpropiverine 20mg for next 8 weeks. The efficacy of treatment wasassessed base on the response of Benefit, Satisfaction andWillingness to Continue questionnaire (BSW questionnaire). Change ofOveractive Bladder Symptom Score (OABSS), micturition diaryparameters was assessed. Adverse events were evaluated throughout thestudy.
Results: A total of 86 patients with mixedincontinence were enrolled, 76 patients completed the 3-month study.29 patients (33.7%) responded as “dissatisfied” with thetreatment at week 4 and treated with escalated dose to 30mgpropiverine next 8 weeks. (20mg group; 48 subjects, 30mg group; 28subjects) 90% of patients in 30mg group satisfied with theirtreatment at final follow-up on week 12. Three patients stilldissatisfied with 30mg propiverine treatment in spite of escalatingthe dose. The change in OABSS score were significantly improved after12-week propiverine treatment at both groups. Most clinicalparameters showed much more improvement in 20 mg group than 30mggroup. Most common adverse event was dry mouth and constipation. Twopatients complained dry mouth, one patient had constipation, and twopatients had dyspepsia.
Conclusions: Propiverine 30mg couldbe an effective treatment of mixed incontinence without increasingthe incidence of side effect compared to propiverine 20mg. It couldbe considered to propiverine 30mg as a starting dose.
References:1. Rortveit G, Subak LL, Thom DH, Creasman JM, Vittinghoff E, Van DenEeden SK, etal. Urinary incontinence, fecal incontinence and pelvicorgan prolapse in a population-based, racially diverse cohort:prevalence and risk factors. Female Pelvic Med Reconstr Surg2010;16:278-83. 2. Sugaya K, Sekiguchi Y, Satoh T, Shiroma K,Kadekawa K, Ashitomi K, et al. Effect of propiverine hydrochloride onstress urinary incontinence. Int J Urol 2014;21:1022-5. 3. Li J, YangL, Pu C, Tang Y, Yun H, Han P. The role of duloxetine in stressurinary incontinence: a systematic review and meta-analysis. Int UrolNephrol 2013;45:679-86.