Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
INTRODUCTION:
Overactive bladder is a symptom based
syndrome and defined by the International
Continence Society (ICS) as urgency, with or
without urgency incontinence, usually with
frequency and nocturia, if there is no proven
infection or other obvious pathology


(1)
.
* Department of Urology, Al-Karama Teaching
Hospital; Baghdad.
** Department of Gynecology and Obstetrics,
Ibn Al-Baladi Hospital; Baghdad.


BACKGROUND:
Overactive bladder (OAB) is a symptom based syndrome. These symptoms include: urgency, with
or without urgency incontinence, usually with frequency and nocturia with no proven infection or
other pathology. It is encountered in women visiting urodynamic units as part of mixed urinary
incontinence (MUI). It greatly affects physical and social activities. Incontinence is often the key
symptom for the assessment of OAB symptoms and the decision to treat patients. Antimuscarinic
drugs are the main agents used to treat this condition. Oxybutynin (immediate-release) 5 mg orally
is the main available form in our clinical practice.
OBJECTIVE:
The objective of this study is to assess the efficacy of Oxybutynin immediate-release (OXY-IR) 5
mg oral tablets, in the treatment of women with overactive bladder, i.e. reduction in episodes of
urge incontinence, total incontinence, and micturition frequency.
MATERIALS AND METHODS:
Twenty-five patients, age range from 18-75 years, diagnosed as having overactive bladder
symptoms were treated with Oxybutynin immediate-release (IR) 5 mg tablets 2-3 times daily for 8
weeks period. Homma OAB symptom score system was used for assessment of treatment efficacy.
Cystometry was done in all patients to look for detrusor overactivity.
RESULTS:
After Oxybutynin treatments, all the parameters in micturition patterns improved significantly:
frequency, nocturia, urgency (p value < 0.005). Homma overactive bladder symptoms scores also
improved following the treatment (p value <0.001). Cystometric examination revealed the presence
of detrusor overactivity in 20 of the 25 (80%) patients at presentation. This was reduced to 4/25
(16%) following treatment. About two-thirds (64%) of the patients reported good to great benefit
from the treatment and had a positive effect on their life concerning physical and social activity,
sleep and feeling of well-being.
CONCLUSION:
The selective antimuscarinic agent Oxybutynin (OXY-IR) 5 mg 2-3 times orally is effective in
treating overactive bladder symptoms in these women by reducing incontinence attacks, urgency,
micturition times and nocturia; consequently, it improves their life quality. We recommend
devising a score system for OAB suiting Iraqi patients