Effects of Oxybutynin and Detrusitol on Urinary Dysfunction of MS Patients

Document Type : Research Paper

Authors

Abstract

Introduction:Multiple Sclerosis (MS) is a chronic disease of high prevalence of central nervous system, mostly affecting young adualts especially females. Voiding dysfunction is one of its complications, diagnosis and treatment of which will be of great value in patients, quality of life. In this study, frequency and type of urinary dysfunction in MS were evaluated and effects and side effects of two drugs of Oxybutynin and Detrusitol were compared.
Materials and Methods:This clinical trial study was performed from July 2004 until July 2005 at Ghaem Hospital of Mashhad University of Medical Sciences on women with clinical manifestations of voiding dysfunction (overactive bladder). Patients were divided into two groups randomly. One group treated with Oxybutynin 5 mg bid, and the other with Detrusitol 2 mg bid, and effects and side effecto of these drugs were compared. Data analyzed using χ2, fisher T-student andcochrane tests.
 
Results:The ratio of female to male was 6 to 1. The average age of onset was 25.8. Spastic urinary dysfunction prevalence was 61.2%. The most common symptom was urination frequency. Improvement in urinary symptoms were similar in both groups. Among observed side effects, only dry mouth was statistically more frequent in patients who used Oxybutynin in comparison to those who used Detrusitol. Patients satisfaction was similar in both groups. There was a relationship between existence of plaques in periventricular white matter and urinary dysfunction symptoms.
 
Conclusion:According to the rate of improvement, side effects and the costs, Oxybutynin is more suitable for overactive bladder treatment.

Keywords


1- Miller JR. Multiple sclerosis. In: Row land LP, editor. Merritt’s neurology.10th ed. Philadelphia: Lippincott Williams
and Wilkins; 2000.773-792.
2- Bradley WG, Daroff RB, Fenichel GM, et al. Neurology in clinical practice. 4th ed. Philladelphia: Butter worth
Heinemann; 2004.Vol 2. p. 1631-1664.
3- MC Alpine D, Compston A, Ebers G. McAlpine’s multiple sclerosis. 3th ed. London: Churchill living stone; 1998.
32-33.
4- Tanagho EA, Lue TF. Neuropathic bladder disorders,.In: Tanagho EA, Mcaninch JW, editors. Smiths general
urology. 15th ed. New York: Mc Graw-Hill; 2000. 498-515.
5- Limbird LE. Goodman and Gilman’s the pharmacological basis of therapeutics. 10th ed.New York: McGraw-Hill;
2001.175-193.
6- Brown JH, Taylor P.Reseptor against and antagonist. In: Hardman JG, Limbird LE, editors. Goodman and Gilman’s
the pharmacological basis of therapeutics. 10th ed.New York: McGraw-Hill; 2001.175-193.
7- Pappan AJ, Katzung BG. Cholinoreceptor- Blocking drugs .In: Katzung BG, editor. Basic and clinical pharmacology.
8
th ed. New York: McGraw-Hill; 2001.107-120.
8- Betts DM, Fawler D. Vesicourethral dysfunction associated with multiple sclerosis: clinical and urodynamic
perspectives. J Urol 1993 Jul; 160(1): 106-111.
9- Garely AD, Burrows L. Benefit-risk assessment of Tolterodine in the treatment of overactive bladder in adults. Drug
Saf 2004; 17(13):1043-57.
10- Hughes DA, Dubois D. Cost effectiveness analysis of extended-release formulations of Oxybutynin and Tolterodine
for the management of urge incontinence. 2004; 22(16): 1043-59.