The Effect of Bethanechol Chloride with an alpha-adrenergic Blocker in Patients with Impaired Detrusor Contractility.
10.4111/kju.2007.48.10.1040
- Author:
Ji Young KIM
1
;
Jeong Hee HONG
;
Kyu Sung LEE
Author Information
1. Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea. ksleedr@skku.edu
- Publication Type:Original Article
- Keywords:
Neurogenic bladder;
Bethanechol;
Alpha-adrenergic blockers
- MeSH:
Adrenergic alpha-Antagonists;
Bethanechol*;
Doxazosin;
Follow-Up Studies;
Humans;
Urinary Bladder;
Urinary Bladder, Neurogenic;
Urodynamics
- From:Korean Journal of Urology
2007;48(10):1040-1043
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Bethanechol enhances detrusor contraction and alpha1-blockers reduce bladder outlet resistance. We evaluated the effects of bethanechol with doxazosin in patients with impaired detrusor contractility. MATERIALS AND METHODS: Fifty-six patients that had confirmed detrusor underactivity with at least 150ml of postvoid residual urine volume(PVR) based on a urodynamic study were enrolled. The initial dosage of bethanechol given was 75mg/day, and the dosage was gradually increased to 150mg/day if necessary. Doxazosin gastro-intestinal therapeutic system(GITS)(4mg) was also given. The effect of the treatment was evaluated by a urine flow test, the amount of PVR, and frequency of clean intermittent catheterization(CIC). RESULTS: The mean follow-up period was 6 months(range, 1 to 9 months). After treatment, the mean PVR decreased from 251.8+/-149.6ml to 136.4+/-153.2ml(p<0.001) and was less than 100ml in 22(39%) of the 38 patients that showed a decrease. The maximum flow rate(Qmax) increased from 8.7+/-4.7ml/s to 11.1+/-5.6ml/s(p=0.024) and was more than 5ml/s in 13 patients(23%). Five of the 18 patients that previously required CIC could discontinue this treatment and another nine patients showed a decrease in the frequency. The mean daily frequency of CIC was reduced from 3.2 to 1.5(p=0.004). Ten of the 12 patients that were not able to void became capable of voluntary voiding. Five patients(9%) complained of adverse reactions and four of them were taken off the medication. CONCLUSIONS: The combination therapy of bethanechol with doxazosin improved emptying ability in patients with impaired detrusor contractility.
