PURPOSE: We studied the voiding dysfunction after surgical treatment of female stress urinary incontinence and diagnosis and treatment. MATERIALS AND METHODS: Three hundred women with stress urinary incontinence underwent surgical procedure between January 1998 and December 2004. Ninety two patients(30.6%) experienced the postoperative voiding dysfunction. As the primary procedure for the management of postoperative voiding dysfunction alpha-blockers medication and clean intermittent catheterization(CIC) were performed. Then, hegar dilation and urethral pull-down procedure were performed as a secondary measure. For the patients who showed persistent obstructed symptoms, cutting of mesh or sling materials were performed. RESULTS: In 57 patients, symptoms improved by alpha-blockers medication and CIC. The others were received hegar dilation and urethral pull-down procedure, and 29 patients were improved. 6 patients were not controlled by conservative treatment, of which 3 patients underwent cutting of mesh or sling. De novo urgency was developed in 12 patients. Anticholinergics were taken, symptoms were diminished in 10 patients after 5 months of medication. CONCLUSION: Most voiding dysfunction after surgery may be effectively managed by conservative treatment. In cases of failure, hegar dilation and urethral pull-down procedure may be useful within postoperative first weak. Finally, cutting of mesh or sling must be considered in patient whose the secondary measure is failed.
Cholinergic Antagonists ; Diagnosis ; Female* ; Humans ; Urinary Incontinence*

Cholinergic urticaria with acquired generalized hypohidrosis, and its pathophysiology is not well known. Autoimmunity to sweat glands or to acetylcholine receptors on sweat glands has been mentioned as one of the possible etiologies. Systemic steroid therapy, antihistamines, anticholinergics, and avoidance of the stimulatory situations are recommended for treatment. We experienced a case of cholinergic urticaria with acquired generalized hypohidrosis in a patient who had no other associated disease, and the symptoms eased after repeated bilateral stellate ganglion block. Stellate ganglion block normalized the elevated sympathetic tone and may relieve symptoms in patients with this condition.
Autoimmunity ; Cholinergic Antagonists ; Histamine Antagonists ; Humans ; Hypohidrosis ; Receptors, Cholinergic ; Stellate Ganglion ; Sweat Glands ; Urticaria

Prostatitis is a common syndrome that is confusing and frustrating for urologists. Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) is the most common form of prostatitis. The etiology of CP/CPPS is unknown, but possibilities include infectious, autoimmune, neurological and psychiatric causes. Clinical, laboratory, and imaging evaluations for the patient presenting prostatitis can be categorized as basic or mandatory evaluations, further or recommended evaluations, and optional evaluations in selected patients. Evaluation can aid in diagnosis and follow-up of the patient's response to therapy. Treatment for CP/CPPS is empiric and limited by a lack of randomized, placebo-controlled clinical trials. Antimicrobials are commonly used to treat patients with prostatitis. Other commonly used drugs include alpha-adrenoceptor antagonists, anti-inflammatory drugs, tricyclic antidepressants, and anticholinergic agents. Also, minimally invasive procedures are considered in patients with CP/CPPS. Although much progress has been made in therapy, there is no distinct treatment for patients with CP/CPPS. It is possible to treat intractable patients with 'care' not 'cure'.
Antidepressive Agents, Tricyclic ; Cholinergic Antagonists ; Diagnosis ; Humans ; Pelvic Pain ; Prostatitis*

Tardive dystonia is an uncommon late side-effect of neuroleptic drug treatment and a difficult condition to treat. We report a single case of tardive dystonia that has successfully responded to clozapine. This patient has undergone more than thirteen years of antipsychotic treatment and developed severe and persistent tardive dystonia. Treatment with benzodiazepine, anticholinergics and muscle relaxant were ineffective in this patient. Thus, clozapine was tried. Treatment with clozapine brought about marked improvement and this remission has been sustained. We reviewed the literatures about successful treatment of tardive dystonia with clozapine. Finally, we recommend a trial of clozapine in adequate doses and for adequate duration on patients with drug-induced tardive dystonia.
Benzodiazepines ; Cholinergic Antagonists ; Clozapine* ; Humans ; Movement Disorders* ; Schizophrenia*

BACKGROUND: After sinus surgery, airway dryness is made worse because patients breathe by mouth. Anticholinergic agents have antisialogogue effects. The airway dryness that occurs after surgery is severe and can increase the incidence of postoperative sore throat. MATERIALS AND METHODS: One-hundered patients who were scheduled for endoscopic sinus surgery(ESS) were divided into four groups. Each group was premedicated with glycopyrrolate or had no premedication and reversed with glycopyrrolate or atropine. After the surgery the patients were asked about a sore throat and hoarseness postoperatively after 1h, 6h, 12h, 24h, and 48hours, respectively. RESULTS: The incidence of postoperative sore throat and hoarseness was not significantly different among the four groups at any time. CONCLUSION: The severity of complications after ESS was low and subsided within 24 hours. Therefore, the use of anticholinergic agents does not need to be limited.
Atropine ; Cholinergic Antagonists* ; Glycopyrrolate ; Hoarseness ; Humans ; Incidence ; Mouth ; Pharyngitis* ; Premedication

Asthma is the most common chronic illness to affect children and is a major cause of morbidity in adults, affecting 4~17% of children and 7.3~10.1% of adults, which translates to approximately 300 million people globally. This article reviews recently published data over the past 1~2 years on asthma, and covers the 3 aspects of current advancement for the diagnosis of severe asthma, including the controversy to long-acting bronchodilator treatment for treatment of asthma, and the role of long-acting anticholinergics treatment in asthma patients.
Adult ; Asthma ; Child ; Cholinergic Antagonists ; Chronic Disease ; Humans

Idiopathic torsion dystonia is a syndrome of sustained muscle contraction, frequently causing twisting and repetitive movement, or abnormal posture, which is both hereditary or sporadic. It is also classified by age of onset(childhood, adult, juveni1e) and distribution(generalized, focal, multifocal, segmental or hemidystonic). Its anatomical and biochemical pathophysiology are not exactly known yet, but high dosage anticholinergics are known to reduce the dystonic movement and posture in majority. We present a case of idiopathic torsion dystonia who has a family history of same syndrome, with review of literature.
Adult ; Cholinergic Antagonists ; Dystonia Musculorum Deformans ; Humans ; Muscle Contraction ; Posture

This study was performed to determine whether there were retinal changes in Parkinson's disease. Photopic and scotopic Flash ERGs were conducted for 21 patients with Parkinson's disease and for 19 control subjects. Seventeen patients were medicated with anticholinergics and L-dopa containing drugs. Five findings were observed from the study. 1. There was no difference in implicit time of photopic and scotopic a-and b-waves between the control and the Parkinsonian groups (p(t)>0.05). 2. Amplitude of photopic b-wave was smaller in the Parkinsonian group than the control group (p(t)<0.05). 3. Amplitudes of photopic and scotopic a-and b-waves did not differ between the control and the medicated Parkinsonian groups (p(t)>0.05). 4. Amplitudes of photopic (p(t)<0.001) and scotopic (p(t)<0.01) b-wave were smaller in the nonmedicated Parkinsonian group than the control group. 5. Age and sex characteristics did not affect the results in either group. From the above findings, it is suggested that there is a retinal cell change responsible for b-wave generation in Parkinson's disease, and it is reversed by anti-Parkinsonian medication.
Cholinergic Antagonists ; Humans ; Levodopa ; Parkinson Disease ; Retinaldehyde ; Sex Characteristics

Overactive bladder is a chronic condition defined by bothersome urgency with or without urgency incontinence, usually associated with daytime frequency and nocturia. The treatment of this condition is to control bothersome urinary symptoms and is therefore to improve quality of life. The Korean Continence Society published the overactive bladder guideline in 2007, which suggested the mainstay of management is behavioral therapy and antimuscarinic pharmacotherapy. With growing awareness toward overactive bladder and quality of life, clinical information regarding antimuscarinic agents should be updated. There are several agents with good level of evidence and good grade of recommendation. Newer antimuscarinic agents are available or will be available in near future. The pharmacological properties, efficacy and tolerability of oxybutynin, trospium, propiverine, tolterodine, darifenacin, solifenacin, fesoterodine and imidafenacin are reviewed and discussed here. The results of major clinical studies are summarized.
Cholinergic Antagonists* ; Drug Therapy ; Muscarinic Antagonists ; Nocturia ; Quality of Life ; Urinary Bladder, Overactive* ; Solifenacin Succinate ; Tolterodine Tartrate

An 18-year-old male visited our department complaining of recurrent episodes of an itchy rash after hand washing, showering/bathing, drinking water, and getting rain-soaked. He was diagnosed with aquagenic urticaria after a water provocation test and histopathologic examination. Five months of antihistamine treatment successfully prevented further wheal formation. Aquagenic urticaria is a very unusual form of physical urticaria caused by contact with water. It manifests as pruritic small wheals surrounded by erythema within 30 minutes of exposure. The condition can be diagnosed by a water provocation test. Systemic antihistamines are the first-line treatment, with anticholinergics, phototherapy, or barrier cream used alternatively or additionally. Four cases of aquagenic urticaria have been reported in Korea, but no histopathologic evaluation was reported in the English or Korean literature. Herein, we provide both a case report of aquagenic urticaria diagnosed by the water provocation test and histopathologic examination results for this patient.
Adolescent ; Cholinergic Antagonists ; Drinking Water ; Erythema ; Exanthema ; Hand Disinfection ; Histamine Antagonists ; Humans ; Korea ; Male ; Phototherapy ; Urticaria* ; Water*