EFFICACY OF NON-PHARMACOLOGICAL AND PHARMACOLOGICAL TREATMENT OF OVERACTIVE BLADDER: A RANDOMIZED TRIAL

Abstract

The article presents information on a scientific study conducted to assess the efficacy of pelvic floor muscle stimulation (PFMS) with biofeedback and fractional CO2 laser, either seperately or in combination with an antimuscarinic and selective β3-agonist in the treatment of patients with overactive bladder (OAB). 105 female patients with OAB were included in a prospective randomized trial and divided into three equal groups: Group 1, patients receiving a PFMS with a fractional CO2 laser (non-pharmacological treatment group, Non-Pharm); Group 2, patients receiving a combination of PFMS with fractional CO2 laser and pharmacological agents (Mix), Group 3, patients receiving a pharmacological agent (Pharm). PFMS treatment continued for 10 days, fractional CO2 laser was used twice, and pharmacological agents were prescribed for three months. The time points: before treatment, 3 and 6 months after treatment. All parameters of the bladder diary improved significantly in all groups after 3 months (p<0.05), but the beneficial effect persisted up to 6 months in the Mix group. There was a higher improvement in frequency of urination per day and night, no urinary urgency, and no postmicturition urinary residual in Mix and Pharm groups than in Non-Pharm after 3 months. There was a higher improvement in urine flow rate in Non-Pharm and Mix groups after 3 and 6 months. The frequency of urination and urine flow rate before treatment were predictors of favorable outcome. The combination of an antimuscarinic and a selective β3 agonist with biofeedback PFMS and fractional CO2 laser is superior to either method alone in patients with OAB.