The Efficacy And Safety Of Tolterodine Tartrate In Treatment Of Ureteral Stent-Related Overactive Bladder Symptoms

Objective To investigate the efficacy and the safety of Tolterodine tartrate for prevention and treatment of the overactive bladder caused by the indwelling double-J tube after urological surgery.Patients and Methods60cases with indwelling double-J tube in our department were collected from June2011to December2012. They were randomly assigned into treatment and control group with30cases in each group. Their age ranges from22to72years old.We primarily conducted our OABSS score on the lth day after urethra catheter’s removal,then patients received Tolterodine tartrate ER in treatment group,4mg once daily,while patients in control group not. Secondary evaluation was conducted at4weeks after catheter’s removal, before double-J tube’s removal. Treatment-emergent adverse events with Tolterodine tartrate were recorded as well.Results In treatment group, the total number of patients was30, with9female cases and21male cases, their mean age was45.47±12.72years old. In the control group, the total number of patients was also30, with11female cases and19male cases,their mean age is45.10±12.42years old. it’s comparable in gender distribution and mean age between the two groups(respectively P=0.58and P=0.95).The median and quantiles of urgency scores at the first scoring in treatment group were0(0,0.5), the scores at the second scoring were0(0,0). The urgency scores at the first scoring in control group were0(0,0.5), the scores at the second scoring were1(0,4.00). The total OAB scores of treatment group before and after tolterodine tartrate therapy are3.23±2.66and2.00±1.91,respectively. The total OAB scores of control group in first and second evaluations are3.37±2.20and4.77±3.51, respectively. The prevalence of OAB in treatment group before and after tolterodine tartrate therapy are26.67%(8/30) and6.67%(2/30), respectively. The prevalence of the OAB in control group in first and second evaluations are20%(6/30) and46.67%(14/30), respectively. As to the three indexes, urgency scores, the total OAB scores and the prevalence of OAB, referred above,there was no significant difference between the two groups in the first evaluations (respectively P=0.60,P=0.83and P=0.54). However, compared with the baseline,there were significant differences in the treatment group in the second evaluations on the urgency scores—1st Ss:0(0,0.5) vs Sec Ss:0(0,0)(P=0.03), the total OAB scores (1st Ss:3.23±2.66vs Sec Ss:2.00±1.91, P=0.006), and the prevalence of OAB (1st Ss:26%vs Sec Ss:6%,P=0.04), similarily, there were significant differences in the control group in the second evaluations compared to the first evaluation on the urgency scores—1st Ss:0(0,0.5) vs Sec Ss:1(0,4.00)(P<0.01), the total OAB scores (1st Ss:3.37±2.19vs Sec Ss:4.77±3.51, P=0.002), and the prevalence of OAB (1st Ss:20%vs Sec Ss:46%,P=0.03).Moreover, there was also a significant difference in the second evaluation on the urgency scores—reatment G:0(0,0) vs Control G:1(0,4.00)(P<0.01), the total OAB scores (Treatment G:2.00±1.91vs Control G:4.77±3.51, P<0.01), and the prevalence of OAB (Treatment G:6%vs Control G:46%, P<0.01) between the two groups. The number of patients suffered from urgency incontinence (OAB wet) in treatment at both evaluations are2and0, respectively. The number of patients suffered from OAB wet in control group at both evaluations are2and4, respectively, the results between the twice evaluations in control group are significantly different. Only2patients complained of mild dry mouth,both not ceased their treatment.Conclusion Tolterodine tartrate can prevent and relieve ureteral stent-related overactive bladder symptoms safely and effectively,especially for those who mainly suffer from urgency or urgency incontinence.