INTRAVESICAL TROSPIUM CHLORIDE, OXYBUTYNI N AND VERAPAMIL FOR RELAXATION OF DETRUSOR MUSCLE - A PLACEBO-CONTROLLED, RANDOMIZED CLINICAL-TRIAL

Therapy of detrusor hyperactivity with anticholinergic agents often is followed by adverse drug reactions. Intravesical application may be a n interesting alternative. A randomised, single-blind, placebo-control led, mono-centre clinical trial was carried out in 84 patients with ur gency or urge incontinence. Due to intravesical administration of oxyb utynin (CAS 5633-20-5) (n = 21) and trospium chloride (CAS 10405-02-4) (n = 21), respectively, a significant increase in maximum bladder cap acity and decrease of detrusor pressure accompanied by an increase of residual urine were found in comparison to placebo in urodynamical inv estigations. Improvement of uninhibited bladder contractions occured l eading to higher filling volume. Under verapamil (CAS 152-11-4) (n = 2 1) no marked changes in the efficacy variables were found compared wit h placebo. All patients completed the study and were assessed with reg ard to efficacy and safety. No adverse events or marked changes in the vital signs were reported. The immediate onset of effect and the lack of adverse drug reactions suggest that treatment with topical oxybuty nin or trospium chloride is an effective alternative in patients with intolerable side effects when orally treated. In addition, intravesica l administration may be indicated in patients with bladder spasms due to indwelling catheter or in order to increase bladder capacity before percutaneous cystostomy.