Intravesically administered ketoprofen in treatment of detrusor instability: Cross-over study

Aim. To evaluate the therapeutic efficacy of intravesically administered ke toprofen in patients with urodynamically verified detrusor instability. Methods. This double-blind randomized placebo-controlled cross-over study i ncluded 30 patients with urodynamically verified detrusor instability. Thei r mean age was 44 +/- 3.6 years (range 37-49) and the median of the parity was 2 years (1-3). The mean duration of symptoms was 18.3+/-3.1 months (ran ge 14-23). After a 6-week screening, patients were randomized to receive ke toprofen or placebo once a day for 4 weeks. Out of 30 patients, 16 started with ketoprofen, and 14 received placebo. After a week of washing period, 1 6 patients received placebo, and 14 received ketoprofen. The solution for i ntravesical application was 50 mL of saline with 2 mL (100 mg) of ketoprofe n warmed to 37 degreesC. The placebo solution contained 2 mt of distilled w ater instead of ketoprofen. The assessment including micturition diaries, c ystometric measurements, and bacteriological analysis of urine specimens wa s performed at the beginning of the study and after the treatment. Results. The subjective cure rate was 18/30 after ketoprofen. The instabili ty index was lower after ketoprofen than before treatment or after placebo (p<0.001). Maximal cystometric capacity and the urinary bladder volume at w hich the patients felt urgency to void were larger after ketoprofen than be fore it (p<0.001) or after placebo (p<0.001). The number of patients with u ninhibited bladder contractions decreased significantly after ketoprofen, b ut not after placebo (p<0.001). No side effects were observed. Conclusion. Intravesically administrated ketoprofen is a feasible and effec tive treatment for detrusor instability.