Article

The purpose of this retrospective study was to investigate the urodynamic
effects of solifenacin treatment for neurogenic detrusor overactivity (NDO) in
patients with spinal cord injury (SCI). SETTING: Paraplegic center in
Switzerland.Methods:Retrospective analysis of case histories and urodynamic data
of 35 SCI patients receiving solifenacin for treatment of NDO between 2008 and
2012. Patients were categorized as being at risk of renal damage when maximum
detrusor pressure was >40 cm H2O or detrusor compliance was <20 ml cm(-1) H2O.
RESULTS: Solifenacin treatment was initiated 7.3 years after SCI. Most patients
(63%) had already been taking other antimuscarinic drugs. After 13.1 months
(median, interquartile range 6.1-19.5 months), solifenacin treatment had resulted
in significant (P<0.03) improvements in bladder capacity (median +30.0 ml),
maximum detrusor pressure (median -7.0 cm H2O), reflex volume (median +62.5 ml)
and detrusor compliance (median +25.0 ml cm(-1) H2O). Furthermore, fewer patients
presented with a risk of renal damage. However, this difference was not
significant (P>0.1). The number of patients suffering from incontinence had not
changed significantly. Eight and two patients discontinued solifenacin treatment
as a result of insufficient efficacy and intolerable adverse events,
respectively. One patient had discontinued solifenacin treatment without further
explanation. CONCLUSION: Solifenacin treatment significantly improved bladder
capacity, detrusor compliance, reflex volume and maximum detrusor pressure.
Solifenacin treatment seems to be an effective oral treatment of NDO after SCI.

Langue : ANGLAIS