PURPOSE: To perform an update on the treatment of masculine urinary incontinence due to idiopathic overactive bladder.
METHOD: A systematic review was conducted using PubMed/MEDLINE with the following keywords: "overactive bladder", "male urinary incontinence", "urgency", "antimuscarinic", "onabotulinumtoxinA", "neurostimulation", "cystoplasty".
RESULTS: Antimuscarinic treatments were the first line option for overactive bladder incontinence (decreased incontinence under tolterodine versus placebo respectively -71% vs. -40%, P< 0.05). Their main side effects were dry mouth (16-29.6%) and constipation (4%), which might decrease the observance. In case of failure, neuromostimulation could be prosed with a 67% efficacy rate. Intra-detrusorian injections of onabotulinumtoxinA were an option, however there were still not validated for this indication and their efficacy decreases with time and after repeated injections. The ultimate option in case of refractory major over-activity was cystoplasty, which involves major morbidity for inconstant efficacy.
CONCLUSIONS: The same treatments are available for non-neurologic urinary incontinence by bladder over-activity for men and women: antimuscarinic drugs, neurostimulation, onabotulinumtoxinA. However, only few data is available for masculine population exclusively.
Written by:
Lebdai S, Haillot O, Azzouzi AR, Benchikh A, Campeggi A, Cornu JN, Delongchamps NB, Dumonceau O, Faix A, Fourmarier M, Lukacs B, Mathieu R, Misrai V, Robert G, de La Taille A, Descazeaud A. Are you the author?
Service d'urologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France; Service d'urologie, CHU de Tours, 37044 Tours, France; Service d'urologie, hôpital Bichat-Claude-Bernard, groupe des hôpitaux universitaires Paris-Nord-Val-de-Seine, université Denis-Diderot, Paris-VII, 75018 Paris, France; Service d'urologie, CHU Mondor, 75000 Paris, France; Service d'urologie, hôpital Tenon, université Paris-VI, 75020 Paris, France; Service d'urologie, CHU Cochin, 75014 Paris, France; Service d'urologie, clinique Turin, 75008 Paris, France; Clinique mutualiste Beausoleil, 34070 Montpellier, France; Service d'urologie, centre hospitalier Aix-en-Provence, 13616 Aix-en-Provence, France; Service d'urologie, hôpital Pontchaillou, CHU de Rennes, 35000 Rennes, France; Service d'urologie, clinique Pasteur, 31300 Toulouse, France; Service d'urologie, université Bordeaux Segalen, CHU de Bordeaux, 33076 Bordeaux, France; Service de chirurgie urologique, CHU de Limoges, 87042 Limoges, France.
Reference: Prog Urol. 2014 Jul;24(9):588-94.
doi: 10.1016/j.purol.2014.01.002
PubMed Abstract
PMID: 24975794
Article in French.
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