Urology. 2006 Aug;68(2 Suppl):38-48.
The effects of antimuscarinics on health-related quality of life in overactive bladder: a systematic review and meta-analysis.
Khullar V, Chapple C, Gabriel Z, Dooley JA.
Department of Obstetrics and Gynaecology, St. Mary's Hospital, London, United Kingdom. vik.khullar@imperial.ac.uk
The objective of this study was to review the effects of antimuscarinic treatments on health-related quality of life (HRQL) in patients with overactive bladder (OAB). MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and the Cumulative Index to Nursing and Allied Health Literature databases were searched from 1966 through August 2004 for randomized controlled trials of antimuscarinic agents. HRQL data from included trials were extracted, and meta-analysis was performed where possible. Of 56 trials included, 25 (45%) reported HRQL and/or patient-reported outcomes. The most commonly used instruments were the Incontinence Impact Questionnaire (3 trials), the King's Health Questionnaire (KHQ; 5 trials), the Medical Outcomes Study Short Form-36 (2 trials), the Gaudenz Appraisal Questionnaire (3 trials), and the Urogenital Distress Inventory (2 trials). Results from the meta-analyses of placebo-controlled trials showed statistically significant differences in favor of antimuscarinic therapy. Differences in HRQL as assessed using the KHQ were also clinically meaningful. The meta-analysis results of active-controlled trials did not show significant differences among antimuscarinic agents. This review provides evidence that antimuscarinics provide an HRQL benefit to patients with OAB. HRQL outcomes using validated instruments are recommended for inclusion in active-controlled trials, and agreement on the most appropriate HRQL instrument is now required.
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- 1 How is urine produced?
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- 3 How prevalent is cystitis?
- 4 What is honeymoon cystitis?
- 5 What are Frequency and nocturia?
- 6 How prevalent are Frequency and nocturia?
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- 8 What is stress incontinence of urine?
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- 10 What causes stress and urge incontinence?
- 11 What is dribbling incontinence?
- 12 How prevalent is urinary incontinence?
- 13 What is the urethral syndrome?
- 14 How can I record my bladder problems and monitor the effects of treatment?
- 15 What simple measures are available to reduce urinary incontinence?
- 16 What are pelvic floor exercises?
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- 18 What is bladder training?
- 19 How effective is bladder training?
- 20 Are there any alternatives to bladder training for urgency symptoms?
- 21 If simple measures do not suffice, what else is available for the treatment of urinary stress incontinence?
- 22 What are urodynamic studies?
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