Efficacy of Combination Therapy with Mirabegron for Anticholinergic-Resistant Neurogenic Bladder : Videourodynamic Evaluation

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  • Wada, Naoki
    The Department of Renal and Urologic Surgery, Asahikawa Medical University
  • Okazaki, Satoshi
    The Department of Renal and Urologic Surgery, Asahikawa Medical University
  • Kobayashi, Shin
    The Department of Renal and Urologic Surgery, Asahikawa Medical University
  • Hashizume, Kazumi
    The Department of Renal and Urologic Surgery, Asahikawa Medical University
  • Kita, Masafumi
    The Department of Renal and Urologic Surgery, Asahikawa Medical University
  • Matsumoto, Seiji
    The Department of Renal and Urologic Surgery, Asahikawa Medical University
  • Kakizaki, Hidehiro
    The Department of Renal and Urologic Surgery, Asahikawa Medical University

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Other Title
  • 抗コリン薬抵抗性の神経因性膀胱に対するミラベグロンの併用効果 : ビデオウロダイナミクスを用いた検討
  • コウコリンヤク テイコウセイ ノ シンケイインセイ ボウコウ ニ タイスル ミラベグロン ノ ヘイヨウ コウカ : ビデオウロダイナミクス オ モチイタ ケントウ

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Abstract

Using a videourodynamic study, we examined the efficacy of combination therapy with mirabegron for anticholinergic-resistant neurogenic bladder. We retrospectively studied 7 patients with neurogenic bladder (5 males and 2 females) who had detrusor overactivity (DO) or low compliance bladder (＜10 ml/cmH2O) despite taking anticholinergic medication. Bladder deformity was categorized from G0 to G3 by Ogawa’s classification. Mean age of study patients was 51 years (25-76). Underlying diseases were spinal cord injury in 3 patients, spina bifida in 2, spinal cord infarction in 1, and post-radical hysterectomy in 1. Preceding anticholinergic medication was solifenacin 5 mg in 1 patient, solifenacin 10 mg in 5, and tolterodine 4 mg in 1. Before mirabegron, bladder deformity was G1 in 4 patients, G2 in 1 and G3 in 2, and vesicoureteral reflux (VUR) was detected in 3 patients. Five and 4 patients had detrusor overactivity and low compliance bladder, respectively. Videourodynamic study was reevaluated at a mean of 7 months (2- 12 months) after mirabegron. After mirabegron, urinary incontinence was improved in all patients. G3 bladder deformity was improved to G2 and G1 in one patient each, and VUR disappeared in all 3 patients. DO disappeared in 2 of the 5 patients, and bladder compliance was improved in all 4 patients with low compliance bladder. In conclusion, combination therapy of mirabegron is effective and beneficial for anticholinergic-resistant neurogenic bladder.

Journal

  • Hinyokika Kiyo

    Hinyokika Kiyo 61 (1), 7-11, 2015-01

    泌尿器科紀要刊行会

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