Improving the global management of the neurogenic bladder patient: part II. Future treatment strategies.

Details

Serval ID
serval:BIB_CB5BDF0435E1
Type
Article: article from journal or magazin.
Collection
Publications
Title
Improving the global management of the neurogenic bladder patient: part II. Future treatment strategies.
Journal
Current Medical Research and Opinion
Author(s)
Denys P., Corcos J., Everaert K., Chartier-Kastler E., Fowler C., Kalsi V., Nitti V., Schulte-Baukloh H., Schurch B.
ISSN
0300-7995 (Print)
ISSN-L
0300-7995
Publication state
Published
Issued date
2006
Volume
22
Number
5
Pages
851-860
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; ReviewPublication Status: ppublish
Abstract
BACKGROUND: Patients with neurogenic bladder represent a small fraction of the total overactive bladder population. As a consequence, development of new therapies in this area has largely focused on idiopathic urinary incontinence. The absence of data for patients with neurological disease has far-reaching implications, affecting reimbursement and physicians' willingness to prescribe therapies, and limiting access of potential valuable treatments to patients whose lives are significantly impaired by inadequately managed bladder symptoms.
SCOPE: The range of new therapies is increasing. Although many reviews of the overall safety, efficacy and mode of action of such treatments are available, there is limited information on how these treatments will best be used in clinical practice. We considered the current benefits and limitations of the various new licensed and unlicensed therapies and what role each would have in the future management of neurogenic urinary incontinence.
CONCLUSIONS: A wide range of new treatments have been investigated for the management of overactive bladder; few, however, have been evaluated extensively in neurogenic urinary incontinence. Further studies are required to determine the optimal dosing regimes and formulations for individual sub-populations of neurogenic bladder patients and to determine the cost-effectiveness of these interventions. With the current experience available, two treatment algorithms for a subset of patients with neurological disease have also been proposed, which suggest at which stage of management and in which patients individual therapies for neurogenic urinary incontinence could be used.
Keywords
Algorithms, Botulinum Toxins, Type A/pharmacology, Botulinum Toxins, Type A/therapeutic use, Cannabinoids/pharmacology, Cannabinoids/therapeutic use, Capsaicin/pharmacology, Capsaicin/therapeutic use, Cholinergic Antagonists/pharmacology, Cholinergic Antagonists/therapeutic use, Diterpenes/pharmacology, Diterpenes/therapeutic use, Humans, Muscarinic Antagonists/pharmacology, Muscarinic Antagonists/therapeutic use, Treatment Outcome, Urinary Bladder, Neurogenic/complications, Urinary Bladder, Neurogenic/drug therapy, Urinary Incontinence/drug therapy, Urinary Incontinence/etiology
Pubmed
Web of science
Create date
05/11/2014 13:12
Last modification date
20/08/2019 16:46
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