STUDY DESIGN: It is a retrospective chart analysis. OBJECTIVES: In patients with neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury (SCI), neurogenic detrusor overactivity (NDO) can cause both deterioration of the upper urinary tract and urinary incontinence. Antimuscarinic treatment is frequently discontinued due to side effects or lack of efficacy, whereas injection of onabotulinumtoxin into the detrusor is a minimally invasive procedure with risks of urinary retention, infection and haematuria. Mirabegron, a new β-3 agonist, is a potential new agent for treatment of NDO. Aim of the study was to evaluate the efficacy of mirabegron in SCI patients with NLUTD. SETTING: Swiss Paraplegic Center, Nottwil, Switzerland. METHODS: A retrospective chart analysis of SCI patient treated with mirabegron. RESULTS: Fifteen patients with NDO were treated with mirabegron for a period of at least 6 weeks. Significant reduction of the frequency of bladder evacuation per 24 h (8.1 vs 6.4, P=0.003), and of incontinence episodes per 24 h (2.9 vs 1.3, P=0.027) was observed. Furthermore, we observed improvements in bladder capacity (from 365 to 419 ml), compliance (from 28 to 45 ml cm(-1) H(2)0) and detrusor pressure during storage phase (45.8 vs 30 cm H(2)0). At follow-up, 9/15 patients were satisfied with the therapy, 4/15 reported side effects (3 × aggravation of urinary incontinence, 1 × constipation). CONCLUSIONS: Mirabegron may evolve as an alternative in the treatment of NDO. We observed improvements in urodynamic and clinical parameters. Due to the limited number of patients and the retrospective nature of the study, prospective, placebo-controlled studies are necessary.
STUDY DESIGN: It is a retrospective chart analysis. OBJECTIVES: In patients with neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury (SCI), neurogenic detrusor overactivity (NDO) can cause both deterioration of the upper urinary tract and urinary incontinence. Antimuscarinic treatment is frequently discontinued due to side effects or lack of efficacy, whereas injection of onabotulinumtoxin into the detrusor is a minimally invasive procedure with risks of urinary retention, infection and haematuria. Mirabegron, a new β-3 agonist, is a potential new agent for treatment of NDO. Aim of the study was to evaluate the efficacy of mirabegron in SCI patients with NLUTD. SETTING: Swiss Paraplegic Center, Nottwil, Switzerland. METHODS: A retrospective chart analysis of SCI patient treated with mirabegron. RESULTS: Fifteen patients with NDO were treated with mirabegron for a period of at least 6 weeks. Significant reduction of the frequency of bladder evacuation per 24 h (8.1 vs 6.4, P=0.003), and of incontinence episodes per 24 h (2.9 vs 1.3, P=0.027) was observed. Furthermore, we observed improvements in bladder capacity (from 365 to 419 ml), compliance (from 28 to 45 ml cm(-1) H(2)0) and detrusor pressure during storage phase (45.8 vs 30 cm H(2)0). At follow-up, 9/15 patients were satisfied with the therapy, 4/15 reported side effects (3 × aggravation of urinary incontinence, 1 × constipation). CONCLUSIONS: Mirabegron may evolve as an alternative in the treatment of NDO. We observed improvements in urodynamic and clinical parameters. Due to the limited number of patients and the retrospective nature of the study, prospective, placebo-controlled studies are necessary.
Authors: Christopher R Chapple; Linda Cardozo; Victor W Nitti; Emad Siddiqui; Martin C Michel Journal: Neurourol Urodyn Date: 2013-10-11 Impact factor: 2.696
Authors: Thomas M Kessler; Lucas M Bachmann; Christoph Minder; David Löhrer; Martin Umbehr; Holger J Schünemann; Alfons G H Kessels Journal: PLoS One Date: 2011-02-23 Impact factor: 3.240
Authors: Christopher R Chapple; Steven A Kaplan; David Mitcheson; Mary Beth Blauwet; Moses Huang; Emad Siddiqui; Vik Khullar Journal: Int J Urol Date: 2014-08-04 Impact factor: 3.369
Authors: Paholo G Barboglio Romo; Christopher P Smith; Ashley Cox; Márcio A Averbeck; Caroline Dowling; Cleveland Beckford; Paul Manohar; Sergio Duran; Anne P Cameron Journal: World J Urol Date: 2018-07-26 Impact factor: 4.226
Authors: Elie El Helou; Chris Labaki; Roy Chebel; Jeanine El Helou; Georges Abi Tayeh; Georges Jalkh; Elie Nemr Journal: World J Urol Date: 2019-12-05 Impact factor: 4.226
Authors: Michelle Trbovich; Terry Romo; Marsha Polk; Wouter Koek; Che Kelly; Sharon Stowe; Stephen Kraus; Dean Kellogg Journal: Spinal Cord Ser Cases Date: 2021-06-10