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KMID : 0358320070480101040
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Korean Journal of Urology
2007 Volume.48 No. 10 p.1040 ~ p.1043
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The Effect of Bethanechol Chloride with an ?-adrenergic Blocker in Patients with Impaired Detrusor Contractility
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Kim Ji-Young
Hong Jeong-Hee
Lee Kyu-Sung
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Abstract
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Purpose:Bethanechol enhances detrusor contraction and ?1-blockers reduce bladder outlet resistance. We evaluated the effects of bethanechol with doxazosin in patients with impaired detrusor contractility.
Materials and methods: Fifty-six patients that had confirmed detrusor underactivity with at least 150ml of postvoid residual urine volume(PVR) based on a urodynamic study were enrolled. The initial dosage of bethanechol given was 75mg/day, and the dosage was gradually increased to 150mg/day if necessary. Doxazosin gastro-intestinal therapeutic system(GITS)(4mg) was also given. The effect of the treatment was evaluated by a urine flow test, the amount of PVR, and frequency of clean intermittent catheterization(CIC).
Results:The mean follow-up period was 6 months(range, 1 to 9 months). After treatment, the mean PVR decreased from 251.8±149.6ml to 136.4± 153.2ml(p＜0.001) and was less than 100ml in 22(39%) of the 38 patients that showed a decrease. The maximum flow rate(Qmax) increased from 8.7±4.7ml/s to 11.1±5.6ml/s(p=0.024) and was more than 5ml/s in 13 patients(23%). Five of the 18 patients that previously required CIC could discontinue this treatment and another nine patients showed a decrease in the frequency. The mean daily frequency of CIC was reduced from 3.2 to 1.5(p=0.004). Ten of the 12 patients that were not able to void became capable of voluntary voiding. Five patients(9%) complained of adverse reactions and four of them were taken off the medication.
Conclusions:The combination therapy of bethanechol with doxazosin improved emptying ability in patients with impaired detrusor contractility. (Korean J Urol 2007;48:1040-1043)
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KEYWORD
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Neurogenic bladder, Bethanechol, Alpha-adrenergic blockers
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