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Pharmacological Therapy

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Clinical Urodynamics in Childhood and Adolescence

Part of the book series: Urodynamics, Neurourology and Pelvic Floor Dysfunctions ((UNPFD))

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Abstract

Urologists utilize clinical history, elimination diaries, noninvasive urodynamics, and conventional urodynamics to help gain an understanding of each patient’s unique bladder characteristics. It is from this information that urologists can determine whether implementing pharmacologic therapy will benefit a patient; furthermore, this information helps the physician tailor the correct pharmacotherapy to each patient based on their individual bladder physiology. Figure 28.1 shows a treatment algorithm which includes the optimal time to initiate pharmacotherapy for two common urologic issues: frequency and incontinence. There is a multitude of pharmacotherapy agents in an urologist’s armamentarium, and having an in-depth understanding of each agent is key in helping to determine the correct drug needed for each clinical scenario.

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References

  1. Finney SM, Andersson KE, Gillespie JI, et al. Antimuscarinic drugs in detrusor overactivity and the overactive bladder syndrome: motor or sensory actions? BJU Int. 2006;98:503–7.

    Article  CAS  PubMed  Google Scholar 

  2. Nijman RJ. Role of antimuscarinics in the treatment of nonneurogenic daytime urinary incontinence in children. Urology. 2004;63:45–50.

    Article  PubMed  Google Scholar 

  3. Austin PF, Vricella GJ. Functional disorders of lower urinary tract in children. In: Campbell-walsh urology tenth edition. Part XV Pediatric urology. 2012. pp. 3297–316.

    Google Scholar 

  4. Austin PF, Franco I. Chapter 15: Pharmacotherapy of the child with functional incontinence retention. In:Pediatric incontinence: evaluation and clinical management. Chichester: John Wiley and Sons, Ltd; 2015. https://doi.org/10.1002/9781118814789.ch15.

    Chapter  Google Scholar 

  5. Andersson KE, Chapple CR, Cardozo L, Cruz F, Hashim H, Michel MC, et al. Pharmacological treatment of overactive bladder: report from the international consultation on incontinence. Curr Opin Urol. 2009;19(4):380–94.

    Article  PubMed  Google Scholar 

  6. Sommer BR, O’Hara R, Askari N, et al. The effect of oxybutynin treatment on cognition in children with diurnal incontinence. J Urol. 2005;173:2125–7.

    Article  CAS  PubMed  Google Scholar 

  7. Veenboer PW, Huisman J, Chrzan RJ. Behavioral effects of long-term antimuscarinic use in patients with spinal dysraphism: a case control study. J Urol. 2013;190:2228–32.

    Article  CAS  PubMed  Google Scholar 

  8. Youdim K, Kogan BA. Preliminary study of the safety and efficacy of extended-release oxybutynin in children. Urology. 2002;59:428–32.

    Article  PubMed  Google Scholar 

  9. Gillespie JI, Palea S, Guilloteau V, Guerard M, Lluel P, Korstanje C. Modulation of non-voiding activity by the muscarinergic antagonist tolterodine and the beta(3)-adrenoceptor agonist mirabegron in conscious rats with partial outflow obstruction. BJU Int. 2012;110(2 Pt 2):E132–42.

    Article  CAS  PubMed  Google Scholar 

  10. Reddy PP, Borgstein NG, Nijman RJ, Ellsworth PI. Long-term efficacy and safety of tolterodine in children with neurogenic detrusor overactivity. J Pediatr Urol. 2008;4(6):428–33.

    Article  PubMed  Google Scholar 

  11. Ayan S, Kaya K, Topsakal K, Kilicarslan H, Gokce G, Gultekin Y. Efficacy of tolterodine as a first-line treatment for non-neurogenic voiding dysfunction in children. BJU Int. 2005;96(3):411–4.

    Article  CAS  PubMed  Google Scholar 

  12. Ek A. Adrenergic innervation and adrenergic mechanisms: a study of the human urethra. Acta Pharmacol Toxicol (Copenh). 1978;43:35–40.

    Article  Google Scholar 

  13. Krane RJ, Olsson CA. Phenoxybenzamine in neurogenic bladder dysfunction. II. Clinical considerations. J Urol. 1973;110(6):653–6.

    Article  CAS  PubMed  Google Scholar 

  14. Austin PF, Homsy YL, Masel JL, Cain MP, Casale AJ, Rink RC. Alpha-adrenergic blockade in children with neuropathic and nonneuropathic voiding dysfunction. J Urol. 1999;162(3 Pt 2):1064–7.

    Article  CAS  PubMed  Google Scholar 

  15. Homsy Y, Arnold P, Zhang W. Phase IIb/III dose ranging study of tamsulosin as treatment for children with neuropathic bladder. J Urol. 2011;186(5):2033–9.

    Article  CAS  PubMed  Google Scholar 

  16. Schulte-Baukloh H, Michael T, Miller K, Knispel HH. Alfuzosin in the treatment of high leak-point pressure in children with neurogenic bladder. BJU Int. 2002;90(7):716–20.

    Article  CAS  PubMed  Google Scholar 

  17. Cain MP, Wu SD, Austin PF, et al. Alpha blocker therapy for children with dysfunctional voiding and urinary retention. J Urol. 2003;170:1514–5.

    Article  CAS  PubMed  Google Scholar 

  18. Franco I, Cagliostro S, Collett T, Reda E. The use of alpha blockers to treat urgency/frequency syndrome in children. San Francisco, CA: American Acadamey of Pediatrics Meeting; 2007.

    Google Scholar 

  19. Ishihama H, Momota Y, Yanase H, Wang X, de Groat WC, Kawatani M. Activation of alpha1D adrenergic receptors in the rat urothelium facilitates the micturition reflex. J Urol. 2006;175(1):358–64.

    Article  CAS  Google Scholar 

  20. Somogyi GT, Tanowitz M, de Groat WC. Prejunctional facilitatory alpha 1-adrenoceptors in the rat urinary bladder. Br J Pharmacol. 1995;114(8):1710–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Szell EA, Yamamoto T, de Groat WC, Somogyi GT. Smooth muscle and parasympathetic nerve terminals in the rat urinary bladder have different subtypes of alpha(1) adrenoceptors. Br J Pharmacol. 2000;130(7):1685–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Athanasopoulos A, Gyftopoulos K, Giannitsas K, Fisfis J, Perimenis P, Barbalias G. Combination treatment with an alpha-blocker plus an anticholinergic for bladder outlet obstruction: a prospective, randomized, controlled study. J Urol. 2003;169(6):2253–6.

    Article  CAS  PubMed  Google Scholar 

  23. Van Batavia JP, Combs AJ, Horowitz M, et al. Primary bladder neck dysfunction in children and adolescents III: results of long-term alpha-blocker therapy. J Urol. 2010;183:724–30.

    Article  CAS  PubMed  Google Scholar 

  24. Van Batavia JP, Combs AJ, Hyun G, et al. Simplifying the diagnosis of 4 common voiding conditions using uroflow/electromyography, electromyography lag time and voiding history. J Urol. 2011;186(Suppl. 4):1721–6.

    Article  PubMed  Google Scholar 

  25. Andersson KE, Martin N, Nitti V. Selective beta(3)-adrenoceptor agonists for the treatment of overactive bladder. J Urol. 2013;190(4):1173–80.

    Article  CAS  PubMed  Google Scholar 

  26. Chapple CR, Cardozo L, Nitti VW, Siddiqui E, Michel MC. Mirabegron in overactive bladder: a review of efficacy, safety, and tolerability. Neurourol Urodyn. 2014;33(1):17–30.

    Article  CAS  PubMed  Google Scholar 

  27. Yamaguchi O, Marui E, Kakizaki H, Homma Y, Igawa Y, Takeda M, et al. Phase III, randomised, double-blind, placebo-controlled study of the beta3 -adrenoceptor agonist mirabegron, 50 mg once daily, in Japanese patients with overactive bladder. BJU Int. 2014;113(6):951–60.

    Article  CAS  PubMed  Google Scholar 

  28. Austin PF, Bauer SB. Chapter 27: Medical management of the neurogenic bladder. In:Pediatric incontinence; evaluation and clinical management. Chichester: John Wiley and Sons, Ltd; 2015. https://doi.org/10.1002/9781118814789.ch27.

    Chapter  Google Scholar 

  29. Chase J, Austin PF, Hoebeke P, et al. The management of dysfunctional voiding in children: a report from the standardisation committee of the International children’s continence society. J Urol. 2010;183:1296–302.

    Article  PubMed  Google Scholar 

  30. Thom M, Campigotto M, Vemulakonda V, et al. Management of lower urinary tract dysfunction: a stepwise approach. J Pediatr Urol. 2012;8:20–93.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Urologic Surgery, St. Louis Children’s Hospital, Washington University School, St. Louis, MO, USA

    John Weaver M.D. & Paul Austin M.D.

Authors
  1. John Weaver M.D.
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  2. Paul Austin M.D.
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Corresponding author

Correspondence to Paul Austin M.D. .

Editor information

Editors and Affiliations

  1. Pediatric NeuroUrology Research and Clinic, Bambino Gesù Pediatric Hospital, Rome, Italy

    Giovanni Mosiello

  2. Neurourology Department, Careggi Hospital, Florence, Italy

    Giulio Del Popolo

  3. Pediatric Urodynamic Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Jian Guo Wen

  4. Urology Unit, Bambino Gesù Pediatric Hospital, Rome, Italy

    Mario De Gennaro

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Weaver, J., Austin, P. (2018). Pharmacological Therapy. In: Mosiello, G., Del Popolo, G., Wen, J., De Gennaro, M. (eds) Clinical Urodynamics in Childhood and Adolescence. Urodynamics, Neurourology and Pelvic Floor Dysfunctions. Springer, Cham. https://doi.org/10.1007/978-3-319-42193-3_27

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  • DOI: https://doi.org/10.1007/978-3-319-42193-3_27

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42191-9

  • Online ISBN: 978-3-319-42193-3

  • eBook Packages: MedicineMedicine (R0)

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