Effects of bethanechol chloride and distigmine bromide on postvoiding residual volume in patients with underactive bladder

Minerva Urol Nefrol. 2014 Dec;66(4):241-7.

Abstract

Aim: The efficacy of cholinergic drugs for reduction of post-voiding residual volume (PVR) in patients with underactive bladder is still controversial. This study was performed to examine whether cholinergic drugs have such an effect on PVR.

Methods: Patients with underactive bladder treated for more than two months with cholinergic drugs, which were later discontinued, were extracted retrospectively based on their charts. The changes in PVR, cholinesterase activity (ChE), renal function, and voiding function before and after discontinuation of cholinergic drugs were reviewed and analyzed.

Results: Twenty-nine patients were included in this study. In multiple linear regression analysis, the discontinuation of distigmine bromide (DB) was indicated as a significant covariate for PVR increase and ChE increase, while bethanechol chloride (BC) was not a significant covariate. The increase in ChE was significantly correlated with both PVR and voided volume after discontinuation of cholinergic drugs.

Conclusion: DB could reduce PVR via a decrease in ChE. However, BC at doses up to 60 mg did not reduce PVR. DB may be recommended for the reduction of PVR in patients with underactive bladder.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bethanechol / pharmacology
  • Bethanechol / therapeutic use*
  • Cholinesterase Inhibitors / pharmacology
  • Cholinesterase Inhibitors / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscarinic Agonists / pharmacology
  • Muscarinic Agonists / therapeutic use*
  • Pyridinium Compounds / pharmacology
  • Pyridinium Compounds / therapeutic use*
  • Retrospective Studies
  • Urinary Bladder / drug effects*
  • Urinary Bladder Diseases / drug therapy*
  • Urinary Bladder Diseases / physiopathology*

Substances

  • Cholinesterase Inhibitors
  • Muscarinic Agonists
  • Pyridinium Compounds
  • Bethanechol
  • distigmine