Korean J Urol.  2007 Oct;48(10):1040-1043. 10.4111/kju.2007.48.10.1040.

The Effect of Bethanechol Chloride with an alpha-adrenergic Blocker in Patients with Impaired Detrusor Contractility

• Kim JY
• Hong JH
• Lee KS

• KMID: 2139736
• DOI: http://doi.org/10.4111/kju.2007.48.10.1040

Abstract

PURPOSE: Bethanechol enhances detrusor contraction and alpha1-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.

Keyword

Neurogenic bladder; Bethanechol; Alpha-adrenergic blockers

MeSH Terms

Adrenergic alpha-Antagonists
Bethanechol*
Doxazosin
Follow-Up Studies
Humans
Urinary Bladder
Urinary Bladder, Neurogenic
Urodynamics
Adrenergic alpha-Antagonists
Bethanechol
Doxazosin

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