5 A study done by Kessler-Zumpe PL et al, demonstrated that 12 weeks of treatment with the slow-release form of propiverine (ER 30 mg) reduced the frequency of urinary incontinence within 24 hours by 68.3%. The efcacy of propiverine is enhanced when combined with α-blockers. Lee KS et al, demonstrated this in a multicentre, randomized, double-blind study of the α1 adrenoceptor antagonist doxazosin and propiverine in patients with obstruction due to benign enlargement of the prostate and overactive bladder. This study concluded that the combination of antimuscarinics and α1 adrenoceptor antagonists is effective and safe in patients with obstruction due to benign enlargement of the prostate and overactive bladder. Side effects The most common side effect of antimuscarinic drugs compared to placebo is dry mouth. Other side effects include constipation, pruritus, and headache. However, constipation may be the most bothersome side effect, particularly in the elderly where it can impact their QOL. There are a number of studies that show a decrease in the frequency of side effects, especially dry mouth, with the long-term use of propiverine. The impact of Propiverine on various parameters Conclusion Propiverine is an effective treatment option with a favourable side effect prole for the symptomatic treatment adult patients with overactive bladder or neurogenic detrusor overactivity. Patients using propiverine 45 mg have been observed to experience signicantly less frequent urinary urgency, urinary frequency, incontinence, and nocturia (p<0.0001) compared to patients using 30 mg. Both propiverine 45 mg and propiverine 30 mg have similar tolerability. Parameter frequency mean urinary volume IPSS symptoms of storage Effect 23.5% to 14.3% 32.3%-19.2% 41.3% vs. 32.6% P value p=0.004 p=0.004 p=0.029 Parameter Blurred vision Effect in the elderly on heart rate and PQ, QRS, QT, or QTc intervals in resting and ambulatory ECGs Cognitive function Psychomotor parameters such as alertness, attention, reaction times, complex acoustic and optical reaction times Post-void residual (PVR) in patients with overactive bladder Effect of Propiverine No clinical difference in the incidence of blurred vision side effects when comparing propiverine to placebo control groups No signicant differences between placebo and the propiverine group No signicant changes observed in post-void residual measures, higher brain function scales, parameters, and motor functions measured by CIBIC (Clinician's Interview-Based Impression of Change) No signicant difference was found between the placebo and propiverine groups None UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE
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