[Treatment of non-neurogenic masculine urinary incontinence due to overactive bladder: a review by the LUTS committee of the French Urological Association]

Prog Urol. 2014 Jul;24(9):588-94. doi: 10.1016/j.purol.2014.01.002. Epub 2014 Feb 10.
[Article in French]

Abstract

Purpose: To perform an update on the treatment of masculine urinary incontinence due to idiopathic overactive bladder.

Method: A systematic review was conducted using PubMed/MEDLINE with the following keywords: "overactive bladder", "male urinary incontinence", "urgency", "antimuscarinic", "onabotulinumtoxinA", "neurostimulation", "cystoplasty".

Results: Antimuscarinic treatments were the first line option for overactive bladder incontinence (decreased incontinence under tolterodine versus placebo respectively -71% vs. -40%, P < 0.05). Their main side effects were dry mouth (16-29.6%) and constipation (4%), which might decrease the observance. In case of failure, neuromostimulation could be prosed with a 67% efficacy rate. Intra-detrusorian injections of onabotulinumtoxinA were an option, however there were still not validated for this indication and their efficacy decreases with time and after repeated injections. The ultimate option in case of refractory major over-activity was cystoplasty, which involves major morbidity for inconstant efficacy.

Conclusions: The same treatments are available for non-neurologic urinary incontinence by bladder over-activity for men and women: antimuscarinic drugs, neurostimulation, onabotulinumtoxinA. However, only few data is available for masculine population exclusively.

Keywords: Anticholinergiques; Antimuscarinic; Cystoplasty; Entérocystoplastie; Hyperactivité vésicale; Incontinence urinaire masculine; Male urinary incontinence; Neurostimulation; Neurostimultion; OnabotulinumtoxinA; Overactive bladder; Urgency; Urgenturies.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Acetylcholine Release Inhibitors / therapeutic use
  • Botulinum Toxins, Type A / therapeutic use
  • Cholinergic Antagonists / therapeutic use
  • Humans
  • Male
  • Spinal Cord Stimulation
  • Urinary Bladder, Overactive / complications*
  • Urinary Incontinence / etiology*
  • Urinary Incontinence / therapy*

Substances

  • Acetylcholine Release Inhibitors
  • Cholinergic Antagonists
  • Botulinum Toxins, Type A