Efficacy and safety of solifenacin to treat overactive bladder symptoms in patients with idiopathic normal pressure hydrocephalus: an open-label, multicenter, prospective study

Abstract

AIMS: To evaluate the efficacy and safety of solifenacin 5 mg to treat voiding symptoms caused by idiopathic normal pressure hydrocephalus (iNPH) after a ventriculoperitoneal (V-P) shunt operation.

METHODS: A total of 53 patients diagnosed with iNPH and complaining of voiding symptoms were enrolled. Before treatment with solifenacin (V1), 4 (V2) and 12 (V3) weeks after starting solifenacin overactive bladder symptom score (OABSS), the International Prostate Symptom Score (IPSS), Quality of Life (QoL) score, maximal urine flow rate (Q(max) ), voided volume, and post-voiding residual urine volume (PVR) were measured. An urodynamic study (UDS) was performed at V1 and V3, and the safety of solifenacin was assessed at V1, V2, and V3.

RESULTS: Of the 53 patients, 38 patients (71.70%) completed the 12-week clinical trial. The mean patient age was 52.24 ± 10.08 years. OABSS and IPSS were significantly improved. The mean voided volume was 147.18 ± 61.84 ml at V1 and 160.03 ± 62.59 ml at V3 (P < 0.001), and PVR was 64.87 ± 41.11 ml at V1 and 69.05 ± 39.54 ml at V3 (P = 0.009). Of the 31 patients who underwent UDS, 26 patients (83.87%) had detrusor overactivity (DO) at V1, with a mean value of 107.67 ± 18.13 ml. Of the 26 with DO at V1, 22 (84.62%) still had DO at V3. A mean DO of 131.66 ± 15.27 ml was observed at V3 (P < 0.001). The most common adverse effects was dry mouths.

CONCLUSIONS: Solifenacin is effective in the treatment of OABS in iNPH patients who underwent the V-P shunt operation. Solifenacin increases bladder capacity causing of DO at UDS.