New Pharmacologic and Minimally Invasive Therapies for the Overactive Bladder

Michael Franks, MD, Emmanuel Chartier-Kastler, MD, Michael B. Chancellor, MD

In This Article

Intravesical Therapy

Intravesical administration of traditional drugs has been tried as an alternative to conventional oral administration for the unstable bladder. This route of instillation offers the possibility to obtain a high concentration of drug at the target organ, avoiding systemic side effects. In the properly motivated patients or patients who cannot tolerate oral anticholinergic agents, intravesical instillation should be considered as a nonsurgical option. Agents studied thus far include emepronium bromide, intravesical lidocaine, oxybutynin, and verapamil. These all have varying degrees of success; however, it may be noted that oxybutynin may be tolerated much better intravesically, may reach plasma levels comparable to those with oral administration, and may cause a lesser dry mouth problem.


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