Source: DGNews  |  Posted 4 years ago

By Shazia Qureshi

ROTTERDAM, NETHERLANDS -- August 23, 2007 -- Tolterodine extended release (ER) administered to women with overactive bladder and impaired sexual functioning led to improvements in patients' self-reported sexual quality of life, researchers reported here at the 37th Annual Meeting of the International Continence Society (ICS).

Lead author Rebecca Rogers, MD, Associate Professor and Director of Urogynecology, University of New Mexico School of Medicine, Albuquerque, New Mexico, United States, presented the results of this randomised, double-blind, placebo-controlled study.

She noted in her presentation on August 22, "The more that women are bothered by overactive bladder and urgency urinary incontinence symptoms, the more likely they are to experience sexual dysfunction."

The study also showed that 12 weeks of treatment with 4 mg once-daily of tolterodine ER significantly reduced levels of anxiety, but not depression, compared with placebo.

The women all were in a stable relationship with a male partner for 6 months or longer and were sexually active. At baseline, they all had self-reported overactive bladder (including symptoms of urgency urinary incontinence) as well as self-reported impaired sexual functioning.

In addition to bladder diaries, the women completed the Sexual Quality of Life Questionnaire-Female (SQOL-F) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ) before and after treatment.

In the 201 women given the antimuscarinic agent tolterodine ER, symptoms of urgency urinary incontinence, frequency, and urgency, and pad use were all significantly improved compared with the 201 women who received placebo.

With the SQOL-F, higher scores indicate better sexual functioning, and scores below 75 indicate impaired functioning. Higher scores also indicate better sexual functioning with the PISQ.

After the treatment period, women on tolterodine ER showed a significantly greater change in the SQOL-F score than women receiving placebo (mean change +- standard error was 6.4 +- 1.2 vs 1.5 +- 1.2; P =.0042).

Tolterodine ER treatment also led to greater improvements in the PISQ physical domain and total scores (P <.015 vs placebo for both), but not in the PISQ scores of behavioural/emotive or partner-related domains.

At baseline, 59% of all patients showed HAD scores indicating a clinical diagnosis of anxiety and 27% had scores indicating depression on the Hospital Anxiety and Depression (HAD).

After 12 weeks of treatment, the researchers observed improvements in anxiety scores that were significantly greater in the women taking tolterodine ER than in the group taking placebo (P <.04).

The change in HAD depression score was not significantly different between the 2 groups. Dr. Rogers said during the presentation that this could be because few patients had depression at baseline, which she speculated could be at least partly due to the relatively young mean age (48 years) of the cohort and the fact that all patients reported themselves to be sexually active.

Dr. Rogers concluded that "nonurologic aspects of a woman's life, including sexual quality of life and psychological health, may affect her response to treatment, and these factors should be investigated in larger controlled trials."

The study was funded by Pfizer.

[Presentation title: Tolterodine Extended Release and Sexual Quality of Life, Anxiety, and Depression Among Women With Overactive Bladder and Urgency Urinary Incontinence. Abstract 39]