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Solifen Refresher Slides
Solifen Refresher Slides
BRIEF REFRESHER
Urinary Incontinence & Overactive Bladder
Involuntary leakage associated with physical activities that increase intra abdominal
Stress
pressure, such as coughing, sneezing, or laughing, or upon effort or exertion, such as
Incontinence
lifting objects or exercising.
Mixed
Involves the coexistence of urge and stress incontinence.
Incontinence
Overactive Bladder
“Urgency, with or without urge incontinence, usually with frequency & nocturia”
Symptoms
A Worldwide problem
2 0 0 5 B J U I N T E R N A T I O N A L | 9 5 , 8 1 – 8 5 |doi:10.1111/j.1464-410X.2005.05255.x
A Not So Discussed Problem
Urinary Incontinence is observed as frequent health problem among women in
Pakistan 2
40% of Pakistani women face hindrance in daily life by experiencing once or more
leakages during a day 1
Overactive Bladder is perceived as part of ageing process rather than disease thus
goes untreated despite of affecting quality of life and restricting mobility of patient 3
Patient History
(past genitourinary
disorders)
Physical Examination
(inflammation, prolapse, masses)
Urine Analysis
(Urinary Tract Infections)
• Antimuscarinic agents block the muscarinic receptors that are found in the
urinary bladder muscles and prevent Acetylcholine binding to muscarinic
Receptors.
• Thus antimuscarinics relax the urinary bladder muscle and ultimately reduce:
14
Effective Bladder Control
80% 75.20%
% Mean improvement from base line
70% 64.60%
60% 52.90%
50%
41.80%
40%
30%
20% 15.60%
12.30%
10%
0%
Urgency Incontinence Frequency
Solifenacin Placebo
-0.5 -0.4
-0.5
-1 -0.9 -0.9
-1.2
-1.3
-1.5
-1.5
-1.7 -1.7 Solifenacin 5mg
-2
-2 Tolterodine ER 4mg
Solifenacin 5mg provided 44% additional improvement in resolving OAB symptoms as compared to
Tolterodine ER
4mg
European Urology, Volume 52 Issue 4, October 2007, Pages 1195-1203
COMPARISON OF SOLIFENACIN 5 MG AND TOLTERODINE ER 4 MG IN THE STAR OAB STUDY
A Better Treatment Option than Flavoxate
Solifenacin Flavoxate
Anti muscarinic Drug with mixed action
Level of evidence for OAB
management
1 (Randomized control clinical trials) 4 (Case studies)
Grade of recommendation A (Highly recommended) D (Not recommended)
Dose frequency O.D. T.i.d.
Based on meta-analysis findings and OD dose benefit Solifenacin has strong evidence and level of
recommendation as a treatment option in Overactive
Bladder management than Flavoxate.
NICE. Urinary incontinence in women pathway, 11 Oct 2016
Chapple C. The contemporary pharmacological management of overactive bladder. BJOG 2006;113(Suppl. 2):19–28
Drugs.com
Pharmacokinetic Profile Of Anticholinergics