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Kim, Hong, and Lee: The Effect of Bethanechol Chloride with an α-adrenergic Blocker in Patients with Impaired Detrusor Contractility
Original Article
Korean Journal of Urology

Korean Journal of Urology 2007; 48(10): 1040-1043.

Published online: 31 October 2007

DOI: https://doi.org/10.4111/kju.2007.48.10.1040

The Effect of Bethanechol Chloride with an α-adrenergic Blocker in Patients with Impaired Detrusor Contractility

Ji Young Kim, Jeong Hee Hong1, Kyu-Sung Lee

Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea.

1Department of Urology, Dankook University College of Medicine, Cheonan, Korea.

Corresponding author (ksleedr@skku.edu)

Received 25 April 2007       Accepted 20 August 2007

Copyright © 2007 The Korean Urological Association

Abstract

Purpose

Bethanechol enhances detrusor contraction and α1-blockers reduce bladder outlet resistance. We evaluated the effects of bethanechol with doxazosin in patients with impaired detrusor contractility.

Materials and Methods

Fifty-six patients that had confirmed detrusor underactivity with at least 150ml of postvoid residual urine volume (PVR) based on a urodynamic study were enrolled. The initial dosage of bethanechol given was 75mg/day, and the dosage was gradually increased to 150mg/day if necessary. Doxazosin gastro-intestinal therapeutic system (GITS) (4mg) was also given. The effect of the treatment was evaluated by a urine flow test, the amount of PVR, and frequency of clean intermittent catheterization (CIC).

Results

The mean follow-up period was 6 months (range, 1 to 9 months). After treatment, the mean PVR decreased from 251.8±149.6ml to 136.4±153.2ml (p<0.001) and was less than 100ml in 22 (39%) of the 38 patients that showed a decrease. The maximum flow rate (Qmax) increased from 8.7±4.7ml/s to 11.1±5.6ml/s (p=0.024) and was more than 5ml/s in 13 patients (23%). Five of the 18 patients that previously required CIC could discontinue this treatment and another nine patients showed a decrease in the frequency. The mean daily frequency of CIC was reduced from 3.2 to 1.5 (p=0.004). Ten of the 12 patients that were not able to void became capable of voluntary voiding. Five patients (9%) complained of adverse reactions and four of them were taken off the medication.

Conclusions

The combination therapy of bethanechol with doxazosin improved emptying ability in patients with impaired detrusor contractility.

Keywords: Neurogenic bladder, Bethanechol, Alpha-adrenergic blockers

Figures and Tables

Table 1
The baseline characteristics of the patients
kju-48-1040-i001

CIC: clean intermittent catheterization

Table 2
The results of combination therapy of bethanechol and alpha adrenergic blocker
kju-48-1040-i002

PVR: postvoid residual urine volume, MFR: maximal urine flow rate, CIC: clean intermittent catheterization, *: statistical difference was detected using a Student's t-test (paired) or Wilcoxon signed-rank test

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