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dc.contributor.author Sohor, Katelyn
dc.date.accessioned 2017-09-19T17:33:06Z
dc.date.available 2017-09-19T17:33:06Z
dc.date.issued 2016
dc.identifier.uri http://hdl.handle.net/1993/32631
dc.description.abstract Background: As many as 75% of multiple sclerosis (MS) patients experience urinary symptoms during the course of their disease, which can affect many aspects of their daily life.28 Though effective pharmacological treatment for bladder dysfunction exists, effectiveness in the MS population has not been adequately reviewed. Objective: To identify, appraise, and synthesize data to determine efficacy of current pharmacological treatments for bladder dysfunction, specifically overactive bladder in patients with MS. Methods: We searched the Cochrane Database for related systemic reviews, in addition to searching the following databases for randomized controlled trials: PubMed, Medline [OVID], EMBASE [OVID], and Cochrane Central Register of Controlled Trials. Databases were searched from inception date to December 15th, 2015. We used comprehensive Cochrane review search terms for Medline, EMBASE, and the Cochrane central register. Two reviewers independently screened titles, abstracts, and full text articles to ensure all studies were randomized controlled trials, that results for MS patients were presented separately if the study had also included other patients with bladder dysfunction, and that the outcomes of interest were reported. We included studies meeting the following criteria: (1) prospective, and randomized controlled trials conducted in any setting; (2) published in English; (3) conducted on adult patients with a diagnosis of MS and experiencing bladder dysfunction, as defined by health professional or self reported symptoms; (4) Studies that examined any pharmacological therapy for treatment of bladder dysfunction in MS patients. Results: Of 69 unique abstracts, 6 unique clinical trials met the final inclusion criteria. Oxybutynin was superior to Propatheline in the domains of mean cystometric capacity, frequency, urgency, nocturia, and incontinence. There were no statistical differences between Atropine and Oxybutynin in similar domains. Further, Methantheline Bromide, was subjectively superior to Flavoxate Chloride, and Meladrazine tartrate. OnabotulinumtoxinA was found to be superior in all measures of bladder dysfunction in comparison with the placebo group. THC and Cannabinoid trials produced mixed results. A significant reduction in UIEs from baseline in both treatment groups was found in one trial. The other study did not find significant differences between treatment and placebo groups in terms of UIEs, however demonstrated significant improvement on other measures, such as daily voids, and nocturia episodes, and patients perception of the their bladder condition. Conclusion: This review suggests that OnabotulinumtoxinA injections, and Anticholinergic Medications reduce urinary symptoms. Results of studies on Cannabinoids and THC products are inconsistent. Relative lack of current trials and poor study quality limit conclusions, and further researcher is warranted. en_US
dc.rights info:eu-repo/semantics/openAccess
dc.title Pharmacological interventions for bladder dysfunction in muptiple sclerosis: A systematic literature review en_US


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