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19–22 APRIL, 2017, BARCELONA, SPAIN
MATERIAL AND METHODS
Mixed therapy including two anticholinergic drugs (solifenacine in connection with oxybutynine and
solifenacine in connection with tolterodine ) was used in 30 patients with neurogenic bladder resist-
ant to anticholinergic monotherapy. In twelve patients (40%) of 30 treated with two anticholinergic
drugs achieved success with decrease of detrusor pressure to 20-30 cm H2O, but 18 patients
(60%) of them demonstrated lack of treatment efficacy. In these group of 18 patients without ef-
fectiveness of treatment with mixed therapy 8 (44.4%) had urine incontinence between CIC and
5 (27.7%) dilatation of upper urinary tract.
All these 18 patients with lack of anticholinergic mixed therapy effect were qualified to mirabegron
therapy. In all anticholinergic therapy was discontinued and in all started mirabegron therapy in dose
of 50 mg. Urodynamic examination was performed after 3, 6, 12 months of mirabegron treatment.
RESULTS
The follow-up examination performed in 17/18 patients (94.4%). The dilatation of upper urinary tract
disappeared in all 5 patients. Urinary continence achieved in 7/8 patients and 1/8 demonstrated
intermittent urinary incontinence.
Decrease of detrusor pressure to 20 cm H2O was observed in 4/17 patients (24%), but unsatisfac-
tory decrease of detrusor pressure to 30-40 cm H2O obtained in 13/17 patients (76%).
In group of 13/17 patients without satisfactory decrease of detrusor pressure, combination of small
dose of anticholinergic medication and mirabegron was applied. Solifenacine in dose of 5 mg com-
bined with mirabegron in dose of 50 mg was used in 9/13 patients and tolterodine in dose of 2 mg
was applied in 4/13 patients. These combinations became successfully to decreased of detrusor
pressure to 20-25 cm H2O in all.
CONCLUSIONS
1. Mirabegron can be used in the treatment of patients with neurogenic bladder, especially those,
who are resistant to anticholinergic therapy, as monotherapy or more often in combination with
small dose of anticholinergic medication.
2. This type of therapy allows to avoid surgical treatment, especially, bladder augmentation with the
use of different bowel segments and following that metabolic disorders.
12:19–12:22
S24-6 (PP)
THE INFLUENCE OF BOWEL MANAGEMENT ON URINARY
INCONTINENCE IN PATIENTS WITH SPINA BIFIDA
Sasa MILIVOJEVIC and Zoran RADOJICIC
University Children’s Clinic Belgrade, Urology department, Belgrade, SERBIA
PURPOSE
To examine the effects of bowel management on urinary incontinence in patients with spina bifida.
MATERIAL AND METHODS
The research was carried out in the 2010-2015 period, during which 40 patients with spina bifida
aged 4 to 22 were observed. The first group consists of 20 patients on average aged 9.2 +/- 3.12 SD,
out of whom 55% are male and 45% are female, in whom a bowel management programme was
established in combination with CIC and anticholinergic medication therapy. The second group
consists of 20 patients on average aged 10.9 +/- 5.38 SD, out of whom 30.0% are male and 70%
are female, who were treated only with CIC and anticholinergic medication therapy. There are no
statistical differences regarding age and sex between the two examined groups (p> 0.05). Bowel