Elderly patients with overactive bladder (OAB) that does not respond sufficiently to dose-escalated antimuscarinic monotherapy may benefit from combined high-dosage antimuscarinics, researchers reported online in the UroToday International Journal.

They studied 81 OAB patients older than 65 years who previously recxeived double-dose antimuscarin monotherapy with trospium. After at least six months of such treatment with no or short-lived symptom improvement, patients were treated with two antimuscarinics.

Significant improvements were seen at a six-week follow-up, with the average number of daily incontinence events declining from six to two, average maximum bladder capacity increasing from 177 to 356 mL, average reflex volume rising from 149 to 284 mL, and average detrusor compliance improving from 16 to 37 mL/cm H2O. 

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Side effects were comparable to that of normal-dosed antimuscarinics.