Table 6.

Management of urinary dysfunction in PSP/CBS.

1. Pharmacologic therapy for overactive bladder

a. Alpha-receptor antagonists

i. Terazosin

ii. Doxazosin

iii. Tamsulosin

iv. Alfuzosin

v. Silodosin

b. 5-alpha reductase inhibitors

i. Finasteride

ii. Dutasteride

c. Beta-3 adrenoceptor agonists

i. Mirabegron

ii. Vibegron

d. Selective M3 anti-muscarinic anticholinergics

i. Darifenacin

ii. Solifenacin

e. Avoid non-selective anti-muscarinic agents due to central anticholinergic side effects

i. Avoid oxybutynin

ii. Avoid tolterodine

iii. Avoid fesoterodine

iv. Trospium has limited brain penetration and may be considered

f. BoNT injections for refractory overactive bladder

2. Non-pharmacologic therapy

a. Alcohol and caffeine avoidance

b. Nocturia

i. Compression stockings during day

ii. Elevate lower limbs in the late afternoon

iii. Restrict fluids in the evening

iv. Fully empty bladder before bed

v. Elevate the head of the bed at night

vi Bladder training and pelvic floor exercises

c. Condom catheter for men

d. Clean intermittent catheterization for refractory urinary voiding dysfunction with residual volume over 100 mL.

e. Trans-tibial nerve stimulation