Details of trials included in systematic review
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w7 Whitehead JA. Urinary incontinence in the aged. Propantheline bromide as an adjunct to treatment. Geriatrics 1967;22:154-8.
w8 Williams AJ, Prematalake JKTG, Palmer RL. A trial of emepronium bromide for the treatment of urinary incontinence in the elderly mentally ill. Pharmatherapeutica 1981;2:539-42.
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w10 Davila GW, Daugherty CA, Sanders SW, for the Transdermal Oxybutynin Study Group. A short-term, multicenter, randomized double-blind dose titration study of the efficacy and anticholinergic side effects of transdermal compared to immediate release oral oxybutynin treatment of patients with urge urinary incontinence. J Urol 2001;166:140-5.
w11 Robinson JM, Brocklehurst JC. Emepronium bromide and flavoxate hydrochloride in the treatment of urinary incontinence associated with detrusor instability in elderly women. Br J Urol 1983;55:371-6.
w12 Rosario DJ, Smith DJ, Radley SC, Chapple CR. Pharmacodynamics of anticholinergic agents measured by ambulatory urodynamic monitoring: a study of methodology. Neurourol Urodyn 1999;18:223-34.
w13 Griebenow R, Wieners F, Lange T. Possible induction of cardiac dysrhythmia in elderly patients under therapy with propiverine hydrochloride. Neurourol Urodyn 1994;13:430-2.
w14 Bagger P, Fischer-Rasmussen W, Hansen RI. Emepronium carregeenate: clinical effects and urinary excretion in treatment of female urge incontinence. Scand J Urol Nephrol 1985;19:31-5.
w15 Bono AV, Marconi AM, Gianneo E. Oxybutynin for unstable bladder. A preliminary placebo controlled trial. Urologia 1982;49:764-8.
w16 Di Stasi SM, Giannantoni A, Vespasiani G, Navarra P, Capelli G, Massoud R, et al. Intravesical electromotive administration of oxybutynin in patients with detrusor hyperreflexia unresponsive to standard anticholinergic regimens. J Urol 2001;165:491-8.
w17 Kramer AEJL, Zeegers AGM, Kiesswetter H, Jonas U. Drug treatment of urgency: a double blind trial of cetiprin, dridase, urispas and placebo. TGO Tijdschr Ther, Geneesmiddel, Onderzoek 1987;12:256-61.
w18 Massey JA, Abrams P. Dose titration in clinical trials. An example using emepronium carrageenate in detrusor instability. Br J Urol 1986;58:125-8.
w19 Meyhoff HH, Gerstenberg TC, Nordling J. Placebo—the drug of choice in female motor urge incontinence? Br J Urol 1983;55:34-7.
w20 Moisey CU, Stephenson TP, Brendler CB. The urodynamic and subjective results of treatment of detrusor instability with oxybutynin chloride. Br J Urol 1980;52:472-5.
w21 Moore KH, Hay DM, Imrie AE, Watson A, Goldstein M. Oxybutynin hydrochloride (3 mg) in the treatment of women with idiopathic detrusor instabilty. Br J Urol 1990;66:479-85.
w22 Murray KHA, Patterson JR, Stephenson TP. A double-blind three way cross over placebo controlled trial of cystrin and cetiprin novum. Proceedings of the 14th annual meeting of the International Continence Society, Innsbruck, Austria, 1984:454.
w23 Riva D, Casolati E. Oxybutynin chloride in the treatment of female idiopathic bladder instability. Results from double blind treatment. Clin Exp Obstet Gynecol 1984;11:37-42.
w24 Rosario DJ, Leaker BR, Noble JG, Milroy E, Chapple CR. A double-blind placebo controlled crossover study of the effects of single doses of darifenacin on cystometric parameters in patients with detrusor instability. Proceedings of the 25th annual meeting of the International Continence Society, Sydney, Australia, 1995:223.
w25 Rosario DJ, Leaker BR, Smith DJ, Chapple CR. A pilot study of the effects of multiple doses of the M3 muscarinic receptor agonist darifenacin on ambulatory parameters of detrusor activity in patients with detrusor instability. Neurourol Urodyn 1995;14:464-5.
w26 Serrano Brambila EA, Quiroga Avila RG, Lorenzo Monterrubio JL, Moreno Aranda J. Assessment of the effectiveness of and tolerance to oxybutynin in the treatment of unstable bladder in women. Ginecol Obstet Mex 2000;68:174-81.
w27 Tapp AJS, Cardozo LD, Versi E, Cooper D. The treatment of detrusor instability in post-menopausal women with oxybutynin chloride: a double blind placebo controlled study. Br J Obstet Gynaecol 1990;97:521-6.
w28 Walter S, Hansen J, Hansen L, Maegaard E, Meyhoff HH, Nordling J. Urinary incontinence in old age. A controlled clinical trial of emepronium bromide. Br J Urol 1982;54:249-51.
w29 Wehnert VJ, Sage S. Comparative study of the effect of Mictonorm (propiverine hydrochloride) and Spasuret (flavoxate hydrochloride) on the bladder detrusor muscle. Zentralblatt Urol Nephrol 1989;82:259-63.
w30 Wehnert VJ, Sage S. Treatment of bladder unstability and urge incontinence with propiverine hydrochloride (Mictonorm) and oxybutynin chloride (Dridase)—a randomised crossover study. Akt Urol 1992;23:7-11.
w31 Zeegers AGM, Kiesswetter H, Kramer AEJL, Jonas U. Conservative therapy of frequency, urgency and urge incontinence: a double-blind clinical trial of flavoxate hydrochloride, oxybutynin chloride, emepronium bromide and placebo. World J Urol 1987;5:57-61.
w32 Zorzitto ML, Holliday PJ, Jewett MAS, Herschorn S, Fernie GR. Oxybutynin chloride for geriatric urinary dysfunction: a double-blind placebo-controlled study. Age Ageing 1989;18:195-200.
w33 Abrams P, Jackson S, Mattiasson A, Krishnan K, Haendler L. A randomised, double-blind, placebo controlled, dose ranging study of the safety and efficacy of tolterodine in patients with hyperreflexia. Proceedings of the International Continence Society 26th annual meeting, Athens, Greece, 1996;276-7.
w34 Abrams P, Freeman R, Anderstrom C, Mattiasson A. Tolterodine, a new antimuscarinic agent: as effective but better tolerated than oxybutynin in patients with an overactive bladder. Br J Urol 1998;81:801-10.
w35 Abrams P, Kaplan S, Millard R. Tolterodine treatment is safe in men with bladder outlet obstruction (BOO) and symptomatic detrusor overactivity (DO). Proceedings of the International Continence Society 32nd annual meeting, Seoul, Korea. 2001.
w36 Alloussi S, Laval KU, Ballering-Bruhl B, Grobe-Freese M, Bulitta M, Schafer M. Trospium chloride (Spasmo-lyt) in patients with motor urge syndrome (detrusor instability): a double-blind, randomised, multicentre, placebo-controlled study. J Clin Res 1998;1:439-51.
w37 Burgio KL, Locher JL, Goode PS, Hardin M, McDowell BJ, Dombrowski M, et al. Behavioral vs drug treatment for urge urinary incontinence in older women. A randomized controlled trial. JAMA 1998;280:1995-2000.
w38 Cardozo L, Chapple CR, Toozs-Hobson P, Grosse-Freese M, Bulitta M, Lehmacher W, et al. Efficacy of trospium chloride in patients with detrusor instability: a placebo-controlled, randomised, double-blind, multicentre clinical trial. Br J Urol Int 2000;85:659-64.
w39 Chaliha C, Halaska M, Stanton S. Trospium chloride for the treatment of detrusor instability: a placebo-controlled dose-finding study. Br J Obstet Gynaecol 1998;105(suppl 17):276.
w40 Davila GW, Sanders S, for the Transdermal Oxybutynin Study Group. Transdermal oxybutynin: a multi-center, prospective, randomized, double-blind, placebo-controlled study in adults with urge urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2001;12(suppl 3):S43.
w41 Dorschner W, Stolzenburg JU, Griebenow R, Halaska M, Schubert G, Murtz G, et al. Efficacy and cardiac safety of propiverine in elderly patients—a double-blind, placebo-controlled clinical study. Eur Urol 2000;37:702-8.
w42 Drutz HP, Appell RA, Gleason D, Klimberg I, Radomski S. Clinical efficacy and safety of tolterodine compared to oxybutynin and placebo in patients with overactive bladder. Int Urogynecol J Pelvic Floor Dysfunct 1999;10:283-9.
w43 Enzelsberger H, Helmer H, Kurz CH. Intravesical instillation of oxybutynin in women with idiopathic detrusor instablity: a randomised trial. Br J Obstet Gynaecol 1995;102:929-30.
w44 Froehlich G, Burmeister S, Wiedemann A, Bulitta M. Intravesical trospium chloride, oxybutynin and verapamil for relaxation of detrusor muscle. A placebo-controlled, randomised clinical trial. Arzneimittelforschung 1998;48:486-91.
w45 Halaska M, Dorschner W, Frank M. Treatment of urgency and incontinence in elderly patients with propiverine hydrochloride. Neurourol Urodyn 1994;13:428-30.
w46 Jacquetin B, Wyndaele JJ. Tolterodine reduces the number of incontinence episodes in patients with an overactive bladder. Eur J Obstet Gynecol Reprod Biol 2001;98:97-102.
w47 Jonas U, Hofner K, Madersbacher H. Efficacy and safety of two doses of tolterodine versus placebo in patients with detrusor overactivity and symptoms of frequency, urge incontinence, and urgency: urodynamic evaluation. World J Urol 1997;15:144-51.
w48 Junemann KP, Fusgen I. Placebo-controlled, randomised, double-blind, multicentre clinical trial on the efficacy and tolerability of 1 ´ 40 mg and 2 ´ 40 mg trospium chloride (Spasmo-lyt) daily for 3 weeks in patients with urge-syndrome. Neurourol Urodyn 1999;18:375-6.
w49 Junemann KP, Al-Shukri S. Efficacy and tolerability of trospium chloride and tolterodine in 234 patients with urge-syndrome: a double-blind, placebo-controlled, multicentre clinical trial. Neurourol Urodyn 2000;19:488-90.
w50 Krishnan KR, Fowler C, Powell J, Soni BM, Lukkari E, Vaidyanathan S. A double-blind, randomized, placebo-controlled, parallel-group, multicenter study of intravesical oxybutynin in symptomatic relief of urge incontinence in patients with detrusor instability/hyperreflexia. Neurourol Urodyn 1996;15:674-6.
w51 Madersbacher H, Halaska M, Voigt R, Alloussi S, Hofner K. A placebo-controlled, multicentre study comparing the tolerability and efficacy of propiverine and oxybutynin in patients with urgency and urge incontinence. Br J Urol Int 1999;84:646-51.
w52 Malone-Lee JG, Walsh JB, Maugourd MF. Tolterodine: a safe and effective treatment for older patients with overactive bladder. J Am Geriatr Soc 2001;49:700-5.
w53 Millard R, Tuttle J, Moore K, Susset J, Clarke B, Dwyer P, et al. Clinical efficacy and safety of tolterodine compared to placebo in detrusor overactivity. J Urol 1999;161:1551-5.
w54 Obrink A, Bunne G. Treatment of urgency by instillation of emepronium bromide in the urinary bladder. Scand J Urol Nephrol 1978;12:215-8.
w55 Rentzhog SL, Stanton L, Cardozo L, Nelson E, Fall M, Abrams P. Efficacy and safety of tolterodine in patients with detrusor instability: a dose-ranging study. Br J Urol 1998;81:42-8.
w56 Stohrer M, Bauer P, Giannetti BM, Richter R, Burgdorfer H, Murtz G. Effect of trospium chloride on urodynamic parameters in patients with detrusor hyperreflexia due to spinal cord injuries. A multicentre placebo-controlled double-blind trial. Urol Int 1991;47:138-43.
w57 Stohrer M, Madersbacher H, Richter R, Wehnert J, Dreikorn K. Efficacy and safety of propiverine in SCI-patients suffering from detrusor hyperreflexia—a double-blind, placebo-controlled clinical trial. Spinal Cord 1999;37:196-200.
w58 Szonyi G, Collas DM, Ding YY, Malone-Lee JG. Oxybutynin with bladder retraining for detrusor instability in elderly people: a randomised controlled trial. Age Ageing 1995;24:287-91.
w59 Tago K, Ueno A, Takayasu H. Clinical study of propiverine hydrochloride for the treatment of patients with urinary frequency and incontinence. Neurourol Urodyn 1990;9:337-8.
w60 Thuroff JW, Bunke B, Ebner A, Faber P, de Geeter P, Hannappel J, et al. Randomized, double-blind, multicenter trial on treatment of frequency, urgency and incontinence related to detrusor hyperactivity: oxybutynin versus propantheline versus placebo. J Urol 1991;145:813-7.
w61 Ulshofer B, Bihr AM, Bodeker RH, Schwantes U, Jahn HP. Randomised, double-blind, placebo-controlled study on the efficacy and tolerance or trospium chloride in patients with motor urge incontinence. Clin Drug Invest 2001;21:563-9.
w62 Van Kerrebroeck PEVA, Amarenco G, Thuroff JW, Madersbacher HG, Lock MTWT, Messelink EJ, et al. Dose-ranging study of tolterodine in patients with detrusor hyperreflexia. Neurourol Urodyn 1998;17:499-512.
w63 Van Kerrebroeck P, Kreder K, Jonas U, Zinner N. Tolterodine once-daily: superior efficacy and tolerability in the treatment of overactive bladder. Urology 2001;57:414-21.
w64 Wein AJ, Hanno PM, Raezer DM, Benson GS. Effect of oxybutynin chloride on bladder spasm following transurethral surgery. Urology 1978;12:184-6.
Details of trials included in systematic review
| Trial | No of participants randomised/No analysed | Details of participants | Interventions | Duration | Outcomes measured |
| Abrams et al 1996w33 | 82/not stated | Detrusor overactivity; no anticholinergics for 14 days | Tolterodine 0.5 mg twice daily, 1 mg twice daily, 2 mg twice daily, or 4 mg twice daily | 14 days | Urinary diary, urodynamic results, adverse events |
| Abrams et al 1998w34 | 293/256 | ³18 years; detrusor overactivity; no urinary tract infection; no bladder outlet obstruction; no conservative treatment; no catheterisation | Tolterodine 2 mg twice daily or 5 mg twice daily | 12 weeks | Symptom questionnaire, urinary diary, adverse events |
| Abrams et al 2001w35 | 221/193 | Men >40 years with bladder outlet obstruction; detrusor overactivity; no concurrent drugs; no prior surgery on prostate or bladder | Tolterodine 2 mg twice daily | 12 weeks | Urodynamic results, adverse events |
| Alloussi et al 1998w36 | 309/252 | ³18 years; detrusor overactivity; maximum cystometric capacity <350 ml; no recent gynaecological surgery; no predominant stress incontinence; no urinary tract infection; not on a list of excluded drugs | Trospium chloride 20 mg twice daily | 3 weeks | Patient perceived improvement, urinary diary, urodynamic results, adverse effects |
| Burgio et al 1998w37 | 197/169 | Women at least 55 years old, community dwelling, and ambulatory; detrusor overactivity and urge incontinence at least twice a week for three months; no contraindications for anticholinergics; no impaired mental status | Oxybutynin 2.5-5 mg three times daily | 8 weeks | Patient satifaction and perceived improvement, leakage episodes, adverse events |
| Cardozo et al 2000w38 | 208/not stated | 18-70 years; detrusor overactivity; no contraindications; no stress incontinence; no other drug treatment | Trospium chloride 20 mg twice daily | 3 weeks | Patient perceived improvement, urodynamic results, adverse events |
| Chaliha et al 1998w39 | 76/not stated | Detrusor overactivity | Trospium chloride 10 mg twice daily, 20 mg twice daily, or 40 mg twice daily | 3 weeks | Urodynamic results, adverse events |
| Davila et al 2001w40 | 520/not stated | At least 10 urge leakages a week; at least eight voids a day; average urinary volume <350 ml | Transdermal oxybutynin twice a week, 1.3 mg/day, 2.6 mg/day, or 3.9 mg/day | 12 weeks | Urinary diary, quality of life, adverse events |
| Dorschner et al 2000w41 | 107/98 | >60 years; >7 voids in 24 hours; >0 urge leakages in 24 hours; <300 ml a void; no large residual volumes; no contraindications; no serious cardiovascular disease | Propiverine 15 mg three times daily | 4 weeks | Urinary diary, quality of life, adverse events |
| Drutz et al 1999w42 | 277/220 | ³18 years; detrusor overactivity; no stress incontinence; no recurrent urinary tract infection; no recent treatment with bladder retraining or anticholinergic; no urinary retention | Tolterodine 2 mg twice daily or oxybutynin 5 mg three times daily | 12 weeks | Urinary diary, adverse events |
| Enzelsberger et al 1995w43 | 52/43 | Women only with idiopathic detrusor overactivity; no genuine stress incontinence | Intravesical administration of oxybutynin 20 mg/40 ml | 12 days | Voiding questionnaire, urodynamic results, adverse events |
| Froelich et al 1998w44 | 84/84 | Detrusor overactivity or clinical diagnosis; no contraindications to drugs used | Intravesical administration of oxybutynin (30 mg/30 ml), trospium chloride (40 mg/30 ml), or verapamil (80 mg) | Single instillation | Urodynamic results, adverse events |
| Halaska et al 1994w45 | 93/not stated | >60 years; urgency or urge incontinence; no large residual volume | Propiverine 15 mg three times daily | 4 weeks | Urinary diaries, urodynamic results, quality of life |
| Jacquetin and Wyndaele 2001w46 | 251/245 | >18 years; detrusor overactivity; no recurrent urinary tract infection; no stress incontinence; no recent treatment with bladder retraining or electrostimulation | Tolterodine 1 mg twice daily or 2 mg twice daily | 4 weeks | Urinary diaries, adverse events |
| Jonas et al 1997w47 | 242/232 | At least 18 years; detrusor overactivity with symptoms; no contraindications; no recurrent urinary tract infection; no recent treatment with bladder retraining or electrostimulation | Tolterodine 1 mg twice daily or 2 mg twice daily | 4 weeks | Urodynamic results, adverse events |
| Junemann and Fusgen 1999w48 | 175/not stated | Urge syndrome, but otherwise not stated | Trospium chloride 40 mg four times daily or 80 mg four times daily | 3 weeks | Urinary diaries, urodynamic results, adverse events |
| Junemann and Al-Shukri 2000w49 | 234/not stated | Detrusor overactivity | Trospium chloride 20 mg twice daily or tolterodine 2 mg twice daily | 3 weeks | Urinary diaries, adverse events |
| Krishnan et al 1996w50 | 103/95 | 18-75 years; symptoms of overactivity; no recent treatment with anticholinergics | Intravesical administration of oxybutynin 5 mg/30 ml three times daily | 2 weeks | Leakage episodes, adverse events |
| Madersbacher et al 1999w51 | 366/324 | Symptoms of overactivity, idiopathic only; no contraindications; no acute urinary tract infection; residual volume not >15%; no recent use of anticholinergics | Propiverine 15 mg three times daily or oxybutynin 5 mg twice daily | 4 weeks | Urinary diaries, urodynamic results, symptoms, quality of life |
| Malone-Lee et al 2001w52 | 177/165 | ³65 years; symptoms of overactivity; "standard" exclusion criteria | Tolterodine 1 mg twice daily or 2 mg twice daily | 4 weeks | Urinary diaries, adverse events |
| Millard et al 1999w53 | 316/291 | ³18 years; detrusor overactivity with symptoms; no stress incontinence; no recurrent urinary tract infection; no contraindications to drug; no recent treatment with bladder retraining, electrostimulation, or anticholinergic drugs | Tolterodine 1 mg twice daily or 2 mg twice daily | 12 weeks | Patient perceived improvement, urinary diaries, adverse events |
| Obrink and Bunne 1978w54 | 20/20 | Women with symptoms of overactivity; no urinary tract infection | Intravesical administration of emepronium bromide 100 mg/100 ml | Single dose, with results at 1 week | Patient perceived improvement, urinary diaries, urodynamic results |
| Rentzhog et al 1998w55 | 81/65 | 18-75 years; detrusor overactivity with symptoms, idiopathic only; no urinary tract infection; no outlet obstruction; no stress incontinence; no contraindications to anticholinergics | Tolterodine 0.5 mg twice daily, 1 mg twice daily, 2 mg twice daily, or 4 mg twice daily | 2 weeks | Patient perceived improvement, urinary diaries, urodynamic results, adverse events |
| Stohrer et al 1991w56 | 61/55 | Spinal cord injury with overactivity; no urinary tract infection; no outlet obstruction; no contraindications to anticholinergics, no recent anticholinergic treatment | Trospium chloride 20 mg twice daily | 3 weeks | Urodynamic results, adverse events |
| Stohrer et al 1999w57 | 113/102 | Inpatients with spinal cord injury and detrusor overactivity; no urinary tract infection; no outlet obstruction; no contraindications to anticholinergics, no other major health problems | Propiverine 15 mg three times daily | 2 weeks | Patient perceived improvement, urinary diaries, urodynamic results, adverse events |
| Szonyi et al 1995w58 | 60/47 | >70 years; symptoms of overactivity; mobile; no urinary tract infection; no contraindications; no recent or current other anticholinergics | Oxybutynin 2.5 mg twice daily with bladder retraining, placebo with bladder retraining | 6 weeks | Patient perceived improvement, urinary diaries, adverse events |
| Tago et al 1990w59 | 142/not stated | Overactive bladder; no urinary tract infection | Propiverine | 2 weeks | Patient perceived improvement, urodynamic results, adverse events |
| Thuroff et al 1991w60 | 169/154 | >15 years; detrusor overactivity with symptoms; no drugs affecting urinary tract; no major health problems; no outlet obstruction; no untreated urinary tract infection | Oxybutynin 5 mg three times daily, propantheline 15 mg three times daily | 4 weeks | Patient perceived improvement, urinary diaries, urodynamic results, adverse events |
| Ulshofer et al 2001w61 | 46/39 | 18-75 years; urodynamically proved urge incontinence; no urinary tract infection; not pregnant; no contraindications; no recent drugs with anticholinergic properties | Trospium chloride 15 mg three times daily | 4 weeks | Urodynamic results, adverse events |
| Van Kerrebroeck et al 1998w62 | 90/90 | 18–75 years with neurological disease and detrusor overactivity and symptoms; no stress incontinence; no outlet obstruction; no poor general or mental health; no contraindications to anticholinergics; not already receiving therapy | Tolterodine 0.5 mg twice daily, 1 mg twice daily, 2 mg twice daily, 4 mg twice daily | 2 weeks | Subjective symptoms, urinary diaries, urodynamic results, adverse events |
| Van Kerrebroeck et al 2001w63 | 1529/1342 | ³ 18 years; urge incontinence and urgency; no stress incontinence; no contraindications to anticholinergics; no recurrent or current urinary tract infection; no outlet obstruction; no recent anticholinergics | Tolterodine 4 mg once daily extended release or 2 mg twice daily immediate release | 12 weeks | Urinary diaries, adverse events, quality of life |
| Wein et al 1978w64 | 106/106 | Men with transurethral resection within 3 days of surgery; overactive bladder symptoms; not neurogenic; no urinary tract infection; no recent anticholinergic drug use; no other serious health problems | Oxybutynin (no dose specified) | 6 hours | Urodynamic results |
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