Terodiline treatment of detrusor hyperreflexia in sclerosis multiplex

A single-blind placebo controlled study on the efficacy of the anticholinergic and calcium blocking agent terodiline (Mictrol) on detrusor hyperreflexia has been done in 10 patients with multiple sclerosis in a stable state. The patients were evaluated by means of micturition charts, uroflowmetry and cystourethrometry, including electromyography of the periurethral sphincter in females and the bulbocavernosus muscle in males. After 6 weeks on terodiline 25 mg twice a day, the volume per voluntary micturition increased 23 per cent. The number of incontinence episodes decreased. Bladder volume at first urge increased 55 per cent, the maximum cystometric capacity increased 52 per cent, and the detrusor pressure of the first involuntary contraction decreased 27 per cent. The number of voluntary micturitions and voided volume per 24-hour, maximum and average flow, residual urine and urethral pressure at first urge remained unaltered. Terodiline is an alternative drug in the treatment of detrusor hyperreflexia. A follow-up investigation indicates that an increase in terodiline dosage may improve the results.