Oxybutynin chloride for geriatric urinary dysfunction: a double-blind placebo-controlled study

Area of Science:

• Gerontology
• Urology
• Clinical Pharmacology

Background:

• Urinary incontinence is a prevalent issue among elderly institutionalized individuals.
• Detrusor instability contributes significantly to incontinence in this population.
• Pharmacological interventions are often explored to manage these symptoms.

Purpose of the Study:

• To evaluate the efficacy and tolerability of oxybutynin chloride compared to placebo in elderly institutionalized patients with detrusor instability.
• To assess the impact of oxybutynin on incontinence episodes recorded by an electronic monitor.

Main Methods:

• A double-blind, placebo-controlled, crossover trial involving 24 incontinent elderly institutionalized subjects.
• Participants received oral oxybutynin 5 mg or placebo twice daily for 8 days, followed by a 6-day washout period and then the alternative treatment.
• Incontinence was objectively measured using a bedside electronic monitor.

Main Results:

• No clinically significant differences in efficacy were observed between oxybutynin chloride and placebo treatments.
• Both oxybutynin and placebo groups reported side effects, with dry mouth being the most frequently reported adverse event.
• Four subjects withdrew due to side effects before completing the study.

Conclusions:

• Oxybutynin chloride does not appear to be more effective than placebo for treating incontinence associated with detrusor instability in elderly institutionalized individuals.
• The findings suggest a need for further research into alternative or adjunctive treatments for this patient group.
• Tolerability, particularly dry mouth, remains a consideration for anticholinergic medications in the elderly.