An overactive bladder treatment: Mirabegron versus Tolterodine

Background: Overactive bladder (OAB), as described by the International Continence Society (ICS), is characterized by complex symptoms, which include urinary urgency (strong, sudden need to urinate that is difficult to delay) with or without urge incontinence that is usually associated with frequency (abnormally frequent urination) and nocturia (excessive urination at night). 1 The objective of this study is to assess the efficacy of mirabegron and tolterodine, comparing both drugs by International Prostate Symptom Score (IPSS), micturition episodes per 24 hours, nocturia, urgency, urge incontinence after 12 weeks of intervention among patients who presented with predominantly storage lower urinary tract symptoms (LUTS). 2,3 METHODS: This is a prospective observational study conducted on 40 patients with overactive bladder over a period of 15 months, from January 2019 to March 2020. 20 patients received Mirabegron 50 mg (tablet) once daily (Group-M) and the other 20 patients received Tolterodine 4 mg (tablet) once daily (Group-T). RESULTS: The difference in urinary frequency episodes per 24 hours after 12 weeks in the Group-M was 2.75 ± 1.41, while that among Group-T was 1.15 ± 1.04 with significant p-value < 0.05. The difference of nocturia episodes after 12 weeks in the Group-M was 1.45 ± 0.88, while that in Group-T was 0.7 ± 0.65 with significant p-value < 0.05. The difference of urgency episodes after 12 weeks in Group-M was 1.65 ± 0.99, while that among Group-T was 1 ± 0.79 with significant p-value < 0.05. The difference of urge incontinence episodes after 12 weeks was not statically significant between the two groups (Table 1). The difference of IPSS after 12 weeks in the Group-M was 5.7 ± 3.65, while that among Group-T was 3.85 ± 1.27 with significant p-value < 0.05 (Table 2). CONCLUSION: Mirabegron improved urinary urgency, total number of micturition episodes/24 hours, nocturia, IPSS score more than Tolterodine in over active bladder patients. There was no statistical difference between Mirabegron and Tolterodine in terms of urinary incontinence episodes.