Bladder Dysfunction in Dementia Patients Showing Urinary Incontinence

Evaluation with Cystometry and Treatment with Propiverine Hydrochloride

Abstract

In a total of 46 dementia patients with urinary incontinence, filling cystometry was performed to evaluate bladder function, followed by peroral administration of propiverine hydrochloride. Therapeutic effects were evaluated in terms of changes in cystometric bladder capacity and urinary incontinence.
Based on cystometric findings, 58.1%, 35.3% and 6.4% of Alzheimer dementia patients proved to have overactive bladder, normoactive bladder and low compliant bladder, respectively. Similarly, 90.9% and 9.1% of vascular dementia patients had overactive detrusor and low compliance, respectively. As a result of propiverine hydrochloride administrarion for 2 weeks, both bladder capacity and incontinence improved in around 40%, irrespective of the dementia type (Alzheimer vs vascular). It is of interest, however, that patients with overactive bladder demonstrated more satisfactory response to the treatment than those with normoactive bladder.
It is accordingly suggested that propiveline hydrochrolide is a promising treatment option for urinary incontinence in demented elderly and cystometry could be useful in predicting treatment outcome.