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European Urology
Volume 56, issue 1, pages 1-236, July 2009Letters to the Editor published online
Re: Daniela Marshall-Kehrel, Cornelia Feustel, Charlotta Persson de Geeter, et al. Treatment with Propiverine in Children Suffering from Nonneurogenic Overactive Bladder and Urinary Incontinence: Results of a Randomized Placebo-Controlled Phase 3 Clinical Trial. Eur Urol 2009;55:729–38
Ferhat Ates 
, Ilker Akyol, Abdullah Cirakoglu.
Accepted 17 November 2008, Published online 25 November 2008, page e1
Full-Text PDF (55 KB) Place a comment
Refers to article:
Treatment with Propiverine in Children Suffering from Nonneurogenic Overactive Bladder and Urinary Incontinence: Results of a Randomized Placebo-Controlled Phase 3 Clinical Trial
Accepted 24 April 2008
March 2009 (Vol. 55, Issue 3, pages 729 - 738)
Article Outline
We read with interest the abovementioned article by Marschall-Kehrel et al [1] and thank the authors for this nice study. However, we would like to point out a couple of issues related to the subject.
First, it is a well-known fact that making a diagnosis of constipation is often difficult, and parental history is misleading [2]. This is even more important when a medication that could potentially cause and/or worsen constipation is to be prescribed. Should a problem with bowel movements be overlooked, this could complicate the clinical picture or at least cause a delay in the recovery. Therefore, we are curious to know how the researchers made the diagnosis of constipation and what they would recommend on the subject for the practicing pediatric urologist.
A second issue is the adverse effects of antimuscarinics on cognitive function, which has been studied in adults and in children taking oxybutynin and tolterodine [3], [4], and [5]. We expected to find an input or a comment in such a phase 3 study on children receiving propiverine treatment.
Finally, the formula for age-expected bladder capacity in Table 2 should be corrected as capacity (in ml) = (age + 2) × 30, as defined by Koff [6]. We assume that this is nothing more than a printing error.
Conflicts of interest: The authors have nothing to disclose.
References
- [1] D. Marschall-Kehrel, C. Feustel, C. Persson de Geeter, et al.. Treatment with propiverine in children suffering from nonneurogenic overactive bladder and urinary incontinence: results of a randomized placebo-controlled phase 3 clinical trial. Eur Urol 55 (2009) (729 - 738) Abstract, Full-text, PDF, Crossref.
- [2] I. Akyol, C. Adayener, T. Senkul, K. Baykal, C. Iseri. An important issue in the management of elimination dysfunction in children: parental awareness of constipation. Clin Pediatr (Phila) 46 (2007) (601 - 603) Crossref.
- [3] G.G. Kay, M.B. Abou-Donia, W.S. Messer Jr., D.G. Murphy, J.W. Tsao, J.G. Ouslander. Antimuscarinic drugs for overactive bladder and their potential effects on cognitive function in older patients. J Am Geriatr Soc 53 (2005) (2195 - 2201) Crossref.
- [4] G. Kay, T. Crook, L. Rekeda, et al.. Differential effects of the antimuscarinic agents darifenacin and oxybutynin ER on memory in older subjects. Eur Urol 50 (2006) (317 - 326) Abstract, Full-text, PDF, Crossref.
- [5] K.M. Giramonti, B.A. Kogan, L.F. Halpern. The effects of anticholinergic drugs on attention span and short-term memory skills in children. Neurourol Urodyn 27 (2008) (315 - 318) Crossref.
- [6] S.A. Koff. Estimating bladder capacity in children. Urology 21 (1983) (248) Crossref.
Footnotes
GATA Haydarpasa Teaching Hospital, Department of Urology, Istanbul, Turkey
Corresponding author. GATA Haydarpasa Teaching Hospital, Department of Urology, Istabul, Turkey. Tel: +902165422020/4306; Fax: +902163487880.
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