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European Urology
Volume 56, issue 1, pages 1-236, July 2009Letters to the Editor published online
Reply to Ferhat Ates, Ilker Akyol and Abdullah Cirakoglu's Letter to the Editor re: Daniela Marschall-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
Daniela Marschall-Kehrel 
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Accepted 17 November 2008, Published online 25 November 2008, page e2
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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)
Refers to article:
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;55:72938
Accepted 17 November 2008
July 2009 (Vol. 56, Issue 1, page e1)
Article Outline
We thank Ates et al for their interest and for their letter to the editor [1]. I will try to answer the questions they raised.
With regard to constipation, it is well known that bowel transit time in this age group is about 16 h and we followed the Rome III criteria. Patients were asked whether they pass stool every day without difficulty or pain, without soiling or encopresis, and without big stool mass. If there were any hints of a bowel problem, the patient was excluded from the study.
Concerning side effects, all were mentioned in the publication [2]. Central nervous system (CNS) side effects did not occur in the study group, but the trial was not powered to focus on them. From extensive daily use of propiverine in neurogenic and nonneurogenic children, it is known that CNS side effects occur less frequently compared with oxybutynin.
The use of the Hjalmas formula ([age + 30] × 30) is definitely not a printing error but is used intentionally because this trial is based on bladder diaries, not urodynamics. This method is approved by the International Children's Continence Society [3].
Conflicts of interest: The author has nothing to disclose.
References
- [1] F. Ates, I. Akyol, A. Cirakoglu. Re: Daniela Marschall-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 56 (2009) (e1) Abstract, Full-text, PDF, Crossref.
- [2] 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.
- [3] T. Nevéus, A. von Gontard, P. Hoebeke, et al.. The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children's Continence Society. J Urol 176 (2006) (314 - 323)
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