Efficacy and Adverse Effects of Solifenacin in the Treatment of Lower Urinary Tract Symptoms in Patients With Overactive Bladder

Solifenacin is an anticholinergic agent selective to M3 cholinergic receptor and has been widely used to treat overactive bladder (OAB). In this study, the efficacy and safety of solifenacin in patients with OAB were evaluated. A prospective study for evaluating the therapeutic results of solifenacin in patients with “OAB dry” (OAB without urge incontinence) or “OAB wet” (OAB with urge incontinence) was performed. Solifenacin 5 mg daily was given and the endpoint was set at the 6th month to evaluate the changes in urgency severity score (USS) after treatment. The measured parameters, including urinary frequency, nocturia, USS, maximum flow rate (Qmax), voided volume, post-voiding residual volume (PVR) and functional bladder capacity (FBC), were recorded at every visit. Patients were further categorized into OAB wet (USS, 4) and OAB dry (USS, 1, 2 and 3), and the effect and adverse events of solifenacin treatment were analyzed. A total of 54 patients was enrolled in this study and completed all follow-up visits. Significant improvements of USS, daytime urinary frequency and nocturia were noted in both OAB dry and OAB wet groups. The urinary frequency and nocturia episodes also improved significantly after taking solifenacin. Mean USS improved from 3.28 ± 0.94 to 2.02 ± 1.62 (p < 0.001), and Qmax increased significantly from 13.9 ± 8.9 mL/s to 15.8 ± 9.6 mL/s (p = 0.04) at baseline and 6 months, respectively. FBC and voiding volume were also found to have significant improvement; however, no significant change in PVR was noted from baseline to endpoint. The therapeutic efficacy showed no significant difference between the OAB dry and OAB wet groups. Minor adverse effects were noted in only seven patients (13.0%), and the most common complaint was difficult urination (5.6%). This study demonstrated that solifenacin is an effective antimuscarinic for treatment of OAB with few adverse effects. Patients with either OAB wet or OAB dry can benefit from solifenacin treatment, in terms of improvement in USS, frequency, nocturia episodes and bladder capacity, without compromising voiding efficiency. Only 13.0% of patients had minor adverse effect, typically dysuria.