***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The Authors carried out a r and om double-blind trial on 30 patients affected by idiopathic urge incontinence with oxybutynin chloride ( 15 mg/die ) and placebo for two 20 day therapeutical cycles . The 24 patients who completed the trial oxybutynin chloride induced statistically significant effects -- compared to placebo too -- both on the subjective symptoms ( reduction or disappearance of the urgency in 14 cases - 60.8 % - and of urge incontinence in 16 cases - 76.1 % ) and on the objective symptoms showed by cystomanometry ( increased bladder capacity at the FD and VSD in 14 and 15 cases , respectively ; absence of involuntary contraction in 9 cases and normal or reduced detrusor pressure at the VSD in 13 out of 16 cases ) . Improvements , though less significant , were also obtained with the placebo Eighteen women ( median age 54 years , 36 - 79 ) with urinary motor urge ( n = 13 ) or sensory urge ( n = 5 ) incontinence were treated for three 2-week periods with emepronium carrageenate ( EC ) ( Cetiprin Novum ) in daily doses of 500 and 1000 mg and placebo . Subjectively the women experienced an increased ability to control micturition , i.e. less urge , during EC treatment . Only mild and mainly anticholinergic side effects were recorded , most frequently dryness of the mouth . As regards side effects , the evaluation of objective effects were complicated by a tendency towards carry-over effect to placebo . Placebo in the first treatment periods were analysed solely ; no effects of placebo could be demonstrated . Compared with the reference period , decreases in the total number of micturitions ( approx . 20 % ) and in the number of urge incontinence episodes ( approx . 75 % ) were seen . As compared with placebo , a significant increase ( approx . 25 % ) in the average micturition volume could be demonstrated . The percentage urinary excretion of emepronium  decreased with increasing oral intake and with advancing age . Probably , an initial daily dosage of 500 mg EC will do well in younger women ( less than 50 years ) , whereas elder patients may need 1000 mg . Further dosage recommendations are given In a multicentre placebo-controlled double-blind study 61 patients with spinal cord injuries and detrusor hyperreflexia were treated : 20 mg trospium chloride was given twice daily over a period of 3 weeks . Pre- and posttreatment urodynamic measurements demonstrated large improvements in maximum cystometric capacity ( mean = 138.1 ml ) , decreased maximum detrusor pressure ( mean = -37.8 cm H2O ) and an increase in compliance ( mean = 12.1 ml/cm H2O ) in the treatment group . Urodynamic parameters in the placebo group remained substantially unchanged . Comparisons between the two groups revealed highly significant differences for these parameters ( all , p less than 0.001 ) . No effect on maximum flow rate and residual urine was detected in either group . The incidence of spontaneously reported side-effects was extremely low and comparable for both groups Idiopathic detrusor instability is a common cause of lower urinary tract symptoms at all ages and in both sexes . Treatment initially is conservative and often includes drug therapy . Terodiline has the theoretical advantage of being a drug with anticholinergic and calcium channel blocking effects . Theoretically , by using a drug with dual action the beneficial effect of reduced detrusor overactivity might occur at a dosage below that likely to lead to the troublesome side effects experienced by patients who take pure anticholinergic agents . A total of 70 female patients completed a study characterized by extremely strict inclusion criteria and a tight protocol . Other novel elements to the study were the extensive use of urinary diaries for symptom evaluation , st and ardized urodynamic studies agreed upon by the participating centers and the dose titration design of the trial . Terodiline has been demonstrated to be a safe , well tolerated and effective drug in the treatment of idiopathic detrusor instability . Drug treatment led to significant decreases in urinary frequency and incontinence episodes . Pre-micturition symptoms , such as urgency , were markedly reduced and the voided volume was significantly increased . Although there were consistent trends towards greater improvement in the urodynamic measurements , when the terodiline and placebo groups were compared these did not reach statistical significance , partly due to a large improvement in the placebo group . Nevertheless , terodiline has been shown to be a useful drug for conservative management of patients with detrusor instability The purpose of this study was to explore changes in psychological distress associated with behavioral treatment and drug treatment for urge incontinence in community-dwelling older women . Participants were 197 ambulatory , nondemented women ( aged 55 years or older ) with persistent urge urinary incontinence . Participants were patients in a r and omized clinical trial comparing biofeedback-assisted behavioral treatment , drug treatment with oxybutynin chloride , and a placebo-control condition .  Psychological distress was measured before and after treatment using the Hopkins Symptom Checklist ( SCL-90-R ) . Multivariate and univariate analyses of variance showed that the two treatment groups and the control group had similar significant improvements on the nine subscales and the global severity index . Analysis of individual SCL-90-R subscale scores revealed trends suggesting that behavioral treatment tended to produce the largest improvements . The reductions of distress were not correlated consistently with reduction of incontinence . The results of this study showed that psychological distress was significantly reduced after treatment , regardless of the type of treatment OBJECTIVE To evaluate the long-term effects of tolterodine on the health-related quality of life ( HRQoL ) of patients diagnosed with overactive bladder with incontinence . METHODS Patients who completed a 12-week r and omized , double-blind , safety and efficacy trial comparing tolterodine with placebo  were invited to enroll in a 12-month open-label continuation trial to assess the long-term safety and efficacy of tolterodine . This study reports the HRQoL results from the King 's Health Question naire ( KHQ ) and the Short Form-36 ( SF-36 ) that were administered at baseline , at the end of the 12-week trial , and 3 and 12 months following open-label treatment with tolterodine . RESULTS One thous and seventy-seven patients were included in the intent-to-treat ( ITT(B ) ) population . KHQ translations were available for 838 patients ( mean age , 61.1 years ; 80.9 % women ) in the ITT(B ) population .  HRQoL , as measured by the KHQ , significantly improved from baseline to months 3 and 12 on the following domains : incontinence impact , role limitations , physical limitations , social limitations , personal relationships , emotions , sleep and energy , severity ( coping ) measures , and symptom severity . Improvements were generally consistent across all analyses for the 3- and 12-month measurements and for the ITT(B ) and completer ( C(B ) ) population s. Patients receiving tolterodine in the double-blind study showed additional improvement at the 3-month open-label assessment on all but the general health domain . At 12 months from treatment rollover , all improvements from rollover to 3 months were sustained with additional improvement seen on the incontinence impact and role limitations domains . The general health perceptions domain showed a slight decline from rollover that might be attributable to a natural decline in patients ' health status at this life stage . These findings were consistent with other efficacy results whereby efficacy was maintained over the 12-month open-label period . SF-36 results were consistent with previous experience of reduced sensitivity , as population groups were similar to the SF-36 Physical Component and Mental Component scores at various time points and with all population s. CONCLUSION Continued treatment with tolterodine provides additional benefits in HRQoL as measured by the KHQ . Of particular importance are improvements on the psychological aspects after longer-term treatment not detected after a short-term trial . Treatment effects on HRQoL are evident even after a 12-week placebo run-in supporting the true clinical effect of active treatment Aims of the study : The aim of this double-blind , r and omised , prospect i ve , multicentre trial was to evaluate the efficacy of propiverine in patients suffering from detrusor hyperreflexia caused by spinal cord injury in comparison to placebo . Study design : The treatment period of 14 days comprised visits at baseline ( V1 ) and after 14 days treatment ( V2 ) . Fifteen mg propiverine t.i.d . or placebo t.i.d . were administered as medication . The following efficacy parameters were adopted : the urodynamic parameters maximal cystometric bladder capacity , bladder volume on onset of the first as well as duration and amplitude of the maximum detrusor contraction , bladder compliance and residual urine , and subjective assessment of efficacy by physicians . For the evaluation of the safety of propiverine the incidence rate of adverse events by directly question ing as well as laboratory parameters were investigated . For biometrical evaluation t-test for independent groups was applied . Results : One hundred and thirteen patients were investigated .  The maximal cystometric bladder capacity increased significantly in the propiverine group , on average by 104 ml ( V1 : 262±132 ml . V2 : 366±143 ml , P<0.001 ) . The changes in bladder capacity during the first contraction and the maximum detrusor contraction in the verum group were both statistically significant . The bladder compliance documented a more pronounced increase under propiverine in comparison to placebo . Residual urine increased by 37±71 ml in the propiverine group , significantly more than in the placebo group ( P=0.01 ) . Sixty-three per cent of the patients expressed subjectively an improvement under propiverine in comparison with 23 % of the placebo group . Expected anticholinergic adverse events occurred : dryness of the mouth ( 37 % in the verum and 8 % in the placebo group ) , accommodation disorders ( 28 % and 2 % respectively ) . Nausea , constipation , headache , dizziness , tiredness and palpitations were reported in almost comparable incidence rates between 3 and 13 % in both treatment groups . Eight drop-outs were registered in the propiverine group ( five due to adverse events ) and three in the placebo group ( one due to adverse events ) . The laboratory parameters revealed no changes . Conclusion : Propiverine proved its efficacy in detrusor hyperreflexia with regard to the urodynamic parameters of the maximal cystometric bladder capacity and detrusor contractility . Anticholinergic adverse events such as dryness of the mouth and accommodation disorders were considered being tolerable . The increase in residual urine reflects the therapeutically desired effect of detrusor relaxation because the majority of patients normally practise intermittent catheterisation for bladder emptying Abstract : In this study we aim ed to assess the reproducibility of the 7-day voiding diary in women with stress urinary incontinence . We compared two 7-day voiding diaries completed at 4-week intervals by 138 women with stress urinary incontinence enrolled in an interventional trial . The correlation coefficient for the number of weekly incontinence episodes between the two diaries was 0.831 . For 280 voiding diaries the results of the first 3 days correlated well with results of the last 4 days ( r= 0.887 ) . The number of incontinence episodes , as recorded on a 7-day voiding diary , is a reproducible outcome measure in women with stress urinary incontinence . Results from the first 3 days of a diary correlate well with the last 4 days , suggesting that a 3-day diary is an appropriate outcome measure for clinical trials evaluating treatments for stress incontinence OBJECTIVES To evaluate the efficacy and tolerability of a new extended-release ( ER ) , once-daily , capsule formulation of tolterodine , relative to placebo and the existing immediate-release ( IR ) , twice-daily , tablet formulation , for treatment of the overactive bladder . METHODS This was a double-blind , multicenter , r and omized , placebo-controlled trial . One thous and five hundred twenty-nine patients ( 81 % women ) with urinary frequency ( eight or more micturitions every 24 hours ) and urge incontinence ( five or more episodes per week ) were r and omized to oral therapy with tolterodine ER 4 mg once daily ( n = 507 ) , tolterodine IR 2 mg twice daily ( n = 514 ) , or placebo ( n = 508 ) for 12 weeks . Efficacy was assessed at the end of the treatment period on the basis of the micturition diary variables . Tolerability and safety were assessed by evaluating the adverse events , electrocardiogram parameters , laboratory values , and treatment withdrawals . RESULTS Tolterodine ER 4 mg once daily ( P = 0.0001 ) and tolterodine IR 2 mg twice daily ( P = 0.0005 ) both significantly reduced the mean number of urge incontinence episodes per week compared with placebo . The median reduction in these episodes as a percentage of the baseline values was 71 % for tolterodine ER , 60 % for tolterodine IR , and 33 % for placebo . The ER formulation was 18 % more effective than the IR formulation ( P < 0.05 ) . Treatment with both formulations of tolterodine was also associated with statistically significant improvements in all other micturition diary variables compared with placebo . For both formulations , the mean decreases in micturition frequency ( P < 0.0079 ) and pad usage ( P 
    Output:
    
The use of anticholinergic drugs by people with overactive bladder syndrome results in statistically significant improvements in symptoms .
Recent trials suggest that this is associated with modest improvement in quality of life .
Dry mouth is a common side effect of therapy but did not seem to have an effect on the numbers of withdrawals .
It is not clear whether any benefits are sustained during long-term treatment or after treatment stops