الفهرس 
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Abstract
The Aim of this study is to compare between the
efficacy of continuous anticholinergic therapy and
intermitted anticholinergic therapy for the treatment of
the overactive bladder.
Overactive bladder (OAB) also referred to as the
urgency-frequency syndrome, with or without urge
urinary incontinence can considerably impair the
patient’s quality of life. It is widely accepted that diet
and life style modifications, behavioural therapy and
medication belong to the standard conservative
therapeutic options and considered as first-line
measures. The International Consultation on
Incontinence (ICI) guidelines state that when the first
line approach is not fully satisfactory or fails after 8-12
weeks, alternative therapies should be sought out. It is
worthwhile and justified to proceed to second-line
therapy if patients are refractory to antimuscarinic
therapy or if the treatment is contraindicated. Secondline
therapies include less-invasive measures such as
percutaneous posterior tibial neve stimulation, sacral
neuromodulation, detrusor injections with botulinum
toxin (BTX) and whereas more-invasive measures
constitute surgical techniques e.g. bladder
augmentation or substitution. Pelvic neuromodulation
has been proven effective and is today an established
treatment option for patients refractory to or intolerant
of conservative treatments.
Summary
74
Recent data suggest that the prevalence of OAB
symptoms (using the 2002 International Continence
Society (ICS) definition) is closer to 12% in the
community; and of these sufferers, approximately 50%
experience significant bother from their symptoms.
The initial treatment (Behavioral therapy and
pharmaco therapy in the form of anticholinergic agents
such solifenacin aims mainly to reduce the sensation of
urgency, increase the voided volume, reduce
frequency, and eliminate leakage episodes. If OAB
symptoms fail to be controlled by these measures,
percutaneous posterior tibial nerve stimulation (PTNS)
or any other form of neuromodulation can be
introduced to alleviate patient symptoms. If sacral
neuromodulation proves to be ineffective, surgery is
the last option that can be offered to these patients.
Components of behavioral therapy include
education, timed voiding, delayed voiding, dietary
modifications, and pelvic floor muscle exercises
Oxybutynin, Tolterodine, propiverine,
solifenacin, darifenacin, trospium and fesoterodine are
antimuscarinic agents approved for use in OAB
treatment.
A combination of behavioral and drug therapy
has been shown to be more effective than either
treatment alone.
Our study included 60 patients divided into two
groups: continuous anticholinergic therapy group &
intermitted anticholinergic therapy
Summary
75
By using 12 weekly intermitted anticholinergic
therapy, remarkable clinical results were .obtained.
Percent of the patients who complain of OAB in the
intermitted anticholinergic group reported a
statistically significant subjective success. These
patients chose to continue treatment to maintain the
response.
Also patients in the intermitted anticholinergic
therapy group showed significant improvement of
frequency (31%) urgency (50%) and urge incontinence
(50%) and nocturia (53%) compared to propiverine
group frequency (50%) urgency (60%) urge
incontinence (67%) and nocturia (67%)
No serious side effects were reported, group A.
8 patients in the horm of dry mouth in 5 cases (16.7%),
constipation in 2 cases (67%) 8 blurred vision in one
case (33%). group B, 5 patients (16.7%) in the horm
of dry mouth in 3 cases (10% constipation in one case
(3.3) and blurred vision in one case (3.3%).
Our study concluded that intermittent
anticholinergic therapy induces improvement of
bladder over activity symptoms and less side effects
than continuous anticholinergic group