You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Basic Research I1 Apr 2014MP1-20 COMBINATION OF FOOT STIMULATION AND TOLTERODINE ELIMINATES BLADDER OVERACTIVITY IN CATS Zeyad Schwen, Yosuke Matsuta, Bing Shen, Jeremy Reese, Jicheng Wang, James Roppolo, William deGroat, and Changfeng Tai Zeyad SchwenZeyad Schwen More articles by this author , Yosuke MatsutaYosuke Matsuta More articles by this author , Bing ShenBing Shen More articles by this author , Jeremy ReeseJeremy Reese More articles by this author , Jicheng WangJicheng Wang More articles by this author , James RoppoloJames Roppolo More articles by this author , William deGroatWilliam deGroat More articles by this author , and Changfeng TaiChangfeng Tai More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.118AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent clinical evidence supports the concept of neuromodulation and antimuscarinic combination therapy as a treatment for overactive bladder (OAB) to increase treatment efficacy and reduce unwanted side effects. Our previous studies in cats demonstrated transcutaneous foot stimulation is a novel, noninvasive form of neuromodulation to effectively inhibit bladder overactivity. The purpose of our study is to investigate the efficacy of combined low-dose tolterodine, a first-line antimuscarinic, and transcutaneous foot stimulation in cats to noninvasively inhibit bladder overactivity and lower adverse antimuscarinic effects. METHODS Cystometrograms were performed on alpha-chloralose anesthetized cats (N=6) by infusing 0.25% acetic acid (AA) to induce bladder overactivity. Foot stimulation (5 Hz) was applied at 2 and 4 times the threshold (T) intensity for inducing toe movement to inhibit the bladder overactivity. Cumulative doses of tolterodine (0.003-0.3 mg/kg, i.v.) were also administered to determine the effect of combination treatment on bladder overactivity. RESULTS AA irritation of the bladder significantly (P<0.0001) reduced bladder capacity to 23.6±7.1% of saline control capacity. Foot stimulation alone at 2T and 4T inhibited bladder overactivity and significantly (P<0.0001) increased bladder capacity to 50.7±6.8% and 79.0±11.6% of saline control, respectively. Tolterodine alone at 0.3 mg/kg significantly (P<0.05) increased bladder capacity to 65.6±15.5% of saline control. However, when tolterodine at a threshold dose (0.3 mg/kg) was combined with foot stimulation, the bladder capacity was significantly (P<0.05) increased to 86.2±6.2% and 107.9±10.6% by 2T and 4T stimulation, respectively. Complete inhibition of bladder overactivity could be achieved at a lower tolterodine dose (0.1 mg/kg) when combined with 4T stimulation (97.0±11.2% of saline control). The amplitude of micturition contraction was not changed by tolterodine treatment. CONCLUSIONS This study suggests a novel, efficacious, non-invasive OAB treatment by combining foot stimulation with a lower dose tolterodine to limit the adverse effects. It also provides the first objective evidence supporting an additive therapeutic benefit of neuromodulation and antimuscarinic combination treatment. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e9 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Zeyad Schwen More articles by this author Yosuke Matsuta More articles by this author Bing Shen More articles by this author Jeremy Reese More articles by this author Jicheng Wang More articles by this author James Roppolo More articles by this author William deGroat More articles by this author Changfeng Tai More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...