Overactive Research Articles

A retrospective analysis of sacral neuromodulation for female overactive bladder and interstitial cystitis/painful blader syndrome

Objective To evaluate the effects of sacral neuromodulation (SNM) on female overactive bladder (OAB) and interstitial cystitis/ painful bladder syndrome (IC/PBS). Methods From May 2016 to April 2017, 13 patients with OAB or IC/PBS who had been treated with SNM were assessed retrospectively. Among them, 6 cases were OAB patients, and 7 cases were IC/PBS patients.The average age was 52.3 (42-67)years old, and the preoperative and postoperative 24 h urine frequency, night urination frequency and average voided volume were compared . Results Totally 13 patients underwent stage Ⅰ procedure. The operation time for stage I was 52-125min(average 92 min). After an average follow-up of 3.6 weeks, stage Ⅱ procedures were performed on responders. Four OAB patients accepted stage Ⅱ surgery (conversion rate: 66.7%), and the 24h frequency and night urination frequency reduced from preoperative 22.5 and 5.2 times to postoperative 14.3 and 2.3 times (P<0.05) respectively, and average voided volume increased from 120.3ml to 166.4ml (P<0.05). Among 4 patients presenting IC/PBS who had underwent stage Ⅱ surgery (conversion rate: 57.1%), VAS score and 24 h voiding frequency reduced from 7.3 and 21.6 to 3.8 and 16.8(P<0.05), respectively. No adverse event, such as wound infection or electrode translocation was detected during an average follow-up of 8.3 months. Conclusions Stage Ⅰ procedure is crucial for the long term efficacy of SNM. Postsurgical wound management and parameter adjustment are equal essential in order to achieve a maximum benefits. SNM has advantages in minimal invasiveness and less bleeding, which provides a minimal invasive approach for the management of OAB and IC/PBS. Key words: Sacral neuromodulation(SNM); Overactive bladder(OAB); Interstitial cystitis/painful bladder syndrome(IC/PBS)

Strategy of clinical diagnosis and treatment in women with lower urinary tract symptoms

Lower urinary tract symptoms (LUTS) are common in women. The etiology , clinical manifestation, diagnosis and management of LUTS in women are different from those in men. A detailed history, a physical examination and a urine analysis are essential components of the initial evaluation of lower urinary tract symptoms in the female. Thoroughly treating urinary tract infection is very important in management of frequency . In addition, management of fluid intake, behavioral and drug therapies are often used in combination to optimize patient symptom and the quality of life. Intravesical injection of onabotulinumtoxinA is highly effective, but often requires repeated treatments. Sacral neuromodulation is an effective, minimally invasive surgical treatment for refractory overactive bladder in carefully selected, cognitively capable patients. Detrusor underactivity is a common cause of LUTS in women. Female bladder outlet obstruction was divided into two categories, anatomical and functional obstruction. So far, there is no uniform urodynamic standard for diagnosing bladder outlet obstruction in women . The clinical manifestations are various in different types of obstruction , so is the management. It is important to find out the causes of obstruction, and only in this way can we get correct diagnosis, thus treating patients successfully. Key words: Lower urinary tract symptoms; Female; Diagnosis; Treatment

The research of α-blocker in the patients with double-J sent related symptoms after operation of the upper urinary tract

Objective To explore the applied value and safety of therapy with α-receptors antagonist for double-J sent related symptoms in operation on kidney and ureter. Methods A total of 212 patients from June 2014 to April 2016 were randomly divided into two groups with intervention group (n=107) and control group (n=105). The catheter was removed on the third day post-operation and then remained double-J tube for one month. Quality of life(QOL), theprevalence of overactive bladder symptom score(OABSS), backache, painful urination, fever and the serious of hematuria at 3, 7, 14, 21, 28 days after operation were assessed. Results There were no significant difference in age and gender between the two groups(P>0.05). On postoperative 3 d, QOL and double-J tube related symptoms were not statistically significant (P>0.05). There was statistically significant in QOL, the score of the prevalence of overactive bladder(OAB), backache, painful urination and the serious of hematuria between the two groups at 7, 14, 21, 28 days after operation(P 0.05). Conclusions α-receptors antagonist(Tamsulosin) can be an effective therapeutic method for patients with double-J-sent related symptoms, and helps with OAB and decreases postoperative back pain and hematuria. Key words: Urologic Surgical Procedures; Adrenergic alpha-Antagonists; Catheters, Indwelling

Application of immunological checkpoint inhibitor in tumor therapy

Immunological checkpoints are a mechanism evolved by human beings to control the intensity and duration of immunoreaction and minimize the excessive inflammatory responses and autoimmune diseases caused by overactive immune responses. Compared to radiotherapy, chemotherapy and other traditional treatments, immunotherapy has fewer side effects on normal cells, and has become an emerging technology in tumor treatments. As the focus on tumor treatment research, immunological checkpoint therapy can damage the tumor cells by breaking the immune tolerance and activating the body's own immune system, which make it a promising treatment method. In this paper, the mechanisms of immune activation, immune regulation and immune evasion were described. The action mechanism and clinical application of anti-cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and programmed cell death receptor-1 (PD-1) were summarized. The application prospect of immune checkpoint inhibitors was discussed. Key words: Immune checkpoint; Cancer immunity; CTLA-4; PD-1

Application effect of peer education in the behavior intervention for females with overactive bladder

Objective To explore the application effects of peer education on behavior intervention in female patients with overactive bladder (OAB) . Methods A total of 111 cases with OAB were randomly divided into control group (55 cases) and experimental group (56 cases) since January 2015. The patients in the experimental group were treated with drugs combined with behavioral intervention from peers, while patients in the control group were given drug treatment combined with behavioral intervention from nurses. The improvement of micturition symptoms, quality of life (QOL) score and compliance in two groups of patients were compared. Results The patients' compliance in the experimental group was (25.23±2.24) score while it was (21.17±3.27) that in the control group (t=-7.764, P<0.01) . Three months after intervention, the quality of life was (3.68±0.75) score in the experimental group and (2.67±0.69) score in the control group (P<0.01) . The incidence of urinary frequency, urgency and nocturia of patients in the experimental group were lower than that in the control group (P<0.05) . Conclusions Peer education is an acceptable behavior intervention model for OAB patients. Peer education model can improve the self-management ability and improve the quality of life for patients with OAB. Key words: Female; Overactive bladder; Peer education; Behavior intervention

Botulinum Toxin Treatment in Multiple Sclerosis—a Review

Purpose of review The purpose of this review is to provide updated information on the role of botulinum neurotoxin (BoNT) therapy in multiple sclerosis (MS). This review aims to answer which symptoms of multiple sclerosis may be amenable to BoNT therapy. Recent findings We searched the literature on the efficacy of BoNTs for treatment of MS symptoms up to April 1st 2017 via the Yale University Library's search engine including but not limited to Pub Med and Ovis SP. The level of efficacy was defined according to the assessment's criteria set forth by the Subcommittee on Guideline Development of the American Academy of Neurology. Significant efficacy was found for two indications based on the available blinded studies (class I and II) and has been suggested for several others through open-label clinical trials. Summary There is level A evidence (effective- two or more class I) that injection of BoNT-A into the bladder's detrusor muscle improves MS-related neurogenic detrusor overactivity (NDO) and MS-related overactive (OA) bladder. There is level B evidence (probably effective- two class II studies) for utility of intramuscular BoNT-A injections for spasticity of multiple sclerosis. Emerging data based on retrospective class IV studies demonstrates that intramuscular injection of BoNTs may help other symptoms of MS such as focal tonic spasms, focal myokymia, spastic dysphagia, and double vision in internuclear ophthalmoplegia. There is no data on MS-related trigeminal neuralgia and sialorrhea, two conditions which have been shown to respond to BoNT therapy in non-MS population.

Bladder symptoms and its impact on quality of life in type 2 diabetes mellitus

Objective To estimate the bladder symptoms, and explore its impact on patients′ quality of life in type 2 diabetes mellitus. Methods Overactive bladder symptom score (OABSS) was used to evaluate patients′ bladder symptoms, and Medical Outcome Study 12-Item Short Form Health Survey Scale (SF-12), Overactive Bladder Questionnaire Short Form (OABq-SF) were conducted to test the effect of bladder symptoms on general and disease-specific quality of life. Results Among the four bladder symptoms, nocturia was the most prevalent symptom (46.7%,479/1 025), followed by urinary frequency (14.9%,153/1 025), urinary urgency (14.2%,146/1 025), urge urinary incontinence (7.9%, 81/1 025). Nocturia and urge urinary incontinence significantly increased symptom bother (nocturia B=0.337, P<0.01; urge urinary incontinence B=0.437, P<0.01) and decreased disease-specific quality of life (nocturia B=-0.364, P < 0.01; urge urinary incontinence B=-0.346, P < 0.01) in these patients. Meanwhile, urge urinary incontinence was negatively associated with general mental health (B=-0.255, P=0.011). Conclusions The prevalence of bladder symptoms in type 2 diabetes patients was high, and was found to be associated with patients′ general and disease-specific quality of life. Health care providers should be aware of the high prevalence of bladder symptoms and its impact on QOL to facilitate early diagnosis and treatment of bladder symptoms during diabetic care. Key words: Diabetes mellitus, type 2; Bladder; Quality of life

Efficacy and safety of RevoLix 2 micron continuous wave laser vaporesection in treatment for senile patients with benign prostatic hyperplasia

The clinical efficacy and safety of RevoLix 2 μm continuous wave laser vaporesection in treatment of senile patients with benign prostatic hyperplasia (BPH) were retrospective evaluated. In 291 senile patients with BPH, 213 received 2 μm continuous wave laser vaporesection (group A) and other 78 patients received transurethral resection of prostate (TURP, group B). Compared with group B the intraoperative blood loss was less, the bladder irrigation time, catheter time and hospitalization time were shorter in group A. The subjective or objective indexes were all significantly improved at 3 and 12 months after laser treatment. The improvements of international prostate symptom score (IPSS), IPSS-S, overactive bladder symptom score (OABSS) in patients of 70-79 were more marked than those of 80 or older. Patients with mild overactive bladder (OAB) had less improvement in IPSS and IPSS-S than those with moderate-severe OAB which suggest that the storage symptoms could be improved significantly by removing obstruction. Key words: Lasers therapy; Prostatic hyperplasia; Transurethral resection of prostate

Tension-Free Vaginal Taping in Pakistani Women with Stress Urinary Incontinence.

To evaluate the effectiveness and determine the peroperative and postoperative complications of tension-free vaginal tape (TVT) sling for urinary stress incontinence (USI) and contributing factors to complications. Descriptive study. Kidney Centre Postgraduate Institute, Karachi, from January 2009 to December 2010. One hundred consecutive patients underwent TVT as per Ulmsten Technique for urinary stress incontinence and patients were followed for 3 years. The subjective cure rate and improvement rate was based on the international consultation on incontinence questionnaire for evaluating female lower urinary tract symptoms (ICIQ - FLUS). The subjective cure was defined as the statement of the woman not experiencing any loss of urine upon physical stress and improvement rate was defined as occasional leakage during stress. Patients at 1- and 3-year up follow-up showed subjective cure rate and improvement rate of 98% and 2%, and 95% and 5%, respectively. Mean operative time was 32 minutes. UTI was the commonest complication observed in 7 (7%) patients. Women with voiding dysfunction preoperatively had 9-fold odds of difficulty postoperatively (0<0.001). There was a significant association of preoperative symptoms of overactive bladder (OAB) with the same postoperative symptoms (p<0.0001). Preoperative hysterectomy had a significant (p< 0.005) 15.63 fold odds of intraoperative bladder perforation. Tension-free vaginal tape sling is an efficacious and secure surgical procedure for the treatment of urinary stress incontinence. Bladder perforation, voiding dysfunction, supra-pubic discomfort and UTI are the commonest complications. Risk factors for perforation include preoperative hysterectomy. Pre-existing voiding dysfunction and UTI lead to persistent similar postoperative problems.

Tadalafil treatment improves the cardiovascular dysfunction and overactive bladder in heart failure rats

Heart failure (HF) is a major public health issue, with an increasing prevalence in the world. Studies have shown a strong association of HF with development of low urinary tract symptoms (LUTS), where approximately 34% of men and 62% of women with HF reported having LUTS. Moreover, 57% of these HF patients present with overactive bladder syndrome. Dysfunction of the autonomic nervous system and alterations in important signaling pathways such as the nitric oxide/cyclic guanosine monophosphate pathway (NO‐GCs‐GMPc) are present in the HF. Therefore, drugs were synthesized to potentiate the effect exerted by NO, such as Tadalafil. Recent studies have shown that daily treatment with Tadalafil has been effective in decreasing symptoms related to urination and urine storage, in addition to improving the quality of life of patients with LUTS who have or not associated erectile dysfunction. Thus, using the aortocaval fistula model (FAC) we investigated the contribution of chronic treatment with tadalafil in the cardiovascular dysfunction and low urinary tract alterations of HF rats. HF was surgically induced through the FAC model and after 8 weeks of the surgical procedure the animals were divided into 4 groups: Sham and HF (0.9% saline solution) and Sham/Tadalafil and HF/Tadalafil (tadalafil 5mg/day for more 4 weeks). After 12 weeks, HF group presented increased left ventricle (LV) mass, decreased ejection fraction and increased LV end‐systolic and diastolic volumes when compared to the respective Sham group (p&lt;0.05). However, tadalafil treatment restored cardiac function in the HF/Tadalafil group, with a decreased in hypertrophy and an improved in LV function when compared to the HF group (p&lt;0.05). In addition, in the assessment of isolated detrusor contractile response (in vitro) to carbachol, KCl, alpha‐beta methyl ATP and EFS were increased in the HF group (p&lt;0.05) compared to Sham group. In agreement with these findings, changes in cystometric parameters also were observed in vivo, with an increased in baseline pressure, threshold pressure, number of involuntary contractions and decreased bladder capacity in the HF group (p&lt;0.05), when compared to the respective Sham. However, after treatment with tadalafil, the HF/Tadalafil group showed a decreased in contractile hyperactivity mediated by carbachol, KCl, alpha‐beta methyl ATP and EFS, as well as restoration of urinary function assessed by cystometry (p&lt;0.05) compared to HF group. Renal function and the REDOX also were changed in the HF group, with increased urea plasma levels, as well as changes in REDOX balance, with increased lipoperoxidation and decreased total antioxidant capacity and activity Enzymatic activity of the superoxide dismutase. However, treatment with tadalafil was able to restore urea levels, decrease lipoperoxidation and increase the activity of the antioxidant system in the HF group (p&lt;0.05). Therefore, chronic treatment with tadalafil showed cardioprotective effect and reversed the detrusor overactivity (in vitro) with improved urinary function (in vivo), as well as restoring renal function and REDOX balance in HF animals.Support or Funding InformationFundação de Amparo à Pesquisa do Estado de São Paulo ‐ FAPESP

Combined chronic blockade of hyper-active L-type calcium channels and NMDA receptors ameliorates HIV-1 associated hyper-excitability of mPFC pyramidal neurons

Human Immunodeficiency Virus type 1 (HIV-1) infection induces neurological and neuropsychological deficits, which are associated with dysregulation of the medial prefrontal cortex (mPFC) and other vulnerable brain regions. We evaluated the impact of HIV infection in the mPFC and the therapeutic potential of targeting over-active voltage-gated L-type Ca2+ channels (L-channel) and NMDA receptors (NMDAR), as modeled in HIV-1 transgenic (Tg) rats. Whole-cell patch-clamp recording was used to assess the membrane properties and voltage-sensitive Ca2+ potentials (Ca2+ influx) in mPFC pyramidal neurons. Neurons from HIV-1 Tg rats displayed reduced rheobase, spike amplitude and inwardly-rectifying K+ influx, increased numbers of action potentials, and a trend of aberrant firing compared to those from non-Tg control rats. Neuronal hyper-excitation was associated with abnormally-enhanced Ca2+ influx (independent of NMDAR), which was eliminated by acute L-channel blockade. Combined chronic blockade of over-active L-channels and NMDARs with open-channel blockers abolished HIV effects on spiking, aberrant firing and Ca2+ potential half-amplitude duration, though not the reduced inward rectification. In contrast, individual chronic blockade of over-active L-channels or NMDARs did not alleviate HIV-induced mPFC hyper-excitability. These studies demonstrate that HIV alters mPFC neuronal activity by dysregulating membrane excitability and Ca2+ influx through the L-channels. This renders these neurons more susceptible and vulnerable to excitatory stimuli, and could contribute to HIV-associated neuropathogenesis. Combined targeting of over-active L-channels/NMDARs alleviates HIV-induced dysfunction of mPFC pyramidal neurons, emphasizing a potential novel therapeutic strategy that may effectively decrease HIV-induced Ca2+ dysregulation in the mPFC.

Efficacy of solifenacin in the treatment of bladder spasm after surgical operation of chlidren hypospadias

Objective To evaluate the efficacy and safety of solifenacin in the treatment of bladder spasm after surgical operation of chlidren hypospadias. Methods From January 2014 to May 2015, 60 cases of children more than 4 years old after surgical operation of hypospadias who had symptom of bladder spasm on the day of surgery were assigned into the study group(n=30) and control group(n=30), based on simple randomization.On the first day , the frequency of spasm, the duration of spasm and the incidence of urine extravasation were recorded regarded as the first day condition of bladder spasm. Patients in the study group were treated with solifenacin (5 mg once daily) for a nine days period from 1th day postoperation.Patients in the control group were not treated with solifenacin.The frequency of spasm , the duration of spasm and the incidence of urine extravasation of the two groups were recorded and compared on the 3th and 9th day.Adverse events with solifenacin of two groups were recorded .The function of liver and kidney in the study group were recorded and compared. Results There were statistically significant differences(P<0.01) in favor of the study group over the control group in the aspect of the frequency of spasm, the duration of spasm and the incidence of urine extravasation on the 3th and 9th day.In the study group, the data compared among 1th, 3th and 9th was statistically significantly different, opposite to the control group.There was no statistically significant difference between the liver and kidney function of preoperation and the 9th day in the study group .The frequency of adverse events between two groups had no statistically significant difference. Conclusions Solifenacin is effective and safe in the treatment of bladder spasm after surgical operation of chlidren hypospadias Key words: Solifenacin; Children; Bladder spasm; Overactive bladder

Efficacy of hot–water hip bath combined with pelvic floor training in the treatment of overactive bladder

Objectives To investigate the efficacy of hot–water hip bath combined with pelvic floor training (PFT) in the treatment of overactive bladder(OAB). Methods 197 cases with OAB were allocated to four groups according to registration order and gender: group A(simple medicine, solifenacin ), group B(hot–water hip bath combined with solifenacin), group C(pelvic floor muscle training combined with solifenacin) and group D(hot–water hip bath combined with pelvic floor muscle training and solifenacin). After 8 weeks of treatment, estimate the effects of four groups according to voiding diary (the first three days and the last three days) and the OAB symptoms score card were estimated. Results The efficacy of the group B, group C and group D were more effective than group A. There was no significant difference in group B and group C. The efficacy of group D was better than group A, group B and group C obviously. Conclusions Hot–water hip bath with solifenacin is a potential therapy for OAB patients. A combination of hot–water hip bath and PFT with solifenacin can relieve the symptoms of OAB obviously. The clinical efficacy of the combination is better than the simple hip bath or PFT, worth clinical promotion. Key words: Urinary Bladder Diseases; Pelvic Floor

Clinical efficacy of combination therapy of Tamsulosin plus Tolterodine sustained-release capsules on benign prostatic hyperplasia with overactive bladder in elderly men

Objective To evaluate the efficacy of combination therapy of cholinergic receptor blocker Tolterodine and Alpha-adrenergic receptor blocker Tamsulosin sustained-release capsules on benign prostatic hyperplasia(BPH)with overactive bladder(OAB)in elderly men. Methods A total of 97 male BPH patients aged 80 years and over(80~98 years old, mean 87.7 years old)were enrolled in this study, who met the diagnosis and treatment guidelines of OAB formulated by Chinese Urological Association and were admitted to our hospital from Jan. 2015 to July. 2015. Patients were randomly divided into Tamsulosin group(n=51, treated with Tamsulosin)and combination group(n=46, treated with Tamsulosin and Tolterodine). Results In Tamsulosin group after treatment, the international prostate symptom score(IPSS)was reduced from(18.3±2.7)to(13.3±3.1)(t=14.94, P 0.05). The total incidences of adverse events(mainly mouth dryness)had no significant differences between the Tamsulosin group and the combination group(8.7% vs. 5.9%, χ2=99.47, P>0.05). No acute urinary retention was found in the two groups. Conclusions The combination therapy of Tamsulosin and Tolterodine has better efficacy and safety than single Tamsulosin application in the treatment of BPH with OAB in elderly men. Key words: Prostatic hyperplasia; Urinary bladder, overactive; Muscarinic antagonists; Adrenergic alpha- antagonists

Гиперактивный мочевой пузырь в постменопаузе. Прогнозирование и ранняя диагностика

Гиперактивный мочевой пузырь в постменопаузе. Прогнозирование и ранняя диагностика

Bladder warming: a future therapeutic treatment for the overactive bladder?

Bladder warming: a future therapeutic treatment for the overactive bladder?

Evaluation of Overactive Bladder in Type 2 Diabetes Patients with a Questionaire-Based Study

Haseki T›p Bulteni, Galenos Yay›nevi taraf›ndan bas›lm›flt›r. Ad­dress­for­Cor­res­pon­den­ce/Ya­z›fl­ma­Ad­re­si:­Levent Verim Haydarpasa Numune Training and Research Hospital, Clinic of Urology, Istanbul, Turkey Phone: +90 216 542 32 32-1639 E-mail: leventverim@hotmail.com Received/Gelifl­Tarihi:­13 October 2015 Ac­cep­ ted/Ka­bul­Ta­ri­hi:­28 October 2015 Levent Verim, Kadir Kayatas*, Gul Babacan Abanonu*, Zerrin Alper**, Omer Yuksel**

Clinical efficacy of prostatic hyperplasia in elderly patients

Objectives To investigate the clinical efficacy of elderly prostatic hyperplasia plasma kinetic resection treatment. Methods 78 elderly patients with prostatic hyperplasia were admitted in our hospital from July 2012 to August 2014. All patients were treated with transurethral plasmakinetic resection of prostatic hyperplasia.The international prostate symptom score(IPSS), overactive bladder symptom score(OABSS), quality of life score(QOL), maximal urinary flow rate(Qmax), residual urine volume (PVR) and other indicators were observed before and after treatment. Results 78 cases of patients were operated successfully without intraoperative capsular perforation, urethral sphincter and ureteral orifice injury.All patients were followed up for 6 months.No incontinence and recurrence of prostatic hyperplasia were found .The scores of IPSS, OABSS and QOL were significantly less after surgery than before surgery (10.27±3.41) vs. (22.18±5.18), (3.86±1.44) vs. (5.97±1.36) and (2.18±0.94) vs. (5.11±0.12), which was significant difference(P<0.05); After 6 months, maximum flow rate Qmax was significantly higher after sugery than before surgery (15.24±2.84)mL/s vs.(8.87±1.59)mL/s, (P<0.05); PVR was significantly less after surgery than before surgery (21.05±2.56)mL vs.(105.56 ±32.19)mL, (P<0.05). Conclusions Transurethral plasmakinetic resection for treatment of prostatic hyperplasis is safe and effective in elderly patients, and is worthy of promoting. Key words: Prostatic Hyperplasia; Electrosurgery; Aged

Help-seeking behavior among individuals with overactive bladder in type 2 diabetes mellitus and its influencing factors

Objective To estimate help-seeking behavior among individual with overactive bladder (OAB) in type 2 diabetes mellitus and its influencing factors. Methods This was a cross-sectional survey with a representative sample of 133 patients with OAB in type 2 diabetes mellitus responded the questionnaires, including a self-designed Demographic Data Questionnaire, 12-item Short-Form health survey questionnaire, Overactive Bladder Symptom Score, Patient Perception of Bladder Condition, Help-seeking Behavior Questionnaire. Results Among cases, 21.8%(29/133) had seen a doctor for voiding problems. In the Logistic model, educational status, Charlson comorbidity index, glycosylated hemoglobin, and OAB symptom bother were found to be associated with help-seeking behavior, OR value(95% confidence interval) were 3.158(1.511-6.599), 2.537(1.327-4.849), 0.631(0.430-0.926), 1.655(1.126-2.434), P<0.01 or 0.05. Conclusions The help-seeking rate of OAB individuals in type 2 diabetes mellitus patients is low. Health care providers should understand the predictors of help-seeking behavior and take actions to improve patient's health care utilization and quality of life. Key words: Diabetes mellitus, type 2; Urinary bladder, overactive; Help-seeking behavior

Oxybutynin for Hyperhidrosis

Oxybutynin is an anticholinergic medication indicated for treatment of overactive bladder. As might be predicted, it also has beneficial effects on overactive sweating. A prospective, randomized 6-week trial compared low doses of oxybutynin to placebo for treatment of hyperhidrosis. The investigators enrolled 62 consecutive patients with localized or generalized hyperhidrosis. All patients had grade 2 or greater palmar, plantar, axillary, facial, or truncal primary hyperhidrosis …