EFFICACY OF PHARMACOLOGICAL MANAGEMENT ON CYSTOMETRIC CAPACITY IN NEUROGENIC DETRUSOR OVERACTIVITY DUE TO SPINAL CAUSES IN ADULTS: SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

This research aims to evaluate the effects of pharmacological management on maximal bladder capacity (MCC) in patients with neurogenic detrusor overactivity (NDO) due to spinal causes. Literature searches were carried out in Pubmed and Scopus databases from the inception to November 2024. Randomized controlled trials on pharmacological treatments for storage symptoms compared to usual care or placebo (i.e., controls) in NDO patients with MCC as an outcome were included. Mean differences (MD) were pooled in meta-analyses. The results showed that MCC was significantly higher after treatment with antimuscarinics, intravesical vanilloids, and botulinum toxin type A injection (BONT-A) compared to controls, with MDs (95% confidence intervals) of 90.97 (57.30, 124.64), 90.70 (46.12, 135.29), and 158.55 (132.76, 184.34) ml, respectively. Subgroup analysis showed a dose-response relationship between BONT-A and MCC. This systematic review and meta-analysis supports the efficacy of antimuscarinics, intravesical vanilloids, and BONT-A in improving MCC in NDO patients due to spinal causes.