Video-urodynamic effects of mirabegron, a β3 -adrenoceptor agonist, in patients with low-compliance bladder

Int J Urol. 2015 Oct;22(10):956-61. doi: 10.1111/iju.12867. Epub 2015 Jul 14.

Abstract

Objectives: To investigate video-urodynamic effects of mirabegron, a β3 -adrenoceptor agonist, on low-compliance bladder.

Methods: We retrospectively reviewed nine patients (three men, six women, age 17-68 years) who had been diagnosed with lower urinary tract dysfunction with low-compliance bladder, and who underwent video-urodynamic study before and during administration of mirabegron 50 mg once daily. Urodynamic parameters were compared before and after treatment.

Results: Mirabegron treatment significantly increased first desire to void and cystometric capacity with an average increment of 80 mL (P = 0.027) and 123 mL (P = 0.005), respectively. Bladder compliance also significantly increased (mean value 8.1 mL/cmH2 O before, 18.2 mL/cmH2 O after, P = 0.024). In the six patients who had been taking anticholinergic agents at baseline video-urodynamic study and then switched to mirabegron, mean cystometric capacity and bladder compliance were also increased significantly from 208.3 to 346.8 mL (P = 0.015) and from 7.2 to 17.5 mL/cmH2 O (P = 0.047), respectively. Vesicoureteral reflux grade was improved in three of the four patients who had shown vesicoureteral reflux on cystography before treatment.

Conclusions: Mirabegron improves cystometric capacity and bladder compliance, and it lowers vesicoureteral reflux grade in patients with low-compliance bladder. Thus, mirabegron might represent a good alternative drug for low-compliance bladder refractory to anticholinergic treatment.

Keywords: compliance; lower urinary tract dysfunction; mirabegron; urodynamics; vesicoureteral reflux.

MeSH terms

  • Acetanilides / pharmacology*
  • Acetanilides / therapeutic use
  • Adolescent
  • Adrenergic beta-3 Receptor Agonists / pharmacology*
  • Adrenergic beta-3 Receptor Agonists / therapeutic use
  • Adult
  • Aged
  • Cholinergic Antagonists / therapeutic use
  • Compliance / drug effects
  • Female
  • Humans
  • Lower Urinary Tract Symptoms / diagnostic imaging
  • Lower Urinary Tract Symptoms / drug therapy*
  • Lower Urinary Tract Symptoms / physiopathology*
  • Male
  • Middle Aged
  • Radiography
  • Retreatment
  • Retrospective Studies
  • Thiazoles / pharmacology*
  • Thiazoles / therapeutic use
  • Urinary Bladder / drug effects*
  • Urinary Bladder / physiopathology
  • Urodynamics / drug effects*
  • Young Adult

Substances

  • Acetanilides
  • Adrenergic beta-3 Receptor Agonists
  • Cholinergic Antagonists
  • Thiazoles
  • mirabegron