Bethanechol: Is it still being prescribed for bladder dysfunction in women?

Abstract

PURPOSE:

Few medical treatment options exist for detrusor underactivity or urinary retention in women. Bethanechol, a cholinergic agonist, may improve detrusor contractility in these conditions; however, its clinical efficacy is limited. We sought to examine the patterns of Bethanechol use by physicians in an ambulatory care setting using a national database to determine if it is still prescribed for patients with bladder dysfunction.

MATERIALS AND METHODS:

The National Ambulatory Medical Care Survey (NAMCS) database was queried for a sample of patient visits to office-based physicians from 2003-2013. Visits were included for women aged 18 years or older with diagnosed lower urinary tract symptoms (LUTS), neurogenic bladder, or urinary retention based on ICD-9-CM codes. Visits in which Bethanechol was prescribed were analysed with descriptive statistics. Sampling weights were adjusted for nonresponders to yield an unbiased national estimate of ambulatory care visits.

RESULTS:

Out of a weighted sample of 17 321 630 included patient visits, 132 281 (0.8%) visits included a prescription for Bethanechol. Patients prescribed Bethanechol had a mean age of 62.3 ± 2.1 and were predominantly Caucasian (67%) followed by African American (18%). The primary diagnosis associated with Bethanechol was atony of bladder (35%), urinary retention (20%), neurogenic bladder (18%), urinary incontinence (16%), and incomplete bladder emptying (10%). Visits were primarily for chronic conditions (63%). It was typically prescribed as a continued medication (79%) most often by urologists (92%) followed by internal medicine clinicians (8%).

CONCLUSIONS:

Bethanechol continues to be prescribed in elderly women primarily for detrusor atony, urinary retention, or incomplete bladder emptying.

• Authors: Shivani Gaitonde, Rena D Malik, Alana L Christie, Philippe E Zimmern
• Journal: International journal of clinical practice (Int J Clin Pract) Vol. 73 Issue 8 Pg. e13248 (Aug 2019) ISSN: 1742-1241 [Electronic] India
• PMID: 30112787 (Publication Type: Journal Article)
• Copyright: © 2018 John Wiley & Sons Ltd.

Chemical References

• Muscarinic Agonists
• Bethanechol

Topics

• Adolescent
• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Bethanechol (administration & dosage, therapeutic use)
• Ethnicity
• Female
• Health Care Surveys (statistics & numerical data)
• Humans
• Lower Urinary Tract Symptoms (drug therapy, epidemiology, ethnology)
• Middle Aged
• Muscarinic Agonists (administration & dosage, therapeutic use)
• Practice Patterns, Physicians'
• United States (epidemiology)
• Women's Health
• Young Adult