Darifenacina versus Estimulação Elétrica Transcutânea Parasacral para Tratamento da Síndrome da Bexiga Hiperativa Neurogênica em Individuos Infectados pelo HTLV-1

Abstract

Background: Overactive bladder (OAB) is observed in approximately 78% of individuals infected with HTLV-1 with associated myelopathy and in 59% of infected individuals without motor impairment. Anticholinergic medications are widely used to treat OAB symptoms, but the frequency of adverse events such as constipation, dry mouth, visual and mental disturbances, and even urinary retention should not be overlooked. Dry syndrome and constipation are common in people with HTLV, which limits adherence to anticholinergic therapy. Objective: To evaluate the effectiveness of transcutaneous parasacral nerve stimulation (PTENS) compared to darifenacin in reducing OAB symptoms in individuals infected with HTLV-1. Materials and Methods: This randomized proof-of-concept clinical trial was conducted at the HTLV-1 Outpatient Clinic of the University Hospital. The participants were 42 HTLV-1 individuals with OAB symptoms. The OAB symptom score questionnaire (OABSS) was administered before and after treatment to assess each group: Group 1 received Darifenacin, and Group 2 was treated with PTENS. Random sequences and statistical analyses were generated using the SPSS statistical package, version 27 (IBM Inc). Results: There were no differences between the groups regarding demographic, socioeconomic, and clinical characteristics. Both groups showed a reduction in OABSS scores, daytime urinary frequency, nocturia, and urgency. However, 5 (23.8%) of the participants in the darifenacin group discontinued therapy, while only 1 patient (4.8%) stopped PTENS (p<0.05). Conclusions: Both protocols used in this study were effective in treating OAB syndrome, reducing OABSS. However, adverse events and treatment discontinuation were more frequent in the darifenacin group compared to the PTENS group.