Assessment of the Usefulness and Optimal Method of Administration of Distigmine Bromide for the Treatment of Voiding Dysfunction Due to Underactive Detrusor

Hypothesis / aims of study No effective treatment for voiding dysfunction due to underactive detrusor is available anywhere in the world. Distigmine bromide is an anticholinesterase that inhibits acetylcholine breakdown by acetylcholinesterase (AChE) and cholinesterase (ChE) at neuromuscular junctions. The inhibition of Ach breakdown prolongs its action at nerve endings and its ability to act on Ach receptors. Since using distigmine bromide involves the risk of causing a cholinergic crisis, patients should be monitored for diarrhea, sweating, bradycardia, fatigue, etc., as early symptoms of a cholinergic crisis. Distigmine bromide is commonly used to temporarily treat early dysuria in other countries, but in Japan it is often used to treat patients as many as several years after surgery, or to treat diabetic neurogenic bladder. We evaluated the usefulness of distigmine bromide for the treatment of voiding dysfunction due to underactive detrusor and optimal method of administration of it.