Efficacy of Mirabegron and Propiverine Combination in the Treatment of Refractory Overactive Bladder

Introduction and Hypothesis The aim of this study is to evaluate the effectiveness and safety of mirabegron + propiverine combination in the treatment of overactive bladder (OAB) resistant to anticholinergic agent or beta-3 agonist treatment. Method Patients who presented with OAB symptoms between March 2019 and August 2023 and did not respond to anticholinergic or beta-3 agonist treatment were included in the study. All patients were recommended to use mirabegron 50 mg (Betmiga, Astellas Pharma, Japan) and propiverine 30 mg (Mictonorm SR, 30 mg, Recordati Pharmaceuticals, Italy) once a day. Patients' symptoms were evaluated with OABSS and bladder diary 3 months after treatment. Side effects and satisfaction rates were recorded. Results A total of 320 patients were included in the study. One-year data of a total of 264 patients were examined. After 1 year of treatment, the patients' OABSS score, mean daily micturition frequency according to the bladder diary, frequency of urge incontinence, nocturia, and number of pads decreased compared to before treatment (p < 0.001 for each). After 1 year, 62.1% (164/264) of patients benefited from the mirabegron + propiverine combination. The most common side effects were dry mouth in 43 patients (16.3%) and constipation in 59 patients (22.3%). Conclusion Mirabegron + propiverine treatment is an effective and reliable treatment option in the treatment of OAB resistant to medical monotherapy. With this combination treatment to be used before botulinum toxin application in the treatment of resistant OAB, the number of patients who will receive Botox may decrease.