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Abstract The Aim of this study is to compare between the efficacy of continuous anticholinergic therapy and intermitted anticholinergic therapy for the treatment of the overactive bladder. Overactive bladder (OAB) also referred to as the urgency-frequency syndrome, with or without urge urinary incontinence can considerably impair the patient’s quality of life. It is widely accepted that diet and life style modifications, behavioural therapy and medication belong to the standard conservative therapeutic options and considered as first-line measures. The International Consultation on Incontinence (ICI) guidelines state that when the first line approach is not fully satisfactory or fails after 8-12 weeks, alternative therapies should be sought out. It is worthwhile and justified to proceed to second-line therapy if patients are refractory to antimuscarinic therapy or if the treatment is contraindicated. Secondline therapies include less-invasive measures such as percutaneous posterior tibial neve stimulation, sacral neuromodulation, detrusor injections with botulinum toxin (BTX) and whereas more-invasive measures constitute surgical techniques e.g. bladder augmentation or substitution. Pelvic neuromodulation has been proven effective and is today an established treatment option for patients refractory to or intolerant of conservative treatments. Summary 74 Recent data suggest that the prevalence of OAB symptoms (using the 2002 International Continence Society (ICS) definition) is closer to 12% in the community; and of these sufferers, approximately 50% experience significant bother from their symptoms. The initial treatment (Behavioral therapy and pharmaco therapy in the form of anticholinergic agents such solifenacin aims mainly to reduce the sensation of urgency, increase the voided volume, reduce frequency, and eliminate leakage episodes. If OAB symptoms fail to be controlled by these measures, percutaneous posterior tibial nerve stimulation (PTNS) or any other form of neuromodulation can be introduced to alleviate patient symptoms. If sacral neuromodulation proves to be ineffective, surgery is the last option that can be offered to these patients. Components of behavioral therapy include education, timed voiding, delayed voiding, dietary modifications, and pelvic floor muscle exercises Oxybutynin, Tolterodine, propiverine, solifenacin, darifenacin, trospium and fesoterodine are antimuscarinic agents approved for use in OAB treatment. A combination of behavioral and drug therapy has been shown to be more effective than either treatment alone. Our study included 60 patients divided into two groups: continuous anticholinergic therapy group & intermitted anticholinergic therapy Summary 75 By using 12 weekly intermitted anticholinergic therapy, remarkable clinical results were .obtained. Percent of the patients who complain of OAB in the intermitted anticholinergic group reported a statistically significant subjective success. These patients chose to continue treatment to maintain the response. Also patients in the intermitted anticholinergic therapy group showed significant improvement of frequency (31%) urgency (50%) and urge incontinence (50%) and nocturia (53%) compared to propiverine group frequency (50%) urgency (60%) urge incontinence (67%) and nocturia (67%) No serious side effects were reported, group A. 8 patients in the horm of dry mouth in 5 cases (16.7%), constipation in 2 cases (67%) 8 blurred vision in one case (33%). group B, 5 patients (16.7%) in the horm of dry mouth in 3 cases (10% constipation in one case (3.3) and blurred vision in one case (3.3%). Our study concluded that intermittent anticholinergic therapy induces improvement of bladder over activity symptoms and less side effects than continuous anticholinergic group |