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On the basis of clinical and urodynamic results the authors adopt a definite attitude to the treatment of the urgency syndrome in the woman with the anticholinergic drug propiverin hydrochloride (Mictonorm). The results show a satisfactory improvement in 42 of 68 women (= 62%), whereas 24 of 68 women (= 35%) reported a subjective improvement of the clinical symptoms. These results correspond with the data from literature. In 15 women with no satisfactory effect the beta 2-sympathicomimetic drug clenbuterol (Contraspasmin) was additionally applied. There was a satisfactory success under this medication in 11 of the 15 women (= 72%). The results are discussed with the references of the literature to the conservative therapy of the urgency syndrome.

In a study for the recognition of the urodynamics of the detrusor after administration of the anticholinergic drug Mictonorm 14 patients with obstinate urge symptoms were examined. According to an examination plan every woman underwent three cystometric examinations each which were performed by means of a special urodynamic measuring device. Apart from a distinct improvement of the subjective complaints with the help of significantly different cystometry parameters the change of the urodynamics of the detrusor after therapy may be made evident in the results.

The motor urge incontinence is characterized through a hyperactivity of the detrusor muscle. Whereas in the secundar form of motor urge incontinence the evoked moment must be abolished in the primar form no method of choice exist. Many different drugs are used in the pharmacological therapy. Biofeedback will be more important in the future. The sensor urge incontinence is caused through urethral relaxation. For the objective assessment must be taken out intraurethral pressure measurements. In this measurements it gives some problems due to the influence of physiological functions.

The new anticholinergic agent Propiverinhydrochlorid (Mictonorm) is used in the treatment of the Enuresis nocturna et diurna combined with urgency, frequency and small amounts of voided urine. The urodynamic investigation shows an unstable bladder. No urinary tract obstruction or neurogenic injuries are detected at the 26 normal-developed children of 5-11 years of age. Mictonorm was given for 3 months, in a dosage of 0,4 mg/kg bw/d. The bladder capacity, the volume at the desire to void and the compliance of the detrusor significantly increased and the frequency decreased. Application of placebo shows no variation of these parameters. No side-effects were to be distinguish. The wetting improved significantly in 16 of the 26 children but dryness seldom was reached. Therefore the dose was doubled in 19 children at the fourth month, and a second equal group of 26 children primary was treated with 0,7-0,8 mg/kg bw/d. With good compatibility especially the higher dose given from the beginning improved the enuresis better. All children showed a more distinct influence to the enuresis diurna than to the nocturna. The prescription of the anticholinergic neurotrope and myotrope drug is interpreted as a part of the management of the wetting child and its environment.

In the context of treating hyperactivity of the detrusor the newly developed preparation Propiverin (Mictonorm) is presented. It is postganglionic and anticholinergic and mainly acts peripherally and selectively on the bladder. At the same time a musculotropic relaxing effect with a specific affinity to the unstriated musculature of the bladder can be demonstrated in experiments on animals. In our urodynamic investigations the application of the medicament resulted in an increase in bladder capacity, a reduction of urge symptoms, a decrease in bladder tension and a depression of the uroflow. These results justify the clinical use of Propiverin after appropriate urodynamic diagnostic checks.