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Objective: To evaluate the evidence regarding the therapeutic benefits and safety of oral detrusor relaxing agents (DRAs) in treating neurogenic detrusor overactivity (NDO). Methods: A comprehensive search was performed on 1 September 2022. Two authors independently reviewed the articles to extract data using a pre‐designed form. The meta‐analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. A common‐effect or random‐effects model was used based on the heterogeneity among studies. Bayesian network meta‐analysis (NMA) was further performed to make indirect comparisons of antimuscarinics and mirabegron. Results: A total of 23 randomised controlled trials (RCTs) comprising 1697 patients were included in our analysis. Compared to placebo, the clinical benefits of oral DRAs, along with more adverse events (AEs), were demonstrated in the treatment of NDO. In the subgroup analysis, antimuscarinics significantly improved both urodynamic and bladder diary outcomes (including urinary incontinence episodes, urinary frequency, and residual volume), with a higher rate of AEs, such as xerostomia. Mirabegron improved some of the parameters and had fewer bothersome side‐effects in patients with NDO. The NMA showed that none of the antimuscarinics or mirabegron was superior or inferior to the other. Conclusions: Detrusor relaxing agents are associated with improved outcomes in patients with NDO and our analysis has added new evidence regarding antimuscarinics. Evidence concerning mirabegron as first‐line therapy for NDO is still limited. Well‐designed RCTs are still required in this specific population. [ABSTRACT FROM AUTHOR]

Purpose: To establish typical value ranges (TVRs) of the air‐charged catheter (ACC) system, and analyze the typical signal patterns (TSPs) of cough under different bladder volumes for quality control of a urodynamic study using the ACC system. Materials and Methods: The urodynamic traces of 1977 patients with neurogenic bladder (NB) were analyzed for intravesical pressure (pves), abdominal pressure (pabd), and detrusor pressure (pdet) in the cough test at our center from July 2017 to December 2021. The pdet cough signals were described and classified. The pdet cough signal patterns in different bladder volumes and postures were analyzed. Results: The 50% range of the initial resting pves, pabd, and pdet in the supine and sitting positions were 7–15, 7–14, and 0–0 cmH2O, and 24–33, 24–33, and 0–0 cmH2O, respectively. The cough amplitudes for pves and pabd were similar in the 50% range, as follows: 10–27 and 8–25 cmH2O in the supine position, respectively; and 18–43 and 17–40 cmH2O in the sitting position, respectively. The cough amplitude of pves and pabd was not related to bladder volume (p > 0.05). The cough spikes of pdet were divided into three types: type I, in which pdet has a minimal change (<5 cmH2O); type II, a monophasic cough spike, in which could be a positive (IIa, ≥5 cmH2O) or negative spike (IIb, ≥5 cmH2O); and type III, a biphasic spike, in which could be a positive‐to‐negative biphasic (IIIa) or negative‐to‐positive spike (IIIb). Under different bladder volumes, the cough signals of pdet were all expressed as type I, II, or III, and the cough signals were unrelated to bladder volume (p > 0.05). Conclusions: TVRs of the initial resting state in patients with NB were established to provide guidance for quantitative quality control of the ACC system. The TSPs of the pdet cough signal under different bladder volume and posture were described, which could be used for qualitative quality control of the ACC system. [ABSTRACT FROM AUTHOR]