{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:16:59Z","timestamp":1768004219777,"version":"3.49.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Biological rationale suggests that parasympathomimetics (cholinergic receptor stimulating agents) could be beneficial for patients with underactive bladder. However, no systematic review with meta\u2010analysis addressing potential benefits or adverse effects exists. The aim of this review was to assess the effectiveness, both benefits and harms, of using parasympathomimetics for the treatment of underactive bladder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The protocol was registered in PROSPERO, and searches undertaken in PubMed, Embase, and CENTRAL, including randomized and non\u2010randomized controlled trials of patients with underactive bladder, comparing parasympathomimetic to placebo, no treatment, or other pharmaceuticals. Risk ratios, odds ratios, and mean differences were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve trials with 3024 participants were included. There was a significant difference between parasympathomimetics and comparators (favoring parasympathomimetics) in the number of patients with urinary retention (risk ratio 0.55, 95% confidence interval [CI] 0.3\u20130.98,<jats:italic>p<\/jats:italic>\u2009=\u20090.04, low quality of evidence). There was no difference in mean postvoid volume overall (MD \u221241.4\u2009ml, 95% CI \u221292.0 to 9.1,<jats:italic>p<\/jats:italic>\u2009=\u20090.11, low quality of evidence). There was a significant difference at up to 1 week post\u2010intervention, favoring parasympathomimetics (MD \u221277.5\u2009ml, 95% CI \u221290.9 to \u221264.1,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, low quality of evidence), but no difference at 1 month post\u2010intervention. There was no difference in adverse events (odds ratio 1.19, 95% CI 0.62\u20132.28,<jats:italic>p<\/jats:italic>\u2009=\u20090.6, moderate quality of evidence).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The evidence supporting the use of parasympathomimetics is of low quality, with relatively short follow\u2010up durations. Overall, it is not possible to draw clear evidence\u2010based conclusions from the current literature, presenting the use of parasympathomimetics for treating underactive bladder as a key area that requires future well\u2010controlled clinical trials.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.24839","type":"journal-article","created":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T08:56:07Z","timestamp":1637744167000},"page":"127-139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The effectiveness of parasympathomimetics for treating underactive bladder: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2190-8301","authenticated-orcid":false,"given":"Christian","family":"Moro","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences and Medicine Bond University Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4217-0214","authenticated-orcid":false,"given":"Charlotte","family":"Phelps","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine Bond University Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vineesha","family":"Veer","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine Bond University Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0133-1613","authenticated-orcid":false,"given":"Justin","family":"Clark","sequence":"additional","affiliation":[{"name":"Institute for Evidence\u2010Based Healthcare Bond University Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7564-073X","authenticated-orcid":false,"given":"Paul","family":"Glasziou","sequence":"additional","affiliation":[{"name":"Institute for Evidence\u2010Based Healthcare Bond University Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1389-8214","authenticated-orcid":false,"given":"Kari A. 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