OBJECTIVES: To compare the efficacy of tolterodine plus simplified bladder 
training (BT) with tolterodine alone in patients with an overactive bladder.
PATIENTS AND METHODS: In a multicentre, single-blind study at 51 Scandinavian 
centres, 505 patients aged >or= 18 years with symptoms of urinary frequency 
(>or= 8 micturitions/24 h) and urgency, with or without urge incontinence, were 
randomized to oral treatment with either tolterodine 2 mg twice daily plus 
simplified BT or tolterodine alone. Changes in voiding diary variables were 
evaluated after 2, 12 and 24 weeks of treatment. The patients' perceptions of 
their bladder symptoms and tolerability (adverse events) were also determined.
RESULTS: In all, 501 patients (75% women) were evaluable on an 
intention-to-treat basis (244 on tolterodine + BT and 257 on tolterodine alone). 
Tolterodine significantly reduced the voiding frequency and increased the volume 
voided per void at all sample times; these effects were significantly increased 
by adding BT. At the end of the study the median percentage reduction in voiding 
frequency was greater with tolterodine + BT than with tolterodine alone (33% vs 
25%, P < 0.001), while the median percentage increase in volume voided per void 
was 31% with tolterodine + BT and 20% with tolterodine alone (P < 0.001). There 
was a median of 81% fewer incontinence episodes than at baseline with 
tolterodine alone, which was not significantly different from that with 
tolterodine + BT (- 87%). The two groups had comparable median percentage 
reductions in urgency episodes. Some 76% of patients on tolterodine + BT 
reported an improvement in their bladder symptoms relative to baseline, compared 
with 71% on tolterodine alone. Tolterodine was well tolerated; the most common 
adverse event was mild dry mouth.
CONCLUSION: Tolterodine 2 mg twice daily is an effective and well tolerated 
treatment for an overactive bladder, the effectiveness of which can be augmented 
by a simplified BT regimen.