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Initial combined treatment with anticholinergics and α-blockers for men with lower urinary tract symptoms related to BPH and overactive bladder: a prospective, randomized, multi-center, double-blind, placebo-controlled study

Authors
 S H Lee  ;  B H Chung  ;  S J Kim  ;  J H Kim  ;  J C Kim  ;  J Y Lee 
Citation
 PROSTATE CANCER AND PROSTATIC DISEASES, Vol.14(4) : 320-325, 2011 
Journal Title
PROSTATE CANCER AND PROSTATIC DISEASES
ISSN
 1365-7852 
Issue Date
2011
MeSH
Adrenergic alpha-Antagonists/therapeutic use* ; Aged ; Aged, 80 and over ; Cholinergic Antagonists/therapeutic use* ; Double-Blind Method ; Drug Therapy, Combination ; Humans ; Lower Urinary Tract Symptoms/drug therapy* ; Lower Urinary Tract Symptoms/etiology ; Male ; Middle Aged ; Prostatic Hyperplasia/complications ; Prostatic Hyperplasia/drug therapy* ; Severity of Illness Index ; Time Factors ; Treatment Outcome ; Urinary Bladder, Overactive/complications ; Urinary Bladder, Overactive/drug therapy*
Keywords
overactive bladder ; BPH ; [alpha]-blocker ; anticholinergics ; combination therapy
Abstract
We aimed to evaluate the efficacy and safety of combination treatment using anticholinergics with α-blocker for initial treatment of both overactive bladder (OAB) and other lower urinary tract symptoms (LUTS), secondary to BPH. A 12-week, randomized, double-blind, placebo-controlled trial was conducted at four urology clinics in Korea, involving men, aged 50 years or older, with LUTS related to BPH and OAB. A total of 176 patients were randomly assigned to receive doxazosin (4 mg) plus placebo or doxazosin (4 mg) plus tolterodine SR (4 mg), once a day for 12 weeks. Changes from baseline in total International Prostate Symptom Score (IPSS), bladder diary variables, patient perception of bladder condition (PPBC), uroflowmetry, postvoid residual volume and IPSS subscores (voiding and storage) were analyzed. Of the 176 enrolled patients, 91 had doxazosin gastrointestinal therapeutic system (GITS) and placebo, and 85 had combined medication with doxazosin GITS and tolterodine SR. Compared with the doxazosin plus placebo group, the doxazosin plus tolterodine group showed significant reductions in IPSS storage subscore and improvement in the quality of life item, urgency episodes, as well as in micturition frequency at weeks 4 and 12. However, it failed to improve PPBC at week 4 as well as at week 12. Earlier intervention with anticholinergics plus α-blocker was tolerated well, including the questions about urinary retention (n=1) and dry mouth (n=2). Initial combination treatment of anticholinergics plus α-blocker showed positive results for men with LUTS related to BPH and OAB symptoms and did not increase the risk of urinary retention.
Full Text
http://www.nature.com/pcan/journal/v14/n4/full/pcan201122a.html
DOI
10.1038/pcan.2011.22
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jang Hwan(김장환) ORCID logo https://orcid.org/0000-0002-9056-7072
Lee, Seung Hwan(이승환) ORCID logo https://orcid.org/0000-0001-7358-8544
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/95103
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