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Tolterodine extended release with or without tamsulosin in men with lower urinary tract symptoms including overactive bladder symptoms: effects of prostate size.
Eur Urol. 2009 Feb; 55(2):472-9.EU

Abstract

BACKGROUND

Some men with lower urinary tract symptoms (LUTS) including overactive bladder (OAB) symptoms may benefit from antimuscarinic therapy, with or without an alpha-adrenergic antagonist.

OBJECTIVES

To evaluate the safety and efficacy of tolterodine extended release (ER), tamsulosin, or tolterodine ER+tamsulosin in men meeting symptom entry criteria for OAB and prostatic enlargement trials, stratified by prostate size.

DESIGN, SETTING, AND PARTICIPANTS

Subjects with an International Prostate Symptom Score (IPSS) >or=12; frequency and urgency, with or without urgency urinary incontinence; postvoid residual volume (PVR) <200 mL; and maximum urinary flow rate (Q(max)) >5 mL/s were randomized to receive placebo, tolterodine ER (4 mg), tamsulosin (0.4 mg), or tolterodine ER+tamsulosin for 12 wk. Data were stratified by median baseline prostate volume (<29 mL vs >or=29 mL).

MEASUREMENTS

Endpoints included week 12 changes in bladder diary variables, IPSS scores, and safety variables.

RESULTS AND LIMITATIONS

Among men with larger prostates, tolterodine ER+tamsulosin significantly improved frequency (p=0.001); urgency (p=0.006); and IPSS total (p=0.001), storage (p<0.001), and voiding scores (p<0.013). Tamsulosin significantly improved IPSS voiding scores (p=0.030). Among men with smaller prostates, tolterodine ER significantly improved frequency (p=0.016), UUI episodes (p=0.036), and IPSS storage scores (p=0.005). Tolterodine ER+tamsulosin significantly improved frequency (p=0.001) and IPSS storage scores (p=0.018). Tamsulosin significantly improved nocturnal frequency (p=0.038) and IPSS voiding (p=0.036) and total scores (p=0.044). There were no clinically or statistically significant changes in Q(max) or PVR; incidence of acute urinary retention (AUR) was low in all groups (<or=2%).

CONCLUSIONS

Men with smaller prostates and moderate-to-severe LUTS including OAB symptoms benefited from tolterodine ER. Therapy with tolterodine ER+tamsulosin was effective regardless of prostate size. Tolterodine ER, with or without tamsulosin, was well tolerated and not associated with increased incidence of AUR.

Authors+Show Affiliations

Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9110, USA. claus.roehrborn@utsouthwestern.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18583022

Citation

Roehrborn, Claus G., et al. "Tolterodine Extended Release With or Without Tamsulosin in Men With Lower Urinary Tract Symptoms Including Overactive Bladder Symptoms: Effects of Prostate Size." European Urology, vol. 55, no. 2, 2009, pp. 472-9.
Roehrborn CG, Kaplan SA, Jones JS, et al. Tolterodine extended release with or without tamsulosin in men with lower urinary tract symptoms including overactive bladder symptoms: effects of prostate size. Eur Urol. 2009;55(2):472-9.
Roehrborn, C. G., Kaplan, S. A., Jones, J. S., Wang, J. T., Bavendam, T., & Guan, Z. (2009). Tolterodine extended release with or without tamsulosin in men with lower urinary tract symptoms including overactive bladder symptoms: effects of prostate size. European Urology, 55(2), 472-9. https://doi.org/10.1016/j.eururo.2008.06.032
Roehrborn CG, et al. Tolterodine Extended Release With or Without Tamsulosin in Men With Lower Urinary Tract Symptoms Including Overactive Bladder Symptoms: Effects of Prostate Size. Eur Urol. 2009;55(2):472-9. PubMed PMID: 18583022.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tolterodine extended release with or without tamsulosin in men with lower urinary tract symptoms including overactive bladder symptoms: effects of prostate size. AU - Roehrborn,Claus G, AU - Kaplan,Steven A, AU - Jones,J Stephen, AU - Wang,Joseph T, AU - Bavendam,Tamara, AU - Guan,Zhonghong, Y1 - 2008/06/17/ PY - 2007/12/21/received PY - 2008/06/03/accepted PY - 2008/6/28/pubmed PY - 2009/9/26/medline PY - 2008/6/28/entrez SP - 472 EP - 9 JF - European urology JO - Eur. Urol. VL - 55 IS - 2 N2 - BACKGROUND: Some men with lower urinary tract symptoms (LUTS) including overactive bladder (OAB) symptoms may benefit from antimuscarinic therapy, with or without an alpha-adrenergic antagonist. OBJECTIVES: To evaluate the safety and efficacy of tolterodine extended release (ER), tamsulosin, or tolterodine ER+tamsulosin in men meeting symptom entry criteria for OAB and prostatic enlargement trials, stratified by prostate size. DESIGN, SETTING, AND PARTICIPANTS: Subjects with an International Prostate Symptom Score (IPSS) >or=12; frequency and urgency, with or without urgency urinary incontinence; postvoid residual volume (PVR) <200 mL; and maximum urinary flow rate (Q(max)) >5 mL/s were randomized to receive placebo, tolterodine ER (4 mg), tamsulosin (0.4 mg), or tolterodine ER+tamsulosin for 12 wk. Data were stratified by median baseline prostate volume (<29 mL vs >or=29 mL). MEASUREMENTS: Endpoints included week 12 changes in bladder diary variables, IPSS scores, and safety variables. RESULTS AND LIMITATIONS: Among men with larger prostates, tolterodine ER+tamsulosin significantly improved frequency (p=0.001); urgency (p=0.006); and IPSS total (p=0.001), storage (p<0.001), and voiding scores (p<0.013). Tamsulosin significantly improved IPSS voiding scores (p=0.030). Among men with smaller prostates, tolterodine ER significantly improved frequency (p=0.016), UUI episodes (p=0.036), and IPSS storage scores (p=0.005). Tolterodine ER+tamsulosin significantly improved frequency (p=0.001) and IPSS storage scores (p=0.018). Tamsulosin significantly improved nocturnal frequency (p=0.038) and IPSS voiding (p=0.036) and total scores (p=0.044). There were no clinically or statistically significant changes in Q(max) or PVR; incidence of acute urinary retention (AUR) was low in all groups (<or=2%). CONCLUSIONS: Men with smaller prostates and moderate-to-severe LUTS including OAB symptoms benefited from tolterodine ER. Therapy with tolterodine ER+tamsulosin was effective regardless of prostate size. Tolterodine ER, with or without tamsulosin, was well tolerated and not associated with increased incidence of AUR. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/18583022/Tolterodine_extended_release_with_or_without_tamsulosin_in_men_with_lower_urinary_tract_symptoms_including_overactive_bladder_symptoms:_effects_of_prostate_size_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(08)00697-0 DB - PRIME DP - Unbound Medicine ER -