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Tolterodine treatment improves storage symptoms suggestive of overactive bladder in men treated with alpha-blockers.
Eur Urol. 2009 Sep; 56(3):534-41.EU

Abstract

BACKGROUND

Some men receiving alpha-blocker therapy for lower urinary tract symptoms report persistent storage symptoms suggestive of overactive bladder (OAB).

OBJECTIVE

To evaluate the efficacy of tolterodine extended release (ER) in men on alpha-blocker therapy.

DESIGN, SETTING, AND PARTICIPANTS

This double-blind trial included men aged > or = 40 yr with frequency, urgency, and at least moderate problems reported on the Patient Perception of Bladder Condition (PPBC), despite being on a stable dose of alpha-blocker for > or = 1 mo.

INTERVENTIONS

Subjects were randomized to tolterodine ER 4 mg per day or placebo for 12 wk while continuing their prescribed alpha-blocker therapy.

MEASUREMENTS

At baseline and week 12, subjects completed the PPBC, International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire (OAB-q), and 5-d bladder diaries using the five-point Urinary Sensation Scale (USS). Frequency-urgency sum was defined as the sum of USS ratings for all micturitions.

RESULTS AND LIMITATIONS

PPBC improvement from baseline to week 12 was reported by 63.6% and 61.6% of subjects receiving tolterodine ER plus alpha-blocker and placebo plus alpha-blocker, respectively; this treatment difference, which was the primary end point, was not statistically significant (p>0.6699). At week 12, subjects receiving tolterodine ER plus alpha-blocker had significantly greater improvements versus placebo plus alpha-blocker in 24-h micturitions (-1.8 vs -1.2; p=0.0079) and daytime micturitions (-1.3 vs -0.8; p=0.0123); 24-h urgency episodes (-2.9 vs -1.8; p=0.0010), daytime urgency episodes (-2.2 vs -1.4; p=0.0017), and nocturnal urgency episodes (-0.5 vs -0.3; p=0.0378); frequency-urgency sum (-7.8 vs -5.1; p=0.0065); IPSS storage subscale (-2.6 vs -2.1; p=0.0370); and OAB-q symptom bother scale (-17.9 vs -14.4; p=0.0086) and coping domain (15.4 vs 12.4; p=0.0491). Acute urinary retention requiring catheterization occurred in < 1% of either group. There were no clinically meaningful changes in postvoid residual volume or maximum urinary flow rate.

CONCLUSIONS

Men with bothersome OAB symptoms despite continued alpha-blocker therapy showed significantly greater improvements in diary variables, IPSS Storage scores, and symptom bother when receiving additional tolterodine ER versus placebo plus alpha-blocker.

Authors+Show Affiliations

Sheffield Teaching Hospitals, Sheffield, UK. c.r.chapple@shef.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19070418

Citation

Chapple, Christopher, et al. "Tolterodine Treatment Improves Storage Symptoms Suggestive of Overactive Bladder in Men Treated With Alpha-blockers." European Urology, vol. 56, no. 3, 2009, pp. 534-41.
Chapple C, Herschorn S, Abrams P, et al. Tolterodine treatment improves storage symptoms suggestive of overactive bladder in men treated with alpha-blockers. Eur Urol. 2009;56(3):534-41.
Chapple, C., Herschorn, S., Abrams, P., Sun, F., Brodsky, M., & Guan, Z. (2009). Tolterodine treatment improves storage symptoms suggestive of overactive bladder in men treated with alpha-blockers. European Urology, 56(3), 534-41. https://doi.org/10.1016/j.eururo.2008.11.026
Chapple C, et al. Tolterodine Treatment Improves Storage Symptoms Suggestive of Overactive Bladder in Men Treated With Alpha-blockers. Eur Urol. 2009;56(3):534-41. PubMed PMID: 19070418.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tolterodine treatment improves storage symptoms suggestive of overactive bladder in men treated with alpha-blockers. AU - Chapple,Christopher, AU - Herschorn,Sender, AU - Abrams,Paul, AU - Sun,Franklin, AU - Brodsky,Marina, AU - Guan,Zhonghong, Y1 - 2008/11/24/ PY - 2008/07/07/received PY - 2008/11/14/accepted PY - 2008/12/17/entrez PY - 2008/12/17/pubmed PY - 2009/12/25/medline SP - 534 EP - 41 JF - European urology JO - Eur. Urol. VL - 56 IS - 3 N2 - BACKGROUND: Some men receiving alpha-blocker therapy for lower urinary tract symptoms report persistent storage symptoms suggestive of overactive bladder (OAB). OBJECTIVE: To evaluate the efficacy of tolterodine extended release (ER) in men on alpha-blocker therapy. DESIGN, SETTING, AND PARTICIPANTS: This double-blind trial included men aged > or = 40 yr with frequency, urgency, and at least moderate problems reported on the Patient Perception of Bladder Condition (PPBC), despite being on a stable dose of alpha-blocker for > or = 1 mo. INTERVENTIONS: Subjects were randomized to tolterodine ER 4 mg per day or placebo for 12 wk while continuing their prescribed alpha-blocker therapy. MEASUREMENTS: At baseline and week 12, subjects completed the PPBC, International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire (OAB-q), and 5-d bladder diaries using the five-point Urinary Sensation Scale (USS). Frequency-urgency sum was defined as the sum of USS ratings for all micturitions. RESULTS AND LIMITATIONS: PPBC improvement from baseline to week 12 was reported by 63.6% and 61.6% of subjects receiving tolterodine ER plus alpha-blocker and placebo plus alpha-blocker, respectively; this treatment difference, which was the primary end point, was not statistically significant (p>0.6699). At week 12, subjects receiving tolterodine ER plus alpha-blocker had significantly greater improvements versus placebo plus alpha-blocker in 24-h micturitions (-1.8 vs -1.2; p=0.0079) and daytime micturitions (-1.3 vs -0.8; p=0.0123); 24-h urgency episodes (-2.9 vs -1.8; p=0.0010), daytime urgency episodes (-2.2 vs -1.4; p=0.0017), and nocturnal urgency episodes (-0.5 vs -0.3; p=0.0378); frequency-urgency sum (-7.8 vs -5.1; p=0.0065); IPSS storage subscale (-2.6 vs -2.1; p=0.0370); and OAB-q symptom bother scale (-17.9 vs -14.4; p=0.0086) and coping domain (15.4 vs 12.4; p=0.0491). Acute urinary retention requiring catheterization occurred in < 1% of either group. There were no clinically meaningful changes in postvoid residual volume or maximum urinary flow rate. CONCLUSIONS: Men with bothersome OAB symptoms despite continued alpha-blocker therapy showed significantly greater improvements in diary variables, IPSS Storage scores, and symptom bother when receiving additional tolterodine ER versus placebo plus alpha-blocker. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/19070418/Tolterodine_treatment_improves_storage_symptoms_suggestive_of_overactive_bladder_in_men_treated_with_alpha_blockers_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(08)01359-6 DB - PRIME DP - Unbound Medicine ER -