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Therapeutic effect of α-blockers and antimuscarinics in male lower urinary tract symptoms based on the International Prostate Symptom Score subscore ratio.
Int J Clin Pract. 2012 Feb; 66(2):139-45.IJ

Abstract

AIMS

To investigate if the International Prostate Symptom Score (IPSS) voiding-to-storage subscore ratio (IPSS-V/S) can help to guide the treatment for male lower urinary tract symptoms (LUTS).

METHODS

Men aged 40 years or older with a total IPSS (IPSS-T) 8 or more were constitutively enrolled from January 2010 to December 2010. The IPSS voiding (IPSS-V) and storage subscore (IPSS-S) were recorded separately, and the IPSS-V/S was calculated. Patients were divided into two groups according to the baseline IPSS-V/S value. First-line doxazosin (4 mg per day) and tolterodine (4 mg per day) monotherapy were given to patients with IPSS-V/S > 1 and IPSS-V/S ≤ 1, respectively. The IPSS-T, IPSS-V, IPSS-S, quality of life (QoL), maximum flow rate (Qmax), voided volume and postvoid residual (PVR) were measured at 1 month (visit 1) and 3 months (visit 2) after treatment.

RESULTS

After medical treatment for 1 month, 89/116 (76.7%) patients receiving tolterodine and 218/279 (78.1%) patients receiving doxazosin reported an improved outcome (global response assessment, GRA ≥ 1 point). The mean IPSS-T, IPSS-S decreased, and QoL improved significantly in both groups. Significant increased Qmax, voided volume, decreased IPSS-V and PVR were noted only in patients receiving doxazosin. There was no significant increase of PVR (from 50.1 to 60.4 ml, p = 0.106), and no patient developed urinary retention after tolterodinie monotherapy for 1 month. However, patients aged more than 70 years had significant association with increased PVR (≥ 50 ml).

CONCLUSION

Initial treatment with doxazosin for patients with IPSS-V/S > 1 and tolterodine for patients with IPSS-V/S ≤ 1 is safe and feasible. Elderly people (≥ 70 years) and patients with Qmax < 10 ml/s are more likely to have increased PVR (≥ 50 ml).

Authors+Show Affiliations

Division of Urology, Department of Surgery, Cardinal Tien Hospital, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22257039

Citation

Liao, C-H, et al. "Therapeutic Effect of Α-blockers and Antimuscarinics in Male Lower Urinary Tract Symptoms Based On the International Prostate Symptom Score Subscore Ratio." International Journal of Clinical Practice, vol. 66, no. 2, 2012, pp. 139-45.
Liao CH, Lin VC, Chung SD, et al. Therapeutic effect of α-blockers and antimuscarinics in male lower urinary tract symptoms based on the International Prostate Symptom Score subscore ratio. Int J Clin Pract. 2012;66(2):139-45.
Liao, C. H., Lin, V. C., Chung, S. D., & Kuo, H. C. (2012). Therapeutic effect of α-blockers and antimuscarinics in male lower urinary tract symptoms based on the International Prostate Symptom Score subscore ratio. International Journal of Clinical Practice, 66(2), 139-45. https://doi.org/10.1111/j.1742-1241.2011.02864.x
Liao CH, et al. Therapeutic Effect of Α-blockers and Antimuscarinics in Male Lower Urinary Tract Symptoms Based On the International Prostate Symptom Score Subscore Ratio. Int J Clin Pract. 2012;66(2):139-45. PubMed PMID: 22257039.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapeutic effect of α-blockers and antimuscarinics in male lower urinary tract symptoms based on the International Prostate Symptom Score subscore ratio. AU - Liao,C-H, AU - Lin,V C, AU - Chung,S-D, AU - Kuo,H-C, PY - 2012/1/20/entrez PY - 2012/1/20/pubmed PY - 2012/3/14/medline SP - 139 EP - 45 JF - International journal of clinical practice JO - Int J Clin Pract VL - 66 IS - 2 N2 - AIMS: To investigate if the International Prostate Symptom Score (IPSS) voiding-to-storage subscore ratio (IPSS-V/S) can help to guide the treatment for male lower urinary tract symptoms (LUTS). METHODS: Men aged 40 years or older with a total IPSS (IPSS-T) 8 or more were constitutively enrolled from January 2010 to December 2010. The IPSS voiding (IPSS-V) and storage subscore (IPSS-S) were recorded separately, and the IPSS-V/S was calculated. Patients were divided into two groups according to the baseline IPSS-V/S value. First-line doxazosin (4 mg per day) and tolterodine (4 mg per day) monotherapy were given to patients with IPSS-V/S > 1 and IPSS-V/S ≤ 1, respectively. The IPSS-T, IPSS-V, IPSS-S, quality of life (QoL), maximum flow rate (Qmax), voided volume and postvoid residual (PVR) were measured at 1 month (visit 1) and 3 months (visit 2) after treatment. RESULTS: After medical treatment for 1 month, 89/116 (76.7%) patients receiving tolterodine and 218/279 (78.1%) patients receiving doxazosin reported an improved outcome (global response assessment, GRA ≥ 1 point). The mean IPSS-T, IPSS-S decreased, and QoL improved significantly in both groups. Significant increased Qmax, voided volume, decreased IPSS-V and PVR were noted only in patients receiving doxazosin. There was no significant increase of PVR (from 50.1 to 60.4 ml, p = 0.106), and no patient developed urinary retention after tolterodinie monotherapy for 1 month. However, patients aged more than 70 years had significant association with increased PVR (≥ 50 ml). CONCLUSION: Initial treatment with doxazosin for patients with IPSS-V/S > 1 and tolterodine for patients with IPSS-V/S ≤ 1 is safe and feasible. Elderly people (≥ 70 years) and patients with Qmax < 10 ml/s are more likely to have increased PVR (≥ 50 ml). SN - 1742-1241 UR - https://www.unboundmedicine.com/medline/citation/22257039/Therapeutic_effect_of_α_blockers_and_antimuscarinics_in_male_lower_urinary_tract_symptoms_based_on_the_International_Prostate_Symptom_Score_subscore_ratio_ DB - PRIME DP - Unbound Medicine ER -