The Evolution of Detrusor Overactivity After Watchful Waiting, Medical Therapy and Surgery in Patients with Bladder Outlet Obstruction

NUNZIO, COSIMO de; Franco, Giorgio; ROCCHEGIANI, ANDREA; Iori, F.; LEONARDO, COSTANTINO; Laurenti, C

doi:10.1097/00005392-200302000-00021

Cited by 43 publications

(70 citation statements)

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“…Retreatment rates are high with BOO, based on a pressure-flow study [4]. In addition, in a study by de Nunzio et al in 101 BPH patients with BOO and detrusor overactivity (DO) [15], finasteride and/or alfuzosin had no effects on IPSS, IPSS-QOL or maximum flow rate (Q max ), whereas prostatectomy was effective. Thus, a PVR ‡ 30 ml should be considered a risk factor for treatment failure.…”

Section: Discussionmentioning

confidence: 99%

Long-term treatment and prognostic factors of α₁-blockers for lower urinary tract symptoms associated with benign prostatic hyperplasia: A pilot study comparing naftopidil and tamsulosin hydrochloride

Kawachi

Sakurai

Sugimura

et al. 2010

Scandinavian Journal of Urology and Nephrology

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Section: Discussionmentioning

confidence: 99%

Long-term treatment and prognostic factors of α₁-blockers for lower urinary tract symptoms associated with benign prostatic hyperplasia: A pilot study comparing naftopidil and tamsulosin hydrochloride

Kawachi

Sakurai

Sugimura

et al. 2010

Scandinavian Journal of Urology and Nephrology

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“…4 However, storage symptoms often occur independently of BPO and persist in many men, despite pharmacological or surgical treatment. 5 Therefore, therapies that target the prostate often fail to alleviate OAB and may not be the most appropriate therapy for men with storage LUTS. 3 If OAB can be detected early, then combination therapy can be instituted and more men can show clinical improvement sooner, with no additional adverse events.…”

Section: Introductionmentioning

confidence: 99%

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

Lee

Chung

Kim

et al. 2011

Prostate Cancer Prostatic Dis

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Initial combined treatment with anticholinergics and a-blockers for men with lower urinary tract symptoms related to BPH and overactive bladder: a prospective, randomized, multi-center, double-blind, placebo-controlled study We aimed to evaluate the efficacy and safety of combination treatment using anticholinergics with a-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 a-blocker was tolerated well, including the questions about urinary retention (n ¼ 1) and dry mouth (n ¼ 2). Initial combination treatment of anticholinergics plus a-blocker showed positive results for men with LUTS related to BPH and OAB symptoms and did not increase the risk of urinary retention.

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“…15 When OAB symptoms develop in patients with LUTS accompanied by BPH, the condition becomes more complicated. Thus, monitoring the response to treatment also becomes more important.…”

Section: Discussionmentioning

confidence: 99%

Additive Role of Trospium Chloride in the Management of Men with Voiding and Storage Symptoms

Malkoç¹,

Ateş²,

Şenkul³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : In patients who suffer from Lower Urinary Tract Symptom (LUTS) and overactive bladder (OAB), the quality of life is affected negatively. The aim of this study was to assess the efficacy and safety of trospium chloride, which is here used for the first time in an alpha-blocker and anticholinergic combination therapy for older men who suffer from benign prostate hypertrophy (BPH)-related LUTS with OAB. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This prospective, randomized, placebo controlled, double-blind trial included men aged ≥45 years with LUTS and OAB. Subjects were randomized into trospium chloride 45 mg with terazosin 5 mg or placebo with terazosin 5mg for 12 weeks. At baseline and week 12, subjects were evaluated using total prostate serum antigen, uroflowmetry, and post voiding residual urine (PVRU) and completed the International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire (OAB-q), 3-day bladder diaries, BPH impact index, and Urolife quality of life questionnaire form. The patients were monitored for side effects and safety at 4, 8 and 12 weeks. R Re es su ul lt ts s: : While the improvement in maximum and average urination streams, PVRU, bladder capacity, IPSS, OAB, BPH impact index scores was not significant, ther was significant improvement in Urolife quality of life questionnaire score and voiding frequency in favour of the trospium chloride group (0.0009 and 0.0216 respectively). There was no statistically significant difference in side effect profile between the groups. C Co on nc cl lu us si io on n: : In men with BPH-related OAB trospium chloride and alpha-blocker combination treatment is effective and safe. The improvement in quality of life is remarkable. K Ke ey y W Wo or rd ds s: : Prostatic hyperplasia; lower urinary tract symptoms; urinary bladder, overactive; cholinergic antagonists; male Ö ÖZ ZE ET T A Am ma aç ç: : Benign prostat hipertrofisi (BPH) ve aşırı aktif mesane (AAM) birlikteliğinin görüldüğü hastalarda yaşam kalitesi olumsuz yönde etkilenmektedir. Bu çalışmanın amacı, BPH ve buna bağlı alt üriner sistem yakınmaları olan ileri yaştaki erkeklerin tedavisinde kullanılan alfa bloker ve antikolinerjik kombinasyonunda daha önce hiç denenmemiş olan trospiyum klorürün etkinliğinin ve güveni-lirliğinin araştırılmasıdır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : İleri dönük, randomize, plasebo kontrollü ve çift kör olarak planlanan çalışma, alt üriner sistem yakınmaları ve aşırı aktif mesanesi olan 45 yaşından büyük hastaları kapsamaktadır. Hastalar 12 hafta boyunca 45 mg trospiyum klorür ile 5 mg terazosin veya plasebo ve 5 mg terazosin almak üzere randomize edilmiştir. Çalışmanın başlangıcında ve 12. haftada hastalar total prostat serum antijeni, üroflovmetri, işeme sonrası üriner kalıntı, enternasyonel prostat semptom skoru, AAM sorgulama formu, 3 günlük işeme günlüğü, BPH etki indeksi ve Urolife yaşam kalitesi sorgu formu kullanılarak değerlendirilmiştir. Hastalar 4., 8. ve 12. h...

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The Evolution of Detrusor Overactivity After Watchful Waiting, Medical Therapy and Surgery in Patients with Bladder Outlet Obstruction

Cited by 43 publications

References 0 publications

Long-term treatment and prognostic factors of α₁-blockers for lower urinary tract symptoms associated with benign prostatic hyperplasia: A pilot study comparing naftopidil and tamsulosin hydrochloride

Long-term treatment and prognostic factors of α₁-blockers for lower urinary tract symptoms associated with benign prostatic hyperplasia: A pilot study comparing naftopidil and tamsulosin hydrochloride

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

Additive Role of Trospium Chloride in the Management of Men with Voiding and Storage Symptoms

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The Evolution of Detrusor Overactivity After Watchful Waiting, Medical Therapy and Surgery in Patients with Bladder Outlet Obstruction

Cited by 43 publications

References 0 publications

Long-term treatment and prognostic factors of α1-blockers for lower urinary tract symptoms associated with benign prostatic hyperplasia: A pilot study comparing naftopidil and tamsulosin hydrochloride

Long-term treatment and prognostic factors of α1-blockers for lower urinary tract symptoms associated with benign prostatic hyperplasia: A pilot study comparing naftopidil and tamsulosin hydrochloride

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

Additive Role of Trospium Chloride in the Management of Men with Voiding and Storage Symptoms

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Product

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Long-term treatment and prognostic factors of α₁-blockers for lower urinary tract symptoms associated with benign prostatic hyperplasia: A pilot study comparing naftopidil and tamsulosin hydrochloride

Long-term treatment and prognostic factors of α₁-blockers for lower urinary tract symptoms associated with benign prostatic hyperplasia: A pilot study comparing naftopidil and tamsulosin hydrochloride