Tolterodine Extended Release Attenuates Lower Urinary Tract Symptoms in Men With Benign Prostatic Hyperplasia

Abstract

Treatment with tolterodine ER in men with BPH and LUTS may be a reasonable therapeutic option as initial therapy or after failed treatment with alpha-blockers.

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

“…However, prescribing anticholinergics to men with LUTS or even voiding symptoms was not shown to elevate the risk of AUR in previous studies, which is consistent with our results. [22][23][24] Our results will help encourage urologists to treat, initially, patients with concomitant voiding and storage symptoms with combined a-blocker and anticholinergic agent without fear of AUR.…”

Clinical Use of Tolterodine Extended Release in Overactive Bladder

“…These results are maintained over time. 7,[12][13][14][15] In males with lower urinary tract symptoms (LUTS) and non-obstructive benign prostate hyperplasia (BPH), urinary frequency, urgency episodes and UUI arereportedtobesignificantlyreduced,andmedian volume voided per micturition increased with Tolterodine ER, 16 while nocturnal micturitions, both severe and non-severe, have been found by Rackley et al 17 to be diminished in comparison to placebo (P = 0.0086). InassociationwithTamsulosin,significantimprovement in the International Prostate Symptom Score (IPSS) storage subscale (−2.6 vs. −2.1 with tamsulosin and placebo; P = 0.0370) and OAB symptom bother questionnaire (OABq) scores (−17.9 vs. −14.4; P = 0.0086) has been observed, along with a low incidence of acute urinary retention (less than 1%).…”

“…InassociationwithTamsulosin,significantimprovement in the International Prostate Symptom Score (IPSS) storage subscale (−2.6 vs. −2.1 with tamsulosin and placebo; P = 0.0370) and OAB symptom bother questionnaire (OABq) scores (−17.9 vs. −14.4; P = 0.0086) has been observed, along with a low incidence of acute urinary retention (less than 1%). 18,19 Kaplan et al 20 reported significant improvement of post void residual (PVR) in these patients. Men with small prostates and moderate-to-severe LUTS, including OAB symptoms, seem to benefit from Tolterodine ER monotherapy, while Tolterodine ER plus Tamsulosin combination appears to be effective regardless of prostate size.…”

Effects of Tolterodine and Tamsulosin Combination on Sypmtoms and Bladder Outlet Obstruction in Patients with Benign Prostate Hyperplasia

“…Ancak son yıllarda yapılan önemli bazı çalışmalarda AÜSS tedavisinde antimuskarinik ilaçların etkili ve güvenli olduğu vurgulanmaktadır ( 9,10). BPH medikal tedavisinde alfa blokör ilaçlar ile prostatik düz kas relaksayonu sağlanarak, 5 alfa redüktaz inhibitörleri ile de prostat boyutu küçültülerek ÜSS nın işeme semptomlarında düzelme elde edilirken, AAM ile ortak olan depolama semptomlarının tedavisi hakkında güncel bilgilere göre standart bir yaklaşım yoktur (11).…”

“…BPH tedavisinde tamsulusin monoterapisi ve tolterodin+tamsulosin kombinasyonunun obstrüksiyon bulguları üzerine etkilerini semptomatik ve ürodinamik açıdan karşılaştıran çalışmalar mevcut iken tolterodin monoterapi kolunu da içeren bir çalışma mevcut değildir (16,17,18,20 Kaplan ve arkadaşlarının başka bir çalışmalarında da daha önceden alfa blokör kullanan, yan etkilerden dolayı veya şikayetleri geçmediği için tedaviyi 1 ay veya daha uzun süre önce bırakan hastalara 6 ay boyunca tolterodin uygulanmış, sık idrara çıkma ve noktüride gözlenen iyileşmelerin istatistiksel olarak anlamlı olduğu görülmüş (17).…”