Urodynamic parameters after solifenacin treatment in men with overactive bladder symptoms and detrusor underactivity

Ronchi, Piero; Gravina, Giovanni Luca; Galatioto, Giuseppe Paradiso; Costa, Alessia Mariagrazia; Martella, Oreste; Vicentini, Carlo

doi:10.1002/nau.20586

Cited by 22 publications

(17 citation statements)

References 17 publications

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“…Ronchi et al. evaluated the efficacy of solifenacin 5 mg once daily in a non‐comparative prospective study of 49 men aged ≥ 40 years with OAB and urodynamically diagnosed detrusor underactivity (41). After 4 months, solifenacin significantly improved bladder diary variables and PPBC scores.…”

Section: Resultsmentioning

confidence: 99%

“…These findings are important because the storage symptoms that define OAB are common and bothersome in men and adversely affect HRQL, perhaps to a greater extent than voiding symptoms (12,52,53). Most of the evidence suggests that antimuscarinics alone can effectively treat OAB symptoms in men (13,29,(33)(34)(35)(36)38,41). However, tolterodine ER alone was not very effective in the general population of the TIMES study (19)(20)(21), which likely reflects the unique TIMES study population.…”

Section: Discussionmentioning

confidence: 96%

“…In the TIMES and ADAM studies, changes in PVR and Q max were not clinically significant and rates of AUR were low in men treated with tolterodine ER, with or without an a-blocker, regardless of PSA level or prostate size (19,(22)(23)(24)(25). Similarly, in oxybutynin, propiverine and solifenacin studies, there was little indication of safety concerns in men whether these agents were used with an ablocker or as monotherapy (37)(38)(39)41,42). The results of smaller prospective studies and post hoc analyses support these findings.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Antimuscarinics for treatment of storage lower urinary tract symptoms in men: a systematic review

Kaplan

Roehrborn

Abrams

et al. 2011

International Journal of Clinical Practice

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Despite potential benefits, primary care clinicians may avoid using antimuscarinics in men with overactive bladder (OAB) symptoms because of safety concerns. To review the efficacy and safety of antimuscarinics, alone or in combination with an α-blocker, for the treatment of men with OAB symptoms, we conducted a systematic review of articles published before 22 July 2010, using PubMed. Data from 12-week, randomised, double-blind, placebo-controlled trials of tolterodine extended release (ER), oxybutynin and solifenacin show that combined antimuscarinic+α-blocker treatment is generally more effective than monotherapy or placebo in men with OAB symptoms. The efficacy and safety of tolterodine ER+α-blocker treatment was not affected by prostate size or prostate-specific antigen (PSA) level. In men meeting entry criteria for OAB and benign prostatic obstruction trials, tolterodine ER alone was effective selectively in men with prostate size or PSA level below study medians. Incidence of acute urinary retention (AUR) in men receiving antimuscarinics with or without an α-blocker was ≤3% in all of these trials; changes in postvoid residual volume and maximum flow rate did not appear clinically meaningful. Post hoc analyses from double-blind, placebo-controlled trials and prospective studies of fesoterodine, oxybutynin, propiverine, solifenacin and tolterodine also suggest that antimuscarinics are generally safe and efficacious in men. A retrospective database study found that risk of AUR in men was the highest in the first month of treatment and decreased considerably thereafter. Antimuscarinics, alone or with an α-blocker, appear to be efficacious and safe in many men with predominant OAB symptoms or persistent OAB symptoms despite α-blocker or 5-α-reductase inhibitor treatment. However, antimuscarinics are not approved for the treatment of benign prostatic hyperplasia. Monitoring men for AUR is recommended, especially those at increased risk, and particularly within 30 days after starting antimuscarinic treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Antimuscarinics for treatment of storage lower urinary tract symptoms in men: a systematic review

Kaplan

Roehrborn

Abrams

et al. 2011

International Journal of Clinical Practice

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show abstract

“…The changes of urodynamic parameters after solifenacin treatment in men with OAB and detrusor underactivity were reported 12 . The bladder contractility index (BCI) was significantly decreased after solifenacin treatment and this change showed that solifenacin decreased bladder contraction during the urine voiding phase.…”

Section: Discussionmentioning

confidence: 99%

Urodynamic effects of solifenacin in untreated female patients with symptomatic overactive bladder

2010

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Objectives:To investigate the urodynamic effects of solifenacin in untreated female patients with symptomatic overactive bladder (OAB). Methods: A total of 52 untreated female patients with OAB symptoms were given 5 mg solifenacin once daily for 12 weeks. Before and after treatment, the frequency volume chart, overactive bladder symptom score (OABSS), postvoid residual volume, filling cystometry and adverse events were evaluated. Results: After solifenacin treatment, OAB symptoms were improved , voided volume was increased and voiding number was decreased. Bladder capacities at the first sensation of bladder filling, first desire to void and strong desire to void were significantly increased. Intravesical pressure at the first sensation of bladder filling was significantly decreased. Detrusor overactivity (DO) disappeared in five patients. For 28 patients with persisting DO after treatment, bladder capacity at DO was significantly increased. Both groups with and without DO at baseline had significant improvements of OAB symptoms. Conclusions: Solifenacin urodynamically increases bladder capacity in female patients with symptomatic OAB.

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“…As regards solifenacin, Tanaka et al [20] found a significant increase of bladder capacity and of PVR in female patients with OAB, but in this study data regarding the voiding phase of micturition have not been reported. Ronchi et al [21] found a significant decrease of the bladder contractility index after solifenacin treatment in men with OAB and detrusor underactivity; these data show that solifenacin decreases bladder contraction during the urine voiding phase [20], whereas no significant differences were found by Hsiao et al [22] in changes of Qmax and pdet.Qmax after solifenacin in female patients with OAB. As regards patients with outlet obstruction, mirabegron did not adversely affect the voiding function [23].…”

Section: Discussionmentioning

confidence: 97%

Comparison of Therapeutic Efficacy and Urodynamic Findings of Solifenacin Succinate versus Mirabegron in Women with Overactive Bladder Syndrome: Results of a Randomized Controlled Study

Scaldazza¹,

Morosetti²

2016

Urol Int

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Introduction: We assessed clinical and urodynamic effects of solifenacin versus mirabegron in women with overactive bladder (OAB) syndrome. Material and Methods: Eighty women with OAB were randomized into 2 groups. In group A, the patients received solifenacin 5 mg once a day for 12 weeks; in group B, the patients received mirabegron 50 mg once a day for 12 weeks. Symptoms were assessed with OAB Symptom Score (OABSS). Patients underwent urodynamic investigation with pressure flow study. OABSS and urodynamic study were performed before and after treatment. Results: Both solifenacin and mirabegron were effective in improving OAB symptoms. Mirabegron showed greater tolerability with fewer patients discontinuing therapy because of side effects. Both solifenacin and mirabegron were effective in improving the storage function in the pressure flow study, but solifenacin showed a significant reduction of the detrusor pressure in the voiding phase with an increase in the postvoid residual urine volume. Conclusions: Mirabegron has shown to be a drug with the better balance between efficacy and tolerability in women with OAB.

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Urodynamic parameters after solifenacin treatment in men with overactive bladder symptoms and detrusor underactivity

Abstract: Solifenacin treatment results in changes of urodynamic parameters. These changes, however, seem not to be of clinical significance as suggested by the lack of subjective deterioration in voiding difficulties and by the low incidence of AUR.

Cited by 22 publications

References 17 publications

Antimuscarinics for treatment of storage lower urinary tract symptoms in men: a systematic review

Antimuscarinics for treatment of storage lower urinary tract symptoms in men: a systematic review

Urodynamic effects of solifenacin in untreated female patients with symptomatic overactive bladder

Comparison of Therapeutic Efficacy and Urodynamic Findings of Solifenacin Succinate versus Mirabegron in Women with Overactive Bladder Syndrome: Results of a Randomized Controlled Study

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