BERKELEY, CA (UroToday.com) - In our study, we included male patients with both voiding and storage symptoms. Understandably, the most frequently observed lower urinary tract symptoms (LUTS) in real clinical circumstances are both voiding and storage symptoms.
The incidence of overactive bladder (OAB) associated with benign prostatic obstruction (BPO) is 40 to 75%, and because the symptoms of the 2 are similar and often overlap, it can be difficult to separate them diagnostically. However, most previous clinical studies focused on either of the 2 symptoms. Our study is important in that we included male patients with not only storage (storage sub-score ³ 6) but also voiding (voiding sub-score ³ 8) symptoms.
Most urologists appear to give more weight to elderly men with voiding symptoms than storage symptoms, and they are more concerned with initial anticholinergic treatment for males with storage symptoms. The 2010 guidelines from the European Association of Urologists suggested that combination treatment should cautiously be prescribed in men who are suspicious of having BPO. In a clinical practice setting, many physicians are still reluctant to prescribe anticholinergics due to the concern of acute urinary retention (AUR), especially in men with voiding symptoms. 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. Our results will help encourage urologists to treat patients with concomitant voiding and storage symptoms with combined alpha-blockers and anticholinergic agents without fear of AUR.
Seung Hwan Lee, MD, as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations, etc... of their research by referencing the published abstract.
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 - Abstract