An exploratory analysis of tamsulosin for Overactive Bladder (OAB) in men with varying voiding symptom burden.

To evaluate tamsulosin (α-blocker therapy) for male overactive bladder (OAB) and to examine if indicators of concomitant benign prostatic hyperplasia (BPH) are associated with OAB symptom improvement.

This was a planned, exploratory analysis of a 4-week, α-blocker (tamsulosin 0.4mg) run-in phase of the Male Overactive Bladder Trial in Veterans (MOTIVE). Participants with urinary urgency and urinary frequency (> 8 voids / 24 hours) completed bladder diaries, answered symptom questionnaires (AUA-7 SI), and had post-void residual and non-invasive uroflowmetry measurement.

116 male Veterans aged 42-88 years with OAB participated. There were statistically significant reductions in voiding frequency (11.3 to 10.0 voids/24 hours, p < .0001), urgency scores (mean 2.5 to 2.2 points, p < .0001), and nightly nocturia (2.1 to 1.8, p < .001). Only baseline AUA-7 SI total and voiding subscale categories (mild, moderate, severe) were associated with significant reduction in AUA-7 SI total score. For continuous variables, only AUA-7 SI baseline total score was associated with AUA-7 SI storage symptom changes. No other baseline measures were associated with changes in urgency, frequency, or nocturia.

Initiation of short course tamsulosin therapy in men was associated with statistical reduction in OAB symptoms. Baseline post-void residual, uroflow rate, and the voiding symptom sub-score of the AUA-7 SI were not predictive of OAB symptom improvement with tamsulosin. These findings merits further exploration.

Urology. 2021 Jan 19 [Epub ahead of print]

Theodore M Johnson, Patricia S Goode, Lee Hammontree, Alayne D Markland, Camille P Vaughan, Joseph G Ouslander, Kerac Falk, Gerald McGwin, Kathryn L Burgio

Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL and Atlanta, GA; Emory University, Atlanta, GA. Electronic address: ., Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL and Atlanta, GA; University of Alabama at Birmingham, Birmingham, AL., Urology Centers of Alabama. Electronic address: ., Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL and Atlanta, GA; University of Alabama at Birmingham, Birmingham, AL. Electronic address: ., Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL and Atlanta, GA; Emory University, Atlanta, GA. Electronic address: ., Charles E. Schmidt College of Medicine, Florida Atlantic University, Miami, FL. Electronic address: ., Emory University, Atlanta, GA. Electronic address: ., Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL and Atlanta, GA; University of Alabama at Birmingham, Birmingham, AL. Electronic address: ., Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL and Atlanta, GA; University of Alabama at Birmingham, Birmingham, AL. Electronic address: .

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