Published online Dec 30, 2011.
https://doi.org/10.5534/kja.2011.29.3.236
Experience of Combination Therapy with Alpha Adrenergic Receptor Antagonist and Anticholinergic Agent in Patients with Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia: 12 Month Follow-up
Abstract
Purpose
Through more than 12 months of follow-up, the efficacy and safety of combination therapy with alpha adrenergic receptor antagonist and anticholinergic agent was investigated retrospectively.
Materials and Methods
This study retrospectively analyzed the data of 84 patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) who were managed with an alpha adrenergic receptor antagonist and anticholinergic agent for at least 12 months between Jan 2007 and Dec 2010. On patients' first visit to our department, we obtained the patients' demographic data and information about the prostate total volume, serum prostate specific antigen (sPSA), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and postvoid residual (PVR) of each patient. After 12 months, changes in the above factors and the side-effects of anticholinergic agents were investigated.
Results
The mean age of the patients was 66.1 years and the total observation period after drug administration was an average 20 months; the total sPSA and prostatic volume of patients was 1.8±0.8 ng/dl and 37.3±9.5 g, respectively. Qmax in uroflowmetry was improved after 12 months of medication (changed from 9.0±3.4 to 13.8±4.5 ml/sec; p<0.001). PVR was increased from 35±22.2 ml to 49.3±37 ml (p<0.001), but the change was not clinically significant, and no acute urinary retention occurred. The total IPSS score decreased from 21.4±5.1 to 13.3±4.6 (p<0.001), the storage score of IPSS decreased from 9.8±2.4 to 5.6±2 (p<0.001), and the voiding score was decreased from 11.6±3.7 to 7.7±3.2 (p<0.001). The QoL with IPSS was improved from 4.2±0.8 to 2.8±0.7 (p<0.001). During the 12 months there were 34 patients (56 cases) of adverse events. However, no serious adverse events were reported.
Conclusions
Combination therapy with alpha adrenergic receptor antagonist and anticholinergic agent was safe and made an improvement in LUTS in patients with BPH and storage symptoms.
Table 1
Baseline characteristics, IPSS, and QoL index before and after combined therapy
Table 2
Reported adverse events during the medication period
References
-
Engström G, Henningsohn L, Walker-Engström ML, Leppert J. Impact on quality of life of different lower urinary tract symptoms in men measured by means of the SF 36 questionnaire. Scand J Urol Nephrol 2006;40:485–494.
-
-
Lee KS, Choo MS, Kim DY, Kim JC, Kim HJ, Min KS, et al. Combination treatment with propiverine hydrochloride plus doxazosin controlled release gastrointestinal therapeutic system formulation for overactive bladder and coexisting benign prostatic obstruction: a prospective, randomized, controlled multicenter study. J Urol 2005;174:1334–1338.
-
-
Chapple CR, Rechberger T, Al-Shukri S, Meffan P, Everaert K, Huang M, et al. YM-905 Study Group. Randomized, double-blind placebo- and tolterodine-controlled trial of the once-daily antimuscarinic agent solifenacin in patients with symptomatic overactive bladder. BJU Int 2004;93:303–310.
-
-
Hong WS, Chung H, Lee JM, Kim TW, Kim HS, Kim HJ, et al. Polypharmacy and central nervous system adverse effects of anticholinergic agents in the men with benign prostate hyperplasia. J Korean Continence Soc 2007;11:24–29.
-
-
Sun YH, Liu ZY, Zhang ZS, Xu CL, Ji JT, Wu YY, et al. Long-term efficacy and safety of tamsulosin hydrochloride for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: data from China. Chin Med J (Engl) 2011;124:56–60.
-