Efficacy of tolterodine in preventing urge incontinence immediately after prostatectomy.
OBJECTIVE
Urgency and urge incontinence are frequently observed after prostatectomy. Although symptoms ameliorate within a relatively short time, they usually cause significant stress and anxiety to the patient as far as their duration is concerned. Aim of our study was to determine the efficacy of tolterodine in preventing urgency and urge incontinence after catheter removal in patients that underwent prostatectomy for benign prostate hyperplasia.


METHODS
Twenty-seven patients with moderate/severe lower urinary tract symptoms due to benign prostatic enlargement, scheduled for prostatectomy, were randomised into two groups, Group A (14 pts) received tolterodine 2 mg b.i.d starting the day of surgery, while group B patients received no such treatment. Tolterodine treatment was discontinued 15 days after catheter removal. All patients completed the International Prostatic Symptom Score (IPSS) and the International Continence Society (ICS-BPH) forms the day before surgery, and three times more, one, fifteen and thirty days after catheter removal.


RESULTS
Pre-operative total 1PSS and frequency of urgency/urge incontinence as determined by questions 3 and 4 of the ICS-BPH questionnaire were equally distributed between groups. Tolterodine was well tolerated and no adverse effects were reported. Post-operative IPSS and QoL scores did not differ between groups. However, the frequency of urge incontinence both the first day and fifteen days after catheter removal was significantly lower in the tolterodine group (16.6% vs. 69.2%, p=0.004 and 8.3% vs. 38.4%, p=0.039, respectively).


CONCLUSIONS
Tolterodine was well tolerated in all patients and had a beneficial effect regarding the postoperative urge incontinence. Trials of a larger scale could determine which patients would benefit more, especially according to the presence of storage lower urinary tract symptoms prior to surgery.
Mitropoulos
Dionisios
D
Department of Urology, Medical School, University of Athens, Laikon Hospital Ag.Thoma 17, 11528, Athens, Greece. dmp@otenet.gr
Papadoukakis
Stefanos
S
Zervas
Anastasios
A
Alamanis
Christos
C
Giannopoulos
Aris
A
D000368:Aged; D001559:Benzhydryl Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D003408:Cresols / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010665:Phenylpropanolamine / Q000008:administration & dosage* / Q000009:adverse effects; D011468:Prostatectomy / Q000009:adverse effects*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery; D011795:Surveys and Questionnaires; D000068737:Tolterodine Tartrate; D016896:Treatment Outcome; D053202:Urinary Incontinence, Urge / Q000188:drug therapy / Q000517:prevention & control*
D001559:Benzhydryl Compounds; D003408:Cresols; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate