[Does alpha1-blocker provide additional improvement of quality-of-life in patients with overactive bladder?--a multi-center prospective randomized trial between anti-cholinergic (propiverine chloride) with and without alpha1-blocker (urapidil)].
OBJECTIVE
Storage/filling symptoms caused by overactive bladder (OAB) are bothersome to patients. The aim of this study is to clarify if alpha1-blocker provides additional benefit in combination with anticholinergic treatment in patients with OAB.


METHODS
In total, 100 patients (men/women: 43/57, mean age: 71.3 years) who had frequency (more than eight times a day) and urgency (more than three times a week) were prospectively randomized, and allocated to two groups (monotherapy group [n = 52]: propiverine alone or combination group [n = 48]: propiverine plus urapidil). The primary end point was to compare the improvement of storage symptoms (numbers of frequency, urgency, disappearance of urge incontinence) as well as patients' quality of life (QOL) assessed by King's Health Questionnaires (KHQ) at baseline, 2 weeks, and 6 weeks after the start of treatment in both groups. The second end point was to evaluate the safety of these agents.


RESULTS
Statistically significant improvements in terms of urgency and frequency were observed in both groups at two-weeks after the start of treatment as compared with baseline (p < 0.01 and < 0.05, respectively), while no inter-group difference was observed between the two groups. Significant improvement of QOL was observed after six weeks treatment in overall mean score, general health perception, incontinence impact, sleep/energy domains in both groups as compared with baseline. No significant difference was observed in terms of toxic events between the two groups.


CONCLUSIONS
Although both groups showed identical improvement of storage symptoms and tolerability, no additional benefit of alpha1-blocker was observed.
Matsuyama
Hideyasu
H
Department of Urology, Yamaguchi University Graduate School of Medicine, Ube.
Shimizu
Yoshiyuki
Y
Kamiryo
Yoriaki
Y
Joko
Keiji
K
Shimabukuro
Tomoyuki
T
Suga
Akinobu
A
Takemoto
Masahiko
M
Imoto
Katsuhiko
K
Hara
Yoshihiro
Y
Yamamoto
Norio
N
Kaneda
Yoshitaka
Y
Harada
Noriaki
N
Naito
Katsusuke
K
D000203:Activities of Daily Living; D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D001561:Benzilates / Q000008:administration & dosage*; D018680:Cholinergic Antagonists / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage*; D011446:Prospective Studies; D011788:Quality of Life; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000523:psychology
D000317:Adrenergic alpha-Antagonists; D001561:Benzilates; D018680:Cholinergic Antagonists; D010879:Piperazines; C015586:propiverine; C015568:urapidil