[Clinical effectiveness and safety study of combined therapy with an alpha-blocker and an anticholinergic for patients with LUT/BPH].
OBJECTIVE
The effectiveness and safety of the combined therapy of terazosin and tolterodine for LUT/BPH patients with dominant storage symptoms was evaluated.


METHODS
The present study included 69 patients diagnosed as LUT/BPH by IPSS, flowmetry, ultrasound for prostate volume, residual urine, serum PSA and other methods, all of them fulfilled the study's inclusive/exclusive criteria. The principal exclusive criteria were prostate volume > 50 ml, Qmax < 10 ml/s and residual urine > 50 ml. All 69 patients had bothering storage symptoms after initial treatment with terazosin 2 mg once daily for one week., they were divided randomly into two groups. Terazosin group in which patients were treated with terazosin 2 mg once daily for six weeks, and combination group in which patients were treated with terazosin 2 mg once daily and tolterodine 2 mg twice daily for 6 weeks.


RESULTS
Sixty-nine patients with LUT/BPH were recruited with inclusive/exclusive criteria of our study, thirty-six patients were in terazosin group and 33 were in combination group. At baseline there were no significant differences between the groups, in mean age, body weight, prostate volume, IPSS, storage IPSS, voiding IPSS, Qmax and residual urine. The results showed that the IPSS was significantly improved in the two groups after treatment, but the reduction of IPSS in combination group was significantly greater than that in terazosin group (P < 0.001), and the decreased storage IPSS was the main contribution to the reduction of IPSS in combination group. There were no differences between the groups for Qmax and residual urine.


CONCLUSIONS
Combined therapy with terazosin plus tolterodine for LUT/BPH patients with dominant storage symptoms can improve the IPSS, especially the storage IPSS, without any negative effects on uroflow rate and residual urine. Combining with inclusion/exclusion criteria of the study, we believe that combined therapy with alpha-blocker plus anticholinergics is an effective and safe treatment for LUT/BPH patients with relatively small prostate volume, moderate impaired Q(max) and dominant storage symptoms.
Xiao
He
H
The Department of Urology, Peking Union Medical College Hospital, Beijing 100730, China.
Li
Han-Zhong
HZ
Yang
Yong
Y
Huang
Zhong-Ming
ZM
Li
Yong-Qiang
YQ
Zhao
Xiao-Feng
XF
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000187:drug effects / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D014555:Urination Disorders / Q000150:complications / Q000188:drug therapy*