Naftopidil and propiverine hydrochloride for treatment of male lower urinary tract symptoms suggestive of benign prostatic hyperplasia and concomitant overactive bladder: a prospective randomized controlled study.
OBJECTIVE
To assess the efficacy and safety of propiverine hydrochloride (antimuscarinic), naftopidil (alpha(1)-adrenoceptor antagonist) or both in patients with male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia and concomitant overactive bladder (OAB).


METHODS
Men aged at least 50 years who had a total International Prostate Symptom Score (IPSS) of 8 or higher and bladder dairy documenting micturition frequency (more than eight micturitions/24 h) and urgency (more than one episode/24 h), with or without urgency urinary incontinence were randomized into three groups: group N, naftopidil (50 mg once daily) only; group P, propiverine hydrochloride (20 mg once daily); and group NP, naftopidil (50 mg once daily) plus propiverine hydrochloride (20 mg once daily) for a 4-week treatment regimen.


RESULTS
A total of 66 men, including 20 in group N, 23 in group P and 23 in group NP, were treated and 58 (87.9%) completed the 4 weeks of treatment. IPSS improved significantly in groups N and NP. Urinary frequency improved significantly in groups P and NP. Postvoid residual urine volume increased significantly in groups P and NP. Significant improvements in urgency episodes were noted in each group. One patient in group P required catheterization owing to acute urinary retention and another stopped medication because of difficulty in voiding.


CONCLUSIONS
These results suggest that each treatment showed effectiveness for male LUTS with OAB. However, there are some possibilities of adverse effects with propiverine hydrochloride monotherapy.
Yokoyama
Teruhiko
T
Department of Urology, Kawasaki Medical School, Kurashiki, Japan. uroyoko@med.kawasaki-m.ac.jp
Uematsu
Katsutoshi
K
Watanabe
Toyohiko
T
Sasaki
Katsumi
K
Kumon
Hiromi
H
Nagai
Atsushi
A
D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000368:Aged; D001561:Benzilates / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D009281:Naphthalenes / Q000009:adverse effects / Q000627:therapeutic use*; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000150:complications*; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000150:complications*; D014554:Urination / Q000502:physiology; D014570:Urologic Diseases / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology
D000317:Adrenergic alpha-Antagonists; D001561:Benzilates; D018727:Muscarinic Antagonists; D009281:Naphthalenes; D010879:Piperazines; C015586:propiverine; C064357:naftopidil