Antimuscarinics and bladder outlet obstruction: From a contraindication to an indication?
OBJECTIVE
To review if the existing data support the new concept that antimuscarinic agents can be used for the treatment of bladder outlet obstruction (BOO) with coexisting overactive bladder (OAB).


METHODS
A literature search of Medline publications (up to 2008) on use of antimuscarinic agents for treatment BOO was performed and all data were presented. All relevant data from published studies in congress abstracts were as well included.


RESULTS
The existing data show that this treatment effectively improves patient quality of life. Concerns about the possibility of urinary retention were shown to be unfounded. It seems that antimuscarinic agents do not affect voiding pressures and the use of antimuscarinic agents for BOO seems safe.


CONCLUSIONS
The combination of an alpha-blocker and antimuscarinic agent for the treatment of BOO with concomitant OAB seems promising.
Athanasopoulos
Anastasios
A
Urodynamic Urology Unit, Department of Urology, Medical School, University of Patras, Patras, Greece. tassos_athan@hotmail.com
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000075202:Contraindications; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D006801:Humans; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D011788:Quality of Life; D018570:Risk Assessment; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D014563:Urodynamics
D000317:Adrenergic alpha-Antagonists; D018727:Muscarinic Antagonists