title: Efficacy and safety of combined therapy with tamsulosin and tolterodine in female patients with a maximal flow rate less than 12 ml/s.
abstract: OBJECTIVE
  We assessed the effect of tamsulosin HCl (0.2 mg) with or without tolterodine extended release (2 mg) on female patients with a maximal flow rate (Qmax) less than 12 ml/s who were suspected of having functional bladder outlet obstruction.
  
  
  METHODS
  From January 2007 to December 2008, 250 patients with a Qmax less than 12 ml/s were selected for this study. Initial drop-out rates in groups I (15.2%) and II (40.0%) are significantly different: 19 of 125 patients in groups I and 50 of 125 patients in group II failed to complete the 12-week clinical trial. The patients were treated with tamsulosin alone (0.2 mg/day; group I, n = 106) or with tamsulosin combined with tolterodine (2 mg/day; group II, n = 75). The effectiveness of these medications was assessed at baseline and after 12 weeks of treatment on the basis of the International Prostate Symptom Score (IPSS) and other measures including the Qmax and the postvoid residual urine volume.
  
  
  RESULTS
  The total IPSS, the voiding symptom score, the Qmax, and the residual urine volume were significantly improved from baseline after 12 weeks of treatment (p < 0.05) in both groups, whereas the storage symptom score significantly improved only in group II (p < 0.05). After 12 weeks of treatment, there were no significant differences in subjective symptom scores or objective uroflowmetric parameters between the two groups, except for storage symptoms (group I, 4.3 ± 1.6 vs group II, 3.8 ± 0.9) and postvoid residual urine (group I, 31.8 ± 22.4 vs group II, 56.1 ± 29.7), which was not considered to be clinically meaningful.
  
  
  CONCLUSIONS
  Combination therapy with tamsulosin and tolterodine improved the subjective symptoms and uroflowmetric measures of female patients with a maximal flow rate of less than 12 ml/s. Women with a slight degree of storage symptoms will not be benefitted by prescribing anticholinergics.
authors: Department of Urology, Chonnam National University Hospital and Medical School, 671, Jebongro, Dong-ku, Gwangju, #501-757, South Korea.
authors: Sun-Ouck
authors: SO
authors: Kim
authors: Eu Chang
authors: EC
authors: Hwang
authors: Kyung Jin
authors: KJ
authors: Oh
authors: Dongdeuk
authors: D
authors: Kwon
authors: Kwangsung
authors: K
authors: Park
authors: Soo Bang
authors: SB
authors: Ryu
references: Br J Urol. 1975;47(7):815-22
references: 1241332
references: Neurourol Urodyn. 2000;19(5):553-64
references: 11002298
references: Neurourol Urodyn. 2000;19(3):213-20
references: 10797578
references: J Urol. 1999 May;161(5):1535-40
references: 10210391
references: Int Urogynecol J Pelvic Floor Dysfunct. 2005 Jan-Feb;16(1):52-5; discussion 55
references: 15647963
references: BJU Int. 2006 Aug;98(2):359-66
references: 16879678
references: Urology. 1998 Mar;51(3):408-11
references: 9510344
references: Urol Int. 2005;74(3):256-61
references: 15812214
references: Nat Clin Pract Urol. 2006 Jan;3(1):38-44
references: 16474493
references: J Urol. 2006 Oct;176(4 Pt 1):1487-92
references: 16952666
references: Obstet Gynecol. 1983 Feb;61(2):144-7
references: 6823355
references: Int Urogynecol J Pelvic Floor Dysfunct. 2009 Feb;20(2):217-22
references: 18982236
references: J Urol. 1984 Aug;132(2):294-8
references: 6539828
references: Br J Urol. 1997 Jul;80 Suppl 1:43-8
references: 9240224
references: Neurourol Urodyn. 2003;22(6):569-73
references: 12951665
references: J Urol. 1987 Mar;137(3):497-9
references: 3820385