title: Can we decide the optimal initial treatment for male lower urinary tract symptoms patients with overactive bladder by the most bothersome symptom? A randomized, prospective, open-label study.
abstract: OBJECTIVE
  To compare the treatment outcome of tamsulosin 0.4 mg (TAM) with or without solifenacin 5 mg (SOL) for the most bothersome symptom in male lower urinary tract symptoms (LUTS) with overactive bladder (OAB).
  
  
  METHODS
  Male LUTS/OAB (≥50 years) patients who had a total International Prostate Symptom Score (I-PSS) of ≥12, I-PSS urgency-related question of ≥2, and quality of life (QoL) of ≥3 points were enrolled. Patients who complained of storage symptoms as the most bothersome were included in the 'storage' group. Patients who complained of voiding symptoms as the most bothersome were included in the 'voiding' group. The change in the I-PSS was compared between the two groups 4 weeks after commencing treatment.
  
  
  RESULTS
  In the storage group, 172 were able to finish this study (TAM: 88, TAM + SOL: 84). The improvement of I-PSS and QoL with TAM + SOL was significantly greater than with TAM alone (p < 0.001). In the voiding group, 108 were able to finish the study (TAM: 54, TAM + SOL: 54). The improvement of I-PSS and QoL with TAM alone was significantly greater than with TAM + SOL (p < 0.001).
  
  
  CONCLUSIONS
  The most bothersome symptom in male LUTS/OAB should be considered when choosing the appropriate medical treatment.
authors.affiliation: Department of Urology, Soonchunhyang University College of Medicine, Gumi Hospital, Gumi, South Korea.
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Yun
authors.forename: Jae Heon
authors.initials: JH
authors.lastname: Kim
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Lee
authors.forename: Hee Jo
authors.initials: HJ
authors.lastname: Yang
authors.forename: Seung Whan
authors.initials: SW
authors.lastname: Doo
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Yang
mesh_terms: D000368:Aged; D003657:Decision Making; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage; D011446:Prospective Studies; D011467:Prostate; D011788:Quality of Life; D011812:Quinuclidines / Q000008:administration & dosage*; D056910:Republic of Korea; D000069464:Solifenacin Succinate; D013449:Sulfonamides / Q000008:administration & dosage*; D063189:Symptom Assessment; D000077409:Tamsulosin; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage*; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D014554:Urination
chemical_list: D018727:Muscarinic Antagonists; D011812:Quinuclidines; D013449:Sulfonamides; D044005:Tetrahydroisoquinolines; D000077409:Tamsulosin; D000069464:Solifenacin Succinate