title: Rate and associated factors of solifenacin add-on after tamsulosin monotherapy in men with voiding and storage lower urinary tract symptoms.
abstract: OBJECTIVE
  To explore the rate of add-on therapy with solifenacin in men with voiding and storage lower urinary tract symptoms (LUTS) after tamsulosin monotherapy and to explore predictive factors for starting solifenacin add-on therapy.
  
  
  METHODS
  Men aged ≥ 45 years with IPSS ≥ 12 and symptoms of OAB (OAB-V8 ≥ 8, micturition ≥ 8/24 h, urgency ≥ 2/24 h) were enrolled to receive tamsulosin 0.2 mg once daily. After 4 weeks, men with residual symptoms of OAB and reported 'dissatisfied' or 'a little satisfied' were received solifenacin 5 mg in combination with tamsulosin monotherapy. Subjects completed an IPSS, a Quality of life (QoL) index, OAB V8, and an International Consultation of Incontinence Questionnaire (ICIQ)-Male LUTS, and patient perception of bladder condition (PPBC) at baseline and week 4.
  
  
  RESULTS
  Of a total of 305 patients, 254 patients completed 4 weeks of tamsulosin treatment. For 176 patients, solifenacin was added (69.3%). Significant predictive factors of solifenacin add-on therapy included long LUTS duration, high IPSS, number of micturitions per 24 h, more urgency episodes, high urgency severity score in a voiding diary and high OAB V8 score. Based on multivariable analysis, potential predictive factors of solifenacin add-on therapy included long LUTS duration (OR = 1.008, 95% CI: 1.001-1.014), high serum PSA (OR = 1.543, 95% CI: 1.136-2.095) and small prostate size (OR = 0.970, 95% CI: 0.947-0.994) (p < 0.05). IPSS, daytime micturitions and urgency episodes, OAB V8 scores, ICIQ and PPBC were improved after tamsulosin monotherapy.
  
  
  CONCLUSIONS
  Two thirds of men with voiding and storage LUTS needed to add anticholinergics after 4 weeks of tamsulosin monotherapy. Patients with longer lasting symptoms and storage symptoms with small prostate volume may require the anticholinergic add-on.
authors.affiliation: Department of Urology, Seoul Seonam Hospital, Ewha Womans University, Seoul, Korea.
authors.forename: H N
authors.initials: HN
authors.lastname: Lee
authors.forename: K-S
authors.initials: KS
authors.lastname: Lee
authors.forename: J C
authors.initials: JC
authors.lastname: Kim
authors.forename: B H
authors.initials: BH
authors.lastname: Chung
authors.forename: C-S
authors.initials: CS
authors.lastname: Kim
authors.forename: J G
authors.initials: JG
authors.lastname: Lee
authors.forename: D K
authors.initials: DK
authors.lastname: Kim
authors.forename: C H
authors.initials: CH
authors.lastname: Park
authors.forename: J K
authors.initials: JK
authors.lastname: Park
authors.forename: S J
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D000069464:Solifenacin Succinate / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D064804:Urological Agents / Q000627:therapeutic use*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D018727:Muscarinic Antagonists; D013449:Sulfonamides; D064804:Urological Agents; D000077409:Tamsulosin; D000069464:Solifenacin Succinate