The therapeutic effect of solifenacin succinate on the recovery from voiding dysfunction after radical prostatectomy in men with clinically localized prostate cancer: a prospective, randomized, controlled study.
OBJECTIVE
To evaluate whether anticholinergic medication contributes to early recovery of continence and improvement of other voiding symptoms after radical prostatectomy (RP).


METHODS
A total of 78 patients with clinically localized prostate cancer who had incontinence at 1 week after RP were enrolled prospectively. The patients were allocated to one of the 2 groups: group 1 (α-adrenergic agonist [midodrine] plus an anticholinergic [solifenacin]) or group 2 (α-adrenergic agonist only). A urodynamic study and the International Continence Society male Short Form questionnaire were completed preoperatively and 4 months after RP. One-hour pad test and 3-day frequency volume chart at 1 and 4 months after medication were also analyzed.


RESULTS
The rate of continence, defined as being pad free, did not differ between the groups at 4 months (both 71.8%; P >.05). However, the decreased value of mean weight of daily pads worn by groups 1 and 2 were 51.5 vs 11.7 g, respectively (P = .005). The incontinence (P = .008) and quality of life (P = .044) subscale scores significantly worsened in group 2, whereas they remained unchanged in group 1. Maximal detrusor pressure and maximal urethral closure pressure significantly decreased in both groups, whereas maximal cystometric capacity increased significantly in group 1 only (290.8-332.0 cm H2O; P <.001).


CONCLUSIONS
Anticholinergics may facilitate early recovery from incontinence and prevent worsening of quality of life, which might be attributed to increased cystometric capacity after their use.
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Myungsun
M
Shim
Department of Urology, Korea Cancer Center Hospital, Seoul, Korea.
Jongwon
J
Kim
Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Sejun
S
Park
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Seung-Kwon
SK
Choi
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Sang Mi
SM
Lee
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kyeong Ohk
KO
Huh
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Cheryn
C
Song
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Myung-Soo
MS
Choo
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: hjahn@amc.seoul.kr.
Hanjong
H
Ahn
D058646:Adrenergic alpha-1 Receptor Agonists / Q000627:therapeutic use*; D000368:Aged; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008879:Midodrine / Q000627:therapeutic use*; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000601:surgery*; D011812:Quinuclidines / Q000627:therapeutic use*; D020127:Recovery of Function / Q000187:drug effects*; D016037:Single-Blind Method; D000069464:Solifenacin Succinate; D044005:Tetrahydroisoquinolines / Q000627:therapeutic use*; D014549:Urinary Incontinence / Q000188:drug therapy* / Q000209:etiology
D058646:Adrenergic alpha-1 Receptor Agonists; D018727:Muscarinic Antagonists; D011812:Quinuclidines; D044005:Tetrahydroisoquinolines; D008879:Midodrine; D000069464:Solifenacin Succinate