title: Tolterodine in the Treatment of Male LUTS.
abstract: Storage lower urinary tract symptoms (LUTS) in men are usually chronic, with a high prevalence and a substantial impact on quality of life; therefore, adequate therapies are desirable and crucial for these men. First line treatment for all patients with storage LUTS should always be behavioral. The gold standard for pharmacological treatment of overactive bladder/storage symptoms is a muscarinic receptor antagonist such as tolterodine. First-marketed antimuscarinics were limited by several adverse events such as dry mouth, constipation, tachycardia, accommodation disorder, and cognitive dysfunction, resulting in poor compliance and early treatment discontinuation in a large number of patients. In order to improve compliance with oral drug treatment, tolterodine was developed, providing a better efficacy/adverse event profile. Tolterodine is available in the following two formulations: the intermediate release (IR) and extended release form (ER). Tolterodine ER 4 mg administered once daily is pharmacokinetically equivalent to tolterodine IR 2 mg twice daily but has a lower incidence of adverse events and increased efficacy. Combination therapy of tolterodine and an alpha-blocker is significantly more efficacious than either monotherapy. Even when compared and added to tamsulosin, tolterodine shows a good safety profile. The incidence of acute urinary retention requiring catheterization and treatment withdrawals due to adverse events are low in all the studies included in the present review.
authors.affiliation: Department of Urology, University of Florence, Careggi Hospital, Florence, Italy, maurogacci@yahoo.it.
authors.forename: Mauro
authors.initials: M
authors.lastname: Gacci
authors.forename: Arcangelo
authors.initials: A
authors.lastname: Sebastianelli
authors.forename: Matteo
authors.initials: M
authors.lastname: Salvi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Schiavina
authors.forename: Eugenio
authors.initials: E
authors.lastname: Brunocilla
authors.forename: Giacomo
authors.initials: G
authors.lastname: Novara
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
authors.forename: Matthias
authors.initials: M
authors.lastname: Oelke
authors.forename: Stavros
authors.initials: S
authors.lastname: Gravas
authors.forename: Marco
authors.initials: M
authors.lastname: Carini
authors.forename: Sergio
authors.initials: S
authors.lastname: Serni
mesh_terms: D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy*; D008297:Male; D018727:Muscarinic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D011788:Quality of Life; D000068737:Tolterodine Tartrate / Q000008:administration & dosage / Q000627:therapeutic use*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy
chemical_list: D018727:Muscarinic Antagonists; D000068737:Tolterodine Tartrate