title: Initial Use of High-Dose Anticholinergics Combined with Alpha-Blockers for Male Lower Urinary Tract Symptoms with Overactive Bladder: A Prospective, Randomized Preliminary Study.
abstract: OBJECTIVE
  To evaluate the clinical efficacy of initial combined treatment of alpha-blocker plus dose-dependent anticholinergic agent compared to the alpha-blocker monotherapy in benign prostatic hyperplasia patients with overactive bladder.
  
  
  METHODS
  Male lower urinary tract symptoms (LUTS) patients with International Prostate Symptom Score (IPSS) of 8 or higher, total overactive bladder Symptom Score (OABSS) of 3 or higher, and 2 points or higher in the OABSS questionnaire number 2 were enrolled. Eligible subjects (total n = 146) were randomly assigned to receive tamsulosin 0.2 mg (Group I, n = 44), tamsulosin 0.2 mg plus solifenacin 5 mg (Group II, n = 55), or tamsulosin 0.2 mg plus solifenacin 10 mg (Group III, n = 47) for 12 weeks. Efficacy and safety assessments for each group were done using detailed questionnaires, and evaluating urinary parameters such as maximal urinary flow rate (Qmax) and postvoid residual volume (PVR) at 4 and 12 weeks.
  
  
  RESULTS
  Groups II and III (combined use of tamsulosin and solifenacin) showed significant improvement in storage symptoms compared to group I (tamsulosin monotherapy), as reflected by IPSS storage subscore and OABSS (P < 0.05). Dry mouth developed in four (7%) and eight (17%) cases in group II and III, respectively, so that one (2%) and three (6%) cases dropped out in group II and III, respectively. Two cases (4%) of AUR developed in group III, and one of them was withdrawn (2%) from the study.
  
  
  CONCLUSIONS
  Initial combined treatment of tamsulosin plus solifenacin for men with LUTS improves storage symptoms significantly, but dose modification is necessary to prevent adverse events.
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kyu Won
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kyung Jae
authors.initials: KJ
authors.lastname: Hur
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Su Yeon
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sang Rak
authors.initials: SR
authors.lastname: Bae
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Bong Hee
authors.initials: BH
authors.lastname: Park
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yong Seok
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Chang Hee
authors.initials: CH
authors.lastname: Han
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Kim
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage*; D000368:Aged; D018680:Cholinergic Antagonists / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy; D000069464:Solifenacin Succinate / Q000008:administration & dosage; D013449:Sulfonamides / Q000008:administration & dosage; D000077409:Tamsulosin; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D064804:Urological Agents / Q000008:administration & dosage
chemical_list: D000317:Adrenergic alpha-Antagonists; D018680:Cholinergic Antagonists; D013449:Sulfonamides; D064804:Urological Agents; D000077409:Tamsulosin; D000069464:Solifenacin Succinate
keywords: adrenergic alpha antagonists; anticholinergics; lower urinary tract symptoms; overactive bladder