What Are Factors Contributing to Improvement of Overactive Bladder Symptoms after Alpha-1 Blocker Treatment in Patients with Both Storage and Voiding Symptoms?

To determine the pre-treatment factors related to the improvement of overactive bladder (OAB) symptom after alpha-1 blocker monotherapy in patients with benign prostatic hyperplasia complicated by OAB (BPH/OAB).

Post-hoc analysis of a prospective study in patients with BPH/OAB, randomized to receive silodosin 8 mg (n = 157) or naftopidil 75 mg (n = 157) treatment for 12 weeks, was performed. At 12 weeks post-administration, patients were divided into 2 groups (good responder [GR] group and poor responder [PR] group), according to the improvement in the OAB symptom score (OABSS). We compared the pre-administration parameters between both groups and evaluated the factors related to OAB improvement.

Of 314 patients, 159 patients (50.6%) were classified into the GR and 155 (49.4%) into the PR. International Prostate Symptom score, total OABSS, OABSS urgency-score, OABSS urgency urinary incontinence (UUI)-score, post-void residual urine volume (PVR), and selection rate of naftopidil were significantly higher in the PR than in the GR. On multivariate logistic regression analysis, larger PVR, higher OABSS-UUI-score, and the choice of naftopidil were significant risk factors for insufficient improvement of OAB symptoms.

Pre-treatment PVR, UUI severity, and the choice of treatment agent are predicting factors related to OAB improvement after alpha-1 blocker monotherapy in patients with BPH/OAB.

Urologia internationalis. 2019 Sep 25 [Epub ahead of print]

Yoshihisa Matsukawa, Tsuyoshi Majima, Shun Takai, Yasuhito Funahashi, Masashi Kato, Momokazu Gotoh

Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan, ., Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.