To analyze the efficacy and safety of standard-dose antimuscarinic treatment on male patients with overactive bladder (OAB) symptoms showing poor efficacy after low-dose antimuscarinics.
We retrospectively reviewed the data of 566 male patients aged ≥40 with OAB symptoms between January 2017 and June 2018. They were treated with low-dose antimuscarinics for at least 4 weeks and showed poor efficacy; therefore, they were switched to standard dose antimuscarinic treatment (5 mg of solifenacin) for ≥12 weeks. The international prostate symptom score (IPSS) and overactive bladder symptom score (OABSS) at baseline (V0), 4 weeks (V1), and 12 weeks (V2) were analyzed. Post void residual urine volume (PVR) was also recorded.
The median age, body mass index, and prostate-specific antigen levels were 69.0 years, 24.2 kg/m², and 1.24 ng/dL, respectively. The mean value of the total IPSS and OABSS significantly decreased between V0 and V2 (from 16.73 to 13.69 and 7.33 to 5.34, respectively, all p<0.001). All component scores from each questionnaire demonstrated a significant decrease except for numbers three and six on the IPSS questionnaire. PVR was increased from V0 to V2 (36.40 to 68.90 mL, p=0.015). Four and nine patients experienced constipation and thirst, respectively, and all adverse effects were graded as ≤2.
Standard dose antimuscarinic treatment using solifenacin (5 mg) may be a safe and effective treatment for patients with OAB symptoms refractory to low-dose antimuscarinic treatment.
Investigative and clinical urology. 2020 Sep 18 [Epub ahead of print]
Myungsun Shim, Jong Keun Kim, Woo Jin Bang, Yong Seong Lee, Sung Tae Cho, Jin Seon Cho, Kwan Joong Joo, Jae Seog Hyun, Byung Hoon Kim, Jong Bok Lee, Young Jin Seo, Cheol Young Oh
Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea., Department of Urology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea., Department of Urology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea., Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea., Department of Urology, Gyeongsang National University School of Medicine, Jinju, Korea., Department of Urology, Keimyung University School of Medicine, Daegu, Korea., Department of Urology, National Medical Center, Seoul, Korea., Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea., Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. .