Investig Clin Urol.  2020 Nov;61(6):600-606. 10.4111/icu.20200053.

Efficacy and safety of dose escalation in male patients with overactive bladder showing poor efficacy after low-dose antimuscarinic treatment: A retrospective multicenter study

Affiliations
  • 1Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
  • 2Department of Urology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
  • 3Department of Urology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
  • 4Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 5Department of Urology, Gyeongsang National University School of Medicine, Jinju, Korea
  • 6Department of Urology, Keimyung University School of Medicine, Daegu, Korea
  • 7Department of Urology, National Medical Center, Seoul, Korea
  • 8Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea

Abstract

Purpose
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.
Materials and Methods
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.
Results
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.
Conclusions
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.

Keyword

Muscarinic antagonists; Prostatic hyperplasia; Treatment outcome; Urinary bladder; overactive
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