Skip to main content

Advertisement

Log in

Efficacy and safety of combined therapy with tamsulosin and tolterodine in female patients with a maximal flow rate less than 12 ml/s

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

We assessed the effect of tamsulosin HCl (0.2 mg) with or without tolterodine extended release (2 mg) on female patients with a maximal flow rate (Qmax) less than 12 ml/s who were suspected of having functional bladder outlet obstruction.

Methods

From January 2007 to December 2008, 250 patients with a Qmax less than 12 ml/s were selected for this study. Initial drop-out rates in groups I (15.2%) and II (40.0%) are significantly different: 19 of 125 patients in groups I and 50 of 125 patients in group II failed to complete the 12-week clinical trial. The patients were treated with tamsulosin alone (0.2 mg/day; group I, n = 106) or with tamsulosin combined with tolterodine (2 mg/day; group II, n = 75). The effectiveness of these medications was assessed at baseline and after 12 weeks of treatment on the basis of the International Prostate Symptom Score (IPSS) and other measures including the Qmax and the postvoid residual urine volume.

Results

The total IPSS, the voiding symptom score, the Qmax, and the residual urine volume were significantly improved from baseline after 12 weeks of treatment (p < 0.05) in both groups, whereas the storage symptom score significantly improved only in group II (p < 0.05). After 12 weeks of treatment, there were no significant differences in subjective symptom scores or objective uroflowmetric parameters between the two groups, except for storage symptoms (group I, 4.3 ± 1.6 vs group II, 3.8 ± 0.9) and postvoid residual urine (group I, 31.8 ± 22.4 vs group II, 56.1 ± 29.7), which was not considered to be clinically meaningful.

Conclusion

Combination therapy with tamsulosin and tolterodine improved the subjective symptoms and uroflowmetric measures of female patients with a maximal flow rate of less than 12 ml/s. Women with a slight degree of storage symptoms will not be benefitted by prescribing anticholinergics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Nitti VW, Tu LM, Gitlin J (1999) Diagnosing bladder outlet obstruction in women. J Urol 161:1535–1540

    Article  PubMed  CAS  Google Scholar 

  2. Pischedda A, Pirozzi Farina F, Madonia M, Cimino S, Morgia G (2005) Use of alpha1-blockers in female functional bladder neck obstruction. Urol Int 74:256–2561

    Article  PubMed  CAS  Google Scholar 

  3. Kessler TM, Studer UE, Burkhard FC (2006) The effect of terazosin on functional bladder outlet obstruction in women: a pilot study. J Urol 176:1487–1492

    Article  PubMed  CAS  Google Scholar 

  4. Athanasopoulos A, Gyftopoulos K, Giannitsas K, Perimenis P (2009) Effect of alfuzosin on female primary bladder neck obstruction. Int Urogynecol J Pelvic Floor Dysfunct 20:217–222

    Article  PubMed  CAS  Google Scholar 

  5. Stanton SL, Ozsoy C, Hilton P (1983) Voiding difficulties in the female: prevalence, clinical and urodynamic review. Obstet Gynecol 61:144–147

    PubMed  CAS  Google Scholar 

  6. Groutz A, Blaivas JG, Chaikin DC (2000) Bladder outlet obstruction in women: definition and characteristics. Neurourol Urodyn 19:213–220

    Article  PubMed  CAS  Google Scholar 

  7. Goldman HB, Zimmern PE (2006) The treatment of female bladder outlet obstruction. BJU Int 98:359–366

    Article  PubMed  Google Scholar 

  8. Abrams P (1997) Lower urinary tract symptoms in women: who to investigate and how. Br J Urol 80:43–48

    PubMed  Google Scholar 

  9. Farrar DJ, Osborne JL, Stephenson TP, Whiteside CG, Weir J, Berry J, Milroy EJ, Warwick RT (1975) A urodynamic view of bladder outflow obstruction in the female: factors influencing the results of treatment. Br J Urol 47:815–822

    Article  PubMed  CAS  Google Scholar 

  10. Diokno AC, Hollander JB, Bennett CJ (1984) Bladder neck obstruction in women: a real entity. J Urol 132:294–298

    PubMed  CAS  Google Scholar 

  11. Axelrod SL, Blaivas JG (1987) Bladder neck obstruction in women. J Urol 137:497–499

    PubMed  CAS  Google Scholar 

  12. Blaivas JG, Groutz A (2000) Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn 19:553–564

    Article  PubMed  CAS  Google Scholar 

  13. Dietz HP, Haylen BT (2005) Symptoms of voiding dysfunction: what do they really mean? Int Urogynecol J Pelvic Floor Dysfunct 16:52–55

    Article  PubMed  CAS  Google Scholar 

  14. Costantini E, Mearini E, Pajoncini C, Biscotto S, Bini V, Porena M (2003) Uroflowmetry in female voiding disturbances. Neurourol Urodyn 22:569–573

    Article  PubMed  Google Scholar 

  15. Bass JS, Leach GE (1991) Bladder outlet obstruction in women. Prog Urol 5:141

    Google Scholar 

  16. Lemack GE (2006) Urodynamic assessment of bladder-outlet obstruction in women. Nat Clin Pract Urol 3:38–44

    Article  PubMed  Google Scholar 

  17. Chassagne S, Bernier PA, Haab F, Roehrborn CG, Reisch JS, Zimmern PE (1998) Proposed cutoff values to define bladder outlet obstruction in women. Urology 51:408–411

    Article  PubMed  CAS  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dongdeuk Kwon.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, SO., Hwang, E.C., Oh, K.J. et al. Efficacy and safety of combined therapy with tamsulosin and tolterodine in female patients with a maximal flow rate less than 12 ml/s. Int Urogynecol J 22, 1287–1291 (2011). https://doi.org/10.1007/s00192-011-1453-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-011-1453-9

Keywords

Navigation