A Study on the Efficacy of Combination Therapy with Alpha-blockers and Anticholinergics in the Lower Urinary Tract Symptoms Patients Accompanied with Overactive Bladder Symptoms

2007 ◽  
Vol 11 (1) ◽  
pp. 63 ◽  
Author(s):  
Keon-Cheol Lee ◽  
In-Rae Cho
Keyword(s):  
Urinary Tract ◽  
Overactive Bladder ◽  
Combination Therapy ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Alpha Blockers ◽  
Overactive Bladder Symptoms ◽  
Urinary Tract Symptoms ◽  
Bladder Symptoms ◽  
Lower Urinary

scholarly journals Use of a symptom-based questionnaire to screen for the presence of significant voiding dysfunction in patients with multiple sclerosis and lower urinary tract symptoms: a pilot study

2020 ◽  
Vol 267 (12) ◽  
pp. 3683-3688
Author(s):  
Vivien Li ◽  
Jalesh N. Panicker ◽  
Collette Haslam ◽  
Jeremy Chataway
Keyword(s):  
Multiple Sclerosis ◽  
Urinary Tract ◽  
Overactive Bladder ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Overactive Bladder Symptoms ◽  
Urinary Tract Symptoms ◽  
Bladder Symptoms ◽  
Voiding Difficulties ◽  
Lower Urinary

Abstract Introduction Lower urinary tract dysfunction is common in people with multiple sclerosis, leading to overactive bladder symptoms, voiding difficulties or a combination. First-line medications for overactive bladder symptoms are effective. Current guidelines recommend measuring post-void residual volume (PVR) before commencing these treatments, as they can potentially exacerbate voiding difficulties in those with significant underlying voiding dysfunction (pre-treatment PVR > 100 ml). However, facilities to do so are not readily available to all clinicians, potentially delaying effective therapy. Aims To conduct a pilot study investigating the association between lower urinary tract symptoms and PVR volume in people with multiple sclerosis using a validated questionnaire and to determine if questionnaire scores can be used to exclude a significantly elevated (> 100 ml) PVR volume. Methods Patients with multiple sclerosis referred to a tertiary hospital uro-neurology service completed the Urinary Symptom Profile questionnaire and underwent PVR measurement by bladder ultrasound. A ratio of the questionnaire low stream score/total score was calculated to standardise the relative degree of voiding symptoms compared to overall lower urinary tract symptoms. Results Of 40 patients (29 females, mean age 50 years), 30% had an elevated PVR volume. PVR volume was correlated with low stream score and ratio of low stream/total score. A cut-off of > 0.15 for low stream/total score ratio had 92% sensitivity and 71% specificity in predicting an elevated PVR volume. Conclusion A symptom-based questionnaire maybe a useful screening tool to distinguish patients in whom PVR measurement is required from those who could safely start on treatment for overactive bladder symptoms.

Mirabegron add-on therapy to tamsulosin for the treatment of overactive bladder in men with lower urinary tract symptoms

2021 ◽  
Vol 14 (1) ◽  
pp. 58-62
Author(s):  
Tomasz Wiatr ◽  
Piotr Chłosta
Keyword(s):  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Overactive Bladder ◽  
Combination Therapy ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Prostatic Hyperplasia ◽  
Urinary Tract Symptoms ◽  
Frequency Score ◽  
Lower Urinary

Men with lower urinary tract symptoms (LUTS) treated with α-blockers may experience overactive bladder (OAB) symptoms and receive antimuscarinic drugs. Mirabegron (B3-adrenoreceptor agonist) is an alternative add-on therapy, that has been shown to be more effective than placebo in improving OAB symptoms. Superior results observed for tamsulosin plus mirabegron in mean volume voided per micturition, urgency episodes per day, and total urgency and frequency score. Higher rates of drug related treatment emergent adverse events were noted with tamsulosin plus mirabegron. The results of PLUS reveal the utility of mirabegron and tamsulosin therapy in the treatment of men with benign prostatic hyperplasia who developed symptoms of overactive bladder. The MATCH study confirmed that combination therapy for 12 weeks in men with symptoms of LUTS and OAB was more effective than placebo and was well tolerated.

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