Anticholinergics in men: Does the evidence support combination therapy? |
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Authors: | Senthy V Sellaturay Ben Blake-James |
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Institution: | (1) Department of Urology, Barnet Hospital, Wellhouse Lane, Barnet, Herts, EN5 3DJ, UK |
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Abstract: | Benign prostatic hyperplasia (BPH) is common in men older than age 50, and the symptoms occurring from bladder outlet obstruction
(BOO) commonly overlap with lower urinary tract symptoms (LUTS) experienced in overactive bladder (OAB). Anticholinergics
are often withheld from men with BOO. This article reviews seven randomized controlled trials (RCTs) and a meta-analysis study
examining anticholinergic use in men with LUTS associated with OAB and BPH. There is growing evidence that anticholinergics
are a suitable, safe treatment in men with persistent LUTS associated with BOO, refractory to α-blockers. Only four of 750
men treated with anticholinergics in the seven RCTs reviewed had acute urinary retention. Further well-designed, placebo-controlled
RCTs are required to assess the efficacy and long-term safety outcomes of combination therapy. However, it appears feasible
to effectively use adjunctive anticholinergic therapy in men with LUTS/BPH and no significant increase in postvoid residual
volume. |
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Keywords: | |
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