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Urinary research offers hope to men
by Tim
Gehret
Public
Relations
Research conducted at MUSC shows remarkable success in treatment of men
with overactive bladder and lower urinary tract symptoms. The results
of the 12-week study appeared in the Journal of the American Medical
Association (JAMA) Nov. 15.
Males with lower urinary tract symptoms and overactive bladder
experience symptom relief with a novel combination of medications,
according to the study.
The American Medical Association estimates that overactive bladder
(OAB), a type of lower urinary tract symptom, affects 30 million to 40
million Americans including an estimated 10 million adult men 40 years
or older. People with OAB may experience a sudden intense urge to
urinate more than eight times a day. In many cases, patients will
experience excessive urinary urges throughout the night. OAB adversely
affects a person’s daily routines and quality of life. In fact, persons
with OAB experience a lower quality of life than those with certain
forms of diabetes. Male patients with lower urinary tract symptoms are
often treated with drugs that target the prostate and/or the bladder.
Eric Rovner, M.D., associate professor of urology, along with
colleagues at 95 urology clinics across the country, performed a
randomized, double blind, placebo-controlled trial on more than 850 men
40 years and older. In the study, funded by Pfizer Pharmaceuticals,
patients were assigned to receive either a placebo, Tamsulosin
(Flomax), Tolterodine ER (Detrol), or both Tamsulosin and Tolterodine
ER for 12 weeks. The results show 80 percent of the men who received
the combination of Tolterodine ER and Tamsulosin reported treatment
benefits by the 12th week compared to the 62 percent who took the
placebo, 71 percent who took only Tamulosin, or 65 percent who took
only Tolterodine ER.
“This study enrolled a unique patient population which had not been
extensively studied. Most trials for overactive bladder medications
included predominantly women,” Rovner said. “There was a feeling among
many urologists that this class of medications, antimuscarinics, would
result in unacceptably high rates of urinary retention in men due to
undiagnosed prostatic obstruction. Therefore, men with lower urinary
tract symptoms, of which overactive bladder is a component, have been
traditionally treated primarily with alpha blockers and five alpha
reductase inhibitors.”
Rovner said that, contrary to those existing fears, the study found
that this class of medication was safe, and the combination of
antimuscarinics and alpha blockers afforded the best symptom relief.
“This may signal a shift in the paradigm of the treatment of lower
urinary tract symptoms in men,” Rovner said.
Friday, Nov. 24, 2006
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