Data from 12-week , r and omised , double-blind , placebo-controlled trials of tolterodine extended release ( ER ) , oxybutynin and solifenacin show that combined antimuscarinic+α-blocker treatment is generally more effective than monotherapy or placebo in men with OAB symptoms .
The efficacy and safety  of tolterodine ER+α-blocker treatment was not affected by prostate size or prostate-specific antigen ( PSA ) level .
In men meeting entry criteria for OAB and benign prostatic obstruction trials  , tolterodine ER alone was effective selectively in men with prostate size or PSA level below study medians .
Post hoc analyses from double-blind , placebo-controlled trials and prospect i ve studies of fesoterodine , oxybutynin , propiverine , solifenacin and tolterodine also suggest that antimuscarinics are generally safe and efficacious in men .
A retrospective data base study found that risk of AUR in men was the highest in the first month of treatment and decreased considerably thereafter .
Antimuscarinics , alone or with an α-blocker , appear to be efficacious and safe in many men with predominant OAB symptoms or persistent OAB symptoms despite α-blocker or 5-α-reductase inhibitor treatment .
Despite potential benefits , primary care clinicians may avoid using antimuscarinics in men with overactive bladder ( OAB ) symptoms because of safety concerns .
Urodynamic parameters after solifenacin treatment in men with overactive bladder symptoms and detrusor underactivity.
AIMS To describe the changes in urodynamic parameters and to assess patients ' perceptions of voiding difficulties and improvements in symptom bother after solifenacin treatment in men with overactive bladder ( OAB ) and detrusor underactivity ( DUA ) . METHODS In this prospect i ve study , 49 neurologically intact men were enrolled . DUA was defined as a bladder contractility index ( BCI ) < 100 . All subjects received 5 mg of solifenacin once a day for 120 days . A complete urodynamic study was carried out on the day before to the first dose of solifenacin and at day 120 . RESULTS Solifenacin treatment result ed in a decrease in Q(max ) during UDS ( -0.6 ml/sec ; P = 0.007 ) , P(det)Q(max ) ( -6.4 cmH(2)O ; P < 0.001 ) , BOOI ( -7.5 ; P < 0.001 ) , BCI ( -3.8 ; P = 0.001 ) , BVE ( -4.4 % ; P = 0.006 ) , and voided volume ( -7.5 ml ; P = 0.09 ) . On the contrary , PVR ( + 6 ml ; P = 0.152 ) , and maximum cystometric capacity ( + 22.9 ml ; P = 0.001 ) increased . The regression analysis suggested that changes in urodynamic parameters after solifenacin treatment were limited for BOOI ( 9.4 % ) , P(det)Q(max ) ( 8.4 % ) , and BCI ( 6.5 % ) , with no significant impact on Q(max ) during UDS , BVE , volume voided and PVR . No significant change in subjective perception of voiding difficulties was found . The incidence of AUR was 2.2 % and improvement in patient 's experience of OAB symptoms bother after solifenacin treatment was observed . CONCLUSIONS Solifenacin treatment results in changes of urodynamic parameters . These changes , however , seem not to be of clinical significance as suggested by the lack of subjective deterioration in voiding difficulties and by the low incidence of AUR
Data from 12-week , r and omised , double-blind , placebo-controlled trials of tolterodine extended release ( ER ) , oxybutynin and solifenacin show that combined antimuscarinic+α-blocker treatment is generally more effective than monotherapy or placebo in men with OAB symptoms .
The efficacy and safety  of tolterodine ER+α-blocker treatment was not affected by prostate size or prostate-specific antigen ( PSA ) level .
In men meeting entry criteria for OAB and benign prostatic obstruction trials  , tolterodine ER alone was effective selectively in men with prostate size or PSA level below study medians .
Post hoc analyses from double-blind , placebo-controlled trials and prospect i ve studies of fesoterodine , oxybutynin , propiverine , solifenacin and tolterodine also suggest that antimuscarinics are generally safe and efficacious in men .
A retrospective data base study found that risk of AUR in men was the highest in the first month of treatment and decreased considerably thereafter .
Antimuscarinics , alone or with an α-blocker , appear to be efficacious and safe in many men with predominant OAB symptoms or persistent OAB symptoms despite α-blocker or 5-α-reductase inhibitor treatment .
Despite potential benefits , primary care clinicians may avoid using antimuscarinics in men with overactive bladder ( OAB ) symptoms because of safety concerns .