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 .
Efficacy and tolerability of fesoterodine in men with overactive bladder: a pooled analysis of 2 phase III studies.
OBJECTIVES To assess the efficacy , safety , and tolerability of fesoterodine 4 and 8 mg in men with overactive bladder . METHODS This was a sub analysis of pooled data from 358 men enrolled in 2 double-blind , placebo-controlled phase III trials . Subjects with frequency and urgency or urgency urinary incontinence ( UUI ) were r and omized to fesoterodine 4 mg , fesoterodine 8 mg , or placebo for 12 weeks . Efficacy endpoints included bladder diary variables and subject-reported treatment response . RESULTS By week 12 , men treated with fesoterodine 4 or 8 mg had significantly greater median percentage improvements in micturition frequency , urgency episodes , and UUI episodes versus placebo and significantly greater percentages reported a treatment response versus placebo . Significant increases in mean voided volume ( MVV ) per micturition versus placebo occurred with fesoterodine 8 mg only . At week 12 , fesoterodine 8 mg was significantly more efficacious than fesoterodine 4 mg in improving UUI episodes and MVV per micturition . The most commonly reported adverse events with fesoterodine 4 and 8 mg were dry mouth ( 12.5 % and 37.7 % vs 5.6 % with placebo ) and constipation ( 2.5 % and 8.8 % vs 0.8 % with placebo ) . Symptoms suggestive of urinary retention were reported in 0.8 % , 0.8 % , and 5.3 % of men in the placebo , fesoterodine 4 mg , and fesoterodine 8 mg groups , respectively ; only 1 subject , in the fesoterodine 8 mg group , was catheterized . CONCLUSIONS Fesoterodine 4 and 8 mg are generally safe , efficacious , and well tolerated for the treatment of overactive bladder symptoms in men . The 8 mg dose provides additional benefit and allows for treatment individualization
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 .