Incont Pelvic Floor Dysfunct 2008; 2(Suppl 1):21-24

Combination Therapy Using an -blocker Together with an Antimuscarinic

Agent for Treatment of Men with Benign Prostatic Obstruction and
Overactive Bladder: Results of Clinical Experience and a Mini-review
Qian-Sheng Ke, M.D., Hann-Chorng Kuo, M.D.1
Department of Urology, Lotung Poh-Ai Hospital, Yilan, Taiwan; Department of Urology1, Buddhist Tzu Chi General Hospital and Tzu Chi University,
Hualien, Taiwan

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Received: March 12, 2008 Accepted: May 8, 2008

Address correspondence to: Dr. Hann-Chorng Kuo, Department of Urology, Buddhist
Tzu Chi General Hospital, 707, Chung Yang Road, Section 3, Hualien, 97002, Taiwan
E-mail: hck@tzuchi.com.tw

ON

Q. S. Ke, et al

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Table 1. Relationships of variables and therapeutic outcomes in group A with

antimuscarinics (N=67)

IPSS (emptying)
IPSS (storage)
QoL
Qmax (mL/sec)
Volume (mL)
PVR (mL)
TPV (mL)
TZI
PSA (ng/mL)

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Baseline

6-month

8.096.93
7.573.87
3.581.41
9.994.46
151.20102.6
78.8072.1
44.8022.9
0.450.12
3.243.58

2.693.28
5.042.85
2.191.00
11.595.23
163.40108.7
71.0060.5
38.0015.7
0.410.13
1.971.73

p value
< 0.001
< 0.001
< 0.001
0.009
0.356
0.505
0.001
0.003
0.002

IPSS: International Prostate Symptom Score; QoL: quality of life; Qmax: maximum flow
rate; PVR: postvoid residual; TPV: total prostate volume; TZI: transition zone index; PSA:
prostate-specific antigen

Table 2. Relationships of variables and therapeutic outcomes in group B without antimuscarinics (N=73)

IPSS (emptying)
IPSS (storage)
QoL
Qmax (mL/sec)
Volume (mL)
PVR (mL)
TPV (mL)
TZI
PSA (ng/mL)

Baseline

6-month

9.156.11
7.852.46
3.861.26
9.354.79
156.20110.6
77.8084.2
48.1032.9
0.440.14
3.233.83

4.594.52
6.591.67
2.520.93
11.795.86
200.30115.4
69.6065.5
38.9017.3
0.410.13
2.623.28

p value
< 0.001
< 0.001
< 0.001
< 0.001
0.002
0.457
0.009
0.027
0.147

IPSS: International Prostate Symptom Score; QoL: quality of life; Qmax: maximum flow
rate; PVR: postvoid residual; TPV: total prostate volume; TZI: transition zone index; PSA:
prostate-specific antigen

Table 3. Comparison of the changes in measured parameter for the two groups
after 6-month follow-up

Age (years)

IPSS (emptying)

IPSS (storage)

QoL

Qmax (mL/sec)

Volume (mL)

PVR (mL)

TPV (mL)

TZI

PSA (ng/mL)

Group A

Group B

P value

75.708.32
5.406.53
2.524.06
1.391.56
-1.604.89
-11.52101.45
6.3877.95
6.7816.09
0.040.11
1.273.25

73.408.45
4.566.48
1.262.67
1.341.61
-2.445.70
-43.49111.64
7.9090.35
9.2529.54
0.030.11
0.613.56

0.098
0.446
0.030
0.865
0.350
0.087
0.915
0.544
0.493
0.252

IPSS: International Prostate Symptom Score; QoL: quality of life; Qmax: maximum flow
rate; PVR: postvoid residual; TPV: total prostate volume; TZI: transition zone index; PSA:
prostate-specific antigen

OO

Combination Therapy Using an -blocker Antimuscarinic Agent

Table 4. Summary of similar trials

Kuo
2008

Steven et al
2007

Country

age

Taiwan

74.5

73

BPH with LUTS and OAB
B without antiM

67

BPH with LUTS and OAB
B with antiM

USA

61.9

Study design

F/U

Results

6-24 mons

*Improved UDS parameters and QoL in the two groups

*Combination
significantly decreased storage IPSS
*No difference in PVR or Qmax

12 wks

209

IPSS12 and QoL3
B without antiM

217

IPSS12 and QoL3
B with antiM

*Improved urgency (-3.33), urge incontinence, IPSS (-8), and

QoL (-1.61) in combination
*AUR in only 0.4% with the combination therapy

Yang et al
2007

China

69.1

36
33

BPH with continued LUTS
B without antiM 6 wks

BPH with continued LUTS
B with antiM

*Improved IPSS in the two groups

*No difference (vs. baseline and 2 groups) in PVR and Qmax

Lee et al
2005

Korea

66

67

BOO with OAB
B without antiM

8 wks

*Improved UDS parameters and IPSS in the two groups

without AUR
*greater reduction in storage IPSS with the combination therapy
(-8.7%)

3 mons

*Improved UDS parameters in the two groups

*Improved QoL and reduced OAB with the combination
therapy

131

Athanasopoulos Greece
et al
2003

68

25
25

BOO with OAB
B with antiM

BOO with OAB
B without antiM
BOO with OAB
B with antiM

BPH: benign prostatic hyperplasia; LUTS: lower urinary tract symptom; OAB: overactive bladder; B: -blocker; antiM: antimuscarinic agent; UDS: urodynamic study; QoL: quality of life; IPSS:
International Prostate Symptom Score; PVR: postvoid residual; Qmax: maximum flow rate; AUR: acute urinary retention; BOO: bladder outlet obstruction

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OP

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