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Combination Therapy More Effective for Treating Lower Urinary Tract Symptoms

tamsulosin reported treatment benefit by week 12, compared with 62 percent of patients receiving placebo, 65 percent of patients receiving tolterodine ER, or 71 percent of patients receiving tamsulosin. Neither group receiving monotherapy demonstrated significant differences vs. placebo in percentages of patients reporting treatment benefit.

The symptoms of urgency urinary incontinence, urgency, and 24-hour and nocturnal urination frequency were also significantly improved by week 12 in the group receiving tolterodine ER plus tamsulosin vs. placebo but not in the tamsulosin group. In the tolterodine ER group, only urgency urinary incontinence episodes per 24 hours were significantly reduced at week 12. The International Prostate Symptom Score and quality-of-life scores were significantly improved by week 12 among patients receiving tolterodine ER plus tamsulosin. All interventions were well tolerated.

"The results of this study demonstrate that some men bothered by lower urinary tract symptoms, including bladder diary-documented overactive bladder symptoms, might not respond to monotherapy with either ?-receptor antagonists or antimuscarinic agents. Treatment with tolterodine ER plus tamsulosin resulted in statistically and clinically significant treatment benefit. Similarly low incidences of acute urinary retention were observed in all treatment groups, and there were no significant differences in maximum urinary flow rate or postvoid residual volume between any 2 groups," the authors conclude.

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