Aim: To compare the symptomatic and urodynamic aspects of mono-therapies and combination therapies of tolterodine and tamsulosin.
Meterial and Methods: Sixty-six patients with lower urinary tract symptoms due to benign prostatic hyperplasia were separated into three treatment groups as tolterodine only group, tamsulosin mono-therapy group, and tolterodine+tamsulosin combination therapy group. Demographics of the patients were noted and prostate specific antigen, prostate volumes, and international prostate symptom scores were determined before and after the treatment. Qmax, PdetQmax, cystometric bladder capacities and detrusor hyperactivities, residual urine portions, Abrams-Griffith obstruction scores (ObstInd) were established. Patients took 2 mg of tolterodine twice a day in first group, 0.4 mg of tamsulosine once a day in second group, and equal doses of these medicines were given as combination in third group. All three groups took the medications for six months. International prostate symptom score and pressure-flow studies were repeated after the treatment, and the differences were analyzed both in, and between the groups.
Results: There was no statistically significant difference in tolterodine group for residual urine portions, but these values were significantly lowered in tamsulosin group and combination-therapy groups. Qmax, PdetQmax, cystometric capacity, and Abrams-Griffith obstruction scores were similar in tolterodine and tamsulosin monotherapy groups, whereas significant improvements were achieved in combination therapy group.
Tamsulosin group had similar international prostate symptom score -total, international prostate symptom score -obstructive, Vr, PdetQmax and ObstInd values with combination therapy group. Moreover, combination therapy group was significantly more efficient in international prostate symptom score irritative sub-score and nocturia frequency.
Conclusions: We concleded that patients who have overactive bladder symptoms and lower urinary tract symptoms due to benign prostatic hyperplasia, and who do not benefit from alpha-blockers will benefit from combined treatment.
Key Words: Lower Urinary Tract Symptoms; Benign Prostatic Hyperplasia; Anticholinergic Treatment.
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