SaturdayNovember 6, 2010 2:00 pm

Several studies have already demonstrated that antichloinergic medications are safe to use in  men with bladder outflow obstruction.  Abrams et al performed urodynamics in men with bladder outflow obstruction before and after commencing anticholinergics (1).  there was no increased risk of urinary retention and no clinically significant change invoiding pressures or residual volumes.  a systematic review and meta-analysis by Blake-James et al confirmed these findings.

In this months BJU Int a futher paper adds evidence to the safety and efficacy of anticholinergics in men with residual overactive symptoms (urgency and frequency) already treated with an alpha blocker.  They also looked to see if Prostate Specific Antigen (PSA) influenced safety and efficacy.  They concluded that the addition of tolterodine-ER (anticholinergic) to alphablocker therapy improved key overactive bladder symptoms and appeared to be well tolerated regardless of subjects prostate size as judged by serum PSA concentrations (3).

(1)  Abrams P et Al.  Safety and tolerability of Tolterodine in the treatment of Overactive bladder in men with Bladder Outflow Obstruction.  J Urol 2006; 175:999-1004.

(2)  Blake-James et al.  the role of anticholinergics in men with LUTS suggestive of BPH: a systematic review and meta-analysis.  BJU Int 2006; 99:85-96.

(3)  Chapple et al.  Efficacy and safety of tolterodine-ER in men with overactive bladder symptoms treated with alpha-blocker:  effect of baseline PSA concentrstion.  BJU Int 2010; 106: 1332-1338.

Posted by: Andrew Sinclair | November 6, 2010 « Requesting a PSA test | News home | PCA3 test may predict prostate cancer occurring in the future »

I was curious if Prostattis or BPH, can be treated the same way, that is, initially with Cipro and the combination of a Alpha Blocker and DHT Reductase (i.e., Cardura and Proscar)? how long does it take for symptoms, such as severe pain in area of prostate and urine retention, to begin to see results? thank you