Rate and associated factors of solifenacin add-on after tamsulosin monotherapy in men with voiding and storage lower urinary tract symptoms

초록

AimTo explore the rate of add-on therapy with solifenacin in men with voiding and storage lower urinary tract symptoms (LUTS) after tamsulosin monotherapy and to explore predictive factors for starting solifenacin add-on therapy. MethodsMen aged 45years with IPSS12 and symptoms of OAB (OAB-V88, micturition 8/24h, urgency 2/24h) were enrolled to receive tamsulosin 0.2mg once daily. After 4weeks, men with residual symptoms of OAB and reported dissatisfied' or a little satisfied' were received solifenacin 5mg in combination with tamsulosin monotherapy. Subjects completed an IPSS, a Quality of life (QoL) index, OAB V8, and an International Consultation of Incontinence Questionnaire (ICIQ)-Male LUTS, and patient perception of bladder condition (PPBC) at baseline and week 4. ResultsOf a total of 305 patients, 254 patients completed 4weeks of tamsulosin treatment. For 176 patients, solifenacin was added (69.3%). Significant predictive factors of solifenacin add-on therapy included long LUTS duration, high IPSS, number of micturitions per 24h, more urgency episodes, high urgency severity score in a voiding diary and high OAB V8 score. Based on multivariable analysis, potential predictive factors of solifenacin add-on therapy included long LUTS duration (OR=1.008, 95% CI: 1.001-1.014), high serum PSA (OR=1.543, 95% CI: 1.136-2.095) and small prostate size (OR=0.970, 95% CI: 0.947-0.994) (p<0.05). IPSS, daytime micturitions and urgency episodes, OAB V8 scores, ICIQ and PPBC were improved after tamsulosin monotherapy. ConclusionsTwo thirds of men with voiding and storage LUTS needed to add anticholinergics after 4weeks of tamsulosin monotherapy. Patients with longer lasting symptoms and storage symptoms with small prostate volume may require the anticholinergic add-on.

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