1. Among men with symptoms of overactive bladder with or without concomitant benign prostatic hyperplasia, tamsulosin therapy significantly reduced the symptoms of overactive bladder.
Evidence Rating Level: 2 (Good)
Lower urinary tract symptoms (LUTS) are common among older male adults and are most commonly attributed to either benign prostatic hyperplasic (BPH) or overactive bladder (OAB). Though there is significant overlap between the two pathologies in terms of signs and symptoms, it is recommended that men presenting with OAB only are managed with antimuscarinic medications or β-3 agonists; α-blockers like tamsulosin are notably absent from treatment guidelines. This study is a planned, secondary analysis of the Male Overactive Bladder Trial in Veterans (MOTIVE) trial, examining the effect of 0.4 mg of tamsulosin therapy nightly for four weeks on the symptoms of OAB among male veterans who may or may not have concomitant BPH. 116 participants were included in the analysis (mean [SD] age = 64.6 [10.4] years, 57.1% white). It was found that four weeks of tamsulosin therapy significantly reduced multiple OAB outcome measures, including a reduction in 24-hour urinary frequency from 11.3 to 9.9 (p < 0.0001); a decrease in mean maximum urgency rating from 2.5 to 2.2 points (p < 0.0001); and a decrease in mean nocturia from 2.1 to 1.8 nightly episodes (p < 0.001). Furthermore, the mean total AUA-7 SI score – a standardized questionnaire tracking storage symptoms (urgency, frequency, and nocturia) that most often map to OAB and voiding symptoms (hesitancy, weak stream, feeling of incomplete emptying, and interrupted stream) that are most often associated with BPH – decreased from 16.3 to 11.3. Finally, it was found that higher AUA-7 SI and voiding symptom scores at baseline were significantly associated with achieving a 3-point decline in total AUA-7 SI score (p < 0.0001). In all, this study suggests that tamsulosin may be an effective drug for OAB among men; future, prospective studies may further clarify these data.
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