Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Current Bladder Dysfunction Reports
Published in: Current Bladder Dysfunction Reports 2/2013

01-06-2013 | BPH-Related Voiding Dysfunction (Y Kojima, Section Editor)

Current Understanding of the Interplay between Oab & Bph

Authors: Konstantinos Giannitsas, Anastasios Athanasopoulos

Published in: Current Bladder Dysfunction Reports | Issue 2/2013

Login to get access

Abstract

Lower urinary tract symptoms (LUTS) are very common and bothersome to men. For many years all male LUTS, even the storage ones, were attributed to the prostate, which was the target of therapeutic approaches. Increasing knowledge of the contribution of bladder dysfunction to LUTS pathophysiology has brought into focus detrusor overactivity (DO) and its treatments. Available data indicate that in many cases DO and overactive bladder (OAB) symptoms are secondary to bladder outlet obstruction (BOO), due to prostatic disease. Accumulating evidence also suggests that the two pathologies may coexist because they share etiologic factors. Despite the prevalence of storage symptoms in men with benign prostatic hyperplasia (BPH), antimuscarinics, the main treatment for OAB, were infrequently used because of fear of urinary retention. Available clinical trials indicate that the addition of an antimuscarinic to prostate-targeted treatments, or treatment initiation with a combination regimen, is safe in terms of urinary retention and offers improvements in storage symptoms. Nevertheless, the improvement in overall quality of life is modest. Criteria for the selection of patients likely to benefit most from the addition of antimuscarinics to common BPH treatments are lacking.
Literature
1.
Irwin DE, Milsom I, Hunskaar S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50:1306–14.PubMedCrossRef
2.
Coyne KS, Sexton CC, Irwin DE, et al. The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexu ality and emotional well-being in men and women: results from the EPIC study. BJU Int. 2008;101:1388–95.PubMedCrossRef
3.
Coyne KS, Sexton CC, Thompson CL, et al. The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study. BJU Int. 2009;104:352–60.PubMedCrossRef
4.
5.
Lepor H, Kazzazi A, Djavan B. α-Blockers for benign prostatic hyperplasia: the new era. Curr Opin Urol. 2012;22:7–15.PubMedCrossRef
6.
Naslund MJ, Miner M. A review of the clinical efficacy and safety of 5alpha-reductase inhibitors for the enlarged prostate. Clin Ther. 2007;29:17–25.PubMedCrossRef
7.
Kaplan SA, McConnell JD, Roehrborn CG, et al. Combination therapy with doxazosin and finasteride for benign prostatic hyperplasia in patients with lower urinary tract symptoms and a baseline total prostate volume of 25 ml or greater. J Urol. 2006;175:217–20.PubMedCrossRef
8.
Montorsi F, Roehrborn C, Garcia-Penit J, et al. The effects of dutasteride or tamsulosin alone and in combination on storage and voiding symptoms in men with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH): 4-year data from the Combination of Avodart and Tamsulosin (CombAT) study. BJU Int. 2011;107:1426–31.PubMedCrossRef
9.
Chapple CR, Roehrborn CG. A shifted paradigm for the further understanding, evaluation, and treatment of lower urinary tract symptoms in men: focus on the bladder. Eur Urol. 2006;49:651–8.PubMedCrossRef
10.
Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Am J Obstet Gynecol. 2002;187:116–26.PubMedCrossRef
11.
Sexton CC, Coyne KS, Kopp ZS, et al. The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS. BJU Int. 2009;103 Suppl 3:12–23.PubMedCrossRef
12.
Oelke M, Baard J, Wijkstra H, de la Rosette JJ, Jonas U, Höfner K. Age and bladder outlet obstruction are independently associated with detrusor overactivity in patients with benign prostatic hyperplasia. Eur Urol. 2008;54:419–26.PubMedCrossRef
13.
Liu N, Man LB, He F, et al. Multiple factors related to detrusor overactivity in Chinese patients with benign prostate hyperplasia. Chin Med J (Engl). 2012;125:3778–8.
14.
Oh MM, Choi H, Park MG, et al. Is there a correlation between the presence of idiopathic detrusor overactivity and the degree of bladder outlet obstruction? Urology. 2011;77:167–70.PubMedCrossRef
15.
Sriplakich S, Promwatcharanon K. The resolution of detrusor over activity after medical and surgical treatment in patients with bladder outlet obstruction. J Med Assoc Thail. 2007;90:2326–31.
16.
Nepomnyashchikh LM, Lushnikova EL, Neimark AI. Remodeling of the muscle layer (detrusor muscle) of hyperactive bladder disease in patients with benign prostatic hyperplasia. Bull Exp Biol Med. 2012;153:778–83.PubMedCrossRef
17.
Andersson KE. Detrusor myocyte activity and afferent signaling. Neurourol Urodyn. 2010;29:97–106.PubMedCrossRef
18.
Wada N, Watanabe M, Kita M, Matsumoto S, Kakizaki H. Analysis of bladder vascular resistance before and after prostatic surgery in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction. Neurourol Urodyn. 2012;31:659–63.PubMedCrossRef
19.
Kurizaki Y, Ishizuka O, Imamura T, et al. Relationship between expression of β3-adrenoceptor mRNA in bladder mucosa and urodynamic findings in men with lower urinary tract symptoms. Neurourol Urodyn. 2013;32(1):88–91. doi:10.​1002/​nau.​22278.PubMedCrossRef
20.
Aydin M, Wang HZ, Zhang X, et al. Large-conductance calcium-activated potassium channel activity, as determined by whole-cell patch clamp recording, is decreased in urinary bladder smooth muscle cells from male rats with partial urethral obstruction. BJU Int. 2012;110:402–8.CrossRef
21.
Cho ST, Park EY, Kim JC. Effect of angiotensin II receptor antagonist telmisartan on detrusor overactivity in rats with bladder outlet obstruction. Urology. 2012;80:1163e1–7.
22.
Yuan X, Wu S, Lin T, et al. Role of nitric oxide synthase in bladder pathologic remodeling and dysfunction resulting from partial outlet obstruction. Urology. 2011;77:1008e1–8.CrossRef
23.
Gacci M, Corona G, Salvi M, et al. A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with α-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2012;61:994–1003.PubMedCrossRef
24.
Lee RK, Chung D, Chughtai B, Te AE, Kaplan SA. Central obesity as measured by waist circumference is predictive of severity of lower urinary tract symptoms. BJU Int. 2012;110:540–5.PubMedCrossRef
25.
Abdollah F, Briganti A, Suardi N, et al. Metabolic syndrome and benign prostatic hyperplasia: evidence of a potential relationship, hypothesized etiology, and prevention. Korean J Urol. 2011;52:507–16.PubMedCrossRef
26.
Matsumoto S, Kakizaki H. Causative significance of bladder blood flow in lower urinary tract symptoms. Int J Urol. 2012;19:20–5.PubMedCrossRef
27.
Yoshida M, Masunaga K, Nagata T, Satoji Y, Shiomi M. The effects of chronic hyperlipidemia on bladder function in myocardial infarction-prone Watanabe heritable hyperlipidemic (WHHLMI) rabbits. Neurourol Urodyn. 2010;29:1350–4.PubMedCrossRef
28.
Ohgaki K, Horiuchi K, Kondo Y. Association between metabolic syndrome and male overactive bladder in a Japanese population based on three different sets of criteria for metabolic syndrome and the Overactive Bladder Symptom Score. Urology. 2012;79:1372–8.PubMedCrossRef
29.
Roehrborn CG, Van Kerrebroeck P, Nordling J. Safety and efficacy of alfuzosin 10 mg once-daily in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a pooled analysis of three double-blind, placebo-controlled studies. BJU Int. 2003;92:257–61.PubMedCrossRef
30.
Song K, Choo MS, Lee KS, et al. The long-term effect of alfuzosin in patients with lower urinary tract symptoms suggestive of benign prostate hyperplasia: evaluation of voiding and storage function with respect to bladder outlet obstruction grade and contractility. Urology. 2011;77:1177–82.PubMedCrossRef
31.
Takahashi S, Tajima A, Matsushima H, Kawamura T, Tominaga T, Kitamura T. Clinical efficacy of an alpha1A/D-adrenoceptor blocker (naftopidil) on overactive bladder symptoms in patients with benign prostatic hyperplasia. Int J Urol. 2006;13:15–20.PubMedCrossRef
32.
Tsujimura A, Takao T, Miyagawa Y, et al. Survey of overactive bladder symptoms influencing bother before and after treatment with tamsulosin hydrochloride in Japanese patients with benign prostatic hyperplasia. Urology. 2011;78:1058–62.PubMedCrossRef
33.
Cho KJ, Kang SH, Kim HS, et al. Effect of 5-alpha reductase inhibitor on storage symptoms in patients with benign prostatic hyperplasia. Int Neurourol J. 2011;15:152–7.PubMedCrossRef
34.
Malloy BJ, Price DT, Price RR, et al. Alpha1-adrenergic receptor subtypes in human detrusor. J Urol. 1998;160:937–43.PubMedCrossRef
35.
Ukimura O, Kanazawa M, Fujihara A, et al. Naftopidil versus tamsulosin hydrochloride for lower urinary tract symptoms associated with benign prostatic hyperplasia with special reference to the storage symptom: a prospective randomized controlled study. Int J Urol. 2008;15:1049–54.PubMedCrossRef
36.
Kim SE, Shin MS, Kim CJ, et al. Effects of Tamsulosin on urinary bladder function and neuronal activity in the voiding centers of rats with cyclophosphamide-induced overactive bladder. Int Neurourol J. 2012;16:13–22.PubMedCrossRef
37.
Yazaki J, Aikawa K, Shishido K, et al. Alpha1-adrenoceptor antagonists improve bladder storage function through reduction of afferent activity in rats with bladder outlet obstruction. Neurourol Urodyn. 2011;30:461–7.PubMedCrossRef
38.
Lee JY, Kim HW, Lee SJ, Koh JS, Suh HJ, Chancellor MB. Comparison of doxazosin with or without tolterodine in men with symptomatic bladder outlet obstruction and an overactive bladder. BJU Int. 2004;94:817–20.PubMedCrossRef
39.
Matsukawa Y, Hattori R, Sassa N, Yamamoto T, Gotoh M. What are the factors contributing to failure in improvement of subjective symptoms following silodosin administration in patients with benign prostatic hyperplasia? investigation using a pressure-flow study. Neurourol Urodyn. 2012. doi:10.​1002/​nau.​22286.PubMed
40.
Novara G, Galfano A, Secco S, et al. A systematic review and meta-analysis of randomized controlled trials with antimuscarinic drugs for overactive bladder. Eur Urol. 2008;54:740–63.PubMedCrossRef
41.
• Athanasopoulos A, Chapple C, Fowler C. The role of antimuscarinics in the management of men with symptoms of overactive bladder associated with concomitant bladder outlet obstruction: an update. Eur Urol. 2011;60:94–105. An extensive review summarizing the most important aspects of the clinical use of antimuscarinics in men.PubMedCrossRef
42.
Roehrborn CG, Kaplan SA, Jones JS, Wang JT, Bavendam T, Guan Z. Tolterodine extended release with or without tamsulosin in men with lower urinary tract symptoms including overactive bladder symptoms: effects of prostate size. Eur Urol. 2009;55:472–9.PubMedCrossRef
43.
Park JS, Lee HW, Lee SW, Moon HS, Park HY, Kim YT. Bladder wall thickness is associated with responsiveness of storage symptoms to alpha-blockers in men with lower urinary tract symptoms. Korean J Urol. 2012;53:487–91.PubMedCrossRef
44.
Yamaguchi O, Kakizaki H, Homma Y, et al. Solifenacin as add-on therapy for overactive bladder symptoms in men treated for lower urinary tract symptoms–ASSIST, randomized controlled study. Urology. 2011;78:126–33.PubMedCrossRef
45.
Kaplan SA, He W, Koltun WD, Cummings J, Schneider T, Fakhoury A. Solifenacin plus tamsulosin combination treatment in men with lower urinary tract symptoms and bladder outlet obstruction: a randomized controlled trial. Eur Urol. 2012;63(1):158–65. doi:10.​1016/​j.​eururo.​2012.​07.​003.PubMedCrossRef
46.
Lee SH, Chung BH, Kim SJ, Kim JH, Kim JC, Lee JY. Initial combined treatment with anticholinergics and α-blockers for men with lower urinary tract symptoms related to BPH and overactive bladder: a prospective, randomized, multi-center, double-blind, placebo-controlled study. Prostate Cancer Prostatic Dis. 2011;14:320–5.PubMedCrossRef
47.
Kaplan SA, Roehrborn CG, Gong J, Sun F, Guan Z. Add-on fesoterodine for residual storage symptoms suggestive of overactive bladder in men receiving α-blocker treatment for lower urinary tract symptoms. BJU Int. 2012;109:1831–40.PubMedCrossRef
48.
Witte LP, Chapple CR, de la Rosette JJ, Michel MC. Cholinergic innervation and muscarinic receptors in the human prostate. Eur Urol. 2008;54:326–34.PubMedCrossRef
49.
Wuest M, Witte LP, Michel-Reher MB, et al. The muscarinic receptor antagonist propiverine exhibits α(1)-adrenoceptor antagonism in human prostate and porcine trigonum. World J Urol. 2011;29:149–55.PubMedCrossRef
Metadata
Title
Current Understanding of the Interplay between Oab & Bph
Authors
Konstantinos Giannitsas
Anastasios Athanasopoulos
Publication date
01-06-2013
Publisher
Current Science Inc.
Published in
Current Bladder Dysfunction Reports / Issue 2/2013
Print ISSN: 1931-7212
Electronic ISSN: 1931-7220
DOI
https://doi.org/10.1007/s11884-013-0178-7

Other articles of this Issue 2/2013

Current Bladder Dysfunction Reports 2/2013 Go to the issue

BPH-Related Voiding Dysfunction (Y Kojima, Section Editor)

Contemporary Combination Therapy in the Treatment of LUTS/BPH

Voiding Dysfunction Evaluation (H Atiemo, Section Editor)

Evaluation and Treatment of Post Mid-Urethral Sling Incontinence and Voiding Dysfunction

BPH-Related Voiding Dysfunction (Y Kojima, Section Editor)

Natural History of Lower Urinary Tract Symptoms Secondary to BPH

Voiding Dysfunction Evaluation (H Atiemo, Section Editor)

Evaluation and Treatment of Female Urethral Stricture Disease

Voiding Dysfunction Evaluation (H Atiemo, Section Editor)

Detrusor Underactivity and Urinary Retention in Geriatric Patients: Evaluation, Management and Recent Research

Voiding Dysfunction Evaluation (H Atiemo, Section Editor)

Current State of the Art in Non-Invasive Urodynamics