Skip to main content

Advertisement

SpringerLink
Log in

Male overactive bladder: The role of urodynamics and anticholinergics

  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Millions of men suffer from overactive bladder and lower urinary tract symptoms. The adverse effects on quality of life and costs associated with the condition have been well described. In men, the pathophysiology of lower urinary tract symptoms may be from a number of causes including bladder outlet obstruction, detrusor overactivity, or both. Increasing data and clinical experience support the efficacy and safety of anticholinergics in men; the rate of urinary retention has been equal to that of placebo in short-term studies. Urodynamics play a vital role in defining the bladder and/or outlet dysfunction and help direct one’s therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Stewart WF, Van Rooyen JB, Cundiff GW, et al.: Prevalence and burden of overactive bladder in the United States. World J Urol 2003, 20:327–336.

    PubMed  CAS  Google Scholar 

  2. Engstrom G, Henningsohn L, Steineck G, Leppert J: Self-assessed health, sadness and happiness in relation to the total burden of symptoms from the lower urinary tract. BJU Int 2005, 95:810–815.

    Article  PubMed  Google Scholar 

  3. Hu TW, Wagner TH, Bentkover JD, et al.: Estimated economic costs of overactive bladder in the United States. Urology 2003, 61:1123–1128.

    Article  PubMed  Google Scholar 

  4. 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. Urology 2003, 61:37–49.

    Article  PubMed  Google Scholar 

  5. Peters TJ, Donovan JL, Kay HE, et al.: The International Continence Society “Benign Prostatic Hyperplasia” Study: the bothersomeness of urinary symptoms. J Urol 1997, 157:885–889.

    Article  PubMed  CAS  Google Scholar 

  6. Jacobsen SJ, Girman CJ, Lieber MM: Natural history of benign prostatic hyperplasia. Urology 2001, 58(Suppl 1):5–16.

    Article  PubMed  CAS  Google Scholar 

  7. Barry MJ, Cockett ATK, Hotgrewe HL, et al.: Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia. J Urol 1993, 150:351–358.

    PubMed  CAS  Google Scholar 

  8. Fusco F, Groutz A, Blaivas JG, et al.: Videourodynamic studies in men with lower urinary tract symptoms: a comparison of community based versus referral urological practices. J Urol 2001, 166:910–913.

    Article  PubMed  CAS  Google Scholar 

  9. Levin RM, Haugaard N, O’Connor L, et al.: Obstructive response of human bladder to BPH vs. rabbit bladder response to partial outlet obstruction: a direct comparison. Neurourol Urodyn 2000, 19:609–629.

    Article  PubMed  CAS  Google Scholar 

  10. Levin RM, Brading AE, Mills IW, et al.: Experimental models of bladder obstruction. In Prostatic Diseases. Edited by Lepor H. Philadelphia: WB Saunders; 2000:169–196.

    Google Scholar 

  11. Hyman MJ, Groutz A, Blaivas JG: Detrusor instability in men: correlation of lower urinary tract symptoms with urodynamic findings. J Urol 2001, 166:550–553.

    Article  PubMed  CAS  Google Scholar 

  12. Kaplan SA, Bowers DL, Te AE, et al.: Differential diagnosis of prostatism: a 12-year restrospective analysis of symptoms, urodynamics and satisfaction with therapy. J Urol 1996, 155:1305–1308.

    Article  PubMed  CAS  Google Scholar 

  13. Van Venrooij GE, Van Melick HH, Eckhardt MD, et al.: Correlations of urodynamic changes with changes in symptoms and well-being after transurethral resection of the prostate. J Urol 2002, 169:605–609.

    Article  Google Scholar 

  14. de Groat WC: A neurologic basis for the overactive bladder. Urology 1997, 50:36–52.

    Article  PubMed  Google Scholar 

  15. Brading AF: A myogenic basis for the overactive bladder. Urology 1997, 50:57–67.

    Article  PubMed  CAS  Google Scholar 

  16. Steers WD: Pathophysiology of overactive bladder and urge urinary incontinence. Rev Urol 2002, 4(Suppl):S7–S18.

    PubMed  Google Scholar 

  17. Nordling J: The aging bladder: a significant but underestimated role in the development of lower urinary tract symptoms. Exp Gerontol 2002, 37:991–999.

    Article  PubMed  Google Scholar 

  18. Van Kerrebroeck P, Kreder K, Jonas U, Zinner N, Wein A: Tolterodine once-daily: superior efficacy and tolerability in the treatment of overactive bladder. Urology 2001, 57:414–421.

    Article  PubMed  Google Scholar 

  19. Roehrborn CG, Guan Z, Wang JT, et al.: Efficacy and safety of tolterodine in male patients with overactive bladder and urinary urge incontinence. Neurourol Urodyn 2005, 24:174–175.

    Google Scholar 

  20. Abrams P, Kaplan S, Guan Z, et al.: Efficacy and safety of tolterodine in a predominantly continent population of male patients with overactive bladder and nocturia. Neurourol Urodyn 2005, 24:495–496.

    Article  Google Scholar 

  21. Kaplan S, Walmsley K, Te A: Tolterodine extended release attenuates lower urinary tract symptoms in men with benign prostatic hyperplasia. J Urol 2005 174:2273–2275.

    Article  PubMed  Google Scholar 

  22. Abrams P, Kaplan S, Millard R: Tolterodine treatment is safe in men with bladder outlet obstruction (BOO) and symptomatic detrusor overactivity (DO). Neurourol Urodyn 2001, 20:547–548.

    Google Scholar 

  23. Lee JY, Kim HW, Lee SJ, et al.: Comparison of doxazosin with or without tolterodine in men with symptomatic bladder outlet obstruction and overactive bladder. BJU Int 2004, 94:817–820.

    Article  PubMed  CAS  Google Scholar 

  24. Athanasopoulos A, Gyftopoulos K, Giannitsas K, et al.: Combination treatment with an α-blocker plus an anticholinergic for bladder outlet obstruction: a prospective, randomized, controlled study. J Urol 2003, 169:2253–2256.

    Article  PubMed  CAS  Google Scholar 

  25. MacDiarmid S, Chen A, Tu N, et al.: Effects of tamsulosin and extended-release oxybutynin on lower urinary tract symptoms in men [abstract 1638]. Program and abstracts of the American Urological Association 2006 Annual Meeting. May 20–25, 2006; Atlanta, GA.

  26. AUA Practice Guidelines Committee: AUA guideline on management of benign prostatic hyperplasia. Chapter 1: diagnosis and treatment recommendations. J Urol 2003, 170:530–547.

    Article  Google Scholar 

  27. Singapore Ministry of Health: The evaluation and treatment of lower urinary tract symptoms (LUTS) in older men. Proceedings of the 5th International Consultation on BPH. Paris: International Scientific Committee; 2000:519–532.

    Google Scholar 

  28. Gerstenberg TC, Andersen JT, Klarskov P, et al.: High flow infravesical obstruction in men: symptomatology, urodynamics, and the results of surgery. J Urol 1982, 127:943–945.

    PubMed  CAS  Google Scholar 

  29. Abrams P, Bruskewitz R, De La Rosette J, et al.: The diagnosis of bladder outlet obstruction: urodynamics. Edited by Cockett ATK, Khoury S, Aso Y, et al. Proceedings of the 3rd International Consultation on BPH. World Health Organization; 1995:299–367.

  30. Porru D, Jallous H, Cavalli, et al.: Prognostic value of a combination of IPSS, flow rate, and residual urine volume compared to pressure-flow studies in the preoperative evaluation of symptomatic BPH. Eur Urol 2002, 41:246–249.

    Article  PubMed  CAS  Google Scholar 

  31. Lim CS, Abrams P: The Abrams-Griffiths nomogram. World J Urol 1995, 13:34–39.

    Article  PubMed  CAS  Google Scholar 

  32. Schafer W: The contribution of the bladder outlet to the relation between pressure and flow rate during micturition. In Benign Prostatic Hypertrophy. Edited by Hinman F Jr, Boyarsky S. New York: Springer Verlag; 1983:470–496.

    Google Scholar 

  33. Schafer W: Principles and clinical application of advanced urodynamic analysis of voiding function, Urol Clin North Am 1990, 17:553–566.

    PubMed  CAS  Google Scholar 

  34. Abrams P: Bladder outlet obstruction index, bladder contractility index and bladder voiding efficiency: three simple indices to define bladder voiding symptoms. BJU Int 1999, 84:14–15.

    Article  PubMed  CAS  Google Scholar 

  35. Machino R, Kakizaki H, Ameda K, et al.: Detrusor instability with equivocal obstruction: A predictor of unfavorable symptomatic outcomes after transurethral prostatectomy. Neurourol Urodyn 2002, 21:444–449.

    Article  PubMed  Google Scholar 

  36. Abrams PH, Farrar DJ, Turner-Warwick RT, et al.: The results of prostatectomy: a symptomatic and urodynamic analysis of 152 patients. J Urol 1979, 121:640–642.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Alliance Urology Specialists, Bladder Control and Pelvic Pain Center, 509 N. Elam, Greensboro, NC, 27403, USA

    Scott MacDiarmid MD

Authors
  1. Scott MacDiarmid MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexandra Rogers MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Scott MacDiarmid MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

MacDiarmid, S., Rogers, A. Male overactive bladder: The role of urodynamics and anticholinergics. Curr Urol Rep 8, 66–73 (2007). https://doi.org/10.1007/s11934-007-0023-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-007-0023-7

Keywords

Search

Navigation