Safety And Efficacy Of Solifenacin In Men With Overactive Bladder (OAB) And Detrusor Underactivity
Status:
Completed
Trial end date:
1969-12-31
Target enrollment:
Participant gender:
Summary
Detrusor underactivity (DUA) in men is responsible for LUTS in a significant minority, the
symptoms being indistinguishable from those seen in BOO. The International Continence Society
(ICS) defines DUA as 'a detrusor contraction of inadequate magnitude and/or duration to
effect complete bladder emptying in the absence of urethral obstruction. Whilst a reduced
maximum urinary flow rate (Qmax) is indicative of voiding dysfunction, flow studies cannot
distinguish between DUA and BOO, which are the two principal causes of low flow rates. DUA is
diagnosed from a pressure-flow study (PFS)and is characterized by a low-pressure, poorly
sustained, or wave-like detrusor contraction with an associated poor flow rate.
Overactive bladder (OAB) is the most common term currently used in clinical medicine to
describe a complex of lower urinary tract symptoms (LUTS) with or without incontinence but
most commonly consisting of urgency, frequency, nocturia, troublesome or incomplete
emptying,and, occasionally, pain. With the exception of pain and incontinence, these symptoms
are often found together; thus, the term LUTS has come to replace previous terms, such as
urgency-frequency syndrome,urethral syndrome, and prostatism.
Drug treatment is frequently used as the initial management approach for LUTS in older
men.Among men who desire treatment, general practice prescribing data have shown that
antimuscarinics are not often given to elderly men. There is theoretical concern that the
inhibitory effect of antimuscarinics on detrusor contraction could aggravate voiding
difficulties or cause urinary retention in patients with BOO. There are virtually no data
evaluating the safety and efficacy of solifenacin treatment in men with DUA and OAB.