Editorial comment

摘要

Editorial Comment: Please read the abstract for this article. The results of this study should put to bed once and for all the notion that antimuscarinics, at least in combination with an alpha-blocker, result in deleterious changes in the emptying phase of micturition in men who have urodynamic evidence of bladder outlet obstruction, a minimal to moderate residual urine volume, and filling/ storage and voiding/emptying symptoms. That was the main purpose of the article and is well stated in the abstract. In an accompanying editorial comment Gratzke and Andersson point out that an equally or perhaps more interesting aspect of discussion could be gleaned from the secondary end points, since there was essentially no significant improvement in symptoms (International Prostate Symptom Score patient perception of bladder condition, Incontinence Questionnaire male lower urinary tract symptoms score, Incontinence Questionnaire lower urinary tract symptoms quality of life score) between placebo and either of the 2 drug groups. Similarly there was no significant difference for changes in urgency episodes or incontinence episodes between the 3 groups. The number of micturitions per 24 hours (baselines between 10.5 and 10.7) decreased by 1 in the placebo group and 1.9 in each of the 2 drug groups. The only real change was in the volume voided micturition, which increased by 7.6 ml in the placebo group, 36.3 ml in the solifenacin 6 mg group and 30.3 ml in the solifenacin 9 mg group. The results here in this group of patients, with a combination of drugs considered to be "good," are quite different from some more favorable results in the literature. The lack of dose response between the 2 doses of antimuscarinics with respect to symptom relief is also noteworthy and requires explanation.