Editorial comment on: Tolterodine treatment improves storage symptoms suggestive of overactive bladder in men treated with alpha-blockers.

摘要

Heretofore, lower urinary tract symptoms (LUTS) in men have been arbitrarily assumed to arise from benign prostatic disease (some combination of fibromuscular hypertrophy and smooth muscle activity). This unifying pathophysiology was used to explain the combination of obstructive and irritative complaints that constitute the LUTS syndrome. While the contribution of prostatic disease cannot be minimized, it is becoming clear that therapy primarily focused on bladder storage (and the associated predominant irritative symptoms) can have beneficial effect for at least some men bothered by the LUTS complex. Accruing short-term evidence suggests that antimus-carinic therapy can improve global LUTS symptom scores when combined with alpha-blocker therapy or, in some cases, as monotherapy in selected men. Patient selection and appropriate parameters of therapy, however, are not yet adequately defined.