Effects of Terazosin and Tolterodine on Ureteral Stent Related Symptoms: A Double-Blind Placebo-Controlled Randomized Clinical Trial

Objective To evaluate the effects of terazosin and tolterodine on ureteral stent discomfort. Materials and Methods Of 163 patients assessed for eligibility, 104 patients were randomly assigned to receive placebo, 2 mg of terazosin twice daily, 2 mg of tolterodine daily, or both terazosin plus tolterodine during the stenting period. Prior to stenting and at stent removal, the International Prostate Symptom Score (IPSS), the IPSS quality of life (QoL) subscore and the Visual Analog Scale for Pain were determined. The patients also reported their analgesic use during the stenting period. Results Ninety-four patients completed the study. We noted significant decreases in the total IPSS scores (p = 0.002), irritative subscore (p = 0.039), QoL (p = 0.001), flank pain (p = 0.013), voiding pain (p = 0.01) and amount of analgesics used (p = 0.02) in the groups. However, neither the obstructive subscore nor the suprapubic pain improved significantly (p = 0.251 and p = 0.522, respectively). The patients receiving terazosin plus tolterodine experienced significant reductions in the total IPSS, irritative symptoms, QoL, flank pain, voiding pain and decreased analgesics use compared with those patients receiving placebo. However, compared with placebo, terazosin monotherapy did not affect pain levels, and tolterodine monotherapy did not improve QoL, flank pain or analgesics use. Conclusions Terazosin plus tolterodine improves ureteral stent-related complications, including irritative symptoms, the amount of analgesics used, QoL, flank pain and voiding pain but does not decrease obstructive symptoms or suprapubic pain. This trial was registered at www.clinicaltrials.gov as NCT01530243. .

Effects of Bladder Training and/or Tolterodine in Female Patients with Overactive Bladder Syndrome: A Prospective, Randomized Study

We compared the effects of bladder training and/or tolterodine as first line treatment in female patients with overactive bladder (OAB). One hundred and thirty-nine female patients with OAB were randomized to treatment with bladder training (BT), tolterodine (To, 2 mg twice daily) or both (Co) for 12 weeks. Treatment efficacy was measured by micturition diary, urgency scores and patients' subjective assessment of their bladder condition. Mean frequency and nocturia significantly decreased in all treatment groups, declining 25.9% and 56.1%, respectively, in the BT group; 30.2% and 65.4%, respectively, in the To group; and 33.5% and 66.3%, respectively in the Co group (p<0.05 for each). The decrease in frequency was significantly greater in the Co group than in the BT group (p<0.05). Mean urgency score decreased by 44.8%, 62.2% and 60.2% in the BT, To, and Co groups, respectively, and the improvement was significantly greater in the To and Co groups than in the BT group (p<0.05 for each). Although BT, To and their combination were all effective in controlling OAB symptoms, combination therapy was more effective than either method alone. Tolterodine alone may be instituted as a first-line therapy, but may be more effective when combined with bladder training.

Urinary symptoms and quality of life changes in Thai women with overactive bladder after tolterodine treatment.

OBJECTIVES: To study the urinary symptoms and quality of life changes in Thai women with overactive bladder (OAB) after tolterodine treatment. MATERIAL AND METHOD: Thirty women (aged 30-77 years) diagnosed as having OAB at the Gynecology Clinic, King Chulalongkorn Memorial Hospital from January to April 2004 were included in the present study. Tolterodine 2 mg, twice daily was given. After 8 weeks treatment, changes in micturition diary variables and tolerability were determined. Short form 36 (SF36) questionaires (Thai version) were given before and after 8 weeks of treatment. RESULTS: At 8 weeks, all micturition per day decreased from 16. 7 +/- 5. 3 to 6. 7 +/- 2.4 times per day. The number of nocturia episodes decreased from 5.4 +/- 4.2 to 1.1 +/- 1.0 times per night. The most common side effect was dry month in 5 cases (16.7%) with 2 cases reporting a moderate degree and 1 case with severe degree. Only one case (3.3%) withdrew from the present study due to a severe dry mouth. The SF-36 scores changed significantly in the domains of physical functioning, role function emotional, social function and mental heath. CONCLUSION: Tolterodine was well tolerated and its effects improved the quality of life in Thai women with OAB.

Eficácia e tolerabilidade das substâncias calorigênicas: ioimbina, triiodotironina, aminofilina combinada a efedrina e feniolpropanolamina no tratamento da obesidade a curto prazo / Efficacy and tolerability of calorigenic substances: yoimbine, triiodothyronine, aminophylline combined with ephedrine and phenylpropanolamine in the short term obesity treatment

Objetivo: Determinar a eficácia e tolerabilidade de 4 substâncias calorigênicas: ioimbina, triiodotironina (T3), combinação efedrina-aminofilina e fenilpropanolamina (FPA). Material, Métodos e Desenho da Pesquisa: 103 mulheres obesas (30 < BMI < 40kg/m 2 ), de 18 a 55 anos, foram submetidas a estudo cego comparativo das 4 substâncias associadas a uma dieta com 1.200 calorias (55 por cento HC, 30 por cento gordura e 15por cento proteínas). As doses utilizadas foram 8mg de ioimbina, 25mcg de T3, 100mg de aminofilina + 25mg de efedrina e 25mg de FPA. Foi ainda incluído um grupo placebo. Os 4 medicamentos e o placebo foram dados 3 vezes ao dia, antes do desjejum, do almoço e do jantar. O estudo se realizou num período de 12 semanas, para cada paciente e no início e o fim do mesmo foram avaliados peso, composição corpórea por bioimpedância, metabolismo de repouso (por calorimetria), pulso e pressão arterial e eventos adversos. Resultados: Houve perda de peso em todos os grupos, mas o único que perdeu peso significativamente em relação ao grupo placebo foi o que recebeu FPA (p < 0,05). Não houve diferença quanto à composição corpórea e metabolismo de repouso entre os 5 grupos. Conclusão: Em nossa amostra, a FPA se revelou mais eficaz, embora este fato não possa ser atribuído a uma maior queima energética em repouso, já que não houve diferença apreciável no metabolismo de repouso entre os grupos.