March 23, 2006

Tolterodine safe in men with overactive bladder

NEW YORK (Reuters Health) - Tolterodine treatment, sold in
the US under the name of Detro, is part of a class of
medications called antimuscarinics, which prevent bladder
contractions, according to researchers who also found that
tolterodine is a well-tolerated treatment for overactive
bladder in men with bladder outlet obstruction and the drug
does not seem to cause urinary retention,

Antimuscarinic agents are typically not given to elderly
men with bladder outlet obstruction, because of concerns that
inhibiting bladder contractility could make urination even more
difficult, researchers report in the March issue of the Journal
of Urology. However, few studies have actually examined the
safety of antimuscarinic therapy in this patient population.

Therefore, Dr. Paul Abrams, from the Bristol Urologic
Institute in the UK, and colleagues, evaluated 221 men with
bladder outlet obstruction and detrusor overactivity who were
randomized to receive tolterodine (2 mg twice daily) or placebo
for 12 weeks. All of the men were over 40 years old and the
average age was about 64 years.

Urodynamic testing revealed that tolterodine had
significant beneficial effects on the urinary obstruction,
detrusor overactivity, and bladder capacity compared with

Treatment with tolterodine was well tolerated and, except
for dry mouth, and was not associated with an increased risk of
side effects, including urinary retention.

Tolterodine reduced bladder contractions without causing
urinary retention and did not worsen voiding difficulties in
this urodynamically obstructed population, the investigators

Dr. Rodney A. Appell, from Baylor College of Medicine in
Houston, comments in a related editorial that the current
findings "should allay those fears of urologists that treating
the overactive bladder component by using an antimuscarinic
agent in men with lower urinary tract symptoms will tip the
scale so that the residual urine will drastically increase, or
worse, the patient will end up in frank urinary retention."

The study was funded by Pharmacia, which markets
tolterodine as Detrol.

SOURCE: The Journal of Urology, March 2006.