Increasing solifenacin dose is effective and safe for male patients with unresponsive overactive bladder

This study investigated the effectiveness and safety of increasing the dose of solifenacin (Vesicare) treatment in male patients with overactive bladder (OAB) that does not respond to low-dose treatment. Researchers suggested that increasing the dose of solifenacin is safe and improves the outcomes of these patients.

OAB consists of an uncontrollable urge to urinate. It also involves an increased frequency of urination and nocturia (urinating more than once at night-time). Incontinence (leakage of urine) might also be present. Around 16% of the population aged 40 years or older can have OAB symptoms. OAB also increases the risk of falling and bone fractures by 30%. Altogether, OAB affects the quality of life of the patients.

OAB is most common in elderly male patients due to disorders such as benign prostatic hyperplasia. Patients with this disorder have bladder obstruction and urinary symptoms due to an enlarged prostate. 

Male patients with OAB and enlarged prostate are usually treated with low-dose anticholinergics (such as solifenacin) instead of the standard dose. The low dose is given to patients due to the risk of bladder obstruction and increased residual urine. However, patients are often unsatisfied with the outcomes related to this treatment. Therefore, more studies about the effectiveness and safety of anticholinergic standard dose in OAB are necessary. 

This study included information about 566 male patients with OAB aged 40 years or older. These patients were treated with low dose anticholinergic drugs such as 10mg propiverine (Mictoryl) or 2 mg tolterodine (Detrol). All patients showed decreased effectiveness with this treatment. Patients were switched to standard dose (5 mg) solifenacin for 12 or more weeks. Patients were followed-up before the start of the treatment, at 4 and 12 weeks. Residual urine volume after urination was also recorded.

OAB and prostate symptoms significantly decreased between week 0 and week 12. Residual urine increased between week 0 and week 12. The most common moderate side effects were constipation (4 patients) and thirst (9 patients).

This study concluded that a standard dose of solifenacin might be a good and safe option for the treatment of OAB patients not satisfied with low-dose anticholinergics.

This study was based on medical records. Some information might have been incomplete. This might affect the results.