In a nutshell
This study reviewed treatment options for the treatment of overactive bladder (OAB) in men. Researchers suggested that mirabegron (Myrbetriq) is associated with increased effectiveness and safety in these patients.
Some background
OAB consists of a frequent and sudden urge to urinate that is difficult to control. Urgency incontinence (leakage of urine) might also be present. The occurrence of OAB is around 10.8% in men and 12.8% in women. OAB symptoms have a significant negative effect on the quality of life of patients.
A change of behaviors and lifestyles are considered the first step for OAB treatment. Bladder and pelvic muscle training can also improve OAB symptoms. However, if OAB keeps progressing despite treatment, medication is necessary.
The OAB treatment guidelines recommend antimuscarinics such as solifenacin (Vesicare) or tolterodine (Detrol) as first-line therapy and beta-3 agonists such as mirabegron as second-line therapy. However, many patients do not clinically respond to the treatment. In this case, these patients undergo an alternative medical treatment, such as botulinum toxin A (Botox) injections or nerve stimulation.
Most studies investigating OAB treatment options were performed in female patients only. As no studies were performed in male populations, information on clinical outcomes and safety is scarce.
Methods & findings
This study reviewed 24 other studies including information about male patients with OAB.
Mirabegron was associated with a greater reduction in the frequency of OAB symptoms when compared to placebo. The combination of mirabegron with alpha1-blocker tamsulosin (Flomax) improves the number of OAB symptoms, such as urgency episodes.
Botulinum toxin A is recommended as a third-line treatment in male patients with OAB. In these patients, the rate of self-catheterization (patients are taught how to insert a tube through the penis into their bladder) is higher (5-42%) than in female patients. This procedure is necessary so the patient can fully empty his bladder.
The bottom line
This study concluded that mirabegron and botulinum toxin A might be good treatment options in the treatment of male patients with OAB.
Published By :
European Urology
Date :
Jan 02, 2021
