Tamsulosin combined with solifenacin versus tamsulosin monotherapy for male lower urinary tract symptoms: a meta-analysis

Abstract

Objective:

To evaluate the efficacy and safety of tamsulosin and solifenacin combination therapy compared with tamsulosin monotherapy for male lower urinary tract symptoms (LUTS).

Methods:

We identified all eligible studies that compared tamsulosin and solifenacin combination therapy with tamsulosin monotherapy for male LUTS (up to January 2015). The fixed- or random-effects model was selected depending on the proportion of heterogeneity.

Results:

Seven articles were identified as eligible for this meta-analysis, with a total of 3063 participants. Synthetic data showed combination therapy had significant improvements in Storage International Prostate Symptom Score (WMD = −0.60; 95% CI: −0.81 to −0.38, P < 0.0001), quality of life (WMD = −0.23; 95% CI: −0.34 to −0.11, P < 0.0001), micturitions per 24 hours (WMD = −0.70; 95% CI: −0.86 to −0.55, P < 0.0001) and urgency episodes per 24 hours (WMD = −0.26; 95% CI: −0.48 to −0.05, P = 0.018). The incidence of adverse effects in the tamsulosin and solifenacin combined therapy group (30.82%) was similar to the tamsulosin monotherapy group (25.75%). Acute urinary retention was seldom reported in the studies and no clinically significant changes regarding Qmax were showed in our meta-analysis.

Conclusions:

Tamsulosin and solifenacin combination therapy may be a reasonable option for male LUTS patients, especially for those who have significant storage symptoms. However, PVR should be measured during treatment to assess the increase in PVR or the incidence of AUR.

Keywords: :

• BPH
• Male LUTS
• Meta-analysis
• Solifenacin
• Tamsulosin

Transparency

Declaration of funding

This study was not funded.

Declaration of financial/other relationships

M.G., W.D., G.H., Z.G., D.D., S.Q., and R.Y. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewer 1 has disclosed that she is a consultant to AMS, Astellas, Pfizer and Ferring; she is also on the Speakers’ Bureaus of Pfizer, Astellas, Allergan and Laborie. Peer reviewer 2 has disclosed that he has received grants from Astellas and Pfizer; and he has been a speaker/lecturer for Astellas, Pfizer and GlaxoSmithKline. Peer reviewer 3 has no relevant financial or other relationships to disclose.

Acknowledgments

The authors thank Dr. Wenjun Ni, Ph.D., Department of Urological Surgery, The Hei Longjiang Hospital, Harbin, China, for manuscript revision.