PROSPECTIVE-STUDY COMPARING HYOSCYAMINE, DOXAZOSIN, AND COMBINATION THERAPY FOR THE TREATMENT OF URGENCY AND FREQUENCY IN WOMEN

Anticholinergics are commonly used for the treatment of frequency, urg ency, and urge incontinence in women. Alpha-blockers have been shown t o have a modulating effect on bladder smooth muscle but are not common ly used clinically for this indication. To evaluate the clinical effec tiveness of each treatment as well as the combination therapy, we perf ormed an open prospective study comparing these agents. Between Septem ber 1994 and October 1995, 34 women aged 28-91 (mean age, 62) received either 0.375 mg of sustained-release hyoscyamine twice a day or 2 mg doxazosin QHS prior to being crossed over to the other drug and/or the combination. Symptoms were assessed using an expanded American Urolog ical Association (AUA) symptoms score, which included questions regard ing incontinence at completion of each therapeutic phase. Evaluation i ncluded 6-channel urodynamics. All three therapies were noted to be ef fective in reducing AUA symptom scores. By urodynamic evaluation, a gr eater percentage of patients with increased voiding pressures or decre ased compliance responded to doxazosin than hyoscyamine. Side effects were noted to be less prevalent with doxazosin than with the other the rapies. There appears to be a significant role for alpha-blockers in t he treatment of voiding symptoms in women. (C) 1998 Wiley-Liss, Inc.