Purpose: Urgency and urge incontinence are frequently observed after
prostatectomy. Although symptoms ameliorate within a relatively short
time, they usually cause significant stress and anxiety to the patient
as far as their duration is concerned. Aim of our study was to determine
the efficacy of tolterodine in preventing urgency and urge incontinence
after catheter removal in patients that underwent prostatectomy for
benign prostate hyperplasia. Patients and methods: Twenty-seven patients
with moderate/severe lower urinary tract symptoms due to benign
prostatic enlargement, scheduled for prostatectomy, were randomised into
two groups, Group A (14 pts) received tolterodine 2 mg b.i.d starting
the day of surgery, while group B patients received no such treatment.
Tolterodine treatment was discontinued 15 days after catheter removal.
All patients completed the International Prostatic Symptom Score (IPSS)
and the International Continence Society (ICS-BPH) forms the day before
surgery, and three times more, one, fifteen and thirty days after
catheter removal. Results: Pre-operative total IPSS and frequency of
urgency/urge incontinence as determined by questions 3 and 4 of the
ICS-BPH questionnaire were equally distributed between groups,
Tolterodine was well tolerated and no adverse effects were reported.
Post-operative IPSS and QoL scores did not differ between groups.
However, the frequency of urge incontinence both the first day and
fifteen days after catheter removal was significantly lower in the
tolterodine group (16.6% vs. 69.2%, p=0.004 and 8.3% vs. 38.4%,
p=0.039, respectively). Conclusion: Tolterodine was well tolerated in
all patients and had a beneficial effect regarding the postoperative
urge incontinence. Trials of a larger scale could determine which
patients would benefit more, especially according to the presence of
storage lower urinary tract symptoms prior to surgery
