Tailoring Medication for Lower Urinary Tract Symptoms in Men Based on International Prostate Symptom Score Voiding to Storage Ratio

OBJECTIVE To investigate therapeutic results of tailoring medication for lower urinary tract symptoms (LUTS) in men according to initial treatment results and International Prostate Symptom Score (IPSS)-voiding to storage subscore (V/S) ratio. METHODS Men with mild-to-moderate LUTS were initially treated for 1 month with doxazosin 4 mg daily for IPSS-V/S >1 or tolterodine 4 mg daily for IPSS-V/S <= 1. They then underwent the Global Response Assessment (GRA) to tailor their medication by changes in IPSS-V/S, uroflow, and GRA, which were compared at baseline, 1, and 3 months post-treatment. RESULTS Upon baseline, 162/374 men had IPSS-V/S <= 1, and 212/374 had an IPSS-V/S >1. Both groups had significant improvement in IPSS-T, IPSS-S, and IPSS-V/S 1 month post-treatment. Of the 162 men initially receiving tolterodine, 102 (63.0%) continued monotherapy; 20 (12.3%) had IPSS-V/S >1.5 and were shifted to doxazosin monotherapy, and 40 (24.7%) had IPSS-V/S >1 but <= 1.5 and added doxazosin. Among the 212 men initially receiving doxazosin, 171 (80.7%) continued monotherapy; 9 with IPSS-V/S <1.5 were switched to tolterodine, and 32 had IPSSV/S <2 but >1.5 and added tolterodine. Improvement in GRA was remarkable in all subgroups with tailoring the medication to patient symptomatology. CONCLUSION This study reveals that treatment customization according to IPSS-V/S after initial medical therapy provided satisfactory outcomes for men with mild-to-moderate LUTS. (C) 2018 Elsevier Inc.