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Comment & Response
May 11, 2020

Considering the Effect of Combining α-Blockers With Bladder Antimuscarinics in Treatment of Overactive Bladder Symptoms—Reply

Author Affiliations
  • 1Division of General Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia
  • 2Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Birmingham, Alabama
  • 3Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham
  • 4Department of Urology, University of Texas Health Science Center at San Antonio
JAMA Intern Med. Published online May 11, 2020. doi:10.1001/jamainternmed.2020.1253

In Reply In designing this trial,1 we sought to test 2 treatments with known effectiveness for urinary symptoms and implement them as one would in clinical practice. To optimize the drug therapy, we chose to use both an antimuscarinic and an α-adrenergic antagonist (α-blocker), based on evidence that using both drugs can yield better outcomes than either one alone.2 We had previously shown the behavioral intervention to be useful for urinary symptoms in men.3 The study objective was to determine whether combining behavioral and drug therapies improves outcomes compared with each therapy alone for overactive bladder in men and to compare 3 sequences for implementing combined therapy. Our study outcomes focused on the overactive bladder symptoms of urgency, frequency, nocturia, and urge urinary incontinence (UI).

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