Antimuscarinics and bladder outlet obstruction: From a contraindication to an indication?

AIM: To review if the existing data support the new concept that antimuscarinic agents can be used for the treatment of bladder outlet obstruction (BOO) with coexisting overactive bladder (OAB). METHOD: A literature search of Medline publications (up to 2008) on use of antimuscarinic agents for treatment BOO was performed and all data were presented. All relevant data from published studies in congress abstracts were as well included. RESULTS: The existing data show that this treatment effectively improves patient quality of life. Concerns about the possibility of urinary retention were shown to be unfounded. It seems that antimuscarinic agents do not affect voiding pressures and the use of antimuscarinic agents for BOO seems safe. CONCLUSIONS: The combination of an alpha-blocker and antimuscarinic agent for the treatment of BOO with concomitant OAB seems promising.