Drug Design, Development and Therapy (Jul 2016)
Voiding dysfunction in patients with nasal congestion treated with pseudoephedrine: a prospective study
Abstract
I-Hung Shao,1,* Chia-Chen Wu,2,* Hsiao-Jung Tseng,3 Ta-Jen Lee,2 Yu-Hsiang Lin,4 Yuan-Yun Tam5 1Division of Urology, Department of Surgery, Lotung Poh-Ai Hospital, Yilan County, 2Department of Otorhinolaryngology – Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, 3Biostatistical Center for Clinical Research, Chang-Gung Memorial Hospital, Taoyuan City, 4Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, 5Department of Otorhinolaryngology – Head and Neck Surgery, Lotung Poh-Ai Hospital, Yilan County, Taiwan *These authors contributed equally to this work Background: Pseudoephedrine is a sympathomimetic drug widely used as a nasal decongestant. However, it can cause adverse effects, such as voiding dysfunction. The risk of voiding dysfunction remains uncertain in patients without subjective voiding problems.Methodology: We prospectively enrolled patients with nasal congestion who required treatment with pseudoephedrine from May to August 2015. All patients denied concomitant subjective voiding problem. The International Prostate Symptom Score (IPSS) questionnaire was used to evaluate voiding function before and 1 week after the pseudoephedrine treatment. The results of the IPSS questionnaire were analyzed as the total (IPSS-T), voiding (IPSS-V), storage (IPSS-S), and quality of life due to urinary symptom scores.Results: We enrolled 131 males with a mean age of 42.0±14.3 years. The IPSS-T, IPSS-V, and IPSS-S scores slightly increased after the medication (IPSS-T increased from 6.49 to 6.77, IPSS-V from 3.33 to 3.53, and IPSS-S from 3.17 to 3.24). The quality of life due to urinary symptom score nonsignificantly decreased from 2.02 to 1.87. We observed that older age and a higher premedication IPSS-V score yielded significant differences (P<0.05) for subclinical voiding dysfunction and unchanged voiding function. In patients aged ≥50 years, the IPSS-T, IPSS-V, and IPSS-S scores significantly increased after the pseudoephedrine treatment (IPSS-T increased from 9.95 to 11.45, IPSS-V from 5.38 to 6.07, and IPSS-S 4.57 to 5.38), whereas the quality of life due to urinary symptom score nonsignificantly decreased from 2.71 to 2.48 (P=0.057). In patients aged <50 years, all scores did not significantly differ.Conclusion: Pseudoephedrine treatment for nasal congestion requires extra precautions in males >50 years, even without subjective voiding symptoms. Keywords: pseudoephedrine, nasal congestion, voiding dysfunction, IPSS
