The Impact of Pseudoephedrine and Antihistamine on Lower Urinary Tract Symptoms in Male Patients with Rhinitis

Abstract

Purpose: The effects of medications for treating nasal congestion on voiding function remain unclear. In this study, we aimed to elucidate the effects of the common decongestants, pseudoephedrine, and antihistamine, on voiding dysfunction in men without clinical lower urinary tract symptoms. Materials and Methods: We prospectively enrolled 200 consecutive male patients who visited the otolaryngology department for rhinitis from August 2015 to August 2016. These patients were then randomized to the pseudoephedrine or antihistamine groups. The International Prostate Symptom Score (IPSS) and postvoiding residual urine (PVR) were assessed before and 1 week after treatment and the results were analyzed. Patients were further stratified by age (≥50 years old vs. <50 years old) and IPSS (>7 vs. ≤7) in each group and comparison analyses were conducted. Results: There were no significant differences between the baseline characteristics of the pseudoephedrine and antihistamine groups. The IPSS total, IPSS voiding, and IPSS storage (IPSS-T, IPSS-V, and IPSS-S, respectively) tended to increase in the pseudoephedrine group but did not reach statistical significance. Similar results regarding IPSS-T and IPSS-V were seen in the antihistamine group. The IPSS-T increased significantly in patients ≥50 years old treated with pseudoephedrine, which was not observed in the antihistamine group. The IPSS-V was significantly higher in patients <50 years old treated with antihistamine. The PVR did not significantly change after treatment with both drugs. However, in patients with baseline IPSS-T >7 treated with pseudoephedrine, the PVR tended to increase. Conclusion: Pseudoephedrine and antihistamine have minimal effects on lower urinary tract function in the general male population. However, pseudoephedrine worsened IPSS-T in elderly men, whereas antihistamines worsened IPSS-V in younger men. In self-unaware voiding dysfunction male with IPSS-T > 7, pseudoephedrine may cause more PVR. Thus, in elderly men with rhinitis, antihistamines may be more suitable, while pseudoephedrine would be preferable in younger men.