The impact of pseudoephedrine and antihistamine on male lower urinary tract symptoms

Purpose: Pseudoephedrine and antihistamine are sympathomimetic drugs that are widely used as nasal decongestants, but both of them can also cause adverse effects including voiding dysfunction. However, the risk of developing voiding dysfunction remains uncertain in patients without subjective voiding problems.

Materials and Methods: We prospectively enrolled patients with nasal congestion who required treatment with pseudoephedrine in the period from August to December 2015. All of the patients denied concomitant subjective voiding problem. International prostate symptom score (IPSS) questionnaires were used to evaluate voiding function before and one week after pseudoephedrine was taken. The results of IPSS questionnaires were analyzed as a total score (IPSS-T), voiding score (IPSS-V), storage score (IPSS-S), and quality of life due to urinary symptoms (QoL-US).

Results: We enrolled a total of 94 male patients, with pseudoephedrine group and antihistamine group accounted for 47 patients respectively. Mean age of each groups were 38.9 and 42.9 y/o in pseudoephedrine and antihistamine respectively. The mean age, initial IPSS-T, IPSS-V, and IPSS-S score of both group showed no significant difference. The IPSS-T, IPSS-V, and IPSS-S scores increased slightly after pseudoephedrine was taken (IPSS-T from 5.47 to 5.96, IPSS-V from 2.83 to 3.19, and IPSS-S from 2.68 to 2.77), while all change showed no significant difference. In antihistamine group, the score changed were as followed: IPSS-T from 6.00 to 6.66, IPSS-V from 2.30 to 2.96, and IPSS-S from 3.70 to 3.74. In this group, the IPSS-V score increased significantly after taking antihistamine (p value = 0.015). The urinary symptom related quality of life of both groups did not differ significantly after taking pseudoephedrine and antihistamine.

Conclusion: Comparing to pseudoephedrine, antihistamine treatment for nasal congestion may increase the risk of voiding dysfunction in those without subjective voiding symptoms.