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Behavioral and antimuscarinic therapy are effective when added to alpha-blocker therapy for OAB in men without outlet obstruction. Behavioral treatment is at least as effective as antimuscarinic therapy.

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Patients are at an elevated risk of urothelial cancers after renal transplantation probably from immune suppression.

• Nocturia is a common and bothersome lower urinary tract symptom, particularly in men. Many single drug therapies have limited benefit.• For men who have persistent nocturia despite alpha-blocker therapy, the addition of behavioural and exercise therapy is statistically superior to anticholinergic therapy. Objective• To compare reductions in nocturia resulting from adding either behavioural treatment or antimuscarinic drug therapy to a-adrenergic antagonist (a-blocker) therapy in men. Patients and Methods• Participants were men who had continuing urinary frequency >8 voids/day) and urgency after 4 weeks of a-blocker therapy run-in and who had Ն1 nightly episode of nocturia.• Participants received individually titrated drug therapy (extended-release oxybutynin) or multicomponent behavioural treatment (pelvic floor muscle training, delayed voiding and urge suppression techniques).• Seven-day bladder diaries were used to calculate reductions in mean nocturia. Results• A total of 127 men aged 42-88 years with Ն1 nocturia episode per night were included in the study.• There were 76 men who had a mean of Ն2 nocturia episodes.• Among those with Ն1 nocturia episode, behavioural treatment reduced nightly nocturia by a mean of 0.97 episodes and was significantly more effective than drug therapy (mean reduction = 0.56 episodes; P = 0.01).• Participants with Ն2 episodes nocturia at baseline also showed larger changes with behavioural treatment compared with antimuscarinic therapy (mean reduction = 1.26 vs 0.61; P = 0.008). Conclusions• Both behavioural treatment and drug therapy reduced nocturia in men with Ն1 episode of nocturia/night when added to a-blocker therapy.• These results were similar even when only those with Ն2 episodes of nocturia were considered. • The addition of behavioural treatment was statistically better than bladder-relaxant therapy for nocturia.