Michel M C, Goepel M
Department of Medicine and Urology, University of Essen, Hufelandstrasse 55, D-45122 Essen, Germany.
Eur Urol. 2001;39 Suppl 3:20-5. doi: 10.1159/000052563.
The primary treatment goal in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO) is symptom relief. However, it is also important to assess the effects of medical treatments on disease progression because this can lead to complications such as acute urinary retention or can ultimately require surgical treatment. In a placebo-controlled study finasteride was shown to reduce the incidence of acute urinary retention and the need for surgery in patients with LUTS suggestive of BPO. While alpha(1)-adrenoceptor antagonists are superior to finasteride with regard to LUTS relief, systematic studies on their effects on BPO complications and progression to surgery are not available. However, we reviewed a number of smaller studies which consistently indicate that alpha(1)-adrenoceptor antagonists may be at least as effective as finasteride in the prevention of acute urinary retention or the need for surgery in patients with LUTS suggestive of BPO. While this needs to be confirmed in adequately designed and powered studies, such evidence should be taken into consideration when choosing between alpha(1)-adrenoceptor antagonists and finasteride treatment.
对于提示存在良性前列腺梗阻（BPO）的下尿路症状（LUTS）患者，主要治疗目标是缓解症状。然而，评估药物治疗对疾病进展的影响也很重要，因为这可能导致诸如急性尿潴留等并发症，或最终需要手术治疗。在一项安慰剂对照研究中，非那雄胺被证明可降低提示BPO的LUTS患者急性尿潴留的发生率以及手术需求。虽然α1肾上腺素能受体拮抗剂在缓解LUTS方面优于非那雄胺，但尚无关于其对BPO并发症及手术进展影响的系统性研究。然而，我们回顾了一些较小规模的研究，这些研究一致表明，α1肾上腺素能受体拮抗剂在预防提示BPO的LUTS患者急性尿潴留或手术需求方面可能至少与非那雄胺一样有效。虽然这需要在设计充分且样本量足够的研究中得到证实，但在选择α1肾上腺素能受体拮抗剂和非那雄胺治疗时，应考虑到此类证据。
