Porst Hartmut, Sandner Peter, Ulbrich Ernst
Private Practice, Neuer Jungfernstieg 6A, 20354 Hamburg, Germany.
Curr Urol Rep. 2008 Jul;9(4):295-301. doi: 10.1007/s11934-008-0052-x.
Alpha-blockers, the current common treatment for lower urinary tract symptoms (LUTS), are also used to treat bladder outlet obstruction (BOO), but the effect is not as clinically significant as in LUTS. All currently marketed phosphodiesterase type 5 (PDE5) inhibitors have recently been shown to significantly affect LUTS, although BOO-related efficacy has not been determined. Therefore, the extent of a causal relationship between LUTS and underlying benign prostatic enlargement (BPE) is questionable. LUTS may also be interpreted as symptoms related to detrusor overactivity, especially when no significant BOO is associated with BPE. Research is required to understand the efficacy of PDE5 inhibitors in LUTS but not in BOO. For vardenafil, nonclinical experiments and initial, preliminary clinical data suggest that the underlying effect may occur on the detrusor and not the prostate.
α受体阻滞剂是目前治疗下尿路症状（LUTS）的常用药物，也用于治疗膀胱出口梗阻（BOO），但其效果在临床上不如在LUTS中显著。最近研究表明，所有目前上市的5型磷酸二酯酶（PDE5）抑制剂均对LUTS有显著影响，不过其对BOO相关的疗效尚未确定。因此，LUTS与潜在良性前列腺增生（BPE）之间因果关系的程度值得怀疑。LUTS也可被解释为与逼尿肌过度活动相关的症状，尤其是当BPE未伴有明显BOO时。需要开展研究以了解PDE5抑制剂对LUTS而非BOO的疗效。对于伐地那非，非临床实验以及初步临床数据表明，其潜在作用可能发生在逼尿肌而非前列腺上。
