Ishizaka Kazuhiro, Machida Tatsuya, Tanaka Masaki, Kawamura Naoko, Nakamura Keisuke, Kihara Kazunori
Department of Urology, Kanto Central Hospital, Tokyo, Japan.
Int J Urol. 2009 Mar;16(3):299-302. doi: 10.1111/j.1442-2042.2008.02234.x. Epub 2009 Jan 20.
The management of lower urinary tract symptoms that persist after radical prostatectomy remains to be established. We investigated whether an alpha1-blocker, naftopidil, improves LUTS in patients >or=1 year after radical prostatectomy.
A total of 29 male patients received 25 mg/day of naftopidil for the first week, then 75 mg/day for 4 weeks. The frequency-volume chart, international prostate symptom score and quality of life index (QOL) were examined before and at the end of the 5-week administration in all subjects.
Total international prostate symptom score (I-PSS) and I-PSS subtotals associated with voiding symptoms and storage symptoms were significantly decreased at 5 weeks compared with baseline (P < 0.001 each). QOL index was significantly improved with naftopidil for 5 weeks (P < 0.001). From analyses of the frequency-volume chart, mean and maximum volume/void were significantly increased (P < 0.05 each).
Lower urinary tract symptoms detected in patients >or=1 year after radical prostatectomy were markedly improved with administration of naftopidil at 75 mg/day. These symptoms could represent a novel target for medical treatment by improved understanding of the symptom pathology in the near future.
根治性前列腺切除术后持续存在的下尿路症状的管理方法仍有待确立。我们研究了α1受体阻滞剂萘哌地尔是否能改善根治性前列腺切除术后≥1年患者的下尿路症状。
总共29例男性患者在第一周接受每日25mg萘哌地尔治疗,然后4周内每日75mg。在所有受试者给药前及给药5周结束时检查频率-尿量图、国际前列腺症状评分和生活质量指数(QOL)。
与基线相比,5周时总的国际前列腺症状评分(I-PSS)以及与排尿症状和储尿症状相关的I-PSS分项评分均显著降低(均P<0.001)。萘哌地尔治疗5周后QOL指数显著改善(P<0.001)。通过频率-尿量图分析,平均尿量和最大尿量/排尿量均显著增加(均P<0.05)。
根治性前列腺切除术后≥1年患者出现的下尿路症状,给予每日75mg萘哌地尔治疗后有显著改善。通过在不久的将来更好地理解症状病理学,这些症状可能成为药物治疗的新靶点。