Hanuš T, Zámečník L, Doležal T, Karmazínová Z
Department of Urology, Charles University, 1st Faculty of Medicine, Prague, Czech Republic.
Urol Int. 2011;86(4):407-13. doi: 10.1159/000320996. Epub 2011 Apr 1.
Bladder outlet obstruction (BOO) due to prostatic hyperplasia is often accompanied by overactive bladder (OAB) symptoms, which often disappear after specific BOO pharmacotherapy. The aim of this study was to map out the spectrum in BOO pharmacotherapy to find out the occurrence of OAB in this population and to find its treatment.
Follow-up consists of a retrospective and a prospective part, which includes all the patient's data related to the lower urinary tract symptoms in BOO and OAB. In all, 654 data record forms were distributed during the study and 98% of those were validated.
According to our observations, alpha-blockers were used most frequently at the beginning of BOO treatment (73%), followed by phytopharmaca (19.9%) and finally finasteride (5.5%). If the treatment is changed, the proportion of finasteride increases. Only a small number of patients with BOO and OAB are treated in combination with antimuscarinics.
A combined therapy (alpha-blocker + antimuscarinics) is effective in a majority of men with infravesical obstruction and symptoms of OAB. However, OAB in our study was primarily underdiagnosed in almost 50% of all patients treated for LUTS.
前列腺增生所致膀胱出口梗阻（BOO）常伴有膀胱过度活动症（OAB）症状，而在进行特定的BOO药物治疗后这些症状往往会消失。本研究的目的是梳理BOO药物治疗的情况，以查明该人群中OAB的发生率及其治疗方法。
随访包括回顾性和前瞻性两部分，涵盖了与BOO和OAB患者下尿路症状相关的所有数据。在研究期间共发放了654份数据记录表，其中98%得到了验证。
根据我们的观察，在BOO治疗开始时，α受体阻滞剂的使用最为频繁（73%），其次是植物药（19.9%），最后是非那雄胺（5.5%）。如果更换治疗方法，非那雄胺的使用比例会增加。只有少数BOO合并OAB患者接受抗毒蕈碱药物联合治疗。
联合治疗（α受体阻滞剂 + 抗毒蕈碱药物）对大多数伴有膀胱下梗阻和OAB症状的男性有效。然而，在我们的研究中，几乎50%接受下尿路症状治疗的患者中，OAB主要存在漏诊情况。
