中国单中心研究：α1-肾上腺素能阻滞剂治疗青年男性原发性膀胱颈梗阻的长期安全性、耐受性和疗效。

Long-term safety, tolerability, and efficacy of α1-adrenergic blocker in young men with primary bladder neck obstruction: results from a single centre in China.

机构信息

Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277, Jiefang Road, Wuhan 430022, China.

出版信息

Int Urol Nephrol. 2012 Jun;44(3):711-6. doi: 10.1007/s11255-011-0096-6. Epub 2011 Dec 1.

DOI:10.1007/s11255-011-0096-6

PMID:22130960

Abstract

OBJECTIVE

Primary bladder neck obstruction (PBNO) is a nonneurogenic voiding disorder and frequently overlooked in young men. Prior studies have reported the efficacy of α-blockers only in the short-term for male patients with PBNO. We hereby report our long-term results using α1-blocker therapy in young men with PBNO.

METHODS

Between January 2005 and December 2009, PBNO was diagnosed in 30 young men (mean age 27.3 years, range 18-35) at our institution. Doxazosin 4 mg once daily was administered for at least 12 months. Safety and tolerability were assessed, and efficacy was evaluated from International Prostate Symptom Score (I-PSS), Quality of Life (QOL), uroflowmetry, and post-void residual following 3- and 12-month treatment. Successful treatment was defined as at least 3 ml per second increase in the maximum flow rate and more than a 40% decrease in I-PSS.

RESULTS

In all 30 patients, Mean symptom duration was 26.4 (3-65) months. The most common symptoms were hesitancy (93.3%), weak stream (76.7%), and frequency (66.7%). A total of 24 patients (80%, 24/30) successfully completed the 12 month of treatment. The medication period was 15.2 months, and follow-up duration was 16.3 months. Doxazosin was safe and well tolerated. The efficacy of doxazosin was maintained over the 12-month treatment period. Relative to baseline, there were reductions in the number of mean I-PSS (from 17.7 ± 4.2 to 10.4 ± 4.8), mean QOL (from 4.2 ± 1.1 to 2.4 ± 1.3), and mean post-void residual urine (from 79.3 ± 33.4 to 47.1 ± 21.3), and an increase in mean maximum flow rate (from 11.4 ± 2.9 to 15.1 ± 3.2 ml) after 12-month treatment. Treatment was successful in 16 patients (66.7%, 16/24) according to the improvement in both symptoms and maximum urine flow.

CONCLUSIONS

α1-blocker therapy displayed a favorable safety, tolerability, and efficacy profile during 12-month treatment in young male patients with PBNO.

摘要

目的

原发性膀胱颈梗阻（PBNO）是一种非神经源性排尿障碍，在年轻男性中经常被忽视。先前的研究报告称，α受体阻滞剂仅在短期治疗男性 PBNO 患者方面有效。我们在此报告使用α1受体阻滞剂治疗年轻男性 PBNO 的长期结果。

方法

2005 年 1 月至 2009 年 12 月，我院诊断 30 例年轻男性（平均年龄 27.3 岁，范围 18-35 岁）患有 PBNO。给予多沙唑嗪 4mg，每日 1 次，至少治疗 12 个月。评估安全性和耐受性，并在治疗 3 个月和 12 个月后，通过国际前列腺症状评分（I-PSS）、生活质量（QOL）、尿流率和残余尿量评估疗效。成功治疗定义为最大尿流率至少增加 3ml/s，I-PSS 至少降低 40%。

结果

所有 30 例患者的平均症状持续时间为 26.4（3-65）个月。最常见的症状是犹豫（93.3%）、尿流弱（76.7%）和尿频（66.7%）。共有 24 例患者（80%，24/30）成功完成 12 个月的治疗。用药期为 15.2 个月，随访期为 16.3 个月。多沙唑嗪安全且耐受良好。多沙唑嗪的疗效在 12 个月的治疗期间得以维持。与基线相比，I-PSS 的平均评分（从 17.7±4.2 降至 10.4±4.8）、QOL 的平均评分（从 4.2±1.1 降至 2.4±1.3）、残余尿量的平均评分（从 79.3±33.4 降至 47.1±21.3）以及最大尿流率的平均评分（从 11.4±2.9 增至 15.1±3.2ml）均有所降低。根据症状和最大尿流的改善，12 个月后 16 例患者（66.7%，16/24）治疗成功。