Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277, Jiefang Road, Wuhan 430022, China.
Int Urol Nephrol. 2012 Jun;44(3):711-6. doi: 10.1007/s11255-011-0096-6. Epub 2011 Dec 1.
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.
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.
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.
α1-blocker therapy displayed a favorable safety, tolerability, and efficacy profile during 12-month treatment in young male patients with PBNO.
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。
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%。
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。
在年轻男性 PBNO 患者的 12 个月治疗期间，α1受体阻滞剂治疗显示出良好的安全性、耐受性和疗效。
