Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-040, Korea.
Int Urol Nephrol. 2012 Aug;44(4):1077-84. doi: 10.1007/s11255-012-0173-5. Epub 2012 Apr 15.
To analyze the treatment outcomes and clinical courses for men with lower urinary tract symptoms, after long-term treatment of alpha-blocker and anticholinergic combination in real-life practice.
A total of 210 men, with lower urinary tract symptoms, had combination therapy for 3 months. Patients were reevaluated and were decided on an alpha-blocker single treatment or a combination therapy, according to the patient-reported outcome for 2 years. The patient responses in 2-year treatment were divided into 3 groups, which depended on clinical courses: 56 patients had an alpha-blocker single therapy after 3-month combination therapy (group I); 106 patients had a continuous alpha-blocker therapy with intermittent 3-month anticholinergic therapy (group II); 48 patients with continuous storage symptoms maintained a combination therapy (group III). Endpoints included 2-year changes in International Prostate Symptom Score (IPSS), Qmax, and residual volume.
Group III had significantly increased IPSS total and subscores compared to that of the other groups in the baseline characteristics. IPSS total and subscores significantly decreased at 3 months and were maintained for 2 years in all groups. Increase in Qmax was significant in all the groups at 3 months, and its increase was still significant after 2 years. Residual urine volume increased in all the groups at 3 months, but changes at 2 years were not statistically significant.
After 3 months of alpha-blocker and anticholinergic combination treatment, 73.4 % of the patients still needed a combination therapy. Although only one patient developed acute urinary retention, voiding difficulty was common (13.3 %), after a combination treatment in the real-life practice.
分析在真实实践中，长期接受α受体阻滞剂和抗胆碱能药物联合治疗后，男性下尿路症状的治疗效果和临床过程。
共有 210 名患有下尿路症状的男性患者接受了 3 个月的联合治疗。根据患者 2 年的报告结果，对患者进行重新评估，并决定是继续接受α受体阻滞剂单药治疗还是联合治疗。将患者在 2 年治疗中的反应分为 3 组，这取决于临床过程：56 名患者在 3 个月联合治疗后接受了 α受体阻滞剂单药治疗（组 I）；106 名患者接受了持续的 α受体阻滞剂治疗，并间歇性接受 3 个月的抗胆碱能药物治疗（组 II）；48 名持续存在储存症状的患者维持联合治疗（组 III）。终点包括 2 年时国际前列腺症状评分（IPSS）、最大尿流率（Qmax）和残余尿量的变化。
组 III 的基线特征中，IPSS 总分和各分项评分明显高于其他组。所有组的 IPSS 总分和各分项评分在 3 个月时显著下降，并在 2 年内保持稳定。所有组的 Qmax 在 3 个月时均显著增加，2 年后其增加仍有统计学意义。所有组的残余尿量在 3 个月时均增加，但 2 年后的变化无统计学意义。
在接受 3 个月的 α受体阻滞剂和抗胆碱能药物联合治疗后，仍有 73.4%的患者需要联合治疗。尽管只有 1 名患者发生急性尿潴留，但在真实实践中，联合治疗后排尿困难很常见（13.3%）。
