Tadayyon Farhad, Izadpanahi Mohammadhossein, Aali Saeed, Mazdak Hamid, Khorrami Mohammad-Hatef
Department of Urology, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Saudi J Kidney Dis Transpl. 2012 Jul;23(4):782-5. doi: 10.4103/1319-2442.98160.
Acute urinary retention (AUR) is one of the most important long-term compli-cations of benign prostatic hyperplasia (BPH). Nitric oxide (NO) as a transmitter can relax smooth muscles of the bladder neck and external sphincter. Several studies have reported that sublingual isosorbide dinitrate (ISDN), as a NO donor, can lead to significant decrease in resting pressure of the external sphincter, and its rapid onset of action may be useful in the treatment of AUR. This study was designed to asses the effect of ISDN on AUR in patients with BPH. In this clinical trial, 60 men with BPH-induced AUR were randomly selected via a simple sampling method. Participants were randomly divided into case and control groups. Patients in the case group received 200 mg of sublingual ISDN and participants in the control group received placebo. After 20 min, participants were asked to void spontaneously and the urine was collected in scale containers. Following this, urethral catheterization was done on all the participants and the residual urine was measured. Data were analyzed using SPSS version 15. There was no signi-ficant difference in the mean age of the two groups (P-value = 0.28). The mean voided urine volume in the case group was 201 mL and, in the control group, it was 18 mL (P = 0.004). About 30% in the case group and 3.3% in the control group could void spontaneously after receiving ISDN or placebo (P = 0.006). In the case group, there was a significant correlation between voided urine volume and total urine volume in the bladder (P = 0.03) and in the size of the prostate (P = 0.001). Our study shows that ISDN can be effective in the treatment of BPH-induced AUR with decrease in bladder outlet resistance. ISDN is more effective in younger men and in those with smaller prostates.
急性尿潴留（AUR）是良性前列腺增生（BPH）最重要的长期并发症之一。一氧化氮（NO）作为一种递质，可使膀胱颈和外括约肌的平滑肌松弛。多项研究报告称，硝酸异山梨酯（ISDN）作为一种NO供体，可导致外括约肌静息压力显著降低，其快速起效可能对AUR的治疗有用。本研究旨在评估ISDN对BPH患者AUR的影响。在这项临床试验中，通过简单抽样方法随机选取了60名因BPH导致AUR的男性。参与者被随机分为病例组和对照组。病例组患者舌下含服200 mg ISDN，对照组参与者服用安慰剂。20分钟后，要求参与者自主排尿，并将尿液收集到刻度容器中。在此之后，对所有参与者进行导尿，并测量残余尿量。使用SPSS 15版软件对数据进行分析。两组的平均年龄无显著差异（P值 = 0.28）。病例组的平均排尿量为201 mL，对照组为18 mL（P = 0.004）。在接受ISDN或安慰剂后，病例组约30%的患者和对照组3.3%的患者能够自主排尿（P = 0.006）。在病例组中，排尿量与膀胱总尿量（P = 0.03）以及前列腺大小（P = 0.001）之间存在显著相关性。我们的研究表明，ISDN可有效治疗BPH导致的AUR，并降低膀胱出口阻力。ISDN在年轻男性和前列腺较小的男性中更有效。
