Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Urol. 2013 Jan;189(1 Suppl):S117-21. doi: 10.1016/j.juro.2012.11.031.
We investigated the effect of the new sympathetic α1A-adrenoceptor antagonist silodosin for relieving benign prostatic obstruction by pressure flow study.
In this open, nonblinded, prospective study we administered 8 mg silodosin daily for 4 weeks in 60 patients with lower urinary tract symptoms associated with benign prostatic enlargement. As a primary outcome measure, we assessed changes in bladder function and benign prostatic obstruction using pressure flow study. As secondary outcome measures, changes in subjective symptoms and quality of life were assessed by the International Prostate Symptom Score. Objective changes in urination status were also assessed by free uroflowmetry in terms of maximum flow rate and post-void residual urine volume.
A total of 57 patients were enrolled for analysis. In the storage phase of the pressure flow study bladder capacity at first desire to void increased significantly with no significant change in maximum cystometric capacity. Of 24 patients 14 (58.3%) with uninhibited detrusor contractions before administration showed apparent improvement in detrusor overactivity after administration, including 6 in whom uninhibited contractions disappeared. In the voiding phase mean detrusor pressure at maximum flow significantly decreased from 72.5 to 51.4 cm H(2)O. The mean bladder outlet obstruction index decreased significantly from 60.6 to 33.8. Obstruction grade assessed by the Schaefer nomogram improved in all except 1 patient. Total symptom and quality of life scores, maximum flow rate and post-void residual urine volume on free uroflowmetry significantly improved.
Silodosin improved lower urinary tract symptoms by improving bladder storage function and relieving benign prostatic obstruction.
通过压力-流率研究，我们考察了新型交感神经α1A-肾上腺素能受体拮抗剂司洛多辛缓解良性前列腺梗阻的效果。
在这项开放、非盲、前瞻性研究中，我们给予 60 例下尿路症状合并良性前列腺增生的患者每日 8mg 司洛多辛，疗程 4 周。主要疗效评估指标为压力-流率研究中膀胱功能和良性前列腺梗阻的变化。次要疗效评估指标为国际前列腺症状评分（IPSS）评估的主观症状和生活质量变化，以及自由尿流率测定评估的排尿状态的客观变化，包括最大尿流率和残余尿量。
共有 57 例患者入组分析。在压力-流率研究的储尿期，首次排尿意愿时膀胱容量显著增加，而最大膀胱容量无明显变化。24 例逼尿肌无抑制收缩患者中，14 例（58.3%）治疗后逼尿肌过度活动明显改善，其中 6 例无抑制收缩消失。在排尿期，最大尿流率时逼尿肌压力均值从 72.5cmH2O 显著下降至 51.4cmH2O。膀胱出口梗阻指数均值从 60.6 显著下降至 33.8。除 1 例外，所有患者的 Schaefer 图示梗阻分级均改善。IPSS 总分和生活质量评分、最大尿流率和自由尿流率测定的残余尿量均显著改善。
司洛多辛通过改善膀胱储尿功能和缓解良性前列腺梗阻改善下尿路症状。
